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Öğe Acute Promyelocytic Leukemia Diagnosed at the End of First Trimester with a Successful Outcome(Kare Publ, 2018) Baysal, Mehmet; Umit, Elif G.; Ozdover, Ali Caner; Sutcu, Havva; Cilingir, Isil Uzun; Kirkizlar, Onur; Sayin, CenkThe treatment and management of patients with acute promyelocytic leukemia (APL) diagnosed in pregnancy can involve a wide range of difficulties and limitations. Thus, these cases are each unique and present challenges to physicians. The aim of this study was to present the case of a 24-year-old patient who was diagnosed with APL in the 14th week of pregnancy who was treated successfully with all-trans retinoic acid and chemotherapy.Öğe Assessment of ventricular and left atrial mechanical functions, atrial electromechanical delay and P wave dispersion in patients with scleroderma(Via Medica, 2011) Aktoz, Meryem; Yilmaztepe, Mustafa; Tatli, Ersan; Turan, Fatma Nesrin; Umit, Elif G.; Altun, ArmaganBackground: The aim of this study was to investigate ventricular functions and left atrial (LA) mechanical functions, atrial electromechanical coupling, and P wave dispersion in scleroderma patients. Methods: Twenty-six patients with scleroderma and twenty-four controls were included. Left and right ventricular (LV and RV) functions were evaluated using conventional echocardiography and tissue Doppler imaging (TDI). LA volumes were measured using the biplane area-length method and LA mechanical function parameters were calculated. Inter-intraatrial electromechanical delays were measured by TDI. P wave dispersion was calculated by 12-lead electrocardiograms. Results: LV myocardial performance indices (MPI) and RV MPI were higher in patients with scleroderma (p = 0.000, p = 0.000, respectively) while LA passive emptying fraction was decreased and LA active emptying fraction was increased (p = 0.051, p = 0.000, respectively). P wave dispersion and inter-intraatrial electromechanical delay were significantly higher in patients with scleroderma (25 [10-60] vs 20[0-30], p = 0.000, 16.50 [7.28-26.38] vs 9.44 [3.79-15.78] and 11.33 [4.88-16.06] vs 4.00 [0-12.90], p < 0.05, respectively). Interatrial electromechanical delay was negatively correlated with LV E wave, (p = 0.018). LV E wave was demonstrated to be a factor independent of the interatrial electromechanical delay (R(2) = 0.270, beta = -0.52, p = 0.013). Conclusions: This study showed that in scleroderma patients, global functions of LV, RV and mechanical functions of LA were impaired, intra-interatrial electromechanical delays were prolonged and P wave dispersion was higher. LV E wave was demonstrated to be a factor that is independent of the interatrial electromechanical delay. Reduced LV E wave may also give additional information on the process of risk stratification of atrial fibrillation. (Cardiol J 2011; 18, 3: 261-269)Öğe A biomarker and therapeutical target in immune thrombocytopenia: TNF receptor-associated factor 6(Future Medicine Ltd, 2019) Asoglu, Veysi; Umit, Elif G.; Demir, MuzafferBackground: Immune thrombocytopenia (ITP) is an acquired disease characterized by various pathogenetic mechanisms. We aimed to evaluate the value of TRAF6 as a biomarker of pathogenesis in ITP. Methods:85 newly diagnosed ITP patients and 85 controls were included. Results: In the patient group, mean TRAF6 level was 2348pg/ml and in the control group, TRAF6 level was 25.57pg/ml. In corticosteroid-responding patients, TRAF6 levels were lower than nonresponding patients. Discussion: TRAF6 levels were observed to be higher than healthy controls, which suggest a solid relation with ITP pathogenesis. The observation that in patients who present with high TRAF6 levels, there was a significant corticosteroid refractoriness and responsiveness.Öğe A case of refractory chronic lymphocytic leukaemia with an unusual course(All India Inst Medical Sciences, 2019) Umit, Elif G.; Baysal, Mehmet; Ozdover, Ali Caner; Kirkizlar, Onur; Demir, Ahmet MuzafferChronic lymphocytic leukaemia (CLL) is a heterogeneous disease with uncertain course. Treatment should be tailored to the patient's disease as well as the prognostic subgroup. With the increased use of rituximab as well as other selective and non-selective immunomodulatory agents, the incidence of infectious complications and second malignancies has also increased. Progressive multifocal leucoencephalopathy (PML) is a complication of rituximab in HIV-negative patients. A 56-year-old male with CLL had been treated and relapsed four times in 6 years. Rituximab was added to the combination after the second relapse and repeated in the third relapse in combination with bendamustine. In the seventh year of diagnosis, relapse of CLL and an ulcerated tumorous lesion was observed in the left index finger, which progressed in 3 months and was later diagnosed as angiosarcoma. The cancer was treated with local radiotherapy and combination chemotherapy. One year after the last rituximab exposure, progressive muscle weakness developed and polyoma JC virus DNA was observed with increased titres in the cerebrospinal fluid, and the patient was diagnosed as having PML. The patient died 2 months later. Our patient had an unusual course of CLL over 8 years, with relapses, complicated with a secondary malignancy and an infectious complication.Öğe CD5 as a prognostic marker in patients with diffuse large B-cell lymphoma: a multicenter study(Springer Heidelberg, 2022) Demirci, Ufuk; Kirkizlar, Hakki Onur; Umit, Elif G.; Gursoy, Vildan; Pinar, Ibrahim Ethem; Ozkalemkas, Fahir; Guven, Zeynep TugbaDiffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma (NHL) and comprises a heterogeneous group of disease. While classification of B-cell lymphomas has been evolving to include clonality in a specific manner, morphology, and immunohistochemistry remain the backbone. We aimed to evaluate the value of CD5 expression on disease characteristics as well as prognosis in patients with DLBCL. Data of 131 patients with DLBCL with CD5 positivity and as a comparison arm, data of 129 patients with DLBCL without CD5 positivity were evaluated. Mean age was 59 and 55.7% of the patients were male. Overall survival was 29.8 months. Poor prognostic factors including (high-LDH levels, B symptoms, low ECOG score, high R-IPI and NCCN-IPI score) were observed to be significantly related with CD5 positivity. Mean survival in CD5 positive patients were 29.8 months, which is significantly shorter than the general DLBCL survival worldwide. CD5 expression shall be evaluated in all samples of DLBCL patients due to its possible effects on outcomes.Öğe A comment on a prospective, multicenter study of low dose decitabine in adult patients with refractory immune thrombocytopenia by Zhou et al(Wiley, 2020) Demirci, Ufuk; Umit, Elif G.; Demir, Ahmet Muzaffer[Abstract Not Available]Öğe Efficacy and Safety of Ibrutinib Use in Patients with Chronic Lymphocytic Leukemia in Real World Experiences: Results of a Prospective Multicenter Study(Amer Soc Hematology, 2019) Tombak, Anil; Tanrikulu, Funda Pepedil; Durusoy, Salih Sertac; Gurkan, Emel; Kaya, Emin; Umit, Elif G.; Yavasoglu, Irfan[Abstract Not Available]Öğe Evaluation of Sarcopenia with F-18 FDG PET/CT and relation with disease outcomes in patients with multiple myeloma(Wiley, 2020) Umit, Elif G.; Korkmaz, Ulku; Baysal, Mehmet; Karaman Gulsaran, Sedanur; Bas, Volkan; Demirci, Ufuk; Onur Kirkizlar, HakkiIntroduction Multiple myeloma (MM) is a potentially incurable haematological malignancy with devastating manifestations including lytic bone lesions leading to fractures and renal insufficiency. As a disease of patients with a mean age of 66 years, both the disease and the continuous efforts of treatments lead to frailty and devastation. From this stand point, we aimed to evaluate the development of muscle loss in MM patients and also with a new method of sarcopenia evaluation, F-18 FDG PET/CT. While used for bone disease routinely, this method brings a fresh perspective of metabolic quantitation of alteration of muscles which may be regarded as muscle quality. Materials and Methods Data and images of 105 patients with MM both before and after treatment were evaluated in a retrospective manner. Results Both female and male patients were observed to be effected after MM treatment in terms of lumbar and femoral muscle evaluations with CT. Metabolic evaluations confirmed a loss of quality in muscles in terms of metabolic volume and total lesion glycolysis. Conclusion Sarcopenia should be evaluated in every patient and regarded as a treatment target. FDG PET/CT is an easy and handy tool to assess muscle mass and quality as well as MM disease status.Öğe The impact of new generic formulations of imatinib mesylate on general quality of life in chronic phase chronic myeloid leukaemia patients(Wiley, 2017) Uyanik, Mehmet S.; Pamuk, Gulsum E.; Maden, Muhammet; Merev, Elif; Cevik, Gokcen; Uyanik, Vesile; Umit, Elif G.Treatment with tyrosine kinase inhibitors (TKIs) has dramatically changed the life expectancy of chronic myeloid leukaemia (CML) patients. Although the impact of first-generation TKIs on quality of life (QoL) was shown in CML, the effects of new generic formulations of imatinib mesylate (IM) are unclear. We evaluated differences in QoL under treatment with first-or second-generation TKIs. Fifty-two patients diagnosed with CP-CML completed the European Organization for Research and Treatment of Cancer Quality of Life Questionaire-C30, Hospital Anxiety and Depression Scale, and General Health Questionnaire. General QoL scores were similar between groups. There was a significant difference in the frequency of diarrhoea between IM group and the group using new generic formulations of IM (P = 0.012). General QoL score tended to be higher in patients with disease duration longer than 3 years (P = 0.052). GHQ, anxiety and depression scores correlated positively with symptom scales and negatively with functional subscales. CML patients using new generic formulations of IM reported a higher frequency of diarrhoea than patients using original IM and second-generation TKIs that could result in more drug discontinuation.Öğe Improving Care of Older Patients with Hemophilia During COVID-19 Pandemic, Reducing the Risk of Venous Thrombosis with Home Exercises(Sage Publications Inc, 2022) Demirci, Ufuk; Umit, Elif G.; Ozdemir, Hande; Demirbag Kabayel, Derya; Demir, Ahmet Muzaffer[Abstract Not Available]Öğe Management of Patients with Factor VII Deficiency in Surgery: A Single-center Experience(Erciyes Univ Sch Medicine, 2022) Demirci, Ufuk; Gulsaran, Sedanur Karaman; Bas, Volkan; Umit, Elif G.; Kirkizlar, Hakki Onur; Demir, Ahmet MuzafferFactor VII deficiency is a rare condition characterized by a broad spectrum of clinical phenotypes, from asymptomatic status to severe, life-threatening bleeding, such as central nervous system or gastrointestinal bleeding. Factor VII deficiency is usually diagnosed after a bleeding attack or as a result of screening tests performed in cases with a family history. Importantly, bleeding may also occur in patients with a factor level of 20% to 50%. This report describes the approach to management before, during, and after surgery used in 5 patients with varying factor levels. The use of recombinant factor VIIa (15-30 mu g kg) was required in 3 of the patients. No bleeding or thromboembolism was observed in any of the 5 patients.Öğe Polypharmacy and potentially inappropriate medication use in older patients with multiple myeloma, related to fall risk and autonomous neuropathy(Sage Publications Ltd, 2020) Umit, Elif G.; Baysal, Mehmet; Bas, Volkan; Asker, Ismail; Kirkizlar, Onur; Demir, Ahmet M.Purpose Multiple myeloma is a chronic, uncurable hematological cancer with the involvement of multiple organ systems. As a disease affecting older patients, the treatment of multiple myeloma should be based on individual patient characteristics. Polypharmacy is an increasing problem in the care of older patients and in patients with multiple myeloma, polypharmacy is almost inevitable. We aimed to evaluate the applicability of polypharmacy definitions and the relation of polypharmacy with disease outcomes in patients with multiple myeloma. Methods Eighty patients older than 65 years and diagnosed with multiple myeloma were retrospectively enrolled. Patient files, prescriptions, evaluations for polypharmacy were determined according to Beers and START/STOPP criteria. Outcomes were recorded from files in terms of fractures, autonomous neuropathy, and renal functions. Results Polypharmacy with >= 4 drugs was observed in 65 patients while polypharmacy with >= 5 drugs was observed in 51 patients. Autonomous neuropathy, polypharmacy with more than four or five medications, and use of multiple medications in the same category were related with poor ECOG performance status in women, while prolonged use of benzodiazepines and central nervous system (CNS) affecting drugs and inappropriate polypharmacy were more frequent in men with poor ECOG performance status. The majority of patients aged 75-84 years were observed to use inappropriate polypharmacy. Autonomous neuropathy and fall risk were observed to be significantly related with inappropriate polypharmacy. Conclusions Drugs affecting balance and perception should be reconsidered in patients with multiple myeloma.Öğe Reducing the Risk of Venous Thrombosis During Self-Isolation and COVID-19 Pandemic for Patients With Cancer: Focus on Home Exercises Prescription(Sage Publications Inc, 2020) Demirci, Ufuk; Ozdemir, Hande; Demirbag-Kabayel, Derya; Umit, Elif G.; Demir, Ahmet Muzaffer[Abstract Not Available]Öğe Thalidomide for the Management of Bleeding Episodes in Patients with Hereditary Hemorrhagic Telangiectasia: Effects on Epistaxis Severity Score and Quality of Life(Galenos Yayincilik, 2019) Baysal, Mehmet; Umit, Elif G.; Kirkizlar, Hakki Onur; Ozdover, Ali Caner; Demir, Ahmet MuzafferHereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominantly inherited disorder characterized by bleeding episodes. These episodes tend to happen spontaneously and reduce the quality of life. Patients are often unresponsive to local measures. With the pathophysiological role of angiogenesis in HHT, antiangiogenic drugs including thalidomide are used to control bleeding episodes. In our study, we evaluated 6 patients with HHT, calculating their Epistaxis Severity Score (ESS) and performing a quality of life assessment with the 36-Item Short Form Health Survey Questionnaire (SF-36), and we studied the alterations of these evaluations with thalidomide treatment. Three patients were male and three were female. Mean age was 60.50 years. No side effects were observed during the treatment period. Improvements of certain SF-36 dimensions including physical functioning, physical component summary, and mental component summary and of the ESS were observed after treatment. Thalidomide may be effective to control bleeding episodes with a reasonable tolerance profile in patients with HHT.
