66 results on '"Süheyl Asma"'
Search Results
2. Septorhinoplasty in sickle cell anemia: a case report
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Can Alper Çağıcı, Süheyl Asma, and Mesut Şener
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Otorhinolaryngology ,RF1-547 - Published
- 2020
- Full Text
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3. Effectiveness of Visual Methods in Information Procedures for Stem Cell Recipients and Donors
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Çağla Sarıtürk, Çiğdem Gereklioğlu, Aslı Korur, Süheyl Asma, Mahmut Yeral, Soner Solmaz, Nurhilal Büyükkurt, Songül Tepebaşı, İlknur Kozanoğlu, Can Boğa, and Hakan Özdoğu
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hematopoietic stem cell ,donor ,informed consent ,audiovisual method ,bone marrow transplantation ,Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Objective: Obtaining informed consent from hematopoietic stem cell recipients and donors is a critical step in the transplantation process. Anxiety may affect their understanding of the provided information. However, use of audiovisual methods may facilitate understanding. In this prospective randomized study, we investigated the effectiveness of using an audiovisual method of providing information to patients and donors in combination with the standard model. Materials and Methods: A 10-min informational animation was prepared for this purpose. In total, 82 participants were randomly assigned to two groups: group 1 received the additional audiovisual information and group 2 received standard information. A 20-item questionnaire was administered to participants at the end of the informational session. Results: A reliability test and factor analysis showed that the questionnaire was reliable and valid. For all participants, the mean overall satisfaction score was 184.8+-19.8 (maximum possible score of 200). However, for satisfaction with information about written informed consent, group 1 scored significantly higher than group 2 (p=0.039). Satisfaction level was not affected by age, education level, or differences between the physicians conducting the informative session. Conclusion: This study shows that using audiovisual tools may contribute to a better understanding of the informed consent procedure and potential risks of stem cell transplantation.
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- 2017
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4. A rare hematological complication of visceral leishmaniasis: hemophagocytic syndrome
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Can Boğa, İlknur Kozanoğlu, Soner Solmaz, Süheyl Asma, Tuba Turunç, and Yusuf Demiroğlu
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Medicine (General) ,R5-920 - Abstract
The term “hemophagocytosis” describes the pathologic finding of activated macrophages, engulfing erythrocytes, leukocytes, platelets and their precursor cells. This phenomenon is an important finding in patients with hemophagocytic syndrome. It is a distinct clinical entity characterized by fever, pancytopenia, splenomegaly and hemophagocytosis in bone marrow, liver and lymph nodes. Hemophagocytic syndrome can be classified according to the underlying etiology into either primary (genetic) or secondary (acquired). Severe infections, malignancies, rheumatologic disorders and some metabolic diseases can lead to secondary hemophagocytic syndrome. Infection-associated hemophagocytic syndrome implicating Leishmania is very rare and often difficult to diagnose. Therefore, we aimed to report a young boy with Visceral Leishmaniasis associated hemophagocytic syndrome.
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- 2016
5. Implementation of an ISBT 128-Compatible Medical Record System to Facilitate Traceability of Stem Cell Products
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Can Boğa, Erkan Maytalman, Çiğdem Gereklioğlu, Süheyl Asma, Fatih Kandemir, Pelin Aytan, Aslı Korur, Mahmut Yeral, İlknur Kozanoğlu, and Hakan Özdoğu
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hematopoietic stem and progenitor cells ,stem cell mobilization ,apheresis ,isbt 128 ,traceability ,Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2017
- Full Text
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6. Intracranial Involvement Of Multiple Myeloma
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Özlem Alkan, Ebru Kızılkılıç, Tülin Yıldırım, Mutlu Kasar, Osman Kızılkılıç, Mahmut Yeral, Süheyl Asma, Semih Giray, and Hakan Özdoğu
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multiple myeloma ,central nervous system involvement ,MR ,Medicine ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
OBJECTIVE: Multiple myeloma is usually restricted to the bone marrow. Central nervous system involvement is uncommon and can be observed in approximately 1% of the multiple myeloma patients. OBJECTIVES: We aimed to demonstrate brain magnetic resonance patterns in patients with multiple myeloma with neurologic symptoms and the literature is reviewed. METHODS: We retrospectively studied 39 patients with multiple myeloma with neurologic symptoms. All the patients underwent classic and contrast enhanced brain MR examination. RESULTS: Patients presented with the following symptoms: impaired consciousness (n=8, 20.5%), headache (n=6, 15.3%), hemiparesis (n=2, 5.1%), aphasia (n=6, 15.3%), scalp swelling (n=2, 5.1%), visual loss (n=1, 2.5%), seizure (n=2, 5.1%), vertigo (n=4, 10.2%), ophthalmoplegia (n=4, 10.2%), meningeal irritation findings (n=2, 5.1%), and orientation disorder (n=2, 5.1%). Among 39 patients with multiple myeloma, 14 (35.8%) had ischemic lesions, 14 (35.8%) had calvarial diploic metastases, 5 (12.8%) had dura mater mass, 4 (10.2%) had dura mater involvement, 2 (5.1%) had sinonasal mass, 1 had cavernous sinus and orbital apex mass, 1 (2.5%) had leptomeningeal involvement, 1 (2.5%) had intraorbital mass, 3 (7.6%) had clivus mass, 1 (2.5%) had optic neuritis, 1 (2.5%) had central pontine myelinolysis and 2 (5.1%) had meningitis. Examination of the cerebrospinal fluid was performed in 6 patients. Cerebrospinal fluid studies showed malignant plasma cells in 1 patient with leptomeningeal contrast enhancement. Despite serial cerebrospinal fluid examination, plasma cells in cerebrospinal fluid were not showed in 2 patients with dura mater involvement. Two patients had menengitis. CONCLUSION: Involvement of the central nervous system in multiple myeloma is very uncommon. The occurrence of neurological symptoms in a patient with myeloma requires an accurate evaluation with MR and lumbar puncture to detect a possible meningeal or cerebral involvement, when metabolic factors (hypercalcemia,drug toxicity, uremia), hyperviscosity, or medullary compression can be excluded
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- 2008
7. Eritema Ab Igne Olgusu
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Süheyl ASMA
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General Medicine - Abstract
Eritema ab igne (EAI) “kızarmış cilt sendromu”, “ephelis ab igne ”, ve “ephelis ignealis” olarak da adlandırılan bir retiküler eritematöz pigmentli dermatozdur. Kızılötesi radyasyona tekrarlayan ve uzun süreli maruz kalmaya bağlı olarak gelişir. Genellikle iyi seyirli olan bu cilt lezyonlarının aile hekimleri tarafından erken tanınması ve önlenmesi önemlidir. Bu olgu sunumunda, elektrik sobası kullanımına bağlı göğüs ön duvarında, her iki kol ve bacakta yaygın eritema ab igne gelişen bir hastayı sunmayı amaçladık.
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- 2023
8. Sickle Cell Leg Ulcer Extending to the Achilles Tendon
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Süheyl Asma, Bircan Boğa, and Murat Kaçmaz
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Hematology - Published
- 2022
9. Factors Associated With Overall Survival in Acute Myeloid Leukemia Patients Before and After Hematopoietic Stem Cell Transplant
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Çiğdem Gereklioğlu, Nur Hilal Buyukkurt, Can Boga, Aslı Korur, Hakan Ozdogu, Mahmut Yeral, Ilknur Kozanoglu, Süheyl Asma, Mutlu Kasar, and Pelin Aytan
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Oncology ,medicine.medical_specialty ,Neoplasm, Residual ,Graft vs Host Disease ,Disease ,030230 surgery ,Donor lymphocyte infusion ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Internal medicine ,medicine ,Overall survival ,Humans ,Retrospective Studies ,Transplantation ,business.industry ,Hematopoietic Stem Cell Transplantation ,Myeloid leukemia ,Hematopoietic stem cell ,Minimal residual disease ,Leukemia, Myeloid, Acute ,Treatment Outcome ,medicine.anatomical_structure ,Supportive psychotherapy ,Chronic Disease ,030211 gastroenterology & hepatology ,Stem cell ,business - Abstract
OBJECTIVES Our aim was to identify factors associated with overall survival and the efficacy of postrelapse treatment protocols and to determine whether pretransplant consolidation therapy and minimal residual disease status pose a survival benefit. MATERIALS AND METHODS Patients with acute myeloid leukemia who underwent stem cell transplant between 2007 and 2018 were enrolled retrospectively. The effects of pretransplant cytogenetic and minimal residual disease status, pretransplant consolidation therapies, development of graft-versus-host disease, postrelapse treatment protocols, and type of con-ditioning regimens on overall survival were analyzed. RESULTS In 76 study patients, the cumulative overall 1- and 5-year relapse probabilities were 67.8% and 58.7%, respectively. Overall survival rates at 3 and 5 years in patients with and without relapse were 23.5% and 0% and 95.9% and 91.1% (P < .001), respectively. Although mean postrelapse overall survival was better with intensive salvage plus donor lymphocyte infusion, no significant differences were shown versus other therapies (intensive salvage, nonintensive salvage, intensive salvage or nonintensive salvage plus donor lymphocyte infusion, or supportive therapy). Twenty-three patients (30.3%) died during the study period with a median survival of 9.6 months. Patients with favorable, intermediate, and unfavorable cytogenetic status showed overall survival of 46.6 ± 10.4, 54.6 ± 4.4, and 36.9 ± 5.9 months (P = .807). Patients with and without minimal residual disease and patients who received or did not receive consolidation therapy had similar overall survival. Relapse was an independent predictor of overall survival (increased mortality risk of 26.22). Patients who developed graft-versus-host disease showed decreased relapse. CONCLUSIONS Relapse is the most important predictor of overall survival and is associated with poor prognosis. Pretransplant minimal residual status and cytogenetic status showed no effect on relapse rates and overall survival, and consolidation therapy did not improve outcomes.
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- 2021
10. Role of prophylactic and therapeutic red blood cell exchange in pregnancy with sickle cell disease: Maternal and perinatal outcomes
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Can Boga, Ilknur Kozanoglu, Aslı Korur, Gülşen Doğan Durdağ, Songül Alemdaroğlu, Şafak Yılmaz Baran, Hakan Kalaycı, Süheyl Asma, and Esra Bulgan Kilicdag
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Adult ,medicine.medical_specialty ,Cell ,Anemia, Sickle Cell ,Disease ,030204 cardiovascular system & hematology ,Preeclampsia ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,medicine ,Humans ,Retrospective Studies ,Fetus ,Obstetrics ,business.industry ,Incidence (epidemiology) ,Pregnancy Complications, Hematologic ,Pregnancy Outcome ,Genetic disorder ,Hematology ,General Medicine ,medicine.disease ,Red blood cell ,Cross-Sectional Studies ,medicine.anatomical_structure ,Female ,Erythrocyte Transfusion ,business ,030215 immunology - Abstract
Background and aim The incidence of fetomaternal complications during pregnancy is high for women with sickle cell disease (SCD), which is the most common hematologic genetic disorder worldwide. Prophylactic red blood cell exchange (pRBCX) has been shown to be efficient, safe, and feasible for preventing complications. The aim of this study was to observe maternal, perinatal, and neonatal outcomes of pregnancies in which pRBCX was. Method This was a single-center, retrospective, cross-sectional study, which recruited 46 consecutive adult pregnant women with SCD between January 2012 and June 2019. Obstetric features, SCD-related complications, and fetomaternal outcomes were compared between the 27 patients who received prophylactic exchange and the 19 who did not (therapeutic exchange was performed in 7 and was not performed in 12 cases). Results Painful crises, preeclampsia, and preterm birth rates were significantly higher in the group that did not receive prophylactic exchange (control group; P = .001, P = .024, and P = .027, respectively). There was one maternal mortality in the control group (P = .41). Incidence of adverse fetal or maternal complications was significantly higher in the control group (P = .044 and P = .007, respectively). Conclusions Our center's experience over a 7.5-year period, as described above, demonstrates that pRBCX in SCD affects the course of pregnancy positively by ameliorating negative fetomaternal outcomes.
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- 2020
11. The clinicopathologic features of multiple primary malignancies in hematology: A cross sectional descriptive study
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Mahmut Yeral, Nurhilal Büyükkurt, Can Boga, Aslı Korur, Hakan Ozdogu, Süheyl Asma, Ilknur Kozanoglu, Pelin Aytan, Mutlu Kasar, and Çiğdem Gereklioğlu
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Oncology ,medicine.medical_specialty ,lcsh:R5-920 ,Hematology ,business.industry ,medicine.medical_treatment ,metachronous malignancy ,lcsh:R ,lcsh:Medicine ,Retrospective cohort study ,medicine.disease ,Chemotherapy regimen ,Lymphoma ,Radiation therapy ,Thyroid carcinoma ,Internal medicine ,Concomitant ,medicine ,Carcinoma ,hematologic malignancy ,multiple primary malignancy ,synchronous malignancy ,business ,lcsh:Medicine (General) - Abstract
In Turkish literature there are very few studies regarding multiple primary malignancies (MPM). The aim of this study was to analyze the synchronous and the metachronous malignancies that occurred with a hematologic malignancy. All the patients with a hematologic malignancy were enrolled in this cross-sectional, definitive retrospective study. Data were obtained from the medial records. Patients characteristics including demographic features, treatment protocols and overall survival (OS) were recorded. Among 663 patients with a hematologic malignancy, there were 26 patients with MPMs (3.9%). Synchronous malignancies constitute 0.9% and metachronous malignancies were present in 3%. In men diffuse large B-cell lymphoma (DLBCL) and non-small cell lung carcinoma (NSCLC) and in women breast and acute myeloid leukemia were the most common primary and secondary MPMs respectively. The mean cumulative OS of all patients with MPMs was 246.3±33.4 months and the 5 years-OS was 91.3%. In synchronous MPMs the most frequent concomitant tumors were DLBCL and NSCLC. In metachronous tumors the median time interval between first and second malignancies was 69.5 months (range: 31-312). In four patients there were three MPMs. After radiotherapy three patients developed breast, thyroid and skin cancers and in one patient who received radioiodine for the treatment of thyroid carcinoma, DLBCL had developed. The chemotherapeutic agents applied for the primary malignancies consisted of alkylating agents, antimetabolites, anthracyclines, topoisomerase II inhibitors, monoclonal antibodies and mitotic inhibitors. In 75% of the patients with DLBCL who had received R-CHOP chemotherapy regimen, NSCLC had developed during the follow-up period. In conclusion secondary malignancies with hematologic malignancies are not rare and the clinicians should keep the possibility of secondary malignancies in mind and be suspicious during diagnostic evaluations. Warning with regard to the risk of development of secondary malignancies due to the primary treatment should be given to any patient with a hematologic malignancy. [Med-Science 2020; 9(1.000): 94-9]
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- 2020
12. Is It Possible to be a Stem Cell Donor for the Second Time: A Single-Center Report of 12 Consecutive Procedures
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Can Boga, Süheyl Asma, Hakan Ozdogu, Cem Kis, Mahmut Yeral, Nurhilal Büyükkurt, Ilknur Kozanoglu, and Hacer Ucmak
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Transplantation ,medicine.medical_specialty ,business.industry ,Lymphocyte ,Bone Marrow Stem Cell ,Single Center ,Cell therapy ,medicine.anatomical_structure ,Donation ,Internal medicine ,Stem cell donor ,Medicine ,Bone marrow ,Stem cell ,business - Abstract
Objectives The use of unrelated donors as a source of stem cells for patients with blood disorders continues to increase. Approximately 5% to 7% of unrelated stem cell donors are asked to donate stem cells a subsequent time to the same or a different patient. We investigated donors who accepted to be a donor for the second time between 2015 and 2021; donors were evaluated in terms of procedure-related complications, product quality, and donor follow-up in a JACIEaccredited (Joint Accreditation Committee of the International Society for Cellular Therapy and European Society for Blood and Marrow Transplantation). Materials and methods Stem cell collections were performed in accordance with relevant standard operating procedures from healthy volunteer donors. Data on sequence of peripheral blood stem cell, bone marrow, and donor lymphocyte collection procedures; presence of complications during procedures; time between 2 donations; need for granulocyte colonystimulating factor again; and first and second donation types were noted. Data on donor and stem cell products were determined using the hospital information management system. Results Our study included 12 donors (9 men and 3 women) who donated a second time within the specified date range. In the evaluation of the second donation types, 7 were lymphocyte collection donations, 4 were peripheral blood stem cell donations, and 1 was a bone marrow stem cell donation. In shortterm and long-term follow-ups, there were no complications among the donors. In the second donations, targeted product values were reached. Conclusions Although it is safe to have a second donation from a donor for the same patient, collection centers may collect more products than requested from eligible donors.
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- 2021
13. A Novel Parameter for Predicting Therapeutic Response in Iron Deficiency Anemia: Red Blood Cell Distribution Width
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Süheyl Asma, Didar Yanardag Acik, Aslı Korur, Hakan Ozdogu, Çiğdem Gereklioğlu, and Soner Solmaz
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03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,Endocrinology ,Iron-deficiency anemia ,business.industry ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Red blood cell distribution width ,030204 cardiovascular system & hematology ,medicine.disease ,business - Abstract
Aim: Anemia is a public health problem worldwide. Cost effectiveness and efficient use of resources are vitally important. Red blood cell distribution width, which can be obtained from a standard complete blood count, is a measure of the variability in size of circulating erythrocytes. The present study was performed to investigate whether red blood cell distribution width can be used to predict response to iron therapy. Methods: This study was conducted in 50 patients admitted to hematology and family medicine clinics. Complete blood count and reticulocyte count were determined on day 5; complete blood count was examined 1 month after commencement of therapy. Results: Statistically significant differences were detected between hemoglobin levels and red blood cell distribution width values at the time of diagnosis and on day 5 and after 1 month of therapy. A significant positive correlation was found between the increase in red blood cell distribution width and the increase in hemoglobin. Conclusion: Red blood cell distribution width may be used in place of reticulocyte count to predict response to iron therapy. Red blood cell distribution width is the best biomarker for this purpose as a component of complete blood count, and therefore it may be accepted as superior to reticulocyte count.
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- 2019
14. The Impact of the Ferric Carboxymaltose on Hemoglobin and Ferritin Levels
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Can Boga, Hakan Ozdogu, Mahmut Yeral, Nurhilal Büyükkurt, Pelin Aytan, Süheyl Asma, Funda Pepedil Tanrikulu, Çiğdem Gereklioğlu, Soner Solmaz, Aslı Korur, and Mutlu Kasar
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medicine.medical_specialty ,biology ,Anemia, Iron-Deficiency ,business.industry ,Transferrin saturation ,Anemia ,Ferritin levels ,Iron deficiency ,medicine.disease ,Gastroenterology ,Ferric Compounds ,General Biochemistry, Genetics and Molecular Biology ,FERRIC CARBOXYMALTOSE ,Ferritin ,Hemoglobins ,Iron-deficiency anemia ,Internal medicine ,Ferritins ,medicine ,biology.protein ,Humans ,Hemoglobin ,business ,Maltose - Abstract
Background Anemia is a frequent disorder worldwide. Iron deficiency anemia (IDA) is the most common form of anemia. Although oral iron is the first choice for treatment, the efficacy of oral iron preparations may be limited. Ferric carboxymaltose (FCM) is a novel parenteral iron preparation which can rapidly replenish iron stores. The aim of the present study is to investigate the impact of FCM dose on hemoglobin (Hb) and ferritin levels and the frequency of hypersensitivity reactions. Methods This study was conducted with 765 IDA patients between September 1, 2016 and September 1, 2018. He-moglobin (Hb), serum ferritin, transferrin saturation values were examined at the time of diagnosis, Hb and ferritin values at first month. Results Post-treatment Hb and ferritin levels significantly increased. The mean Hb level alteration was 2.43 ± 1.2 g/dL, the median ferritin level alteration was 157.3 ng/mL. The mean Hb level was lower and the mean change in Hb level was higher in higher doses. Allergic reactions were more frequent in higher doses. Conclusions Ferric carboxymaltose is a novel treatment option with a low risk of hypersensitivity reactions and well tolerated even in high doses.
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- 2020
15. The Clinicopathologic Features and the Factors Associated with the Survival in Light -Chain Amyloidosis Patients: A Single Center Descriptive Study
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Mahmut Yeral, Nurhilal Büyükkurt, Can Boga, Pelin Aytan, Hakan Ozdogu, Süheyl Asma, Aslı Korur, Mutlu Kasar, Çiğdem Gereklioğlu, and Ilknur Kozanoglu
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medicine.medical_specialty ,business.industry ,Internal medicine ,Amyloidosis ,Medicine ,General Medicine ,Descriptive research ,Single Center ,Immunoglobulin light chain ,business ,medicine.disease - Published
- 2020
16. Effects of two doses of anti-T lymphocyte globulin-Fresenius given after full-match sibling stem cell transplantation in acute myeloblastic leukemia patients who underwent myeloablative fludarabine/busulfan conditioning
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Can Boga, Mahmut Yeral, Hakan Ozdogu, Erkan Maytalman, Cagla Sariturk, Ilknur Kozanoglu, Çiğdem Gereklioğlu, Süheyl Asma, and Pelin Aytan
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Male ,Transplantation Conditioning ,Graft vs Host Disease ,Acute myeloblastic leukemia ,Graft-versus-host disease ,Gastroenterology ,0302 clinical medicine ,Hematology ,General Medicine ,lcsh:Diseases of the blood and blood-forming organs ,Middle Aged ,Allografts ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Tissue Donors ,Fludarabine ,Survival Rate ,Leukemia, Myeloid, Acute ,Oncology ,030220 oncology & carcinogenesis ,Female ,Vidarabine ,medicine.drug ,Adult ,medicine.medical_specialty ,lcsh:RC254-282 ,Disease-Free Survival ,03 medical and health sciences ,Internal medicine ,Anti-T lymphocyte globulin ,medicine ,Humans ,Busulfan ,Survival rate ,Antilymphocyte Serum ,Retrospective Studies ,Thymoglobulin ,business.industry ,lcsh:RC633-647.5 ,Siblings ,medicine.disease ,Allogeneic stem cell transplantation ,Peripheral stem cell transplantation ,Transplantation ,Antithymocyte globulin ,business ,Stem Cell Transplantation ,030215 immunology - Abstract
Objective/background: Anti-T lymphocyte globulin Fresenius (rATG-F; ATG-Fresenius) and antithymocyte globulin (thymoglobulin), which are included in transplant protocols, are used to reduce the risk of chronic graft-versus-host disease (cGVHD) or suppress allograft rejection. Available clinical studies have been conducted in heterogenous patient populations and with different administration protocols including stem cell sources. Additionally, the pharmacokinetics of ATG is variable, and the clinically effective dose of rATG-F, in particular, is not exactly known. The aim of the study was to investigate the clinical outcomes of acute myeloid leukemia (AML) patients who underwent hemopoietic peripheral stem cell transplantation from full-matched sibling donors and given two different doses of r-ATG-F. Methods: This was a single-center, retrospective chart review conducted between July 2005 and July 2016. Sixty-nine consecutive AML patients who underwent transplant with fludarabine- and busulfan-based conditioning were included in the study. Patients in Group 1 received 15 mg/kg body weight rATG-F to 2013 (n = 46), and Group 2 received 30 mg/kg of rATG-F dose begining in 2013 to reduce to cGVHD (n = 23). Cyclosporine and methotrexate were used to treat acute GVHD (aGVHD) prophylaxis. Outcome parameters were compared between the groups. Results: Although the recommended dose r-ATG-F had led to a decrease in the cumulative incidence of cGVHD (27 [58.7%] vs. 8 [34.8%]; p = .03), it also increased the infection rate at 1 year (3 [6.5%] vs. 4 [17.4%]; p = .02). The two groups were similar in terms of engraftment time, aGVHD, relapse, nonrelapse mortality, and rATG-F-related toxicity. A Cox regression model revealed that aGVHD III–IV was associated with increased nonrelapse mortality at 1 year (hazard ratio = 18.2; 95% confidence interval, 1.667–199.255; p =
- Published
- 2018
17. Allogenic peripheral stem cell transplantation from HLA-matched related donors for adult sickle cell disease: remarkable outcomes from a single-center trial
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Çiğdem Gereklioğlu, Cagla Sariturk, Mahmut Yeral, Can Boga, Pelin Aytan, Nurhilal Büyükkurt, Soner Solmaz, Aslı Korur, Hakan Ozdogu, Ilknur Kozanoglu, Süheyl Asma, and Mutlu Kasar
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Adult ,Male ,medicine.medical_specialty ,Anemia, Sickle Cell ,Single Center ,Gastroenterology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Transplantation, Homologous ,Medicine ,Retrospective Studies ,Peripheral Blood Stem Cell Transplantation ,Transplantation ,business.industry ,Hematology ,Middle Aged ,Total body irradiation ,medicine.disease ,Tissue Donors ,Fludarabine ,Peripheral stem cell transplantation ,surgical procedures, operative ,Graft-versus-host disease ,030220 oncology & carcinogenesis ,Female ,Stem cell ,business ,Busulfan ,030215 immunology ,medicine.drug - Abstract
Adult patients with sickle cell disease (SCD) are highly susceptible to stem cell transplant complications, including drug toxicity, graft versus host disease (GVHD), and graft rejection due to SCD-related tissue damage, endothelial activation, and inflammation. The scarcity of compatible stem cells for transplantation further limits treatment options, with only 43 cases of adult allogeneic peripheral blood stem cell transplantation (allo-PSCT) from human leukocyte antigen (HLA)-identical sibling donors reported in the international registry for the period 1986-2013. Herein we report remarkable outcomes in a cohort of adult SCD patients who underwent allo-PSCT using a fludarabine (Flu), busulfan (Bu), and anti-T-cell lymphocyte globulin (ATG)-based conditioning regimen in combination with very low dose total body irradiation (TBI), followed by post-transplant cyclophosphamide (Cy) and sirolimus as GVHD prophylaxis. We performed a single-center, retrospective study consisting of 20 consecutive patients (mean age 33.4 years) who underwent allo-PSCT from HLA-matched related donors with a conditioning regimen of Flu 150/Bu 3.2/Cy 29/ATG 30 (Fresenius)/TBI 200 between September 2013 and September 2017. Data were validated by an independent data audit group of the affiliated JACIE-accredited transplantation center. All patients experienced a sustained donor cell engraftment. Full donor chimerism (total cell) occurred within 180 days in all patients. Mean duration of follow-up was 13.8 months (range: 0.3-50 months), with 12 (60%) patients completing 12 months. No non-relapse mortality or graft rejection occurred. Successful treatment was achieved without the presence of graft loss, grade III-IV acute GVHD, extensive chronic GVHD, or other major complications. Allo-PSCT in combination with Flu 150/Bu 3.2/Cy 29/ATG 30(Fresenius)/TBI 200- Cy/Sirolimus therapy yielded encouraging outcomes with no mortality and low incidence of GVHD. Further controlled studies will be necessary to compare transplant protocols and long-term outcomes.
- Published
- 2018
18. Problems With Unrelated Donors For Stem Cell Transplant and Proposed Solutions: A Single-Center Experience
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Songul Tepebasi, Medine Has Cuhadar, Mahmut Yeral, Ilknur Kozanoglu, Can Boga, Süheyl Asma, Sevtap Atar, Murat Ozturk, and Hakan Ozdogu
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Transplantation ,Text mining ,business.industry ,MEDLINE ,Medicine ,Stem cell ,Single Center ,business ,Bioinformatics - Published
- 2020
19. Türkiye’ de orak hücre hastalığına sahip hastalarda eritrosit alloimmünizasyonu: tek merkez geriye dönük kohort çalışması
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Pelin Karacaoğlu, Soner Solmaz, Ilknur Kozanoglu, Can Boga, Çiğdem Gereklioğlu, Süheyl Asma, Hakan Ozdogu, Mutlu Kasar, Aslı Korur, Mahmut Yeral, and Nurhilal Büyükkurt
- Subjects
Orak hücre hastalığı,transfüzyon,alloimmünizasyon ,03 medical and health sciences ,0302 clinical medicine ,Health Care Sciences and Services ,030220 oncology & carcinogenesis ,Sickle cell disease,transfusion ,General Medicine ,Sağlık Bilimleri ve Hizmetleri ,030204 cardiovascular system & hematology - Abstract
Amaç: Orak hücre hastalığının sık görüldüğü bölgemizde eritrosit alloimmmünizasyon sıklığını ve ilişkili durumları araştırmayı amaçladık.Gereç ve Yöntem: bu çalışma tek merkezli, zamansal kesitli ve geriye dönük kohort çalşıması olarak planlanmıştır. Toplamda 216 orak hücre hastalığı [Hemoglobin (Hb) SS, Hb S-β talasemi, Hb S-α talasemi] tanısı olan hasta çalışmaya dahil edilmiştir. Hastalar transfüzyon miktarına gore iki gruba ayrılmıştır. Yılda 6’dan daha az transfüzyon alan ya da eritroferez öyküsü olmayan hastalar Grup 1’e, yılda 6 ve daha fazla basit transfüzyon alan ya da eritroferez işlemine alınan hastalar Grup 2’ye dahil edilmiştir.Bulgular: Çalışmamıza 216 hasta dahil edilmiştir. Transfüzyon tedavisi alan toplam 216 hastanın 67 (%31.0)’sinde, Grup 1’deki 56 hastanın 17’sinde (%30.4), Grup 2’deki 160 hastanın 50’sinde (%31.3) tespit edilmiştir. Hastalar alloimmünizasyon gelişimi açısından analiz edildiğinde, çalışmamız ne orak hücre komplikasyonlarının alloimmünizasyon gelişimi için ne de alloimmünizasyonun ölüm için bir risk faktörü olmadığını göstermiştir.Sonuç: Çalışmamamızda bulunan yüksek alloimmünizasyon sıklığı, tecrübeli merkezler dışında yapılan transfüzyonlarda alloimmünizasyonu önleyici politikalara yeteri kadar uyulmadığı konusunda fikir vermektedir. Bu nedenle orak hücre anemili hastalarda alloimmünizasyon, ayrıntılı eritrosit antijen tanımlama işlemi yapılarak azaltılabilir veya önlenebilir., Purpose: We aimed to investigate erythrocyte alloimmunization frequency and related factors in our region where SCD is common.Material and Methods: This study was planned as a single center, cross-sectional and retrospective cohort study. A total of 216 patients who had been followed up due to SCD [Hemoglobin (Hb) SS, Hb S-β thalassemia, Hb S-α thalassemia] were included in this study. Patients were divided to two groups according to amount of transfusion. The patients who had received less than 6 transfusions per year and who did not have the history of erythropheresis were allocated to Group 1, and the patients who had received 6 or more simple transfusion per year or who had undergone erythrocyte exchange were allocated to Group 2.Results: Of 216 SCD patients included in the study. Alloimmunization was detected in 67 (31.0%) out of 216 patients who underwent transfusion, and in 17 (30.4%) out of 56 patients in Group 1 and in 50 (31.3%) out of 160 patients in Group 2. When the patients were analyzed according to alloimmunization development, our study revealed that neither SCD complications are a risk factor for alloimmunization nor alloimmunization increases mortality rates.Conclusion: High alloimmunization frequency found in our study suggests the insufficient adherence of alloimmunization-prevention policies in RBC transfusions performed except experienced institutions. Therefore alloimmunization may be reduced or prevented through performing extended red cell typing among SCD patients
- Published
- 2016
20. Excellent outcomes of allogeneic transplantation from peripheral blood of HLA-matched related donors for adult sickle cell disease with ATLG and posttransplant cyclophosphamide-containing regimen: an update work
- Author
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Süheyl Asma, Mutlu Kasar, Mahmut Yeral, Çiğdem Gereklioğlu, Aslı Korur, Nurhilal Büyükkurt, Pelin Aytan, Cagla Sariturk, Ilknur Kozanoglu, Can Boga, and Hakan Ozdogu
- Subjects
Oncology ,Adult ,medicine.medical_specialty ,Allogeneic transplantation ,Transplantation Conditioning ,Cyclophosphamide ,Cell ,MEDLINE ,Graft vs Host Disease ,Disease ,Human leukocyte antigen ,Anemia, Sickle Cell ,Internal medicine ,medicine ,Humans ,Transplantation, Homologous ,Transplantation ,business.industry ,Hematopoietic Stem Cell Transplantation ,Hematology ,Peripheral blood ,Tissue Donors ,Regimen ,medicine.anatomical_structure ,business ,medicine.drug - Published
- 2019
21. Assessment of Quality of Life in Caregivers of the Patients with Hematologic Neoplasms
- Author
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Çiğdem Gereklioğlu, Can Boğa, Süheyl Asma, Aslı Korur, Nurhilal Büyükkurt, Hakan Özdoğu, and Soner Solmaz
- Subjects
Gynecology ,Hematology department ,medicine.medical_specialty ,General and Internal Medicine ,business.industry ,Significant difference ,Bone marrow transplant unit ,Life quality ,Hasta ,General Medicine ,Hematologic Neoplasms ,Quality of life ,Medicine ,Hematologic neoplasms,quality of life,caregivers,family practice ,business ,Genel ve Dahili Tıp ,Social functioning - Abstract
Aim/Background: Malignant diseases impair not only the quality of life of the patient but also the caregivers. The present study aims to investigate the quality of life in caregivers of the patients with hematologic neoplasms and determine the relationship between the subscales of quality of life (QOL) and socio-demographic characteristics of caregivers. Methods: One hundred consecutive caregivers of the patients who were hospitalized at Bone Marrow Transplant Unit and Hematology Department between 01 May 2015 and 30 June 2015 were included in this prospective, single center, cross-sectional study. Socio-demographic data of the patients and the caregivers were collected using a questionnaire form, QOL was evaluated using short-form 36. Results: Quality of life was found to be impaired in 46% of the caregivers. Given that a score of 100 defines full health status, bodily pain (31.3) and mental role (35.9) subscale scores were found to be the most affected subscales and physical functioning (71.8) subscale was found to be the least affected. There was a statistically significant difference between the age of the caregiver and physical role. Physical role and social functioning were better in caregivers who have economic support. There was a difference between employed and unemployed caregivers with regard to physical role and pain subscales. Overall health perception subscale score was higher for the caregivers of male patients. Graduates of the university were found to experience less pain. Conclusions: Cancer impairs not only the life quality of the patient but also the caregiver. So, the patient and the caregiver should be evaluated together and family physicians should take place in the center of and coordinate the interventions required for improving the quality of life of the caregivers.Giriş ve Amaç: Malign hastalıklar sadece hastanın değil, ailenin de yaşam kalitesini etkiler. Bu çalışmada hematolojik neoplazmı olan hastaların bakım verenlerinin yaşam kalitesinin araştırılması ve yaşam kalitesi alt ölçekleri ile bakım verenlerin sosyo-demografik özellikleri arasındaki ilişkinin belirlenmesi amaçlanmıştır. Yöntem: Bu prospektif, tek merkez, kesitsel çalışmaya 01 Mayıs 2015 ile 30 Haziran 2015 tarihleri arasında Başkent Üniversitesi Kemik İliği Nakli Ünitesi ve Hematoloji Bölümü’nde yatırılan yüz ardışık hastanın bakım verenleri alınmıştır. Hastaların ve bakım verenlerin sosyo-demografik verileri anket formu kullanılarak toplanmıştır, yaşam kalitesi ise kısa-form 36 ile toplanmıştır. Bulgular: Bakım verenlerin %46’sında yaşam kalitesinin bozulduğu bulunmuştur. Tam sağlık durumunu belirten skorun 100 olduğu düşünüldüğünde, vücut ağrısı (31.3) ve mental rol (35.9) en fazla etkilenen alt ölçekler iken fiziksel işlevselliğin (71.8) en az etkilendiği bulunmuştur. Bakım verenin yaşı ile fiziksel rol arasında istatistiksel olarak anlamlı fark vardı. Ekonomik desteği olan bakım verenlerin fiziksel rol ve sosyal işlev alt ölçekleri daha iyiydi. Çalışan ve çalışmayan bakım verenler arasında fiziksel rol ve ağrı alt ölçekleri bakımından fark vardı. Genel sağlık algısı alt ölçeği skoru erkek hastaların bakım verenlerinde daha yüksekti. Üniversite mezunlarının daha az ağrı yaşadıkları bulunmuştur. Sonuç: Kanser sadece hastanın değil, aynı zamanda bakım vericinin de yaşam kalitesini etkiler. Bu nedenle hasta ve bakım vericisi birlikte değerlendirilmeli, aile hekimleri bakım vericilerin yaşam kalitesinin artırılması için gereken girişimlerde merkezde olarak koordinasyon sağlamalıdır.
- Published
- 2019
22. Factors influencing vaccination status against influenza and pneumococcus in sickle cell anemia patients
- Author
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Can Boga, Hakan Ozdogu, Aslı Korur, Çiğdem Gereklioğlu, and Süheyl Asma
- Subjects
Pediatrics ,medicine.medical_specialty ,business.industry ,General Medicine ,medicine.disease ,Sickle cell anemia ,Seasonal influenza ,Vaccination ,Vaccination status ,Training center ,Hematologic disease ,medicine ,In patient ,business ,Volunteer - Abstract
Aim: The aim of the present study is to investigate the factors which influence vaccination status against seasonal influenza and pneumococcus in patients with sickle cell anemia which is known to be the most common hereditary hematologic disease worldwide.Materials and Methods: This prospective, cross-sectional study was conducted with the volunteer patients above 18 years who were admitted to Hematology Clinic of Baskent University Adana Research and Training Center due to sickle cell anemia during 01 December – 31 December 2018.Results: Of 38 patients, 22 (57.9%) were females. Ratio of vaccination against pneumococcus was found to be higher among the patients who had vaccination cards (p0.05). Ratio of vaccination against pneumococcus and influenza was found to be higher among the patients who were coming for regular controls and the difference was statistically significant (p0.05). The reason for not getting vaccinated was detected to be “forgetting vaccination” (37.5%), “not believing the necessity of vaccination” (25%) and “not being recommended by health authorities” (25%).Conclusion: It was concluded that vaccination rates could be increased through using vaccination cards, inviting the patients for regular controls and health authorities’ recommending vaccination.
- Published
- 2021
23. QTc prolongation during peripheral stem cell apheresis in healthy volunteers
- Author
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Mahmut Yeral, Çiğdem Gereklioğlu, Ilknur Kozanoglu, Can Boga, Nurhilal Büyükkurt, Fatih Kandemir, Süheyl Asma, Aslı Korur, Hakan Ozdogu, Cagla Sariturk, and Soner Solmaz
- Subjects
medicine.diagnostic_test ,business.industry ,Physical examination ,Hematology ,General Medicine ,Leukapheresis ,030204 cardiovascular system & hematology ,QT interval ,Sudden death ,Transplantation ,03 medical and health sciences ,0302 clinical medicine ,Apheresis ,Anesthesia ,medicine ,cardiovascular diseases ,Prospective cohort study ,business ,Electrocardiography ,030215 immunology - Abstract
Background and aim Today, voluntary donation of peripheral blood stem cells by healthy donors for allogeneic hemopoietic cell transplantation is common worldwide. Such donations are associated with small but measurable risks of morbidity and mortality. Most complications are associated with citrate infusion during cell collection. We studied the effects of citrate infusion on the QTc and other vital parameters during and after peripheral stem cell apheresis in volunteers. Method To ensure that donors were healthy, screening included taking a detailed medical history, physical examination, and laboratory measurements of plasma calcium and magnesium. Corrected QT (QTc) values were assessed using a 12-lead electrocardiographic platform that derived QTc values automatically. Results In all, 141 apheresis procedures were performed. The mean QTc values at baseline, at 2 and 4 h during the procedure, and at 30 min after the procedure, were 347.6 ± 59.5, 349.9 ± 52.8, 391.8 ± 54.0, and 404.8 ± 59.2 ms, respectively. The baseline and 2 h QTcs did not differ significantly, but the baseline QTc did differ significantly from the 4 h and 30 min after the procedure values. The plasma levels of calcium and magnesium did not significantly differ before and after the procedure. Conclusion QTc prolongation may develop during leukopheresis, particularly if the procedure takes more than 2 h. Thus, to enhance donor safety, QTc measurement should be standard for all donors. In addition, any family history of sudden death should be noted, to prevent the development of possible fatal arrhythmia in susceptible donors.
- Published
- 2016
24. An Overlooked Side Effect of Iron Treatment: Changes in Menstruation
- Author
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Hakan Kalaycı, Aslı Korur, Süheyl Asma, Soner Solmaz, Çiğdem Gerekli̇ oğlu, Can Boga, Bilal Aygün, and Hakan Ozdogu
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Menstruation ,Side effect ,business.industry ,Medicine ,Physiology ,business - Published
- 2016
25. Final diagnosis of patients referred to hematologist due to anemia
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Funda Pepedil Tanrikulu, Nurhilal Büyükkurt, Süheyl Asma, and Hakan Ozdogu
- Subjects
lcsh:R5-920 ,Pediatrics ,medicine.medical_specialty ,business.industry ,Anemia ,lcsh:R ,medicine ,lcsh:Medicine ,Hematologist ,lcsh:Medicine (General) ,business ,medicine.disease ,no keywords - Abstract
No Abstract [Med-Science 2020; 9(1.000): 287-8]
- Published
- 2020
26. Comparative efficacy in red blood cell exchange transfusions with different apheresis machines in patients with sickle cell disease
- Author
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Aslı Korur, Mahmut Yeral, Nurhilal Büyükkurt, Can Boga, Hakan Ozdogu, Fatih Kandemir, Çiğdem Gereklioğlu, Cagla Sariturk, Soner Solmaz, Ilknur Kozanoglu, and Süheyl Asma
- Subjects
medicine.medical_specialty ,Hematology ,business.industry ,Cell ,Disease ,030204 cardiovascular system & hematology ,Gastroenterology ,03 medical and health sciences ,Red blood cell ,0302 clinical medicine ,medicine.anatomical_structure ,Apheresis ,Cobe spectra ,Internal medicine ,medicine ,In patient ,Original Article ,Foot ulcers ,business ,030215 immunology - Abstract
The purpose of this study is to compare the efficacy and side effects of two red blood cell exchange (RBCX) transfusion systems in sickle cell disease (SCD). The data is collected retrospectively from the January 2010 to March 2015. 447 RBCX transfusions were performed to 165 patients. Side effects, clinical and technical efficacy were compared in between procedures with Cobe Spectra (CS) and Spectra Optia (SO) systems. Furthermore a subgroup analyses was performed for 40 patients who had RBCX transfusions with both system at least two times. Vasoocclusive crises, preoperative period and foot ulcers (49.6, 13, and 15.2% respectively) were the common indications of RBCX transfusion. While the levels of post-RBCX HbS and the actual fraction of cells remaining (FCRa) were found significantly higher in the SO compared to CS system (p = 0.018 and p = 0.016 respectively), the rate of targeted hemoglobin S (HbS) levels (
- Published
- 2017
27. Effectiveness of Fludarabine- and Busulfan-Based Conditioning Regimens in Patients With Acute Myeloblastic Leukemia: 8-Year Experience in a Single Center
- Author
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Erkan Maytalman, Can Boga, Süheyl Asma, Hakan Ozdogu, Mahmut Yeral, Ilknur Kozanoglu, and Mutlu Kasar
- Subjects
Adult ,Male ,medicine.medical_specialty ,Transplantation Conditioning ,Acute myeloblastic leukemia ,medicine.medical_treatment ,Graft vs Host Disease ,Hematopoietic stem cell transplantation ,Gastroenterology ,Disease-Free Survival ,Donor lymphocyte infusion ,Cohort Studies ,Internal medicine ,medicine ,Humans ,Transplantation, Homologous ,Busulfan ,Antilymphocyte Serum ,Retrospective Studies ,Transplantation ,business.industry ,Hematopoietic Stem Cell Transplantation ,Myeloablative Agonists ,medicine.disease ,Minimal residual disease ,Surgery ,Fludarabine ,Leukemia, Myeloid, Acute ,Regimen ,Cross-Sectional Studies ,surgical procedures, operative ,Multivariate Analysis ,Female ,business ,Immunosuppressive Agents ,Vidarabine ,medicine.drug - Abstract
Objective Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative treatment for acute myeloblastic leukemia (AML). Because the conditioning regimen of busulfan plus cyclophosphamide carries significant risks of toxicity, we evaluated the factors affecting survival after fludarabine replacement instead of cyclophosphamide. Methods The study included 55 patients who underwent allo-HSCT for AML and received busulfan, fludarabine, and antithymocyte globulin (ATG). Results Forty-eight patients received a myeloablative regimen; 7 patients received a reduced-intensity conditioning regimen. The neutrophil and platelet engraftment times were 12 days (range 9 to 20) and 12 days (range 7 to 19), respectively. Graft-vs-host disease (GvHD) developed in 10% and 50% of the patients, respectively. Seven patients received donor lymphocyte infusion. Of them, 5 patients developed grade I or II GvHD, one grade IV GvHD. The median follow-up period was 20.6 months. The predicted progression-free survival (PFS) at 1 and 3 years after transplantation was 78% and 74%, respectively. The overall survival (OS) at 1, 3, and 5 years was 76%, 74%, and 62%, respectively. Treatment-related mortality (infection in 1 patient, GvHD in 2 patients) occurred in 3 patients (5.5%). Multivariate analysis revealed that OS and PFS were not influenced by age, dose of busulfan or ATG, or presence of cytomegalovirus antigenemia. Acute GvHD and pretransplantation minimal residual disease positivity negatively affected the transplant outcome. The presence of active disease at the time of transplantation was found as an independent risk factor for AML. Conclusions Busulfan- and fludarabine-based conditioning regimens are effective for AML, and have acceptable toxicity, morbidity, and mortality.
- Published
- 2015
28. Granulocyte-colony stimulating factor administration among hemoglobin S trait donors: A single center experience from the Eastern Mediterranean region
- Author
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Süheyl Asma, Can Boga, Aslı Korur, Hakan Ozdogu, Ilknur Kozanoglu, Mahmut Yeral, Pelin Aytan, Songul Tepebasi, and Çiğdem Gereklioğlu
- Subjects
Adult ,Male ,Hemoglobin, Sickle ,Physiology ,Disease ,030204 cardiovascular system & hematology ,Single Center ,Sickle Cell Trait ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Granulocyte Colony-Stimulating Factor ,Medicine ,Humans ,business.industry ,Mediterranean Region ,Incidence (epidemiology) ,Hematology ,General Medicine ,Middle Aged ,Hematopoietic Stem Cell Mobilization ,Tissue Donors ,Granulocyte colony-stimulating factor ,Transplantation ,Cross-Sectional Studies ,Immunology ,Trait ,Female ,Stem cell ,business ,030215 immunology ,Cohort study - Abstract
Background and Objective Assessment of Hemoglobin S trait donors has gained importance together with the increased allogeneic peripheral stem cell transplant activity for sickle cell disease in the regions where the disease is prevalent. Outcomes of Granulocyte-Colony Stimulating Factor (G-CSF) administration are obscure for hemoglobin S trait donors. This study aims at investigating the incidence of hemoglobin S carrier status and outcomes of G-CSF administration among donors who live in Eastern Mediterranean region. Material and Method The cross-sectional, single-center cohort study was performed with 147 donors between January 2013 and March 2017. Prevalence of hemoglobin S trait was estimated and subjects with or without Hemogobin S trait were compared with regard to stem cell characteristics, early and late clinical outcomes after G-CSF administration. Results Eleven out of 147 donors (7.48%) were found as hemoglobin S trait. G-CSF administration was successfully completed and yielded good harvesting results in hemoglobin S trait donors. No statistically significant difference was found between groups with regard to early and late side effects, stem cell characteristics. Blood pressures and QTc values were within normal ranges in both groups. Groups were similar with regard to CD34 values. Conclusion G-CSF seems safe in hemoglobin S trait donors. Their being eligible as donors would increase the chance of the patients for allogeneic stem cell transplantation in high prevalence regions. Further studies are required to reveal the safety profile of G-SCF in hemoglobin S carriers in different regions.
- Published
- 2017
29. Significance of electronic health records: A comparative study of vaccination rates in patients with sickle cell disease
- Author
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Akatlı Kürsat Ozsahin, Çiğdem Gereklioğlu, Süheyl Asma, Aslı Korur, Soner Solmaz, Can Boga, and Altuğ Kut
- Subjects
medicine.medical_specialty ,Vaccination schedule ,business.industry ,Sickle cell disease ,Significant difference ,Vaccination ,General Medicine ,Disease ,Health records ,Health problems ,Internal medicine ,Immunology ,medicine ,Outpatient clinic ,Electronic health records ,Original Article ,In patient ,business - Abstract
Objective: In this study, we investigated the influence of electronic health records (EHR) and electronic vaccination schedule applications on the vaccination status of patients who were admitted to our Center for the treatment of sickle cell disease (SCD). Methods: The vaccination status against influenza and pneumococcus infection was determined in 93 patients who were admitted to the hematology outpatient clinic, Baskent University Adana Hospital from April 2004 to March 2009. The vaccination status was then re-evaluated following establishment of EHR and electronic vaccination schedules in 2012. Results: Of the 93 patients with SCD 21.5% (n = 20) were vaccinated against pneumococcus and 21.5% (n = 20) were regularly vaccinated against influenza. When the vaccination rates of 59 of 93 patients who presented for their regular control examinations were analyzed following establishment of EHR and vaccination schedules in 2012, these rates were 49.2% (n = 29) and 50.8% (n = 30) for influenza and pneumococcus, respectively, after EHR; there were 23.7% (n = 14) and 20.3% (n = 12), respectively, before EHR. A statistically significant difference was found between the vaccination rates before and after EHR (p < 0.05). Conclusion: Although viral and bacterial infections are life-threatening health problems in patients with SCD, the vaccination rates were low in high-risk patients. However, these rates increased after application of electronic vaccination schedules.
- Published
- 2017
30. An Unusual Cause of Febrile Neutropenia: Brucellosis
- Author
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Süheyl Asma, Tuba Turunç, Mahmut Yeral, Hakan Ozdogu, and Soner Solmaz
- Subjects
Male ,Microbiology (medical) ,medicine.medical_specialty ,Fever ,Meropenem ,Tazobactam ,Brucellosis ,Fatal Outcome ,Internal medicine ,medicine ,Humans ,Blood culture ,Leukocytosis ,Febrile Neutropenia ,General Immunology and Microbiology ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,Shock, Septic ,Leukemia, Myeloid, Acute ,Infectious Diseases ,Absolute neutrophil count ,Vancomycin ,medicine.symptom ,business ,Febrile neutropenia ,medicine.drug - Abstract
Febrile neutropenia which is a common complication of cancer treatment, is one of the major causes of morbidity and mortality. Several gram-negative and gram-positive bacteria are responsible for infections in neutropenic patients, however the most common microorganisms are Escherichia coli and coagulase-negative staphylococci, in decreasing order. Although Brucella spp. infections are endemic in Turkey, brucellosis-related febrile neutropenia has only rarely been reported. In this report, a case of brucellosis-related febrile neutropenia in a patient with acute myeloblastic leukemia (AML) was presented. A 56-year-old male patient presenting with fever, petechiae/purpura, leukocytosis, thrombocytopenia, and anemia was admitted to our hospital. Laboratory studies revealed a hemoglobin level of 8.27 g/dl, leukocyte count of 77.100 k/ml, absolute neutrophil count of 200 k/ml, and platelets at 94.200 k/ml. The patient was diagnosed as AML-M1 and piperacillin/tazobactam was started as the first-line antibiotic therapy due to the febrile neutropenia. On admission, blood and urine cultures were negative. Once the fever was controlled, remission/induction chemotherapy was initiated. However, fever developed again on the eight day, and vancomycin was added to the therapy. Since the fever persisted, the antibiotic therapy was gradually replaced with meropenem and linezolid. However, fever continued and the patient's general condition deteriorated. Subsequently performed Brucella tube agglutination test revealed positivity at 1/320 titer and the microorganism grown in blood culture (Bactec 9050; BD, USA) was identified as B.melitensis by conventional methods. Rifampicin and doxycycline therapy was started immediately, however, the patient died due to septic shock. If the tests for brucellosis were performed earlier when response to second step antibiotic therapy lacked in this patient, it was assumed that mortality could be prevented by the prompt initiation of the appropriate treatment. Thus, since brucellosis is endemic in Turkey, it should be considered as a possible agent of febrile neutropenia especially in patients unresponsive to empiric antibiotherapy and appropriate diagnostic tests should be performed.
- Published
- 2014
31. Prophylactic red blood cell exchange may be beneficial in the management of sickle cell disease in pregnancy
- Author
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Aydan Akdeniz, N. Turgut, Ilknur Kozanoglu, Süheyl Asma, Ebru Tarim, Mahmut Yeral, Fatih Kandemir, Çiğdem Gereklioğlu, Mutlu Kasar, Can Boga, Hakan Ozdogu, and Cagla Sariturk
- Subjects
Pediatrics ,medicine.medical_specialty ,Pregnancy ,Eclampsia ,business.industry ,Anemia ,Immunology ,Intrauterine growth restriction ,Beta thalassemia ,Retrospective cohort study ,Hematology ,medicine.disease ,Preeclampsia ,Immunology and Allergy ,Medicine ,Gestation ,business - Abstract
BACKGROUND: Sickle cell disease (SCD) is associated with chronic hemolysis and painful episodes. Pregnancy accelerates sickle cell complications, including prepartum and postpartum vasoocclusive crisis, pulmonary complications, and preeclampsia or eclampsia. Fetal complications include preterm birth and its associated risks, intrauterine growth restriction, and a high rate of perinatal mortality. The purpose of this study was to evaluate pregnancy outcomes in patients with SCD who underwent planned preventive red blood cell exchange (RBCX). STUDY DESIGN AND METHODS: We retrospectively evaluated the complications of SCD in 37 pregnant patients. Patients with SCD who had undergone prophylactic RBCX were compared with a control group who had not undergone RBCX during pregnancy. RESULTS: Forty-three exchange procedures were performed in 24 patients. The control group comprised 13 patients with a mean age of 27.4 ± 3.3 years who had not undergone RBCX during pregnancy. Four of the five patients who developed a vasoocclusive crisis died. There was a significant difference in maternal mortality between the study and control groups (p = 0.011). There was also a significant difference in the incidence of vasoocclusive crisis between the study and control groups. One fetal death occurred in the 20th gestational week in a patient in the control group, although there were no postpartum complications in either the babies or the mothers in the control group. CONCLUSION: This study has demonstrated that prophylactic RBCX during pregnancy is a feasible and safe procedure for prevention of complications. Given the decrease in the risks of transfusion, RBCX warrants further study. S ickle cell diseases (SCDs) are a group of inherited single-gene autosomal recessive disorders caused by the sickle cell gene, which affects hemoglobin (Hb) structure. 1 SCD includes sickle cellanemiawiththeSSgenotype,someheterozygousconditions of the S gene, and other clinically abnormal Hbs such as beta thalassemia, HbC, HbD, and HbE among others. The primary manifestations of SCD are chronic hemolytic anemia and episodes of severe pain crises due to vasoocclusion. 1-3
- Published
- 2014
32. Clinical significance of circulating blood and endothelial cell microparticles in sickle-cell disease
- Author
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Mahmut Yeral, Can Boga, Hakan Ozdogu, Ilknur Kozanoglu, Süheyl Asma, and Mutlu Kasar
- Subjects
Adult ,Blood Platelets ,Male ,medicine.medical_specialty ,Pathology ,Erythrocytes ,Adolescent ,Inflammation ,Anemia, Sickle Cell ,Pathogenesis ,Antisickling Agents ,Cell-Derived Microparticles ,Thrombocyte activation ,Internal medicine ,Humans ,Hydroxyurea ,Medicine ,Platelet ,Prospective Studies ,Microparticle ,Hematology ,business.industry ,Endothelial Cells ,Middle Aged ,Flow Cytometry ,Platelet Activation ,Antigens, Differentiation ,Endothelial stem cell ,Cross-Sectional Studies ,Immunology ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,CD61 - Abstract
Increased thrombocyte activation leads to a higher likelihood of coagulation in sickle-cell disease. On the other hand, chronic inflammation and endothelial cell activation promote vaso-occlusion. The effect of circulating microparticles derived from erythrocytes, monocytes, thrombocytes, and endothelial cells on the vaso-occlusive process is unclear. This study aims to analyze the relationship between sickle-cell disease and miscellaneous organ complications by defining the circulating microparticles during the steady-state and painful crisis periods in 45 patients with sickle-cell disease. Microparticle analysis was conducted using an eight-parameter flow cytometric method, using CD61 PERCP, CD142PE, CD106 FITC, CD14 APC-H7, CD235a FITC, and Annexin-V APC monoclonal antibodies. Microparticle levels of sickle-cell patients were found to be significantly higher during both painful crisis and steady-state situations compared with the control group (for all, p 0.001). Among these microparticles, levels of erythrocyte microparticles (eMPs) were significantly higher during crisis than in the steady-state period (eMP steady state vs. painful crisis: 7.59 ± 12.24 vs. 7.59 ± 12.24, respectively; p 0.01). Microparticles, including eMPs, were not affected by hydroxyurea treatment. Their level did not reflect the high frequency of crisis (3 times/year). Thrombocyte microparticle levels were found to be higher in patients with nephropathia than in those without (48.05 ± 40.23 vs. 7.67 ± 6.75, respectively; p 0.049). Circulating microparticles seem to be involved in the pathogenesis of sickle-cell disease. eMPs may help with the management of crisis. Thrombocyte microparticles might predict renal damage induced by vaso-occlusion.
- Published
- 2013
33. Survival of AML Patients Relapsing after Hematopoetic Stem Cell Transplantation: A Single Center Experience
- Author
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Mutlu Kasar, Çiğdem Gereklioğlu, Ilknur Kozanoglu, Pelin Aytan, Soner Solmaz, Funda Pepedil Tanrikulu, Aslı Korur, Süheyl Asma, Can Boga, Hakan Ozdogu, Mahmut Yeral, and Nurhilal Büyükkurt
- Subjects
medicine.medical_specialty ,education.field_of_study ,business.industry ,medicine.medical_treatment ,Immunology ,Population ,Salvage therapy ,Cell Biology ,Hematology ,Hematopoietic stem cell transplantation ,medicine.disease ,Biochemistry ,Minimal residual disease ,Gastroenterology ,Transplantation ,Graft-versus-host disease ,Internal medicine ,Medicine ,business ,education ,Survival rate ,Progressive disease - Abstract
Although it is presumed to be a curative strategy for intermediate and high risk acute myeloid leukemia (AML), many patients relapse after allogeneic hematopoietic stem cell transplantation. This prompt us to examine the ways to improve the outcomes. We retrospectively evaluated 76 AML patients who were transplanted between 2007-2017 years in our clinic. We tried to identify the factors associated with posttransplant relapse, postrelapse survival and if there was a survival benefit of pretransplant consolidation and minimal residual disease (MRD) negativity. We examined the effect of the acute-chronic graft versus host disease (GVHD) and salvage therapy after the posttransplant relapses. The mean age of the patients was 44.6±1.21 years (ranges 21-67). 42.1% were females and 57.9% were males. 43.3% of the patients were in complete remission (CR) MRD positive state before the transplantation whereas 35.5% were in CR MRD negative and 3.9% were in progressive disease state. In 13 patients who were in CR state, the MRD status were not known. 11 (14.5%) patients were considered as in favorable risk, 52 (68.4%) in intermediate risk and 13 (17.1%) in unfavorable risk with respect to cytogenetic analysis before the transplantation. The donors were HLA compatible relatives (77.6%), HLA compatible non-relatives (10.5%), haploidentical people (9.2%), one HLA incompatible relative (1.3%) and one HLA incompatible nonrelative (1.3%). 74 bone marrow transplantations (97.4%) were allogeneic and the remaining two (2.6%) were autologous. Myeloablative conditioning regimen was applied to 57 patients (75%) and 19 patients got (25%) reduced intensity conditioning regimen. GVHD developed in 51.3% after transplantation and 61.5% of these were chronic extensive. Relapse occurred in 27 patients (35.5%), hematological relapse being the most common (31.6%). The median time for the development of relapse was found to be 5.5 months (range: 1.5-37). The overall probability for the development of a relapse was found to be 48.7% (95% CI: 40.9-56.5)(Figure1A). 23 patients (30.3%) died during the study period with a median survival of 9.6 months (range: 1.6-45). In the studied population the overall survival probability was found to be 52.8% (95% CI: 45.4 - 60.2) [Figure 1B]. 36.4%, 28.8% and 30.8% of the patients with favorable, intermediate and unfavorable cytogenetic status died respectively during the study period. The comparison of the survival probability of the patients with favorable, intermediate and unfavorable cytogenetic status was depicted in Figure 2. The overall survival probability of the patients with favorable, intermediate and unfavorable cytogenetic status were 46.6% (95% CI: 26.2-66.9), 54.6% (95 % CI: 45.9 - 63.2) and 36.9 % (95% CI: 25.4 - 48.5) respectively (p=0.807). MRD status of 60 patients were known. At the end of the study period 75.8% of the CR MRD positive and 70.4% of the CR MRD negative patients remained alive. The comparison of the survival of patients in CR with respect to MRD status is shown in Figure 3. The overall survival probability of CR MRD positive patients was 56.3 % (95% CI: 45.3 - 67.3) and this rate was 52.5 % (95% CI: 40.8 - 64.3) in MRD negative patients (p=0.770) [Figure 3]. Patients who developed GVHD had similar overall survival probability with the patients who did not developed the disease; 47.0% vs 57.2%, p=0.115 (Figure 4A). Even the patients with chronic extensive GVHD had similar overall survival rates with the patients who had none or acute GVHD; 49.3 % vs 58.2%, p=0.27 (Figure 4B). 66.7% of the patients with a progressive disease before the transplantation died during the study period and this rate was 27.1% in the patients with CR (p=0.005). In conclusion the overall survival rate of the transplanted AML patients was 52.8% in the study group. The overall survival did not seem to be affected by pre-transplant MRD status, cytogenetic risk factors and administration of consolidation therapy. The only patients who had significantly worse results were the ones who had progressive disease before the transplantation. From this point it would be logical to make transplantation whenever the patient is in first CR regardless of the MRD status and a matched donor is found so that the toxic effects of the consolidation chemotherapy may be prevented. Disclosures No relevant conflicts of interest to declare.
- Published
- 2018
34. Survival Outcomes of Young Multiple Myeloma Patients: A Single Center Experience
- Author
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Can Boga, Süheyl Asma, Hakan Ozdogu, Mahmut Yeral, Mutlu Kasar, Pelin Aytan, Nurhilal Büyükkurt, Aslı Korur, Funda Pepedil Tanrikulu, Çiğdem Gereklioğlu, Ilknur Kozanoglu, and Soner Solmaz
- Subjects
Chemotherapy ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Incidence (epidemiology) ,Immunology ,Complete remission ,Cell Biology ,Hematology ,medicine.disease ,Single Center ,Biochemistry ,Chemotherapy regimen ,Transplantation ,Internal medicine ,medicine ,business ,Kappa ,Multiple myeloma - Abstract
Multiple myeloma (MM) is a disease of the elderly. It shows rapidly increasing incidence with increased age. Although MM is rare in young people, patients diagnosed before the age of 50 years account for 10% of the overall incidence and approximately 2% are diagnosed before 40 years of age. The aim of the study was to assess the clinical results of the young MM patients diagnosed at the age of ≤45 years. All the MM patients who were ≤45 years old at the time of diagnosis and who were admitted to our clinic between January 2004 and December 2017 were retrospectively assessed. There was a total of 31 patients and 14 (45.2%) of them were females and 17 (54.8%) of them were males. The mean age was 40.4±3.8 years. The most frequent myeloma types were Ig G Kappa (n:12, 38.7%) and Kappa light chain (n: 10, 32.3%). The remaining types were Ig A lambda (n:4, 12.9%), Ig G lambda (n:2, 6.5%), Lambda light chain (n: 2, 6.5%) and non-secretory myeloma (n:1, 3.2%). Before transplantation 12 patients (38.7%) were in complete remission, 11 patients (35.5%) were in very good partial remission, 4 patients (12.9%) were in partial remission state and 4 patients (12.9%) had refractory disease. VAD + VCD protocol was given to 12 (38.7%) patients. 6 (19.8%) patients had VCD, 3 (9.7%) got VCD + VRD, 2 (6.5%) got VAD and 8 (25.8%) got other chemotherapy protocols. Transplantation was done in 26 patients (83.9%). Overall 9 patients (29%) died during the study period. Second or tandem transplantation was performed to 10 patients and 30% (n:3) of these re-transplanted patients died. The overall survival for these patients was estimated to be 70% (95% CI: 64.2-75.8). In conclusion MM in patients younger than 45 years is rare. In these patients Ig G Kappa and Kappa Light chain types are the most frequent types. Heterogeneous of individual patients may exist within these young myeloma patients. For those who are expected to show a poor response to current treatments despite their young age, the efficacy of an alternative therapeutic strategy such as front line allo-HSTC should be further investigated. Disclosures No relevant conflicts of interest to declare.
- Published
- 2018
35. Short-term central venous catheter complications in patients with sickle cell disease who undergo apheresis
- Author
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Süheyl Asma, Mahmut Yeral, Can Boga, Mutlu Kasar, Levent Oguzkurt, and Ilknur Kozanoglu
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Anemia ,medicine.medical_treatment ,Femoral vein ,Hemorrhage ,Anemia, Sickle Cell ,Infections ,Hematoma ,medicine ,Central Venous Catheters ,Humans ,Internal jugular vein ,Retrospective Studies ,business.industry ,Thrombosis ,Hematology ,Middle Aged ,medicine.disease ,Surgery ,Catheter ,Apheresis ,Anesthesia ,Blood Component Removal ,Female ,Cardiology and Cardiovascular Medicine ,business ,Central venous catheter - Abstract
Patients with sickle cell disease (SCD) are prone to develop thrombosis and infection due to their inflammatory and immune deficiency state. These patients require red cell exchange therapy for treatment or prevention of hemoglobin S associated complications. Owing to vascular access problems, adult patients need central venous catheterization (CVC) for exchange procedures. Procedure related complications have been reported for long-term CVCs in pediatric patients. However, short-term CVC complications in adult patients are not clear. This report represents the results of documented complications of short-term CVCs in patients with SCD who undergo apheresis. A total of 142 non-tunneled catheters with average median diameter of 9 F (range 8-16 F) were implanted for apheresis. The catheters were mainly inserted through the right internal jugular vein (66.2 %). Total days of catheter were 412. Results were reported as a complication rate and event according to 1,000 catheter days and compared to a control group including 37 healthy stem cell donors. In the patient group, 1 (1 %) hematoma and 1 (1 %) infection were observed for internal jugular vein catheterization (3.7 hemorrhages and 3.7 infections according to 1,000 catheter days), whereas four (8.9 %) cases of thrombosis and 1 (2.2 %) infection (27 and 6.9 according to 1,000 catheter days) developed in femoral vein. There was a significant difference in terms of thrombosis (P = 0.009). In the control group, only individual developed thrombosis in internal jugular vein. Short-term CVC inserted through to the internal jugular vein seems to be safer than femoral vein in patients with SCD.
- Published
- 2013
36. Effectiveness of Visual Methods in Information Procedures for Stem Cell Recipients and Donors
- Author
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Cagla Sariturk, Can Boga, Hakan Ozdogu, Ilknur Kozanoglu, Songul Tepebasi, Mahmut Yeral, Süheyl Asma, Nurhilal Büyükkurt, Aslı Korur, Çiğdem Gereklioğlu, and Soner Solmaz
- Subjects
Adult ,Male ,Audiovisual method ,lcsh:Internal medicine ,medicine.medical_specialty ,Adolescent ,Bone marrow transplantation ,Video Recording ,Affect (psychology) ,Hematopoietic stem cell ,Session (web analytics) ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Informed consent ,Surveys and Questionnaires ,Medicine ,Humans ,Prospective randomized study ,Prospective Studies ,lcsh:RC31-1245 ,Aged ,Informed Consent ,lcsh:RC633-647.5 ,business.industry ,Hematopoietic Stem Cell Transplantation ,lcsh:Diseases of the blood and blood-forming organs ,Hematology ,Middle Aged ,Tissue Donors ,Transplant Recipients ,Test (assessment) ,Transplantation ,030220 oncology & carcinogenesis ,Physical therapy ,Anxiety ,Female ,medicine.symptom ,business ,Donor ,030215 immunology ,Visual methods ,Stem Cell Transplantation ,Research Article - Abstract
Obtaining informed consent from hematopoietic stem cell recipients and donors is a critical step in the transplantation process. Anxiety may affect their understanding of the provided information. However, use of audiovisual methods may facilitate understanding. In this prospective randomized study, we investigated the effectiveness of using an audiovisual method of providing information to patients and donors in combination with the standard model.A 10-min informational animation was prepared for this purpose. In total, 82 participants were randomly assigned to two groups: group 1 received the additional audiovisual information and group 2 received standard information. A 20-item questionnaire was administered to participants at the end of the informational session.A reliability test and factor analysis showed that the questionnaire was reliable and valid. For all participants, the mean overall satisfaction score was 184.8±19.8 (maximum possible score of 200). However, for satisfaction with information about written informed consent, group 1 scored significantly higher than group 2 (p=0.039). Satisfaction level was not affected by age, education level, or differences between the physicians conducting the informative session.This study shows that using audiovisual tools may contribute to a better understanding of the informed consent procedure and potential risks of stem cell transplantation.Amaç: Hematopoietik kök hücre alıcıları ve donörlerden bilgilendirilmiş onam alınması, nakil sürecinin en önemli basamağıdır. Görsel yöntemlerden yararlanılması anlamayı kolaylaştırabilir. Bu prospektif randomize çalışmada sözel ve yazılı bilgilendirmeye ilave olarak audiovizüel yöntem kullanılmasının standart yönteme göre etkinliğinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: On dakikalık kısa bir bilgilendirme animasyonu hazırlatıldı. Toplam 82 katılımcı rastgele 2 gruba ayrıldı: Grup 1 (görsel bilgilendirme yönteminin ilave edildiği grup) ve grup 2 (standart yöntem uygulanan grup). Bilgilendirme işlemi sonunda katılımcılara 20 soruluk bir anket uygulandı. Ayrıca, yeni yöntemin sonuçlarının kişiler arası farklılıktan etkilenip etkilenmediği test edildi. Bulgular: Güvenirlik testi ve faktör analizi anketin güvenilir ve geçerli olduğunu gösterdi. Tüm olgular için genel memnuniyet ortalama değeri 200 üzerinden 184,8±19,8 olarak bulundu. Yazılı bilgilendirilmiş onam form memnuniyeti ortalama puanları yönünden grup 1’deki olguların memnuniyetleri grup 2’ye oranla anlamlı olarak daha yüksek olduğu saptandı (p=0,039). Sözel olarak bilgi veren doktor ve bilgilendirme animasyonu memnuniyeti bakımından gruplar arasında fark saptanmadı. Olguların memnuniyet seviyesi yaş, eğitim durumu ve bilgilendiren kişiler arası farklılıktan etkilenmedi. Sonuç: Bu çalışma, görsel yöntemlerin kullanılmasının işlem ve muhtemel risklerinin daha iyi anlaşılmasına katkı sağlayabileceğini göstermektedir. Anahtar Sözcükler: Hematopoietik kök hücre, Donör, Bilgilendirilmiş onam, Audovizuel yöntem, Kemik iliği nakli.
- Published
- 2016
37. Factors effecting influenza vaccination uptake among health care workers: a multi-center cross-sectional study
- Author
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İbrahim Başhan, Süheyl Asma, Mustafa Haki Sucakli, A. Ferit Erdogan, Erhan Yengil, Altuğ Kut, Aslı Korur, Yücel Uysal, Çiğdem Gereklioğlu, Hülya Akan, A. Gürhan Poçan, and A. Kürşat Özşahin
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,Adolescent ,Turkey ,Cross-sectional study ,Attitude of Health Personnel ,Health Personnel ,030106 microbiology ,Nurses ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Physicians ,Surveys and Questionnaires ,Health care ,Influenza, Human ,medicine ,Healthcare workers ,Humans ,030212 general & internal medicine ,Young adult ,Multiple choice ,Univariate analysis ,business.industry ,Vaccination ,Middle Aged ,Influenza ,Hospitals ,Vaccination behavior ,Infectious Diseases ,Cross-Sectional Studies ,Influenza Vaccines ,Family medicine ,Immunology ,Tropical medicine ,Chronic Disease ,Female ,business ,Research Article - Abstract
Background: The present study aimed to identify factors affecting vaccination against influenza among health professionals. Methods: We used a multi-centre cross-sectional design to conduct an online self-administered questionnaire with physicians and nurses at state and foundation university hospitals in the south-east of Turkey, between 1 January 2015 and 1 February 2015. The five participating hospitals provided staff email address lists filtered for physicians and nurses. The questionnaire comprised multiple choice questions covering demographic data, knowledge sources, and Likert-type items on factors affecting vaccination against influenza. The target response rate was 20 %. Results: In total, 642 (22 %) of 2870 health professionals (1220 physicians and 1650 nurses) responded to the questionnaire. Participants' mean age was 29.6 +/- 9.2 years (range 17-62 years); 177 (28.2 %) were physicians and 448 (71.3 %) were nurses. The rate of regular vaccination was 9.2 % (15.2 % for physicians and 8.2 % for nurses). Increasing age, longer work duration in health services, being male, being a physician, working in an internal medicine department, having a chronic disease, and living with a person over 65 years old significantly increased vaccination compliance (p < 0.05). We found differences between vaccine compliant and non-compliant groups for expected benefit from vaccination, social influences, and personal efficacy (p < 0.05). Univariate analysis showed differences between the groups in perceptions of personal risks, side effects, and efficacy of the vaccine (p < 0.05). Multivariate analysis found that important factors influencing vaccination behavior were work place, colleagues' opinions, having a chronic disease, belief that vaccination was effective, and belief that flu can be prevented by natural ways. Conclusion: Numerous factors influence health professionals' decisions about influenza vaccination. Strategies to increase the ratio of vaccination among physicians and nurses should consider all of these factors to increase the likelihood of success.
- Published
- 2016
38. A Rare Cause of Recurrent Iron Deficiency Anemia: Osler Weber Rendu Syndrome
- Author
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Çiğdem Gereklioğlu, Gürcan Erbay, Nurhilal Büyükkurt, Aslı Korur, Barış Soydaş, and Süheyl Asma
- Subjects
Pathology ,medicine.medical_specialty ,business.industry ,Mucous membrane of nose ,Disease ,030204 cardiovascular system & hematology ,medicine.disease ,Dermatology ,body regions ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Neurologic problems ,Iron-deficiency anemia ,medicine ,Osler-Weber-Rendu Syndrome ,Oral mucosa ,business ,030217 neurology & neurosurgery ,Recurrent hemorrhage - Abstract
Osler-Weber-Rendu Syndrome (hereditary hemorrhagic telengiectasis) is a hereditary disease with autosomal dominant inheritance characterized by muco-cutaneous telengiectasis, arterio-venous malformations in internal organs. The disease is manifested by telengiectasis in oral mucosa, ear, nasal mucosa, fingertips and finger-beds and recurrent hemorrhage. Epistaxis is among the typical findings of the disease. Coexistence with arterio-venous malformations is common. It may lead to gastrointestinal hemorrhage and neurologic problems due to mucosal telengiectasis. Herein, we presented a case who had recurrent iron deficiency anemia and diagnosed with Osler-Weber-Rendu Syndrome as the result of radiologic and endoscopic examinations performed due to the presence of oral telengiectasis.
- Published
- 2016
39. ANORECTAL COMPLICATIONS DURING NEUTROPENIC PERIOD IN PATIENTS WITH HEMATOLOGIC DISEASES
- Author
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Çiğdem Gereklioğlu, Süheyl Asma, Mutlu Kasar, Soner Solmaz, Mahmut Yeral, Aslı Korur, Nurhilal Büyükkurt, Ilknur Kozanoglu, Can Boga, and Hakan Ozdogu
- Subjects
medicine.medical_specialty ,Disease ,Neutropenia ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,In patient ,business.industry ,lcsh:RC633-647.5 ,Mortality rate ,Hematology ,lcsh:Diseases of the blood and blood-forming organs ,medicine.disease ,Surgery ,Leukemia ,leukemia, neutropenia, anorectal complication, perianal infection ,Infectious Diseases ,Hematologic disease ,INFECTIONS ,030220 oncology & carcinogenesis ,Absolute neutrophil count ,Original Article ,030211 gastroenterology & hepatology ,business ,Complication - Abstract
Background: Neutropenic patients are susceptible to any anorectal disease, and symptomatic anorectal disease afflicts 2-32% of oncology patients. Perianal infections are the most feared complication, considering the lack of natural defense against infectious microorganisms. When septic complications develop, the anorectal disease is potentially fatal, especially in neutropenic patients in whom mortality rates range between 11-57%. Although anorectal diseases are a frequent complication with potentially fatal outcomes among patients with hematologic diseases, sufficient data are not available in the literature. In this study, we aimed to investigate the anorectal complications developing during the neutropenic period in patients with hematologic diseases. Methods: A total of 79 patients whose neutropenic period (absolute neutrophil count < 500/mcL) continued for 7 days, or longer were included in the study. Results: A total of 34 patients out of 79 (43%) were detected to develop anorectal complications, of them 6 (7.6%) developed an anorectal infection. The patients were characterized according to the hematological disease and its status (active or not), the type of treatment and the presence of a history of an anorectal pathology before the onset of the hematologic disease. Nineteen (24.1%) patients had the history of anorectal disturbances before diagnosis of the hematologic disease, and recurrence of an anorectal pathology was found in 14 out of 19 patients(73.7%). In addition, the overall mortality rate was higher among the patients who developed anorectal complications compared to another group (41.2% vs. 22.2%, p= 0.059). Conclusion: Anorectal pathology is a common complication with high recurrence rate in neutropenic patients. Perianal infections are important as they can cause life-threatening outcomes although they are relatively rare among all anorectal complications. Therefore perianal signs and symptoms should be meticulously evaluated concerning early diagnosis and treatment.
- Published
- 2016
40. East Mediterranean region sickle cell disease mortality trial: retrospective multicenter cohort analysis of 735 patients
- Author
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Çiğdem Gereklioğlu, Cagla Sariturk, Selma Unal, Süheyl Asma, Can Boga, Hakan Ozdogu, Mutlu Kasar, Pelin Karacaoğlu, Aslı Korur, Demircan Ozbalci, Mahmut Yeral, Nurhilal Büyükkurt, Hasan Kaya, Soner Solmaz, Emel Gürkan, and Çukurova Üniversitesi
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Turkey ,Thalassemia ,Population ,Anemia, Sickle Cell ,Cohort Studies ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,hemic and lymphatic diseases ,medicine ,Humans ,Mortality ,education ,Retrospective Studies ,education.field_of_study ,Univariate analysis ,Mediterranean Region ,business.industry ,Painful crisis ,Sickle cell disease ,Retrospective cohort study ,Hematology ,General Medicine ,Middle Aged ,medicine.disease ,Acute chest syndrome ,Cross-Sectional Studies ,Hemoglobinopathy ,030220 oncology & carcinogenesis ,Female ,Transfusion therapy ,business ,030215 immunology ,Cohort study - Abstract
PubMedID: 27068408 Sickle cell disease (SCD), one of the most common genetic disorders worldwide, is characterized by hemolytic anemia and tissue damage from the rigid red blood cells. Although hydroxyurea and transfusion therapy are administered to treat the accompanying tissue injury, whether either one prolongs the lifespan of patients with SCD is unknown. SCD-related mortality data are available, but there are few studies on mortality-related factors based on evaluations of surviving patients. In addition, ethnic variability in patient registries has complicated detailed analyses. The aim of this study was to investigate mortality and mortality-related factors among an ethnically homogeneous population of patients with SCD. The 735 patients (102 children and 633 adults) included in this retrospective cohort study were of Eti-Turk origin and selected from 1367 patients seen at 5 regional hospitals. A central population management system was used to control for records of patient mortality. Data reliability was checked by a data supervision group. Mortality-related factors and predictors were identified in univariate and multivariate analyses using a Cox regression model with stepwise forward selection. The study group included patients with homozygous hemoglobin S (Hgb S) disease (67 %), Hb S-ß0 thalassemia (17 %), Hgb S-ß+ thalassemia (15 %), and Hb S-? thalassemia (1 %). They were followed for a median of 66 ± 44 (3–148) months. Overall mortality at 5 years was 6.1 %. Of the 45 patients who died, 44 (6 %) were adults and 1 (0.1 %) was a child. The mean age at death was 34.1 ± 10 (18–54) years for males, 40.1 ± 15 (17–64) years for females, and 36.6 ± 13 (17–64) years overall. Hydroxyurea was found to have a notable positive effect on mortality (p = 0.009). Mortality was also significantly related to hypertension and renal damage in a univariate analysis (p = 0.015 and p = 0.000, respectively). Acute chest syndrome, splenic sequestration, and prolonged painful-crisis-related multiorgan failure were the most common causes of mortality. In a multivariate analysis of laboratory values, only an elevated white blood cell count was related to mortality (p = 0.009). These data show that despite recent progress in the treatment of SCD, disease-related factors continue to result in mortality in young adult patients. Our results highlight the importance of evaluating curative treatment options for patients who have an appropriate stem cell donor in addition to improving patient care and patient education. © 2016, Springer-Verlag Berlin Heidelberg.
- Published
- 2016
41. Medication adherence to oral iron therapy in patients with iron deficiency anemia
- Author
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Çiğdem Gereklioğlu, Süheyl Asma, Aslı Korur, Ferit Erdogan, and Altuğ Kut
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Side effect ,business.industry ,Medication adherence ,General Medicine ,medicine.disease ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Iron-deficiency anemia ,030220 oncology & carcinogenesis ,Internal medicine ,Family medicine clinic ,Iron deficiency anemia ,Female patient ,medicine ,Oral iron therapy ,Original Article ,In patient ,medicine.symptom ,business ,Weight gain ,Iron therapy - Abstract
Objective: This study aimed at investigating the factors affecting medication adherence in patients who use oral iron therapy due to iron deficiency anemia. Methods: A total of 96 female patients in fertile age with mean age of 30 +/- 10.1 years (range 18-53) who were admitted to Family Medicine Clinic between 01 January and 31 March 2015 and who had received iron therapy within the recent three years were enrolled in the study. Data were collected through a questionnaire form. Results: Of the patients, 39 (40,6%) were detected not to use the medication regularly or during the recommended period. A statistically significant relationship was found between non-adherence to therapy and gastrointestinal side effects and weight gain (p
- Published
- 2016
42. Is the Game Over or Starting Again? The Role of the Transplant Team in Genetic Counseling for Adult Sickle Cell Disease Recipients
- Author
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Ilknur Kozanoglu, Mahmut Yeral, Aslı Korur, Çiğdem Gereklioğlu, Can Boga, Hakan Ozdogu, Süheyl Asma, and Pelin Aytan
- Subjects
Adult ,lcsh:Internal medicine ,Pathology ,medicine.medical_specialty ,Anemia ,medicine.medical_treatment ,Genetic counseling ,Cell ,MEDLINE ,Anemia, Sickle Cell ,Disease ,Hematopoietic stem cell transplantation ,Bioinformatics ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Transplantation, Homologous ,Letters to the Editor ,lcsh:RC31-1245 ,Transplantation ,lcsh:RC633-647.5 ,business.industry ,Hematopoietic Stem Cell Transplantation ,lcsh:Diseases of the blood and blood-forming organs ,Hematology ,medicine.disease ,Sickle cell anemia ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,business ,030215 immunology - Published
- 2017
43. Detection of vitamin B12 levels with the aid of some hematological and biochemical parameters that are more sensitive
- Author
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ILKNUR KOZANOGLU, SÜHEYL ASMA, HAKAN ÖZDOĞU, ERKAN MAYTALMAN, and Can Boga
- Subjects
Pharmacology (medical) ,General Pharmacology, Toxicology and Pharmaceutics - Published
- 2010
44. The association of pagophagia with Helicobacter pylori infection in patients with iron-deficiency anemia
- Author
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ILKNUR KOZANOGLU, SÜHEYL ASMA, HAKAN ÖZDOĞU, Ender Serin, and Can Boga
- Subjects
Adult ,Male ,medicine.medical_specialty ,Anemia ,Iron ,Spirillaceae ,Gastroenterology ,Helicobacter Infections ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Humans ,Pica (disorder) ,Aged ,Breath test ,Hematology ,Anemia, Iron-Deficiency ,Helicobacter pylori ,medicine.diagnostic_test ,biology ,business.industry ,Ice ,Pagophagia ,Middle Aged ,biology.organism_classification ,medicine.disease ,Breath Tests ,Intestinal Absorption ,Iron-deficiency anemia ,Immunology ,Pica ,Female ,medicine.symptom ,business - Abstract
This study aimed to determine the relationship between pagophagia (compulsive ice eating) and H. pylori infection in patients with iron-deficiency anemia. We identified H. pylori infection using the (13)C-urea breath test in 45 patients with iron-deficiency anemia (group 1) and 55 patients with iron-deficiency anemia and pagophagia (group 2). Subgroups for testing oral intestinal iron absorption were randomly assigned from both groups. These subgroups consisted of (a) 10 patients with iron-deficiency anemia, (b) 10 patients with iron-deficiency anemia and pagophagia, (c) 10 patients with iron-deficiency anemia, pagophagia, and H. pylori infection before the eradication of H. pylori and (d) subgroup c after eradication therapy. There was no difference in the rate of H. pylori infection in the iron-deficiency anemia groups, with or without pagophagia. Furthermore, oral intestinal iron absorption was not influenced by pagophagia and/or H. pylori infection. Pagophagia did not increase the risk of H. pylori infection in patients with iron-deficiency anemia. Pagophagia and H. pylori infection do not synergistically affect the development of intestinal iron absorption abnormalities.
- Published
- 2009
45. Visseral leishmaniazisin nadir bir hematolojik komplikasyonu: hemofagositik sendrom
- Author
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Can Boga, Ilknur Kozanoglu, Yusuf Ziya Demiroglu, Süheyl Asma, Soner Solmaz, and Tuba Turunç
- Subjects
0301 basic medicine ,Pathology ,medicine.medical_specialty ,030231 tropical medicine ,030106 microbiology ,lcsh:Medicine ,hemophagocytic syndrome ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,In patient ,Leishmania ,lcsh:R5-920 ,hemophagocytosis ,business.industry ,lcsh:R ,General Medicine ,medicine.disease ,Pancytopenia ,zoonoses ,medicine.anatomical_structure ,Visceral leishmaniasis ,Immunology ,Etiology ,Bone marrow ,Lymph ,Hemophagocytosis ,lcsh:Medicine (General) ,business - Abstract
The term “hemophagocytosis” describes the pathologic finding of activated macrophages, engulfing erythrocytes, leukocytes, platelets and their precursor cells. This phenomenon is an important finding in patients with hemophagocytic syndrome. It is a distinct clinical entity characterized by fever, pancytopenia, splenomegaly and hemophagocytosis in bone marrow, liver and lymph nodes. Hemophagocytic syndrome can be classified according to the underlying etiology into either primary (genetic) or secondary (acquired). Severe infections, malignancies, rheumatologic disorders and some metabolic diseases can lead to secondary hemophagocytic syndrome. Infection-associated hemophagocytic syndrome implicating Leishmania is very rare and often difficult to diagnose. Therefore, we aimed to report a young boy with Visceral Leishmaniasis associated hemophagocytic syndrome., Hemofagositoz terimi, aktive makrofajlari, fagosite edilmiş eritrosit, lökosit, trombosit ve onların öncül hücrelerini tarif etmektedir. Bu fenomen, hemofagositik sendromun önemli bir bulgusudur. Hemofagositik sendrom, ateş, pansitopeni, splenomegali ve kemik iliği, karaciğer ile lenf nodunda hemofagositoz ile karakterizedir. Hemofagositik sendrom, altta yatan etyolojiye göre primer (genetik) ve sekonder (kazanılmış) olmak üzere sınıflandırılabilir. Ağır enfeksiyonlar, kanserler, romatolojik hastalıklar ve bazı metabolik hastalıklar sekonder hemofagositik sendroma neden olabilmektedir. Leishmania’ nın neden olduğu enfeksiyon ilişkili hemofagositik sendrom çok nadirdir ve sıklıkla tanıda zorluklara yol açmaktadır. Bundan dolayı Visseral Leishmaniazis ilişkili hemofagotik sendromlu genç bir hasta sunulması amaçlanmıştır.
- Published
- 2015
46. Plasma-exchange treatment for severe carbamazepine intoxication: A case study
- Author
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Mahmut Yeral, Can Boga, Hakan Ozdogu, Aytül Noyan, Suat Kahveci, Ilknur Kozanoglu, and Süheyl Asma
- Subjects
Generalized tonic-clonic seizure ,business.industry ,Hematology ,General Medicine ,Carbamazepine ,Ventricular tachycardia ,medicine.disease ,First line treatment ,Apheresis ,Anesthesia ,Accidental ,medicine ,Ingestion ,business ,Complication ,medicine.drug - Abstract
Acute poisoning is an important cause of morbidity and mortality during childhood. This manuscript reports the positive outcome of a pediatric case with a history of accidental carbamazepine intake treated using plasma exchange. A 3-year-old male presented with severe carbamazepine intoxication. He was comatose and had generalized tonic clonic seizure, ventricular tachycardia, and hypotension. Although he did not respond to classical therapies, we performed two sessions of plasma exchange. The patient recovered rapidly and was discharged from the hospital six days from the time of carbamazepine ingestion with no complication or neurologic impairment. Plasma exchange can be performed safely in very small children, and it might be the first line treatment, particularly for intoxication with drugs that have high plasma-protein-binding properties. J. Clin. Apheresis 29:178–180, 2014. © 2013 Wiley Periodicals, Inc.
- Published
- 2013
47. An iron deficiency anemia and a different pica substance: a case report
- Author
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Kutlu Abacı, Ahmet Ferit Erdoğan, and Süheyl Asma
- Published
- 2009
48. Waterpipe Smoking: An Incidios Threat For The Young
- Author
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Süheyl Asma, Çiğdem Gereklioğlu, Asslı Korur, and Soner Solmaz
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,Waterpipe Smoking ,Medicine ,business - Abstract
Tutunun kullanim bicimleri arasinda tutun cigneme, pipo, puro, sigara ve nargile bulunmaktadir. Nargile, daha cok Ortadogu ulkelerinde yaslilar tarafindan kullanilmaktadir. Son yillarda tum dunyada oldugu gibi, ulkemizde de kullanimi artmaktadir. Aromali formlarinin uretilmesiyle ozellikle gencler arasinda hizla yayilmaktadir. Tutun ve nargile kullanimi, ciddi bir halk sagligi sorunudur. Nargile kullanimina bagli gelisebilecek saglik riskleri bilinmektedir. Kullanim sikliginin azaltilmasi icin, medya disinda, kanun belirleyicilerin, yerel yonetimlerin alacaklari onlem ve bilgilendirme onemlidir. Ayrica, aile hekimliginin toplum yonelimli hasta bakimi, uygun ve etkili girisimler ile, saglik ve iyilik durumunun gelistirilmesi ilkeleri cercevesinde, aile hekiminin ozellikle genc nufusu, aile bireylerini ve yasadigi toplumu bu konuda yeterli bilgilendirmesi ve tedbirlerin alinmasinda oncu olmasi onem tasimaktadir. Bu calisma ile, aile hekimlerinin nargile kullanimi ile ilgili, farkindaliginin arttirilmasini amaclanmistir.
- Published
- 2016
49. Beta-thalassemia intermedia associated with moyamoya syndrome
- Author
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Levent Oguzkurt, Hakan Ozdogu, Tulin Yildirim, Başak Karakurum Göksel, and Süheyl Asma
- Subjects
Male ,medicine.medical_specialty ,Anemia ,White matter ,Young Adult ,hemic and lymphatic diseases ,Physiology (medical) ,medicine.artery ,Internal medicine ,Occlusion ,medicine ,Humans ,Stroke ,Thrombocytosis ,medicine.diagnostic_test ,business.industry ,beta-Thalassemia ,General Medicine ,Digital subtraction angiography ,medicine.disease ,medicine.anatomical_structure ,Neurology ,Middle cerebral artery ,Angiography ,Cardiology ,Surgery ,Neurology (clinical) ,Radiology ,Moyamoya Disease ,business - Abstract
Moyamoya syndrome (MMS) is a progressive disorder. We report a 19-year-old boy with β-thalassemia who presented with a left hemiparesis. Brain MRI showed old middle cerebral artery and left frontal subcortical white matter infarcts. Brain magnetic resonance angiography and digital subtraction angiography revealed occlusion of the bilateral internal carotid arteries with a rich network of basal collateral vessels. To our knowledge this is the third report of β-thalassemia intermedia and MMS, and the first report of a patient in Turkey. It emphasizes the potential for cerebral infarct due to anemia, protein S and thrombocytosis.
- Published
- 2009
50. Safety, therapeutic effectiveness, and cost of parenteral iron therapy
- Author
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Can Boga, Hakan Ozdogu, and Süheyl Asma
- Subjects
Adult ,Male ,medicine.medical_specialty ,Cost effectiveness ,Anemia ,medicine.medical_treatment ,Hematocrit ,Iron sucrose ,Gastroenterology ,Ferric Compounds ,Glucaric Acid ,Hemoglobins ,Internal medicine ,medicine ,Humans ,Mean corpuscular volume ,Ferric Oxide, Saccharated ,medicine.diagnostic_test ,Anemia, Iron-Deficiency ,business.industry ,Hematology ,Middle Aged ,medicine.disease ,Surgery ,Iron-deficiency anemia ,Intravenous therapy ,Ferritins ,Costs and Cost Analysis ,Hematinics ,Female ,Hemoglobin ,business ,medicine.drug - Abstract
Patients have to discontinue the use of oral iron therapy due to the development of side effects and lack of long-term adherence to medication for iron deficiency anemia. This study aimed to evaluate the therapeutic effectiveness, safety, and cost of intravenous iron sucrose therapy. The computerized database and medical records of 453 patients diagnosed with iron deficiency anemia who received intravenous iron sucrose therapy for iron deficiency anemia between 2004 and 2008 were reviewed. The improvement of hematologic parameters and cost of therapy were evaluated 4 weeks after therapy. 453 patients (443 females, 10 males; age: 44.2 +/- 12.3 years) received iron sucrose therapy. Mean hemoglobin, hematocrit, and mean corpuscular volume values were 8.2 +/- 1.4 g/dL, 26.9 +/- 3.8%, and 66.1 +/- 7.8 fL, respectively, before therapy and 11.5 +/- 1.0 g/dL, 35.8 +/- 2.5%, 76.5 +/- 6.1 fL, respectively, after therapy (P0.001). A mean ferritin level of 3.4 +/- 2.4 ng/mL before therapy increased to 65.9 +/- 40.6 ng/mL after therapy (P0.001). All patients responded to intravenous iron therapy (transferrin saturation values of the patients were50%). The mean cost of therapy was 143.07 +/- 29.13 US dollars. The therapy was well tolerated. Although the cost of intravenous iron sucrose therapy may seem high, a lack of adherence to therapy and side effects including gastrointestinal irritation during oral iron therapy were not experienced during intravenous therapy.
- Published
- 2008
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