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Case Report: Hemophilia A is a hereditary bleeding disorder due to factor VIII deficiency. With the advances in the treatment of hemophilia in recent years, the average life expectancy of patients has reached the healthy population. Along with prolonged life, additional diseases and intervention requirements are developing in this patient group. Due to the developments, management of patients going under interventions are more clear and easier. In this case, a patient who underwent an intervention with extended half-life factor therapy was presented.Forty-three-year-old male patient with severe hemophilia A was evaluated on request for circumcision surgery while using prophylactically extended half-life factor therapy 2 × 1000 Units / week. Tranexamic acid was started one day preoperatively to the patient whose basal factor level was below 1% and whose inhibitory level was negative. Body weight of the patient was 63 kg. Extended half-life factor VIII preparation (efmorogtocog alfa) loading dose of 3000 units was administered befrore half an hour of the procedure. aPtt was detected for 30 seconds and factor VIII level was 55% 30 minutes after loading dose. The patient was given appropriate sedative treatment to prevent pre-perioperative erection. The operation was carried out without any problems. 1500 Units 12 hours after the loading dose, and 24 hours after this dose was performed. The patient was discharged without complications without bleeding. Factor therapy was continued with prophylaxis dosing. Tranexamic acid was continued for 7 days. No complications were observed.Interventional procedures of hemophilia patients can be performed without complications with a multidisciplinary approach under appropriate dose and scheme factor therapy. In the case, an interventinal procedure was made by giving an extended half-life factor to a severe hemophilia patient who could not have a circumcision operation for many years due to previous hesitations of both patient and surgeons.

Abstract Background/Aims: In this study, the results of patients who had orthotopic heart transplantation (OHT) in acute rejection who admitted to our clinic with decompensated heart failure and who could not undergo endomyocardial biopsy (EMB) were evaluated. Methods: The study included 27 patients who underwent OHT in our clinic between December 1998 and November 2021, who admitted with acute rejection causing decompensated heart failure during follow-up, and who could not undergo EMB and administered IV pulse steroid plus plasmapheresis. Demographics of patients, peri-treatment left ventricular functions, survival rates and causes of mortality were analyzed. Results: 19 (70.4%) were male and mean age was 28.7 ± 14.7 (range: 3-54). After OHT, overall survival rates were 92.6%, 77.6%, and 69.4% at 1st, 3rd and 5th year respectively. During the follow-up, the survival rates of patients who presented with decompensated heart failure and given pulse steroid plus plasmapheresis were 70.4%, 58.8%, and 53.4% at 1st, 3rd and 5th year respectively after plasmapheresis. Median rejection time after transplant was 19 months (range 0-113 months). Pre-, and post-treatment left ventricle ejection fractions were 25.11% ± 11.1%, and 52.14% ± 13.4% respectively (p

Objective: There is limited data in the literature on the mental health of newly diagnosed hematological cancer (HC) patients in COVID-19 pandemic. This study evaluates the mental health statuses of HC inpatients diagnosed during the COVID-19 pandemic in comparison to the statuses of patients diagnosed with HC before the pandemic. Methodology: A cross-sectional survey collected the mental health measurements of 77 inpatients with HC between March and May 2021. The levels of depression, generalized anxiety, distress, sleep disorder, health anxiety, trait anxiety, coronaphobia, and resilience in HC patients newly diagnosed during the pandemic (NDHC) (n=38) and HC patients diagnosed before the pandemic (BPHC) (n=39) were compared. The relationships between predictive factors and cancer patients’ mental health statuses were evaluated. Results: Depression (63.2% vs. 35.9%, p=0.017) and sleep disorder (67.8% vs. 38.5, p=0.016) were significantly higher, while generalized anxiety (57.9% vs. 38.5%, p=0.088) and distress (52.6% vs. 33.3%, p=0.087) were higher in NDHC.Health anxiety was more common in BPHC (53.8% vs. 31.6%, p=0.048).Among NDHC, women had more anxiety symptoms than men (76.5% vs. 42.9%, p=0.037).Diagnosing newly increased the risk of severity of depression and sleep disorders, bu decreased the risk of health anxiety. Conclusion: Our data indicate that patients with HC are vulnerable to mental health problems in the COVID-19 pandemic. This vulnerability is higher in newly diagnosed HC patients than in patients diagnosed before the pandemic. These findings may help develop interventions that reduce the vulnerability to adverse psychological effects by identifying risk factors for HC patients under pandemic conditions.

Background: Fractalkine (FKN) is an inflammatory cytokine that has been shown with increased serum levels in diabetic patients and is considered to contribute to the adipose tissue inflammation by supporting monocyte adhesion to adipocytes which has an important role in the pathogenesis of type 2 diabetes mellitus (T2DM). Our aim was to evaluate the effects of glucose ingestion on the serum fractalkine levels in healthy subjects with normal glucose tolerance (NGT) and newly diagnosed T2DM patients. Methods: A total of 67 patients were included in this study, and they were divided into NGT (n= 34) and T2DM (n= 33) groups according to their oral glucose tolerance test (O G TT) results. The serum FKN and C-reactive protein (CRP) levels were measured at 0 and 120 minutes during an O G TT following overnight fasting. Results: The 0-minute (basal) and 120-minute O G TT FKN levels were found to be significantly higher in the T2DM group when compared to the NGT group (p= 0.012 and p= 0.001, respectively). However, no significant differences were observed in terms of the changes in the basal and 120-minute O G TT FKN levels in the T2DM and NGT groups (p= 0.433 and p= 0.06, respectively). A significant positive correlation was observed between the 120-minute O G TT FKN and glucose levels in the study group consisting of all of the patients (r= 0.331, p= 0.006). Conclusions: In this study, basal and post-glycemic load FKN levels were found to be higher in newly diagnosed T2DM patients than those with NGT; however, there was no additional change in FKN levels by glycemic load.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematological malignancy characterized by proliferation of plasmacytoid dendritic cell precursors. Herein, we describe a 65-year-old male presented with a 6 month history of a progressively enlarging purple mass over his forehead. The histopathological examination revealed non-epidermotropic, dermal, and subepidermal homogeneous infiltration with moderate-sized cells resembling lymphoblasts or myeloblasts. The neoplastic clone diffusely stained positive with CD4 and CD56. They were negative for CD3, CD20, pax-5, CD30, myeloperoxidase, and TdT. Rearrangement studies for T and B cell receptor were negative. Ki-67 proliferation index was 80%. Involvement of multiple lymph nodes was detected. Bone marrow biopsy was normal. The patient was put on six cycles of R-CHOP chemotherapy which was successfully cleared all lesions. A rapid recurrence was observed after 1.5 months. While being prepared for autologous stem cell transplantation, the patient died due to rapidly onset myelosuppression and systemic infections. In conclusion, BPDCN should be in the clinical and histopathological differential diagnosis of rapidly developing tumoral cutaneous lesions. Early diagnosis is important to initiate aggressive treatments in BPDCN, in which skin involvement is very frequent.

Objective:Mammography-screening (MS) rates remain low in underdeveloped populations. We aimed to find the barriers against MS in a low socioeconomic population.Materials and Methods:Women aged 40-69 years who lived in the least developed city in Turkey (Mus), were targeted. A survey was used to question breast cancer (BC) knowledge and health practices.Results:In total, 2054 women were surveyed (participation rate: 85%). The MS rate was 35%. Women aged 50-59 years (42%, p

In this study, it is aimed to analyze the quasi-static response of viscoelastic Kirchhoff plates with mixed finite element formulation based on the Gâteaux differential. Although the static response of elastic plate, beam and shell structures is a widely studied topic, there are few studies that exist in the literature pertaining to the analysis of the viscoelastic structural elements especially with complex geometries, loading conditions and constitutive relations. The developed mixed finite element model in transformed Laplace-Carson space has four unknowns as displacement, bending and twisting moments in addition to the dynamic and geometric boundary condition terms. Four-parameter solid model is employed for modelling the viscoelastic behaviour. For transformation of the solutions obtained in the Laplace-Carson domain to the time domain, different numerical inverse transform techniques are employed. The developed solution technique is applied to several quasi-static example problems for the verification of the suggested numerical procedure.