Introduction
The development of imatinib as a therapeutic agent targeting BCR-ABL has increased the treatment options for chronic myeloid leukemia (CML) by significantly impacting outcomes, and ...imatinib is recommended by treatment guidelines as the first-line therapy. However, treatment of maternal CML with imatinib during gestation is not recommended because of the potential risk to the fetus.
Materials and methods
We describe the clinical presentation, course and outcome of one pregnant patient with CML who was treated with imatinib. We review all pregnancies associated with imatinib documented in the literature.
Case presentation
A 27-year-old pregnant patient was diagnosed to have Philadelphia chromosome positive chronic phase CML in August 2007. Imatinib was administered (400 mg/day) between the 21st and 39th weeks of gestation. The patient tolerated the drug well and achieved complete hematological and cytogenetic remission. There were no imatinib-related maternal complications during the pregnancy. Fetal growth remained normal as well as amniotic fluid volume estimation. Labor was induced at the 39th gestational week, resulting in the uneventful vaginal delivery of a healthy male infant without any congenital anomaly. Umbilical cord blood and infant peripheral blood were collected at delivery. No postnatal complications occurred; however, imatinib was present in the umbilical cord blood (338 ng/mL) and in the infant’s peripheral blood (478 ng/mL). Breast milk was collected on different postpartum days, and concentrations of imatinib were detected. At 10 months of age, the baby had normal growth and development.
Conclusions
In light of reported cases and our experience, treatment of CML during the second and third trimesters of gestation and breast feeding seems to be safe, but the data are still limited and the effects of chronic exposure of infants to imatinib are not known. We think that each case should be examined and considered independently, and decisions should be individualized.
Abstract Aim Sitagliptin is not associated with weight gain and has neutral effects on body weight. It is unclear whether sitagliptin treatment alters serum ghrelin levels in people with type 2 ...diabetes. Methods Forty-four subjects with type 2 diabetes were randomly assigned to receive sitagliptin or medical nutrition therapy (MNT) for 12 weeks. Changes in anthropometric variables, glycemic control, insulin resistance, lipid parameters, and total ghrelin levels were evaluated at baseline and following 12 weeks of treatment. Results Significant decreases in body weight and body mass index were observed over the entire study period in both treatment groups. Glycosylated hemoglobin and postprandial plasma glucose levels were statistically significant decreased in the groups receiving sitagliptin compared with baseline values ( p = 0.021 and p = 0.021, respectively), while they were unchanged in the groups receiving MNT. There was a significant decrease in total ghrelin in the groups receiving sitagliptin ( p = 0.04) compared with baseline values but not in the groups receiving MNT ( p = 0.46) at the end of the 12 weeks. Conclusions In this study of patients with type 2 diabetes, treatment with sitagliptin was associated with a significant decrease in serum ghrelin levels. These results suggest that the neutral effect of sitagliptin on weight might be associated with the suppression of fasting serum ghrelin levels.
İnvaziv fungal sinüzitler, potansiyel olarak oldukça agresif ve genellikle fatal olarak seyreder. Klasik prezentasyon genellikle nazal mukoza ile birlikte paranazal sinüs ve orbita tutulumu ...şeklindedir. Predispozan faktörler başta diyabet olmak üzere hematolojik maligniteler, desferroksamin kullanımı, immünsupresif ilaç alımı (özellikle steroid), kazanılmış immün yetmezlik sendromu ve intravenöz ilaç kullanımıdır. Son 10 yılda özellikle hematopoietik kök hücre nakli yapılan ve hematolojik malignitesi olan hastalarda bir artış göze çarpmaktadır. Amerika Birleşik Devletleri ve Avrupa kaynaklı yayınlarda Zygomycetes sınıfı ve Aspergillus türü mantarların mevsimsel olarak sıklığının değiştiği de vurgulanmaktadır. Tedavi altta yatan sistemik sorunun düzeltilmesi yanı sıra agresif cerrahi debridman ile sistemik amfoterisin B uygulamasıdır. Bu çalışmada, Ocak 2002?Aralık 2009 arasında Uludağ Üniversitesi İç Hastalıkları Anabilim Dalı Hematoloji Bilim Dalı Kliniği'nde yatarak tedavi gören ve Avrupa Kanser Tedavi ve Araştırma Birliği/Mantar Enfeksiyonları Çalışma Grubu'nun (EORTC/MSG) 2008 fikirbirliği kararlarına göre kanıtlanmış invaziv sinonazal fungal enfeksiyon tanısı konan 37 olgunun özellikleri geriye dönük olarak değerlendirildi. Çalışma periyodu boyunca ikinci periyotta kliniğimize yatan hasta sayıları ile uyumlu olarak sinonazal fungal enfeksiyon sıklığının da artmış olduğu görüldü. Özellikle aspergilloza kıyasla zigomikoz sıklığındaki artışın anlamlı olduğu dikkati çekti. Bu artış yaz mevsiminde daha belirgindi. Bizim sinonazal fungal enfeksiyon sıklığımız literatür verilerinden daha yüksek bulundu. Verilerimize göre, şüpheli klinik bulguların varlığında görüntüleme yöntemleri ve endoskopik müdahelenin ivedilikle birlikte yapılmasının sağkalımı arttırdığı tespit edildi. Sonuç olarak, İnvaziv sinonazal fungal enfeksiyonlar, gelişen tedavi yöntemlerine rağmen hala artan oranlarda görülmeye ve ölümcül olmaya devam etmektedirler. Yeni antifungal tedaviler (vorikonazol, kaspofungin) aspergilloz için umut vaat etseler de, şu an için zigomikozlarda tedavi seçenekleri sınırlıdır.
INTRODUCTION: Invasive fungal infections (IFI) are commonly seen in immunosuppressive patients. Early diagnosis is key to optimizing antifungal treatment success. Betaglucan (BG) assay can detect ...most of the fungal pathogens except mucormycosis and Cryptococcus. In this study we aimed to evaluate the value of BG as a diagnostic tool in patients with hematological malignancy and IFI.METHODS: Forty-six hematological malignancy patients under induction and consolidation chemotherapy that expected to have neutropenia for more than 14 days with no clinical and radiological signs of IFI are included in this study. Blood Galactomannan (GM) and BG levels were measured 2 times in a week during the hospitalization period. Method A (proven + probable groups vs non IFI) and Method B (proven + probable + possible groups vs. non IFI) variables were determined to assess the sensitivity, specifity and predictive values.RESULTS: In method A; BG test's sensitivity, specifity, positive predictive value (PPV), negative predictive value (NPV) was determined as 68.75%, 84.1%, 52.4%, 91.4% respectively. In method B (proven + probable + possible groups vs. non IFI) BG test sensitivity, specifity, PPV, NPV was determined as 60%, 88.9%, 71.4%, and 82.8% respectively.DISCUSSION AND CONCLUSION: Depending on our data and present literature; we conclude that BG and GM is a non-invasive contributory test for the diagnosis of IFI The current treatment of the symptomatic extremity
GİRİŞ ve AMAÇ: İnvaziv fungal enfeksiyonlar (IFE) sıklıkla immün süpresif hastalarda görülmektedir. Antifungal tedavi başarısı için erken tanı anahtar öneme sahiptir. Betaglucan (BG) testi mucormikoz ve kriptokoklar dışında birçok mantar patojeni tespit edebilir. Bu çalışmada betaglucan düzeyinin hematolojik kanserli ve IFE'li hastalarda tanısal bir araç olarak değerlendirmeyi amaçladık.YÖNTEM ve GEREÇLER: Indüksiyon veya konsolidasyon tedavisi alan, klinik ve radyolojik IFE bulguları olmayan 14 günden uzun süreli nötropeni beklentisi olan 46 hasta çalışmaya dahil edildi. Hastanede yattıkları süre içerisinde haftada 2 defa kan galaktmannan (GM) ve BG düzeyleri ölçüldü. Sensitivite, spesifite ve öngörğlen değerlerin yorumlanması için Metod A (kanıtlanmış + muhtemel grup vs non-IFE) ve Metod B (kanıtlanmış + muhtemel +olası grup vs non-IFE ) değişkenleri tanımlandı.BULGULAR: Metod A'da; BG testinin sensitivitesi, spesifitesi, pozitif öngörülen değer (PÖD), Negatif öngörülen değer (NÖD) sırasıyla %68.75, %84.1, %52.4, %91.4 olarak tespit edildi. Metod B'de; BG testinin sensitivitesi, spesifitesi, PÖD, NÖD sırasıyla %60, %88.9, %71.4, %82.8 olarak tespit edildi.Hiçbir hastada ameliyat içi istenmeyen durum olmadı. Cerrahi gruptaki 3 hastaya embolizasyon uygulandı. Postoperatif takiplerde 1 hastada enfeksiyon, 2 hastada nüks saptandı.TARTIŞMA ve SONUÇ: Bizim verilerimiz ve mevcut literature dayanarak BG ve GM'nin IFE tanısına katkı sağlayan non-invaziv test olduğu sonucuna vardık.
Changes in olive properties and oil quality, oxidative stability, phenolic and chemical composition of two common Turkish varieties (Memecik and Edremit) during maturation were investigated. Olive ...samples were collected in their own growing region for five different harvest dates and processed to oil with a laboratory scale mill. Metabolic behaviors of these two varieties along with the maturation were different in terms of some compositional parameters. Oleic acid, triolein, β-sitosterol, oleuropein, hydroxytyrosol, and tyrosol contents of olive or olive oils fluctuated with maturation. However, changes in average weight, flesh/pit ratio, water and oil contents of the olives were observed. Phenolics such as trans cinnamic acid contents of both olive fruits decreased whereas cyanidin 3-O-glucoside and cyanidin 3-O-rutinoside anthocyanins increased. Free fatty acids of virgin olive oils were found independent of maturity although some slight changes were determined in peroxide value, dien and trien conjugations. Some compositional parameters such as pigment concentration, tocopherols, stearic acid, linolenic acid, palmitodiolein and monounsaturated/polyunsaturated fatty acid ratio decreased while linoleic acid, dioleolinolein, palmitooleolinolein and Δ-5-avenasterol percentages increased with the maturation. A clear discrimination was observed with principal component analysis. The data obtained can also be considered useful for providing information to determine the ideal maturity stage.
Abstract This is the first comprehensive study of the eclipsing binaries V527 Dra and V2846 Cyg, based on radial velocities and ground- and space-based light curves. We perform detailed modeling of ...these data to derive the absolute parameters and the orbital properties of the two systems. V527 Dra is found to be a semi-detached, and V2846 Cyg a contact binary. Both show continual out-of-eclipse variations that can be explained by migrating dark spots of magnetic origin. We also perform the eclipse timing variation (ETV) analysis which reveals that V527 Dra has a tertiary companion whose mass (∼1M⊙) and orbital inclination (∼70○) are additionally constrained by radial velocities. The ETV diagram of V2846 Cyg displays a quadratic trend accompanied by a low-amplitude cyclic variation, likely due to a magnetic cycle, although further eclipse times are needed to provide a clearer explanation. Lastly, we demonstrate a correlation between the variations in spot parameters obtained via light curve modeling for individual orbital cycles and the residual ETVs, essentially confirming the assumption of magnetic activity in both systems.
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