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    Apheresis in patients with sepsis: A multicenter retrospective study
    (Pergamon-Elsevier Science Ltd, 2021) Aydin, Kaniye; Korkmaz, Serdal; Erkurt, Mehmet Ali; Sarici, Ahmet; Ekinci, Omer; Baysal, Nuran Ahu; Berber, Ilhami
    Background and objectives: To consider the effectiveness of apheresis, which is a supportive treatment method, in sepsis. Materials and methods: A hundred and eleven adults with sepsis or septic shock were included in this retrospective study. The demographic characteristics of the patients, the focus and source of infection causing sepsis or septic shock, characteristics of the pathogen, Acute Physiological and Chronic Health Assessment (APACHE) II score, routine laboratory values, which apheresis method was used, the characteristics of the replacement fluids used during the apheresis procedure, the number of apheresis procedures, complications related to the apheresis procedure, the follow-up time after the procedure, and mortality were recorded. The primary outcome was 28day mortality. Results: Sixty-nine (62.2 %) of the patients were male. The mean age of the patients was 47.7 +/- 18.6 years. The most common source of sepsis was hospital-acquired (79.3 %), the most common pathogen causing sepsis was gram-negative bacteria (41.4 %), and the most common infection site was the respiratory tract (58.7 %). The median APACHE II score was 19 (13-24). 92 (82.9 %) of the patients had septic shock. Theropeutic plasma exchange (TPE) was performed in 11.7 % of the patients and immunoabsorbtion IA in 88.3 %. The median number of sessions was 3 (3-5). No procedure-related fatal complication was observed in the study. While 28day mortality was 61.3 % in all patients, when the mortality according to the apheresis procedures was examined, it was 11.3 % and 88.2 % in the patients who underwent TPE and IA, respectively. The most common cause of mortality was multiorgan failure. Conclusions: Apheresis in sepsis can be considered as a salvage treatment. The indication for apheresis in sepsis is still at the level of patient-based individualized decision in line with the studies done so far, including our study. However, there is a need for a multicenter randomized controlled study with a large number of patients in order to give positive or negative recommendations about its effectiveness.
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    The frequency of anemia in the elderly patient population in Van province, Turkey. A cross-sectional study
    (2021) Eker, Elif; Ekinci, Omer
    Aim: This study aims to determine the prevalence and morphological distribution of anemia among elderly patients who presented to the hospital during a certain time period.Materials and Methods: Haemogram parameters of all patients aged 60 or older who attended our hospital for any reason during a certain time period were reviewed. Anemia was defined according to the criteria by the World Health Organization (WHO). Cases of anemia were classified based on the mean corpuscular volume (MCV) results of the patients as microcytic, normocytic, or macrocytic. The prevalence and morphological classification of anemia were examined with respect to age and gender. Results: Of 1192 total patients, 608(51%) were female. The majority of the patients were in the 60–70–year range, with a rate of 60.3% (718). The mean age was 69.70±7.55 years in females and 69.8±7.15 in males (p=0.680). Anemia was detected in 340 (28.5%) patients in total (24.8% in females, 32.4% in males, p=0.004). Sixty–six (19.4%) patients had microcytic anemia, 245(72.1%) had normocytic anemia, and 29 (8.5%) had macrocytic anemia. Distribution of anemia across age groups revealed 169 (23.5%) patients with anemia in the 60–70–years age group (69 (%18.2) vs 100 (%29.6), p=0.001). The prevalence of anemia was different between genders in both the 60–70–years and ≥81 years groups (respectively, 52 (%14.6) vs 66 (%18.5), p=0.426 and 30 (%25.6) vs 23 (%19.7), p=0.295).Conclusion: The prevalence of anemia increases with aging. Determination of the prevalence and the etiological distribution of anemia, particularly in the elderly patient group, may provide practical information in daily practice regarding the approach to be adopted towards patients in a certain region. We think that these results provide information on the epidemiology of anemia among elderly patients in the specified region and will contribute to future studies in this aspect.
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    Imatinib mesylate in first-line treatment of chronic myeloid leukemia
    (2019) Ekinci, Omer; Kizilkaya, Ismet
    Aim: Sixty nine patients who were diagnosed with CML and were treated with first-generation TKI ( in the form of imatinib mesylate) as initial treatment between 2006 and 2018 were included in this retrospective study. The demographic characteristics, response rates (hematologic, cytogenetic and molecular), adverse events and overall survival (OS) rates were retrospectively analyzed.Results: There were 28 male and 41 female patients with a median age of 49.3. Hematologic, cytogenetic and molecular responses to TKI treatment were evaluated according to the 2013 guidelines of European Leukemia Net (ELN). The complete hematologic response (CHR) rate at three months was 97.1%, the complete cytogenetic response (CCR) rate at 12 months was 73.4%, and the major molecular response (MMR) at 18 months was 77.8%. The most common adverse events were cytopenia (13%), edema (10.1%), nausea/vomiting (7.2%), and musculoskeletal pain (5.8%). The mean follow-up period was 40.4 months for all CML patients, with an overall survival (OS) rate of 84.6% during follow-up.Conclusion: As a real life data in our population, our results were consistent with those reported in the literature. Drug-related adverse events were minimal and tolerable. Long-term survival and disease-free survival can be achieved with proper cytogenetic and molecular monitoring under imatinib treatment and, if necessary, a change in medication.
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    A multicenter retrospective analysis on therapeutic plasma exchange in immune thrombocytopenic purpura
    (Pergamon-Elsevier Science Ltd, 2021) Basturk, Abdulkadir; Sayin, Serhat; Erkurt, Mehmet Ali; Sarici, Ahmet; Ekinci, Omer; Kum, Asli; Berber, Ilhami
    Immune Thrombocytopenia (ITP) is an autoimmune disease characterized by thrombocytopenia and skin and mucosal bleeding. In patients with an indication for treatment, corticosteroids, intravenous immunoglobulin (IVIg) and anti-D are recommended as the first line, while splenectomy, thrombopoietin receptor agonists or rituximab are recommended second line options. Approximately 10 % of adult patients with ITP fall into the chronic refractory ITP group. Therapeutic plasma exchange (TPE) has generally been tested in patients with refractory ITP, who have failed to respond to conventional treatments, in case of bleeding or prior to surgical interventions. It has been stated that elimination of the antibodies that are held responsible in the pathogenesis of the disease has an effective role in the treatment. In this article, we present the results of 17 patients, who underwent TPE for refractory ITP, together with the literature data.
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    A Real-Life Turkish Experience of Ruxolitinib in Polycythemia Vera
    (Galenos Publ House, 2023) Serin, Istemi; Dogu, Mehmet Hilmi; Ekinci, Omer; Cagliyan, Gulsum Akgun; Basturk, Abdulkadir; Aras, Merih Reis; Demircioglu, Sinan
    Introduction: Ruxolitinib is a small -molecule inhibitor of the JAK1/2 pathway. This study aimed to reveal the results and side-effect profile of the use of ruxolitinib as a treatment option in polycythemia vera (PV). Methods: A total of 34 patients with PV from 18 different centers were included in the study. The evaluation of the response under treatment with ruxolitinib was determined as a reduction in spleen volume (splenomegaly size: >= 35%) by imaging and control of hematocrit levels (<= 45%) compared to baseline. Results: While the number of patients in which a reduction in spleen volume and hematocrit control was achieved was 19 (55.9%) at 3 months of treatment, it was 21 (61.8%) at 6 months. Additionally, while the number of side effects was negatively correlated with the reduction in spleen volume (Spearman's rho: -0.365, p=0.034), a decrease in the hematocrit level was positively correlated (Spearman's rho: 0.75, p=0.029). Those without a reduction in spleen volume experienced more constipation (chi-square: 5.988, Fisher's exact test: p=0.033). Conclusion: This study shed light on the use of ruxolitinib in PV and the importance of splenomegaly on studies planned with larger patient groups.
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    The Real-World Experience With Single Agent Ibrutinib in Relapsed/Refractory CLL
    (Cig Media Group, Lp, 2022) Akpinar, Seval; Dogu, Mehmet Hilmi; Celik, Serhat; Ekinci, Omer; Hindilerden, Ipek Yonal; Dal, Mehmet Sinan; Davulcu, Eren Arslan
    We evaluated the safety and efficacy of single-agent ibrutinib in 200 patients presenting with relapsed/refractory CLL in real-world settings. With an estimated median OS of 52 months, 146 patients (75%) achieved at least PR; 16 (8.7%) patients discontinued ibrutinib due to adverse events. The results indicate good safety and efficacy for single-agent ibrutinib in R/R CLL in daily practice. Introduction/Background: The emergence of novel agents targeting the B-cell receptor pathway and BCL-2 has significantly changed the therapeutic landscape of CLL. We evaluated the safety and efficacy of single-agent ibrutinib in relapsed/refractory CLL in real-world settings. Patients/Methods: A total of 200 relapsed/refractory CLL patients with a median age of 68 were included in this retrospective, multicenter, non-interventional study. Data of the study were captured from the patient charts of the par ticipating centers. Results: The median for lines of previous chemotherapy was 2 (1-6); 62 (31.8%) patients had del17p and/or p53 mutations (del17p+ /p53mut). Of the study group, 146 (75%) patients achieved at least PR, while 16 (8.7%) patients discontinued ibrutinib due to TEA. The most common drug-related adverse events were neutropenia (n: 31; 17.4%) and thrombocytopenia (n: 40; 22.3%), which were >= grade 3 in 9 (5%) and 5 (3.9%) patients, respectively. Pneumonia (n: 42; 23.7%) was the most common nonhematologic TEA. Atr ial fibrillation (n: 5; 2.8%) and bleeding (n: 11; 6.3%) were relatively rare dur ing the study period. Within a median follow-up period of 17 (1-74) months, 42 (21%) patients died. The estimated median OS of the study cohort was 52 months. Only the response to ibrutinib (CR/PR vs. SD/PD) was significantly associated with OS. Conclusion: Our results indicate good safety and efficacy for single-agent ibrutinib in R/R CLL in daily practice. (C) 2021 Elsevier Inc. All rights reserved.