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Öğe Adult Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia in Daily Practice: A Multicenter Experience(CIG MEDIA GROUP, LP, 2016) Tekgunduz, Emre; Goker, Hakan; Kaynar, Leylagul; Sari, Ismail; Pala, Cigdem; Dogu, Mehmet Hilmi; Ozturk, Erman; Turgut, Burhan; Korkmaz, Serdal; Tetik, Aysegul; Buyukasik, Yahya; Hacioglu, Sibel Kabukcu; Bozdag, Sinem Civriz; Ozdemir, Evren; Altuntas, FevziIn this retrospective, multicenter study, we evaluated the real-life outcomes of adult Philadelphia-positive acute lymphoblastic leukemia patients. The best results in terms of survival are achieved in patients who were treated with tyrosine kinase inhibitors during induction and received allogeneic hematopoietic cell transplantation as part of consolidation. Background: The prognosis of Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL) is generally poor. Currently, allogeneic hematopoietic cell transplantation (allo-HCT) is the only accepted therapy with curative potential. Patients and Methods: Herein, we report our multicenter, retrospective experience with 46 (23 female; 23 male) Ph+ ALL patients, who were treated off-study between 2005 and 2012. Results: The median age of the patients was 46 years (range, 19-73 years). During induction, 30 (65%), 13 (28%), and 3 (7%) patients received tyrosine kinase inhibitors (TKIs) concurrent with chemotherapy (TKIs/chemotherapy), chemotherapy only, and TKIs only, respectively. Following induction, rates of complete remission (CR) of the study population were 85% (n = 39). CR rate in patients receiving TKIs during induction (n = 33) was significantly higher compared with patients who received chemotherapy only (n = 13; P = .011). Taking TKIs during induction significantly reduced induction mortality (3.3% vs. 38%; P = .01). Allo-HCT was performed subsequently in 21 (46%) patients. More patients who received TKIs with or without chemotherapy (19/33; 58%) during induction were able to undergo to allo-HCT compared with patients who received chemotherapy only (2/13; 15%; P = .005). Median overall survival of patients who were treated with TKIs during induction and received allo-HCT (not reached; NR) was significantly prolonged compared with patients who received allo-HCT but without TKIs during induction (23.2 months) and to the rest of the cohort (21.2 months; P = .019). Conclusions: Current state-of-the art management of Ph+ ALL in real-life seems to be incorporation of TKIs to chemotherapy regimens and proceeding to allo-HCT, whenever possible. (C) 2016 Elsevier Inc. All rights reserved.Öğe The association between therapeutic outcomes and VEGF G-1154A and C-936T gene polymorphisms in patients with glomerulonephritis(INFORMA HEALTHCARE, 2014) Terzi, Hatice; Kayatas, Mansur; Korkmaz, Serdal; Yildiz, Gursel; Candan, FerhanBackground: In this present study, we aimed to investigate the association between therapeutic outcomes and vascular endothelial growth factor (VEGF) G-1154A and C-936T gene polymorphisms in patients with glomerulonephritis. Methods: Thirty-eight patients with glomerulonephritis diagnosed by renal biopsy were included to the study. All patients had proteinuria at least 1 gram (g)/day in urine analysis. At the end of a yearly therapy, patients with proteinuria less than 0.5 g/day were accepted as in complete remission and they were termed as group 1. The patients with proteinuria over 0.5 g/day were accepted as in no remission and they were termed as group 2. Results: The mean age of patients in group 1 and group 2 was 35.88 +/- 13.80 years and 37.30 +/- 13.89 years, respectively. There were nine (50%) male and nine (50%) female patients in group 1. In group 2, seven (35%) male and 13 (65%) female patients were present. Although VEGF G-1154A (GG) gene polymorphism was found in 55% of group 2 patients, and 22.2% of group 1 patients, but the differences did not reach statistical significance. There were no statistical differences between groups in terms of other gene polymorphisms. Namely, we obtained no statistical differences between therapeutic outcomes and gene polymorphisms. Conclusions: There is a significant difference between groups in terms of VEGF G-1154A (GG) gene polymorphism, but the minority of the patient population has led to not to reach statistical significance. So, this gene polymorphism has to be investigated in larger studies.Öğe Characteristic features of 20 patients with Sheehan's syndrome(TAYLOR & FRANCIS LTD, 2006) Doekmetas, Hatice Sebila; Kilicli, Fatih; Korkmaz, Serdal; Yonem, OzlemSheehan's syndrome occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage. The aim of the present study was to determine the clinical characteristics of Sheehan's syndrome in 20 patients (mean age 60.15 +/- 3.41 years) with typical obstetric history. The mean duration between time of diagnosis and date of the last delivery was 26.82 +/- 2.52 years (range 2-40 years). All patients had a history of massive hemorrhage at delivery and physical signs of Sheehan's syndrome. Fourteen patients (70.0%) lacked postpartum milk production and did not menstruate following delivery. Baseline and stimulated anterior pituitary hormone levels were measured in all patients. According to the hormonal values, 18 (90.0%) patients had secondary hypothyroidism, 11 (55.0%) had adrenal failure and all of them had hypogonadism, prolactin and growth hormone deficiency. Hyponatremia was present in seven patients (35.0%). Total or partially empty sella was revealed in all patients by magnetic resonance imaging. Diabetes insipidus was not found in any patient. We found that lack of lactation in the postpartum period and early menopause seemed the most important clues for diagnosis of Sheehan's syndrome, and inadequate prolactin and gonadotropin responses to stimulation tests were the most sensitive diagnostic signs in patients with severe postpartum hemorrhage.Öğe Characteristics and outcomes of patients with primary central nervous system lymphoma: A single center experience and review of the literature(2012) Korkmaz, Serdal; Sencan, Mehmet; Ozum, Unal; Karadag, OzenThis retrospective study was designed to review the clinicopathological characteristics and outcomes of primary central nervous system lymphoma (PCNSL) cases at our institute. Patients diagnosed with PCNSL at our institute from August 2010 to December 2011 were evaluated. During this period, a total of 5 cases have been diagnosed with PCNSL. Parieto-occipital lobe was the most common site of involvement. Diffuse large B-cell lymphoma (DLBCL) was the most common histological pattern. 4 patients were treated with 3.0 g/m2 methotrexate (MTX) intravenously concomitant with intraventricular 15 mg MTX and 1 patient was treated with radiotherapy (RT). The median overall survival (OS) was 8 months (minimum: 1 months, maximum: 15 months) and mean OS was 8.4 ± 5.41 months. As mentioned previous studies, MTX-based chemotherapy regimens are still the most effective treatment option in this patient population.Öğe The Clinical Characteristics and Therapeutic Outcomes of Elderly Patients with Chronic Lymphocytic Leukemia: A Retrospective Multicenter Study(AMER SOC HEMATOLOGY, 2014) Tombak, Anil; Tiftik, Naci; Dogu, Mehmet Hilmi; Sari, Ismail; Akay, Meltem Olga; Karagulle, Mustafa; Kaya, Emin; Korkmaz, Serdal; Sencan, Mehmet; Akyol, Gulsah; Kaynar, Leylagul; Comert, Melda; Saydam, Guray; Dal, Sinan Mehmet; Ayyildiz, Orhan M.; Yildirim, Rahsan; Kiki, Ilhami; Kara, Erdal; Esen, Ramazan; Sungur, Mehmet Ali; Erkurt, Mehmet Ali; Altuntas, Fevzi; Unal, Ali; Ilhan, Osman…Öğe Clinical characteristics and therapeutic outcomes of elderly patients with chronic myeloid leukemia: A retrospective multicenter study(WILEY-BLACKWELL, 2015) Korkmaz, Serdal; Dal, Mehmet Sinan; Berber, Ilhami; Sahin, Deniz Goren; Dogu, Mehmet Hilmi; Ayyildiz, Orhan; Nizam, Ilknur; Albayrak, Murat; Esen, Ramazan; Namdaroglu, Sinem; Sencan, Mehmet; Akay, Olga Meltem; Hacioglu, Sibel; Yildirim, Rahsan; Eser, Ali; Tombak, Anil; Pala, Cigdem; Ilhan, OsmanAimsWe aimed to investigate whether older age leads to limitations in the starting dose of imatinib in daily treatment of chronic myeloid leukemia, and to determine the compliance of elderly patients with tyrosine kinase inhibitors (TKI) therapy. MethodsData including the clinical characteristics, therapeutic outcomes and compliance with TKI therapy of elderly patients with chronic myeloid leukemia aged >65years were collected from 13 institutions in Turkey, retrospectively. ResultsA total of 69 patients (27 [39%] men, 42 [61%] women) were evaluated retrospectively. The median age of the patients was 71years (range 66-85years). Of the patients, 66 (96%) were in the chronic phase and three (4.3%) were in the accelerated phase when diagnosed. A total of 63 (91.3%) patients were receiving imatinib as the first-line therapy. The initial dose of imatinib was 400mg/day in 59 patients (93.6%). Imatinib treatment induced 57 (90.5%) complete hematological responses at 3months, 29 (46%) complete cytogenetic responses at 6months and 49 (77.7%) major molecular responses at 12months. As a result, nilotinib and dasatinib were used in 14 patients as second-line therapy. Second-line TKI induced nine complete hematological responses (64.3%) at 3months, four complete cytogenetic responses (28.6%) at 12months and seven major molecular responses (50%) at 18months. A total of 56 of the patients (81.2%) are still alive. The median overall survival and progression-free survival rates were 35months (range 1-95months) and 17months (range 0.8-95months), respectively. ConclusionElderly patients should receive TKI according to the same guidelines that apply to younger patients. Geriatr Gerontol Int 2015; 15: 729-735.Öğe The clinical characteristics and therapeutic outcomes of elderly patients with chronic myeloid leukemia: A retrospective multicenter study.(AMER SOC CLINICAL ONCOLOGY, 2014) Korkmaz, Serdal; Dal, Mehmet Sinan; Berber, Ilhami; Sahin, Deniz Goren; Dogu, Mehmet Hilmi; Ayyildiz, Orhan; Nizam, Ilknur; Albayrak, Murat; Esen, Ramazan; Namdaroglu, Sinem; Sencan, Mehmet; Akay, Olga Meltem; Hacioglu, Sibel Kabukcu; Yildirim, Rahsan; Eser, Ali; Tombak, Anil; Pala, Cigdem; Ilhan, Osman…Öğe Diffuse Large B-Cell Lymphoma in adults aged 65 years and older: A retrospective multicenter analysis of clinical characteristics and therapeutic outcomes(CIG MEDIA GROUP, LP, 2015) Dogu, Mehmet Hilmi; Keklik, Muzaffer; Terzi, Hatice; Korkmaz, Serdal; Erkurt, Mehmet Ali; Cagliyan, Gulsum Akgun; Kaynar, Leylagul; Sivgin, Serdar; Sari, Ismail; Keskin, Ali; Sencan, Mehmet; Altuntas, Fevzi; Ilhan, Osman…Öğe Diffüz büyük B hücreli lenfoma vakalarında immunhistokimyasal biomarkerların prognostik önemi(Cumhuriyet Üniversitesi, 2013) Korkmaz, Serdal; Şencan, MehmetDiffüz büyük B hücreli lenfoma, non-Hodgkin lenfomalar içerisinde en sık görülen tiptir ve yeni tanı vakaların yaklaşık olarak %30-40?ını oluşturur. Diffüz büyük B hücreli lenfoma hem klinik hem de morfolojik olarak heterojen bir hastalıktır. İlk gen ifade profili çalışmaları, kemoterapi yanıtları ve total yaşam süreleri farklı iki alt grubun varlığını göstermiştir. Bunlardan birincisi; germinal merkez B hücre benzeri gen profili taşıyan grup, diğeri ise aktive B hücre benzeri gen profili taşıyan gruptur. Daha sonra cDNA mikro dizi analizi kullanılarak germinal merkez B hücre benzeri, aktive B hücre benzeri ve tip 3 gen ifade profili olan diffüz büyük B hücreli lenfoma varlığı ortaya konmuştur. Germinal merkez B hücre benzeri grubun aktive B hücre benzeri grubuna göre daha iyi yaşam süresine sahip olduğu gösterilmiştir. Tip 3 gen profili de heterojen bir grup olup aktive B hücre benzeri grubu gibi kötü prognoza sahiptir. Rutin klinik pratikte moleküler yöntemlerin uygulama güçlüğü nedeniyle immunhistokimyasal yöntemler ile bu genetik profile uygun grupların oluşturulması planlanmıştır. Bizim amacımız da kliniğimize başvurup diffüz büyük B hücreli lenfoma tanısı almış hastaların moleküler alt tiplerini belirlemek ve prognoz üzerindeki etkisini retrospektif olarak değerlendirmektir. Bu amaçla 40 hastanın biyopsi örnekleri CD10, Bcl-6 ve MUM-1 monoklonal antikor immun boyaları ile boyandı. 6 (%15) hastanın germinal merkez B hücre benzeri, 34 (%85) hastanın da germinal merkez B hücre dışı fenotipe sahip olduğu saptandı. Hastaların verileri retrospektif olarak değerlendirilerek tüm sağkalım 24.87 ay (min: 1 ay; max: 76 ay) ve olaysız sağkalım 21.97 ay (min: 0 ay; max: 68 ay) olarak hesaplandı. Germinal merkez B hücre benzeri fenotipte tüm sağkalım 31.00±15.49 ay ve olaysız sağkalım 27.66±17.95 ay iken, germinal merkez B hücre dışı fenotipte tüm sağkalım 23.79±17.82 ay ve olaysız sağkalım 20.97±17.12 ay olarak bulunmuştur. Her ne kadar bu iki fenotip ile tüm sağkalım ve olaysız sağkalım arasındaki ilişki istatistiksel olarak anlamlı bulunmasa da germinal merkez B hücre fenotipinde yaşam sürelerinin daha uzun olduğu net olarak görülmektedir. Bu alt grupların hem klinik seyri hem de kemoterapi sonrası survey oranları çok farklıdır. Eğer bu immunhistokimyasal markerlar ileride standardize edilebilirse hastaların risk profili daha net ayırt edilebilecektir. Böylelikle tanı anında agresif tedaviye veya deneysel tedaviye uygun hastalar ayırt edilerek daha doğru tedavi şemaları oluşturulabilecektir. Ayrıca, şunu da söylemeliyiz ki, Türkiye?de bu tarz epidemiyolojik çalışmaların sayısı oldukça sınırlı olduğundan, çalışmamız bu alanda ilkler arasında yer almakta ve bu nedenle de ikincil bir önem kazanmaktadır.Öğe Do neutrophil gelatinase-associated lipocalin and interleukin-18 predict renal dysfunction in patients with familial Mediterranean fever and amyloidosis?(TAYLOR & FRANCIS LTD, 2014) Deveci, Koksal; Korkmaz, Serdal; Senel, Soner; Deveci, Hulya; Sancakdar, Enver; Uslu, Ali U.; Deniz, Abdulkadir; Alkan, Filiz; Seker, Mehmet M.; Sencan, MehmetBackground: The aim of this study was to evaluate whether neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) predict renal disfunction in patients with familial Mediterranean fever (FMF). Methods: This prospective study consisted of 102 patients with FMF in attack-free period, and 40 matched healthy controls. Of the patients, nine were diagnosed as amyloidosis. The patients were divided into two groups according to eGFR as below 120 mL per minute and above 120 mL per minute. Also, patients were divided into three groups according to the degree of urinary albumin excretion as normoalbuminuric, microalbuminuric, and macroalbuminuric. The serum levels of IL-18 (sIL-18) and NGAL (sNGAL), and urinary levels of IL-18 (uIL-18) and NGAL (uNGAL) were measured by using ELISA kits. Results: The levels of sIL-18, sNGAL, uIL-18, and uNGAL were detected significantly higher in FMF patients, particularly in patients with amyloidosis, when compared to controls. sNGAL, uIL-18, and uNGAL were significantly higher in patients with eGFR < 120 mL per minute than in patients with eGFR >= 120 mL per minute. sNGAL, uIL-18, and uNGAL were correlated significantly with urinary albumin excretion, additionally, were inverse correlated with eGFR. The most remarkable findings of this study are of the higher values of sIL-18, sNGAL, uIL-18, and uNGAL in both normoalbuminuric FMF patients and patients with eGFR >= 120 mL per minute. Conclusions: The results of this study suggest that sIL-18, uIL-18, sNGAL, and uNGAL are reliable markers of early renal disfunction in FMF patients, and may let us take measures from the early stage of renal involvement.Öğe Farklı bir bakış açısı ile plazma değişiminin hiperbilirubinemideki rolü(Sivas Cumhuriyet University, 2019) Terzi, Hatice; Korkmaz, Serdal; Şencan, Mehmet; Yönem, Özlem; Yılmaz, Abdulkerim; Ataseven, HilmiAmaç: Bu retrospektif çalışmada hiperbilirubinemiyi yönetme deneyimimizi sunmayı amaçladık.Yöntem: Çalışmaya Sivas Cumhuriyet Üniversitesi Tıp Fakültesi aferez ünitesinde 2006-2017 yılları arasında aferez tedavisi alan 21 hiperbilirubinemili hasta alındı. Hastaların dosyaları retrospektif olarak değerlendirildi ve şu veriler toplandı: hastanın yaşı, cinsiyeti, semptomları, plazma değişimi sayısı, adjuvan tedavi yöntemleri, sıvı replasmanı kullanımı, tedavi sonuçları ve plazma değişim komplikasyonları.Bulgular: Hastaların yaş ortalaması 57 idi (dağılım; 18-82). Ortalama plazma değişim sayısı 5,5'tir (aralık; 1-25). Sıvı değişimi için sadece taze donmuş plazma kullanıldı. Plazma öncesi ve sonrası değişim bilirubin düzeyleri arasında istatistiksel olarak anlamlı fark vardı (p <0.05). Toksik hepatit, hasta popülasyonumuzda en sık görülen hiperbilirubinemi nedeni idi. Hastalar plazma değişiminin yanı sıra, altta yatan durumuna uygun şekilde tedavi edildiler. Komplikasyon olarak, 2 hastada(% 8.69) allerjik reaksiyon ve 3 hastada(% 13) hipotansiyon gözlemledik. Sonuç: Plazma değişimi, bilirubinin uzaklaştırılması için güvenli bir yöntemdir. Ancak, plazma değişimi ve altta yatan durumun uygun tedavisi ile birlikte azalan hiperbilirubinemi, tedavide birincil amaç olmalıdır.Öğe How to manage coronary slow flow following PCI?(ELSEVIER IRELAND LTD, 2012) Korkmaz, Serdal; Yilmaz, Mehmet Birhan; Sencan, Mehmet…Öğe Inspiratory Muscle Strength is Correlated with Carnitine Levels in Type 2 Diabetes(TAYLOR & FRANCIS INC, 2010) Kilicli, Fatih; Dokmetas, Sebila; Candan, Ferhan; Ozsahin, Sefa; Korkmaz, Serdal; Amasyali, Elvan; Fakioglu, Koray; Dal, Kuersat; Acibucu, Fettah; Cakir, IlkayIntroduction. Plasma carnitine insufficiency has been known to cause muscle weakness. Carnitine levels and pulmonary functions were lower in patients with diabetes. Patients and Methods. To determine whether pulmonary functions are correlated with carnitine levels in patients with type 2 diabetes. In this study, we evaluated pulmonary functions and carnitine concentrations in 49 patients with type 2 diabetes and 34 healthy controls. Results. Carnitine levels were lower in type 2 diabetes group than control group (52.56 +/- 12.38 and 78.96 +/- 10.66 hmol/mL, respectively, p < 0.0001). Pulmonary functions were not significantly different between groups. Carnitine levels were not correlated with age, duration of diabetes, fasting blood glucose levels, and glycemic control (HbA1c%) in patients with type 2 diabetes. However, carnitine levels in patient group were correlated with % forced vital capacity (FVC%) (r = 0.35, p = 0.016), % forced expiratory volume in 1 s (FEV1%) (r = 0.318, p= 0.029), FEV1/FVC (r= 0.302, p= 0.039), inspiratory muscle strength (PImax) (r = 0.407, p = 0.023), and PImax% (r = 0.423, p= 0.018). Conclusion. This study suggests that low carnitine levels may be associated with lower PImax and PImax% in type 2 diabetes.Öğe Is Neutrophil/Lymphocyte Ratio Associated with Subclinical Inflammation and Amyloidosis in Patients with Familial Mediterranean Fever?(HINDAWI PUBLISHING CORPORATION, 2013) Uslu, Ali Ugur; Deveci, Koksal; Korkmaz, Serdal; Aydin, Bahattin; Senel, Soner; Sancakdar, Enver; Sencan, MehmetBackground. The purpose of the present study is to determine the association between neutrophil/lymphocyte ratio and both subclinical inflammation and amyloidosis in familial Mediterranean fever. Methods. Ninety-four patients with familial Mediterranean fever and 60 healthy volunteers were included in the study. Of the patients, 12 had familial Mediterranean fever related amyloidosis. The neutrophil/lymphocyte ratio of the patients was obtained from the hematology laboratory archive. Results. The neutrophil/lymphocyte ratio was significantly higher among persons with familial Mediterranean fever compared to healthy individuals (P < 0.0001). Also, neutrophil/lymphocyte ratio was significantly higher in patients with amyloidosis than in amyloidosis-free patients (P < 0.0001). Since NLR was evaluated in nonamyloid and amyloid stages of the same patient population (type 1 phenotype), we obtained significant statistical differences (1.95 +/- 0.30 versus 2.64 +/- 0.48, P < 0.05, resp.). With the cutoff value of neutrophil/lymphocyte ratio >2.21 and AUC = 0.734 (P = 0.009), it was a reliable marker in predicting the development of amyloidosis. Conclusion. The neutrophil/lymphocyte ratio, an emerging marker of inflammation, is higher in patients with familial Mediterranean fever in attack-free periods. The neutrophil/lymphocyte ratio may be a useful marker in predicting the development of amyloidosis.Öğe Is there a link between mean platelet volume and thrombotic events in antiphospholipid syndrome?(TAYLOR & FRANCIS INC, 2014) Korkmaz, Serdal; Uslu, Ali Ugur; Sahin, Safak; Senel, Soner; Sencan, MehmetThe antiphospholipid syndrome (APS) is an autoimmune disease characterized by the production of antiphospholipid antibodies (aPL) that promote vascular thrombosis and pregnancy loss. APS can occur in the absence of underlying or associated disease (primary APS) or in combination with other diseases (secondary APS). Mean platelet volume (MPV) is largely regarded as a useful surrogate marker of platelet activation. We aimed to investigate if there is a relationship between MPV and thrombotic events in APS. The study consisted of 22 patients and 22 healthy controls. Group 1 is defined as all the patients in the first day of thrombotic event. Group 2 is defined as the same patient population three months after the thrombotic event. The erythrocyte sedimentation rate, C-reactive protein, white blood cell count, platelet count, and MPV levels were retrospectively recorded from patient files. Statistical analyses showed that MPV was significantly higher in group 1 than group 2 (p<0.0001) and healthy controls (p<0.05). However, there was no difference between group 2 and healthy controls (p=0.888). WBC, hemoglobin and other platelet indices such as platelet distribution width and platecrit did not differ in groups. In conclusion, MPV was increased at initial thrombotic event of APS, and then it was normalized three months later by therapeutic interventions. To our knowledge, this is the first study demonstrating a correlation between MPV and thrombotic events in APS.Öğe Low L-carnitine levels: Can it be a cause of nocturnal blood pressure changes in patients with toe 2 diabetes mellitus?(TURKISH SOC CARDIOLOGY, 2011) Korkmaz, Serdal; Yildiz, Gursel; Kilicli, Fatih; Yilmaz, Abdulkerim; Aydin, Huseyin; Icagasioglu, Serhat; Candan, FerhanObjective: The nocturnal blood pressure (NBP) reduction is less than normal in the patients with type 2 diabetes mellitus (type 2 DM). L-carnitine deficiency may cause changes of NBP by leading to hyperglycemia, insulin resistance and endothelial dysfunction in patients with type-2 DM. The purpose of the study was to investigate whether there is a difference in levels of L-carnitine in dipper and nondippers patients with type 2 DM. Methods: This is a cross-sectional observational cohort study. We compared the 50 (33 females, 17 males) patients with type 2 DM and the 35 healthy persons (18 females, 17 males) as a control group. In all cases, ambulatory blood pressure monitoring (ABPM) was performed and L-carnitine was measured. The independent samples t test, Chi-square test, Mann-Whitney U test and Pearson correlation analysis were used in the statistical evaluation of data. Results: We found that the percentage of nondipper pattern was 72% in patients with type 2 DM. L-carnitine levels were lower in patients with type 2 DM (52.77+/-12.34 mu mol/L) than those of control group (79.18+/-10.59 mu mol/L), and these differences were statistically significant (p<0.05). L-carnitine levels were lower in nondipper cases (50.02+/-16.30 mu mol/L) than those of dipper cases (53.83+/-10.50 mu mol/L), but these differences were not statistically significant (p=0.125). Conclusion: Nondipper pattern is common in patients with type 2 DM. Nondipper pattern is associated with damage of target organ. Therefore, determination of nondipper pattern by ABPM is very important. L-carnitine levels were found to be lower in nondipper patients than in dipper patients with type 2 DM. Although, these differences were statistically nonsignificant, more detailed studies should be performed to determine the frequencies and relationship between nondipper pattern and L-carnitine levels in patients with type-2 DM. (Anadolu Kardiyol Derg 2011 1: 57-63)Öğe Multicenter retrospective analysis regarding the clinical manifestations and treatment results in patients with hairy cell leukemia: twenty-four year Turkish experience in cladribine therapy(WILEY, 2015) Hacioglu, Sibel; Bilen, Yusuf; Eser, Ali; Sivgin, Serdar; Gurkan, Emel; Yildirim, Rahsan; Aydogdu, Ismet; Dogu, Mehmet Hilmi; Yilmaz, Mehmet; Kayikci, Omur; Tombak, Anil; Kuku, Irfan; Celebi, Harika; Akay, Meltem Olga; Esen, Ramazan; Korkmaz, Serdal; Keskin, AliIn this multicenter retrospective analysis, we aimed to present clinical, laboratory and treatment results of 94 patients with Hairy cell leukemia diagnosed in 13 centers between 1990 and 2014. Sixty-six of the patients were males and 28 were females, with a median age of 55. Splenomegaly was present in 93.5% of cases at diagnosis. The laboratory findings that came into prominence were pancytopenia with grade 3 bone marrow fibrosis. Most of the patients with an indication for treatment were treated with cladribine as first-line treatment. Total and complete response of cladribine was 97.3% and 80.7%. The relapse rate after cladribine was 16.6%, and treatment related mortality was 2.5%. Most preferred therapy ( 95%) was again cladribine at second-line, and third line with CR rate of 68.4% and 66.6%, respectively. The 28-month median OS was 91.7% in all patients and 25-month median OS 96% for patients who were given cladribine as first-line therapy. In conclusion, the first multicenter retrospective Turkish study where patients with HCL were followed up for a long period has revealed demographic characteristics of patients with HCL, and confirmed that cladribine treatment might be safe and effective in a relatively large series of the Turkish study population. Copyright (C) 2014 John Wiley & Sons, Ltd.Öğe Nodular lymphocyte predominant Hodgkin's lymphoma in daily practice: A multicenter experience(WILEY, 2018) Gemici, Aliihsan; Aydogdu, Ismet; Terzi, Hatice; Sencan, Mehmet; Aslan, Alma; Kaya, Ali Hakan; Dal, Mehmet Sinan; Akay, Meltem Olga; Dogu, Mehmet Hilmi; Ayyildiz, Orhan; Sahin, Fahri; Cagliyan, Gulsum Akgun; Yilmaz, Mehmet; Gokgoz, Zafer; Bilen, Yusuf; Demir, Cengiz; Sevindik, Omur Gokmen; Korkmaz, Serdal; Eser, Bulent; Altuntas, FevziNodular lymphocyte predominant Hodgkin's lymphoma (NLPHL) is a rare subtype of Hodgkin's lymphoma. In this study, we aimed to investigate the clinical features and therapeutic outcomes of patients with NLPHL who were diagnosed at different institutes in Turkey. We retrospectively reviewed the records of the patients diagnosed with NLPHL. Adult patients who were diagnosed after 2005 with histological confirmation were selected for the study. Forty-three patients were included in the study. Median age of patients was 37.5years (18-70) at the time of diagnosis. About 60.5% patients were diagnosed as stage I and II NLPHL, and remaining 39.5% had stage III and IV disease. Median follow-up was 46months. During follow-up, none of the patients died. Seven patients relapsed or progressed after initial therapy at a median of 12months. Five of 7 relapsed/refractory patients (71.4%) were salvaged with chemotherapy only (DHAP, ICE), and the remaining 2 (28.6%) were salvaged with chemoimmunotherapy. All of relapsed/refractory patients were able to achieve complete remission after salvage therapy. Lactate dehydrogenase levels were significantly higher in patients with progressive disease compared with nonprogressive disease. Our study showed an excellent outcome with all patients alive at last contact with a median follow up of 46months despite a wide range of different therapeutic approaches. All relapsed and refractory patients were successfully salvaged despite a low frequency of patients received immunotherapy in conjunction with chemotherapy. Our results suggest that immunotherapy may be reserved for further relapses.Öğe Philadelphia-positive acute lymphoblastic leukemia in daily practice: A multicenter experience.(AMER SOC CLINICAL ONCOLOGY, 2013) Goker, Hakan; Tekgunduz, Emre; Sari, Ismail; Pala, Cigdem; Dogu, Mehmet Hilmi; Ozturk, Erman; Turgut, Burhan; Korkmaz, Serdal; Demiriz, Itir Sirinoglu; Buyukasik, Yahya; Hacioglu, Sibel Kabukcu; Kaynar, Leylagul; Bozdag, Sinem Civriz; Altuntas, Fevzi…Öğe Pre-treatment and post-treatment changes in platelet indices in patients with immune thrombocytopenia(SAUDI MED J, 2013) Korkmaz, Serdal; Uslu, Ali U.; Aydin, Bahattin; Dogan, Ozgur; Sencan, MehmetObjectives: To investigate if there is a correlation between pre- and post-treatment mean platelet volume (MPV), platelet size deviation width (PDW), and platecrit (PCT) values and to investigate whether we can use them as laboratory parameters to estimate the relapses of immune thrombocytopenia (ITP) patients. Methods: Patients with ITP diagnosed at the Hematology Clinic, School of Medicine, Cumhuriyet University, Sivas, Turkey between January 2005 and December 2011 were evaluated by a retrospective review of our patients' records. Eighty-one patients with ITP were collected. The first relapse was termed as the hospitalization day before second-line therapy, and the second relapse was termed as the hospitalization day before alternate second-line therapy. We provided the following data of ITP patients at diagnosis, before and after first relapses, and before and after second relapses: presenting symptoms, platelet count, MPV, PDW, and PCT values. Results: We obtained significant statistical differences between MPV values after initial treatment and before second-line therapy (first relapse) (p=0.005), between MPV values after splenectomy and before immunosuppressive or immune modulator therapy (second relapse) (p=0.028), and also, between PCT values after splenectomy and before second relapse (p=0.043). Conclusion: Mean platelet volume is gradually increasing before first and second relapses, and again normal values are being obtained after appropriate therapies. We conclude that MPV is a useful parameter as a predictor of relapses.
