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Journal of Personalized Medicine Jun 2022(1) Background: Our study aimed to assess the association between the neutrophil to lymphocyte ratio (NLR), platelet to leukocyte ratio (PLR), lymphocyte to monocyte... (Review)
Review
(1) Background: Our study aimed to assess the association between the neutrophil to lymphocyte ratio (NLR), platelet to leukocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), red cell distribution width (RDW), and systemic immune inflammation index (SII) and periodontitis. (2) Methods: We searched PubMed, Embase, Scopus, Web of Science, and LILACS databases, identifying observational studies. The Newcastle Ottawa scale was used to evaluate the quality of the included studies. The principal summary outcome measure in our random effects meta-analysis was the mean difference (MD). (3) Results: After screening 682 search results, a total of 10 studies including 3164 subjects were selected for quantitative assessment. We found a higher mean NLR, PLR, and LMR in the periodontitis group compared to the control group (0.41 (95% CI 0.12-0.7), = 0.006; 7.43 (95% CI 0.31-14.54), = 0.04; 2.05 (95% CI 0.27-3.83), = 0.024). No differences were observed for RDW. (4) Conclusions: We found an association between NLR, LMR, and PLR and periodontitis, which might be thought of as emerging blood cell count inflammatory biomarkers that could shed light on the link between periodontitis and systemic disbalances, as well as for periodontitis prognosis and grading.
PubMed: 35743775
DOI: 10.3390/jpm12060992 -
Disease Markers 2022Evidence shows that stroke-induced inflammatory responses play an essential role in the development of poststroke depression (PSD). The goal of this systematic review... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Evidence shows that stroke-induced inflammatory responses play an essential role in the development of poststroke depression (PSD). The goal of this systematic review and meta-analysis was to critically evaluate the literature regarding the use of the neutrophil to lymphocyte ratio (NLR) as a reliable means to detect early PSD development, to help clinicians institute early interventions and improve outcomes.
METHODS
Electronic databases, including Web of Science, PubMed, Google Scholar, and Scopus, were searched, and eight studies were included. We assessed the certainty of the associations with GRADE methods.
RESULTS
We found that patients with PSD had higher NLR than the stroke patients with no depression (SMD = 0.51; CI 95% = 0.29-0.73, < 0.001). Also, we found a significantly higher PLR in the patients with PSD when compared to the stroke patients with no depression (SMD = 0.66; CI 95% = 0.19-1.13, < 0.001).
CONCLUSION
These findings indicated that NLR and PLR could be considered inexpensive biomarkers for the prediction of PSD.
Topics: Biomarkers; Blood Platelets; Humans; Lymphocyte Count; Lymphocytes; Neutrophils; Stroke
PubMed: 35978885
DOI: 10.1155/2022/5911408 -
BioMed Research International 2022The goal of this study was to conduct a systematic review of the literature on the relationship between peripheral blood platelet to lymphocyte ratio (PLR) and mortality... (Meta-Analysis)
Meta-Analysis Review
The goal of this study was to conduct a systematic review of the literature on the relationship between peripheral blood platelet to lymphocyte ratio (PLR) and mortality in sepsis and to integrate the findings in a meta-analysis. An electronic search of three main databases was performed: PubMed, Embase, and Scopus on 19 December 2021. Finally, 16 studies comprising 2403 septic patients, including 1249 survivors and 1154 nonsurvivors, were included in this meta-analysis. We found that PLR levels were significantly higher in nonsurvivors than in survivors (random effect model: SMD = 0.72, 95% CI; 0.35-1.10, < 0.001). However, significant heterogeneity was observed across the studies ( = 94.1%, < 0.01). So, we used random effect model in our meta-analysis. In the subgroup analysis, according to mortality time, patients deceased during one month after sepsis had elevated levels of PLR compared to survivors (SMD = 1.03, 95% CI = 0.15-1.92, = 0.22). However, in-hospital mortality was not associated with PLR level (SMD = 0.41, 95% CI = -0.18-0.99, = 0.175). Our findings support PLR to be a promising biomarker that can be readily integrated into clinical settings to aid in the prediction and prevention of sepsis mortality.
Topics: Biomarkers; Blood Platelets; Humans; Lymphocyte Count; Lymphocytes; Prognosis; Sepsis
PubMed: 35707370
DOI: 10.1155/2022/9056363 -
Journal of Clinical Laboratory Analysis Jul 2022Hypercoagulability in lung cancer patients is associated with a high incidence of mortality and morbidity in the world. Therefore, this meta-analysis aimed to explore... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Hypercoagulability in lung cancer patients is associated with a high incidence of mortality and morbidity in the world. Therefore, this meta-analysis aimed to explore the correlation of the basic coagulation abnormalities in lung cancer patients compared with the control.
METHOD
PubMed, Scopus, and other sources were employed to identify eligible studies. The outcome variable was expressed using mean ± standard deviation (SD). Heterogeneity among studies and publication bias were evaluated. The quality of included studies was also assessed based on Newcastle-Ottawa Scale checklist.
RESULT
Finally, through a total of eight studies, prolonged prothrombin time (PT; standard mean difference [SMD]: 1.29; 95% CI: 0.47-2.11), plasma D-dimer value (SMD 3.10; 95% CI 2.08-4.12), fibrinogen (SMD 2.18; 95% CI:1.30-3.06), and platelet (PLT) count (SMD 1.00; 95% CI 0.84-1.16) were significantly higher in lung cancer patients when compared with the control group. The single-arm meta-analysis also showed that compared with control, lung cancer patients had high pooled PT 13.7 (95% CI:12.2-15.58) versus 11.79 (95% CI = 10.56-13.02), high D-dimer 275.99 (95% CI:172.9-11735.9) versus 0.2 (95% CI:0.20-0.37), high plasma fibrinogen 5.50 (95% CI:4.21-6.79) versus 2.5 (95% CI:2.04-2.91), and high PLT count 342.3 (95% CI:236.1-448.5) versus 206.6 (95% CI:176.4-236.7).
CONCLUSION
In conclusion, almost all the coagulation abnormalities were closely associated with lung cancer, and hence coagulation indexes provide an urgent clue for early diagnosis and timely management.
Topics: Blood Coagulation; Blood Coagulation Disorders; Blood Coagulation Tests; Fibrin Fibrinogen Degradation Products; Fibrinogen; Humans; Lung Neoplasms
PubMed: 35719003
DOI: 10.1002/jcla.24550 -
World Journal of Gastroenterology Apr 2018To perform a systematic review and meta-analysis on platelet-to-lymphocyte ratio (PLR) as a risk factor for post-transplant hepatocellular cancer (HCC) recurrence. (Meta-Analysis)
Meta-Analysis Review
AIM
To perform a systematic review and meta-analysis on platelet-to-lymphocyte ratio (PLR) as a risk factor for post-transplant hepatocellular cancer (HCC) recurrence.
METHODS
A systematic literature search was performed using PubMed. Participants of any age and sex, who underwent liver transplantation for HCC were considered following these criteria: (1) studies comparing pre-transplant low high PLR values; (2) studies reporting post-transplant recurrence rates; and (3) if more than one study was reported by the same institute, only the most recent was included. The primary outcome measure was set for HCC recurrence after transplantation.
RESULTS
A total of 5 articles, published between 2014 and 2017, fulfilled the selection criteria. As for the quality of the reported studies, all the investigated articles presented an overall high quality. A total of 899 cases were investigated: 718 cases (80.0%) were males. Three studies coming from European countries and one from Japan presented HCV as the main cause of cirrhosis. On the opposite, one Chinese study presented a greater incidence of HBV-related cirrhotic cases. In all the studies apart one, the PLR cut-off value of 150 was reported. At meta-analysis, high PLR value was associated with a significant increase in recurrence after transplantation (OR = 3.33; 95%CI: 1.78-6.25; < 0.001). A moderate heterogeneity was observed among the identified studies according to the Higgins statistic value.
CONCLUSION
Pre-transplant high PLR values are connected with an increased risk of post-operative recurrence of hepatocellular cancer. More studies are needed for better clarify the biological mechanisms of this results.
Topics: Blood Platelets; Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Liver Transplantation; Lymphocyte Count; Lymphocytes; Neoplasm Recurrence, Local; Platelet Count; Postoperative Period; Preoperative Period; Risk Factors
PubMed: 29686473
DOI: 10.3748/wjg.v24.i15.1658 -
Tropical Medicine & International... Nov 2008Clinicians in resource-poor countries need to identify patients with dengue using readily-available data. The objective of this systematic review was to identify... (Review)
Review
OBJECTIVE
Clinicians in resource-poor countries need to identify patients with dengue using readily-available data. The objective of this systematic review was to identify clinical and laboratory features that differentiate dengue fever (DF) and/or dengue haemorrhagic fever (DHF) from other febrile illnesses (OFI) in dengue-endemic populations.
METHOD
Systematic review of the literature from 1990 to 30 October 2007 including English publications comparing dengue and OFI.
RESULTS
Among 49 studies reviewed, 34 did not meet our criteria for inclusion. Of the 15 studies included, 10 were prospective cohort studies and five were case-control studies. Seven studies assessed all ages, four assessed children only, and four assessed adults only. Patients with dengue had significantly lower platelet, white blood cell (WBC) and neutrophil counts, and a higher frequency of petechiae than OFI patients. Higher frequencies of myalgia, rash, haemorrhagic signs, lethargy/prostration, and arthralgia/joint pain and higher haematocrits were reported in adult patients with dengue but not in children. Most multivariable models included platelet count, WBC, rash, and signs of liver damage; however, none had high statistical validity and none considered changes in clinical features over the course of illness.
CONCLUSIONS
Several individual clinical and laboratory variables distinguish dengue from OFI; however, some variables may be dependent on age. No published multivariable model has been validated. Study design, populations, diagnostic criteria, and data collection methods differed widely across studies, and the majority of studies did not identify specific aetiologies of OFIs. More prospective studies are needed to construct a valid and generalizable algorithm to guide the differential diagnosis of dengue in endemic countries.
Topics: Adult; Biomarkers; Biomedical Research; Child; Clinical Trials as Topic; Dengue; Dengue Virus; Developed Countries; Diagnosis, Differential; Female; Fever; Humans; Male; Predictive Value of Tests; Severe Dengue
PubMed: 18803612
DOI: 10.1111/j.1365-3156.2008.02151.x -
Frontiers in Medicine 2023Coronary artery disease (CAD) management in the setting of immune thrombocytopenia (ITP) remains very challenging to clinicians as a reasonable balance between bleeding...
INTRODUCTION
Coronary artery disease (CAD) management in the setting of immune thrombocytopenia (ITP) remains very challenging to clinicians as a reasonable balance between bleeding and thrombosis risks needs to be achieved, and the evidence guiding such management is scarce.
METHODS
We conducted a systematic review following the PRISMA guidelines to summarize the available literature on the management and outcomes of CAD coexisting with ITP. We searched PubMed and Embase for studies published in English exploring CAD and ITP management until 05 October 2022. Two independent reviewers screened and assessed the articles for inclusion. Patients' characteristics, CAD treatment modalities, ITP treatment, and complications were reported.
RESULTS
We identified 32 CAD cases, among which 18 cases were revascularized with percutaneous coronary intervention (PCI), 12 cases underwent coronary artery bypass graft surgery (CABG), and two cases were managed conservatively. More than 50% were men, with a mean age of 61 ± 13 years and a mean baseline platelet count of 52 ± 59 × 10/L. Irrespective of the revascularization modality, most patients were treated with either corticosteroids alone, intravenous immunoglobulins (IVIG) alone, or in combination. Among those who underwent PCI, two patients had bleeding events, and one patient died. Similarly, among those with CABG, one patient developed bleeding, and one patient died.
CONCLUSION
We found that revascularization with either PCI or CABG with the concurrent use of corticosteroids and/or IVIG for ITP was feasible, with an existing non-negligible risk of bleeding and mortality.
PubMed: 37886354
DOI: 10.3389/fmed.2023.1213275 -
The Cochrane Database of Systematic... Dec 2015Patients with a low platelet count (thrombocytopenia) often require the insertion of central lines (central venous catheters (CVCs)). CVCs have a number of uses; these... (Review)
Review
BACKGROUND
Patients with a low platelet count (thrombocytopenia) often require the insertion of central lines (central venous catheters (CVCs)). CVCs have a number of uses; these include: administration of chemotherapy; intensive monitoring and treatment of critically-ill patients; administration of total parenteral nutrition; and long-term intermittent intravenous access for patients requiring repeated treatments. Current practice in many countries is to correct thrombocytopenia with platelet transfusions prior to CVC insertion, in order to mitigate the risk of serious procedure-related bleeding. However, the platelet count threshold recommended prior to CVC insertion varies significantly from country to country. This indicates significant uncertainty among clinicians of the correct management of these patients. The risk of bleeding after a central line insertion appears to be low if an ultrasound-guided technique is used. Patients may therefore be exposed to the risks of a platelet transfusion without any obvious clinical benefit.
OBJECTIVES
To assess the effects of different platelet transfusion thresholds prior to the insertion of a central line in patients with thrombocytopenia (low platelet count).
SEARCH METHODS
We searched for randomised controlled trials (RCTs) in CENTRAL (The Cochrane Library 2015, Issue 2), MEDLINE (from 1946), EMBASE (from 1974), the Transfusion Evidence Library (from 1950) and ongoing trial databases to 23 February 2015.
SELECTION CRITERIA
We included RCTs involving transfusions of platelet concentrates, prepared either from individual units of whole blood or by apheresis, and given to prevent bleeding in patients of any age with thrombocytopenia requiring insertion of a CVC.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures expected by The Cochrane Collaboration.
MAIN RESULTS
One RCT was identified that compared different platelet transfusion thresholds prior to insertion of a CVC in people with chronic liver disease. This study is still recruiting participants (expected recruitment: up to 165 participants) and is due to be completed in December 2017. There were no completed studies. There were no studies that compared no platelet transfusions to a platelet transfusion threshold.
AUTHORS' CONCLUSIONS
There is no evidence from RCTs to determine whether platelet transfusions are required prior to central line insertion in patients with thrombocytopenia, and, if a platelet transfusion is required, what is the correct platelet transfusion threshold. Further randomised trials with robust methodology are required to develop the optimal transfusion strategy for such patients. The one ongoing RCT involving people with cirrhosis will not be able to answer this review's questions, because it is a small study that assesses one patient group and does not address all of the comparisons included in this review. To detect an increase in the proportion of participants who had major bleeding from 1 in 100 to 2 in 100 would require a study containing at least 4634 participants (80% power, 5% significance).
Topics: Central Venous Catheters; Chronic Disease; Hemorrhage; Humans; Liver Cirrhosis; Platelet Count; Platelet Transfusion; Randomized Controlled Trials as Topic; Thrombocytopenia
PubMed: 26627708
DOI: 10.1002/14651858.CD011771.pub2 -
International Journal of Environmental... Jul 2020(1) Background: The global threat of Coronavirus disease 2019 (COVID-19) continues. The diversity of clinical characteristics and progress are reported in many countries... (Meta-Analysis)
Meta-Analysis
(1) Background: The global threat of Coronavirus disease 2019 (COVID-19) continues. The diversity of clinical characteristics and progress are reported in many countries as the duration of the pandemic is prolonged. We aimed to perform a novel systematic review and meta-analysis focusing on findings about correlations between clinical characteristics and laboratory features of patients with COVID-19. (2) Methods: We analyzed cases of COVID-19 in different countries by searching PubMed, Embase, Web of Science databases and Google Scholar, from the early stage of the outbreak to late March. Clinical characteristics, laboratory findings, and treatment strategies were retrospectively reviewed for the analysis. (3) Results: Thirty-seven ( = 5196 participants) COVID-19-related studies were eligible for this systematic review and meta-analysis. Fever, cough and fatigue/myalgia were the most common symptoms of COVID-19, followed by some gastrointestinal symptoms which are also reported frequently. Laboratory markers of inflammation and infection including C-reactive protein (CRP) (65% (95% confidence interval (CI) 56-81%)) were elevated, while lymphocyte counts were decreased (63% (95% CI 47-78%)). Meta-analysis of treatment approaches indicated that three modalities of treatment were predominantly used in the majority of patients with a similar prevalence, including antiviral agents (79%), antibiotics (78%), and oxygen therapy (77%). Age was negatively correlated with number of lymphocytes, but positively correlated with dyspnea, number of white blood cells, neutrophils, and D-dimer. Chills had been proved to be positively correlated with chest tightness, lung abnormalities on computed tomography (CT) scans, neutrophil/lymphocyte/platelets count, D-dimer and CRP, cough was positively correlated with sputum production, and pulmonary abnormalities were positively correlated with CRP. White blood cell (WBC) count was also positively correlated with platelet counts, dyspnea, and neutrophil counts with the respective correlations of 0.668, 0.728, and 0.696. (4) Conclusions: This paper is the first systematic review and meta-analysis to reveal the relationship between various variables of clinical characteristics, symptoms and laboratory results with the largest number of papers and patients until now. In elderly patients, laboratory and clinical characteristics indicate a more severe disease course. Moreover, treatments such as antiviral agents, antibiotics, and oxygen therapy which are used in over three quarters of patients are also analyzed. The results will provide "evidence-based hope" on how to manage this unanticipated and overwhelming pandemic.
Topics: Age Factors; Betacoronavirus; C-Reactive Protein; COVID-19; Chills; Coronavirus Infections; Cough; Dyspnea; Fibrin Fibrinogen Degradation Products; Humans; Inflammation; Leukocyte Count; Lymphocyte Count; Pandemics; Platelet Count; Pneumonia, Viral; SARS-CoV-2
PubMed: 32668763
DOI: 10.3390/ijerph17145026 -
Journal of Thrombosis and Haemostasis :... May 2019Essentials The diagnosis of ITP is based on a platelet count < 100 × 10 L and exclusion of other causes. There are no standard tests or biomarkers to diagnose... (Meta-Analysis)
Meta-Analysis
Essentials The diagnosis of ITP is based on a platelet count < 100 × 10 L and exclusion of other causes. There are no standard tests or biomarkers to diagnose ITP. The sensitivity of platelet autoantibody testing is low (53%). The specificity is high (> 90%). A positive autoantibody test can be useful to rule in ITP but a negative does not rule out ITP. SUMMARY: Background Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by a low platelet count and an increased risk of bleeding. The sensitivity and specificity of platelet autoantibody tests is variable and their utility is uncertain. Objective The purpose of this study was to perform a systematic review and meta-analysis of platelet autoantibody tests in the diagnosis of ITP. Methods Ovid Medline, PubMed, and Web of Science were searched from inception until 31 May 2018. Two reviewers independently assessed studies for eligibility and extracted data. Studies that reported testing results for antiplatelet autoantibodies on platelets (direct tests) or in plasma/serum (indirect tests) for 20 or more ITP patients were included. Results Pooled estimates for sensitivity and specificity were calculated using a random effects model. Pooled estimates for the sensitivity and specificity of direct anti-platelet autoantibody testing for either anti-glycoprotein IIbIIIa or anti-glycoprotein IbIX were 53% (95% confidence interval [CI], 44-61%) and 93% (95% CI, 81-99%), respectively. For indirect testing, the pooled estimates for the sensitivity and specificity were 18% (95% CI, 12-24%) and 96% (95% CI, 87-100%), respectively. Conclusions Autoantibody testing in ITP patients has a high specificity but low sensitivity. A positive autoantibody test can be useful for ruling in ITP, but a negative test does not rule out ITP.
Topics: Autoantibodies; Biomarkers; Blood Platelets; Diagnostic Tests, Routine; Hemorrhage; Humans; Integrin beta3; Platelet Count; Platelet Glycoprotein GPIb-IX Complex; Platelet Membrane Glycoprotein IIb; Purpura, Thrombocytopenic, Idiopathic; Risk; Sensitivity and Specificity; Thrombocytopenia
PubMed: 30801909
DOI: 10.1111/jth.14419