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Öğe Anaplastic variant of diffuse large B-cell lymphoma associated with cutaneous fistulas; an unusual presentation(Zerbinis Medical Publ, 2014) Pamuk, Gulsum Emel; Tasci, Murat; Uyanik, Mehmet Sevki; Akker, Mustafa; Puyan, Fulya Oz[Abstract Not Available]Öğe Assessment of cytokine levels and hs-CRP in bipolar I disorder before and after treatment(Elsevier Ireland Ltd, 2015) Uyanik, Vesile; Tuglu, Cengiz; Gorgulu, Yasemin; Kunduracilar, Hakan; Uyanik, Mehmet SevkiWe aimed to assess the relationship between cytokine levels and the severity of the manic period in medication free patients. 30 Medication free patients and 28 healthy subjects (HS) were recruited. Plasma levels of pro-inflammatory, anti-inflammatory, inflammatory cytokines, and hs-CRP levels were investigated upon hospital admission, after six weeks follow up in bipolar disease manic episode and the results were compared to HS. The severity of the manic episodes was assessed according to the Young mania rating scale. TNF-alpha, INF-gamma, IL-6 and hs-CRP levels were significantly higher in patients with manic episode of bipolar I disorder before treatment than HS. After treatment the levels of TNF-alpha, INF-gamma, IL-6 and hs-CRP were observed to be significantly decreased. There was no difference between the levels of anti-inflammatory cytokines in patients before or after treatment of bipolar disorder and HS. hs-CRP was observed to be the only parameter correlated with clinical response. The most significant outcome of this study is the correlation between clinical outcome and hs-CRP levels in treatment naive manic episode bipolar type I patients. hs-CRP is the most consistent indicator according to pro-inflammatory, inflammatory and anti-inflammatory cytokines, in predicting treatment outcomes. (C) 2015 Elsevier Ireland Ltd. All rights reserved.Öğe Brucellosis Triggering Hemolytic Anemia in Glucose-6-Phosphate Dehydrogenase Deficiency(Karger, 2009) Pamuk, Gulsum Emel; Celik, Aygul Dogan; Uyanik, Mehmet SevkiObjectives: To present a case of acute brucellosis triggering acute hemolytic anemia in a subject with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Clinical Presentation and Intervention: A 17-year-old male patient presented with fever, malaise and jaundice. His blood and bone marrow cultures yielded Brucella species. In addition, he was found to have acute hemolytic anemia due to previously undiagnosed G6PD deficiency. He was started on folic acid supplementation and given a combination of doxycycline and rifampicin for 6 weeks. His response to antibiotic therapy was optimal; the hemolytic anemia resolved. There were no further episodes of hemolysis. Conclusion: This case showed that the differential diagnosis of acute hemolytic anemia in subjects with G6PD deficiency should include brucellosis, especially in regions where the infection is endemic. Copyright (c) 2009 S. Karger AG, BaselÖğe CASP10, LEF1, BCL2 genes are hypomethylated and CDKN2B is hypermethylated in chronic lymphocytic leukemia(Taylor & Francis Ltd, 2015) Pamuk, Gulsum Emel; Uyanik, Mehmet Sevki; Gurkan, Hakan; Duymaz, Julide; Tozkir, Hilmi; Pamuk, Omer Nuri[Abstract Not Available]Öğe Clinical and epidemiologic data on chronic lymphocytic leukemia patients followed up at a tertiary center in Turkey(Taylor & Francis Ltd, 2015) Pamuk, Gulsum Emel; Uyanik, Mehmet Sevki; Aydogdu, Erkan; Ak, Recep; Demir, Ahmet Muzaffer; Harmandar, Orbay[Abstract Not Available]Öğe CXCL12 rs18011157 polymorphism in patients with non-Hodgkin's lymphoma: Is it associated with poor outcome?(Wolters Kluwer Medknow Publications, 2018) Pamuk, Gulsum Emel; Tozkir, Hilmi; Uyanik, Mehmet Sevki; Gurkan, Hakan; Duymaz, Julide; Pamuk, Omer NuriObjective: We studied CXCL12-related rs18011157 polymorphism in non-Hodgkin lymphoma (NHL) patients. We also determined the effect of this polymorphism on clinical features and outcome of NHL. Methods: We included 90 NHL patients (54 males, 36 females) and 88 healthy controls (54 males, 34 females). CXCL12-related rs18011157 polymorphism was determined by polymerase chain reaction. Results: rs18011157 polymorphism was significantly more frequent in NHL patients with GA genotype than in healthy controls (37.8% vs. 20.5%, P = 0.011). The frequency of patients with initially high lactate dehydrogenase (LDH) level (65.8% vs. 38.5%) and extranodal involvement (61.1% vs. 43.8%) was significantly higher in the GA plus AA genotype groups when considered altogether (P = 0.01 and 0.09). Poor prognostic factors in univariate analysis were the presence of B symptoms, initially high International Prognostic Index (IPI), splenomegaly, nonresponse to first-line therapy, the presence of early relapse, and carrying A allele (GA plus AA genotypes). The independent prognostic factors in multivariate analysis were only early relapse and an initially high IPI score. Discussion: CXCL12 rs1801157 polymorphism which was found to be associated with extranodal involvement and increased LDH in NHL might be a marker of poor prognosis in patients with GA and AA genotypes. Conclusions: CXCL12-related rs18011517 polymorphism was more frequent in NHL patients: it might be associated with NHL pathogenesis and outcome.Öğe 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, UmitAims: 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.Öğe The Effects of the Spleen Tyrosine Kinase Inhibitor, Fostamatinib, on an Immune Thrombocytopenia Mouse Model(Amer Soc Hematology, 2014) Pamuk, Gulsum Emel; Uyanik, Mehmet Sevki; Karaca, Turan; Selim, Demirtas; Demir, Muzaffer; Pamuk, Omer Nuri[Abstract Not Available]Öğe 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, VesileBACKGROUND 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.Öğe Health-Related Quality of Life in Hematological Malignancy Patients in Northwestern Turkey(Amer Soc Hematology, 2012) Pamuk, Gulsum Emel; Uyanik, Mehmet Sevki; Harmandar, Ferda; Demir, Muzaffer[Abstract Not Available]Öğe Immune thrombocytopenia: epidemiological and clinical features of 216 patients in northwestern Turkey(Springer, 2015) Koylu, Ahmet; Pamuk, Gulsum Emel; Uyanik, Mehmet Sevki; Demir, Muzaffer; Pamuk, Omer NuriWe evaluated the clinical features, treatment modalities, treatment responses, and prognosis of our patients with immune thrombocytopenia (ITP). Furthermore, we estimated the frequency of ITP in the Thrace region of Turkey. Two hundred sixteen patients diagnosed with ITP between 2000 and 2012 at our center were retrospectively evaluated. Patients' clinical features, treatments, and responses to treatment modalities were recorded. The mean annual incidence of ITP was 2.92/100,000 (95%CI: 1.57-4.27). The overall prevalence of ITP was 35.1/100,000 (95%CI: 30.3-39.8). The administration of first-line therapy resulted in complete remission (CR) in 76.5 % of patients and partial remission (PR) in 13.6 %. After 5 years, 33 % of patients who were responsive to first-line therapy were still in relapse-free remission. Of patients who were given second-line therapy, CR was obtained in 71.3 % and PR in 14.9 %. The duration of relapse-free remission was longer with splenectomy than with steroids (p < 0.001). Five years after splenectomy, 62 % of patients were in relapse-free remission; contrarily, this was lower with steroids (36 % at 5 years). The annual incidence and prevalence of ITP in northwestern Turkey was similar to data from western countries-at the lower limit for some countries. Effective treatment strategies seem to be steroids as first-line therapy and splenectomy in refractory cases.Öğe Is iron-deficiency anemia associated with migraine? Is there a role for anxiety and depression?(Springer Wien, 2016) Pamuk, Gulsum Emel; Top, Mehmet Serif; Uyanik, Mehmet Sevki; Koker, Hilal; Akker, Mustafa; Ak, Recep; Yurekli, Omer AtalayIn this study, we determined the frequency of migraine headache in iron-deficiency anemia (IDA) patients and whether it was related to anxiety, depression, and somatization. We included 127 consecutive IDA patients into the study. All patients were asked validated questions about headache and migraine face-to-face. They were administered validated questionnaires for anxiety-depression The Hospital Anxiety and Depression Scale and somatization. The quality of life (QoL) disturbance associated with headache was marked on a 0-10 VAS. Of all IDA patients, 79.5 % defined headache at any time of their life. In addition, 36.2 % of all IDA patients defined the criteria for migraine. IDA patients with migraine were more frequently smokers and had significantly lower hemoglobin and mean corpuscular volume values (p values < 0.05). The IDA group with migraine had significantly higher mean anxiety score (p = 0.046) and headache-related QoL disturbance score (p = 0.021) than the IDA group without migraine. Migraine patients with aura had lower hemoglobin values (p = 0.02), higher depression scores (p = 0.005), and higher migraine-related QoL disturbance scores than others. IDA patients have a high frequency of migraine headache. The presence of anxiety and depression have great influence on the presence of migraine in IDA patients.Öğe Is JAK2V617F Mutation the Only Factor for Thrombosis in Philadelphia-Negative Chronic Myeloproliferative Neoplasms?(Springer India, 2016) Uyanik, Mehmet Sevki; Baysal, Mehmet; Pamuk, Gulsum Emel; Maden, Muhammet; Akker, Mustafa; Umit, Elif Gulsum; Demir, MuzafferThe most common genetic disorder in Philadelphia negative chronic myeloproliferative neoplasms is the JAK2-V617F mutation. In the present study, we aimed to determine risk factors for thrombosis in patients with essential thrombocytosis and polycythemia vera. We screened the medical records of 101 patients. Risk factors which may predict thrombosis were recorded. Venous thrombosis (VT) before diagnosis was significantly higher in JAK2 positive patients. VT after diagnosis was similar in JAK2 positive and negative groups, and was significantly higher in elderly patients. Treatment places importance on the JAK2 mutation under unmodifiable cardiovascular risk factors such as advanced age after diagnosis.Öğe Natural killer cell killer immunoglobulin-like gene receptor polymorphisms in non-Hodgkin lymphoma: possible association with clinical course(Taylor & Francis Ltd, 2015) Pamuk, Gulsum Emel; Tozkir, Hilmi; Uyanik, Mehmet Sevki; Gurkan, Hakan; Duymaz, Julide; Pamuk, Omer NuriNatural killer (NK) cell killer immunoglobulin-like receptors (KIRs) contribute to the pathogenesis of many diseases. We determined the association between polymorphisms of KIR and their ligands and susceptibility to non-Hodgkin lymphoma (NHL), clinical features and prognosis. We included 90 patients with NHL and 94 controls. In the NHL group, KIR2DS1, HLA-Bw4 (Thr80) and HLA-Bw4 (Thr80)+/Bw4 (Iso80)- ligands were significantly more frequent. Patients with early-stage NHL had more frequent KIR2DL5 and KIR2DL5B than patients with advanced-stage NHL. During a median follow-up of 27 months, 26 patients with NHL died. Poor prognostic factors in univariate analysis were KIR2DL5A, KIR2DS1 and KIR3DS1 genotypes. In multivariate Cox regression analysis, advanced age and early relapse were poor prognostic factors. KIR genes and ligands had no significant effect on survival. The activating KIR2DS1 gene might activate NK cells, contributing to the production of more lymphoma cells. In addition, KIR2DS1, KIR2DL5A and KIR3DS1 might also be associated with a poor prognosis in NHL.Öğe PECAM-1 GENE Polymorphisms and Soluble PECAM-1 LEVEL in Rheumatoid Arthritis and Systemic LUPUS Erythematosus Patients Is There a Link with Clinical Atherosclerotic Events?(Wiley, 2014) Pamuk, Omer Nuri; Tozkir, Hilmi; Uyanik, Mehmet Sevki; Gurkan, Hakan; Duymaz, Julide; Donmez, Salim; Yazar, Metin[Abstract Not Available]Öğe PECAM-1 gene polymorphisms and soluble PECAM-1 level in rheumatoid arthritis and systemic lupus erythematosus patients: any link with clinical atherosclerotic events?(Springer London Ltd, 2014) Pamuk, Omer Nuri; Tozkir, Hilmi; Uyanik, Mehmet Sevki; Gurkan, Hakan; Saritas, Fatih; Duymaz, Julide; Donmez, SalimGenetic polymorphisms of platelet endothelial cell adhesion molecule-1 (PECAM-1) were found to play roles in atherosclerotic events. We determined PECAM-1 polymorphisms, soluble PECAM-1, and CD40L levels in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) and evaluated their associations with clinical atherosclerotic complications. We included 100 RA patients, 81 SLE patients, and 94 healthy controls. The clinical features about the patients were obtained from medical records. Past cardiovascular complications were recorded. The most frequent gene polymorphisms of PECAM-1 were studied in our genetics laboratory. Soluble PECAM-1 and CD40L levels in serum were determined with ELISA. The frequencies of 373C (rs668) and 1688A (rs12953) alleles were higher in RA patients when compared to controls (p values, 0.028 and 0.016). RA and SLE patients had significantly higher allele frequencies for 2008A (rs1131012) when compared to controls (p values, 0.016 and 0.001). SLE patients had significantly more frequent AA genotype for rs1131012 polymorphism than RA patients and controls (p values, 0.007 and < 0.001). Soluble PECAM-1 level was significantly higher in RA patients than in SLE patients and healthy controls (p values < 0.001). Atherosclerotic complications were more frequent in SLE patients with AG genotype (rs12953) than those with AA genotype (p = 0.021). SLE patients with CC genotype (rs668) had a significantly lower frequency of atherosclerotic complications than those with CG genotype (p = 0.045). Nevertheless, in multivariate analysis, there was no association between genotype and atherosclerotic complications. We found associations between various PECAM-1 polymorphisms in RA and SLE; PECAM-1 and soluble CD40 ligand (sCD40L) levels were significantly higher in RA patients than in SLE and control groups. PECAM-1 polymorphisms in SLE were protective against atherosclerotic complications.Öğe Susceptibility to Atherosclerosis in Patients with Psoriasis and Psoriatic Arthritis as Determined by Carotid-Femoral (Aortic) Pulse-Wave Velocity Measurement(Ediciones Doyma S A, 2009) Soy, Mehmet; Yildiz, Mustafa; Uyanik, Mehmet Sevki; Karaca, Nuran; Guefer, Goekhan; Piskin, SueleymanIntroduction and objectives. In this study we analyzed the susceptibility to atherosclerosis of patients with psoriasis and psoriatic arthritis (PsA) by determining the femoral-carotid pulse wave velocity (PWV), which is a measure of the viscoelastic properties of blood vessels. Methods. The study included 25 patients with psoriasis (age 18-63 years; 13 male), of whom nine had arthritis, as well as 39 sex- and age-matched healthy control subjects (age 24-70 years, 25 male). The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, body mass index (BMI) and waist-to-hip ratio (WHR) of all participants were recorded and, in patients, skin lesions were assessed using the psoriasis area and severity index (PASI). Arterial distensibility was determined by automatic carotid-femoral PWV measurement using the Complior Colson device. Results. Mean PWV, SBP and DBP were significantly higher in psoriatic patients than in control subjects (P=.036, P<.001, and P=.005, respectively). In PsA patients, the mean WHR, SBP, DBP and PWV were all significantly higher than in control subjects (P=.001, P=.031, P=.001, and P=.014, respectively). Conclusions. The carotid-femoral PWV is increased in patients with psoriasis and PsA.Öğe Systemic antineutrophil cytoplasmic antibody vasculitis in a patient with chronic lymphocytic leukemia -: Quite a rare diagnosis(Pergamon-Elsevier Science Ltd, 2007) Pamuk, Guelsuem Emel; Uyanik, Mehmet Sevki; Demir, Muzaffer; Tekguenduez, Emre; Turgut, Burhan; Soy, MehmetThere might be rheumatic manifestations of malignant diseases, especially those of the hematological type. Until now, antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis in chronic lymphocytic leukemia (CLL) has been reported on only very few occasions. Here, we present our patient with Rai stage II CLL who came to us with constitutional symptoms. She turned out to have hematuria with dysmorphic erythrocytes and developed hemoptysis. She had pulmonary-renal syndrome and was diagnosed with p-ANCA positive microscopic polyangiitis. She is currently using prednisolone and cyclophosphamide and undergoing regular hemodialysis. Constitutional symptoms in patients with hematological malignancies should make the physicians consider systemic vasculitis after exclusion of disease-related complications. (c) 2006 Elsevier Ltd. All rights reserved.Öğe Systemic LUPUS Erythematosus Patients Presenting With Immune Thrombocytopenia and The Association Between Two Diseases(Wiley-Blackwell, 2013) Pamuk, Omer Nuri; Pamuk, Gulsum Emel; Uyanik, Mehmet Sevki[Abstract Not Available]Öğe Tissue factor pathway inhibitor and thrombin-activatable carboxypeptidase B for prediction of early atherosclerosis in gouty arthritis(Pergamon-Elsevier Science Ltd, 2014) Uyanik, Mehmet Sevki; Pamuk, Gulsum Emel; Pamuk, Omer Nuri; Tuncel, Sedat AlpaslanBackground: Gouty arthritis (GA) is a chronic inflammatory arthritis in which both clinical and subclinical atherosclerosis are more frequent. The dynamic equilibrium between coagulation and fibrinolysis is impaired in inflammatory diseases. We determined TFPI and TAFI antigen levels in GA patients and evaluated their association with subclinical atherosclerosis. Methods: We included 45 GA patients (41 males, 4 females; mean age: 51.6 years) and 25 asymptomatic hyperuricemic (AHU) subjects (19 males, 6 females; mean age: 48.1 years). Cardiovascular risk factors were determined. TAFI and TFPI levels were determined by ELISA. B-mode ultrasonography was used to detect subclinical atherosclerosis. Results: Cardiovascular risk factors were similar in both groups. The carotid IMT was significantly higher in GA group than in AHU group (0.74 +/- 0.23 mm vs. 0.61 +/- 0.13 mm, p = 0.009). TFPI level was significantly higher in GA group than in AHU group (86.2 +/- 48.9 ng/mL vs. 25.8 +/- 21.4 ng/mL, p < 0.001); TAFI antigen was significantly higher in AHU group (22.6 +/- 3.6 ng/mL vs. 25.7 +/- 5.3 ng/mL, p = 0.006) than in GA patients. Atherosclerotic plaque formation was more frequent in GA group (p = 0.041). When GA patients with and without plaques were compared, the first group had significantly higher mean age (p = 0.01) and TFPI level (p = 0.028). TFPI level correlated with carotid IMT (r = 0.302; p = 0.028). Logistic regression analysis showed that age (OR: 1.236, 95%CI: 1.059-1.443, p = 0.007) and TFPI (OR: 1.031, 95%CI: 1.008-1.054, p = 0.008) were independent risk factors for the presence of plaques. Conclusions: GA patients had more frequent subclinical atherosclerosis than subjects with AHU. Higher TFPI levels in GA patients -probably associated with enhanced endothelial damage-were related to subclinical atherosclerosis. Lower TAFI levels in GA pointed to impaired fibrinolysis. (C) 2014 Elsevier Ltd. All rights reserved.
