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Öğe Are Platelet-related Parameters Predictive of the Prognosis of Hodgkin’s Lymphoma?(2021) Akdeniz, Aydan; Mehtap, Özgür; Karakuş, Volkan; Ünal, Serkan; Aygün, Kemal; Temel, Gülhan Örekici; Tombak, Anıl; Tiftik, Eyüp NaciObjective: Hodgkin’s lymphoma has a good prognosis unless it has relapsed or become refractory. The predictive value of platelet (Plt)-related parameters, namely, mean Plt volume (MPV), plateletcrit (PCT), Plt distribution width, and Plt, is shown in some solid tumors and hematological malignancies, but it remains unknown in Hodgkin’s lymphoma. This study aimed to define their values and effects on staging and relapsing status in patients with Hodgkin’s lymphoma by comparing them with those in healthy subjects. Methods: Values of Plt-related parameters of 217 patients with Hodgkin’s lymphoma and 205 healthy individuals were documented and compared according to the disease stage and relapsing status. We defined the cutoff values for diagnosis, staging, and relapsing status of these parameters using the receiving operating characteristic curve analysis. Results: For diagnosis, the cutoff values of MPV, Plt, and PCT were 8.49 fL, 32,1000/mm³, and 0.31, respectively. For staging, the cutoff values of MPV and Plt were 9.5 fL and 12 fL, respectively. None of the parameters were associated with relapsing status. Conclusion: This is the first study evaluating Plt-related parameters in Hodgkin’s lymphoma. Further studies including survival analyses will clarify the effect of these parameters on Hodgkin’s lymphoma.Öğe Different clinical courses with the same findings: two cases of paroxysmal nocturnal hemoglobinuria presenting with thrombocytopenia(2021) Karakuş, Volkan; Kaya, Egemen; Dere, Yelda; Şahin, FahriParoxysmal nocturnal hemoglobinuria (PNH) is a clonal stem cell disease that manifests with chronic intravascular hemolysis, thrombosis, and bone marrow failure. Various degrees of cytopenias accompany the disease. Although laboratory and clinical findings are similar, the disease may show different courses and require different treatments. Herein, we report two different courses of PNH with similar clinical and laboratory findings.Öğe Increased QT Dispersion and High Risk of Ventricular Arrhythmias is Associated with Hyperuricemia in Individuals with Normal Renal Function(2021) Huddam, Bülent; Alp, Alper; Genek, Dilek Gibyeli; Azak, Alper; Karakuş, VolkanBackground and aim: Uric acid elevation has been shown to be an important risk factor for cardiovascular and cerebrobascular disease. QT dispersion (QTd) is a parameter that shows the heterogeneity of ventricular repolarization and can be calculated noninvasively from surface electrocardiography. Increased QTd has been associated with severe arrhythmia and risk of sudden death in many patients and disease groups. In this context, we aimed to investigate the effect of uric acid levels on QTd and the effects of decrease in uric acid levels on QTd. Metb-ods: A total of 225 patients with normal renal function were included in the study; 133 of these patients were hyperuricemic (>7 mg/dL), and the remaining 72 patients were normouricemic (Group 1). The hyperuricemic patients were randomly divided into 2 groups, one group (n = 67) was given placebo (Group 2) for 4 months, and the remaining 66 patients were given allopu- rinol 300 mg/day (Group 3). Results: Hyperuricemic patients had higher hsCRP and QTd and lower eGFR values compared to the normouricemic control group. After 4 months of treatment, 66 patients treated with allopurinol showed a significant decrease in serum uric acid, systolic and diastolic blood pressure, and hsCRP levels, and a significant increase in eGFR. Although the QTd values in the treatment group did not decrease to the same levels as in the normouricemic control group, a statistically significant decrease was found compared to their baseline values. In hyperuricemic control and normouricemic control patients, there were no differences in the levels of uric acid, hsCRP, eGFR, systolic and diastolic blood pressure, and QTd values compared to baseline values. Conclusions: There was a significant association between elevated serum uric acid and QTd, as well as with inflammatory biomarkers. Also, patients who had received hypouricemic therapy during the follow-up period presented a significant decrease in inflam- matory markers as well as QTd. This indicates the beneficial effects of decreasing uric acid levels in decreasing the risk for future major adverse events related to ventricular arrhythmias.Öğe Serum soluble Fas-ligand levels and flow-mediated vasodilation in patients undergoing peritoneal dialysis(2022) Huddam, Bülent; Azak, Alper; Karakuş, Volkan; Alp, Alper; Genek, Dilek Gibyeli; Koçak, Meral Gülay Kadıoğlu; Dere, Yelda; Soysal, Dilek Ersil; Duranay, MuratFlow-mediated vasodilation (FMD) has been demonstrated to be a useful, non-invasive tool for the detection ofendothelialdysfunction in atherosclerotic cardiovascular disease, the leading cause of mortality in end-stage kidney disease. The Fas/Fas ligand system of apoptosis resulting from activation of the caspase cascade- contributes to the pathophysiology of atherosclerosis. This ‘apoptotic’ system plays a central role in immune homeostasis. Vascular endothelial cells and inflammatory cells are the main resources of the Fas ligand. In this study, we aimed to investigate the role of soluble Fas ligand (sFasL) as a marker of FMD in peritoneal dialysis (PD) patients. Methods. A total of 43 patients undergoing maintenance PD and 40 healthy donors were enrolled in this cross-sectional observational study. Demographics, anthropometric measurements and clinical examinations were obtained. Endothelial function was evaluated by FMD of the brachial artery with high-resolution ultrasonography. Serum sFasL concentrations were measured with an enzyme-linked immunosorbent assay kit. Results. The enrolled partisipants were devited on 2 groups: PD patients who had been treated at least 12 weeks (group 1; mean age 41±14 years, M/F: 22/21) and gender matched 40 healthy controls (group 2; mean age 50±12 years, M/F: 19/20). The forearm FMD and serum sFasL levels were significantly lower in PD patients (3.95±2.01 vs 8.83 ± 6.17; p<0.001 and 54 ± 24 vs 73 ± 30; p=0.001). Forearm FMD was correlated with sFasL (r=0.289; p=0.008), age, BMI and uric acid (r= 0,32; p=0.003, respectively), hemoglobin (r= 0,293; p=0.007), calcium (r= 0,26; p=0.016), phosphate (r=- 0,250; p=0.023), magnesium (r= 0,255; p=0.020), 24 h SBP (r=- 0,257; p=0.019), creatinine and iPTH (r=- 0.50 and r=- 0,45; p[removed]Öğe Survival outcomes of hypomethylating agents maintenance therapy in new diagnosed AML patients: Real experience data(2022) Karakuş, Volkan; Maral, Senem; Kaya, Egemen; Gemici, Aliihsan; Dere, Yelda; Sevindik, Ömür GökmenOBJECTIVE: Acute myeloid leukemia (AML) is a hematological malignancy that frequently affects elderly population. With introducing the hypomethylating agents (HMAs) in elderly AML treatment, survival rates and quality of life have improved. However, long-term management in elderly and frail patients is still a challenge. In the present study, we aimed to determine whether HMA maintenance therapy is required until disease progression in frail and elderly AML patients by examining with a real-life data. METHODS: In a multicenter study, we analyzed non-promyelocytic elderly AML patients who were treated with first-line azacitidine or decitabine monotherapy in two different groups, retrospectively. While patients were treated with HMA until progression in the maintenance group, 6+3 cycles of azacitidine or decitabine were administered as a standard care of elderly AML patients in the non-maintenance group. Survival outcomes were compared between the groups. RESULTS: HMA therapy was maintained until progression in 20 patients, and HMA therapy was terminated after 6+3 cycles in 21 patients. Patients received a median of 6 (1–14) HMA cycles during follow-up time. The median 7.5 months of overall survival were observed (2–17 months) in maintenance and 3 months (1–13 months) in non-maintenance groups (p=0.001). CONCLUSION: Despite long-term exposure to HMA may appear as a risk factor for complications and toxicities in elderly and frail AML patients, the maintenance of therapy until disease progression provides a significant survival advantage. Therefore, we suggest that HMA therapy should continue until disease progression regardless the sort of HMA.Öğe Talasemi Hastalarında Karaciğer Demir Ölçümünde T2*-ADC Karşılaştırması(İbrahim İKİZCELİ, 2024) Yeniçeri, İbrahim; Güney, Bünyamin; Azık, Fatih Mehmet; Çullu, Neşat; Karakuş, VolkanAmaç: Talasemi, hastalarında tekrarlayıcı transfüzyon bir tedavi opsiyonudur, fakat bu durum başta karaciğer olmak üzere değişik organlarda demir birikimine neden olmaktadır. Bu çalışmada talasemi hastalarında, serum ferritin konsantrasyonları ile karaciğer T2* MR ölçümleri ve ADC değerlerinin korelasyonu konusundaki kendi deneyimimizin sunulması amaçlanmıştır. Gereç ve yöntem: Beta talasemi nedeni ile karaciğere yönelik T2* MR tetkiki yapılan ardışık 74 olgu çalışmaya dahil edilmiştir. Olguların karaciğer T2* ve ADC ölçümleri ile ferritin ölçümleri karşılaştırıldı. MR incelemesi 3T tarayıcı ile yapıldı. T2* MR incelemelerinde multieko gradyan eko kullanıldı. Karaciğer sol lob medial ve lateral segmentten birer ve sağ lob anterior ve posterior segmentlerden birer adet olmak üzere toplam 4 farklı bölgeden T2* ve ADC ölçümleri yapıldı. Serum ferritin düzeyleri ile R2* ve ADC ölçümleri arasındaki korelasyonu değerlendirmek için Spearman korelasyon analizi yapıldı. Bulgular: Hastaların 32’si (%43,24) kadın, 42’si (%56,76) erkekti. Serum ferritin ile karaciğer T2* ölçümleri arasında orta düzeyde negatif bir korelasyon vardı (r= -0,52 p
