Yazar "Pocock, Lesley" seçeneğine göre listele

Listeleniyor 1 - 2 / 2
  • [ X ]
    Öğe
    Left renal atrophy in sickle cell diseases
    (Medi+World Int, 2016) Helvaci, Mehmet Rami; Davran, Ramazan; Davarci, Mursel; Muftuoglu, Orhan Ekrem; Pocock, Lesley
    Background: We tried to understand whether or not there is a difference in occurrence of renal atrophy between the left and right sides in sickle cell diseases (SCDs). Methods: All patients with SCDs were enrolled into the study. Results: The study included 311 patients (153 females). There were seven cases (2.2%) with left renal atrophy against one case (0.3%) with right renal atrophy (p<0.001). Associated thalassemias were detected in 44.0% and splenomegaly in 12.5% of the patients. There was digital clubbing in 6.4%, chronic obstructive pulmonary disease in 4.8%, leg ulcers in 12.8%, stroke in 7.0%, chronic renal disease in 8.6%, pulmonary hypertension in 11.8%, cirrhosis in 3.5%, coronary heart disease in 8.0%, and exitus in 5.7% of the patients. Conclusion: Renal atrophy is significantly higher on the left side in SCDs. Splenomegaly induced flow disorders in left renal vessels, structural anomalies of the left renal vein including nutcracker syndrome and passage behind the aorta, and possibly the higher arterial pressure of left kidney due to the shorter distance to heart as an underlying cause of endothelial damage induced atherosclerosis, may be some of the possible causes. Because of the higher prevalences of left varicocele probably due to drainage of left testicular vein into the left renal vein, high prevalences of associated thalassemias with SCDs as a cause of splenomegaly, and tissue ischemia and infarctions induced edematous splenomegaly in early lives of the SCDs cases, splenomegaly induced flow disorders of left renal vein may be the most significant cause among them.
  • [ X ]
    Öğe
    Red blood cell supports in severe clinical conditions in sickle cell diseases
    (Medi+World Int, 2016) Helvaci, Mehmet Rami; Atci, Nesrin; Ayyildiz, Orhan; Muftuoglu, Orhan Ekrem; Pocock, Lesley
    Background: Sickle cell diseases (SCDs) are accelerated atherosclerotic processes. We tried to understand whether or not there is a prolonged survival with the increased number of red blood cells (RBC) transfusion in the SCDs. Methods: As one of the significant endpoints of the SCDs, cases with chronic obstructive pulmonary disease (COPD) and without, were collected into the two groups. Results: The study included 428 patients (221 males). There were 71 patients (16.5%) with COPD. Mean age was significantly higher in the COPD group (32.8 versus 29.8 years, P=0.005). Male ratio was significantly higher in the COPD group, too (78.8% versus 46.2%, P<0.001). Smoking (35.2% versus 11.4%, P<0.001) and alcohol (7.0% versus 1.9%, P<0.01) were also higher among the COPD cases. Beside these, priapism (14.0% versus 3.0%, P<0.001), HCV RNA positivity (2.7% versus 0.5%, P<0.05), cirrhosis (8.4% versus 3.3%, P<0.05), leg ulcers (23.9% versus 12.0%, P<0.01), digital clubbing (25.3% versus 6.7%, P<0.001), coronary heart disease (23.9% versus 13.7%, P<0.05), chronic renal disease (15.4% versus 7.0%, P<0.01), stroke (16.9% versus 8.1%, P<0.01), and mean transfused RBC units in their lives (63.8 versus 33.0, P=0.003) were all higher among the COPD cases. This was probably due to the higher number of transfused RBC units; the mean age of mortality was also higher in the COPD group, significantly (38.3 versus 30.4 years, P=0.04). Conclusion: SCDs are chronic catastrophic processes on vascular endothelium terminating with accelerated atherosclerosis induced endorgan failures in early years of life. RBC supports in severe clinical conditions probably prolong survival of the patients.