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Mediators of Inflammation 2022Mean platelet volume to platelet count ratio (MPV/PC) has been found to be an independent risk factor for mortality in various diseases, including cardiovascular...
BACKGROUND AND AIMS
Mean platelet volume to platelet count ratio (MPV/PC) has been found to be an independent risk factor for mortality in various diseases, including cardiovascular disease, cancer, and hemodialysis. We aimed to evaluate the association between MPV/PC and all-cause and cardiovascular (CV) mortality in peritoneal dialysis (PD) patients.
METHODS AND RESULTS
We conducted a retrospective cohort study at a single center and enrolled 1473 PD patients who were catheterized at our PD center from January 1, 2006, to December 31, 2013. All patients were divided into four groups according to the quartiles of baseline MPV/PC levels and followed up until December 31, 2018. A total of 453 patients died, and 221 deaths were caused by cardiovascular disease during a median follow-up time of 48.0 (21.9-82.2) months. There was a significant interaction by age of association between MPV/PC level and all-cause mortality ( = 0.009), and multivariate Cox regression analysis showed that higher MPV/PC level was related to a decreased risk of all-cause and CV mortality in PD patients aged < 60 years (HR = 0.62, 95%CI = 0.40 - 0.96, = 0.032; HR = 0.49, 95%CI = 0.26 - 0.93, = 0.029, respectively), rather than in patients aged ≥ 60 years (HR = 1.37, 95%CI = 0.84 - 2.22, = 0.208; HR = 1.50, 95%CI = 0.77 - 2.92, = 0.237, respectively).
CONCLUSION
Our results indicated that low MPV/PC level was an independent risk factor for all-cause and CV mortality in PD patients aged less than 60 years.
Topics: Humans; Mean Platelet Volume; Platelet Count; Retrospective Studies; Cardiovascular Diseases; Prognosis; Peritoneal Dialysis
PubMed: 36405991
DOI: 10.1155/2022/6922809 -
Clinical and Applied... Sep 2016Cardiac surgery involving cardiopulmonary bypass (CPB) is often associated with important blood loss, allogeneic blood product usage, morbidity, and mortality.... (Review)
Review
Cardiac surgery involving cardiopulmonary bypass (CPB) is often associated with important blood loss, allogeneic blood product usage, morbidity, and mortality. Coagulopathy during CPB is complex, and the current lack of uniformity for triggers and hemostatic agents has led to a wide variability in bleeding treatment. The aim of this review is to provide a simplified picture of the data available on patients' coagulation status at the end of CPB in order to provide relevant information for the development of tailored transfusion algorithms. A nonsystematic literature review was carried out to identify changes in coagulation parameters during CPB. Both prothrombin time and activated partial thromboplastin time increased during CPB, by a median of 33.3% and 17.9%, respectively. However, there was marked variability across the published studies, indicating these tests may be unreliable for guiding hemostatic therapy. Some thrombin generation (TG) parameters were affected, as indicated by a median increase in TG lag time of 55.0%, a decrease in TG peak of 17.5%, and only a slight decrease in endogenous thrombin potential of 7%. The most affected parameters were fibrinogen levels and platelet count/function. Both plasma fibrinogen concentration and FIBTEM maximum clot firmness decreased during CPB (median change of 36.4% and 33.3%, respectively) as did platelet count (44.5%) and platelet component (34.2%). This review provides initial information regarding changes in coagulation parameters during CPB but highlights the variability in the reported results. Further studies are warranted to guide physicians on the parameters most appropriate to guide hemostatic therapy.
Topics: Blood Coagulation; Blood Coagulation Tests; Cardiopulmonary Bypass; Fibrinogen; Humans; Platelet Count; Thrombin
PubMed: 27268940
DOI: 10.1177/1076029616651146 -
Journal of Veterinary Internal Medicine Jan 2022Carcinoma-associated thrombocytosis involves tumor production of mediators such as interleukin-6 (IL-6) and thrombopoietin (TPO) that increase thrombopoiesis and may...
BACKGROUND
Carcinoma-associated thrombocytosis involves tumor production of mediators such as interleukin-6 (IL-6) and thrombopoietin (TPO) that increase thrombopoiesis and may play a role in tumor evasion and metastasis. Carcinoma-associated thrombocytosis is described in people, but has not been described in dogs.
HYPOTHESIS/OBJECTIVES
Evaluate the concentrations of IL-6 and TPO in dogs diagnosed with carcinoma with or without thrombocytosis. We hypothesized that IL-6 and TPO concentrations would be higher in dogs with carcinoma compared to healthy dogs, and that IL-6 and TPO concentrations would be higher in dogs with carcinoma and thrombocytosis when compared to dogs with carcinoma and normal platelet counts.
ANIMALS
One-hundred sixteen dogs: 63 with carcinoma and 53 healthy control dogs.
METHODS
Complete blood count was performed in all dogs, and they were stratified for sub-group analysis based on the presence or absence of thrombocytosis (platelet count > 500 103/µL). Serum TPO and IL-6 concentrations were measured by ELISA. Results of selected numeric variables were compared using Wilcoxon rank sum tests for pairwise comparisons. A value of P < .05 was considered significant.
RESULTS
Twelve of the dogs with carcinoma (12/63, 19.0%) and none of the healthy control dogs (0%) had thrombocytosis. Thrombopoietin concentrations (median [range]) were significantly higher in dogs with carcinoma when compared to controls (87.42 pg/mL [0 to >600] vs 15.99 pg/mL [0 to >600], P < .001). Interleukin-6 concentrations (median [range]) were not different between dogs with carcinoma and healthy control dogs (9.70 pg/mL [0-181.53] vs 3.03 pg/mL [0-280.77], P = .15). In dogs with carcinoma, the TPO and IL-6 concentrations were not different between dogs with thrombocytosis and dogs with normal platelet count.
CONCLUSIONS AND CLINICAL IMPORTANCE
Thrombopoietin concentrations were significantly higher in dogs with carcinoma, regardless of platelet count. Thrombopoietin is likely to be 1 of multiple factors that can impact platelet number, production, and consumption in dogs with carcinoma.
Topics: Animals; Carcinoma; Case-Control Studies; Dog Diseases; Dogs; Interleukin-6; Platelet Count; Thrombocytosis; Thrombopoietin
PubMed: 34881459
DOI: 10.1111/jvim.16317 -
Deutsches Arzteblatt International Nov 2015Thrombocytopenia is, after anemia, the second most common abnormality of the complete blood count in pregnancy, with a reported frequency of 6.6% to 11.2%. It has many... (Review)
Review
BACKGROUND
Thrombocytopenia is, after anemia, the second most common abnormality of the complete blood count in pregnancy, with a reported frequency of 6.6% to 11.2%. It has many causes. Thrombocytopenia should be diagnostically evaluated as early as possible in pregnancy, so that the obstetrical management can be accordingly planned to minimize harm to the mother and child. As the various underlying diseases share clinical features and laboratory findings, the differential diagnosis is often a difficult interdisciplinary challenge.
METHODS
In this article, we review pertinent literature (2000-January 2015) retrieved by a selective search in PubMed.
RESULTS
Gestational thrombocytopenia is the most common type, accounting for 75% of cases, followed by severe pre-eclampsia/HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count) in 15-22% and autoimmune thrombocytopenia (ITP) in 1-4%. Gestational thrombocytopenia and ITP differ in the bleeding history, the severity of thrombocytopenia, the frequency of neo - natal thrombocytopenia, and the rate of normalization of the platelet count after delivery. The HELLP syndrome and rarer microangiopathic hemolytic anemias (e.g., thrombotic thrombocytopenic purpura) can be differentiated on the basis of their main clinical features, such as hypertension/proteinuria and upper abdominal pain, the severity of hemolysis and thrombocytopenia, the degree of transaminase elevation, and the rapidity of postpartum remission of the clinical and laboratory findings. A stepwise diagnostic procedure should be followed to distinguish further causes, e.g., to differentiate thrombocytopenia due to infection, autoimmune disease, or drugs from thrombocytopenia due to a rare hereditary disease.
CONCLUSION
The early interdisciplinary evaluation of thrombocytopenia in pregnancy is a prerequisite for the optimal care of the mother and child. The development of evidence-based recommendations for interdisciplinary management should be a goal for the near future.
Topics: Adolescent; Adult; Algorithms; Diagnosis, Differential; Evidence-Based Medicine; Female; Humans; Medical History Taking; Middle Aged; Platelet Count; Pregnancy; Pregnancy Complications, Hematologic; Prenatal Diagnosis; Reproducibility of Results; Sensitivity and Specificity; Symptom Assessment; Thrombocytopenia; Young Adult
PubMed: 26634939
DOI: 10.3238/arztebl.2015.0795 -
Blood Advances Oct 2021Fluctuations in platelet count levels over time may help distinguish immune thrombocytopenia (ITP) from other causes of thrombocytopenia. We derived the platelet...
Fluctuations in platelet count levels over time may help distinguish immune thrombocytopenia (ITP) from other causes of thrombocytopenia. We derived the platelet variability index (PVI) to capture both the fluctuations in platelet count measurements and the severity of the thrombocytopenia over time. Raw PVI values, ranging from negative (less severe thrombocytopenia and/or low fluctuations) to positive (more severe thrombocytopenia and/or high fluctuations) were converted to an ordinal PVI score, from 0 to 6. We evaluated the performance characteristics of the PVI score for consecutive adults with thrombocytopenia from the McMaster ITP Registry. We defined patients with definite ITP as those who achieved a platelet count response after treatment with intravenous immune globulin or high-dose corticosteroids and possible ITP as those who never received ITP treatment or did not respond to treatment. Of 841 patients with thrombocytopenia, 104 had definite ITP, 398 had possible ITP, and 339 had non-ITP thrombocytopenia. For patients with definite ITP, the median PVI score was 5 [interquartile range (IQR) 5, 6] for patients with possible ITP, the median PVI score was 3 (1, 5); and for patients with non-ITP thrombocytopenia, the median PVI score was 0 (0, 2). A high PVI score correlated with the diagnosis of definite ITP even when calculated at the patient's initial assessment, before any treatment had been administered. Platelet count fluctuations alone contributed to the specificity of the overall PVI score. The PVI score may help clinicians diagnose ITP among patients who present with thrombocytopenia for evaluation.
Topics: Adult; Blood Platelets; Humans; Immunoglobulins, Intravenous; Platelet Count; Purpura, Thrombocytopenic, Idiopathic; Thrombocytopenia
PubMed: 34516622
DOI: 10.1182/bloodadvances.2020004162 -
Journal of Veterinary Internal Medicine Nov 2017Thrombocytosis is a hematologic abnormality in dogs that has been associated with various neoplastic, metabolic, and inflammatory conditions.
BACKGROUND
Thrombocytosis is a hematologic abnormality in dogs that has been associated with various neoplastic, metabolic, and inflammatory conditions.
OBJECTIVE
To classify thrombocytosis in dogs based on severity and evaluate whether there are associations between severity and underlying disease processes.
ANIMALS
Seven hundred and fifteen dogs with thrombocytosis and 1,430 dogs with normal numbers of platelets.
METHODS
Retrospective study. Medical records of dogs with increased (>500 × 10 /μL; thrombocytosis group) and normal (300-500 × 10 /μL; control group) platelet counts between 2011 and 2015 were reviewed. Dogs were characterized by severity of platelet increase and diagnosis. Diagnostic categories included neoplasia, endocrine disease, inflammatory disease, or miscellaneous.
RESULTS
A total of 1,254 complete blood counts with thrombocytosis from 715 dogs were included in the study. Median platelet count in this population was 582 × 10 /μL (500-1,810 × 10 /μL). No correlation between severity of thrombocytosis and diagnosis was identified. Causes of secondary thrombocytosis included neoplasia (55.7%), endocrine disease (12.0%), and inflammatory disease (46.6%). Immune-mediated disease was common (22.2%), associated with frequent glucocorticoid administration, and had a significantly higher median platelet count (636 × 10 /μL [500-1,262 × 10 /μL] versus 565 × 10 /μL [500-1,810 × 10 /μL]) when compared to the other inflammatory processes (P < 0.001). The diagnoses in the thrombocytosis dogs differed significantly from the control population (P < 0.001).
CONCLUSIONS AND CLINICAL IMPORTANCE
Thrombocytosis is commonly associated with carcinoma and immune-mediated disease in dogs.
Topics: Animals; Autoimmune Diseases; Dog Diseases; Dogs; Endocrine System Diseases; Female; Glucocorticoids; Inflammation; Male; Neoplasms; Platelet Count; Retrospective Studies; Risk Factors; Thrombocytosis
PubMed: 28895208
DOI: 10.1111/jvim.14831 -
Current Oncology (Toronto, Ont.) Feb 2022The prognostic role of platelet count in hepatocellular carcinoma (HCC) remains unclear, and in fact both thrombocytopenia and thrombocytosis are reported as predictors...
The prognostic role of platelet count in hepatocellular carcinoma (HCC) remains unclear, and in fact both thrombocytopenia and thrombocytosis are reported as predictors of unfavourable outcomes. This study aimed to clarify the prognostic value of preoperative platelet count in potentially resectable HCC. We retrospectively reviewed 128 patients who underwent hepatic resection for HCC at a tertiary academic centre (2007−2019). Patient data were modelled by regression analysis, and platelet count was treated as a continuous variable. 89 patients had BCLC 0/A tumours and 39 had BCLC B tumours. Platelet count was higher in patients with larger tumours and lower in patients with higher MELD scores, advanced fibrosis, and portal hypertension (p < 0.001 for all listed variables). After adjusting for BCLC stage and tumour diameter, low platelet count associated with reduced overall survival (hazard ratio 1.25 per 50/nL decrease in platelet count, 95% confidence interval (CI) 1.02−1.53, p = 0.034) and increased perioperative mortality (odds ratio 1.96 per 50/nL decrease in platelet count, 95% CI 1.19−3.53, p = 0.014). Overall, low platelet count correlates with increased liver disease severity, inferior survival, and excess perioperative mortality in resectable HCC. These insights might be applied in clinical practice to better select patients for resection.
Topics: Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Platelet Count; Retrospective Studies
PubMed: 35323324
DOI: 10.3390/curroncol29030124 -
Haematologica Jan 2011
Topics: Blood Platelets; Humans; Platelet Count; Risk Factors; Thrombocytosis
PubMed: 21193429
DOI: 10.3324/haematol.2010.035287 -
Neonatology 2015Five percent of newborn infants admitted to UK neonatal units during a recent study developed a platelet count <60 × 10(9)/l, and 60% of these were transfused... (Review)
Review
Five percent of newborn infants admitted to UK neonatal units during a recent study developed a platelet count <60 × 10(9)/l, and 60% of these were transfused platelets. This review summarises the common causes and mechanisms of thrombocytopenia in the newborn. Relevant evidence relating the platelet count to the risk of haemorrhage is reviewed, and current UK guidance on transfusion thresholds outlined. The UK policy for the provision of platelets for transfusion to neonates is described, including the particular requirements for neonatal allo-immune thrombocytopenia. Finally, we look towards the future and prospects for reducing the need to expose newborns to donor-derived platelets.
Topics: Hemorrhage; Humans; Infant, Newborn; Needs Assessment; Platelet Count; Platelet Transfusion; Practice Guidelines as Topic; Thrombocytopenia, Neonatal Alloimmune; United Kingdom
PubMed: 25301082
DOI: 10.1159/000365163 -
American Journal of Men's Health May 2017Blood count parameters of patients referring with erectile dysfunction (ED) were examined in this study and it was investigated whether eosinophil count (EC), platelet...
Blood count parameters of patients referring with erectile dysfunction (ED) were examined in this study and it was investigated whether eosinophil count (EC), platelet count (PC), and mean platelet volume values among the suspected predictive parameters which may play a role in especially penile arteriogenic ED etiopathogenesis had a contribution on pathogenesis. Patients referring with ED complaint were evaluated. Depending on the medical story, ED degree was determined by measuring International Index of Erectile Function. Penile Doppler ultrasonography was taken in patients suspected to have vasculogenic ED. According to penile Doppler ultrasonography result, patients with arterial deficiency were included in the penile arteriogenic ED group and the patients with normal results were included in the nonvasculogenic ED group. A total of 36 patients participated in the study from the penile arteriogenic ED group and 32 patients from the nonvasculogenic ED group. Compared with the nonvasculogenic ED group, the penile arteriogenic ED group's low International Index of Erectile Function score, high EC, mean platelet volume and PC values were detected to be statistically significant ( p < .001, p = .021, p = .018, p = .034, respectively). No statistically significant difference was observed among the two groups when age, white blood cells, red blood cells, and hemoglobin values were considered. Pansystolic volume velocities were detected as statistically significantly low compared with the nonvasculogenic ED group in the measurements made in 5th, 10th, 15th, and 20th minutes on the right and left sides in the penile arteriogenic ED group. High MPV value and PC is a significant predictive factor for penile arteriogenic ED and vasculogenic ED and high EC is specifically predictive of arteriogenic ED.
Topics: Adult; Aged; Eosinophils; Humans; Impotence, Vasculogenic; Male; Middle Aged; Platelet Count; Predictive Value of Tests; Ultrasonography, Doppler; Young Adult
PubMed: 27895254
DOI: 10.1177/1557988316679575