Browsing by Author "Akpinar S."
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Item The radiologic evaluation of pediatric acute abdomen; results of tertiary referral center(ARSMB-KVBMG, 2015) Yilmaz G.; Pekindil G.; Akpinar S.; Sencan A.; Günsar C.; Mir E.; Özkol M.Purpose: In this study we aimed to evaluate the radiological examinations of the pediatric patients who were operated with initial diagnosis of acute abdomen. Methods: We retrospectively reviewed the clinical records and imaging findings of 252 children. All patients were evaluated by plain abdominal radiographs (PAX) and ultrasonography (US). Only 10 patients were examined using computed tomography (CT). The findings of the PAX, US and CT of each patient were determined from their detailed archive records according to their clinical diagnosis. Results: The most frequent pathology was appendicitis in our study whereas the other pathologies were invagination, ovarian torsion, the complications of Meckel's diverticulum, gastrointestinal obstruction and tuboovarian abscess in decreasing frequency. PAXs were valuable in diagnosis of the patients with ileus. It has been showed that US was the most useful for patients with appendicitis and invagination. CT was performed only in 4% of our cases as an advanced diagnostic method. Conclusion: The pediatric patients with acute abdomen have been evaluated radiologically by PAX and US routinely and frequently. CT was performed as an advanced diagnostic method very rarely. CT would be utilized to a lower extent as a more advanced method of imaging in unsolved patient group, as US and PAX solve the pediatric acute abdominal pathologies in high percentages. © 2015 The Author(s).Item A multicenter experience of thrombotic microangiopathies in Turkey: The Turkish Hematology Research and Education Group (ThREG)-TMA01 study(Elsevier Ltd, 2018) Tekgündüz E.; Yılmaz M.; Erkurt M.A.; Kiki I.; Kaya A.H.; Kaynar L.; Alacacioglu I.; Cetin G.; Ozarslan I.; Kuku I.; Sincan G.; Salim O.; Namdaroglu S.; Karakus A.; Karakus V.; Altuntas F.; Sari I.; Ozet G.; Aydogdu I.; Okan V.; Kaya E.; Yildirim R.; Yildizhan E.; Ozgur G.; Ozcebe O.I.; Payzin B.; Akpinar S.; Demirkan F.Thrombotic microangiopathies (TMAs) are rare, but life-threatening disorders characterized by microangiopathic hemolytic anemia and thrombocytopenia (MAHAT) associated with multiorgan dysfunction as a result of microvascular thrombosis and tissue ischemia. The differentiation of the etiology is of utmost importance as the pathophysiological basis will dictate the choice of appropriate treatment. We retrospectively evaluated 154 (99 females and 55 males) patients who received therapeutic plasma exchange (TPE) due to a presumptive diagnosis of TMA, who had serum ADAMTS13 activity/anti-ADAMTS13 antibody analysis at the time of hospital admission. The median age of the study cohort was 36 (14-84). 67 (43.5%), 32 (20.8%), 27 (17.5%) and 28 (18.2%) patients were diagnosed as thrombotic thrombocytopenic purpura (TTP), infection/complement-associated hemolytic uremic syndrome (IA/CA-HUS), secondary TMA and TMA-not otherwise specified (TMA-NOS), respectively. Patients received a median of 18 (175) plasma volume exchanges for 14 (153) days. 81 (52.6%) patients received concomitant steroid therapy with TPE. Treatment responses could be evaluated in 137 patients. 90 patients (65.7%) achieved clinical remission following TPE, while 47 (34.3%) patients had non-responsive disease. 25 (18.2%) non-responsive patients died during follow-up. Our study present real-life data on the distribution and follow-up of patients with TMAs who were referred to therapeutic apheresis centers for the application of TPE. © 2018 Elsevier LtdItem Prospective registry of adult patients receiving therapeutic plasma exchange with a presumptive diagnosis of thrombotic microangiopathy (TMA): The Turkish hematology research and education group (ThREG)-TMA02 study(Elsevier Ltd, 2022) Akpinar S.; Tekgunduz E.; Esen R.; Yilmaz M.; Karakus V.; Vural F.; Gediz F.; Aydogdu I.; Kaynar L.; Goker H.; Kelkitli E.; Ayyildiz O.; Demirkan F.Thrombotic microanjiopathy (TMA) is a pathological diagnosis characterized by abnormalities of small vessels leading to microvascular thrombosis of arterioles and capillaries. The current prospective, non-interventional, multicenter study aimed to define the distribution of different TMA forms in adult Turkish patients who were referred for therapeutic plasma exchange (TPE) for presumptive diagnosis of TMA. Patients with serum ADAMTS13 activity <5% were diagnosed as having acquired thrombotic thrombocytopenic purpura (aTTP). Patients presenting with ADAMTS13 activity 6–10 % / normal renal function and patients with ADAMTS13 activity >10 %, normal renal function and no secondary TMA were treated as unclassified TMA. The study included a total of 80 patients (women: 50; man: 30) with a median age of 48 (20−74). Detailed evaluation at 1 month after hospital admission revealed aTTP, secondary TMA, infection/complement-associated hemolytic uremic syndrome and unclassified TMA in 29 (36.2 %), 22 (27.5 %), 23 (28.8 %) and 6 (7.5 %) patients respectively. As subclassification of various TMAs will dictate specific therapy, proper diagnosis in a timely manner is of utmost clinical significance. © 2022Item The Real-World Experience With Single Agent Ibrutinib in Relapsed/Refractory CLL(Elsevier Inc., 2022) Akpinar S.; Dogu M.H.; Celik S.; Ekinci O.; Hindilerden I.Y.; Dal M.S.; Davulcu E.A.; Tekinalp A.; Hindilerden F.; Ozcan B.G.; Hacibekiroglu T.; Erkurt M.A.; Bagci M.; Namdaroglu S.; Korkmaz G.; Bilgir O.; Cagliyan G.A.; Ozturk H.B.A.; Serin I.; Tiryaki T.O.; Ozatli D.; Korkmaz S.; Ulas T.; Eser B.; Turgut B.; Altuntas F.Introduction/Background: The emergence of novel agents targeting the B-cell receptor pathway and BCL-2 has significantly changed the therapeutic landscape of CLL. We evaluated the safety and efficacy of single-agent ibrutinib in relapsed/refractory CLL in real-world settings. Patients/Methods: A total of 200 relapsed/refractory CLL patients with a median age of 68 were included in this retrospective, multicenter, non-interventional study. Data of the study were captured from the patient charts of the participating centers. Results: The median for lines of previous chemotherapy was 2 (1-6); 62 (31.8%) patients had del17p and/or p53 mutations (del17p+/p53mut). Of the study group, 146 (75%) patients achieved at least PR, while 16 (8.7%) patients discontinued ibrutinib due to TEA. The most common drug-related adverse events were neutropenia (n: 31; 17.4%) and thrombocytopenia (n: 40; 22.3%), which were ≥ grade 3 in 9 (5%) and 5 (3.9%) patients, respectively. Pneumonia (n: 42; 23.7%) was the most common nonhematologic TEA. Atrial fibrillation (n: 5; 2.8%) and bleeding (n: 11; 6.3%) were relatively rare during the study period. Within a median follow-up period of 17 (1-74) months, 42 (21%) patients died. The estimated median OS of the study cohort was 52 months. Only the response to ibrutinib (CR/PR vs. SD/PD) was significantly associated with OS. Conclusion: Our results indicate good safety and efficacy for single-agent ibrutinib in R/R CLL in daily practice. © 2021 Elsevier Inc.