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    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, Emin
    The 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.
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    Comparison of patients with fulminant versus near-miss fulminant drug-induced hepatitis
    (Allied Acad, 2017) Bilgic, Yilmaz; Akbulut, Sami; Kutlu, Orkide; Yilmaz, Cengiz; Colak, Cemil; Deviren, Mehmet Veysi; Cagin, Yasir Furkan
    This study aimed to investigate and compare clinical and laboratory properties of patients with fulminant versus near-miss fulminant drug-induced hepatitis and the effect of these properties on mortality. Drug-induced hepatitis is the most common cause of acute liver failure in western countries. In severe drug-induced hepatitis, once encephalopathy develops, prognosis is poor without liver transplantation. Therefore, it is important to predict prognosis and know the clinical differences between patients developing encephalopathy and patients without encephalopathy. Patients with severe drug-induced hepatitis were researched retrospectively. The identified patients were divided into two groups: with encephalopathy (fulminant hepatitis; 25 patients) and without encephalopathy (near-miss fulminant hepatitis; 48 patients). The clinical properties and biochemical results of the two groups were compared, and parameters that could have an effect on mortality were evaluated. Hemoglobin, platelet count, albumin, and fibrinogen levels were found to be decreased, whereas, International Normalized Ratio (INR), total bilirubin, AST, LDH, lactate, and ammonia levels were found to be increased significantly in the fulminant hepatitis group. Creatinine, Model for End-Stage Liver Disease (MELD) score, and platelet count were found to be independent risk factors on mortality. The development of hepatic encephalopathy negatively impacts patient survival. Therefore, the prediction of a progression to fulminant hepatitis before hepatic encephalopathy develops and the clinical follow-up of patients accordingly are important issues. This study can provide significant insight into patients with severe drug-induced hepatitis.
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    The correlation between cytological examination of ascitic fluid and serum ascites albumin gradient in the differential diagnosis of ascites
    (2019) Atayan, Yahya; Erdogan, Mehmet Ali; Calıskan, Ali Riza; Deviren, Mehmet Veysi; Apak, Ayetullah; Yaslikaya, Sendag
    Aim: The accumulation of fluid in pathological quantities in the peritoneal cavity is called ascites. In every newly diagnosed ascites, necessary investigations should be conducted by puncturing ascitic fluid. In this study, we aimed to investigate whether there is any correlation between cytological examination of ascitic fluid and serum ascites albumin gradient (SAAG) in the determination of etiologic causes of ascites. Material and Method: The files of the patients who were admitted to our clinic for the investigation of their ascites etiology between May 2014 and May 2018, were analyzed retrospectively. Pathology reports of the patients whose SAAG was calculated by taking the difference between serum albumin values and simultaneously taken ascitic fluid albumin and whose ascitic fluid cytology examination was performed, were recorded. The data of 248 patients with clinical diagnosis were included in the study. Patients with SAAG <1.1 g / dl and SAAG ≥1.1 g / dl, were divided into two groups. Results: Of the 248 patients included in the study, 114 were female (45.90%) and 134 were male (54.10%) patients. The patients were divided into 2 groups according to SAAG value. In group 1, there were 107 (43.14%) patients with SAAG <1.1 g / dl and in group 2, there were 141 (56.85%) patients with SAAG ≥1.1 g /dl. Group 1: In 70 (28.22%) of 107 patients, positive malignant cytology was consistent with ascites (p<0.0001). In 37 (14.91%) patients, benign cytology ascites was present. Group 2: 133 (53.62%) of 141 patients had benign cytology and 8 (3.23%) had malignant cytology. Conclusion: There was a correlation between malignant cytology of ascites with SAAG <1.1.
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    The correlation between cytological examination of ascitic fluid and serum ascites albumin gradient in the differential diagnosis of ascites
    (2019) Atayan, Yahya; Erdoğan, Mehmet Ali; Çalışkan, Ali Rıza; Deviren, Mehmet Veysi; Apak, Ayetullah; Yaslıkaya, Sendag
    Abstract: Aim: The accumulation of fluid in pathological quantities in the peritoneal cavity is called ascites. In every newly diagnosed ascites, necessary investigations should be conducted by puncturing ascitic fluid. In this study, we aimed to investigate whether there is any correlation between cytological examination of ascitic fluid and serum ascites albumin gradient (SAAG) in the determination of etiologic causes of ascites. Material and Method: The files of the patients who were admitted to our clinic for the investigation of their ascites etiology between May 2014 and May 2018, were analyzed retrospectively. Pathology reports of the patients whose SAAG was calculated by taking the difference between serum albumin values and simultaneously taken ascitic fluid albumin and whose ascitic fluid cytology examination was performed, were recorded. The data of 248 patients with clinical diagnosis were included in the study. Patients with SAAG <1.1 g / dl and SAAG ?1.1 g / dl, were divided into two groups. Results: Of the 248 patients included in the study, 114 were female (45.90%) and 134 were male (54.10%) patients. The patients were divided into 2 groups according to SAAG value. In group 1, there were 107 (43.14%) patients with SAAG <1.1 g / dl and in group 2, there were 141 (56.85%) patients with SAAG ?1.1 g /dl. Group 1: In 70 (28.22%) of 107 patients, positive malignant cytology was consistent with ascites (p<0.0001). In 37 (14.91%) patients, benign cytology ascites was present. Group 2: 133 (53.62%) of 141 patients had benign cytology and 8 (3.23%) had malignant cytology. Conclusion: There was a correlation between malignant cytology of ascites with SAAG <1.1.