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  • Küçük Resim
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    A New Scoring System for the Evaluation of Ibrutinib-Associated Arrhythmias in Chronic Lymphocytic Leukemia: The ACEF Score
    (Galenos Publ House, 2024) Koyuncu, Ilhan; Koyuncu, Betuel; Ugur, Mehmet Can; Koyun, Emin; Senoz, Oktay; Dogdus, Mustafa; Bilgir, Oktay
    Objective: Bruton tyrosine kinase inhibition in cardiac tissue causes inhibition of the PI3K-AKT signaling pathway, which is responsible for protecting cardiac tissue during stress. Therefore, there is an increase in the risk of arrhythmia. This study explores the prediction of that risk with the Age-Creatinine-Ejection Fraction (ACEF) score as a simple scoring system based on the components of age, creatinine, and ejection fraction. Materials and Methods: Patients diagnosed with chronic lymphocytic leukemia (CLL) and receiving ibrutinib treatment for at least 1 year were evaluated with echocardiography and Holter electrocardiography and the results were compared with a control group of CLL patients who had not received treatment. ACEF score was calculated with the formula age/left ventricular ejection fraction+1 (if creatinine >2.0 mg/dL). Results: When the arrhythmia development of the patients was evaluated, no statistically significant difference was found between the control and ibrutinib groups in terms of types of arrhythmias other than paroxysmal atrial fibrillation (PAF). PAF was found to occur at rates of 8% versus 22% (p=0.042) among ibrutinib non -users versus users. For patients using ibrutinib, an ACEF score of >1.21 predicted the development of PAF with 77% sensitivity and 75% specificity (area under the curve: 0.830, 95% confidence interval: 0.698-0.962, p<0.001). Conclusion: The ACEF score can be used as a risk score that predicts the development of PAF in patients diagnosed with CLL who are scheduled to start ibrutinib.
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    COMPARISON OF THE EFFECT OF ORAL AND PARENTERAL IRON PREPARATIONS ON EQ-5D QUALITY OF LIFE SCORE
    (2023) Ugur, Mehmet Can; Mutlu, Cansu Atmaca
    Introduction: Iron deficiency anemia is a common problem that directly affects quality of life. Head-to-head comparative studies on how drugs used in the treatment of iron deficiency affect quality of life are limited. The aim of this study was to compare the effect of oral and parenteral iron preparations on EQ-5D quality of life scores. Materials and Methods: Patients were administered the EQ-5D Qualit y of Life Questionnaire by face-to-face interview at the beginning and 1 mont h of treatment. The patient's demographic data, information about the oral (ferrous or ferric form) or ferrous form parenteral iron preparation given and anemi parameters at diagnosis and at 1 month of treatment were compared. Results: A total of 103 patients were included in the study. When the changes in anemia parameters were evaluated, it was seen that iron carboxymaltose was superior to oral preparations. When comparing the EQ-5D Index score and VAS, although the scores reached at month 1 for index score and VAS were similar, the increase was higher in patients receiving parenteral therapy and this increase was statistically significant (p=0.007 and 0.001 for index score and VAS, respectively). When patients given oral iron preparations were analyzed in ferrous and ferric iron subgroups, no significant difference was found in terms of anemia parameters and EQ-5D scores. Conclusion: Parenteral treatment improves quality of life more than oral iron therapy. There is no difference in the effect of ferrous and ferric ir on on quality of life in oral treatments. These data should be supported by randomized controlled trials with larger samples.
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    Pulmoner Tromboemboli Tanısında Trombosit İndekslerinin Öngörücü Rolü
    (University of Health Sciences, 2024) Koçyiğit, Yalçın; Ugur, Mehmet Can; Ceylan, Cengiz
    Giriş: Endotelyal hasar ve hiperkoagülabilite gelişiminde anahtar rol oynadığı bilinen trombosit aktivasyonu, PTE gelişiminde de önemli bir yere sahiptir. Bu nedenle trombosit indeksleri PTE tanısında yol gösterici olabilir. Amaç: Bu araştırmada, trombosit indekslerinin pulmoner tromboemboli tanısı için öngörüdürücülüğünün araştırılması amaçlanmıştır. Materyal ve Metod: 2020-2023 yılları arasında Aliağa Devlet Hastanesi’nde Bilgisayarlı Tomografi Pulmoner Anjiografi ile tromboemboli tanısı alan 18 yaş üstü hastaların verileri retrospektif olarak tarandı. Herhangi bir ek hastalık ve ilaç kullanım öyküsü olmayan, yaş ve cinsiyet bakımından pulmoner tromboemboli koluna benzer özelliklerde katılımcılardan oluşan bir kontrol grubu oluşturuldu. Bulgular: Çalışmaya 33 PTE grubu, 35 kontrol grubu olmak üzere toplam 68 hasta dahil edildi. PTE kolunda 18 kadın (%54,5), 15 erkek (%45,5); kontrol grubunda 20 kadın (%57,1) 15 erkek (%42,9) yer aldı. PTE ve kontrol grubunun yaş ortalaması sırasıyla 70,9 (40-91) ve 69,2 (49-82) idi. Grupların tanı anındaki trombosit sayısı, MPV, PCT ve PLR karşılaştırıldığında gruplar arasında istatistiksel olarak anlamlı fark saptanmadı. Ancak PTE grubunda PDW değeri istastiksel olarak daha yüksek bulundu (p=0,001). PDW için hesaplanan cut-off değeri 16,35% (%95 Cl, AUC:0,790
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    THE ROLE OF SOCIAL MEDIA ON LIVING WITH HEMOPHILIA: MOTHERS OF HEMOPHILIC CHILDREN IN TURKEY A CROSS-SECTIONAL STUDY
    (2024) Ugur, Mehmet Can; Sezgin, Serra
    Introduction: This study deals with how mothers use social media to develop coping mechanisms and how they benefit from social media, and the impact of social media on life with hemophilia. The aim of this study is to examine the social media usage practices of mothers with children with hemophilia and to evaluate the effect of social media on regulating life with hemophilia. Material and Method: The population of this quantitative and cross-sectional study consisted of 160 mothers who had a child with hemophilia and were caring for them in Turkey. A theme-based online questionnaire consisting of 20 questions was shared with these mothers electronically. 88 of 160 mothers who answered the questionnaire constituted the sample of the study and their answers formed the research material. Results: 81.8% of the participants prefer Instagram as their social media platform. It was found that 94.3% of them were of the opinion that social media contributed to life with hemophilia. The participants stated that accessing medical and technological developments, relevant social and social news, and information about related events regarding hemophilia, and communicating with relevant healthcare professionals, other hemophilia patients and relevant non-governmental organizations are the main benefits of social media. Conclusion: As a result, it has been determined that mothers need more effective dynamics and multi-faceted interaction to strengthen their solidarity opportunities. This result brings up the necessity of cooperation between health professionals and social media experts.
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    The Role of Thalidomide and Its Analogs in the Treatment of Hereditary Hemorrhagic Telangiectasia: A Systematic Review
    (MDPI, 2024) Ugur, Mehmet Can; Baysal, Mehmet; Umit, Elif Gulsum
    Background: Hereditary hemorrhagic telangiectasia (HHT) is a disease characterized by arteriovenous malformations and telangiectases, in which the endothelium and immune system play a role in the pathophysiology. Therefore, treatments with antiangiogenic properties which are also regarded as immunomodulators were demonstrated to play an important role in treatment. This systematic review aimed to gather the accumulated information of the use of thalidomide and its analogs in the treatment of HHT. Methods: In this systematic review, publications that were published up to March 2024 and met the inclusion criteria were compiled using the keywords 'thalidomide', 'lenalidomide', 'pomalidomide', 'immunomodulatory drugs' and 'HHT' in Medline and Scholars databases. Results: A total of 53 articles were evaluated and 15 were included in the study. Thalidomide was the predominant used agent and was observed to be used in patients with ages ranging from 37 to 77 years, with doses ranging from 50 to 200 mg daily, and the mean follow-up period was observed to be 6-60 months. Assessments regarding efficacy were based on the epistaxis severity score (ESS), hemoglobin level, and transfusion independence. While thalidomide showed significant efficacy, it also had an adverse event rate of any severity of up to 85% of patients. Use of lenalidomide to control bleeding in HHT was reported in a single case report, while the use of pomalidomide was observed to be investigated in Phase 1 and Phase 2 studies in patients aged 48 to 70 years, with doses ranging from 1 to 5 mg daily for 6-24 months. This treatment was reported to provide significant improvement in hemoglobin levels and ESS. Adverse events of any severity were observed at a frequency of 60-66%. Conclusions: Antiangiogenic agents such as thalidomide, lenalidomide, and pomalidomide may be effective in managing HHT. However, further studies are needed to optimize the timing, dose, and sequence.
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    Üçüncü Basamak Sağlık Kuruluşunda Kan Ürünü Transfüzyonu İlişkili İstenmeyen Reaksiyonların 5 Yıllık Retrospektif Analizi
    (University of Health Sciences, 2024) Tekbil, Arzu; Kaygusuz, Sitem; Ugur, Mehmet Can
    Öz Giriş: Doğru hastaya, doğru kan ürününün uygun zamanda ve miktarda transfüzyonu hayat kurtarıcıdır. Ancak transfüzyona bağlı gelişen komplikasyonlar morbidite ve mortaliteye neden olabilmektedir. Bu komplikasyonların önlenmesi amacıyla hemovijilans programları geliştirilmiştir. Amaç: Bakırçay Üniversitesi Çiğli Eğitim ve Araştırma Hastanesi’nde 2018-2022 yılları arasında Hemovijilans Birimi tarafından kaydedilen transfüzyon ilişkili reaksiyonların retrospektif değerlendirilmesi amaçlanmıştır. Materyal-Metod: Hemovijilans Birimi’nde akut transfüzyon reaksiyonları için tutulan dosya ve bilgisayar kayıtları retrospektif incelenerek 2018-2022 yılına ait veriler kaydedilmiştir. Bulgular: Beş yılda toplam 35948 eritrosit, 11714 taze donmuş plazma (TDP), Öz Giriş: Doğru hastaya, doğru kan ürününün uygun zamanda ve miktarda transfüzyonu hayat kurtarıcıdır. Ancak transfüzyona bağlı gelişen komplikasyonlar morbidite ve mortaliteye neden olabilmektedir. Bu komplikasyonların önlenmesi amacıyla hemovijilans programları geliştirilmiştir. Amaç: Bakırçay Üniversitesi Çiğli Eğitim ve Araştırma Hastanesi’nde 2018-2022 yılları arasında Hemovijilans Birimi tarafından kaydedilen transfüzyon ilişkili reaksiyonların retrospektif değerlendirilmesi amaçlanmıştır. Materyal-Metod: Hemovijilans Birimi’nde akut transfüzyon reaksiyonları için tutulan dosya ve bilgisayar kayıtları retrospektif incelenerek 2018-2022 yılına ait veriler kaydedilmiştir. Bulgular: Beş yılda toplam 35948 eritrosit, 11714 taze donmuş plazma (TDP), 2511 trombosit, 243 kriyopresipitat, 161 tam kan ve COVID-19 pandemisinin yaşandığı 2020-2021 yıllarında 605 immun plazma kullanılmıştı. Transfüzyon ilişkili reaksiyon prevelansı eritrosit için 100/100.000, TDP için 128/100.000 ve trombosit için 79/100.000 olarak saptandı. Toplam 36 hafif alerjik reaksiyon, 10 febril nonhemolitik transfüzyon reaksiyonu, 2 anafilaksi ve 1 transfüzyon ilişkili akut akciğeri hasarı görüldü. Sonuç: Hemovijilans programlarına olan farkındalığın artırılması, kan ürünlerinin doğru kullanılması ve transfüzyon ilişkili reaksiyonların önlenmesi açısından önemlidir.11 trombosit, 243 kriyopresipitat, 161 tam kan ve COVID-19 pandemisinin yaşandığı 2020-2021 yıllarında 605 immun plazma kullanılmıştı. Transfüzyon ilişkili reaksiyon prevelansı eritrosit için 100/100.000, TDP için 128/100.000 ve trombosit için 79/100.000 olarak saptandı. Toplam 36 hafif alerjik reaksiyon, 10 febril nonhemolitik transfüzyon reaksiyonu, 2 anafilaksi ve 1 transfüzyon ilişkili akut akciğeri hasarı görüldü. Sonuç: Hemovijilans programlarına olan farkındalığın artırılması, kan ürünlerinin doğru kullanılması ve transfüzyon ilişkili reaksiyonların önlenmesi açısından önemlidir.