Browsing by Author "Gediz, F"
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Item Determination of the relationship between mortality and SOFA, qSOFA, MASCC scores in febrile neutropenic patients monitored in the intensive care unitCetintepe, T; Cetintepe, L; Solmaz, S; Calik, S; Ugur, MC; Gediz, F; Bilgir, OPurpose 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.Item The Effect of Cryotherapy on the Prevention of Oral Mucositis and on the Oral pH Value in Multiple Myeloma Patients Undergoing Autologous Stem Cell TransplantationBaysal, E; Sari, D; Vural, F; Cagirgan, S; Saydam, G; Töbü, M; Sahin, F; Soyer, N; Gediz, F; Acarlar, C; Timur, E; Güngör, AObjective: The aim of this study was to evaluate the effectiveness of cryotherapy on the prevention of oral mucositis (OM) and on the oral pH value in patients with multiple myeloma undergoing autologous stem cell transplantation. Data Sources: This nonrandomized controlled clinical trial was carried out in Bone Marrow Transplant Centers of three hospitals with total 32 patients. In addition to standard oral care, a total of 80 minutes of cryotherapy was applied to the experimental group. OM was assessed according to the World Health Organization's Oral Toxicity Scale before chemotherapy and for 21 days after chemotherapy (every day in the first 14 days, then every other day until the 21st day [if not discharged]). Conclusion: According to the findings, cryotherapy did not change the incidence of oral OM, and neither affected the severity of nor decreased the duration of it. Oral pH value was found to be significantly different between the patient groups only before and 1 day after chemotherapy. Implications for Nursing Practice: Cryotherapy is an inexpensive, easy-to-use method with no side effects; it would be beneficial to continue cryotherapy to prevent the development of OM in patients with cancer receiving drugs with a short half-life such as melphalan. It is also recommended to conduct further studies with different chemotherapy drugs with short half-lives to determine its effect on the prevention of OM development. (c) 2021 Elsevier Inc. All rights reserved.Item Efficacy and safety of ruxolitinib in patients with myelofibrosis: a retrospective and multicenter experience in TurkeySoyer, N; Ali, R; Turgut, M; Haznedaroglu, IC; Yilmaz, F; Aydogdu, I; Pir, A; Karakus, V; Özgür, G; Kis, C; Ceran, F; Ilhan, G; Özkan, M; Aslaner, M; Ince, I; Yavasoglu, I; Gediz, F; Sönmez, M; Güvenç, B; Özet, G; Kaya, E; Vural, F; Sahin, F; Töbü, M; Durusoy, R; Saydam, GBackground/aim: The aim of this study is to assess the efficacy and safety of ruxolitinib in patients with myelofibrosis. Materials and methods: From 15 centers, 176 patients (53.4% male, 46.6% female) were retrospectively evaluated. Results: The median age at ruxolitinib initiation was 62 (28-87) and 100 (56.8%) of all were diagnosed as PMF. Constitutional symptoms were observed in 84.7%. The median initiation dose of ruxolitinib was 30 mg (10-40). Dose change was made in 69 (39.2%) patients. Forty seven (35.6%) and 20 (15.2%) of 132 patients had hematological and nonhematological adverse events, respectively. The mean spleen sizes before and after ruxolitinib treatment were 219.67 +/- 46.79 mm versus 199.49 +/- 40.95 mm, respectively (p < 0.001). There was no correlation between baseline features and subsequent spleen response. Overall survival at 1-year was 89.5% and the median follow up was 10 (1-55) months. We could not show any relationship between survival and reduction in spleen size (p = 0.73). Conclusion: We found ruxolitinib to be safe, well tolerated, and effective in real-life clinical practice in Turkey. Ruxolitinib dose titration can provide better responses in terms of not only clinical benefit but also for long term of ruxolitinib treatment.Item 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 studyAkpinar, S; Tekgunduz, E; Esen, R; Yilmaz, M; Karakus, V; Vural, F; Gediz, F; Aydogdu, I; Kaynar, L; Goker, H; Kelkitli, E; Ayyildiz, O; Demirkan, FTo understand who uses social media and how often they do so, we examined the personality traits that predict frequency of using a set of 10 different types of social media (e.g., social networks, blogs, virtual worlds). Using survey data collected from two large-scale samples of young adults (Exploratory Study 1 N = 1586, Confirmatory Study 2 N =1432), we conducted direct replications of our findings to test whether the observed relationships between social media use and personality traits were reliable. Our replicated findings reveal that sex, age and extraversion are reliable predictors of several types of social media use (e.g., Facebook, Messaging Platforms, Online Forums), while other traits (e.g., agreeableness, Machiavellianism) showed unreliable associations. Our findings also reveal dimensions of multiplatform social media use that categorize the media ecologies of young adults and show significant associations with individual difference measures. (C) 2020 Published by Elsevier Inc.Item Progressive Multifocal Leukoencephalopathy Among Ibrutinib Treatment In Chronic Lymphocytic LeukemiaÇetintepe, T; Gediz, F; Akyar, I; Çetintepe, L; Koç, AMIntroduction: Both chronic lymphocytic leukemia (CLL) itself and the drugs used for its treatment, pose a risk for progressive multifocal leukoencephalopathy (PML). Although the relationship between Rituximab and PML is well known, case reports that have been recently published, suggest that ibrutinib; which is used in the treatment of CLL, may increase the risk of PML. Case report: Here, we report a case of 64 year-old female patient with CLL who was previously treated with rituximab, fludarabine and bendamustin but developed PML after receiving monotherapy with ibrutinib. According to Naranjo's algorithm, the causality relationship with the drug is possible with a score of 3. The patient initially exhibited neurological symptoms. Magnetic resonance of the brain revealed a bilateral asymmetric hyperintensity in the white matter involving the parietal and occipital lobules, and there was no mass effect, edema, hemorrhagic or iscemic lesions. No enhancement of contrast media was observed. The findings were consistent with demyelination and suggestive of PML. Management and outcome: Mirtazapine treatment was initiated. However, neurological sympthoms continuously progressed over the following weeks and the patient, aged 64, died six weeks after diagnosis of PML. Discussion: PML is a rare and often fatal demyelinating disease of the central nervous system (CNS) that is exclusively seen in immunocompromised patients and there is no specific agent to treat PML. The case discussed here, highlights that the use of ibrutinib in chronic lymphocytic leukemia (CLL) therapy may result in PML.