Mean platelet volume as a predictor of pulmonary hypertension in patients with stable COPD.

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.

Screening for Latent Tuberculosis among Healthcare Workers in an Egyptian Hospital Using Tuberculin Skin Test and QuantiFERON-TB Gold In-Tube Test.

BACKGROUND: Early detection of latent tuberculosis infection (LTBI) might prevent active TB development in healthcare workers (HCWs). The aim of the study is to assess the prevalence of LTBI among HCWs exposed to active TB, compare QFT-GIT and TST in the diagnosis of LTBI, and explore possible risk factors of LTBI. SETTING AND DESIGN: This was a cross-sectional study for a period of 6 months among 153 HCWs in high-risk departments dealing with TB infection - Beni-Suef University Hospital, Egypt. MATERIALS AND METHODS: HCWs were asked to fill a questionnaire for possible LTBI risk factors, and tuberculin skin test (TST) and serum QuantiFERON test were used for LTBI screening. STATISTICAL ANALYSIS: Statistical Package for Social Science (SPSS-18) was used for data analysis; qualitative data were compared using Chi-square test, while associations between risk factors for TB and positive QFT or TST were analyzed by a logistic regression model. RESULTS: LTBI detected by QuantiFERON-TB Gold In-Tube Test (QFT-GIT) and by TST was 9.1% and 34.6%, respectively (kappa = 0.028). Logistic regression showed that departments, duration of work, the use of N95 masks, and training in infection control practices were significant predictors for positive QFT-GIT among participants (P < 0.05). CONCLUSION: Work duration of >10 years, nurse profession, diabetics, and smokers were at increased risk of having LTBI. Increased training programs and implementation of infection control measures TB to reduce the risk of LTBI are recommended.