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In this study, it is aimed to estimate the economic value of the recreation function, as being one of forest functions, based on the example of Camili Biosphere Reserve Area, which is the first and only biosphere reserve area of Turkey. Travel cost method and contingent valuation method were used in the research. A survey was conducted with 96 visitors who performed recreational activities in the area in 2016. Based on travel cost method; the average individual travel cost is estimated as 201.57 TL, the individual consumer surplus is 697.16 TL and the total consumer surplus is 12200300 TL. In contingent valuation method, a theoretical scenario about a project for recreation services was presented to the visitors, and the average and total willingness to pay values were tried to be estimated. The average willingness to pay was estimated as 186.48 TL, and the total willingness to pay as 3263400 TL. As a result, it can be said that people are willing to pay less than they spend. In addition, by increasing the awareness and diversifying the recreational activities of the local people, the number of visitors and the expenditures made by the visitors can be increased, and thus the recreational value can be even higher.

Introduction: Inherited factor VII (FVII) deficiency (FVIID) is the most common of inherited rare bleeding disorders. Other determinants of clinical severity apart from FVII level (FVIIL) include genetic and environmental factors. We aimed to identify the cut-off FVIILs for general and severe bleedings in patients with FVIID by using an online national registry system including clinical, laboratory, and demographic characteristics of patients. Methods: Demographic, clinical, and laboratory data of patients with FVIID extracted from the national database, constituted by the Turkish Society of Hematology, were examined. Bleeding phenotypes, general characteristics, and laboratory features were assessed in terms of FVIILs. Bleeding rates and prophylaxis during special procedures/interventions were also recorded. Results: Data from 197 patients showed that 46.2% of patients had FVIIL< 10%. Most bleeds were of mucosal origin (67.7%), and severe bleeds tended to occur in younger patients (median age: 15 (IQR:6-29)). Cut-off FVIILs for all and severe bleeds were 16.5% and 7.5%, respectively. The major reason for long-term prophylaxis was observed as central nervous system bleeding (80%). Conclusion: Our data are consistent with most of the published literature in terms of cut-off FVIIL for bleeding, as well as reasons for prophylaxis, showing both an increased severity of bleeding and younger age at diagnosis with decreasing FVIIL. However, in order to offer a classification similar to that in Hemophilia A or B, data of a larger cohort with information about environmental and genetic factors are required.

Bu çalışmada Artvin ili örneğinden hareketle, çeşitli kamu kurum ve kuruluşları tarafından sağlanmakta olan ve kırsalda yaşayan insanların doğrudan geçim faaliyet alanları olan tarım ve hayvancılığa yönelik verilen desteklemeler ile yine kırsalda yaşayan insanların sosyoekonomik kalkınmasına yardımcı olmak amacıyla sağlanan desteklemelerin değerlendirilmesi amaçlanmıştır. Bu kapsamda son 10 yıllık dönemde (2012-2021) sağlanan desteklemelerin türü, miktarı ve etki durumları irdelenmeye çalışılmıştır. İl Tarım ve Orman Müdürlüğü ile Orman ve Köy İlişkileri Şube Müdürlüğü bünyesinde çeşitli ekonomik ve sosyal desteklemeler ile Artvin’de yaşayan kırsal nüfusa önemli katkı sağlanmıştır. Hayvancılık desteklemeleri kapsamında yaklaşık 122 milyon TL, tarımsal desteklemeler kapsamında yaklaşık 375 milyon TL ve kırsal yatırım desteklemeleri kapsamında ise 100 milyon TL’den fazla olmak üzere toplamda 598 milyon TL civarında destekleme sağlanmıştır. Diğer taraftan Orman ve Köy İlişkileri Şube Müdürlüğü bünyesinde sosyal maksatlı desteklemelerden 11 milyon TL ve ekonomik maksatlı desteklemelerden 7.7 milyon TL olmak üzere yaklaşık 18.7 milyon TL kaynak sağlanmıştır. Ayrıca Çoruh Nehri Havzası Rehabilitasyon projesi kapsamında ise yaklaşık 17.2 milyon TL tutarında sosyal ve ekonomik maksatlı desteklemede bulunulmuştur. Sürdürülebilir kırsal kalkınmanın sağlanması için verilen tüm desteklemelerin takibi yapılarak, etkinlik ve verimliliğini belirlemek ve desteklemelerin istenilen hedefe ulaşıp ulaşmadığını ortaya koymak gerekmektedir., In this study, it is aimed to evaluate the supports provided by various state institutions and organizations for agriculture and livestock, and the supports provided to help the socio-economic development of people living in rural areas, based on the example of Artvin province. In this context, the type, amount and effects of the supports provided in the last 10 years period (2012-2021) were examined. A significant contribution has been made to the rural population living in Artvin with various supports within the body of the Provincial Directorate of Agriculture and Forestry, and Forestry and Village Relations Branch Directorate. A total of nearly 598 million TL support was provided, of which 122 million TL to livestock supports, 375 million TL to agricultural supports, and more than 100 million TL to rural investment supports. Forest and Village Relations Branch Directorate provided approximately 18.7 million TL, of which 11 million TL to social support and 7.7 million TL to economic support. In addition, within the scope of the Çoruh River Watershed Rehabilitation Project, approximately 17.2 million TL of social and economic support was given. To ensure sustainable rural development, it is necessary to monitor all the supports given, determine their effectiveness and efficiency and reveal whether the supports reach the desired goal.

In countries where the state is the main owner of the forest resources, forestry activities are carried out with allocated shares from government budget resources. In order to ensure effective and efficient use of financial resources and determine whether forestry goals and targets are achieved, it is necessary to perform financial analysis of public forestry institutions. In Turkey, where the state owns majority of forests, the General Directorate of Forestry (GDF) is the main responsible institution for the management of the forestry sector. This study aimed to make financial statement analysis of working capital budget of the GDF, by applying horizontal analysis, vertical analysis, trend analysis and ratio analysis. In this context, balance sheet and income statement of GDF for the period of 2015-2019 are analyzed. It is determined that in the given period, due to increase in “trade receivables”, “other receivables” and “inventories” accounts, total current assets have shown a positive trend. Also there is a steady increase in the equity, which can be considered as a positive development for the GDF. Gross sales and net sales amount doubled in the given period and, by keeping cost of sales and operating expenses under control, net profit of the GDF showed significant increase especially in last three years. Moreover, ratio analysis results revealed that GDF has capacity to satisfy its current and long-term liabilities and increased its profitability in the mentioned period.

Aims: To establish a dataset including demographic features, disease characteristics, and survival rate of follicular lymphoma patients in Trakya Universi- ty School of Medicine and contribute to the database of follicular lymphoma in Turkey. Methods: In this retrospective cross-sectional study, we analyzed data constituting of follicular lymphoma patients over 18 years of age followed during the years of 2015-2020 in Trakya University Division of Hematology. Results: Out of 43 patients, 22 (51.2%) were female and 21 (48.8%) were male. The mean age was 56.56 (standard deviation 13.24) years. There were 5 (11.6%) pa- tients with B symptoms, presence of bone marrow involvement was seen in 17 (39.5%) patients, lastly, there were 18 (41.9%) patients with splenomegaly. Twen- ty-one (48.8%) patients received rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone, making it the most common treatment protocol administered in our study. Conclusion: Follicular lymphoma patients usually end up getting diagnosed at an advanced stage of the disease, presenting with incidentally noticed painless lymphadenopathy. Additionally, based on evidence in the literature, a clear gap in the successful diagnosis of follic- ular lymphoma patients can be observed between developed and developing countries. To overcome this hurdle, enhanced cooperation with hematopathology may lead to an increased awareness enabling physicians to make a more accurate diagnosis. Nonetheless, further studies are still needed to fully apprehend the epidemiology of follicular lymphoma patients in Turkey.

Background Fulfilling diagnostic criteria of hemophagocytic lymphohistiocytosis (HLH) is challenging due to unavailable laboratory tests. Hence, we aimed to reveal malignancy-associated-HLH (M-HLH) patients in our center, which can not be reached in all tests. Material and Methods Nine patients with M-HLH were analyzed retrospectively. Results The median age was 59 years. The distribution of the underlying diseases was like diffuse large B cell lymphoma in 3 patients, acute myeloid leukemia in 2 patients, Hodgkin lymphoma in 2 patients, T cell non-Hodgkin lymphoma in 1 patient, and small cell lung cancer in 1 patient. According to HLH-2004 diagnostic criteria except for soluble CD25 and natural killer activity tests; one patient had 3/6, six patients had 5/6, two patients had 6/6 criteria while the median H-score was 258 at diagnosis. According to Tamamyan et al’s criteria; at the diagnosis, all patients had ≥7 (between 7-12) of 18 parameters. Patients fulfilled ≥5 parameters a median of 15 days (3-52 days) before the diagnosis and on that time six patients had 3/6 criteria of HLH-2004. 88.8% of the patients died. The median duration of survival was 8.5 days (1-18 days). Conclusions Unavailability of the tests in some countries and centers as in ours results in complications to fulfill 5 of 8 criteria and being delayed in diagnosis and treatment. We need to develop more specific and accessible criteria, and grading systems for M-HLH diagnose.

IntroductionHemoglobin/red cell distribution width (RDW) ratio (HRR) and lymphocyte-to-monocyte ratio (LMR) are two novel bio-markers associated with overall survival (OS) and prognosis in several types of cancers. The aim of this study is to investigate the value of HRR and LMR in newly diagnosed multiple myeloma (MM) patients.MethodsA total of 180 patients were included in this study. Patients diagnosed with MM between May 2013 and May 2019 at a single center were evaluated. HRR was calculated by dividing hemoglobin to RDW, both measured from the same sample. LMR was calculated by dividing absolute lymphocyte count (ALC) to absolute monocyte count (AMC).ResultsThe cutoff value for HRR was taken as 0.61, and the cutoff value for LMR was taken as 3.28. Patients were divided into low HRR, high HRR, low LMR, and high LMR groups. OS of the patients with low HRR was found lower compared with high HRR (36.7 months for low HRR and 53.2 months for high HRR, p < 0.001). Also, OS was found lower in the low LMR group (39.4 months for low LMR and 51.7 months for high LMR, p = 0.016). On multivariate analysis, low HRR and low LMR were predictive factors of OS (hazard ratio (HR) 2.08, 95% confidence intervals (CI) 1.31–3.03, and p = 0.002 for low HRR; HR 1.47, 95% CI 0.92–2.29, and p = 0.010 for low LMR).ConclusionCombining both HRR and LMR could be a prognostic biomarker and it reflects the status of the immune system in newly diagnosed MM patients.

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma (NHL) and comprises a heterogeneous group of disease. While classification of B-cell lymphomas has been evolving to include clonality in a specific manner, morphology, and immunohistochemistry remain the backbone. We aimed to evaluate the value of CD5 expression on disease characteristics as well as prognosis in patients with DLBCL. Data of 131 patients with DLBCL with CD5 positivity and as a comparison arm, data of 129 patients with DLBCL without CD5 positivity were evaluated. Mean age was 59 and 55.7% of the patients were male. Overall survival was 29.8 months. Poor prognostic factors including (high-LDH levels, B symptoms, low ECOG score, high R-IPI and NCCN-IPI score) were observed to be significantly related with CD5 positivity. Mean survival in CD5 positive patients were 29.8 months, which is significantly shorter than the general DLBCL survival worldwide. CD5 expression shall be evaluated in all samples of DLBCL patients due to its possible effects on outcomes. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

© 2022 by Turkish Society of Hematology Turkish Journal of Hematology, Published by Galenos Publishing House.Objective: Patients with solid malignancies are more vulnerable to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection than the healthy population. The outcome of SARS-CoV-2 infection in highly immunosuppressed populations, such as in patients with hematological malignancies, is a point of interest. We aimed to analyze the symptoms, complications, intensive care unit admissions, and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. Materials and Methods: In this multicenter study, we included 340 adult and pediatric patients diagnosed with SARS-CoV-2 from March to November 2020. Diagnosis and status of primary disease, treatment schedules for hematological malignancies, time from last treatment, life expectancy related to the hematological disease, and comorbidities were recorded, together with data regarding symptoms, treatment, and outcome of SARS-CoV-2 infection. Results: Forty four patients were asymptomatic at diagnosis of SARS-CoV-2 infection. Among symptomatic patients, fever, cough, and dyspnea were observed in 62.6%, 48.8%, and 41.8%, respectively. Sixty-nine (20%) patients had mild SARS-CoV-2 disease, whereas moderate, severe, and critical disease was reported in 101 (29%), 71 (20%), and 55 (16%) patients, respectively. Of the entire cohort, 251 (73.8%) patients were hospitalized for SARS-CoV-2. Mortality related to SARS-CoV-2 infection was 26.5% in the entire cohort; this comprised 4.4% of those patients with mild disease, 12.4% of those with moderate disease, and 83% of those with severe or critical disease. Active hematological disease, lower life expectancy related to primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission, and first-line therapy used for coronavirus disease-2019 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azithromycin were associated with a higher rate of mortality in comparison to favipiravir use. Conclusion: Patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality.

Patients with solid malignancies are more vulnerable to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection than the healthy population. The outcome of SARS-CoV-2 infection in highly immunosuppressed populations, such as in patients with hematological malignancies, is a point of interest. We aimed to analyze the symptoms, complications, intensive care unit admissions, and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey.In this multicenter study, we included 340 adult and pediatric patients diagnosed with SARS-CoV-2 from March to November 2020. Diagnosis and status of primary disease, treatment schedules for hematological malignancies, time from last treatment, life expectancy related to the hematological disease, and comorbidities were recorded, together with data regarding symptoms, treatment, and outcome of SARS-CoV-2 infection.Forty four patients were asymptomatic at diagnosis of SARS-CoV- 2 infection. Among symptomatic patients, fever, cough, and dyspnea were observed in 62.6%, 48.8%, and 41.8%, respectively. Sixty-nine (20%) patients had mild SARS-CoV-2 disease, whereas moderate, severe, and critical disease was reported in 101 (29%), 71 (20%), and 55 (16%) patients, respectively. Of the entire cohort, 251 (73.8%) patients were hospitalized for SARS-CoV-2. Mortality related to SARS-CoV-2 infection was 26.5% in the entire cohort; this comprised 4.4% of those patients with mild disease, 12.4% of those with moderate disease, and 83% of those with severe or critical disease. Active hematological disease, lower life expectancy related to primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission, and first-line therapy used for coronavirus disease-2019 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azithromycin were associated with a higher rate of mortality in comparison to favipiravir use.Patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality.Solid malignite hastalarının şiddetli akut solunum yolu enfeksiyonu-koronavirüs-2 (SARS-CoV-2) enfeksiyonuna sağlıklı bireylerden daha yatkın oldukları gösterilmiştir. Bu verilerin ardından oldukça yoğun immünosupresif olan hematolojik malignite hastalarında SARS-CoV-2 infeksiyonu sonuçları ilgi konusu olmuştur. Biz de bu makalede Türkiye’de hematolojik malignite tanısı ile takip ve tedavi edilirken SARS-CoV-2 enfeksiyonu saptanan hastaların semptom, komplikasyon, yoğun bakım ünitesine yatış ve mortalite oranlarını değerlendirmeyi amaçladık.Çok merkezli çalışmamıza Mart-Kasım 2020 tarihleri arasında SARS-CoV-2 enfeksiyonu tanısı alan erişkin ve pediatrik 340 hastayı dahil ettik. Hastaların hematolojik malignite tanıları, hastalık statusları, tedavileri, son tedaviden enfeksiyona kadar geçen süre, komorbiditeleri, yaşam beklentileri değerlendirildi. Semptomları, oluşan komplikasyonlar ve sonuçlar analiz edildi.Kırk-dört hasta semptomsuz olarak enfeksiyonu geçirirken, semptomatik hastaların ateş, öksürük, ve dispne oranları sırasıyla %62,6, %48,8 ve %41,8 idi. Altmış altı hasta (%20) hastalığı hafif geçirirken, orta, ciddi ve kritik hastalık tanısı alanların oranı sırasıyla %29, %20 ve %16 idi. Tüm kohortta ölüm oranı %26,6 idi; ölüm hafif hastalığı olanlarda %4,4 , orta derece hastalık geçirenlerde %12 ve ciddi/kritik hastalık geçirenlerde ise %83 olarak saptandı. Aktif hematolojik hastalık olması, primer hematolojik hastalığa bağlı düşük hayat beklentisi, SARS-CoV-2 tanısı aldığında nötropenik olmak, yoğun bakıma alınmış olmak ve ilk sıra koronavirüs hastalığı-2019 tedavisi yüksek ölüm riski ile ilişkilendirilen faktörlerdendi. Tek başına veya azitromisin ile kombine olarak hidroksiklorokin kullanan hastaların sadece favipiravir kullananlara göre ölüm riskleri daha yüksek saptandı.SARS-CoV-2 infeksiyonu geçiren hematolojik malignite hastalarında daha yüksek oranda ciddi hastalık ve ölüm riski gözlenmektedir.

Introduction: Hematological malignancies are frequently affecting the gastrointestinal (GI) tract, either by secondary extra nodal or extramedullary extension to the GI tract, or as a primary process arising in the GI tract. Gastrointestinal non-Hodgkin lymphomas (gNHL) appear less than other solid organ tumours in the GI tract. Therefore, in the absence of nodal or extra nodal involvement in imaging methods, there may be difficulties in diagnosis. Haematologists provide more important support by pathologists in terms of diagnosis than imaging methods.Methods: We retrospectively investigated all B-cell lymphoma patients diagnosed in our clinic between 01.01.2015- 01.01.2021. After that, patients not diagnosed by gastrointestinal system sampling were excluded from the study. Demographic data of these patients were obtained from the hospital information system and outpatient clinic files. Slides of these patients were obtained from pathology archive and re-evaluated under light microscope by two pathologists. All cases were diagnosed according to revised World Health Organization (WHO) 2017 classification.Results: 55 patients were diagnosed with B-cell lymphoma by sampling by endoscopy or colonoscopy. 40 of the patients were diagnosed with Diffuse Large B Cell Lymphoma (DLBCL), 10 with Marginal Zone Lymphoma (MZL), 2 with Mantle Cell Lymphoma (MCL), 2 patients with Burkitt Lymphoma (BL) and 1 patient with Lymphoplasmacytic Lymphoma (LPL).Conclusion: Like the literature, the frequency of DLBCL was the highest in patients diagnosed with GI tract in our study. The second most common B-cell lymphoma was MALToma. Although MCL is with a high frequency of GI involvement, there were few patients diagnosed with GI involvement. The reason for this was that the patients were diagnosed with nodal involvement rather than GI sampling.

Background: Diffuse large B-cell lymphoma (DLBCL) is the most common sub-type of Non-Hodgkin lymphomas (NHL) and it is a very heterogeneous group of diseases. CD5 positivity is profound in a substantial patient population in DLBCL. In this population, female patient distribution is higher, LDH elevation, extra nodal involvement, bone marrow involvement, ECOG (Eastern Cooperative Oncology Group) performance score elevation and high international prognostic score (IPI> 2) are more frequent for CD5 - DLBCL. Also, it was observed that prognosis of CD5 + DLBCL was worse than CD5 - DLBCL. We aimed to determine the frequency of CD5 positivity in DLBCL in Turkey with this multicenter study.Methods: The study, in order to get the overall parts from Turkey, including from each geographical area, 16 center and 9 cities were included. Each center retrospectively scanned the diagnostic pathology reports of DLBCL patients between January 2015-2021.Results: Two thousand four hundred sixty-nine DLBCL patients were screened retrospectively. CD5 positivity was detected in 169 patients (6.84%). The average age was 59 and 55.7% of the patients were male. Overall survival was 29.8 months. When evaluated with historical data in this group of patients, poor prognostic factors were found to be more common than CD5 - DLBCL patients.Conclusion: Due to its prognostic effect, immunohistochemically, the presence of CD5 in pathological samples of all DLBCL patients should be checked. The effect on prognosis in this patient group should not be forgotten while treatment and follow-up.

Objective: Patients with solid malignancies are more vulnerable to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection than the healthy population. The outcome of SARS-CoV-2 infection in highly immunosuppressed populations, such as in patients with hematological malignancies, is a point of interest. We aimed to analyze the symptoms, complications, intensive care unit admissions, and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. Materials and Methods: In this multicenter study, we included 340 adult and pediatric patients diagnosed with SARS-CoV-2 from March to November 2020. Diagnosis and status of primary disease, treatment schedules for hematological malignancies, time from last treatment, life expectancy related to the hematological disease, and comorbidities were recorded, together with data regarding symptoms, treatment, and outcome of SARS-CoV-2 infection. Results: Forty four patients were asymptomatic at diagnosis of SARS CoV-2 infection. Among symptomatic patients, fever, cough, and dyspnea were observed in 62.6%, 48.8%, and 41.8%, respectively. Sixty nine (20%) patients had mild SARS-CoV-2 disease, whereas moderate, severe, and critical disease was reported in 101 (29%), 71 (20%), and 55 (16%) patients, respectively. Of the entire cohort, 251 (73.8%) patients were hospitalized for SARS-CoV-2. Mortality related to SARS-CoV-2 infection was 26.5% in the entire cohort; this comprised 4.4% of those patients with mild disease, 12.4% of those with moderate disease, and 83% of those with severe or critical disease. Active hematological disease, lower life expectancy related to primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission, and first-line therapy used for coronavirus disease-2019 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azithromycin were associated with a higher rate of mortality in comparison to favipiravir use. Conclusion: Patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality.