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Öğe Association between periodontal inflamed surface area and serum acute phase biomarkers in patients with sickle cell anemia(Pergamon-Elsevier Science Ltd, 2022) Sari, Aysegul; Ilhan, Gul; Akcali, AliyeObjectives: The aim of the present cross-sectional study was to investigate the association between periodontal inflamed surface area (PISA) and serum inflammatory biomarkers in patients with sickle cell anemia. Design: Patients with sickle cell anemia (n = 80) and systemically healthy individuals (n = 80) were enrolled in the study. Crisis episodes were recorded and blood samples were collected from patients with sickle cell anemia. Clinical periodontal parameters and PISA values were calculated from all patients. Ferritin and high sensitivity C-reactive protein (hs-CRP) levels were analyzed biochemically. Results: In sickle cell anemia group, presence of periodontitis (p < 0.001) was more frequent than periodontal health (p < 0.001). All clinical periodontal recordings and PISA values were higher in the sickle cell anemia group compared to controls (p < 0.001). Patients with PISA > 776 mm(2) had 6.06-fold greater chances of having hs-CRP levels above 10 mg/L (OR = 6.06; 95 % CI: 1.9-19.26) and had 31.41-fold greater chances of having ferritin levels above 1000 ng/L (OR = 31.41; 95 % CI: 6.62-149.16). Also, they had 3.27-fold greater risk of having crisis frequency above three times per year (OR = 3.27; 95 % CI: 1.05-10.23) after adjusting for confounders. Conclusion: In patients with sickle cell anemia, positive association was evident between PISA values and serum acute phase biomarkers levels as well as the frequency of acute painful crisis. Patients with increased inflammatory burden may have a higher likelihood of developing periodontitis in the presence of sickle cell anemia. PISA value could be a candidate disease activity indicator in patients with an underlying hematological condition.Öğe A comparison of the mixed and sequential use of acetaminophen and dexketoprofen in painful vaso-occlusive crises(Springer Heidelberg, 2024) Kacmaz, Murat; Ilhan, GulPurpose Opioids are widely used to treat painful vaso-occlusive crises (VOC) in sickle cell disease (SCD). However, due to opioids' significant adverse effect profiles, the search for alternative therapies continues from the past to the present. The study aimed to investigate the efficacy of acetaminophen and dexketoprofen in the treatment of painful VOC.Methods This study is a single-center, prospective, non-randomized, single-blinded, controlled study. The study comprised two groups: the first administered acetaminophen and dexketoprofen mixed group, while the second received them sequential group. Opioids were used in patients with persistent pain despite these analgesics. Demographic and laboratory information, pain scores, opioid requirement, dose amount, side effects, and length of hospital stay of the patients were recorded.Results The study comprised 56 (100%) patients with painful VOC, 29 (51.8%) from the mixed group, and 27 (48.2%) from the sequential group. Opioid use was seen in 16 (55.2%) patients in the mixed group and 21 (77.8%) patients in the sequential group (p = 0.074). The median amount of opioid used was significantly lower in the mixed group than in the sequential group (p < 0.001). Also, the median length of hospital stay was significantly lower in the mixed group than in the sequential group (p < 0.001).Conclusion Our study suggests that administering acetaminophen and dexketoprofen in the mix for the treatment of painful VOC in patients with SCD may be a more efficient approach compared to sequential administration. This approach appears to reduce opioid usage and shorten hospital stays.Öğe Correlations between the Maximum Standard Uptake Value of Positron Emission Tomography/Computed Tomography and Laboratory Parameters before and after Treatment in Patients with Lymphoma(Wolters Kluwer Medknow Publications, 2018) Ucar, Edip; Yalcin, Hulya; Kavvasoglu, Gamze Hande; Ilhan, GulBackground: After the first examination of patients with lymphoma diagnosis, important laboratory tests such as complete blood count; albumin, kidney and liver function tests; uric acid; beta 2-microglobulin; C-reactive protein (CRP); erythrocyte sedimentation rate (ESR); and lactate dehydrogenase (LDH) examinations are recommended. In this study, our aim was to find the relationship between laboratory parameters and the maximum standard uptake value (SUVmax) of positron emission tomography/computed tomography (PET/CT) in patients with lymphoma at the diagnosis and after treatment. Methods: Thirty-four lymphoma patients treated at Mustafa Kemal University Internal Medicine Clinic between 2014 and 2017 were included in this retrospective study. Results of CRP, ESR, LDH, albumin, and white blood cell (WBC) count were recorded before each PET scan test, and each parameter was analyzed for correlation with SUVmax measurements. Results: Spearman's correlation test showed that the after-treatment SUVmax values were significantly correlated with the after-treatment LDH, ESR, and CRP values (for LDH, ESR, and CRP, R-2: 0.453, 0.426, and 0.351; P = 0.007, 0.012, and 0.042, respectively). On the other hand, albumin and WBC count did not show a significant correlation with the after-treatment SUVmax values (all P > 0.05). Conclusions: CRP, ESR, and LDH values may also be good predictors in patients for whom PET/CT imaging cannot be performed.Öğe The effect of pre-conditioning immunoglobulin and absolute lymphocyte count on the outcomes of allogeneic hematopoietic cell transplantation(Elsevier, 2023) Kacmaz, Murat; Basci, Semih; Ilhan, Gul; Yigenoglu, Tugce Nur; Cakar, Merih Kizil; Dal, Mehmet Sinan; Altuntas, FevziIntroduction: The prevention of mortality and morbidity related to the increasingly used allogeneic hematopoietic cell transplantation (allo-HCT), along with the effects of pre-and post-transplant immune status on transplant outcomes, have become the focus of the studies conducted on this subject in recent years. In parallel, this study was designed to investigate the effects of pre-conditioning immunoglobulin (pre-conditioning-Ig) and pre-conditioning absolute lymphocyte count (pre-conditioning-ALC) levels on transplant outcomes.Methods: This study was designed as a retrospective, observational and cross-sectional study. The objective of the study is to investigate the effects of pre-conditioning-Ig and ALC levels primarily on the rate of patients with febrile neutropenia (FEN) and the duration of FEN and length of hospital stay (LoS), and secondarily on acute graft-versus-host disease (aGVHD), cytomegalovirus (CMV) viremia, and mortality in the acute leukemia patients who underwent allo-HCT.Results: A total of 104 acute leukemia patients, of whom 55 had acute lymphoblastic leukemia (ALL) and 49 had acute myeloid leukemia (AML), were included in the study. Compared to the AML group, the median pre-conditioning-IgG, IgA, and IgM levels were found to be significantly lower in the ALL group (11.3 vs. 6.6, p < 0.001; 1.8 vs. 0.9, p < 0.001; and 0.7 vs. 0.4, p < 0.001; respectively). But, there was no significant difference between the groups in pre-conditioning-Ig and ALC levels and transplant outcomes. However, subgroup analysis revealed that high pre-conditioning-ALC levels were significantly correlated with aGVHD levels (Odds Ratio: 1.02; p = 0.034) and low pre-conditioning-IgM levels were significantly correlated with increased mortality rate (Hazard Ratio: 0.08; p = 0.042) in AML patients.Conclusion: The significant difference determined between the ALL and AML groups in pre-conditioning-Ig levels was not reflected on the effects of pre-conditioning-Ig and ALC levels on transplant outcomes. However, we observed that pre-conditioning-IgM and ALC levels have an impact on transplant outcomes in AML patients.Öğe Elastographic evaluation of the effect of sickle cell anemia on testicles: a prospective study(Wiley, 2022) Koras, Omer; Gorur, Sadik; Bayramogullari, Hanifi; Ilhan, Gul; Gokalp, Fatih; Kacmaz, Murat; Ilgezdi, AlicanTo quantitatively determine testicular tissue stiffness values using shear wave elastography (SWE) in males that have sickle cell anemia (SCA) and to evaluate the relationship between elastography results and semen analysis parameters and hormone levels. Fifty patients diagnosed with SCA and followed up in the hematology outpatient clinic were evaluated in the urology outpatient clinic as the study group. In addition, there were 88 patients without any SCA-related complaints in the control group. We compared these groups with respect to their values, spermiogram parameters, testicular volume, and SWE values. Among patients in the SCA group, 28% had impaired sperm parameters. When testicular elastography was assessed, the testicular volumes were materially lower in the SCA group in comparison to the control group [right testicular volume: 14.76 (12.77-18.12) and 19.68 (15.12-24.18), respectively, p < 0.001; left testicular volume: 14.11 (11.06-17.32) and 16.59 (13.38-20.13), respectively, p = 0.015]. Additionally, the left testis central stiffness and the left testis inferior stiffness were significantly higher in the SCA group (p < 0.001 and p = 0.014, respectively). The age and hydroxyurea use had a worse effect on sperm parameters in patients with SCA (odds ratio: -0.161 and -1.914, standard deviation: 0.071 and 0.921, and p = 0.024 and p = 0.038, respectively). We consider that the technique utilized in this study for SWE values is fast and can be adopted as a reliable diagnostic tool and follow-up practice in routine clinical practice to evaluate the acuteness of damage to the testicles in patients having SCA.Öğe Evaluation of the Effect of Mortality, Life Expectancy, and Treatment Modalities of Sickle Cell Patients on Mortality(Erciyes Univ Sch Medicine, 2021) Kaya, Mehmet Nur; Ilhan, GulObjective: We aimed to contribute to the literature by investigating the causes of mortality, average life expectancies, and the clinical features that occur in this process, in relation to sickle cell disease (SCD), and by comparing the results obtained with other similar clinical studies. Materials and Methods: This study was designed as a monocentric, cross-sectional, and retrospective study. The patient files were reviewed in terms of the age, use of hydroxyurea, use of chelators, exchange transfusion history, surgical operation history, the annual frequency of painful crises, the annual hospitalization frequency, and the annual frequency of follow-up visits which the patients have attended, the complications experienced by the patients, and the causes of mortality. Results: Acute chest syndrome was the most prevalent cause of death of the patients included in our study. No significant difference was found between the premature death and late death groups, that is, the groups that we have determined on the basis of the SCD patients ages of death, in terms of use of hydroxyurea, use of iron chelator, and use of exchange transfusion depending on the disease. Conclusion: Based on our findings, acute chest syndrome was the primary cause of death in SCD patients we have studied, followed by pulmonary embolism. Use of hydroxyurea, use of iron chelator, exchange transfusion history, and surgical operation history due to SCD were not found to be significantly effective when the mean age of death reported in the literature was taken as the base value.Öğe Hemoglobin SE disease in Hatay, in the southern part of Turkey(Mdpi, 2015) Acipayam, Can; Oktay, Gonul; Ilhan, Gul; Curuk, Mehmet AkifDouble heterozygosity for hemoglobin (Hb) E and S, known as HbSE disease, is a rare, clinically benign condition involving mild hemolysis. Only 25 cases have been reported to date. The current literature generally associates HbSE with a benign clinical course, although vaso-occlusive complications have been reported. Although only single case reports were previously available, we have observed 20 cases of HbSE and wish to report them. We examined the records of patients presenting to our hemoglobinopathy center in 2001-2013. High performance liquid chromatography (HPLC) was used for hematological assessment of blood samples with ethylenediaminetetraacetic acid. Eight patients were male and 12 female. Mean hemoglobin electrophoresis values were Hb Al: 6.3%, Hb E 34.5%, HbS: 59.5% and Hb F: 1.9%. Three patients (15%) were symptomatic with vaso-occlusive crisis and one had cerebral stroke. These were siblings. The patient with cerebral stroke was using hydroxyurea. The incidence of HbSE disease is rising due to population admixtures and racial intermarriages. Increased numbers of cases of HbSE have been detected after premarital hemoglobinopathy screening in the Antakya and Cukurova regions of Turkey. The aim of this study was to report large numbers of patients with HbSE diagnosed through the routine HPLC method. The secondary aim was to emphasize that severe vaso-occlusive crisis such as infarction symptoms could be seen in HbSE.Öğe The Importance of Demodex Mites (Acari: Demodicidae) in Patients With Sickle Cell Anemia(Oxford Univ Press Inc, 2019) Kaya, Ozlem Aycan; Akkucuk, Serife; Ilhan, Gul; Guneri, Cansu Onlen; Mumcuoglu, KostaAlthough demodicosis caused by Demodex folliculorum and Demodex brevis is widely seen throughout the world, the pathogenic mechanisms are not fully known. To the best of our knowledge, the effect of Demodex mites in patients with sickle cell anemia (SCA) is not known. SCA is a genetic disease characterized by abnormal hemoglobin production and suppression of the immune system. The aim of this study was to determine the prevalence and Demodex density in SCA patients and to compare with healthy subjects. The study included 70 patients diagnosed with SCA and control group of 50 healthy individuals. Samples were taken from cheeks, forehead, nose, and chin and were examined microscopically. Infestation of >= 5 mites/cm(2) was accepted as positive in the diagnosis. Demodex mite positivity was determined in 20 (28.6%) patients and none in subjects of the control group. In the SCA group, the mean number of mites was 26.10/cm(2). A statistically significant correlation was found between Demodex mite positivity and the number of SCA symptom attacks experienced by the patients within the last 1 yr (P <= 0.001). No significant relationship was determined between Demodex mite positivity and age or gender (P = 0.56 and P = 0.11, respectively). Demodex mites are seen more often in SCA patients who suffer from a compromised immune system, and the presence of Demodex mites could be a risk factor in the appearance of SCA symptom attacks.Öğe Is the treatment of inflammatory arthritis different in sickle cell disease?(Tubitak Scientific & Technological Research Council Turkey, 2022) Kimyon, Gezmis; Ilhan, GulBackground/aim: Musculoskeletal findings are common in sickle cell patients and may be confused with inflammatory arthritis. In addition, complications such as frequent infections may create difficulties while choosing drugs such as steroids, methotrexate, or anti-TNFs. Our aim is to reveal whether the treatment is different in sickle cell patients with rheumatic diseases such as rheumatoid arthritis. Materials and methods: Patients followed by Rheumatology and Hematology divisions of Hatay Mustafa Kemal University Hospital were retrospectively screened. Excluding patients with musculoskeletal findings associated with sickle cell disease (SCD), patients with chronic or acute inflammatory arthritis were enrolled into study. Demographic data, disease activities, the drugs used, frequency of infection, and sickle cell-related crisis before and after rheumatic disease diagnosis-treatment of the patients were examined. Results: Inflammatory rheumatic disease was detected in 14 of 28 sickle cell patients evaluated in the rheumatology department for musculoskeletal complaints. Twelve of the patients were female and 2 were male. The median duration of rheumatic disease was 27 months (16.5). Eight of these patients had rheumatoid arthritis, 1 had ankylosing spondylitis, reactive arthritis, gout, connective tissue disease, undifferentiated monoarthritis, and 1 patient had undifferentiated oligoarthritis. For rheumatic disease, 11 (78.6%) of the patients were using steroids, 8 (57.1%) hydroxychloroquine, 4 (28.6%) methotrexate and sulfasalazine, 2 (14.3%) leflunomide, 1 (7.1%) anti-TNF (etanercept), and 1 allopurinol and colchicine. The frequency of SCD-related crisis and annual serious infections before and after rheumatic disease treatment were similar (p = 0.31). Conclusion: The clinical manifestations of inflammatory arthritis such as rheumatoid arthritis and sickle cell disease may overlap. The use of drugs such as steroids, methotrexate, or anti-TNF in sickle cell patients with rheumatic disease is the same as in patients without sickle cell disease. However, treatment should be individualized in patients with complications such as infection.Öğe Mean platelet volume can predict cerebroyascular events in patients with Sickle Cell Anemia(Professional Medical Publications, 2015) Celik, Tanju; Unal, Sule; Ekinci, Ozalp; Ozer, Cahit; Ilhan, Gul; Oktay, Gonul; Arica, VefikObjective: The purpose of this study was to determine the impact of mean platelet volume (MPV) on the frequency and severity of vaso-occlusive and cerebrovascular events in patients with sickle cell anemia (SCA). Methods: The 238 cases diagnosed with SCA were evaluated retrospectively with respect to the occurrence of painful crisis for the previous year. The incidence, severity and type of the vaso-occlusive crises of the patients with SCA between March 2010 and March 2011 were recorded. The last MPV values in patients who were free of erythrocyte transfusion for the last three months and who had no current vaso-occlusive crises were evaluated. All the patients were grouped according to the frequency of the crises for the previous year preceding the data collection. Group 1: 1 to 3 crises, Group 2: 4 to 5 and Group 3: 6 or more crises annually. Results: In accordance with the results obtained during the evaluation of the cases diagnosed with sicklecell anemia, MPV value was found to be significantly higher in patients with cerebrovascular events. Also MPV values increased with increasing incidence of the crises (1=0.297) (p=0.001). Conclusion: One of the contributing factors for this clinical heterogeneity may be related to the MPV values in patients with sickle cell anemia. The higher MPV values may be an early predictor of future cerebrovascular events in patients with sickle cell anemia and may require close follow-up and additional measures.Öğe Metabolic bone diseases in sickle cell anemia patients and evaluation of associated factors(Elsevier Science Inc, 2022) Eskiocak, Ozge; Yilmaz, Muge Ozsan; Ilhan, GulBackground: Metabolic or non-metabolic many bone diseases can be distinguished in sickle cell anemia. Patients with sickle cell anemia have a high risk of osteopenia and osteoporosis. The aim of this study is to reveal bone mineral density abnormalities and related factors in patients with sickle cell anemia. Methods: A total of 70 patients with sickle cell anemia were retrospectively included in our study. Complete blood count (CBC) parameters, serum creatinine, lactate dehydrogenase (LDH), total bilirubin, direct bilirubin, uric acid, calcium, phosphorus, parathormone, alkaline phosphatase, 25 (OH) vitamin D, ferritin, C reactive protein (CRP) and calculated bone mineral densitometry measurements by Dual-Energy X-ray Absorptiometry (DEXA) were assessed and recorded to the statistics program. We diagnosed osteopenia and osteoporosis according to World Health Organization (WHO) criteria. To determine the status of avascular necrosis and bone fracture, we examined x-ray and magnetic resonance imaging reports and epicrisis reports of patients from the records. Results: The average age was 30.01 +/- 8.64 years. Eighteen (26.5%) of the 68 patients whose Z-score was evaluated by DEXA had bone mass below the expected age-related range according to the Z score, while 50 (73.5%) had bone mass within the expected age-related range. Of the patients whose T score was evaluated by DEXA, 46.8% were normal (n=29), 45.1% were osteopenic (n=28) and 8.1% were osteoporotic (n=5). Conclusions: Patients with sickle cell anemia are at increased risk for osteoporosis, osteopenia, and osteomalacia. Bone health should be emphasized in these patients.Öğe Plasma Ischemia-Modified Albumin Levels and Dynamic Thiol/Disulfide Balance in Sickle Cell Disease: A Case-Control Study(Galenos Yayincilik, 2018) Ozcan, Oguzhan; Erdal, Huseyin; Ilhan, Gul; Demir, Damla; Gurpinar, Ahmet Burak; Neselioglu, Salim; Erel, OzcanObjective: Sickle cell disease (SCR described as a group of inherited blood disorders, affects millions of people throughout the world and is particularly common in the southern part of Turkey. We aimed to determine the relationship between ischemia-modified albumin (IMA) and the dynamic thiol/disulfide balance in SCD. Materials and Methods: Fifty-four adult SCD patients and 30 healthy controls were included in the study. The 54 adult patients included 30 (56% males and 24 (44%/) females with a mean age of 28.3 +/- 8.4 years (minimum-maximum: 18-46 years). Of the 54 patients, 46 had homozygous sickle cell anemia (HbSS) and 8 had sickleni/beta-thalassemia (HbS/(beta(+)-thalassemia). Fasting blood samples were collected. After centrifugation at 1500xg for 10 min, plasma samples were portioned and stored at -80 degrees C. IMA levels were determined by albumin cobalt binding test, a colorimetric method. Total and native thiols and disulfide were analyzed with a novel spectrophotometric method. Results: We found significantly lower levels of native thiol (-SH) (284.0 +/- 86.3 mu mol/L), disulfide levels (14.6 +/- 7 pmol/L), and total thiols (-SH + -S-S-) (313.0 +/- 89.3 ilmol/L) in SCD patients compared to healthy controls (respectively 417.0+54.2, 22.7+11.3, and 462.0 +/- 58.7 mu twill.). Plasma albumin levels (34.9 +/- 7.9 g/L) were lower and IMA levels (13.6 +/- 3.1 g/L) were higher in SCD patients compared to controls (respectively 43.5 +/- 3.1 and 8.4 +/- 1.6 g/L). Plasma albumin levels were strongly correlated with both plasma native (r=0.853; p=0.0001) and total thiols (r=0.866; p=0.0001). Conclusion: Decreased plasma native and total thiol levels and increased IMA levels are related to increased oxidative stress and provide an indirect and quick reflection of the oxidative damage in SCD patients.Öğe Polisomographic Investigation of Sleep Disorders in Patients with Sickle Cell Anemia and Evaluation of the Effect on the Prognosis(Aves, 2022) Dikmen, Nursel; Okuyucu, Emine Esra; Guntel, Murat; Ucar, Edip; Ilhan, Gul; Babayigit, Cenk; Karadag, MehmetOBJECTIVE: The aim of this study is to identify sleep disorders in adults with sickle cell disease and to examine the effects of accompanying sleep disorders on the prognosis of sickle cell disease. MATERIAL AND METHODS: Twenty-eight patients followed up with a diagnosis of sickle cell disease and 22 healthy volunteers were included in our study. RESULTS: Both groups had similar characteristics in terms of age, gender, and body mass index. More obstructive sleep apnea syndrome was detected in the sickle cell group than in healthy volunteers. Statistically, the sickle cell patient group had higher apnea-hypopnea index and lower nighttime oxygen desaturation. As the degree of obstructive sleep apnea syndrome increased in the sickle cell group, it was found that there were more emergency admissions and hospitalization due to painful crises and/or acute chest syndrome in the last 1 year. Also, lower sleep efficiency was found in the sickle cell disease patient group. In the sickle cell group, it was found that the restless leg syndrome severity was statistically significantly more. CONCLUSION: As hypoxia deepens in sickle cell patients, mortality and morbidity due to the disease increase significantly. Comorbid sleep disturbances in sickle cell patients exacerbate nocturnal hypoxia and negatively affect the prognosis of the disease. Therefore, patients with sickle cell disease should be questioned in detail in terms of obstructive sleep apnea syndrome and, if necessary, polysomnographic evaluation should be performed to provide treatment for sleep disorders in the early period.Öğe Portal Vein Thrombosis in a Chirrotic Patient with Immune Thrombocytopenic Purpura During Eltrombopag Treatment(Derman Medical Publ, 2016) Ilhan, Gul; Acipayam, CanPortal vein thrombosis (PVT) is a rare but serious complication in liver cirrhosis. Eltrombopag is a new, second generation agent used for immune thrombocytopenic purpura (ITP). It may cause thrombotic events. PVT has been rarely reported as a life threatening complication in some cirrhotic patients during eltrombopag using. We presented 63 years old cirrhotic and immune thrombocytopenic patient who had PVT after eltrombopag.Öğe Presentation of two new mutations in the 3?untranslated region of the ?-globin gene and evaluating the molecular spectrum of thalassemia mutations in the Mediterranean region of Turkey(Springer, 2021) Arpaci, Abdullah; Gul, Bahar Unlu; Ozcan, Oguzhan; Ilhan, Gul; El, Cigdem; Dirican, Emre; Elmacioglu, SibelThalassemia is a common genetic disorder. We aimed to present thalassemia mutation data that covers a period of 7 years from the Mediterranean region of Turkey by comparing with hemoglobin indices and to contribute to prenatal diagnosis and genetic counseling studies which should be decided very quickly. In this study, in which a retrospective archive was scanned, the cases were first grouped as alpha and beta thalassemia, and then beta thalassemia mutations were examined in a total of 5 groups as UTR-Pro, Codon, IVS, beta(0), and beta(+). We have reached the family of the proband that analyzed their Hb indices and genetic mutation. All mutations were statistically compared with Hb indices, HbF, and HbA(2). We have identified two new beta thalassemia mutations that have the feature of not being defined previously [HBB:C*62 A>G. (3 ' UTR+1536 A>G) and HBB:C*1 G>A (3 ' UTR+1475 G>A)]. The most commonly encountered 23 mutations account for 74.7% of all mutations which is unlike the literature. In the beta thalassemia group, 73 different mutations were detected. The most common beta thalassemia mutation was HBB: c.93-21 G>A (IVS I-110 G>A) with a frequency of 19.72%. A statistically significant difference was found when comparing the mutation groups with Hb indices. We think that it may be useful to evaluate the mutations we have newly identified too together with the Hb indices especially in evaluating the carriers of thalassemia and it will contribute to prenatal diagnosis and genetic counseling studies which should be decided very quickly.Öğe Thrombosis of corpus cavernosum in a sickle cell anemia patient with priapism(Cukurova Univ, Fac Medicine, 2017) Ilhan, GulPriapism is prolonged painful erection and can be seen as a sickle cell anemia complication. Thrombosis of the corpus cavernosum is a rare condition. A thirty years old male with of sickle cell anemia was admitted to our clinic with priapism. Corpus cavernosum aspiration and exchange transfusion were performed. Painful erection declined but the pain didn't improved. Corpus cavernosum thrombosis was detected and his pain relieved after systemic anticoagulation treatment. Thrombosis of corpus cavernozum must be in the mind especially for patients who have complaints despite conventional treatment methods.Öğe Ultrasonographic shear wave elastography of the thyroid in patients with sickle cell anemia(Walter De Gruyter Gmbh, 2022) Burakgazi, Gulen; Ilhan, Gul; Ozcan, Oguzhan; Dirican, EmreBackground Although thyroid radiology has been conducted in patients with sickle cell anemia (SCA), to our knowledge, there is no report of thyroid gland assessment using ultrasonographic shear wave elastography (US-SWE). Objectives To determine values for ultrasonographic US-SWE of the thyroid in patients with SCA and correlations between thyroid elasticity and biochemical variables used to evaluate thyroid function. Methods Prospective case-control observational study of 36 patients with SCA and 33 healthy volunteer controls. US-SWE measurements of thyroid gland parenchyma and biochemical parameters of the participants were obtained and compared, and the diagnostic accuracy of elasticity was determined. Results The thyroid volume was smaller in patients with SCA than that in controls (P = 0.001). Compared with the controls, the patients with SCA had significantly lower serum levels of free triiodothyronine (fT3) (P = 0.004) and thyroglobulin (Tg) (P = 0.001) and significantly higher levels of thyroid-stimulating hormone (P = 0.028). Thyroid stiffness was significantly higher in the left lobe (LL) of the patients with SCA than in the controls (P = 0.003). In the patients with SCA, we found a significant correlation between right lobe (RL) and LL stiffness and serum levels of Tg (RL [r = -0.439] and LL [r = -0.484]; P = 0.021) and fT3 (RL [r = -0.463] and LL [r = -0.386]; P = 0.012). Receiver operating characteristic (ROC) curve analysis of thyroid elasticity that represented a diagnosis of SCA found a cutoff of >7.31 kPa, a sensitivity of 52.0%, and a specificity of 72.0% for the RL (P = 0.316, area under the curve [AUC] 0.570), and a cutoff of >8.06 kPa, a sensitivity of 58.0%, and a specificity of 84.0% for the LL (P = 0.011, AUC 0.680). Conclusions US-SWE can be used to follow up thyroid changes in patients with SCA.Öğe The Use of Plasma-Derived Factor VIII in Two Patients Diagnosed with TTP(Galenos Publ House, 2022) Kaya, Mehmet Nur; Ilhan, Gul; Kaya, HasanThrombotic thrombocytopenic purpura (TTP) develops due to increased von Willebrand factor multimers as a result of a deficiency of the a disintegrin and metalloproteinase with thrombospondin type 1 motif, member 13 enzyme. It has two forms; acquired or congenital (hereditary and familial). The initial clinical manifestations of this disease have been defined as a pentad consisting of thrombocytopenia, microangiopathic hemolytic anemia, neurological findings, acute renal failure, and fever. The basis of TTP therapy consists of fresh frozen plasma (FFP) and therapeutic plasma exchange (TPE). Our cases were two patients diagnosed with congenital TTP. Plasma-derived factor 8, which is a Factor VIII concentrate, was administered to these patients at a dose of 30 U/kg/week due to the allergic reactions the patients developed during their FFP and TPE treatments, prevention of exposure to the viral agent and ineffective treatment. After this treatment, laboratory parameters improved in case 1 and clinical improvement was achieved. In case 2, however, the desired level of laboratory parameters could not be reached and no clinical improvement was achieved.Öğe Very high levels of C-reactive protein should alert the clinician to the development of acute chest syndrome in sickle cell patients(Medi+World Int, 2014) Acipayam, Can; Kaya, Sadik; Helvaci, Mehmet Rami; Ilhan, Gul; Oktay, GonulPurpose: Acute chest syndrome (ACS) is associated with both inflammation and tissue ischemia. C-reactive protein (CRP) is a marker of systemic inflammation. The aim of this study was to determine if a relationship exists between CRP and severe ACS. Methods: Forty-three patients with painful crises (range: 4-18 years, mean: 11.4 years) hospitalized between 2012 and 2014, consisting of 23 patients with ACS and 20 patients without ACS (uncomplicated vaso-occlusive crisis) were recruited into this study. Retrospective data were obtained directly from inpatient medical records. ACS was defined as a new pulmonary infiltrate on chest radiograph after admission and before discharge. CRP was measured using a BN II Nephelometer. Results: Mean length of hospital stay of ACS patients was 9.9 days (range 7-18 days) while that of patients without ACS was 5.2 days (range 2-10 days), (p=0.001). In 91% of the ACS cases, ACS developed within the first 72 hours, while the remaining 9% cases were admitted for vaso-occlusive crises but subsequently developed ACS during their hospital stay on the 5th to 7th days. CRP levels on admission were significantly higher in patients with ACS than those without ACS (p=0.001). C onclusion: We investigated CRP in relation to ACS in children with sickle cell disease (SCD). Elevated CRP was determined in all ACS patients with SCD. CRP may be a superior diagnostic marker and herald severe ACS in individuals with SCD.
