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Gemici A, Ozkalemkas F, Dogu MH, Tekinalp A, Alacacioglu I, Guney T, Ince I, Geduk A, Cagliyan GA, Maral S, Serin I, Gunduz E, Karakus V, Bekoz HS, Eren R, Pinar IE, Gunes AK, Sargın FD, Sevindik OG. A Real-life Turkish Experience of Venetoclax Treatment in High-risk Myelodysplastic Syndrome and Acute Myeloid Leukemia. Clin Lymphoma Myeloma Leuk 2021; 21:e686-e692. [PMID: 34059487 DOI: 10.1016/j.clml.2021.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Venetoclax is a selective B-cell lymphoma 2 (BCL2) inhibitor, which is approved to treat elderly patients with newly diagnosed acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS) in combination with either low-dose cytarabine (ARA-C) or hypomethylating agents. We aimed to collect and share data among the efficacy and safety of venetoclax both as a monotherapy or in combination with other drugs used to treat high-risk MDS or AML. MATERIALS AND METHODS A total of 60 patients with a median age of 67 (30-83) years from 14 different centers were included in the final analysis. Thirty (50%) of the patients were women; 6 (10%) of the 60 patients were diagnosed with high-risk MDS and the remaining were diagnosed with AML. RESULTS The best objective response rate (complete remission [CR], complete remission with incomplete hematological recovery (CRi), morphological leukemia-free state [MLFS], partial response [PR]) was 35% in the entire cohort. Best responses achieved during venetoclax per patient number were as follows: 7 CR, 1 CRi, 8 MLFS, 5 PR, and stable disease. Median overall survival achieved with venetoclax was 5 months in patients who relapsed and not achieved in patients who were initially treated with venetoclax. Nearly all patients (86.7%) had experienced a grade 2 or more hematologic toxicity. Some 36.7% of these patients had received granulocyte colony stimulating factor (GCSF) support. Infection, mainly pneumonia (26.7%), was the leading nonhematologic toxicity, and fatigue, diarrhea, and skin reactions were the others reported. CONCLUSION Our real-life data support the use of venetoclax in patients with both newly diagnosed and relapsed high-risk MDS and AML.
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Affiliation(s)
- Aliihsan Gemici
- Department of Hematology, Medipol University, Istanbul, Turkey.
| | | | | | - Atakan Tekinalp
- Department of Hematology, Necmettin Erbakan University, Konya, Turkey
| | | | - Tekin Guney
- Department of Hematology, University of Medical Sciences, Ankara City Hospital, Ankara, Turkey
| | - Idris Ince
- Division of Hematology, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - Ayfer Geduk
- Department of Hematology, Kocaeli University, Kocaeli, Turkey
| | | | - Senem Maral
- Division of Hematology, Diskapi Training and Research Hospital, Ankara, Turkey
| | - Istemi Serin
- Division of Hematology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Eren Gunduz
- Department of Hematology, Osman Gazi University, Eskisehir, Turkey
| | - Volkan Karakus
- Department of Hematology, Alaaddin Keykubat University, Alanya, Turkey
| | | | - Rafet Eren
- Division of Hematology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | | | - Ahmet Kursad Gunes
- Department of Hematology, University of Medical Sciences, Ankara City Hospital, Ankara, Turkey
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Korkmaz SA, Guney T, Dilek I, Caykoylu A. Interactions between Antidepressants and Warfarin: A Review. CPRR 2021. [DOI: 10.2174/2666082216999200622135657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Since warfarin has a very narrow therapeutic index, the interaction between
warfarin and antidepressants is very critical and has potentially severe consequences. It is unclear
whether clinicians have sufficient knowledge about the risk of bleeding when warfarin and antidepressants
are used concomitantly.
Objective:
In this systematic review, we discuss the main considerations when using warfarin with
antidepressants.
Methods:
The information about warfarin-antidepressant interactions was obtained from Google
Scholar®, PubMed/MEDLINE® and a hand search of the published literature. The following research
terms which were systematically combined with each other to find articles: warfarin, anticoagulant,
interactions, antidepressant (and each antidepressant name individually), SSRI, SNRI, TCA, MAOI.
Results:
Several possible mechanisms that can cause bleeding when antidepressants and warfarin
are used concomitantly, have been discussed. According to the available data, sertraline and citalopram/
escitalopram are safer antidepressants to use with warfarin, whereas fluoxetine and fluvoxamine
have a higher interaction potential with warfarin. The remaining antidepressants appear to lie
somewhere in between and have little empirical data to guide the clinicians.
Conclusion:
It is recommended that when an antidepressant is prescribed to a patient using warfarin,
patient’s international normalized ratio (INR) level should be checked regularly. In this review,
the interaction between warfarin and antidepressants, including new ones, were evaluated
inclusively and in detail.
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Affiliation(s)
| | - Tekin Guney
- Department of Hematology, University of Health Sciences Affiliated with of Ankara City Hospital, Ankara, Turkey
| | - Imdat Dilek
- Department of Hematology, Faculty of Medicine, Yildirim Beyazit University Affiliated with of Ankara City Hospital, Ankara, Turkey
| | - Ali Caykoylu
- Department of Psychiatry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
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Abstract
The objective of this study was to evaluate the 24-month clinical performance of three different bulk-fill restorative resin materials in class II restorations. Forty patients with at least three approximal lesions in premolar and molar teeth participated in the study. A total of 120 class II cavities were restored using Tetric EvoCeram Bulk Fill (n=40), SureFil SDR flow + Ceram.X mono (n=40), and everX Posterior + G-aenial Posterior (n=40) with their respective adhesives according to the manufacturers' instructions. All restorations were placed by one operator. The restorations were evaluated at baseline and at six, 12, 18, and 24 months using modified US Public Health Service criteria by one examiner. The restoration groups for each category were compared using the Pearson chi-square test, while the Cochran Q-test was used to compare the changes across different time points within each restorative material (p<0.05). At the end of 24 months, 94 restorations were evaluated in 33 patients, with a recall rate of 82.5%. There were no statistically significant differences between the groups in terms of retention (p>0.05). At the 24-month recall, two restorations from the SureFil SDR flow + Ceram.X mono group and four from the everX Posterior + G-aenial Posterior group showed slight marginal discoloration and were rated as bravo. No marginal discoloration was observed in any of the Tetric EvoCeram Bulk Fill restorations. Six restorations from the Tetric EvoCeram Bulk Fill group, six from the SureFil SDR flow + Ceram.X mono group, and 12 from the everX Posterior + G-aenial Posterior group received bravo scores in terms of marginal adaptation. No difference was found among the three groups for any of the evaluation criteria tested (p>0.05). There were statistically significant differences between the baseline and 24-month recall in the everX Posterior + G-aenial Posterior group in terms of marginal discoloration (p<0.05). For marginal adaptation, a significant difference was observed between baseline and 24 months for all the restorative resins (p<0.05). All the restorative resins tested performed similarly and showed acceptable clinical performance during the 24-month evaluation.
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Hacibekiroglu T, Akinci S, Basturk AR, Bakanay SM, Ulas T, Guney T, Dilek I. A forgotten screening test for iron deficiency anemia: oral iron absorption test. Clin Ter 2016; 164:499-505. [PMID: 24424212 DOI: 10.7417/ct.2013.1627] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE In this study, we aimed to investigate the iron absorption defects using the oral iron absorption test (OIAT) in patients with iron deficiency anemia (IDA). MATERIALS AND METHODS Forty-six patients with IDA which nonresponder to oral iron treatment were included in the study. OIAT was started at 8 a.m. after an overnight fast; 52.8 mg of elemental iron were given orally as 160 mg of iron sulfate. Iron levels of all participants were analyzed at baseline and at the 3rd hour of the study. RESULTS Compared to baseline; serum iron levels whose serum iron levels exceed 91 mcg/ dl in 40(%87) patients. Further investigations in 6 patients revealed that 4 patients had chronic atrophic gastritis with helicobacter pylori infection; while the remaining 2 patients did not have any prominent. CONCLUSIONS This study demonstrated that OIAT is a good index for the evaluation of absorption defects and can be a screening clinical test of IDA.
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Affiliation(s)
- T Hacibekiroglu
- Department of Hematology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
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Guney T, Kanat İF, Alkan A, Alisik M, Akinci S, Silay K, Neselioglu S, Dilek I, Erel O. Assessment of serum thiol/disulfide homeostasis in multiple myeloma patients by a new method. Redox Rep 2016; 22:246-251. [PMID: 27198712 DOI: 10.1080/13510002.2016.1180100] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 12/13/2022] Open
Abstract
OBJECTIVES The etiology of multiple myeloma (MM) is not exactly known. This study investigated the role of thiol/disulfide homeostasis in the etiopathogenesis of MM. METHODS Some 50 patients with MM (aged 39-84 years) and 50 sex-matched healthy volunteer controls (aged 50-91 years) participated in this study. Venous blood samples were collected, and levels of native thiols, total thiols, and disulfide were measured. RESULTS Native and total thiol levels in the control group were determined to be higher than in the study and patient groups (P<0.001). Disulfide levels were found to be higher in the control group than in the study group and higher in newly diagnosed patients than in outpatients who were undergoing treatment (P=0.002). The ratios of thiol levels were found to be similar in both the study and control groups (P>0.05). DISCUSSION The results of the study show that although there was a decrease in the levels of disulfide, native thiol, and total thiol, the balance of thiol/disulfide was maintained. This is the first study to research the homeostasis of dynamic thiol/disulfide from the perspective of the new method that was used. We hope that this study will encourage and facilitate further studies in this area.
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Affiliation(s)
- Tekin Guney
- a Department of Hematology , Turkiye Yuksek Ihtisas Training and Research Hospital , Ankara , Turkey
| | - İlyas Ferit Kanat
- b Department of Internal Medicine , Ataturk Training and Research Hospital , Ankara , Turkey
| | - Afra Alkan
- c Department of Biostatistics and Medical Informatics , Ankara Yildirim Beyazit University
| | - Murat Alisik
- d Department of Medical Biochemistry , Ataturk Training and Research Hospital , Ankara , Turkey
| | - Sema Akinci
- e Department of Hematology , Ataturk Training and Research Hospital , Ankara , Turkey
| | - Kamile Silay
- f Department of Geriatrics , Yildirim Beyazıt University , Ankara , Turkey
| | - Salim Neselioglu
- g Department of Medical Biochemistry , Yildirim Beyazıt University , Ankara , Turkey
| | - Imdat Dilek
- h Department of Hematology , Yildirim Beyazıt University , Ankara , Turkey
| | - Ozcan Erel
- g Department of Medical Biochemistry , Yildirim Beyazıt University , Ankara , Turkey
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Hacibekiroglu T, Akinci S, Basturk A, inal B, Guney T, Bakanay SM, Dilek I. Evaluation of Inflammation Parameters in Philadelphia Negative Chronic Myeloproliferative Neoplasia Patients. Asian Pac J Cancer Prev 2016. [PMID: 26225646 DOI: 10.7314/apjcp.2015.16.13.5159] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic myeloproliferative diseases are clonal stem cell diseases which occur as a result of uncontrollable growth and reproduction of hematopoietic stem cells, which are the myeloid series source in bone marrow. Recent studies have suggested that chronic inflammation can be a triggering factor in the clonal change in chronic myeloproliferative neoplasia (CMPN). In our study, we evaluated the existence of a chronic inflammation process in our Philadelphia negative (Ph-)CMPN patients using inflammation parameters in combination with demographic, laboratory and clinical characteristics of the patients. MATERIALS AND METHODS Demographic characteristics, clinical and laboratorial data, and thrombosis histories of 99 Ph-CMPN patients, who were diagnosed at our outpatient clinic of hematology in accordance with WHO 2008 criteria, were analyzed retrospectively,with 80 healthy individuals of matching gender and age included as controls. Complete blood counts, sedimentation, C reactive protein (CRP), JAK V617F gene mutations, abdomen ultrasound images and previous thrombosis histories of these patients were retrospectively analyzed. RESULTS Ph-CMPN and healthy control groups included 99 and 80 cases, respectively. PV, ET and MF diagnoses of patients were 43 (%43.4), 44 (44.4%) and 12 (12.1%), respectively. JAK V617F gene mutation was found to be positive in 64 (71.1%) of all cases and in 27(65.8%), 32 (82%), 5 (50%) of the cases in PV, ET and PMF groups, respectively. Thrombosis was determined as 12 (12%) in the entire group, 12.5% in the JAK V617F negative and 15.3% in the positive patients, with no statistical significance (p=0.758). No significant difference was observed between patients with and without previous thrombosis history in respect to hemogram parameters, sedimentation and CRP (p>0.05), neutrophil to lymphocyte ratio (NLR), erythrocyte distribution width (RDW), mean platelet volume (MPV) and sedimentation levels of the patient.
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Guney T, Alisik M, Alkan A, Basturk A, Akinci S, Hacibekiroglu T, Dilek I, Erel O. Paraoxonase and arylesterase activities in adults with vitamin B12 deficiency. Redox Rep 2016; 21:1-5. [PMID: 26365721 DOI: 10.1179/1351000215y.0000000042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 10/31/2022] Open
Abstract
OBJECTIVE The purpose of this study was to investigate paraoxonase (PON) and arylesterase (ARES) enzyme activity in adults with vitamin B12 deficiency, and specific changes in the activities of these enzymes following vitamin B12 treatment. METHODS A total of 46 patients with vitamin B12 deficiency (aged 18-82 years) and 45 healthy volunteer controls (aged 19-64 years) participated in this study. Venous blood samples were collected, and serum vitamin B12, homocysteine (HCY), methylmalonic acid, PON1, and ARES levels were measured. RESULTS Paired comparison showed that pre- and post-treatment values for PON and ARES were similar between patients and controls (both P > 0.05). There was no statistically significant relationship between patients' pre-/post-treatment PON or HCY levels and serum vitamin B12 levels, compared with those of the control group (P > 0.05). DISCUSSION The results of the present study do not support the hypothesis that the antioxidant enzymes PON and ARES have an underlying role in vitamin B12 deficiency and related hyperhomocysteinemia. Our findings suggest that PON and ARES do not play a role in the systemic effects of vitamin B12 deficiency.
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Affiliation(s)
- Tekin Guney
- a Department of Hematology , Turkiye Yuksek Ihtisas Training and Research Hospital , Ankara , Turkey
| | - Murat Alisik
- b Department of Medical Biochemistry , Ataturk Training and Research Hospital , Ankara , Turkey
| | - Afra Alkan
- c Department of Biostatistics and Medical Informatics , Yildirim Beyazit University Faculty of Medicine , Ankara , Turkey
| | - Abdulkadir Basturk
- d Department of Hematology , Konya Training and Research Hospital , Konya , Turkey
| | - Sema Akinci
- e Department of Hematology , Ataturk Training and Research Hospital , Ankara , Turkey
| | - Tuba Hacibekiroglu
- f Department of Hematology , Sakarya Training and Research Hospital , Sakarya , Turkey
| | - Imdat Dilek
- g Department of Hematology , Yildirim Beyazit University Faculty of Medicine , Ankara , Turkey
| | - Ozcan Erel
- h Department of Medical Biochemistry , Yildirim Beyazit University Faculty of Medicine , Ankara , Turkey
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Silay K, Akinci S, Silay YS, Guney T, Ulas A, Akinci MB, Ozturk E, Canbaz M, Yalcin B, Dilek I. Hospitalization risk according to geriatric assessment and laboratory parameters in elderly hematologic cancer patients. Asian Pac J Cancer Prev 2015; 16:783-6. [PMID: 25684525 DOI: 10.7314/apjcp.2015.16.2.783] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Utilizing geriatric screening tools for the identification of vulnerable older patients with cancer is important. The aim of this study is to evaluate the hospitalization risk of elderly hematologic cancer patients based on geriatric assessment and laboratory parameters. MATERIALS AND METHODS In this cross sectional study 61 patients with hematologic malignancies, age 65 years and older, were assessed at a hematology outpatient clinic. Standard geriatric screening tests; activities of daily living (ADL), instrumental activities of daily living (IADL), Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE), timed up and go test (TUG), geriatrics depression scale (GDS) were administered. Demographic and medical data were obtained from patient medical records. The number of hospitalizations in the following six months was then recorded to allow analysis of associations with geriatric assessment tools and laboratory parameters. RESULTS The median age of the patients, 37 being males, was 66 years. Positive TUG test and declined ADL was found as significant risk factors for hospitalization (p=0.028 and p=0.015 respectively). Correlations of hospitalization with thrombocytopenia, vitamin B12 and folic acid deficiency were statistically significant (p=0.004, p=0.011 and p=0.05 respectively). CONCLUSIONS In this study, geriatric conditions which are usually unrecognized in a regular oncology office visit were identified. Our study indicates TUG and ADL might be use as predictive tests for hospitalization in elderly oncology populations. Also thrombocytopenia, and vitamin B12 and folic acid deficiencies are among the risk factors for hospitalization. The importance of vitamin B12 and folic acid vitamin replacement should not be underestimated in this population.
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Affiliation(s)
- Kamile Silay
- Department of Geriatrics, Ataturk Research and Training Hospital, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey E-mail :
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Hacibekiroglu T, Basturk A, Akinci S, Bakanay SM, Ulas T, Guney T, Dilek I. Evaluation of serum levels of zinc, copper, and Helicobacter pylori IgG and IgA in iron deficiency anemia cases. Eur Rev Med Pharmacol Sci 2015; 19:4835-4840. [PMID: 26744875] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Iron deficiency anemia (IDA) is the most common form of anemia. Impaired intake absorption and blood loss are the main factors in the etiology. Impaired absorption can be caused by a decrease in trace elements such as copper and zinc, which are found in the structure of enzymes that coordinate iron metabolism or act as a catalyst for them, and the existence of Helicobacter pylori (H. pylori), which inhibits iron absorption in the stomach. Serum levels of zinc, copper, and H. pylori antibodies were measured in IDA cases, and correlations with IDA were evaluated. PATIENTS AND METHODS The study group was composed of 115 IDA cases who were followed at hematology outpatient clinics, and the control group was composed of 92 gender- and age-matched healthy individuals. Patients were diagnosed with iron deficiency anemia according to hemoglobin, serum ferritin, and iron levels and total iron-binding capacity. Serum zinc, copper, H. pylori immunoglobulin A (HpIgA) and immunoglobulin G (HpIgG), vitamin B12, and folic acid levels were examined in the blood specimens collected. RESULTS No statistically significant difference in zinc and copper serum levels between the study and control groups was observed (p > 0.05 for both groups). Although no difference was observed between the HpIgG levels of the two groups, patients with IDA had a statistically significant increase in HpIgA levels (p < 0.05). Pearson's correlation analysis showed that the zinc levels of the IDA group did not have a correlation with any parameters (p < 0.05 for all). Copper levels had a positive correlation with only the HpIgA level in the IDA group (r = 0.222, p = 0.017). CONCLUSIONS Trace elements and H. pylori infection did not have a correlation with IDA. Elevated levels of HpIgA and positive correlation of HpIgA with copper levels were observed. The literature review clearly suggests that several points require further explanation, and extensive research with larger samples is required.
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Affiliation(s)
- T Hacibekiroglu
- Department of Hematology, Edirne Public Hospital, Edirne, Turkey.
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Silay K, Akinci S, Yalcin A, Guney T, Ulas A, Ozer O, Ozbek S, Dilek I. The status of iron absorption in older patients with iron deficiency anemia. Eur Rev Med Pharmacol Sci 2015; 19:3142-3145. [PMID: 26400514] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate the iron absorption status by using the oral iron absorption test (OIAT) in older patients with iron deficiency anemia (IDA) in comparison with younger patients. PATIENTS AND METHODS This is a cross-sectional study including 100 patients with iron deficiency anemia. Patients were divided in two groups; group 1 who is 65 and older and group 2 who is younger than 65. OIAT in which a fasting serum iron level is compared with a second serum iron level obtained three hours following oral ingestion of iron sulfate was performed. An increase in serum iron of at least 100 mcg/dL indicates that oral iron absorption is adequate. The Independent-Samples t-test was used to show the statistical difference between the means of two groups. RESULTS There were 100 patients in the study; 69 of them have completed the study. The means of the oral iron absorption test results of the groups was compared with an independent t-test, which showed that the mean of group 1 was lower than group 2 and this was statistically significant (p = 0.001). The mean of OIAT results was 86.1 and 163.5 in group 1 and 2 respectively. CONCLUSIONS In our knowledge, the present study is among the first that shows the status of iron absorption objectively by using OIAT in older patients. Our study shows iron absorption is decreased in older patients with IDA in comparison with younger patients. In the light of this finding; OIAT should be offered before initiating treatment in older patients when IDA is diagnosed and intravenous iron treatment should be considered more on the base of results.
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Affiliation(s)
- K Silay
- Department of Internal Medicine and Geriatrics, Yildirim Beyazit University, Faculty of Medicine, Ataturk Training and Research Hospital, Ankara, Turkey.
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Anil C, Guney T, Gursoy A. The prevalence of benign breast diseases in patients with nodular goiter and Hashimoto's thyroiditis. J Endocrinol Invest 2015; 38:971-5. [PMID: 25827711 DOI: 10.1007/s40618-015-0269-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 01/16/2015] [Accepted: 03/04/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE The evidence regarding association between thyroid disorders and benign and malignant breast diseases is increasing. The studies exploring the relationship between thyroid and breast diseases usually have focused on thyroid autoimmunity and functions in patients with breast pathologies. In this study, we aimed to reveal the frequency of benign breast conditions in patients with nodular thyroid disease (NTD) and Hashimoto's thyroiditis (HT). METHODS Seventy-one women with NTD, ninety-five women with HT and seventy-two healthy people as a control group were included in the study. Serum thyroid-stimulating hormone, free triiodothyronine, free thyroxine, and thyroid peroxidase autoantibody levels were measured, and thyroid and breast ultrasonography were performed by a single operator in order to determine thyroid and breast pathology. RESULTS Benign breast diseases were detected in 54.9% of patients with NTD, in 47.4% of those with HT, and 29.2% of control group in the study (p < 0.01 for nodular and Hashimoto groups versus control group). Simple cyst was found to be the most frequent pathology among benign breast diseases; fibrocystic changes, mixed lesions, benign solid mass, ductal ectasia, and complex cyst followed it. No significant relation was found regarding thyroid function and autoimmunity in patients diagnosed with benign breast disease (p > 0.05). CONCLUSIONS The results of our study support the association between benign breast diseases and thyroid diseases. An important implication of this finding may be demonstration of the necessity of scanning for potential breast pathology in women with nodular or autoimmune thyroid disease in clinical practice.
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Affiliation(s)
- C Anil
- Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, 5. Sokak No: 48, Bahcelievler, 06490, Ankara, Turkey,
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Basturk A, Akinci S, Hacibekiroglu T, Guney T, Kutlucan A, Ceran F, Akalin SD, Ozturk SMB, Okutan H, Ozet G, Dilek I. Prognostic significance of flow cytometry findings in Turkish adult acute leukemia patients. Eur Rev Med Pharmacol Sci 2015; 19:3360-3366. [PMID: 26439029] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Several factors are known to affect prognosis of acute leukemia such as age, high leukocyte count, cytogenetic abnormality, performance status and recurrent leukemia. We aimed to investigate the association between cell surface markers and prognostic determinants such as recurrence at 6 and 12 months and survival at 6, 12 and 18 months in acute leukemia patients. PATIENTS AND METHODS A total of 142 patients, 101 with acute myeloid leukemia (AML) and 41 with B-cell acute lymphoblastic leukemia (B-ALL) were included. The effects of surface markers on survival and recurrence rates were evaluated retrospectively. RESULTS In AML patients, CD5+ and CD34+ immunophenotypes and in ALL patients cCD22+, CD34+ and CD49f + CD19+ immunophenotypes were positive prognostic indicators. In AML patients CD7 expression, and in ALL patients CD5+, CD7+ and CD117+ immunophenotypes and >90% CD45 expression were negative prognostic indicators. CONCLUSIONS This study demonstrates that flow cytometry, a common diagnostic tool in acute leukemia, may also have prognostic value in acute leukemia in the future.
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Affiliation(s)
- A Basturk
- Division of Hematology, Department of Internal Medicine, Konya Research and Training Hospital, Konya, Turkey.
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Akinci S, Silay K, Ulas A, Guney T, Hacibekiroglu T, Basturk A, Akinci MB, Alkan A, Dilek I. Neutrophil to lymphocyte ratio--not an independent prognostic factor in patients with the myelodysplastic syndrome. Asian Pac J Cancer Prev 2015; 15:10883-5. [PMID: 25605195 DOI: 10.7314/apjcp.2014.15.24.10883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Neutrophil-to-lymphocyte ratio (NLR) was evaluated as a potential prognostic factor in patients with myelodysplastic syndrome (MDS). MATERIALS AND METHODS Between December 2009 and April 2014, 14 female (35%) and 26 male (65%) MDS patients who were followed up in our hematology clinic were included in the study for NLR during diagnosis. Division was into two groups according to the NLR, and the correlation with mortality was evaluated. The prognostic significance of NLR regarding treatment outcome was also evaluated with adjustment for known confounding risk factors. RESULTS The mortality rate of the patient group was 55%, and median survival was 18 months. There was no significant correlation between mortality and NLR at a median value of 1.8 (p=0.75). Thrombocytopenia was observed to increase mortality (p=0.027), and there was a significant correlation between mortality and pancytopenia (p=0.017). CONCLUSIONS This first study of NLR and mortality did not show any significant correlation . In centres with limited access to genetic evaluation for the presence of pancytopenia and/or thrombocytopenia at the time of diagnosis, a platelet level less than 50?109/l may be poor prognostic markers in MDS patients.
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Affiliation(s)
- Sema Akinci
- Department of Hematology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey E-mail :
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Guney T, Bakanay Ozturk SM, Hacibekiroglu T, Akinci S, Basturk A, Dilek I. Diffuse plasma cell infiltration of liver detected initially at diagnosis of multiple myeloma. Clin Ter 2014; 164:e509-10. [PMID: 24424232 DOI: 10.7417/ct.2013.1646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Liver involvement in mutiple myeloma (MM) is not commonly encountered. In this report, we describe a patient who was diagnosed with IgG kappa type MM. A liver biopsy revealed monoclonal plasma cell infiltration. Hepatomegaly was the sole finding in physical examination and the liver function tests were not disturbed.
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Affiliation(s)
- T Guney
- Department of Hematology, Ataturk Training and Research Hospital, Ankara, Turkey
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15
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Solakoglu T, Akyol P, Guney T, Dilek I, Atalay R, Koseoglu H, Akin E, Demirezer Bolat A, Buyukasik NS, Ersoy O. Acute pancreatitis caused by bortezomib. Pancreatology 2013; 13:189-90. [PMID: 23561979 DOI: 10.1016/j.pan.2013.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [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] [Received: 12/26/2012] [Revised: 01/14/2013] [Accepted: 01/15/2013] [Indexed: 12/11/2022]
Abstract
Drug-induced pancreatitis has been reported rarely. Bortezomib is a selective and reversible proteasome inhibitor used for the treatment of patients with multiple myeloma (MM). Recently, one case report about acute pancreatitis (AP) caused by bortezomib was published in the international literature. Herein we report a case of AP in a 67-year-old male on bortezomib therapy. On the fourth day after the first administration of bortezomib, the patient admitted to the hospital with symptoms of AP. The common etiological factors for AP were all excluded. Than the patient was diagnosed as bortezomib-induced pancreatitis.
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Affiliation(s)
- Tevfik Solakoglu
- Department of Gastroenterology, Ankara Ataturk Research and Education Hospital, Bilkent Street, 06800 Ankara, Turkey.
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Akinci S, Hacibekiroglu T, Basturk A, Bakanay SM, Guney T, Dilek İ. Pseudothrombocytosis due to microerythrocytosis: a case of beta thalassemia minor complicated with iron deficiency anemia. Acta Haematol 2013; 130:61-3. [PMID: 23485560 DOI: 10.1159/000346434] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 11/21/2012] [Indexed: 11/19/2022]
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