Browsing by Author "Bilgir O."

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    Sarcoidosis with systemic hypertension: Case report
    (2012) Bilgir O.; Bilgir F.; Çalan M.; Balikçi O.; Canbolat S.; Oztekin O.
    Sarcoidosis, which occurs often with the lung involvement and causes significant morbidity, is a multisystem granulomatous disease. This disease manifests itself with signs, and symptoms of neurological disease such as uveitis, blindness or end-stage pulmonary fibrosis, pulmonary hypertension, dysrhythmias, cardiomyopathy, hypercalcemia and renal insufficiency. However, systemic hypertension secondary to hypercalcemia is very rare. We present a 29-year old male patient admitted to the emergency service with complaints of headache and nausea. His arterial blood pressure and calcium level were 220/110 mmHg, and 17.4 mgldl, respectively, and histopathological evaluation after splenectomy confirmed the diagnosis of sarcoidosis..
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    The levels of adhesion molecules in essential thrombocythemia.
    (2013) Bilgir F.; Bilgir O.; Calan M.; Sari F.
    It is known that thrombocytosis is closely related to vascular complications and particularly thrombosis in essential thrombocytemia (ET) cases. The aim of this study is to investigate a possible correlation between adhesion molecules and vascular attacks as well as the relation of these molecules to the platelet count. The study group consisted of 30 ET patients and 30 healthy controls subjects. Serum intracellular adhesion molecule-1 (ICAM-1), serum vascular adhesion molecule-1 (VCAM-1) and serum E-selectin levels were determined by ELISA method according to manufacturer's instructions. There were no significant differences between two groups with respect to levels of sICAM-1 and sE-selectin (P>0.05). The VCAM-1 levels and platelets were significantly higher in patients with ET compared to controls (P=0.000). Spearman's correlation analysis revealed that sVCAM-1 levels were correlated with platelet counts (r=0.574, P<0.001) CONCLUSION: High VCAM-1 level in ET and its correlation with the platelet count suggest that these may be a factor in vascular complications and thrombocytosis.
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    An experience with plasma exhcange treatment of acute lymphoblastic leukemia in a case with fulminant hepatitis related to l-asparaginase
    (2013) Bilgir O.; Calan M.; Bilgir F.; Cagliyan G.; Arslan O.
    Acute lymphoblastic leukemia (ALL) is a malignant disorder resulting from the clonal proliferation of lymphoid precursors with arrested maturation. l-asparaginase is commonly used in combination chemotherapy of both pediatric and adult acute lymphoblastic leukemias. The most commonly encountered side effects of l-asparaginase are hypersensitivity reactions like pyrexia, urticaria, skin rash, and respiratory distress. There are also other side effects like anaphylaxis, coagulopathy, pancreatitis, thrombosis, and hepatic toxicity. Plasmapheresis can sometimes be appropriate to manage an overdose of drugs that circulate in the plasma compartment. We have reported plasmapheresis treatment of fulminant hepatitis in a patient with ALL after l-asparaginase treatment. © 2013 Elsevier Ltd.
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    Changes in the levels of endothelium-derived coagulation parameters in nonalcoholic fatty liver disease
    (2014) Bilgir O.; Bilgir F.; Bozkaya G.; Calan M.
    In a majority of patients with nonalcoholic fatty liver disease (NAFLD), cardiovascular risk factors including diabetes mellitus type 2, abdominal obesity, and metabolic syndrome are present. The purpose of this study is to investigate the presence of endothelial injury and the changes in coagulation parameters in NAFLD patients. For this purpose, plasma levels of von Willebrand factor (vWF), thrombomodulin, urokinase plasminogen activator (uPA), plasminogen activator inhibitor-1 (PAI-1), and tissue factor pathway inhibitor (TFPI) in patients with NAFLD were measured. There was a significant difference in vWF and TFPI levels between patient and control groups (P<0.05). However, no statistically significant difference was obtained in PAI-1, uPA, and thrombomodulin levels between the two groups (P>0.05). According to our results, an increase in vWF and TFPI levels indicates an endothelial injury in NAFLD cases. © 2014 Wolters Kluwer Health.
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    Comparison of high-sensitivity C-reactive protein and fetuin-A levels before and after treatment for subjects with subclinical hyperthyroidism
    (Humana Press Inc., 2014) Bilgir O.; Bilgir F.; Topcuoglu T.; Calan M.; Calan O.
    This study was designed to show the effect of propylthiouracil treatment on sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels on subjects with subclinical hyperthyroidism. After checking sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels of 35 patients with subclinical hyperthyroidism, each was given 50 mg tablets of propylthiouracil three times daily. After 3 months, sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels were then compared to the levels before treatment. Although high-sensitivity C-reactive protein and sCD40L levels were normal in the subclinical hyperthyroidism patients compared to the healthy controls, fetuin-A levels were statistically significantly higher (*p = 0.022). After treatment, fetuin-A levels of subclinical hyperthyroidism patients decreased statistically significantly compared to the levels before treatment (**p = 0.026). sCD40L and high-sensitivity C-reactive protein levels did not have a statistically significant difference compared to the control group and post-propylthiouracil treatment. In subclinical hyperthyroidism patients, high fetuin-A levels before propylthiouracil treatment and decreases in these levels after treatment in cases with subclinical hyperthyroidism indicated the possibility of preventing long-term cardiac complications with propylthiouracil treatment. © 2013 Springer Science+Business Media New York.
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    Subclinical hypothyroidism: Comparison of adhesion molecule levels before and after levothyroxine therapy
    (SAGE Publications Ltd, 2014) Bilgir F.; Bilgir O.; Calan M.; Calan O.; Isikyakar T.
    Objective: Adhesion molecules are involved in inflammation, atherosclerosis and malignancy. This study measured levels of adhesion molecules before and after levothyroxine therapy in patients with subclinical hypothyroidism (SHO). Methods: Levels of soluble (s) intracellular adhesion molecule (ICAM)-1, s vascular cell adhesion molecule (sVCAM) VCAM-1 and sE-selectin were analysed in patients diagnosed with SHO, prior to administration of 50 mg/day levothyroxine orally for 3 months. Subsequently, levels of sICAM-1, sVCAM-1 and sE-selectin were reanalysed then compared with the pretreatment levels. Results: In 30 patients with SHO, levels of sICAM-1 were found to be significantly higher than those in healthy controls, (P=0.001). Post-treatment sICAM-1 levels were significantly lower than pretreatment levels (P=0.001). No significant differences were found in sVCAM-1 or sE-selectin levels between healthy controls and patients with SHO before treatment, or between patients with SHO pre- and post-treatment. Conclusions: Patients with SHO had significantly higher levels of sICAM-1 compared with controls. Levels became normal after treatment with levothyroxine. These findings emphasize the need for levothyroxine therapy in cases of SHO to normalize sICAM-1 levels. Such treatment helps to prevent the future development of atherosclerosis or cancer. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
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    Determination of the relationship between mortality and SOFA, qSOFA, MASCC scores in febrile neutropenic patients monitored in the intensive care unit
    (Springer Science and Business Media Deutschland GmbH, 2021) Cetintepe T.; Cetintepe L.; Solmaz S.; Calık S.; Ugur M.C.; Gediz F.; Bilgir O.
    Purpose: Febrile neutropenia (FN) is a hematological emergency. It is challenging and confusing for the clinicians to make the decision of the febrile neutropenic patients under chemotherapy to be monitored at intensive care unit (ICU). The aim of this study was to define the factors supporting decision-making for the critical patients with febrile neutropenia. Methods: The data of 60 patients, who were taken to the ICU while they were under treatment in the Hematology Clinic with a diagnosis of febrile neutropenia, were analyzed retrospectively, in order to identify clinically useful prognostic parameters. Results: The ICU mortality rate was 80%. Mortality was significantly associated with higher sequential organ failure assessment score (SOFA), quick sequential organ failure assessment score (qSOFA), and hematological SOFA (SOFAhem) scores on admission. All cases having SOFA score 10 and above and qSOFA score 2 and above died. In multivariate analysis, qSOFA score was found to be statistically significant in predicting mortality in regard to ICU admission (p = 0.004). Conclusion: Mortality of febrile neutropenic patients admitted to ICU is high. It would be appropriate to determine the extent of organ dysfunction instead of underlying disease, for making the decision of ICU admission. It should be noticed that the risk mortality is high for the FN cases with SOFA score 10 or above, qSOFA score 2 or above, and in need of mechanical ventilation and positive inotropic support; hence, early intervention is recommended. In our study, the most significant parameter in predicting ICU mortality was found to be qSOFA. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.
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    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.