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    Decreased dickkopf-1 levels in chronic lymphocytic leukemia and increased osteopontin levels in non-Hodgkin's lymphoma at initial diagnosis: Could they be playing roles in pathogenesis?
    (Maney Publishing, 2015) Pamuk, Gulsum Emel; Uyanik, Mehmet Sevki; Pamuk, Omer Nuri; Maden, Muhammet; Tapan, Umit
    Aims: We determined plasma levels of dickkopf-1 (DKK-1) and osteopontin (OPN) which have roles in the Wnt pathway in chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL) patients and in healthy controls. We also tested whether DKK-1 and OPN levels could be of clinical or prognostic significance in CLL and NHL. Methods: We included 36 CLL, 24 NHL patients, and 21 healthy controls. Patients' clinical and demographic features, treatment modalities, and response to treatment were recorded. DKK-1 and OPN levels in plasma obtained at initial diagnosis were determined with enzyme-linked immunosorbent assay. Results: CLL patients had significantly lower DKK-1 levels than NHL and control groups (P levels, respectively, 0.048 and 0.017). OPN level was significantly higher in NHL group than in CLL and control groups (P values, 0.017 and <0.001). CLL patients with early and late Rai stages of disease had similar DKK-1 and OPN levels. After a median follow-up of 48 months, 13 CLL patients died. Univariate analysis showed that advanced Rai stages and older age were significantly poor prognostic factors. DKK-1 level in CLL patients who have died was significantly lower than those who were alive (P = 0.035). NHL patients with extranodal involvement had significantly higher OPN levels than those with no involvement (P = 0.04). Conclusions: Our results demonstrated that the Wnt pathway inhibitor DKK-1 was decreased in CLL. OPN was increased in NHL and associated with extranodal involvement. In order to reveal the pathogenic and clinical roles of DKK-1 and OPN in CLL and NHL, larger studies need to be conducted.
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    Gastrointestinal symptoms are closely associated with depression in iron deficiency anemia: a comparative study
    (K Faisal Spec Hosp Res Centre, 2015) Pamuk, Gulsum Emel; Uyanik, Mehmet Sevki; Top, Mehmet Serif; Tapan, Umit; Ak, Recep; Uyanik, Vesile
    BACKGROUND AND OBJECTIVES: Until now, very few studies evaluated the association between gastrointestinal and psychiatric symptoms in iron deficiency anemia (IDA). The study investigated the frequency of functional dyspepsia (FD) in IDA patients and determined its association with depression and somatization. DESIGN AND SETTINGS: The study was conducted at the Hematology Department of Trakya University Medical Faculty, which is a tertiary referral center in northwestern Turkey. It was a case-control study. MATERIALS AND METHODS: A total of 125 consecutive IDA patients and 57 healthy control subjects were included. Patients and controls were questioned about the severity of their gastrointestinal system (GIS)-related symptoms and the presence of constipation and associated symptoms using a visual analog scale. In addition, IDA patients were administered a validated depression scale (Beck Depression Inventory, BDI) and somatization symptoms checklist. RESULTS: IDA patients had more frequent self-reported constipation compared with controls (56% vs 22.8%, P<.001). The mean scores of bloating, dyspepsia, and constipation-related quality of life (QoL) disturbance were significantly higher in the IDA group than in the control group (all P values <=.01). A total of 71 IDA patients were depressed according to the BDI. Depressed IDA patients had higher mean reflux, bloating, halitosis, and dyspepsia-related QoL disturbance scores compared with nondepressed patients (all P values <=.01). Their frequency of self-reported constipation and mean constipation-related QoL disturbance score (P values, .002 and <.001) were also higher. Depressed IDA patients had significantly higher somatization scores compared with others (P=.001). CONCLUSION: An increased frequency of dyspepsia symptoms and constipation-related QoL disturbance were observed in IDA patients. The findings of this study suggested that in IDA patients without red flags in favor of malignancy, physicians should try to uncover any psychiatric factors before undertaking extensive GIS investigation.