The prevention of mortality and morbidity related to the increasingly used allogeneic hematopoietic cell transplantation (allo-HCT), along with the effects of pre- and post-transplant immune status ...on transplant outcomes, have become the focus of the studies conducted on this subject in recent years. In parallel, this study was designed to investigate the effects of pre-conditioning immunoglobulin (pre-conditioning-Ig) and pre-conditioning absolute lymphocyte count (pre-conditioning-ALC) levels on transplant outcomes.
This study was designed as a retrospective, observational and cross-sectional study. The objective of the study is to investigate the effects of pre-conditioning-Ig and ALC levels primarily on the rate of patients with febrile neutropenia (FEN) and the duration of FEN and length of hospital stay (LoS), and secondarily on acute graft-versus-host disease (aGVHD), cytomegalovirus (CMV) viremia, and mortality in the acute leukemia patients who underwent allo-HCT.
A total of 104 acute leukemia patients, of whom 55 had acute lymphoblastic leukemia (ALL) and 49 had acute myeloid leukemia (AML), were included in the study. Compared to the AML group, the median pre-conditioning-IgG, IgA, and IgM levels were found to be significantly lower in the ALL group (11.3 vs. 6.6, p < 0.001; 1.8 vs. 0.9, p < 0.001; and 0.7 vs. 0.4, p < 0.001; respectively). But, there was no significant difference between the groups in pre-conditioning-Ig and ALC levels and transplant outcomes. However, subgroup analysis revealed that high pre-conditioning-ALC levels were significantly correlated with aGVHD levels (Odds Ratio: 1.02; p = 0.034) and low pre-conditioning-IgM levels were significantly correlated with increased mortality rate (Hazard Ratio: 0.08; p = 0.042) in AML patients.
The significant difference determined between the ALL and AML groups in pre-conditioning-Ig levels was not reflected on the effects of pre-conditioning-Ig and ALC levels on transplant outcomes. However, we observed that pre-conditioning-IgM and ALC levels have an impact on transplant outcomes in AML patients.
•In allo-HCT patients, the ALL group had lower pre-conditioning Ig levels than the AML group.•But, there was no difference in transplant outcomes between the two groups.•However, in the AML group, low pre-conditioning IgM levels were also associated with increased mortality.•In addition, in the AML group, high pre-conditioning ALC a was associated with aGVHD.
Let (M, g) be a Weyl manifold of dimension m > 2. By using the Sasaki
metric G induced by g, we construct a Weyl structure on TM. Then we prove
that it is never Einstein-Weyl unless (M, g) is flat. ...The main theorem here
extends to the Weyl context a result of Musso and Tricerri.
nema
Purpose
Opioids are widely used to treat painful vaso-occlusive crises (VOC) in sickle cell disease (SCD). However, due to opioids’ significant adverse effect profiles, the search for alternative ...therapies continues from the past to the present. The study aimed to investigate the efficacy of acetaminophen and dexketoprofen in the treatment of painful VOC.
Methods
This study is a single-center, prospective, non-randomized, single-blinded, controlled study. The study comprised two groups: the first administered acetaminophen and dexketoprofen mixed group, while the second received them sequential group. Opioids were used in patients with persistent pain despite these analgesics. Demographic and laboratory information, pain scores, opioid requirement, dose amount, side effects, and length of hospital stay of the patients were recorded.
Results
The study comprised 56 (100%) patients with painful VOC, 29 (51.8%) from the mixed group, and 27 (48.2%) from the sequential group. Opioid use was seen in 16 (55.2%) patients in the mixed group and 21 (77.8%) patients in the sequential group (
p
= 0.074). The median amount of opioid used was significantly lower in the mixed group than in the sequential group (
p
< 0.001). Also, the median length of hospital stay was significantly lower in the mixed group than in the sequential group (
p
< 0.001).
Conclusion
Our study suggests that administering acetaminophen and dexketoprofen in the mix for the treatment of painful VOC in patients with SCD may be a more efficient approach compared to sequential administration. This approach appears to reduce opioid usage and shorten hospital stays.
In the present work, generalized recurrent and generalized concircularly recurrent Weyl manifolds are examined. We define nearly quasi-Einstein Weyl manifolds and we proved that if a generalized ...recurrent or generalized concircularly recurrent Weyl manifold admits a special concircular vector field, then the manifold reduces to a nearly quasi-Einstein Weyl manifold. Also, some other results are presented.
Objective: We aimed to contribute to the literature by investigating the causes of mortality, average life expectancies, and the clinical features that occur in this process, in relation to sickle ...cell disease (SCD), and by comparing the results obtained with other similar clinical studies. Materials and Methods: This study was designed as a monocentric, cross--sectional, and retrospective study. The patient files were reviewed in terms of the age, use of hydroxyurea, use of chelators, exchange transfusion history, surgical operation history, the annual frequency of painful crises, the annual hospitalization frequency, and the annual frequency of follow--up visits which the patients have attended, the complications experienced by the patients, and the causes of mortality. Results: Acute chest syndrome was the most prevalent cause of death of the patients included in our study. No significant difference was found between the premature death and late death groups, that is, the groups that we have determined on the basis of the SCD patients ages of death, in terms of use of hydroxyurea, use of iron chelator, and use of exchange transfusion depending on the disease. Conclusion: Based on our findings, acute chest syndrome was the primary cause of death in SCD patients we have studied, followed by pulmonary embolism. Use of hydroxyurea, use of iron chelator, exchange transfusion history, and surgical operation history due to SCD were not found to be significantly effective when the mean age of death reported in the literature was taken as the base value. Keywords: Hydroxyurea, mortality, sickle cell disease
Metabolic or non-metabolic many bone diseases can be distinguished in sickle cell anemia. Patients with sickle cell anemia have a high risk of osteopenia and osteoporosis. The aim of this study is to ...reveal bone mineral density abnormalities and related factors in patients with sickle cell anemia.
A total of 70 patients with sickle cell anemia were retrospectively included in our study. Complete blood count (CBC) parameters, serum creatinine, lactate dehydrogenase (LDH), total bilirubin, direct bilirubin, uric acid, calcium, phosphorus, parathormone, alkaline phosphatase, 25 (OH) vitamin D, ferritin, C reactive protein (CRP) and calculated bone mineral densitometry measurements by Dual-Energy X-ray Absorptiometry (DEXA) were assessed and recorded to the statistics program. We diagnosed osteopenia and osteoporosis according to World Health Organization (WHO) criteria. To determine the status of avascular necrosis and bone fracture, we examined x-ray and magnetic resonance imaging reports and epicrisis reports of patients from the records.
The average age was 30.01 ± 8.64 years. Eighteen (26.5%) of the 68 patients whose Z-score was evaluated by DEXA had bone mass below the expected age-related range according to the Z score, while 50 (73.5%) had bone mass within the expected age-related range. Of the patients whose T score was evaluated by DEXA, 46.8% were normal (n=29), 45.1% were osteopenic (n=28) and 8.1% were osteoporotic (n=5).
Patients with sickle cell anemia are at increased risk for osteoporosis, osteopenia, and osteomalacia. Bone health should be emphasized in these patients.
Although demodicosis caused by Demodex folliculorum and Demodex brevis is widely seen throughout the world, the pathogenic mechanisms are not fully known. To the best of our knowledge, the effect of ...Demodex mites in patients with sickle cell anemia (SCA) is not known. SCA is a genetic disease characterized by abnormal hemoglobin production and suppression of the immune system. The aim of this study was to determine the prevalence and Demodex density in SCA patients and to compare with healthy subjects. The study included 70 patients diagnosed with SCA and control group of 50 healthy individuals. Samples were taken from cheeks, forehead, nose, and chin and were examined microscopically. Infestation of ≥5 mites/cm2 was accepted as positive in the diagnosis. Demodex mite positivity was determined in 20 (28.6%) patients and none in subjects of the control group. In the SCA group, the mean number of mites was 26.10/cm2. A statistically significant correlation was found between Demodex mite positivity and the number of SCA symptom attacks experienced by the patients within the last 1 yr (P ≤ 0.001). No significant relationship was determined between Demodex mite positivity and age or gender (P = 0.56 and P = 0.11, respectively). Demodex mites are seen more often in SCA patients who suffer from a compromised immune system, and the presence of Demodex mites could be a risk factor in the appearance of SCA symptom attacks.
Musculoskeletal findings are common in sickle cell patients and may be confused with inflammatory arthritis. In addition, complications such as frequent infections may create difficulties while ...choosing drugs such as steroids, methotrexate, or antiTNFs. Our aim is to reveal whether the treatment is different in sickle cell patients with rheumatic diseases such as rheumatoid arthritis.
Patients followed by Rheumatology and Hematology divisions of Hatay Mustafa Kemal University Hospital were retrospectively screened. Excluding patients with musculoskeletal findings associated with sickle cell disease (SCD), patients with chronic or acute inflammatory arthritis were enrolled into study. Demographic data, disease activities, the drugs used, frequency of infection, and sickle cell-related crisis before and after rheumatic disease diagnosis-treatment of the patients were examined.
Inflammatory rheumatic disease was detected in 14 of 28 sickle cell patients evaluated in the rheumatology department for musculoskeletal complaints. Twelve of the patients were female and 2 were male. The median duration of rheumatic disease was 27 months (16.5). Eight of these patients had rheumatoid arthritis, 1 had ankylosing spondylitis, reactive arthritis, gout, connective tissue disease, undifferentiated monoarthritis, and 1 patient had undifferentiated oligoarthritis. For rheumatic disease, 11 (78.6%) of the patients were using steroids, 8 (57.1%) hydroxychloroquine, 4 (28.6%) methotrexate and sulfasalazine, 2 (14.3%) leflunomide, 1 (7.1%) anti-TNF (etanercept), and 1 allopurinol and colchicine. The frequency of SCD-related crisis and annual serious infections before and after rheumatic disease treatment were similar (p = 0.31).
The clinical manifestations of inflammatory arthritis such as rheumatoid arthritis and sickle cell disease may overlap. The use of drugs such as steroids, methotrexate, or anti-TNF in sickle cell patients with rheumatic disease is the same as in patients without sickle cell disease. However, treatment should be individualized in patients with complications such as infection.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Thrombotic thrombocytopenic purpura (TTP) develops due to increased von Willebrand factor multimers as a result of a deficiency of the a disintegrin and metalloproteinase with thrombospondin type 1 ...motif, member 13 enzyme. It has two forms; acquired or congenital (hereditary and familial). The initial clinical manifestations of this disease have been defined as a pentad consisting of thrombocytopenia, microangiopathic hemolytic anemia, neurological findings, acute renal failure, and fever. The basis of TTP therapy consists of fresh frozen plasma (FFP) and therapeutic plasma exchange (TPE). Our cases were two patients diagnosed with congenital TTP. Plasma-derived factor 8, which is a Factor VIII concentrate, was administered to these patients at a dose of 30 U/kg/week due to the allergic reactions the patients developed during their FFP and TPE treatments, prevention of exposure to the viral agent and ineffective treatment. After this treatment, laboratory parameters improved in case 1 and clinical improvement was achieved. In case 2, however, the desired level of laboratory parameters could not be reached and no clinical improvement was achieved. Keywords: TTP, plasma-derived factor VIII, ADAMTS-13
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