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Öğe Acil servise başvuran hastalarda hipernatremi(Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, 2012) Yücel, Neslihan; Şahin, İdris; Akgün, Feride Sinem; Köz, Süleyman; Berber, İlhami; Özdemir, Muzaffer GalipÖz: GİRİŞ: Acil Servise hipernatremi ile başvuran hastaların semptomlarının, klinik özelliklerinin, hipernatremi yaygınlığının (prevalans) ve sağ-kalım oranlarının belirlenmesi. GEREÇ ve YÖNTEMLER: Ocak 2008-Aralık 2008 tarihleri arasında acil servise başvuran ve serum Na>148 meq/l olan hastalar alındı. BULGULAR: Ocak-Aralık 2008 tarihleri arasında 25.545 hasta başvurdu, 86 olguda hipernatremi saptandı. Acil servise başvuran olgularda hipernatremi yaygınlığı %0.34 saptandı. Olguların yaş ortalaması 69.5±15.2 (20-96, median yaş: 75) yıl ve 51'i erkek (%59) idi. Hipernatremi saptanan olguların %40'ı öldü. Ölen ve yaşayan olgular arasında yaş, cinsiyet ve başvuru anındaki serum Na değeri açısından anlamlı fark görülmedi. Acil Servise başvuru sırasında en sık görülen semptomlar sırası ile bilinç değişikliği, ağızdan alım bozukluğu ve ateş (%90,%81 ve %49) idi. Başvuru anında olguların %70'inde akut böbrek yetmezliği, %58'inde akut enfeksiyon vardı. Hastaların %99'unda (85 olgu) herhangi bir eşlik eden hastalık serebrovasküler hastalık, bunama/Alzheimer, ve hipertansiyon (%37, %34 ve %27) idi. Olgularımızın %72'sinde santral sinir sistemi ile ilgili bir hastalık (trombotik ve hemorajik SVO, Alzheimer, intrakranial kitle, vs.) vardı. Hipernatremiye eşlik eden akut hastalıklar sırası ile üriner enfeksiyon, pnömoni ve akut SVO (%30, %20 ve %11) idi. SONUÇ: Hipernatremi genellikle yaşlı popülasyonda görülen, yüksek mortalite ve morbidite oranları ile seyreden elektrolit bozukluğudur. Hastanemizde Acil Servise başvuran hastalarda hipernatremi sıklığı %0,34 bulundu. Hastaların büyük çoğunluğunda eşlik eden hastalıklar vardır.Öğe Agresif seyreden double-hit lenfoma: bir olgu sunumu(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2013) Kaya, Emin; Erkurt, Mehmet Ali; Berber, İlhami; Köroğlu, Mustafa; Kuku, İrfanDouble-Hit lenfoma acil tedavi edilmez ise aylar içinde ölümcül olabilen kötü seyirli B hücreli lenfomadır. Biz burada kötü seyirli giden fatal seyreden Double-Hit Lenfomalı erişkin bir olguyu sunduk. 18 yaşındaki erkek hasta Kulak Burun Boğaz polikliniğine çene altındaki şişlik nedeni ile başvurdu ve eksizyonel biopsi yapıldı. Hastanın biyopsisi CD20(+) Burkitt-like lenfoma olarak rapor edildi. Ann-Arbor evreleme sistemine göre evre IIIB kabul edilen hasta tedavi protokolündeki kemoterapotiklere ve yüksek doz kemoterapi eşliğinde otolog kemik iliği nakline cevap vermedi. Hastamız tanı konulmasından yaklaşık 12 ay sonra kaybedildi. Double-Hit lenfoma agresif gidişli olabilir ve fatal seyirli seyredebilir. Bu yüzden tanıdan sonra zaman kaybetmeden tedavi başlanmalıdır.Öğe BK virus incidence, risk factors and its effect on mortality in hematopoietic stem cell transplant patients-single center experience(2021) Deviren, Mehmet Veysi; Sarıcı, Ahmet; Erkurt, Mehmet Ali; Bahçecioğlu, Ömer Faruk; Biçim, Soykan; Berber, İlhami; Kaya, EminThe aim of this trial is to investigate the risk factors of BK viruria and the effect of BK viruria on mortality in patients undergoing hematopoietic stem cell transplantation (HSCT). The data of 247 patients who underwent HSCT between 01.01.2011-01.12.2017 in Inonu University Faculty of Medicine Department of Hematology were retrospectively analyzed. BK viruria was defined as positive at any copy level in the urine. Of 247 patients, 97 patients (39.2%) were detected to have BK virus-posi- tive. Patients with positive BK virus in urine were younger than BK virus negative patients, and patients with multiple myeloma had a lower rate of BK virus positivity than other patients (p<0.05). The rate of BK viruria was found to be higher in patients who received busulfan and cyclophosphamide-containing conditioning regimens compared to patients who received other conditioning regimens (46% vs 28.9%, p=0.007). In addition, BK virus positivity was found to be lower in those receiving mel- phalan-based conditioning regimens than those receiving other conditioning regimes (28.6% vs 47.2%, p=0.008). BK virus positivity in urine was detected median 20 days after HSCT. BK virus positivity was detected in 80.4% (78/97) of the patients within the first 30 days. Patients with BK viruria had a higher first 100-day mortality than patients without BK viruria (17.5% vs 8%, p=0.023). In this series, BK viruria is a factor associated with mortality in the early period after HSCT and should be closely monitored in these patients.Öğe Clinical characteristics and treatments outcomes in elderly patients with multiple myeloma: A multicenter retrospective study(2017) Terzi, Hatice; Korkmaz, Serdal; Berber, İlhami; Keklik, Muzaffer; Doğu, Mehmet Hilmi; Şencan, Mehmet; Kaya, Emin; Eser, Bülent; Sarı, İsmail; İlhan, OsmanAbstract: Amaç: Mutipl Myeloma, tüm kanser tiplerinin %1' ini, hematolojik malignitelerin ise %10' unu oluşturan tamamen kürün sağlanamadığı fatal bir hastalıktır. Genellikle yaşlı populasyonda izlenir. Bu çalışmanın amacı, son 5 yılda farklı rejimlerle tedavi edilen 65 yaş ve üzerindeki 105 Mutipl Myeloma' lı hastadaki klinik deneyimimizi sunmaktır. Yöntem: 65 yaş üzerindeki Mutipl Myeloma'lı hastaların klinik karakterleri ve terapötik sonuçlarını analize etmek için, Türkiye'deki 5 farklı merkezden retrospektif olarak veriler toplandı.Bulgular: 51 erkek ve 54 kadından oluşan toplam 105 yaşlı Multipl Myeloma hastası (65 yaş ve üzeri) retrospektif olarak değerlendirildi. Hastalara ilk basamak olarak, VAD( vinkrsitin, adriamisin, deksametazon), VCD ( Bortezomib, siklofosfamid, deksametazon), MP( melphalan, prednizolon), MPT (Melphalan, prednizolon, thalidomid) rejimleri verildi. 29 hastada tam yanıt elde edildi ve bu hastaların 18 'ine otolog kök hücre nakli yapıldı. Tam yanıt elde edilemeyen 46 hastaya, ikinci basamak tedavi olarak bortezomib, lenalidomid ve talidomid bazlı rejimler verildi. İkinci basamak tedavi ile tedavi edilenlerin 29'unda tam yanıt elde edildi ve bu hastalardan 20'sine otolog kök hücre nakli yapıldı. 16 hastaya ise birinci ve ikinci basamak rejimlere yanıt vermediğinden lenalidomid bazlı rejimler (n: 10), talidomid bazlı rejimler (n: 6) verildi. Bu tedavilerle remisyona giren 5 hastaya Otolog kök hücre nakli yapıldı. Sonuç: Optimal tedavi yaklaşımı, verimli, güvenli, kaliteli yaşam sağlamalı ve amaç tam yanıtın yanı sıra hastalıksız sağ kalımı ve genel sağ kalımı uzatmak olmalıdırÖğe Clinical features and laboratory values associated with disease severity in Covid-19 patients: a single center experience(2021) Berber, Nurcan; Berber, İlhami; Ulutaş, Özkan; Sarıcı, Ahmet; Yıldırım, Aslı; Çağasar, Özlem; Gözükara Bağ, HarikaAbstract: Background: To date, several studies were published about clinical features and laboratory values associated with diseaseseverity in Covid-19 patients. We aimed to show the relationship between disease severity and clinical and laboratorycharacteristics of the patients as a single center experience.Material and Method: Clinical features and laboratory data of fifty patients diagnosed with Covid-19 by PCR was evaluatedat diagnosis. These patients divided into 2 groups as early and advanced disease. Clinical features and laboratory data werecompared in terms of severity of disease.Results: In all patients, the most common accompanying disease was coronary artery disease. Cough and headache were the most common complaints. Laboratory values showed low lymphocyte count and high CRP levels in all patients. Twenty fourpatients in early stage and 26 patients in advanced stage were compared in terms of clinical features and laboratory values.In advanced stage, it was observed that body weight, number of comorbid diseases, age, CRP, procalcitonin, BUN, GGT,fibrinogen, D-dimer and ferritin levels of patients were higher whereas height, serum total protein, albumin and potassiumlevels were lower when compered with early stage patients (p<0.05).Conclusions: Our data showed that older age, having cough, increased number of comorbid diseases, CRP, BUN, GGT,fibrinogen, D-dimer and ferritin and decresed serum total protein, albumin, potassium levels at the time of diagnosis inCovid-19 patients were associated with advanced stage disease.Öğe Double-Hit Lymphoma Presenting with Aggressive Progression: A Case Report(Turgut Özal Tıp Merkezi Dergisi, 2013) Kaya, Emin; Erkurt, Mehmet Ali; Berber, İlhami; Köroğlu, Mustafa; Kuku, İrfanÖz: Double-Hit lenfoma acil tedavi edilmez ise aylar içinde ölümcül olabilen kötü seyirli B hücreli lenfomadır. Biz burada kötü seyirli giden fatal seyreden Double-Hit Lenfomalı erişkin bir olguyu sunduk. 18 yaşındaki erkek hasta Kulak Burun Boğaz polikliniğine çene altındaki şişlik nedeni ile başvurdu ve eksizyonel biopsi yapıldı. Hastanın biyopsisi CD20(+) Burkitt-like lenfoma olarak rapor edildi. Ann-Arbor evreleme sistemine göre evre IIIB kabul edilen hasta tedavi protokolündeki kemoterapotiklere ve yüksek doz kemoterapi eşliğinde otolog kemik iliği nakline cevap vermedi. Hastamız tanı konulmasından yaklaşık 12 ay sonra kaybedildi. Double-Hit lenfoma agresif gidişli olabilir ve fatal seyirli seyredebilir. Bu yüzden tanıdan sonra zaman kaybetmeden tedavi başlanmalıdır.Öğe Drug-drug interactions in intensive care units and potential clinical consequences of these interactions(2019) Öksüz, Eray; Buğday, Muhammed Serdar; Soyalp, Celaleddin; Karaaslan, Erol; Oto, Gökhan; Temelli Göçeroğlu, Rezzan; Berber, İlhamiAbstract: Aim: Drug-drug interactions (DDIs) are an important factor that can lead to serious health problems by increasing or decreasing theeffects of drugs. This study aimed to evaluate the frequency of DDIs in the intensive care unit (ICU).Material and Methods: All patients who were hospitalized for more than 24 h in the ICU of our hospital between January andSeptember 2018 and received 2 or more medications were included in this retrospective study. Frequency and severity of the DDIswere detected using the Rx Mediapharma and Lexi-Interact programs.Results: Of the 972 patients enrolled in the study, 2742 incidences of DDIs were detected in 626 patients (64%). Of the differentdrug pairs administered, 422 had DDIs, and 64 of those had 10 or more DDIs, constituting 67% of all of the DDIs. The most commonpotential clinical consequences of DDIs were increased risk of bleeding (12.3%), hyperkalemia (8.2%), arrhythmia (7.9%), and CNSdepression (6.6%).Conclusion: The results indicated that DDIs in the ICU were very common in our hospital. Moreover, these results indicated thatpatients should be closely monitored for the prevention of adverse effects, such as electrolyte disturbance, bleeding risk, andarrhythmia of drugs.Öğe The effect of CD 34+ stem cell dose on both short-term and long-term outcomes of autologous stem cell transplantation in multiple myeloma(2023) Uysal, Ayşe; Erkurt, Mehmet Ali; Kuku, İrfan; Kaya, Emin; Berber, İlhami; Sarıcı, Ahmet; Biçim, SoykanAim: In this single-center, retrospective study, we aimed to evaluate the effect of CD34+ stem cell dose on hematologic recovery and long-term outcomes such as progression-free survival and overall survival after autologous stem cell transplantation (ASCT). Materials and Methods: In this study, 282 patients with MM, who underwent ASCT between January 2014 and October 2021 were evaluated. The patients were divided into 2 groups according to the infused cell dose. Patients who received ?5x106/kg CD34+ cells were defined as group A. Patients who received >5x106/kg CD34+ cells were group B. The outcome of ASCT including the time of neutrophil/platelet engraftment, febrile neutropenia status, transplant-related mortality (TRM) at 100 days, duration of hospital- ization and survival status were examined in both groups. Results: There were 118 (41.8%) patients in group A and 164 patients (58.2%) in group B. The median neutrophil engraftment was 12 (7-26) days in A group, 11 (6-28) days in B group. The median platelet engraftment was 12 (6-40) and 11 (6-29) days in group B. There were statically significant different in both group for neutrophil and platelet engraftment time (p=.001 and .002, respectively). The median hospitalization time was 16 (10-53) days and 15 (6-83) days in group A and B, respectively. The hospitalization time was statistically significantly different in two groups (p<.012). The mean OS was 53.1±4.2 months in group A and 58.2±3.5 in group B which was not statistically significant difference (p=.841). The mean PFS was 11.8±1.3 months in group A and 19.1±1.4 months in group B which was statistically significant difference in 2 groups (p<0.001). Conclusion: Infusion of >5x106/kg CD34+ stem cells (median dose 9,6 x106/kg) may have a favorable effect on short-term outcomes of transplantation, including short-term neutrophil engraftment, short-term platelet engraftment, and short-term hospitalization. Additionally, progression-free survival may be positively affected by high dose, but upper limit should be defined by new study.Öğe Efficacy and safety of ruxolitinib plus extracorporeal photopheresis in acute and chronic graft versus host disease: A single center experience(2021) Sarici, Ahmet; Erkurt, Mehmet Ali; Bahcecioglu, Omer Faruk; Tanriverdi, Lokman Hekim; Berber, İlhami; Kaya, Emin; Biçim, Soykan; Gok, Selim; Özgül, Mustafa; Kuku, İrfanAbstract: Aim: There is no standard treatment for corticosteroid refractory acute and chronic graft versus host disease (GVHD). Ruxolitinib and extracorporeal phopheresis (ECP) are promising treatment options in GVHD. In this study, we aimed to share our clinical experience in steroid refractory GVHD patients treated with ruxolitinib plus ECP. Materials and Methods: The data of patients receiving ruxolitinib plus ECP for corticosteroid refractory acute and chronic GVHD patients were analyzed retrospectively. Results: A total of 11 cases, 6 of which were acute, were included in this retrospective, observational and single-center study. Acute GVHD developed in the 6 patients after allogeneic HSCT (median onset of GVHD=27, between 20 and 60 days ). Chronic GVHD developed in the 5 patients after allogeneic HSCT (median onset of GVHD= 159 between 60 and 380 days. The overall response rate of acute GVHD patients to ruxolitinib ECP combination therapy was 16.7% (complete response: 16.7%, partial response: 0%). The overall response rate of chronic GVHD patients to combination therapy was 60% (complete response: 20%, partial response: 40%). As a result of combination therapy, thrombocytopenia occurred in 36% (4/11) of patients, neutropenia in 27% (3/11) of patients, and CMV reactivation in 9% (1/11) of patients. Conclusion: We observed a low rate of overall response to ruxolitinib plus ECP treatment in acute GVHD patients but a high rate in chronic GVHD patients. According to our trial, ruxolitinib ECP combination may be beneficial in GVHD, especially in chronic GVHD, but prospective trials comparing its efficacy with other agents are needed.Öğe Eosinophilic ascites, as a rare manifestation of eosinophilic gastroenteritis: A case report(2018) Akatlı, Ayşe Nur; Seçkin, Yüksel; Altunel Kilinc, Elif; Yıldırım, Oğuzhan; Erdoğan, Mehmet Ali; Berber, İlhami; Bilgiç, Yılmaz; Çağın, Yasir FurkanAbstract: Eosinophilic ascites (EA) can present as an unusual finding of eosinophilic gastroenteritis. We presented this case to remind eosinophilic acid in cases with unexplained etiology. A 29-years old man presented to an emergency department with abdominal swelling, progressively worsening nausea, and fatigue over one month. The patient had no history of allergic disease. There was moderate ascites in the physical examination. Percent eosinophil was 60% in peripheral blood smear while IgE level was increased in the serum. There was ascites on abdominal computed tomography (CT) scan. Serum ascites-albumin gradient (SAAG) was non-portal. Eosinophilic infiltration was detected biopsy samples obtained by upper GI tract endoscopy and in bone marrow aspiration and biopsy. The abdominal pain, ascites and all laboratory tests were completely recovered after 12 weeks of prednisolone therapy. Eosinophilic gastroenteritis should be considered in case of markedly increased eosinophilia in ascites fluid.Öğe Eosinophilic ascites, as a rare manifestation of eosinophilic gastroenteritis: A case report(2018) Cagin, Yasir Furkan; Berber, İlhami; Bilgic, Yilmaz; Erdogan, Mehmet Ali; Yildirim, Oguzhan; Altunel Kilinc, Elif; Seckin, Yuksel; Akatli, Ayşe NurEosinophilic ascites (EA) can present as an unusual finding of eosinophilic gastroenteritis. We presented this case to remind eosinophilic acid in cases with unexplained etiology. A 29-years old man presented to an emergency department with abdominal swelling, progressively worsening nausea, and fatigue over one month. The patient had no history of allergic disease. There was moderate ascites in the physical examination. Percent eosinophil was 60% in peripheral blood smear while IgE level was increased in the serum. There was ascites on abdominal computed tomography (CT) scan. Serum ascites-albumin gradient (SAAG) was non-portal. Eosinophilic infiltration was detected biopsy samples obtained by upper GI tract endoscopy and in bone marrow aspiration and biopsy. The abdominal pain, ascites and all laboratory tests were completely recovered after 12 weeks of prednisolone therapy. Eosinophilic gastroenteritis should be considered in case of markedly increased eosinophilia in ascites fluid.Öğe Etiologic Factors of Nonalcoholic Hepatosteathosis in Malatya(2014) Gündüz, Ercan; Bentil, Receğ; Ukutaş, Özkan; Berber, İlhami; Kurt, Mehmet Ali; Karıncaoğlu, MelihAmaç: Non alkolik karaciğer yağlanmasına neden olan faktörler tam olarak ortaya anlaşılamamıştır. Bu çalışmada Malatya ve çevresinde nonalkolik yağlı karaciğer hastalığı olan hastalarda etiyolojik faktörleri araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmada İnönü Üniversitesi Tıp Fakültesi, Gastroenteroloji Polikliniğine başvuran ve hepatobilier ultrasonografide karaciğer yağlanması tespit edilen hastalar retrospektif olarak incelendi. Alkole bağlı karaciğer yağlanmasının dışlamak amacıyla kadınlarda 20 gram/gün, erkeklerde 30 gram/gün üzerindeki dozlar alkol alımı olarak kabul edildi ve çalışmanın dışında bırakıldı. Karaciğer enzim düzeyleri normal hastalar hepatosteatoz, enzim düzeyi normalin iki katı veya daha yüksek olanlar steatohepatit olarak değerlendirildi. Bulgular: Toplam 112 hastanın 58'i (51,8%) kadın, 54'ü erkek (48,2%) ve tüm hastaların yaş ortalaması 43,8±11,3 yıl idi. Erkeklerin yaş ortalaması 41,8±11,3 yıl, kadınların ise 45,4±11,3 yıldı. Toplam 112 olgunun 97'sinde (%86,6) hiperlipidemi, 53'ünde (%47,3) obezite, 47'sinde (%42) insülin direnci, 16'sında (%14,2) hiperlipidemi ile birlikte insülin direnci, 27'sinde (%24,1) hiperlipidemi ile birlikte obezite, 35'inde (%31,3) obezite ile birlikte insülin direnci, 11 hastada (%9,8) latent diyabetes mellitus tesbit edildi. Sonuç: Hiperlipidemi, obezite, insülin direnci gibi risk faktörlerine sahip bireylerin karaciğer sirozuna kadar ilerleyebilen nonalkolik karaciğer yağlanması açısından değerlendirilmesi önem arzetmektedir. Nonalkolik karaciğer yağlanması hastalığı olan hastalar latent diabet açısından araştırılmalıdırÖğe Etiologic Factors of Nonalcoholic Hepatosteathosis in Malatya(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2014) Gündüz, Ercan; Bentli, Recep; Ulutaş, Özkan; Berber, İlhami; Erkurt, Mehmet Ali; Karıncaoğlu, MelihAim: Etiology of non-alcoholic fatty liver disease is not exactly understood. The aim of this study is to investigate the etiologic factors in patients with non-alcoholic fatty liver disease in and around Malatya, Turkey. Material and Methods: In patients who applied to the Department of Gastroenterology, Inonu University, fatty liver was detected through hepatobiliary ultrasonography; these patients were evaluated retrospectively. Patients having over 20 gram alcohol/day in females and 30 gram alcohol/day in males were ruled out to exclude alcohol dependent fatty liver. Patients with normal liver enzyme levels and those with a two fold or higher increase were accepted as hepatosteatosis and steatohepatitis patients, respectively. Results: A total of 112 patients 58 (51.8%) women, 54 (48.2%) men with the 43.8±11.3 years mean age were included in the study. The mean age of men was 41.8±11.3 years and the mean age of women was 45.4±11.3 years. In a total of 112 patients, we have detected hyperlipidemia in 97 (86.6%), obesity in 53 (47.3%), insulin resistance in 47 (42%), hyperlipidemia with insulin resistance in 16 (14.2%), hyperlipidemia with obesity in 27 (24.1%), obesity with insulin resistance in 35 (31.3%), and latent diabetes mellitus in 11 (31.3%). Conclusion: Our results suggest that it is important to evaluate patients with the risk factors such as hyperlipidemia, obesity, insulin resistance regarding non-alcoholic fatty liver disease, which itself may lead to cirrhosis. Besides patients with non-alcoholic fatty liver disease should be evaluated in terms of latent diabetes.Öğe Etiological evaluation and the role of plasma exchange treatment in tromboticmicroangiopathies: A retrospective analysis from Eastern Anatolia(2022) Hidayet, Emine; Erkurt, Mehmet Ali; Sarıcı, Ahmet; Biçim, Soykan; Kuku, İrfan; Berber, İlhami; Kaya, EminThe aim is this study was to make the etiological classification of patients diagnosed with TMA in our region and to statistically evaluate the effect of therapeutic plasma exchange, which we use in treatment, on laboratory recovery and mortality. In our study, between 2009-2017, 85 patients diagnosed with TMA in our center evaluated retrospectively. Thirty- one (36.5%) of our patients were followed up with HELLP, 23 with thrombotic thrombocytopenic purpura (TTP) (27.1%), 20 (23.5%) snake bites, and 11 (12.9%) with atypical hemolytic uremic syndrome (aHUS). TPE treatment was performed in all patients. TPE treatment was found effective in patients with HELLP syndrome, TTP and snake bite and statistically significant improvement was obtained in laboratory parameters (p<0.05). However, TPE treatment was not found to be effective in the treatment of atipical HUS (p>0.05). Mortality rates were found 9.7%, 21.7%, 27.3%, and 0% in patients with HELLP Syndrome, TTP, aHUS, and snake bite, respectively. The primary treatment in HELLP syndrome was termination of pregnancy, it was observed in our study that TPE was effective in TTP, HELLP syndrome and snake bites and treatment should be started without delayÖğe Evans Syndrome(2013) Berber, İlhami; Erkurt, Mehmet Ali; Köroğlu, Mustafa; Bentli, Recep; Kaya, Emin; Kuku, İrfan[Abstract Not Acailable]Öğe Familial Chronic Lymphocytic Leukemia Patients in Eastern Anatolia Region(2013) Berber, İlhami; Erkut, Mehmet Ali; Köroğlu, Mustafa; Bentli, Recep; Kaya, Emin; Kuku, İrfan[Abstract Not Available]Öğe Haploidentical Transplantation Experience in Turgut Ozal Medical Center: Case Report and a Review of Literature(2014) Berber, İlhami; Erkurt, Mehmet Ali; Kaya, Emin; Köroğlu, Mustafa; Nizam, Ilknur; Bentli, Recep; Kuku, İrfanHaploidentik kök hücre nakli HLA uyumlu donörü olmayan hastalar için başka bir alternatif nakil modelidir. Hala, allojenik nakil gereksinimi olan hastaların ancak üçte biri HLA uyumlu vericiye sahiptir. Acil kök hücre nakli gereksiniminde haploidentik nakil bir çok hasta için önemli bir çözüm yoludur. Daha önceleri haploidentik hematopoetik kök hücre nakli yüksek oranda graft rejeksiyonu, graft versus host hastalığı, graft başarısızlığı ve nakil ile ilgili mortalite ile karakterize idi, fakat T hücre deplesyonundaki yeni gelişmeler ve mega doz kök hücre nakli yönetimi haploidentik kök hücre naklinde bazı problemlere çözüm oldu. Biz bir vakaya uygulanan Turgut Özal Tıp Merkezi' ndeki haploidentik kök hücre nakli deneyimimizi sunduk.Öğe Hipertansiyonu, Renal İnfarktı ve Morgagni Hernisi Olan Marfan Sendromlu Bir Olgu(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2009) Karahan, Doğu; Şahin, İdris; Toylak, Erdem; Berber, İlhami; Taşkapan, HülyaMarfan sendromu 15. kromozomda mutasyonlar ile oluşan konnektif dokunun otozomal dominant kalıtım ile geçen bir hastalığıdır. Kardiyovasküler hastalıklar ve diafragmatik hernileri de içeren yumuşak doku herniasyonları Marfan sendromunda görülebilen durumlardır. Olgu: 22 yaşında erkek hasta, hipertansiyonun klinik bulguları ile nefroloji polikliniğine başvurdu. Hastanın değerlendirmesinde Morgagni diyafragmatik herni ve renal infarkt tespit edildi. Hastanın yapılan muayenesinde Marfan sendromunu düşündüren fiziksel görünümüne sahipti. Radyolojik değerlendirmeler sağ konjenital diyafragmatik Morgagni hernisi ve renal infarktı ortaya çıkardı. Sonuç: Marfan sendromunda akselere hipertansiyon varlığında renal infarkt akla gelmelidir. Ayrıca hastalarda diyafragma yüksekliği varsa Morgagni hernisi olabileceği unutulmamalıdır.Öğe How are the Results of Allogeneic Stem Cell Transplantation in Elderly Patients? A Single-center Experience(2023) Uysal, Ayse; Erkurt, Mehmet Ali; Kuku, İrfan; Kaya, Emin; Berber, İlhami; Sarıcı, Ahmet; Biçim, SoykanINTRODUCTION: In this study, we aimed to present allogeneic hematopoietic stem cell transplantation (allo-HCT) experience in elderly patients with hematological malignancy. METHODS: Thirty-five patients aged 60 years and older who underwent allo-HSCT between 2017 and 2021 were retrospectively analyzed. Patient's demographic/clinical features, and the outcomes of transplantation were reviewed. RESULTS: The median age was 63 (range, 60-74) years and 25 (77,1%) were male. Twenty-seven (60%) were diagnosed with AML, followed by MDS (n: 7, 20%). Twenty-three (65,8%) patients had intermediate, and 6 (17,1%) patients had a high hematopoietic cell transplantation-specific comorbidity index score. Karnofsky performance status of ? 90% was detected in 15 (42,9%) patients. Busulfan plus fludarabine plus anti-thymocyte globulin was used mainly as a reduced-intensity conditioning regimen, which was used in 18 (51,4%) patients. The median duration of neutrophil and platelet engraftments were 18 (range, 11-27) and 18 (range, 11-33) days, respectively. The median follow-up time was 4 months (range, 0-51), with the OS rate %14,2. The transplant-related mortality rate within the first 30 days after allo-HSCT was detected in 10 patients (28,6%) due to infection and/or GvHD. Response assessment could be performed in 25 (71,4%) patients after transplantation. The duration of PFS was 6 (range, 1-51) months in patients with response evaluation. The rate of PFS was 72% in 1 years and 5 (14,2%) patients were still alive with complete response at the last visit. DISCUSSION AND CONCLUSION: Reduced-intensity conditioning regimen has provided the important advantage in allo-HSCT, for elderly patients with hematological malignancies such as AML and MDS.Öğe The impact of laboratory features and comorbidities on the prognosis of patients with COVID-19(2021) Sarıcı, Ahmet; Berber, Nurcan; Çağasar, Özlem; Biçim, Soykan; Cagin, Yasir Furkan; Ulutaş, Özkan; Gözükara Bağ, Harika; Berber, İlhamiAbstract: Objective: Demographic and laboratory values predicting clinical severity in coronavirus disease 2019 (COVID-19) patients havebeen a matter of curiosity since the beginning of the disease. We aimed to show the relationship between the severity of COVID-19disease and comorbidities, clinical and laboratory features of the patients.Material and Method: The data of COVID-19 patients diagnosed with polymerase chain reaction (PCR), were analyzed retrospectively.The patients were divided into 3 groups according to their clinical severity as mild, moderate and severe. Comorbidities and theCharlson comorbidity index (CCI) at the time of diagnosis were calculated for each patient from the patients’ records. Demographicdata, laboratory values, comorbidity and CCI scores were compared between the patient groups. The effect of CCI on survival andlength of hospital stay was examined.Results: One hundred and four patients were included in the trial. The most common comorbid disease in the patients included in thetrial was hypertension. The moderate-severe stage patients were statistically significantly older (p<0.001). The CCI was found to bestatistically significantly different between mild, moderate and severe groups (p<0.001). When CCI increases by one unit, the risk ofdeath increases by 1.193 times (p=0.017). The neutrophil-to-lymphocyte ratio (NLR) was statistically significantly different betweenthe mild, moderate and severe patient groups. It was observed that as the severity of the disease increased, the NLR increased. Olderage, WBC, neutrophil count, NLR, BUN, creatinine, AST, potassium level, C-reactive protein (CRP), procalcitonin, aPTT, fibrinogen,d-dimer, and ferritin levels were found to be higher in the clinically severe patient group. Lymphocyte and eosinophil counts, totalprotein, albumin and sodium levels were found to be lower in the clinically severe patient group.Conclusion: This trial showed that calculating the CCI score in COVID-19 patients can be useful in predicting the severity of thedisease. Examination of CCI, age, WBC, neutrophil, lymphocyte, eosinophil counts, BUN, creatinine, AST, total protein, albumin,sodium, potassium level, CRP, procalcitonin, aPTT, fibrinogen, d-dimer and ferritin levels at the time of diagnosis can be suggested.