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Objective Late-onset sepsis (LOS) is a substantial contributor to morbidity and mortality among neonates. The use of nonculture-based tools for early diagnosis is an area of active investigation. Therefore, we aimed to evaluate the diagnostic value of serum interleukin-27 (IL-27) and mean platelet volume (MPV) in full-term neonates with LOS. Study Design In this single-center, cross-sectional study, 90 full-term newborns were assigned to two equal-matched groups as follows: (1) culture-proven sepsis and (2) control groups. Clinical data and laboratory findings as complete blood pictures, including MPV, highly sensitive C-reactive protein, and blood culture results, were recorded. Moreover, IL-27 levels were measured using enzyme-linked immunosorbent assay. Results IL-27 levels (median = 4,364 pg/mL) and MPV (mean = 12.02 ± 1.54 FL) were significantly higher in the culture-proven sepsis group than in the control group (p < 0.001). For IL-27, the optimum cut-off value for the diagnosis of LOS was 283.8 pg/mL with sensitivity and specificity of 97.8 and 100%, respectively. For MPV, the optimum cut-off value was 11.6 FL, with diagnostic sensitivity and specificity of 77.8 and 97.8%, respectively. Conclusion IL-27 and MPV are promising markers for the diagnosis of LOS in full-term neonates. The diagnostic performance of IL-27 was superior to MPV. Key Points Late-onset neonatal sepsis diagnosis is time consuming. Nonculture-based rapid diagnostic tests are much needed. IL-27 is superior in LOS diagnosis to MPV. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 pneumonia is a leading cause for worse outcome of infected patients. Factors associated with mortality in COVID-19 pneumonia vary among studies; identification of most possible factors related to worse outcome might add for management. Patients and methods: Consecutive COVID-19 pneumonia patients referred to the Assiut University Hospital, Egypt, from June 2020 to August 2022 were included in our study. All the included patients were followed up from admission until discharge to identify the factors that worsen the outcome. Our cohort study includes two groups: survivors and non-survivors. Clinical, laboratory, and management data of both groups were recorded. Results: Two-hundred and fifty-one confirmed COVID-19 pneumonia patients were included in the study; 147 (58.6%) patients were improved (survivors' group), and 104 (41.4%) patients were deteriorated and died (non-survivors' group). Non-survivors' group had significantly higher MMRC dyspnea scale, pneumonia severity index, CURB-65 score, and baseline respiratory rate. Non-survivors group had significantly lower mean lymphocytes (0.81 ± 0.61 vs. 1.25 ± 0.75; p < 0.001), higher ferritin (1272.45 ± 143.76 vs. 615.84 ± 75.47; p < 0.001), and higher d-dimer (6.65 ± 2.67 vs. 2.78 ± 0.38; p < 0.001), with interestingly significantly higher mean platelet volume (MPV) (10.34 ± 1.64 vs. 10.07 ± 1.93 (fl); p < 0.001). Non-survivors group was frequently admitted to ICU (88 (84.6%) vs. 38 (25.9%); p < 0.001) and had longer duration in ICU than survivors group (9.71 ± 3.36 vs. 5.90 ± 2.34 (days); p < 0.001). The predictors for mortality among patients with COVID-19 pneumonia were old age, high MPV, high CT score, and admission to ICU. Conclusion: Old age, severe lung infiltrate with HRCT, high mean platelet volume, and ICU admission are the main clinical determinants of worse outcome of COVID-19 pneumonia. [ABSTRACT FROM AUTHOR]

Objectives To measure CD62p and CD42b levels and to study its correlations with bleeding score, and different prognostic factors in children with primary immune thrombocytopenia (ITP) patients. Methods In all, 60 children with ITP and 30 age- and sexmatched healthy participants were recruited and underwent thorough clinical assessments including bleeding score using the modified Buchanan and Adix bleeding score as well as complete blood count with measurement of mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT), coagulation profiles and measurement of platelet glycoproteins (CD62p and CD42b) using a flow cytometer. Results Children with ITP had lower PCT (P<0.001), CD 62 P, and co-expression of CD 42b/CD 62 P and higher MPV (P=0.009), PDW (P<0.001), and CD 42b level. MPV correlates negatively with lymphocyte count and platelet count, while PDW correlates negatively with neutrophil count and positively with hemoglobin. PCT correlates negatively with total leucocyte count, neutrophil count, and positively with platelet count (P=<0.001). Children with chronic ITP usually presented with mild cutaneous bleeding, while those with acute ITP usually suffered from severe mucosal and life-threatening bleeding (P=0.001). Acute ITP cases had the highest total leucocyte count (P<0.001) and the lowest count of platelet (P<0.001); persistent cases had the lowest lymphocyte count (P=0.023) and co-expression of CD42b/CD62p (P=0.039), while chronic cases had the lowest neutrophil count P<0.001) and highest percentage of PCT (P<0.001) and co-expression of CD42b/CD62p (P=0.039). Conclusion Platelet parameters and platelet glycoprotein CD62P and CD42b expression is a simple noninvasive diagnostic tool in ITP children. [ABSTRACT FROM AUTHOR]

Background: For assisting in the early identification of acute appendicitis (AA) and its prompt therapy, several grading systems have been utilized. Because it takes into account the patient symptoms, findings, and laboratory assessment, the Alvarado score was chosen. Mean platelet volume (MPV) variations could be a sign of production of platelet in addition, a sign of changes in the severity of a number of disorders. Objective: This study aimed to compare MPV and Alvarado score to assess the predictive value for acute appendicitis. Patients and Methods: At the Emergency Hospital Mansoura University, Egypt, a prospective observational cohort research was conducted. 118 participants from both sexes who had right iliac fossa (RIF) pain suggestive of appendicitis participated in this study. Results: when compared to the histological findings, the Alvarado score exhibited a sensitivity and specificity of 67.6% and 61.5% respectively, with an accuracy of 58.5% in diagnosing appendicitis. With an accuracy of 79.7%, ultrasonography demonstrated a sensitivity and specificity of 80.4% and 76.9% in detecting appendicitis respectively. When compared to those without appendicitis, the MPV in cases with AA was statistically considerably smaller. The optimum MPV cutoff point for detecting appendicitis cases was less-than 8.92 with a sensitivity of 78.3%, specificity of 61.5%, and accuracy of 66.2%. Conclusion: While the Alvarado score and the combination of the two exhibited lower accuracy, the MPV had a greater accuracy for diagnosis than the Alvarado score. The sensitivity and accuracy of diagnosing acute appendicitis were significantly improved by combining the Alvarado score with the ultrasound examination. [ABSTRACT FROM AUTHOR]

Objectives Bechet's disease (BD) is a multisystem inflammatory disorder with predominant and frequent vascular complications. The pathogenesis of thrombosis in BD is not clearly known, vasculitis and/or multifactorial procoagulant activities are the cornerstone histopathological features of the disease. Patients and methods In this study, we investigated the role of hypercoagulable state and the hemostatic alteration in BD patients and their susceptibility to develop vascular thrombotic complications using ViennaLab CVD StripAssay for molecular detection of thrombophilia gene mutation by PCR and reverse hybridization to allelespecific oligonucleotide probes immobilized on test strip. Natural anticoagulant levels were also assessed to trace the association between activated coagulation system and increased susceptibility of BD patients to develop vascular complication. Results The study revealed a significant association between human platelet antigen-1 polymorphism and the presence of vascular thrombosis, either arterial or venous, in BD patients. Also, there was a significant relationship between mutant MTHFR genotype and venous thrombosis. But, there was an insignificant association between vascular complications in BD patients from one side and the levels of natural anticoagulants (protein C, protein S, and antithrombin III) and mean platelet volume (MPV) level from the other side. Conclusion Despite the association of some thrombophilic factors with the thrombotic tendency seen in BD, the usage of anticoagulants in BD patients with thrombosis may be unnecessary. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes is a part of metabolic syndrome associated with a higher risk of vascular complications. Diabetes is characterized by changes in platelet morphology, function, and platelet hyperactivity so, it's considered a prothrombotic condition. Morbidity and mortality in people with type 2 diabetes-related to micro and macrovascular complications. Novel biomarkers are needed to identify and treat people at higher risk., Objective: The main objective of this controlled cross-sectional study was to evaluate Platelet volume indices (PVI) in subjects with type 2 diabetes with and without complications in comparison to subjects without diabetes., Methods: Hundred and thirty-five subjects aged from 35 to 60 years were subdivided into 3 groups. Group A includes 55 subjects with type 2 diabetes with complications. Group B includes 45 subjects with type 2 diabetes without complications. Group C includes 35 normal healthy subjects. Detailed clinical history was taken. Also, PVI, fasting blood glucose (FBG), hemoglobin A1c, and creatinine were obtained., Results: Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Plateletcrit (PCT), and Platelet large cell ratio (P-LCR) were significantly higher among subjects with retinopathy, nephropathy, and neuropathy than other subjects with diabetes who didn't develop complications (P<0.001). At cutoff value > 11.9 fL, MPV have diagnostic sensitivity 80% and specificity 97.8%. Whereas PDW >16.9fL has a sensitivity of 74.5% and specificity of 100% for diabetic microvascular complications (retinopathy, nephropathy, and neuropathy)., Conclusion: MPV and PDW may be considered as possible biomarkers for the early detection of diabetic microvascular complications., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Psoriasis vulgaris (PsV) is common, incurable, pro-inflammatory systemic disease with waving course that impacts the life quality. This justifies the need for discovering simple biomarkers with key roles in monitoring systemic inflammation and assessing the disease severity. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) have been suggested as markers of inflammation. We aimed to investigate the role of NLR, PLR and MPV as biomarkers for PsV disease and to examine their possible association with disease severity assessed by Psoriasis Area and Severity Index (PASI score) in Egyptian psoriatic patients. This case control study included 36 PsV patients and 36 healthy controls. Hematological parameters were assessed by automated KX21N cell counters. Significant increase was detected in NLR (P < 0.001) and PLR (P < 0.001) in PsV patients when compared to controls. PASI score positively correlated with PLR (r=0.405; P=0.014) and negatively correlated with MPV (r= -0.471; P=0.004). NLR positively correlated with disease duration/ years (r=0.414; P=0.012). ROC curves data output showed that NLR at cut off of 1.66 yielded a specificity of (94.4%) and sensitivity of (61.1%) (P < 0,001) to differentiate PsV patients from healthy individuals and, PLR at cut-off of 110.6 yielded a higher sensitivity of (77.81%) with specificity of (86.1%) (P < 0.001). We concluded that NLR and PLR can serve as biomarkers for systemic inflammation in PsV disease. Increased NLR is more influenced by disease duration than disease severity. PLR and MPV can be applied to monitor psoriasis vulgaris severity and follow up of patients., (Copyright© by the Egyptian Association of Immunologists.)

Background: Pulmonary hypertension (PH) is one of the most common complications developed during the course of chronic obstructive pulmonary disease (COPD). Platelet activation plays an important role in its pathophysiology, and mean platelet volume (MPV) is considered a respectable index of platelet activation. The aim of this work is to assess the ability of MPV in predicting PH secondary to COPD as well as its severity. Methods: A cross-sectional study was conducted on 228 stable COPD patients. CBC, echocardiography, and pulmonary function tests were performed. Results: The prevalence of PH in stable COPD patients was high (63%), and the majority of patients had a mild degree (33%). There was no significant association between PH presence with different COPD grade, but, in very severe COPD, severe PH was significantly presented. MPV in COPD patients with PH was significantly higher than those without (9.02±1.14 vs 7.11±0.98, P <0.001). Moreover, a significant statistical rising of MPV with increased severity of PH. Multivariate regression analysis of predictors of PH demonstrated that; MPV is a real predictor of PH in such patients. The likelihood probability of PH increased up to 7-times with increasing one unit of MPV; (OR=6.7). A cut-off value of MPV >7.25 had 96% sensitivity and 76% specificity in predicting PH. Conclusion: MPV was higher in COPD patients with PH and positively correlated with PH severity. If the data are to be confirmed, MPV may be taken into consideration in decision-making and management of COPD patients., Competing Interests: The authors report no conflicts of interest in this work.