Platelet indices (PI) — plateletcrit, mean platelet volume (MPV) and platelet distribution width (PDW) — are a group of derived platelet parameters obtained as a part of the automatic complete blood count. Emerging evidence suggests that PIs may have diagnostic and prognostic value in certain diseases. This study aimed to summarize the current scientific knowledge on the potential role of PIs as a diagnostic and prognostic marker in patients having emergency, non-traumatic abdominal surgery. In December 2015, we searched Medline/PubMed, Scopus and Google Scholar to identify all articles on PIs. Overall, considerable evidence suggests that PIs are altered with acute appendicitis. Although the role of PI in the differential diagnosis of acute abdomen remains uncertain, low MPV might be useful in acute appendicitis and acute mesenteric ischemia, with high MPV predicting poor prognosis in acute mesenteric ischemia. The current lack of consistency and technical standards in studies involving PIs should be regarded as a serious limitation to comparing these studies. Further large, multicentre prospective studies concurrently collecting data from different ethnicities and genders are needed before they can be used in routine clinical practice.

BackgroundElectrolyte values are measured in most critically ill intensive care unit (ICU) patients using both an arterial blood gas analyzer (ABG) and a central laboratory auto-analyzer (AA). The aim of the present study was to investigate whether electrolyte levels assessed using an ABG and an AA were equivalent; data on sodium and potassium ion concentrations were examined.MethodsWe retrospectively studied patients hospitalized in the ICU between July and August 2011. Of 1,105 test samples, we identified 84 instances of simultaneous sampling of arterial and venous blood, where both Na+ and K+ levels were measured using a pHOx Stat Profile Plus L blood gas analyzer (Nova Biomedical, Waltham MA, USA) and a Roche Modular P autoanalyzer (Roche Diagnostics, Mannheim, Germany). Statistical measures employed to compare the data included Spearman's correlation coefficients, paired Student’s t-tests, Deming regression analysis, and Bland-Altman plots.ResultsThe mean sodium concentration was 138.1 mmol/L (SD 10.2 mmol/L) using the ABG and 143.0 mmol/L (SD 10.5) using the AA (p < 0.001). The mean potassium level was 3.5 mmol/L (SD 0.9 mmol/L) using the ABG and 3.7 mmol/L (SD 1.0 mmol/L) using the AA (p < 0.001). The extent of inter-analyzer agreement was unacceptable for both K+ and Na+, with biases of 0.150-0.352 and −0.97-10.05 respectively; the associated correlation coefficients were 0.88 and 0.90.ConclusionsWe conclude that the ABG and AA do not yield equivalent Na+ and K+ data. Concordance between ABG and AA should be established prior to introduction of new ABG systems.

Background/aim: In this study, we aimed to evaluate the initial hematological findings analyzed on admission in confirmed COVID-19 patients who were transferred to the intensive care unit (ICU), to predict possible hematological indices. Materials and methods: Initial neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), red cell distribution width to platelet ratio (RPR), mean platelet volume to platelet ratio, and lymphocyte multiplied by platelet count (LYM x PLT), of 695 patients with laboratory-confirmed COVID-19 were investigated and compared between the mild/moderate and severe groups. Results: The proportion of COVID-19 cases admitted to ICU was 3.9%. The median age of patients admitted to ICU was significantly higher than those who were not; (68.5 (interquartile range (IQR); 21.5) years vs. 41.0 (IQR; 15.7) years; p <0.001). Severe cases had higher NLR (6.6 vs 2.4; P <0.001), and MLR (0.40 vs 0.28; P=0.004) and lower PLR (180.0 vs 129.0; P <0.001) compared to that of mild or moderate patients. Among all of the parameters, the ROC curve of NLR gave us the best ability to distinguish serious patients at an early stage (AUC = 0. 819, 95% confidence interval 0.729-0.910; p<0.001). Conclusion: These data showed that age, initial NLR, PLR, and LYM x PLT were associated with the severity of COVID-19 disease and patients' need for the ICU. Therefore, initial hemogram parameters may be essential to predict the prognosis of COVID-19 patients.

IntroductionUrinary tract infection (UTI) is one of the most common types of infection. Currently, diagnosis is primarily based on microbiologic culture, which is time- and labor-consuming. The aim of this study was to assess the diagnostic accuracy of urinalysis results from UriSed (77 Electronica, Budapest, Hungary), an automated microscopic image-based sediment analyzer, in predicting positive urine cultures.Materials and methods:We examined a total of 384 urine specimens from hospitalized patients and outpatients attending our hospital on the same day for urinalysis, dipstick tests and semi-quantitative urine culture. The urinalysis results were compared with those of conventional semi-quantitative urine culture.Results:Of 384 urinary specimens, 68 were positive for bacteriuria by culture, and were thus considered true positives. Comparison of these results with those obtained from the UriSed analyzer indicated that the analyzer had a specificity of 91.1%, a sensitivity of 47.0%, a positive predictive value (PPV) of 53.3% (95% confidence interval (CI) = 40.8–65.3), and a negative predictive value (NPV) of 88.8% (95% Cl = 85.0–91.8%). The accuracy was 83.3% when the urine leukocyte parameter was used, 76.8% when bacteriuria analysis of urinary sediment was used, and 85.1% when the bacteriuria and leukocyturia parameters were combined. The presence of nitrite was the best indicator of culture positivity (99.3% specificity) but had a negative likelihood ratio of 0.7, indicating that it was not a reliable clinical test.Conclusions:Although the specificity of the UriSed analyzer was within acceptable limits, the sensitivity value was low. Thus, UriSed urinalysis results do not accurately predict the outcome of culture.

The aim of this study is to investigate if serum asymmetric dimethylarginine (ADMA) levels can predict restenosis and major adverse cardiac events (MACE) in patients who undergo percutaneous coronary interventions. The most important cause of restenosis following percutaneous coronary intervention is neointimal hyperplasia. Nitric oxide (NO) prevents the neointimal hyperplasia growing. Asymmetric dimethylarginine is a competitive inhibitor of NO synthesis. The effect of ADMA on the restenosis has not yet been investigated. A total of 105 (80 male and 25 female) patients were included in our study. All patients underwent elective percutaneous transluminal coronary angioplasty (PTCA) with bare metal stent implantation or direct stenting for one coronary artery between September 2004 and January 2006. All patients were clinically followed for a period of 6 months, and a control angiography was performed at the end of this period. The probrain natriuretic peptide (pro-BNP), high-sensitivity Creactive protein (hs-CRP), and ADMA levels of the patients were evaluated before the procedure and 6 months afterwards. Biochemical parameters and angiographic features were evaluated in order to determine if they could predict the development of restenosis and MACE by using univariate and multivariate Cox regression analysis. The 65 (61.9%) patients (50 males and 15 females) who had not developed restenosis were designated as Group 1. The 27 (25.7%) patients (21 males and 6 females) who had developed restenosis were designated as Group 2. In terms of predicting the development of restenosis, the presence of diabetes mellitus (hazard ratio [HR]: 2.78; confidence interval [CI]: 1.25-6.20; P = 0.01), type of lesion (HR: 1.89; CI: 1.01-3.55; P = 0.04), form of procedure (HR: 0.30; CI: 0.11-0.81; P = 0.01), and ADMA (HR: 4.08; CI: 1.73-9.62; P = 0.001) were found to be significant in univariate Cox regression analysis. In contrast, only the levels of ADMA were found to be a significant predictor of restenosis in the multivariate Cox regression analysis (HR: 3.02; CI: 1.16-7.84; P = 0.02). The restenosis prediction of ADMA levels continued after excluding the patients with diabetes mellitus in the univariate and multivariate Cox regression analysis (HR: 5.23; CI: 1.99-13.76; P = 0.001 and HR: 5.61; CI: 1.79-17.62; P = 0.003, respectively). Regarding the development of cardiac events, hs-CRP (HR: 1.03; CI: 1.00-1.06; P = 0.01) and ADMA (HR: 17.1; CI: 3.06-95.8; P = 0.001) were found to be significantly correlated with adverse cardiac events in univariate Cox regression analysis, whereas only ADMA levels were significant in the multivariate Cox regression analysis (HR: 2.83; CI: 1.27-6.31; P = 0.01). The levels of ADMA obtained before the procedure predict the development of restenosis and MACE in patients who underwent elective PTCA and bare metal stent procedures.