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Biomedical subjects

H Demiroğlu

Publications and source records attributed to H Demiroğlu.

At least 19 recordsLinked to original sources
PubMed1998

Acalculous acute cholecystitis in leukemia.

Acalculous acute cholecystitis (AAC) is a well-known complication in critically ill patients. However, there is no satisfactory data regarding this complication in leukemic patients. We reviewed the medical records of 426 patients with acute or chronic leukemia retrospectively to investigate the incidence, possible pathogenetic mechanisms, and clinical course of AAC in leukemia. Six cases of AAC were identified. The incidence was 1.65% (5/302) for acute leukemias. Three out of 6 patients underwent cholecystectomy, and two recovered completely. Percutaneous cholecystostomy was performed in another patient successfully. Careful histological examinations of the surgical specimens did not reveal any specific etiopathogenetic finding. However, clinical data suggested that infectious agents and visceral ischemia may contribute to the pathogenesis of AAC in leukemia.

Acute Disease↗
PubMed1998

Increased erythrocyte aggregation as an indicator for an aggressive clinical course in Behçet's disease: a prospective study.

OBJECTIVE: Changes in blood rheology, especially increased erythrocyte aggregation (EA) might play an important part in the development of arterial and venous thrombotic lesions. A prospective study was designed to evaluate EA in patients with Behçet's disease (BD) and to see if this parameter is predictive for the future development of vascular complications, such as deep vein thrombosis of various organ systems and uveitis. METHODS: EA was measured by a photometric Myrenne aggregometer in 38 patients with BD at the time of initial diagnosis and in 40 age and sex matched healthy controls (HC). RESULTS: During a median follow up period of 13.5 months, 13 patients developed vascular-ocular complications (eight deep vein thrombosis, nine uveitis, and four both deep vein thrombosis and uveitis). Patients were further divided into two groups: BD-a with mucocutaneous symptoms and arthritis only; BD-b with associated vascular-ocular complications. EA values at high shear rate (M) and at low shear rate (M1) were compared among the groups. CONCLUSION: EA values at M and M1 were significantly higher in BD-b than BD-a and HC (p < 0.001). These results suggest that determination of EA rates might be useful to identify subgroups who are likely candidates for developing vascular-ocular complications in BD and management of factors known to affect blood rheology might be beneficial.

Adult↗
PubMed1998

Fever, hepatosplenomegaly and pancytopenia in a patient living in the Mediterranean region.

A 24 year old woman living in the Mediterranean region of Turkey present with a three-month history of weight loss and irregular fever that was peaking at 40 degrees C with shivering. No definite aetiology could be identified in a local hospital. A bacterial infection had been suspected, but antibiotic therapy, at first with sulbactam-ampicillin and later with azithromycin, had no influence on the fever. Physical examination revealed an emaciated patient with fever (39 degrees C), pallor, and hepatosplenomegaly (spleen 9 cm and liver 5 cm palpable below the costal margin). No peripheral lymphadenopathy was present. The laboratory examinations are summarised in the table. Notably, a prominent increase of macrophages containing intracellular micro-organisms (figures 1 and 2) was seen in the bone marrow smears. The same micro-organisms were also identified within the Kupffer cells in liver biopsy.

Adult↗
PubMed1997

Pernicious anaemia patients should be screened for iron deficiency during follow up.

AIMS: To investigate if patients with pernicious anaemia (PA) are prone to develop iron deficiency and if there is a difference for this manifestation between younger and older age groups. METHODS: Ninety-five patients with pernicious anaemia were evaluated for body iron status at the time of diagnosis and during follow up. Patients were also divided into two groups; younger than 60 (53 patients) and older than 60 (42 patients) years of age. Groups were compared for iron deficiency both at the time of diagnosis and at the end of follow up period. RESULTS: Iron deficiency was a common finding in patients with pernicious anaemia. This deficiency state was more common in the elderly. During B12 therapy, iron deficiency increased in all groups, but the increased rate of iron deficiency was more prominent in the elderly patients. CONCLUSION: Pernicious anaemia is an atrophic gastropathy in which gastric parietal cells no longer produce hydrochloric acid. These patients with achlorhydria demonstrate impaired absorption of iron. On the other hand, with ageing, gastric acidity is already diminished. Iron deficiency commonly accompanies patients with pernicious anaemia and this is more pronounced in the elderly group. We suggest that all patients with pernicious anaemia, especially the elderly, should be screened for iron deficiency both at the beginning and during the follow up.

Achlorhydria↗
PubMed1997

Acute leukaemia during tamoxifen therapy.

Tamoxifen treatment is a proven therapy for breast cancer that produces a survival advantage when used as an adjuvant, and reduces the incidence of recurrences and controlateral tumor evolution. Although this therapy has a very low toxicity profile, an increase in secondary cancers has been reported. Tamoxifen is suggested to be carcinogenic both through direct genotoxic and epigenetic mechanisms. It is activated by cytochrome P450 to form reactive metabolites that bind covalently to DNA to create adducts. We report two cases that developed acute myeloid leukaemia (AML) during tamoxifen therapy for breast cancer.

Antineoplastic Agents, Hormonal↗
PubMed1997

Risk factor assessment and prognosis of eye involvement in Behcet's disease in Turkey.

BACKGROUND: Behcet's disease (BD) shows great regional differences in clinical manifestations and prognosis, including eye involvement. Thus, it is hard to predict in which patient the eyes will be involved and what the outcome will be. In this study we assessed various risk factors for eye involvement and attempted to predict the visual outcome in our patient population in Turkey. METHODS: Data from a total of 224 patients with BD, diagnosed between 1982 and 1996, were analyzed retrospectively. A detailed physical examination and ophthalmologic work up were performed on each patient. Factors that might contribute to eye involvement were investigated, after which prognostic factors for vision were evaluated. RESULTS: Eighty-eight patients had eye involvement during a median follow-up of 32 months. The risk of involvement was highest within the first year of diagnosis. Young age was the most significant factor for eye involvement (P < 0.0001), but vascular thrombosis, central nervous system (CNS) involvement, and male gender were other risk factors (P < 0.001; P < 0.01; and P < 0.05, respectively). The most important determinant for the prognosis of vision was CNS involvement (P < 0.0001). Vascular thrombosis and an age of < or = 32 were other risk factors for visual impairment (P < 0.001 and P < 0.05, respectively). The risk of eye involvement and prognosis for vision were similar with different treatment regimens (P > 0.05). CONCLUSION: It is suggested that the first 2 years after diagnosis is the most critical period for eye involvement, and conventional forms of therapy generally are unsuccessful in preventing such involvement. It seems reasonable to treat patients who are at increased risk for eye involvement more aggressively, especially within the first 2 years of disease onset.

Adolescent↗
PubMed1997

Is prevention of cancer possible with tumor-specific vaccines?

Cancer is one of the leading causes of death today, and new therapeutic approaches are continuously being explored. In recent years, cancer vaccines have been tried with the aim of induction of an active specific immune response against the tumor. Although some successful results are obtained, cure rates are still disappointing. The main reason for failure is that vaccines are applied to patients diagnosed with cancer; in these patients, tumor cell burden is so high that it is almost impossible to overcome the disease by increasing the immune response with vaccines at this stage. This hypothesis is based on the following idea: since therapy for cancer is unsuccessful in the majority of patients, methods of prevention should be improved. Immunization against microorganisms has largely prevented morbidity and mortality from infectious disease. In a similar way, if we immunize people before the development of malignant disease with tumor-specific vaccines, then prevention of cancer may be possible.

Anticarcinogenic Agents↗
PubMed1997

Hyperkalaemia in acute leukaemia: a sign of adrenocortical insufficiency.

OBJECTIVES: To evaluate adrenal cortical reserve function in hyperkalaemic patients with acute leukaemia (AL). DESIGN: In hyperkalaemic AL patients, after basal blood collection for cortisol, rapid adrenocorticotropic hormone (ACTH) stimulation test was performed with human a1-24-ACTH 0.25 mg, intravenously. Sixty minutes following injection, additional plasma was obtained for cortisol. Normal response was a peak cortisol level greater than 15 micrograms dL-1 with an increment greater than 5 micrograms dL-1. SETTING: Hacettepe University Hospital, Ankara, Turkey. SUBJECTS: Newly diagnosed AL patients with plasma K+ values exceeding 4.5 mmol L-1, who had never received antileukaemia therapy were eligible for entry into the trial. Thirteen patients fulfilled these criteria. Twenty AL patients with normal serum K+ levels were studied as controls. RESULTS: In six patients with hyperkalaemia, adrenal cortical response to rapid ACTH test was inadequate. One patient died during induction chemotherapy due to sepsis. Five of the remaining patients entered remission. Repeat ACTH tests during remission revealed normalization of the adrenocortical function in these patients. However, in only one patient with normal serum K+ level, adrenocortical reserve was decreased. CONCLUSIONS: We suggest that in any AL patient with hyperkalaemia, adrenal reserve function should be evaluated with rapid ACTH stimulation test. In states of resistant hypotension and hyperkalaemia, steroids may be life saving.

Adrenal Cortex↗