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Objective: Chronic myeloid leukemia (CML), is a clonal myeloproliferative disease due to neoplastic transformation of immature hematopoietic stem cells. The introduction of imatinib mesylate, specific BCR-ABL tyrosine kinase inhibitor (TKİ), opened a new era in treatment of CML. Currently, imatinib is considered as the first line treatment regime for CML however nonresponse or intolerance to imatinib therapy may develop. The aim of our study is to evaluate the prognosis and the efficacy of treatment in CML patients treated with TKİ. Methods: In the study; 16 years old and older 54 patients with CML who had been followed-up at Adult Hematology Department in the university hospital between November 1995 and December 2009, were analyzed retrospectively. The disease phases of patients when the TKİ was started were defined according to criteria proposed by World Health Organization (WHO). Risk profiles of patients at the time of diagnosis were determined by Sokal risk scoring system. Response rates (hematologic and cytogenetic), relapse rate (hematologic, cytogenetic or molecular relapse), relapse free survival and overall survival were evaluated. The survival curves were evaluated by Kaplan Meier method. Results: In our study, complete hematologic response(CHR) and complete cytogenetic response (CCR) rates were 94.4% and 75.9%, respectively. Relapse rate was 31.5%. Imatinib therapy was discontinued 40% of patients. Causes for imatinib discontinuation were primary imatinib resistance (40%), secondary imatinib resistance (46.6%) and side effects (13.4%). Estimated rate of relapse free survival was86.7% at 18 months and 56.2% at 5 years. Estimated three-year and five-year overall survival rates were 93.7%. Conclusion: It was concluded that imatinib mesylate is an effective and tolerable treatment choice but further studies that compares TKİ' s or combinations in terms of efficacy and tolerabilitiy are required to decide the most appropriate treatment choice in CML treatment. [ABSTRACT FROM AUTHOR]

Objective: Acute kidney injury (AKI) is an important clinical entity that is known to increase mortality in patients with sepsis. Erythrocyte maturation and proliferation are inhibited by pro-inflammatory cytokines; these cytokines exert effects on red cell distribution width (RDW) well. Based on this knowledge; our aim in this study was to evaluate the impact of RDW on acute kidney injury in patients with sepsis. Methods: 120 patients diagnosed with sepsis and admitted to intesive care unit (ICU) and treated between 2009-2013 were retrospectively evaluated. Patients were divided into two groups as follows: group 1 (RDW≥16.8) and group 2 (RDW<16.8). Multiple logistic regression analysis was used to determine the association between RDW and AKI and mortality. Results: There was a statistically significant relationship between AKI and RDW (p<0.001, OR=11.52) but there were no statistically significant relationship between AKI and sex, age, serum lactate levels as well as SOFA score. Also, there were statistically significant relationship between mortality and RDW (p=0.044, OR=5), serum lactate levels (p=0.030) and SOFA score (p<0.001). RDW was found associated with both AKI and mortality. Conclusions: Results suggest that RDW is an important parameter for predicting development of AKI and mortality in ICU patients with sepsis. [ABSTRACT FROM AUTHOR]

Objectives: It has been reported that increased sempathic nerve system activity due to infalammatory stress and it cause disturbance of heart rate variability (HRV) in rheumatoid arthritis (RA). In this study, it was assessed cardiac sempatovagal activity by noninvasive parameters such as HRV in patients with RA. Materials and methods: 49 patients with RA and age-matched 28 healthy subjects as control group were enrolled to this study. Clinical and laboratory parameters of all subjects were assessed and 24-hour electrocardiographic Holter monitoring were performed to all of them. Results: Minimum, maximum and mean heart rate were significantly higher while mean RR interval were significantly lower in patients with RA when compared with controls. In addition, among time domain HRV parameters, SDNN, SDANN ve triangular index were significantly lower in patients with RA (p<0.05, p<0.01, p<0.01, respectively). In correlation analysis, it was not found a significant association between HRV parameters and age, sex, duration and activity of disease, inflammatory markers, supraventricular or ventricular extrasystole (VES). There were only significant negative associations between VES and pNN50, SDANN and RMSDD. But, there was no independent correlation between these parameters. Conclusion: Non-invasive parameters such as HRV may have a modest role in assessment of cardiovascular risk and prediction of sudden cardiac death risk, in addition to the traditional risk factors, in patients with RA. However, to reach to the more accurate decision, there are need to carry out larger and long term studies which include different patients groups. [ABSTRACT FROM AUTHOR]

Objectives: The early diagnosis of volume overload in chronic kidney disease (CKD) is very important. N-terminal probrain natriuretic peptide (NT-proBNP) is a valuable biomarker for this purpose. Our study aimed to detect the relationship between NT-proBNP and left ventricular hypertrophy (LVH), hypertension (HT), GFR, and proteinuria among diabetic patients with stage 3-4 CKD. Methods: 160 diabetic patients with stage 3-4 CKD [80 patients in stage 3 CKD (group 1) and 80 patients in stage 4 CKD (group 2)] were enrolled. NT-proBNP levels were evaluated in serum, and proteinuria was determined from 24-hour collected urine. Left ventricular hypertrophy was evaluated by M-mode echocardiography. NT-proBNP levels were compared according to their left ventricular hypertrophy, hypertension, and proteinuria levels. Results: NT-proBNP levels was significantly higher, and GFR was lower in group 2 compared to group1 (p < 0.05). NTproBNP was higher in patients with LVH (+) HT (+) and proteinuria = 1gr/d than patients with LVH (-), HT (-), and proteinuria < 1g/d (p < 0.05). We found a significant correlation between NT-proBNP levels and left ventricular posterior wall thickness, diastole (LVPWTd), proteinuria, SBP, and DBP. Proteinuria was the major contributor to increased NTproBNP levels among the independent variables. Conclusion: We detected that NT-proBNP levels are increased during the progression of CKD, and proteinuria is the major cause of increased NT-proBNP levels among the independent variables. [ABSTRACT FROM AUTHOR]

Objectives: The early diagnosis of volume overload in chronic kidney disease (CKD) is very important. N-terminal probrain natriuretic peptide (NT-proBNP) is a valuable biomarker for this purpose. Our study aimed to detect the relationship between NT-proBNP and left ventricular hypertrophy (LVH), hypertension (HT), GFR, and proteinuria among diabetic patients with stage 3-4 CKD. Methods: 160 diabetic patients with stage 3-4 CKD [80 patients in stage 3 CKD (group 1) and 80 patients in stage 4 CKD (group 2)] were enrolled. NT-proBNP levels were evaluated in serum, and proteinuria was determined from 24-hour collected urine. Left ventricular hypertrophy was evaluated by M-mode echocardiography. NT-proBNP levels were compared according to their left ventricular hypertrophy, hypertension, and proteinuria levels. Results: NT-proBNP levels was significantly higher, and GFR was lower in group 2 compared to group1 (p < 0.05). NTproBNP was higher in patients with LVH (+) HT (+) and proteinuria = 1gr/d than patients with LVH (-), HT (-), and proteinuria < 1g/d (p < 0.05). We found a significant correlation between NT-proBNP levels and left ventricular posterior wall thickness, diastole (LVPWTd), proteinuria, SBP, and DBP. Proteinuria was the major contributor to increased NTproBNP levels among the independent variables. Conclusion: We detected that NT-proBNP levels are increased during the progression of CKD, and proteinuria is the major cause of increased NT-proBNP levels among the independent variables. [ABSTRACT FROM AUTHOR]

Objective: Cardiac involvement occurs due to the disease itself and secondary to the used drugs, and commonly develops silent in rheumatoid arthritis (RA). In this study, it was investigated the presence of cardiac involvement by non-invasive electrophysiological parameters Materials and Methods: 49 patients with RA and age-matched 28 healthy subjects as control group were enrolled to this study. Clinical and laboratory parameters of all subjects were assessed and 24-hour electrocardiographic Holter monitoring were performed. Results: Minimum, maximum and mean heart rate were significantly higher (p<0.05, p<0.01, p<0.01, respectively), while maximum QT interval were significantly lower in patients with RA compared to controls (p<0.05). P wave parameters (P maximum, P minimum and P dispersion) were similar both groups. In correlation analysis, there was only significant negative association between erythrocyte sedimentation rate and corrected QT dispersion (r=0.317, p<0.05). However, it was not found any association between P wave and QT parameters and other anyone of clinical or laboratory parameters. Conclusion: There is modest role of non-invasive parameters such as QT dispersion in assessment of cardiovascular risk and prediction of sudden cardiac dead risk in addition to the traditional risk factors in patients with RA. However, prospective, larger and long term studies which include different patient groups are needed to obtain more accurate conclusions. [ABSTRACT FROM AUTHOR]