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Öğe Acquired Inhibitors to Coagulation Factors in a Male Patient with Systemic Lupus Erythematosus: A Case Report and Review of the Literature(Akad Doktorlar Yayinevi, 2012) Erdem, Ozgur; Ayyildiz, Orhan; Aybak, MehmetAcquired coagulation inhibitors are rare but acquired bleeding diathesis caused by autoimmune depletion or dysfunction of coagulation factors can be life-threatening. This occurs most frequently in elderly patients who lack disease associations. Acquired coagulation inhibitors may also arise in association with systemic lupus erythematosus (SLE). The groups of patients who suffer from SLE most frequently are women in their 2nd to 4th decade. In this case, we present a 22-year-old man with systemic lupus erythematosus who developed an acquired inhibitory to factor II, VIII, IX, X and von Willebrand factor (vWF).Öğe Aggressive natural killer cell leukemia in a patient with common variable immunodeficiency syndrome(Parthenon Publishing Group, 2006) Ayyildiz, Orhan; Altintas, Abdullah; Isikdogan, Abdurrahman; Tuzcu, Alpaslan[Abstract Not Available]Öğe Analysis of thrombophilic genetic mutations in patients with Sheehan's syndrome: is thrombophilia responsible for the pathogenesis of Sheehan's syndrome?(Springer, 2011) Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Ayyildiz, Orhan; Yurt, Murat; Celik, Yusuf; Alpagat, GulistanThe gene mutations of Factor V R506Q (FV-Leiden), prothrombin (FII G20210A), methylene tetrahydrofolate reductase (MTHFR) C677T and A1298C and PAI-1 4G/5G are well-established risk factors for thrombosis. We aimed to investigate the prevalence of these gene mutations and their possible impact on the development of pathogenesis in patients with Sheehan's syndrome (SS). 40 female patients with SS compared to a control group of 45 healthy women. The presence of FV-Leiden, FII G20210A, MTHFR C677T, MTHFR A1298C and PAI-1 4G/5G gene mutations were assessed by polymerase chain reaction analysis with a light cycler analyzer. An odds ratio of greater than one is considered to increase the risk of SS disease as found in Factor V Leiden, FII G20210A, MTHFR C677T, MTHFR A1298C and PAI-1 4G/5G polymorphism, as follows respectively: 1.13, 1.85, 6.00, 8.14 and 1.45. MTHFR C677T and MTHFR A1298C polymorphism were found significantly higher in SS patients than the control group (P < 0.001), however FV-Leiden, FII G20210A and PAI-1 4G/5G polymorphism showed no significant difference (P > 0.05). The level of plasma total homocysteine (tHcy) was significantly higher in patients with SS than in the control group (P < 0.001). We suggest that the genetic mutations of FV-Leiden, FII G20210A, MTHFR C677T, MTHFR A1298C and PAI-1 4G/5G increase the risk of SS. Also, high plasma tHcy levels may be a risk factor for the development of SS.Öğe Assessment of bleeding disorders in Sheehan's syndrome: Are bleeding disorders the underlying cause of Sheehan's syndrome??(Informa Healthcare, 2011) Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Ayyildiz, Orhan; Erdemoglu, Mahmut; Alpagat, GulistanSheehan's syndrome (SS) is an adenopituitary insufficiency caused by hypovolemia secondary to excessive blood loss during or after childbirth. However, the mechanism of postpartum hemorrhage and ischemia is not clear. We aimed to evaluate the bleeding disorders among patients with SS, in comparison with healthy controls. In addition, we investigated underlying causes in postpartum hemorrhage that begin the event. The present study was conducted at the Dicle University School of Medicine. Forty-eight patients with SS and 50 age-matched female healthy controls were included. Biochemical and hormonal variables were measured, as was platelet function by means of closure times (PFA-100 testing using collagen plus epinephrine and collagen plus ADP), von Willebrand factor (vWF) level, prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR), and coagulation factors. Although PT and INR were significantly higher in patients with SS (both P < 0.01), aPTT and levels of fibrinogen, vWF, and factors II, V, VII, VIII, IX, X, XI, and XII did not differ significantly. Closure times with collagen/epinephrine and collagen/ADP also did not differ significantly between patients with SS and control patients. The nonspecific etiology and presence of excessive postpartum hemorrhage in patients with SS suggest that coagulation disorders may play a role in their predisposition to bleeding. The increased PT and INR noted might implicate bleeding diathesis as the underlying etiology, although no significant decreases were noted in factor levels. Further studies are needed to elucidate this complex mechanism of this disorder.Öğe Cancer and thrombotic thrombocytopenic purpura(Ortadogu Ad Pres & Publ Co, 2008) Altintas, Abdullah; Cil, Timucin; Atay, A. Engin; Kaplan, M. Ali; Isikdogan, Abdurrahman; Ayyildiz, OrhanThrombotic thrombocytopenic purpura (TTP) is a rare and fatal disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurologic disorder, renal function deterioration and fever. TTP may be idiopathic or secondary to autoimmune diseases, drugs, cancer and infections. Clinical findings of TTP are also present in cancer patients with disseminated intravascular coagulation and sepsis. TTP must be considered in the differential diagnosis in the case of concurrent microangiopathic hemolytic anemia and thrombocytopenia with or without leukoerythroblastic blood smear in cancer patients. Here we presented two patients who were followed up in our clinic with TTP secondary to metastatic breast cancer.Öğe A case of essential mixed cryoglobulinemia and associated acquired von-Willebrand disease treated with rituximab(Springer, 2009) Pasa, Semir; Altintas, Abdullah; Cil, Timucin; Danis, Ramazan; Ayyildiz, Orhan; Muftuoglu, EkremCurrent treatment options of essential mixed cryoglobulinemia (EMC); include immunosuppressive approaches, such as corticosteroids, cyclophosphamide, plasma exchange, other cytotoxic drugs in moderate to severe manifestations. Some controlled studies have been carried out to assess the efficacy of anti-CD20 monoclonal antibody, rituximab in patients with hepatitis C (HCV) related cryoglobulinemia (CG) and in patients with autoimmune disorders. Recent trials and some case reports demonstrate a beneficial role for rituximab in HCV related mixed CG. Although, the published evidence for treatment of EMC with rituximab is restricted to case reports, which have shown positive results. Several diseases include lymphoproliferative and myeloproliferative disorders, solid tumors, immunological disorders, cardiovascular disorders and some drugs associated with acquired von Willebrand disease (avWD). CG, which is a kind of immune complex disease, may be related with development of autoantibodies to various autoantigens. In this present case report, we showed the efficacy of rituximab in a 21-year-old female patient, suffered from neuropathy and arthralgia related with EMC, and developed avWD, presented with mucosal bleeding associated with CG. von Willebrand factor activity of our patient also increased with controlling the underlying disease, EMC by rituximab. This case demonstrate that rituximab may be an effective treatment option in EMC and avWD mainly related to CG.Öğe A Case of Polycythemia Vera Accompanied with Neurofibromatosis Type 1(Akad Doktorlar Yayinevi, 2010) Pasa, Semir; Altintas, Abdullah; Bayan, Kadim; Tuzun, Yekta; Cil, Timucin; Ayyildiz, OrhanClassical myelofibrosis syndromes (MPS) most frequently occur in adults, but MPS unique to childhood also exist. Such syndromes include juvenile chronic myelomonocytic leukemia (JMML), the MPS of monosomy 7 in childhood, familial chronic myeloid leukemia (CML), the transient MPS of infants with trisomy 21, and childhood forms of myelofibrosis. Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder with pigmentary abnormalities and are predisposed to benign and malignant neoplasms, mostly in children. MPSs were disproportionately common among children with NF1. Herein we reported a case of polycythemia vera (PV) accompanied to NF1 in an adult patient. The co-existance of NF1 and childhood MPS is a well known condition. The same relation was not demonstrated in adulthood NF1 patients according to our screening of the literature. Most of the reported cases were define a relation with JMML and monosomy 7 syndrome. Probably this is the first case of PV, a type of classic adult MPS accompanied to NF1.Öğe Central nervous system blastic crisis in chronic myeloid leukemia on imatinib mesylate therapy: a case report(Springer, 2007) Altintas, Abdullah; Cil, Timucin; Kilinc, Ilhan; Kaplan, Muhammet Ali; Ayyildiz, OrhanChronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by a reciprocal translocation between chromosomes 9 and 22. Imatinib mesylate is a potent and selective inhibitory of the BCR/ABL tyrosine kinase. Imatinib is a first choice of treatment of chronic phase CML. It has also shown activity in patients with CML in accelerated or blastic phases. However, the penetration of the drug and its active metabolites into the central nervous system (CNS) is poor. Therefore, the CNS is sanctuary site for malignant cells in patients treated with imatinib. Herein, we report a patient with CML in accelerated phase that developed central nervous system disease while on imatinib mesylate therapy.Öğe Clinical characteristics and therapeutic outcomes of elderly patients with chronic myeloid leukemia: A retrospective multicenter study(Wiley, 2015) Korkmaz, Serdal; Dal, Mehmet Sinan; Berber, Ilhami; Sahin, Deniz Goren; Dogu, Mehmet Hilmi; Ayyildiz, Orhan; Nizam, IlknurAimsWe aimed to investigate whether older age leads to limitations in the starting dose of imatinib in daily treatment of chronic myeloid leukemia, and to determine the compliance of elderly patients with tyrosine kinase inhibitors (TKI) therapy. MethodsData including the clinical characteristics, therapeutic outcomes and compliance with TKI therapy of elderly patients with chronic myeloid leukemia aged >65years were collected from 13 institutions in Turkey, retrospectively. ResultsA total of 69 patients (27 [39%] men, 42 [61%] women) were evaluated retrospectively. The median age of the patients was 71years (range 66-85years). Of the patients, 66 (96%) were in the chronic phase and three (4.3%) were in the accelerated phase when diagnosed. A total of 63 (91.3%) patients were receiving imatinib as the first-line therapy. The initial dose of imatinib was 400mg/day in 59 patients (93.6%). Imatinib treatment induced 57 (90.5%) complete hematological responses at 3months, 29 (46%) complete cytogenetic responses at 6months and 49 (77.7%) major molecular responses at 12months. As a result, nilotinib and dasatinib were used in 14 patients as second-line therapy. Second-line TKI induced nine complete hematological responses (64.3%) at 3months, four complete cytogenetic responses (28.6%) at 12months and seven major molecular responses (50%) at 18months. A total of 56 of the patients (81.2%) are still alive. The median overall survival and progression-free survival rates were 35months (range 1-95months) and 17months (range 0.8-95months), respectively. ConclusionElderly patients should receive TKI according to the same guidelines that apply to younger patients. Geriatr Gerontol Int 2015; 15: 729-735.Öğe The clinical characteristics and therapeutic outcomes of elderly patients with chronic myeloid leukemia: A retrospective multicenter study.(Lippincott Williams & Wilkins, 2014) Korkmaz, Serdal; Dal, Mehmet Sinan; Berber, Ilhami; Sahin, Deniz Goren; Dogu, Mehmet Hilmi; Ayyildiz, Orhan; Nizam, Ilknur[Abstract Not Available]Öğe Clinical characteristics of gastrointestinal stromal tumors in southeast region of Turkey(Oxford Univ Press, 2006) Cil, Timucin; Altintas, Abdullah; Kaplan, Mehmet A.; Ayyildiz, Orhan; Sayar, Suleyman; Akgun, Yilmaz; Isikdogan, Abdurrahman[Abstract Not Available]Öğe Clinical outcome of patients with hairy cell leukemia(Oxford Univ Press, 2006) Altintas, Abdullah; Cil, Timucin; Ayyildiz, Orhan; Atay, Ahmet E.; Kaplan, Mehmet A.; Isikdogan, Abdurrahman; Muftuoglu, Ekrem[Abstract Not Available]Öğe Disturbances of hematologic malignancies between 1995-2005: A single center experience from southeastern region of Turkey(Elsevier, 2006) Altintas, Abdullah; Kaplan, Mehmet Ali; Cil, Timucin; Atay, Ahmet Engin; Isikdogan, Abdurrahman; Ayyildiz, Orhan; Muftuoglu, Ekrem[Abstract Not Available]Öğe The efficacy of rituximab in patients with splenectomized refractory chronic idiopathic thrombocythopenic purpura(Springer, 2009) Pasa, Semir; Altintas, Abdullah; Cil, Timucin; Danis, Ramazan; Ayyildiz, OrhanThe most difficult problem a physician encounters is the management of patients with idiopathic thrombocytopenic purpura (ITP), who has persistent severe thrombocytopenia after failure of initial treatment with glucocorticoids and splenectomy. Most of the patients refractory to corticosteroids and splenectomy will become refractory to other available agents, such as intravenous immunoglobulin (IVIg), danazol or chemotherapy. In this study, we investigated the effect of rituximab on 17 splenectomized refractory chronic ITP patients. Here, we showed that the anti-CD20 antibody, rituximab, induces a clinically significant response in severe chronic ITP patients, who are unresponsive to other therapeutic options. After sixth month, 10 out of 14 responders were still maintaining their durable and significant platelet responses (platelet counts > 50 x 10(9)/l), without requirement to any other ITP medication. Therefore, we suggest that, rituximab is an effective treatment option in splenectomized refractory or relapsed ITP patients. Rituximab was well tolerated without severe side effects.Öğe Eosinophilia and related hematological disorders(Ortadogu Ad Pres & Publ Co, 2007) Altintas, Abdullah; Oezmen, Sehmus; Ayyildiz, OrhanEosinophilia is defined by an eosinophile count of >600/mm(3); it may be primary or secondary due to the underlying cause. End-organ damage may develop in familial form as well as primary or secondary eosinophilia and it may also develop regardless of a specific cause in severe or mild eosinophilia;. Recently, the pathogenesis of clonal hypereosinophilia is well recognized and different variants are defined.Öğe Factor V Leiden and G20210A prothrombin mutations in patients with recurrent pregnancy loss: data from the southeast of Turkey(Springer, 2007) Altintas, Abdullah; Pasa, Semir; Akdeniz, Nurten; Cil, Timucin; Yurt, Murat; Ayyildiz, Orhan; Batun, SabriFactor V Leiden (FV-Leiden) and prothrombin gene mutations (FII G20210A) are well-established independent risk factors for thrombosis. In the recent years, many studies have suggested that these mutations are associated with an increased risk of recurrent pregnancy loss (RPL). We aimed to investigate the prevalence of these molecular defects in subjects with a history of early RPL. One hundred and fourteen women with three or more consecutive unexplained first-trimester miscarriages were compared to 185 parous women with uncomplicated pregnancies from the same ethnic origin. The presence of FV-Leiden and FII G20210A mutations was assessed by polymerase chain reaction analysis. Overall, 11 out of the 114 women with early RPL (9.6%) had either FV-Leiden or FII G20210A mutation, as compared with 16 out of the 185 women with normal pregnancies (8.6%; p=0.756). The prevalence of FV-Leiden mutation was 7.9% (9/114) in patient group, compared with 7% (13/185) in control group (p=0.780). One hundred and two patients were primary and 12 were secondary aborters. All FV-Leiden positive cases were primary aborters (8.8%; 9/102, p=0.584). Concerning the FII G20210A, two out of 114 (1.7%) were first-trimester RPL (primary aborters) and three out of 185 (1.6%) controls were carriers of the FII G20210A mutation (1.7 vs 1.6%, p=0.931). The results obtained from patients with first-trimester RPL and the control group have no statistical significant differences in the prevalence of FV-Leiden and FII G20210A mutations. These results suggest that mutations have no role in etiology of first-trimester recurrent abortions.Öğe Familial Mediterranean fever accompanied by ankylosing spondylitis: Case report(Ortadogu Ad Pres & Publ Co, 2008) Altintas, Abdullah; Pasa, Semir; Cil, Timucin; Ayyildiz, OrhanArthritis is the second most common form of familial Mediterranean fever (FMF) attacks; lower extremity joints, such as knees and ankles, are frequent involvement sites for FMF. Sacroiliitis and spinal involvement is the hallmark of ankylosing spondylitis (AS) and a possible but infrequent feature of FMF. About 10% of the patients experience protracted attacks, usually knees or hips are involved, but sacroiliitis occurs only in 2%. We present and discuss a rare case of FMF accompanying to AS. The diagnosis of FMF must be made on clinical grounds. The combination of irregularly recurrent attacks comprising short, febrile episodes of abdominal pain, pleuritic chest pain or arthritis in children or young adults are the main features of diagnosis. FMF should be considered in the differential diagnosis in patients with inflammatory involvement of the lumbar spine and arthritis in the knees or ankles.Öğe Fetal Loss in a Patient with Acute Myeloblastic Leukemia Associated with FLAG-IDA Regime(Akad Doktorlar Yayinevi, 2009) Pasa, Semir; Altintas, Abdullah; Cil, Timucin; Ayyildiz, OrhanAcute leukemia in pregnancy offers a unique management dilemma in the absence of clear guidelines. There is some transporters localized into the placental trophoblasts plays an important role in limiting the passage of substrate drug. Herein, we reported a case of fetal loss in a pregnant patient in 34 gestational weeks, with acute myeloblastic leukemia who treated with high dose cytarabine plus fludarabine chemotherapy, to discuss the effects of cytotoxic agent on fetus. There were many reports about pregnancies complicated with AML treated with standart dose cytosine arabinoside and antracyclin combination. We suggest that high dose chemotherapy, mainly FLAG-IDA regime may cause fetal death, although in nearby term periods. Understanding the role of drug transporters in moderating transplacental passage of substrates has important clinical implications for choosing specific drugs to achieve therapeutic objectives.Öğe Gender differences in severity of sickle cell diseases in non-smokers(Professional Medical Publications, 2013) Helvaci, Mehmet Rami; Ayyildiz, Orhan; Gundogdu, MehmetObjective: To find out gender differences in severity of sickle cell diseases (SCDs) in non-smokers. Methods: Three groups of SCDs patients on the basis of red blood cell (RBC) transfusions were included. Less than 10 units in their lives were kept in Group-1, Ten units of higher in Group-2 and 50 units or higher as the Third Group. Patients with a history of using one pack of cigarettes -year or above were excluded. Results: The study included 269 patients. Mean ages of the groups were similar (28.4, 28.5, and 28.9 years, respectively). Prevalences of cases without any RBC transfusion in their lives were 7.2% and 3.7% in females and males, respectively (p < 0.05). Prevalences of cases without any painful crisis were 13.8% and 6.0% in females and males, respectively (p < 0.001). There was progressive increase according to mean painful crises, clubbing, chronic obstructive pulmonary disease (COPD), leg ulcers, stroke, chronic renal disease (CRD), pulmonary hypertension, and male ratio from the first towards the third groups (p < 0.05, nearly for all). Mean ages of mortal cases were 29.1 and 26.2 years in females and males, respectively (p > 0.05). Conclusion: The higher painful crises per year, digital clubbing, COPD, leg ulcers, stroke, CRD, pulmonary hypertension, and male ratio of the third group, lower male ratio of patients without any RBC transfusion, lower male ratio of patients without any painful crisis, lower mean ages of male SCDs patients with mortality, and longer overall survival of females in the world could not be explained by well known strong atherosclerotic effects of smoking alone, instead it may be explained by the dominant role of male sex in life.Öğe Hepatitis C virus in patients with non-Hodgkin's lymphoma in southeastern region of Turkey(Elsevier, 2006) Altintas, Abdullah; Cil, Timucin; Kaplan, Mehmet A.; Atay, Ahmet E.; Isikdogan, Abdurrahman; Ayyildiz, Orhan; Muftuoglu, Ekrem[Abstract Not Available]
