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Öğe Atypical presentation of herpes zoster infection following fludarabine treatment for chronic lymphocytic leukemia: a case report(2011) Demircioğlu, Sinan; Aydoğdu, İsmet; Kaya, Emin; Kuku, İrfan; Erkurt, Mehmet AliHerpes zoster (zona), varisella zoster virüsünün neden olduğu akut veziküler erüpsiyon ile seyreden bir infeksiyondur. Dermatomal dağılımla sınırlı, tek taraflı ve ağrılı döküntülerle karakterizedir. 49 yaşında, Kafkasyalı, erkek hastada kronik lenfositik lösemi nedeni ile fludarabin tedavisi alırken karının sağ tarafında ağrılı veziküller oluştu. Nötropenik olan hastaya anamnez ve izik muayene ile zona tanısı kondu ve asiklovir tedavisi başlandı. Tedavinin 3. gününde hastanın yüz ve kafa derisi dahil tüm vücüdunda yaygın eritematöz veziküller gelişti. Tzanck testi ile varisella zoster olduğu gösterildi. Asiklovir tedavisine rağmen hastanın akciğerinde diffüz infiltrasyon izlendi, hipertermi ve dispne meydana geldi. Toraks tomoğrafisi pnömoni ile uyumlu idi. Hastanın hipertermisi teikoplanin, meronepem ve intravenöz immünglobuline cevap vermedi. Hasta öldü.Öğe Clinical management, psychosocial characteristics, and quality of life in patients with homozygous familial hypercholesterolemia undergoing LDL-apheresis in Turkey: Results of a nationwide survey (A-HIT1 registry)(ELSEVIER SCIENCE INC, 2019) Kayıkcıoğlu, Meral; Tunçel, Özlem Kuman; Pırıldar, Şebnem; Yılmaz, Mehmet; Kaynar, Leylagül; Aktan, Melih; Durmuş, Rana Berru; Gökçe, Cumali; Temizhan, Ahmet; Özcebe, Osman İlhami; Akyol, Tülay Karaağaç; Okutan, Harika; Sağ, Saim; Gül, Özen Öz; Salcıoğlu, Zafer; Yenerçağ, Mustafa; Altunkeser, Bülent Behlül; Kuku, İrfan; Yaşar, Hamiyet Yılmaz; Kurtoğlu, Erdal; Demir, Melis; Demircioğlu, Sinan; Pekkolay, Zafer; İlhan, Osman; Tokgözoğlu, LaleBACKGROUND: Homozygous familial hypercholesterolemia (HoFH) is a rare, life-threatening inherited disease leading to early-onset atherosclerosis and associated morbidity. Because of its rarity, longitudinal data on the management of HoFH in the real world are lacking, particularly on the impact the condition has on quality of life (QoL), including the impact of the extracorporeal lipid removal procedure apheresis (LA). METHODS: The A-HIT1 study included 88 patients with HoFH aged >= 12 years receiving regular LA in 19 centers in Turkey. Demographic and disease characteristics data were obtained. For patients aged >= 18 years, additional data on psychosocial status were obtained via the SF-36 score, the Hospital Anxiety and Depression Scale, and a HoFH-specific questionnaire. RESULTS: There was no standardized approach to therapy between centers. Mean (+/-SD) frequency of LA sessions was every 19.9 (+/-14) days, with only 11.6% receiving LA weekly, and 85% of patients were not willing to increase LA frequency. The most common concerns of patients were disease prognosis (31%), and physical, aesthetic, and psychological problems (27.5%, 15.9%, and 11.6%, respectively). Lower age at diagnosis was associated with better QoL, lower anxiety, improved functioning, and greater emotional well-being compared to later diagnosis. CONCLUSIONS: These findings demonstrate that adult patients with HoFH undergoing LA, experience significant impairment of QoL with an increased risk of depression. From patients' point of view, LA is time-consuming, uncomfortable, and difficult to cope with. The speed of diagnosis and referral has a considerable impact on patient well-being. (C) 2019 National Lipid Association. All rights reserved.Öğe Evaluation of Electrocardiographic and Echocardiographic Findings In Patients Diagnosed with Polycythemia Vera and Essential Thrombocythemia(Selçuk Üniversitesi, 2024 Şubat) Kaya, Bahattin Engin; Demircioğlu, Sinan; Tekinalp, Atakan; Sertdemir, Ahmet Lütfi; Ergün, Mustafa Çağrı; Tuna, Ali Kürşat; Kandemir, Şerif Ahmet; İçli, Abdullah; Çeneli, ÖzcanABSTRACT Background/Aims: Polycythemia vera (PV) and essential thrombocythemia (ET) are chronic myeloproliferative diseases that can lead to various clinical outcomes, including arterial and venous thrombosis, pulmonary hypertension, and myocardial infarction. This study was designed to assess the cardiac effects of these diseases using electrocardiography and echocardiography. Methods: A total of 50 patients diagnosed with PV, 50 patients diagnosed with ET, and 50 healthy individuals forming the control group were enrolled in this study. Demographic information for all subjects was collected. Electrocardiography (ECG) recordings and standard transthoracic echocardiographic examinations were conducted for all patients and control subjects. Pulse wave velocity (PWV) measurements were assessed using a Holter blood pressure device. Results: In total, 50 PV patients, 50 ET patients, and 50 control group were included in the study. The demographic characteristics of the PV, ET and control groups were similar. The PR interval was significantly shorter in control subjects than in PV and ET patients (p = 0.007, p = 0.024). Although the measured values were within normal limits, diastolic posterior wall thickness was significantly lower in the control group compared to PV and ET patients (p = 0.019, p = 0.009). PWV was significantly higher in ET patients compared to the control group (p = 0.012). Conclusion: ECG parameters used to predict ventricular arrhythmias (QT, QTc, Tp-Te, Tp-Te/QT) and Pulmonary Artery Pressure showed no significant change, in opposition to existing literature. Nonetheless, similar to previous publications, PV and ET were found to negatively affect the diastolic function parameters on transthoracic echocardiography. While the aortic stiffness was significantly higher in ET patients compared to the control group, no significant difference was noted between PV patients and control subjects in terms of aortic stiffness.Öğe İbrutinib Sonrası Gelişen Dev Ekimoz ve Hematom: Olgu Sunumu(Selçuk Üniversitesi, 2017 Mart) Demircioğlu, Sinan; Çipil, Handan; Çeneli, Özcan; Bilgin, Aynur UğurKronik lenfositik lösemi ve Mantle hücreli lenfoma da yeni bir tedavi seçeneği olan ibrutinib, yüksek etkinliği ile günümüzde sık kullanılmaya başlanmıştır. Hedefe yönelik monoklonal antikorların yan etkileri sitotoksik tedavilere göre daha hafif seviyede görülmektedir. İbrutinibin de ishal, bitkinlik, ateş, bulantı, kanama, sitopeniler, alerjik reaksiyonlar gibi yan etkileri görülmektedir. Kanama %50 den fazla vakada görülmüştür. Çoğunluğu peteşiyal kanamalar olmasına rağmen hayati tehdit eden kanamalara da yol açmaktadır. Bizde ibrutinibin kanamaya eğilimi olan hastalarda dikkatli kullanılmasını vurgulamak amacıyla, ibrutinib sonrası kanama gelişen vakamızı sunduk.Öğe Impact of Hemoglobin, Leucocyte and Thrombocyte Levels at Diagnosis on the Survival Outcomes of Chronic Myeloid Leukemia Patients(Selçuk Üniversitesi, 2024 Şubat) Demircioğlu, Sinan; Çiftçiler, Rafiye; Kars, Taha Ulutan; Tekinalp, AtakanBackground: Since the development of tyrosine kinase inhibitors (TKIs), the prognosis for chronic myeloid leukemia (CML) has significantly improved. Several predicted prognostic scores and indicators at diagnosis have been used to predict the prognosis of chronic phase chronic myeloid leukemia (CML-CP) during the TKI period. When CML patients are first diagnosed, hemogram parameter aberrations are rather prevalent in clinical practice although it is still unknown how those parameters affect the prognosis. This study aims to evaluate the hemogram parameters at diagnosis on the survival outcomes of CML-CP patients. Materials and Methods: One hundred thirty-seven patients who were diagnosed with CML-CP and received treatment were assessed between the years 2006 and 2020. Results: There were 65 (47.4%) males and 72 (52.6%) females with a median age of 50 (range: 18-78) years at diagnosis. Median hemoglobin level was 12.1 gr/dL (4.3-17.4), leucocyte count was 66.2 ×109 /L (7.5-520.2), and thrombocyte count was 362 ×109 /L (18-3.496) for all patients. The median progression-free survival (PFS) was 16.7 (2.0-106.4) months and the median overall survival (OS) was 63.8 (0.43-166.2) months for all patients. Conclusion: This study is valuable in terms of predicting the prognosis of CML patients with hemoglobin, leukocyte, and platelet values at the time of diagnosis. While emphasizing the importance of platelet count at the time of diagnosis, similar to the previously defined risk scores, it showed that leukocyte and hemoglobin values at the time of diagnosis did not have a statistically significant effect on OS and PFS.Öğe Niemann-pick type b disease diagnosed in the adulthood(2018) Demircioğlu, Sinan; Korkmaz, Celalettin; Çizmecioğlu, Hilal Akay; Poyraz, NecdetNiemann-Pick disease (NPD) type B is an autosomal recessive liposomal storage disorder. NPD type B can present later inlife with predominantly visceral symptoms, and has a more favorable prognosis. The natural history of NPD -B is one ofprogressive hypersplenism and gradual deterioration of pulmonary function. In this paper, we presented NPD type Bpatient who were diagnosed at 41 years old while being followed for years with the diagnosis of interstitial lung disease.
