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Kutluk T, Sahin B, Kirazli M, Ahmed F, Aydin S, Yesil Çinkir H, Sezgin G, Bayram I, Ebinç S, Isikdogan A, Sasmaz I, Okan V, Ilhan G, Ören AC, Akbayram S, Harputluoglu H, Ural C, Ayyildiz O, Aktas G, Uçar MA, Güvenç B, Köse D, Acipayam C, Güncan S, Erçolak V, Berber I, Akdeniz A, Akyay A, Üzel VH, Söker M, Sengelen M, Yalçin S, Sullivan R. Clinical Characteristics and Outcomes of Cancer Cases Among Syrian Refugees From Southern Turkey. JAMA Netw Open 2023; 6:e2312903. [PMID: 37219908 DOI: 10.1001/jamanetworkopen.2023.12903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
Importance Cancer was a common noncommunicable disease in Syria before the present conflict and is now a major disease burden among 3.6 million Syrian refugees in Turkey. Data to inform health care practice are needed. Objective To explore sociodemographic characteristics, clinical characteristics, and treatment outcomes of Syrian patients with cancer residing in the southern border provinces of Turkey hosting more than 50% of refugees. Design, Setting, and Participants This was a retrospective hospital-based cross-sectional study. The study sample consisted of all adult and children Syrian refugees diagnosed and/or treated for cancer between January 1, 2011, and December 31, 2020, in hematology-oncology departments of 8 university hospitals in the Southern province of Turkey. Data were analyzed from May 1, 2022, to September 30, 2022. Main Outcomes and Measures Demographic characteristics (date of birth, sex, and residence), date of first cancer-related symptom, date and place of diagnosis, disease status at first presentation, treatment modalities, date and status at last hospital visit, and date of death. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision and International Classification of Childhood Cancers, Third Edition, were used for the classification of cancer. The Surveillance, Epidemiology, and End Results system was applied for staging. The diagnostic interval was defined as the number of days from first symptoms until the diagnosis. Treatment abandonment was documented if the patient did not attend the clinic within 4 weeks of a prescribed appointment throughout the treatment. Results A total of 1114 Syrian adult and 421 Syrian children with cancer were included. The median age at diagnosis was 48.2 (IQR, 34.2-59.4) years for adults and 5.7 (IQR, 3.1-10.7) years for children. The median diagnostic interval was 66 (IQR, 26.5-114.3) days for adults and 28 (IQR, 14.0-69.0) days for children. Breast cancer (154 [13.8%]), leukemia and multiple myeloma (147 [13.2%]), and lymphoma (141 [12.7%]) were common among adults, and leukemias (180 [42.8%]), lymphomas (66 [15.7%]), and central nervous system neoplasms (40 [9.5%]) were common among children. The median follow-up time was 37.5 (IQR, 32.6-42.3) months for adults and 25.4 (IQR, 20.9-29.9) months for children. The 5-year survival rate was 17.5% in adults and 29.7% in children. Conclusions and Relevance Despite universal health coverage and investment in the health care system, low survival rates were reported in this study for both adults and children with cancer. These findings suggest that cancer care in refugees requires novel planning within national cancer control programs with global cooperation.
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Affiliation(s)
- Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey
| | - Berksoy Sahin
- Department of Medical Oncology, Çukurova University, Adana, Turkey
| | - Meral Kirazli
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey
| | - Fahad Ahmed
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey
- Now with Department of Public Health, Yıldırım Beyazıt University, Ankara, Turkey
| | - Sinem Aydin
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey
| | | | - Gülay Sezgin
- Department of Pediatric Hematology-Oncology, Çukurova University, Adana, Turkey
| | - Ibrahim Bayram
- Department of Pediatric Hematology-Oncology, Çukurova University, Adana, Turkey
| | - Senar Ebinç
- Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | | | - Ilgen Sasmaz
- Department of Pediatric Hematology, Çukurova University, Adana, Turkey
| | - Vahap Okan
- Department of Hematology, Gaziantep University, Gaziantep, Turkey
| | - Gül Ilhan
- Department of Hematology, Mustafa Kemal University, Hatay, Turkey
| | - Ayse Ceyda Ören
- Department of Pediatric Hematology-Oncology, Gaziantep University, Gaziantep, Turkey
| | - Sinan Akbayram
- Department of Pediatric Hematology-Oncology, Gaziantep University, Gaziantep, Turkey
| | | | - Cihan Ural
- Department of Hematology, Dicle University, Diyarbakır, Turkey
| | - Orhan Ayyildiz
- Department of Hematology, Dicle University, Diyarbakır, Turkey
| | - Gökmen Aktas
- Department of Medical Oncology, Sütçü İmam University, Kahramanmaraş, Turkey
- Now at Medicalpoint Gaziantep Hospital, Gaziantep, Turkey
| | - Mehmet Ali Uçar
- Department of Hematology, Çukurova University, Adana, Turkey
| | - Birol Güvenç
- Department of Hematology, Çukurova University, Adana, Turkey
| | - Dogan Köse
- Department of Pediatric Oncology, Harran University, Şanlıurfa, Turkey
- Now at Emsey Hospital, İstanbul Turkey
| | - Can Acipayam
- Department of Pediatric Hematology-Oncology, Sütçü İmam University, Kahramanmaraş, Turkey
| | - Sabri Güncan
- Department of Medical Oncology, Mersin University, Mersin, Turkey
| | - Vehbi Erçolak
- Department of Medical Oncology, Mersin University, Mersin, Turkey
| | - Ilhami Berber
- Department of Hematology, İnönü University, Malatya, Turkey
| | - Aydan Akdeniz
- Department of Hematology, Mersin University, Mersin, Turkey
| | - Arzu Akyay
- Department of Pediatric Hematology-Oncology, İnönü University, Malatya, Turkey
| | - Veysiye Hülya Üzel
- Department of Pediatric Hematology-Oncology, Dicle University, Diyarbakır, Turkey
| | - Murat Söker
- Department of Pediatric Hematology-Oncology, Dicle University, Diyarbakır, Turkey
| | - Meltem Sengelen
- Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Suayib Yalçin
- Department of Medical Oncology, Hacettepe University, Ankara, Turkey
| | - Richard Sullivan
- King's College London, Institute of Cancer Policy, Conflict & Health Research Group, London, United Kingdom
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Yılmaz K, Öncül H, Uzel H, Öncel K, Yılmaz ED, Söker M. Evaluation of retinal nerve fiber layer and choroidal thickness with spectral domain optical coherence tomography in children with sickle cell anemia. Turk J Pediatr 2021; 63:875-883. [PMID: 34738369 DOI: 10.24953/turkjped.2021.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aim of this study is to examine the thickness of choroidal, macular and peripapillary retinal nerve fiber layer by spectral-domain optical coherence tomography (SD-OCT) in pediatric patients with sickle cell anemia (SCA) without retinopathy. METHODS A total of 75 children (30 SCA patients (Group 1) and 45 healthy individuals (Group 2) were included in the study. Macular (central, superior, inferior, nasal, temporal), choroidal (subfoveal, at nasal distances from the central fovea of 1000 μm [N1], 2000 μm [N2], 3000 μm [N3], at temporal distances from the central fovea of 1000 μm [T1], 2000 μm [T2], 3000 μm [T3]) and RNFL (average, temporal, superotemporal, inferotemporal, nasal, inferonasal and superonasal) measurements were performed by SD-OCT. These parameters were compared with healthy children with similar demographic characteristics. RESULTS The mean age was 14.11±3.86 (11-18) in sickle cell anemia patients and 13.15± 2.69 (10-18) in the healthy control group. Of the patients, 56.6% (n=17) of Group 1 and 44.4% (n=20) of Group 2 were male. Choroidal measurements made in the subfoveal, N1, N2, N3, T1, T2 and T3 quadrants showed that the choroid was thinner in 6 quadrants in SCA patients compared to the healthy group (p = 0.003, p = 0.039, p = 0.035, p = 0.595, p = 0.006, p = 0.005, p = 0.047, respectively). In RNFL measurements, there was significant thinning in the temporal, inferotemporal, and nasal quadrants of SCA patients compared to the healthy group. Changes in other quadrants were not significant. CONCLUSIONS SD-OCT is a useful imaging method in the diagnosis and screening in patients with SCA without retinopathy. Early diagnosis of retinopathy during subclinical disease will prevent visual loss in these patients.
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Affiliation(s)
- Kamil Yılmaz
- Departments of Pediatrics Infectious Diseases, Dicle University Faculty of Medicine, Diyarbakır
| | - Hasan Öncül
- Departments of Ophthalmology, University of Health Sciences Gazi Yaşargil Education Research Hospital, Diyarbakır, Turkey
| | - Hülya Uzel
- Departments of Pediatric Hematology, Dicle University Faculty of Medicine, Diyarbakır
| | - Kahraman Öncel
- Departments of Pediatric Hematology, University of Health Sciences Gazi Yaşargil Education Research Hospital, Diyarbakır, Turkey
| | - E Deniz Yılmaz
- Departments of Pathology, Dicle University Faculty of Medicine, Diyarbakır
| | - Murat Söker
- Departments of Pediatric Hematology, Dicle University Faculty of Medicine, Diyarbakır
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Ünüvar A, Evim MS, Karaman S, Akçay A, Eker İ, Küpesiz FT, Özbek N, Ertem M, Aydın S, Keskin Z, Aral YZ, Gördü Z, Elli M, Karagenç AÖ, Apak BB, Uzel H, Söker M, Karapınar T, Oymak Y, Karadaş N, Özcan A, Töret E, Koçak Ü, Akbayram S, Cangül ŞÜ, Ayhan AC, Celkan T, Tuğcu D, Zülfikar B, Kebudi R, Hacısalihoğlu Ş, Erduran E, Gelen SA, Sarper N, Erbey F, Kürekçi E, Gülen H, Yılmaz B, Doğru Ö, Koç A, Ünal S, Tokgöz H, Albayrak C, Ay Y, Orhan F, Albayrak D, Karakurt N, Orhaner B, Türkkan E, Yıldırmak Y, Geylani H, Koç B, Öner AF, Timur Ç, Ören H. CHILDHOOD IMMUNE THROMBOCYTOPENIA: A MULTICENTER QUESTIONNAIRE STUDY. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.1070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Üzel VH, Yılmaz K, Şen V, Aktar F, Karabel M, Yolbaş İ, Pirinççioğlu AG, Söker M. Evaluation of Hematological Parameters of Children Diagnosed with COVID-19: Single-Center Experience. Turk Arch Pediatr 2021; 56:463-468. [PMID: 35110115 PMCID: PMC8849318 DOI: 10.5152/turkarchpediatr.2021.21076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Although many pediatric studies on children infected with coronavirus disease 2019 (COVID-19) have been published, the diagnosis, clinical symptoms, laboratory findings, and treatment of COVID-19 in children are still unclear. MATERIALS AND METHODS This study was conducted with an aim to examine the hematological findings of symptomatic pediatric patients diagnosed with COVID-19 in May 2020 at the Pandemic Hospital in Dicle University. Patient records were evaluated retrospectively. This study involved 59 symptomatic pediatric patients with a definite diagnosis of COVID-19 who had positive SARS-CoV-2 RT-PCR test results on nasopharyngeal swab between March 15, 2020 and May 31, 2020. RESULTS The records of a total of 10 (16.9%) patients under the age of 1; 21 (35.6%) patients aged 1-10 years, and, 28 (47.5%) patients aged 10-18 years, who had been diagnosed with COVID-19 were evaluated. Based on severity, 35 (59.3%) patients were in the mild group (group 1) and 24 (40.7%) patients were in the moderate-severe group (group 2). The blood parameters of WBC, neutrophil, lymphocyte, monocyte, and thrombocyte counts, the hemoglobin (Hgb) level, and NLR, PLR, MPV, fibrinogen, ferritin, and D-dimer levels were compared between groups, the difference was not statistically significant (P > .05). LDH was higher in group 2 (P = .014). CONCLUSION Since children infected with COVID-19 show mild clinical symptoms or are asymptomatic, fewer pediatric patients may be detected than adults. Therefore, it should be known that the laboratory findings typical for adults may not accompany the disease in pediatric cases. More studies are needed to determine the most appropriate COVID-19 treatment approach for children, as hospitalization history and testing rates are less reported among children.
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Koca Yozgat A, Leblebisatan G, Akbayram S, Çınar Özel S, Karakaş Z, Erduran E, Yılmaz Ş, Koçak Ü, Ünal Ş, Özdemir GN, Albayrak M, Zengin E, Oymak Y, Bör Ö, Çakmaklı HF, Söker M, Gürlek Gökçebay D, Tokgöz H, Malbora B, Karaman S, Celkan T, Şaşmaz İ, Yaralı N, Ören H, Ünüvar A, Özbek NY. Outcomes of Eltrombopag Treatment and Development of Iron Deficiency in Children with Immune Thrombocytopenia in Turkey. Turk J Haematol 2020; 37:139-144. [PMID: 32181630 PMCID: PMC7463208 DOI: 10.4274/tjh.galenos.2020.2019.0380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective Immune thrombocytopenia (ITP) is a rare autoimmune disease and hematologic disorder characterized by reduced platelet counts that can result in significant symptoms, such as bleeding, bruising, epistaxis, or petechiae. The thrombopoietin receptor agonist eltrombopag (EPAG) is a second-line agent used to treat chronic ITP purpura in adults and children. Materials and Methods The present retrospective study evaluated the efficacy, safety, and side effects of EPAG treatment in pediatric patients with acute refractory and chronic immune thrombocytopenia, particularly focusing on iron-deficiency anemia. Results The diagnosis was chronic ITP in 89 patients and acute refractory ITP in 16 patients. The mean age of patients was 9.5±4.5 years (minimum-maximum: 1.2-18 years) at the beginning of EPAG treatment. The overall response rate was 74.3% (n=78). The mean time for platelet count of ≥50x109/L was 11.6±8 weeks (range: 1-34 weeks). The treatment was stopped for 27 patients (25.7%) at an average of 6.8±9 months (range: 1-38 months). The reason for discontinuation was lack of response in 18 patients, nonadherence in 4 patients, and hepatotoxicity in 2 patients. Response to treatment continued for an average of 4 months after cessation of EPAG in 3 patients. Conclusion Results of the current study imply that EPAG is an effective therapeutic option in pediatric patients with acute refractory and chronic ITP. However, patients must be closely monitored for response and side effects during treatment, and especially for iron deficiency.
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Affiliation(s)
- Ayça Koca Yozgat
- Ankara City Hospital, Clinic of Pediatric Hematology, Ankara, Turkey
| | - Göksel Leblebisatan
- Çukurova University Faculty of Medicine, Department of Pediatric Hematology, Adana, Turkey
| | - Sinan Akbayram
- Gaziantep University Faculty of Medicine, Department of Pediatric Hematology, Gaziantep, Turkey
| | - Simge Çınar Özel
- İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Pediatric Hematology, İstanbul, Turkey
| | - Zeynep Karakaş
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatric Hematology, İstanbul, Turkey
| | - Erol Erduran
- Karadeniz Technical University Faculty of Medicine, Department of Pediatric Hematology, Trabzon, Turkey
| | - Şebnem Yılmaz
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Ülker Koçak
- Gazi University Faculty of Medicine, Department of Pediatric Hematology, Ankara, Turkey
| | - Şule Ünal
- Hacettepe University Faculty of Medicine, Department of Pediatric Hematology, Ankara, Turkey
| | - Gül Nihal Özdemir
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Hematology, İstanbul, Turkey
| | - Meryem Albayrak
- Kırıkkale University Faculty of Medicine, Department of Pediatric Hematology, Kırıkkale, Turkey
| | - Emine Zengin
- Kocaeli University Faculty of Medicine, Department of Pediatric Hematology, Kocaeli, Turkey
| | - Yeşim Oymak
- Dr. Behçet Uz Children’s Training and Research Hospital, Clinic of Pediatric Hematology, İzmir, Turkey
| | - Özcan Bör
- Eskişehir University Faculty of Medicine, Department of Pediatric Hematology, Eskişehir, Turkey
| | - Hasan Fatih Çakmaklı
- Ankara University Faculty of Medicine, Department of Pediatric Hematology, Ankara, Turkey
| | - Murat Söker
- Dicle University Faculty of Medicine, Department of Pediatric Hematology, Diyarbakır, Turkey
| | - Dilek Gürlek Gökçebay
- Ankara Keçiören Training and Research Hospital, Clinic of Pediatric Hematology, Ankara, Turkey
| | - Hüseyin Tokgöz
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Pediatric Hematology, Konya, Turkey
| | - Barış Malbora
- Yeni Yüzyıl University, Gaziosmanpaşa Hospital, Clinic of Pediatric Hematology, İstanbul, Turkey
| | - Serap Karaman
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatric Hematology, İstanbul, Turkey
| | - Tiraje Celkan
- İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Pediatric Hematology, İstanbul, Turkey
| | - İlgen Şaşmaz
- Çukurova University Faculty of Medicine, Department of Pediatric Hematology, Adana, Turkey
| | - Neşe Yaralı
- Ankara City Hospital, Clinic of Pediatric Hematology, Ankara, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Ayşegül Ünüvar
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatric Hematology, İstanbul, Turkey
| | - Namık Yaşar Özbek
- Ankara City Hospital, Clinic of Pediatric Hematology, Ankara, Turkey
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Çetinçakmak MG, Hattapoğlu S, Söker M, Ekici F, Yilmaz K, Göya C, Hamidi C. Evaluation of the relationship between splenic iron overload and liver, heart and muscle features evident on T2*-weighted magnetic resonance imaging. ADV CLIN EXP MED 2020; 29:475-480. [PMID: 32369274 DOI: 10.17219/acem/116758] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Splenic iron overload is the most common clinical condition in patients with thalassemia. However, few studies of the effects of splenectomy have been published. OBJECTIVES To evaluate the relationship between splenic iron overload and liver, heart and muscle features visible in T2*-weighted magnetic resonance imaging, and to investigate the effects of splenectomy on these tissues in patients with beta-thalassemia major (TM). MATERIAL AND METHODS We retrospectively included 131 patients (76 male and 55 female) diagnosed with TM. All radiological assessments were performed with the aid of a Philips Achieva 1.5T scanner running a multiecho gradient-echo sequence. Hepatic and splenic T2* values were assessed in the same gradient multiecho series. Muscle T2* values were assessed in the shoulder girdle muscles adjacent to the heart area. The relationships among splenic T2*, hepatic T2*, cardiac T2* and muscle T2* parameters, serum ferritin levels, age and other parameters were evaluated. RESULTS The splenic T2* value correlated with serum ferritin level and the hepatic T2* value (p < 0.001 and p < 0.001, respectively). The splenic T2* value did not correlate with age, cardiac or muscle T2* values, or with spleen size (p = 0.27, 0.21, 0.99, and 0.39, respectively). The muscle T2* value correlated weakly with the serum ferritin level (p = 0.022). The cardiac T2* value was lower and the liver size greater in patients who had undergone splenectomy compared with those who had not (p < 0.001 and 0.001, respectively). CONCLUSIONS Splenic iron overload correlated with hepatic overload and the serum ferritin level. Splenectomy increased cardiac iron overload and triggered liver enlargement. However, the muscle iron overload was low and the muscles were therefore unaffected by splenectomy.
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Affiliation(s)
| | - Salih Hattapoğlu
- Department of Radiology, Medical School, Dicle University, Diyarbakir, Turkey
| | - Murat Söker
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - Faysal Ekici
- Department of Radiology, Medical School, Dicle University, Diyarbakir, Turkey
| | - Kamil Yilmaz
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - Cemil Göya
- Department of Radiology, Medical School, Dicle University, Diyarbakir, Turkey
| | - Cihad Hamidi
- Department of Radiology, Medical School, Dicle University, Diyarbakir, Turkey
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7
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Yılmaz Karapınar D, Patıroğlu T, Metin A, Çalışkan Ü, Celkan T, Yılmaz B, Karakaş Z, Karapınar TH, Akıncı B, Özkınay F, Onay H, Yeşilipek MA, Akar HH, Tüysüz G, Tokgöz H, Özdemir GN, Aslan Kıykım A, Karaman S, Kılınç Y, Oymak Y, Küpesiz A, Olcay L, Keskin Yıldırım Z, Aydoğan G, Gökçe M, İleri T, Aral YZ, Bay A, Atabay B, Kaya Z, Söker M, Özdemir Karadaş N, Özbek U, Özsait Selçuk B, Özdemir HH, Uygun V, Tezcan Karasu G, Yılmaz Ş. Homozygous c.130-131 ins A (pW44X) mutation in the HAX1 gene as the most common cause of congenital neutropenia in Turkey: Report from the Turkish Severe Congenital Neutropenia Registry. Pediatr Blood Cancer 2019; 66:e27923. [PMID: 31321910 DOI: 10.1002/pbc.27923] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 06/18/2019] [Accepted: 06/26/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Severe congenital neutropenia is a rare disease, and autosomal dominantly inherited ELANE mutation is the most frequently observed genetic defect in the registries from North America and Western Europe. However, in eastern countries where consanguineous marriages are common, autosomal recessive forms might be more frequent. METHOD Two hundred and sixteen patients with severe congenital neutropenia from 28 different pediatric centers in Turkey were registered. RESULTS The most frequently observed mutation was HAX1 mutation (n = 78, 36.1%). A heterozygous ELANE mutation was detected in 29 patients (13.4%) in our cohort. Biallelic mutations of G6PC3 (n = 9, 4.3%), CSF3R (n = 6, 2.9%), and JAGN1 (n = 2, 1%) were also observed. Granulocyte colony-stimulating factor treatment was given to 174 patients (80.6%). Two patients died with infectious complications, and five patients developed myelodysplastic syndrome/acute myeloblastic leukemia. The mean (± mean standard error) follow-up period was 129.7 ± 76.3 months, and overall survival was 96.8% (CI, 94.4-99.1%) at the age of 15 years. In Turkey, severe congenital neutropenia mostly resulted from the p W44X mutation in the HAX1 gene. CONCLUSION In Turkey, mutation analysis should be started with HAX1, and if this is negative, ELANE and G6PC3 should be checked. Because of the very high percentage of consanguineous marriage, rare mutations should be tested in patients with a negative mutation screen.
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Affiliation(s)
| | - Türkan Patıroğlu
- Department of Pediatric Immunology, Erciyes University Faculty of Medicine, İzmir, Turkey
| | - Ayşe Metin
- Department of Pediatric Immunology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Ümran Çalışkan
- Department of Pediatric Hematology-Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Tiraje Celkan
- Department of Pediatric Hematology, Cerrahpaşa Medical Faculty, İstanbul University, Istanbul, Turkey
| | - Barış Yılmaz
- Department of Pediatric Hematology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Zeynep Karakaş
- Department of Pediatric Hematology-Oncology, İstanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Tuba H Karapınar
- Department of Pediatric Hematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, İzmir, Turkey
| | - Burcu Akıncı
- Department of Pediatric Hematology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Ferda Özkınay
- Department of Pediatric Genetic, Ege University Faculty of Medicine, İzmir, Turkey
| | - Hüseyin Onay
- Department of Medical Genetic, Ege University Faculty of Medicine, İzmir, Turkey
| | - Mehmet Akif Yeşilipek
- Pediatric Bone Marrow Transplantation Unit, Medical Park Göztepe Hospital, Istanbul, Turkey
| | - Himmet Haluk Akar
- Department of Pediatric Immunology, Erciyes University Faculty of Medicine, İzmir, Turkey
| | - Gülen Tüysüz
- Department of Pediatric Hematology, Akdeniz University Medical School, Antalya, Turkey
| | - Hüseyin Tokgöz
- Department of Pediatric Hematology-Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Gül Nihal Özdemir
- Department of Pediatric Hematology, Cerrahpaşa Medical Faculty, İstanbul University, Istanbul, Turkey
| | - Ayça Aslan Kıykım
- Department of Pediatric Allergy and Immunology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Serap Karaman
- Department of Pediatric Hematology-Oncology, İstanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Yurdanur Kılınç
- Department of Pediatric Hematology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Yeşim Oymak
- Department of Pediatric Hematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, İzmir, Turkey
| | - Alphan Küpesiz
- Department of Pediatric Hematology, Akdeniz University Medical School, Antalya, Turkey
| | - Lale Olcay
- Department of Pediatric Hematology, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Zuhal Keskin Yıldırım
- Department of Pediatric Hematology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Gönül Aydoğan
- Department of Pediatric Hematology, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Turkey
| | - Müge Gökçe
- Department of Pediatric Bone marrow Transplantation Unit, Yeni Yüzyıl Üniversitesi, Gaziosmanpaşa Hastanesi, Istanbul, Turkey
| | - Talia İleri
- Department of Pediatric Hematology, Ankara University Medical Faculty, Ankara, Turkey
| | - Yusuf Ziya Aral
- Department of Pediatric Hematology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Ali Bay
- Department of Pediatric Hematology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Berna Atabay
- Department of Pediatric Hematology, Tepecik Teaching and Research Hospital, İzmir, Turkey
| | - Zuhre Kaya
- Department of Pediatric Hematology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Murat Söker
- Department of Pediatric Hematology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | | | - Uğur Özbek
- Department of Genetics, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Bilge Özsait Selçuk
- Department of Genetics, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Hamiyet Hekimci Özdemir
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Fırat University, Elazığ, Turkey
| | - Vedat Uygun
- Pediatric Bone Marrow Transplantation Unit, Medical Park Antalya Hospital, Antalya, Turkey
| | - Gülsün Tezcan Karasu
- Pediatric Bone Marrow Transplantation Unit, Medical Park Antalya Hospital, Antalya, Turkey
| | - Şebnem Yılmaz
- Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
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8
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Antmen B, Karakaş Z, Yeşilipek MA, Küpesiz OA, Şaşmaz İ, Uygun V, Kurtoğlu E, Oktay G, Aydogan G, Akın M, Salcioglu Z, Vergin C, Kazancı EG, Ünal S, Çalışkan Ü, Aral YZ, Türkkan E, Meral Güneş A, Tunç B, Gümrük F, Ayhan AC, Söker M, Koç A, Oymak Y, Ertem M, Timur Ç, Yıldırmak Y, İrken G, Apak H, Biner B, Eren TG, Işık Balcı Y, Koçak Ü, Karasu G, Akkaynak D, Patıroğlu T. Deferasirox in children with transfusion‐dependent thalassemia or sickle cell anemia: A large cohort real‐life experience from Turkey (REACH‐THEM). Eur J Haematol 2018; 102:123-130. [DOI: 10.1111/ejh.13180] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 01/01/2023]
Affiliation(s)
| | | | | | | | - İlgen Şaşmaz
- Çukurova University Medical Faculty Adana Turkey
| | - Vedat Uygun
- Antalya Training and Research Hospital Antalya Turkey
| | | | | | - Gonul Aydogan
- Kanuni Sultan Suleyman Training and Research Hospital Istanbul Turkey
| | | | - Zafer Salcioglu
- Kanuni Sultan Suleyman Training and Research Hospital Istanbul Turkey
| | - Canan Vergin
- Dr. Behcet Uz Child Disease and Surgery Training and Research Hospital Izmir Turkey
| | | | - Selma Ünal
- Mersin University Medical Faculty Mersin Turkey
| | - Ümran Çalışkan
- Necmettin Erbakan University Meram Medical Faculty Konya Turkey
| | | | - Emine Türkkan
- Okmeydanı Training and Research Hospital Istanbul Turkey
| | | | - Bahattin Tunç
- Ankara Child Health and Disease, Hematology Oncology Training and Research Hospital Ankara Turkey
| | - Fatma Gümrük
- Hacettepe University Medical Faculty Ankara Turkey
| | | | - Murat Söker
- Dicle University Medical Faculty Diyarbakır Turkey
| | - Ahmet Koç
- Harran University Medical Faculty Şanlıurfa Turkey
| | - Yeşim Oymak
- Harran University Medical Faculty Şanlıurfa Turkey
| | - Mehmet Ertem
- Faculty of Medicine Ankara University Ankara Turkey
| | - Çetin Timur
- Goztepe Training and Research Hospital Istanbul Turkey
| | | | | | - Hilmi Apak
- Istanbul University Cerrahpasa Medical Faculty Istanbul Turkey
| | - Betül Biner
- Trakya University Medical Faculty Edirne Turkey
| | | | | | - Ülker Koçak
- Gazi University Medical Faculty Ankara Turkey
| | - Gülsün Karasu
- Istanbul Zeynep Kamil Women and Children's Diseases raining and Research Hospital Istanbul Turkey
| | - Diyar Akkaynak
- Novartis Saglık, Gıda ve Tarım Ürünleri San. ve Tic. A.S Istanbul Turkey
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9
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Aydınok Y, Oymak Y, Atabay B, Aydoğan G, Yeşilipek A, Ünal S, Kılınç Y, Oflaz B, Akın M, Vergin C, Sezgin Evim M, Çalışkan Ü, Ünal Ş, Bay A, Kazancı E, İleri T, Atay D, Patıroğlu T, Kahraman S, Söker M, Akcan M, Akdeniz A, Büyükavcı M, Alanoğlu G, Bör Ö, Soyer N, Özdemir Karadaş N, Uysalol E, Türker M, Akçay A, Ocak S, Güneş AM, Tokgöz H, Ünal E, Tiftik N, Karakaş Z. A National Registry of Thalassemia in Turkey: Demographic and Disease Characteristics of Patients, Achievements, and Challenges in Prevention. Turk J Haematol 2017; 35:12-18. [PMID: 28404539 PMCID: PMC5843769 DOI: 10.4274/tjh.2017.0039] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: The Turkish Society of Pediatric Hematology set up a National Hemoglobinopathy Registry to demonstrate the demographic and disease characteristics of patients and assess the efficacy of a hemoglobinopathy control program (HCP) over 10 years in Turkey. Materials and Methods: A total of 2046 patients from 27 thalassemia centers were registered, of which 1988 were eligible for analysis. This cohort mainly comprised patients with β-thalassemia major (n=1658, 83.4%) and intermedia (n=215, 10.8%). Results: The majority of patients were from the coastal areas of Turkey. The high number of patients in Southeastern Anatolia was due to that area having the highest rates of consanguineous marriage and fertility. The most common 11 mutations represented 90% of all β-thalassemia alleles and 47% of those were IVS1-110(G->A) mutations. The probability of undergoing splenectomy within the first 10 years of life was 20%, a rate unchanged since the 1980s. Iron chelators were administered as monotherapy regimens in 95% of patients and deferasirox was prescribed in 81.3% of those cases. Deferasirox administration was the highest (93.6%) in patients aged <10 years. Of the thalassemia major patients, 5.8% had match-related hemopoietic stem cell transplantation with a success rate of 77%. Cardiac disease was detected as a major cause of death and did not show a decreasing trend in 5-year cohorts since 1999. Conclusion: While the HCP has been implemented since 2003, the affected births have shown a consistent decrease only after 2009, being at lowest 34 cases per year. This program failure resulted from a lack of premarital screening in the majority of cases. Additional problems were unawareness of the risk and misinformation of the at-risk couples. In addition, prenatal diagnosis was either not offered to or was not accepted by the at-risk families. This study indicated that a continuous effort is needed for optimizing the management of thalassemia and the development of strategies is essential for further achievements in the HCP in Turkey.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Şule Ünal
- Hemoglobinopathy Study Group, Turkey
| | - Ali Bay
- Hemoglobinopathy Study Group, Turkey
| | | | | | | | | | | | | | | | | | | | | | - Özcan Bör
- Hemoglobinopathy Study Group, Turkey
| | - Nur Soyer
- Hemoglobinopathy Study Group, Turkey
| | | | | | | | | | | | | | | | - Elif Ünal
- Hemoglobinopathy Study Group, Turkey
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10
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Akın A, Bilici M, Söker M, Aldudak B, Meteroğlu F. Chest Pain may be the First Symptom of Malignant Tumors in Children: Report of Two Cases. Dicle Med J 2016. [DOI: 10.5798/diclemedj.0921.2016.01.0659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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11
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Güneş A, Ece A, Aktar F, Tan İ, Söker M, Karabel D, Balık H, Uluca Ü, Şen V, Yolbaş İ. Urinary Kidney Injury Molecules in Children with Iron-Deficiency Anemia. Med Sci Monit 2015; 21:4023-9. [PMID: 26697893 PMCID: PMC4694706 DOI: 10.12659/msm.896794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 12/08/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate the urine levels of human kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-β-D-glucosaminidase (NAG), and liver-type fatty acid-binding protein (L-FABP) in children with iron-deficiency anemia (IDA). MATERIAL AND METHODS Thirty-five children with IDA and 32 matched healthy controls were recruited. We assessed complete blood count, serum iron, iron-binding capacity, ferritin, serum levels of urea, creatinine (Cr), sodium (Na), potassium (K), calcium (Ca), and glucose levels. Estimated glomerular filtration rate (eGFR) was calculated. Urinary NAG, NGAL, KIM-1, and L-FABP were measured and divided by urine creatinine for comparisons. RESULTS There were no significant differences in serum urea, Cr, or eGFR between the IDA group and the control group (p>0.05, for all). IDA patients had significantly higher urine NGAL/Cr, L-FABP/Cr, KIM-1/Cr, and NAG/Cr compared with the control group (p<0.05). There were significant negative correlations between hemoglobin, hematocrit, red blood cell count, and urine NGAL/Cr, NAG/Cr, L-FABP/Cr, KIM-1/Cr levels (p<0.05). CONCLUSIONS Higher urinary kidney injury molecule levels in IDA patients suggest a possible subclinical renal injury in pediatric IDA patients whose renal functions and serum electrolytes were normal.
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Affiliation(s)
- Ali Güneş
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - Aydın Ece
- Department of Pediatric Nephrology, Medical School, Dicle University, Diyarbakir, Turkey
| | - Fesih Aktar
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - İlhan Tan
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - Murat Söker
- Department of Pediatric Hematology, Medical School, Dicle University, Diyarbakir, Turkey
| | - Duran Karabel
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - Hasan Balık
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - Ünal Uluca
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - Velat Şen
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
| | - İlyas Yolbaş
- Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey
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12
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Karabel M, Kelekçi S, Sen V, Karabel D, Aliosmanoğlu C, Söker M. A rare cause of recurrent oral lesions: chediak-higashi syndrome. Turk J Haematol 2015; 31:313-4. [PMID: 25330529 PMCID: PMC4287037 DOI: 10.4274/tjh.2013.0282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Müsemma Karabel
- Dicle University Faculty of Medicine, Department of Pediatrics, Diyarbakır, Turkey. E-ma-il:
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13
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Şen V, Ece A, Uluca Ü, Söker M, Güneş A, Kaplan İ, Tan İ, Yel S, Mete N, Sahin C. Urinary early kidney injury molecules in children with beta-thalassemia major. Ren Fail 2015; 37:607-13. [PMID: 25656833 DOI: 10.3109/0886022x.2015.1007871] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate novel urinary biomarkers including N-acetyl-β-D-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and liver-type fatty acid binding protein (L-FABP) in children with β-thalassemia major (β-TM). MATERIALS AND METHODS Totally, 52 patients (29 boys, 23 girls) with β-TM and 29 healthy controls (3-17 years) were included. Various demographic characteristics and blood transfusions/year, disease duration, and chelation therapy were recorded. Serum urea, creatinine, electrolytes, and ferritin and urinary creatinine, protein, calcium, phosphorus, sodium, potassium, and uric acid in first morning urine samples were measured and estimated glomerular filtration rate (eGFR) was calculated. Routine serum and urinary biochemical variables, urinary NAG to Creatinine (U(NAG/Cr)), U(NGAL/Cr), U(KIM-1/Cr), and U(L-FABP/Cr) ratios were determined. RESULTS Patients had similar mean serum urea, creatinine and eGFR levels compared with controls (p > 0.05 for all). The mean urinary protein to creatinine (U(Protein/Cr)) ratio was significantly higher in patients compared to the healthy subjects (0.13 ± 0.09 mg/mg and 0.07 ± 0.04 mg/mg, respectively; p < 0.001). Significantly increased U(NAG/Cr) (0.48 ± 0.58 vs. 0.23 ± 0.16, p = 0.026) and U(NGAL/Cr) (22.1 ± 18.5 vs. 11.5 ± 6.17, p = 0.01) ratios were found in β-TM patients compared with healthy controls. However, no differences were found in serum and urinary electrolytes or U(KIM-1/Cr) and U(L-FABP/Cr) ratios between patients and controls (p > 0.05). Significant correlations were found between urinary biomarkers and urinary electrolytes (p < 0.05). CONCLUSIONS Our results suggest that urinary NAG and NGAL may be considered to be reliable markers to monitor renal injury in β-TM patients.
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Affiliation(s)
- Velat Şen
- Dicle University Medical School Department of Pediatrics , Diyarbakir , Turkey
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14
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Konca Ç, Söker M, Taş MA, Yıldırım R. Hereditary spherocytosis: evaluation of 68 children. Indian J Hematol Blood Transfus 2014; 31:127-32. [PMID: 25548458 DOI: 10.1007/s12288-014-0379-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 03/25/2014] [Indexed: 11/24/2022] Open
Abstract
To determine the clinical and hematologic features of 68 children with hereditary spherocytosis (HS). In this retrospective study, we analyzed recorded information of 68 HS patients diagnosed between March 1997 and March 2007, including clinical manifestations at admission, gender, median age at diagnosis, family history, hematologic and biochemical data, patient management, complications, median age of splenectomy, and median follow-up time. Sixty-eight patients with HS (36 male and female) were investigated. The median age at diagnosis was 5.6 years (range 3 months to 18 years). Twenty-seven (39.7 %) had parents with consanguineous marriages, and 20 (29.4 %) had parents with first-degree consanguinity. Predominant clinical manifestations at admission were anemia in 59 patients (86.76 %), splenomegaly in 49 (72.05 %), and jaundice in 33 (48.52 %). Patients were classified as mild, moderate, or severe in 29.4, 61.7, and 8.8 % of patients, respectively. Five patients (7.3 %) underwent splenectomy. Major complications of HS were hemolytic, aplastic, and megaloblastic crises and cholelithiasis in 7 (10.2 %), 1 (1.4 %), 7 (10.2 %), and 6 (8.8 %) of patients, respectively. There were no deaths during follow-up. HS should be considered in evaluating possible diagnoses in patients with hemolytic anemia. In this study, the clinical course of patients with HS was relatively benign, with low proportions of patients having splenectomized and aplastic crises.
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Affiliation(s)
- Çapan Konca
- Pediatrics Department, Adiyaman Medical Faculty, Manas evleri Uygur sitesi g blok no: 8 Altınsehir, Adiyaman, Turkey
| | - Murat Söker
- Pediatrics Department, Dicle Medical Faculty, Diyarbakir, Turkey
| | - Mehmet Ali Taş
- Pediatrics Department, Dicle Medical Faculty, Diyarbakir, Turkey
| | - Ruken Yıldırım
- Pediatrics Department, Dicle Medical Faculty, Diyarbakir, Turkey
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15
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Şen V, Bozkurt M, Söker S, Ece A, Güneş A, Uluca Ü, Söker M, Yel S, Kaplan İ. The Effects of Pomegranate and Carvacrol on Methotrexate-Induced Bone Marrow Toxicity in Rats. ACTA ACUST UNITED AC 2014; 37:E93-E101. [DOI: 10.25011/cim.v37i2.21091] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Indexed: 11/03/2022]
Abstract
Purpose: The aim of this study was to evaluate the effects of pomegranate (PMG) extract and carvacrol (CARV) on methotrexate (MTX)-induced oxidative stress and bone marrow toxicity.
Methods: Wistar albino rats (32 rats) were divided into four groups (n=8): Group 1 was control; Group 2 was given a single intraperitoneal injection of methotrexate (20 mg/kg); Group 3 was treated with carvacrol (73 mg/kg i.p.) one day before MTX (20 mg/kg i.p.) injection; and, Group 4 received a single dose of MTX (20 mg/kg i.p) while PMG was administered orally for seven days at 225 mg/kg. After animals were euthanized, blood samples were taken to evaluate hematological parameters and oxidative stress. In addition, the femur was cropped and bone marrow was extracted for examination.
Results: White blood cell count, hemoglobin, hematocrit and platelet count were found to be decreased in the MTX group, but these changes were prevented in the groups that received CARV and PMG. Furthermore, decreased bone marrow cellularity was found in the groups treated with MTX, whereas the PMG and CARV groups had cellularity similar to controls. Strikingly, oxidative stress increased in the MTX group, but was ultimately decreased in the rats that received the antioxidants PMG and CARV.
Conclusion: Carvacrol and PMG were found to be protective against methotrexate-induced oxidative bone marrow damage. Use of these antioxidants, in combination with chemotherapeutics, may help to reduce some adverse effects of methotrexate.
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Karabel M, Söker M, Kelekçi S, Karabel D, Yel S, Bilici M. Cardiac tamponade may be the first symptom of leukemia. Pediatr Hematol Oncol 2014; 31:157-9. [PMID: 23560941 DOI: 10.3109/08880018.2013.782517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Müsemma Karabel
- Dicle University, School of Medicine, Department of Pediatrics, Kitilbil, Diyarbakir, Turkey
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17
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Krupp U, Giertler A, Söker M, Fu H, Dönges B, Christ HJ, Istomin K, Hüsecken A, Pietsch U, Fritzen CP, Ludwig W. Significance and Mechanism of the Crack Initiation Process during Very High Cycle Fatigue of Duplex Stainless Steel. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.proeng.2014.06.238] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Karabel M, Söker M, Yıldırım AT, Oymak Y, Kelekçi S, Karabel D. The clinical findings and prophylactic treatment in children with factor X deficiency. Pediatr Hematol Oncol 2013; 30:717-22. [PMID: 23560890 DOI: 10.3109/08880018.2013.782380] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Factor X (FX) is the component of both extrinsic and intrinsic coagulation cascade and is the first enzyme of the common pathway which results in thrombus. Congenital FX deficiency (FXD) is an extremely rare coagulation defect. In this study, we aimed to investigate the clinical and laboratory data of the patients diagnosed with FXD. The files of the 15 patients (7 female, 8 male) diagnosed and followed up for FXD within the last 4 years were evaluated retrospectively. The mean age of the patients was 29 months (min-max:1-144 months). The most presenting complaints were easy bruisability (n = 8; 53%) and epistaxis (n = 8; 53%). FX levels were <1% in six patients, 1-5% in four patients, and >5% in five patients. Heparin added-Protrombin Complex was used for prophlaxy (n = 11; 73%). Any treatment-related complication was not observed. Heparin-added PCC can be used safely for effective prophlaxy. We suggest that family history is important when considering prophlaxy and in patients with life-threatening bleeding or with FXD sibling the prophlaxy should be introduced in the early course.
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Affiliation(s)
- Müsemma Karabel
- Dicle University, School of Medicine, Department of Pediatrics , Kitilbil, Diyarbakir , Turkey
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Pirinççioğlu AG, Akpolat V, Köksal O, Haspolat K, Söker M. Bone mineral density in children with beta-thalassemia major in Diyarbakir. Bone 2011; 49:819-23. [PMID: 21798385 DOI: 10.1016/j.bone.2011.07.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 07/08/2011] [Accepted: 07/11/2011] [Indexed: 10/18/2022]
Abstract
Bone mineral status has extensively been investigated in adult thalassemics but less in thalassemic children. This study involves measurements of the bone mineral density (BMD), various demographic and biochemical parameters in 47 thalassemic children and 50 healthy controls with comparable age, sex, socioeconomic and regional distribution. Patients have significantly higher aspartate aminotransferase, alanine aminotransferase, phosphorous, osteocalcin, serum carboxy terminal teleopeptide fragment of type I collagen, intact parathyroid hormone (iPTH) and ferritin levels while they have significantly lower 25-hydroxy vitamin D (25OH-D), alkaline phosphatase and z-scores both at lumbar and femur compared to controls. Patients with high iPTH (30%) had significantly lower z-scores and 25OH-D while larger osteocalcin. We conclude that a significantly lower BMD in beta-thalassemic children compared with their healthy counterparts is a complex process and may partially attributed to their slower physical development, caused by iron overload and chelation therapy which may influence the liver as well as the endocrine tissues.
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Affiliation(s)
- Ayfer Gözü Pirinççioğlu
- Department of Pediatrics, Faculty of Medicine, University of Dicle, 21280, Diyarbakir, Turkey.
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20
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Pirinççioğlu AG, Deniz T, Gökalp D, Beyazit N, Haspolat K, Söker M. Assessment of thyroid function in children aged 1-13 years with Beta-thalassemia major. Iran J Pediatr 2011; 21:77-82. [PMID: 23056768 PMCID: PMC3446112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Revised: 10/18/2010] [Accepted: 11/02/2010] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Hypothyroidism usually appears in the second decade of life and is thought to be associated with iron overload in patients with thalassemia major. This study aimed to evaluate thyroid dysfunctions in patients with beta-thalassemia major and to see if they appear in the earlier period of life. METHODS Thyroid function and iron load status were evaluated in 90 children with a mean age of 7.17±3.78 years with beta-thalassemia major by measuring serum free thyroxin (FT4), serum free triiodothyronine (FT3), total thyroxin (T3), serum total triiodothyronine (T4), thyroid-stimulating hormone (TSH) and ferritin levels from serum of patients admitted to the Pediatric Department, Faculty of Medicine University of Dicle between March 2005 and July 2009. A control group formed from an age-sex matched healthy children with a mean age of 6.98±3.66 years was also included. A standard thyrotropin releasing hormone test was applied to 3 patients who had high TSH levels and were classified as subclinical primer hypothyroidism. The study was designed according to the Declaration of Helsinki and informed consent was obtained from the parents of all participants. FINDINGS All thyroid parameters in patients were in the normal ranges compared with the controls except three of them which had high TSH levels. Serum ferritin level (2703±1649 ng/mL) in patients was significantly higher than in controls (81.5±15.5 ng/mL). CONCLUSION The work implies that hypothyroidism could be even seen in the first decade of life in patients with beta-thalassemia major in spite of improved hematological cares.
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Affiliation(s)
- Ayfer Gözü Pirinççioğlu
- Department of Pediatrics, Faculty of Medicine, University of Dicle, Diyarbakir, Turkey,Corresponding Author: Address: Department of Pediatrics, Faculty of Medicine, University of Dicle, 21280, Diyarbakir, Turkey. E-mail:
| | - Turgay Deniz
- Department of Pediatrics, Faculty of Medicine, University of Dicle, Diyarbakir, Turkey
| | - Deniz Gökalp
- Department of Endocrinology, Faculty of Medicine, University of Dicle, Diyarbakir, Turkey
| | - Nurcan Beyazit
- Department of Pediatrics, Faculty of Medicine, University of Dicle, Diyarbakir, Turkey
| | - Kenan Haspolat
- Department of Pediatrics, Faculty of Medicine, University of Dicle, Diyarbakir, Turkey
| | - Murat Söker
- Department of Pediatrics, Faculty of Medicine, University of Dicle, Diyarbakir, Turkey
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Tanrikulu R, Erol B, Görgün B, Söker M. The contribution to success of various methods of treatment of temporomandibular joint ankylosis (a statistical study containing 24 cases). Turk J Pediatr 2005; 47:261-5. [PMID: 16250312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Temporomandibular joint (TMJ) ankylosis is an important joint disorder which, in addition to emerging through trauma, can also arise as a result of local and systemic infections. TMJ ankylosis which develops in childhood in particular has its own characteristics. Despite the existence of different views on the treatment of TMJ ankylosis, various techniques have been defined, and three basic techniques are currently employed: gap arthroplasty, interpositional arthroplasty and joint reconstruction. Our study is intended as a statistical inquiry into the contribution to the operation success of the three different methods of treatment. Moreover, the effect on treatment outcome of unilateral or bilateral ankylosis is also statistically evaluated. In our study, eight cases were treated with gap arthroplasty, nine with interpositional arthroplasty and seven with joint reconstruction performed by costochondral graft. As a result of our statistical evaluation, it was determined that the effect of interpositional arthroplasty on post-operative maximal interincisal mouth opening was greater than that observed with the other methods.
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Affiliation(s)
- Rezzan Tanrikulu
- Department of Oral and Maxillofacial Surgery, Dicle University Faculty of Dentistry, Diyarbakir, Turkey
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Affiliation(s)
- Murat Söker
- Dicle University Faculty of Medicine, Diyarbakir, Turkey
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Cakmak SS, Söker M, Ayyildiz O, Devecioglu C, Söker SI. Non-African Burkitt's lymphoma manifesting at the jaw and as a right orbital mass in a child. J Pediatr Ophthalmol Strabismus 2003; 40:306-8. [PMID: 14560842 DOI: 10.3928/0191-3913-20030901-15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Sevin Söker Cakmak
- Department of Ophthalmology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
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24
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Söker M, Dikici B, Devecioglu C, Ece A, Haspolat K. Interferon-alpha treatment as a possible cause of relapse in a child with precursor B acute lymphoblastic leukemia. J Pediatr Hematol Oncol 2001; 23:256-7. [PMID: 11846309 DOI: 10.1097/00043426-200105000-00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Söker M, Devecioğlu C, Gürkan F, Haspolat K. Spontaneous humerus fracture and osteoporosis: an unusual initial presentation of acute lymphoblastic leukemia. J Pediatr Hematol Oncol 2000; 22:358-60. [PMID: 10959909 DOI: 10.1097/00043426-200007000-00016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
OBJECTIVE To study the clinical, laboratory, and treatment features observed in pediatric patients with tuberculous meningitis in Turkey. Study Design. Retrospective case review study. METHODS Review of medical records for demographic data, medical history, clinical manifestations, auxiliary test results, complications, and treatment of 214 children with central nervous system tuberculosis (TB) admitted to Dicle University's hospital between August 1988 and February 1996. RESULTS Of the 214 patients with tuberculous meningitis, 112 (52%) were male. The mean age at presentation was 4. 1 years, with 165 patients (77%) younger than 5 years. Twenty-two patients (10%) were in the first stage of the disease, 120 (56%) in the second, and 72 (34%) in the third. Our epidemiologic data showed that 141 (66%) of the patients had a family history of TB, and 64 (30%) had a Mantoux skin test result of >10 mm of induration. Radiographic studies demonstrated abnormal chest findings in 187 patients (87%) (hilar adenopathy, 33%; infiltrates, 33%; miliary pattern, 20%; and pleural effusions, 1%, and 172 (80%) cases with hydrocephalus, 26% with parenchymal disease, 15% with basilar meningitis, and 2% with tuberculomas. Only 22 (13%) of 164 children had a positive acid-fast bacilli smear in cerebrospinal fluid, and Mycobacterium tuberculosis was isolated in 49 patients (30%). All the patients were treated with Isoniazid, rifampin, and streptomycin or pyrazinamide for 2 months, followed by 10 months of Isoniazid and rifampin alone. Also, all the patients received adjuvant treatment with steroids early in the course of treatment, and 140 of 172 cases with hydrocephalus had surgical intervention. The overall mortality rate was 23%. CONCLUSION One or more of these findings: a family history of TB, positive tuberculin skin test results, abnormal cranial computed tomography, and/or cerebrospinal fluid analysis compatible with TBM were found in all but 3 children in our study. central nervous system, tuberculous meningitis, diagnosis, hydrocephalus, children.
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Affiliation(s)
- A Yaramiş
- Division of Pediatric Diseases, Medical School, Dicle University, Diyarbakir, Turkey
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Bircan Z, Kaplan A, Soran M, Söker M, Kervancioğlu M, Sahin A, Kilinc M. The effect of metabolic acidosis on serum apolipoprotein A I and apolipoprotein B levels in children with chronic renal failure. Int Urol Nephrol 1997; 29:603-7. [PMID: 9413770 DOI: 10.1007/bf02552208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In this report serum apolipoprotein A I (Apo A I) and apolipoprotein B (Apo B) levels were determined in children with chronic renal disease (CRD) during metabolic acidosis, after the correction of metabolic acidosis and in healthy children to look for the effect of metabolic acidosis on Apo A I and B levels. It was found that Apo A I levels were significantly decreased during metabolic acidosis (p < 0.05) but Apo A I/Apo B ratios were not affected before and after the correction of acidosis in the CRD group (p > 0.05) although it was significantly different from those in the controls (p < 0.01).
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Affiliation(s)
- Z Bircan
- Dicle University Hospital Paediatrics, Biochemistry and Statistics, Diyarbakir, Turkey
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28
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Bircan Z, Kaplan A, Söker M, Batun S, Sahin A, Soran M. Serum levels of carnitine, apolipoprotein A I, and apolipoprotein B in children with nephrotic proteinuria. Pediatr Nephrol 1996; 10:680. [PMID: 8897587 DOI: 10.1007/bf03035429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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