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Öğe Candida arthritis in a patient with chronic myelogenous leukemia (CML) in blastic transformation, unresponsive to fluconazole, but treated effectively with liposomal amphotericin B(Springer-Verlag, 2002) Turgut, B; Vural, Ö; Demir, M; Kaldir, MCandida arthritis is quite rare and might be caused either by direct intra-articular inoculation of Candida or secondary to hematogeneous seeding of Candida in immunocompromised hosts. Until now less than 50 cases of Candida arthritis have been reported in the literature. We report a case of Candida arthritis, which occurred in a patient with chronic myelogenous leukemia (CML) in blastic transformation. Aggressive chemotherapy and broad-spectrum antibiotics for a prolonged period for febrile neutropenia had been given to the patient. Arthritis of the left knee appeared during the recovery phase of leukopenia. Despite treatment with fluconazole, no clinical or microbiological improvement was obtained. Thus, administration of liposomal amphotericin B was started and after 3 days there was improvement. We can conclude that fluconazole might not be sufficient in some Candida arthritis cases and liposomal amphotericin B might be a good alternative in these resistant cases.Öğe Diffuse uptake of Tc-99m tin colloid in extramedullary Hematopoiesis of the lungs(Lippincott Williams & Wilkins, 2003) Çermik, TF; Turgut, B; Gultekin, A; Çakir, B; Berkarda, S[Abstract Not Available]Öğe The effects of rosiglitazone treatment on the fibrinolytic system in patients with type 2 diabetes mellitus(Sage Publications Inc, 2006) Guldiken, S; Turgut, B; Demir, M; Arikan, E; Kara, M; Vural, O; Tugrul, APatients with type 2 diabetes mellitus (DM) are at risk for the development of cardiovascular diseases, which can in part be explained by disturbances in the hemostatic and fibrinolytic systems. The effects of rosiglitazone treatment on the fibrinolytic system and insulin sensitivity in patients with type 2 DM were assessed. Twenty-four patients with type 2 DM and 28 healthy subjects were enrolled in the study. Plasma global fibrinolytic capacity (GFC), tissue plasminogen activator (t-PA), and plasminogen activator inhibitor-1 (PAI-1) levels were measured. Insulin resistance was calculated by hoemostasis model assessment. Patients with type 2 DM then were placed on rosiglitazone (4 mg/day, for 12 weeks) in addition coexistent medication, and baseline tests were repeated. There was no difference between mean t-PA levels of the two groups. PAI-1 levels were higher in diabetic patients than control subjects (p < 0.01). Diabetic patients had lower GFC and t-PA/PAI-1 levels than control subjects (p < 0.05, p < 0.05). PAI-1 levels were positively correlated with waist circumference in diabetic group (r = 0.4, p < 0.05). After rosiglitazone treatment, there was no difference in mean plasma levels of GFQ t-PA, PAI-1 and t-PA/PAI-1 in diabetics. Insulin sensitivity significantly improved after the addition of rosiglitazone treatment in diabetic patients (p < 0.01). The short-term and low-dose treatment with rosiglitazone in type 2 diabetic patients has no effects on the fibrinolytic system, although it improves insulin sensitivity.Öğe Global fibrinolytic capacity in patients with subclinical hypothyroidism(Japan Endocrine Society, 2005) Guldiken, S; Demir, M; Turgut, B; Altun, BU; Arikan, E; Kara, MSubclinical hypothyroidism (SH) represents the earliest stages of hypothyroidism but the benefits of detecting and treating SH are not well known. The aim of this Study was to evaluate the alterations in global fibrinolytic capacity (GFC), which indicates the overall fibrinolytic activity, in patients with SH. The study group comprised of 15 patients with SH and 15 healthy controls. The GFC was significantly lower in patients with SH than in control group (p < 0.002). This result suggests a relative hypercoagulable state in SH.Öğe Hypercoagulopathy in stroke patients with nonvalvular atrial fibrillation(Westminster Publ Inc, 2006) Turgut, N; Akdemir, O; Turgut, B; Demir, M; Ekuklu, G; Vural, Ö; Özbay, GThe coagulation system is activated and coagulation activation markers are elevated in acute ischemic stroke with nonvalvular atrial fibrillation (NVAF). The etiology, severity, and prognosis of the ischemic stroke might be estimated with the level of the activation of the coagulation system. In this study, prothrombin F1+2 (F1+2), D-dimer, and fibrinogen levels were measured in patients with acute ischemic stroke with and without NVAF, and stroke severity was compared with these hemostatic parameters. Of 55 patients, 29 had sinus rhythm (group I), 26 had NVAF (group II); 20 healthy subjects (group III) were included in the study. Subtypes of cerebral infarction were classified. The patients underwent stroke severity, electrocardiography, echocardiography, cranial computed tomography, cervical duplex ultrasonography, and hemostatic parameter studies. In group II, F1+2 level (2.83 +/- 0.89) was significantly higher than in group I (2.33 +/- 0.80) and III (1.94 +/- 0.64) (p values: group I-II, 0.036; groups II-III, 0.001; groups I-III, 0.104). In group III, fibrinogen level (251.64 +/- 60.96) was significantly lower than that in groups I (347.97 +/- 111.49) and II (364.04 +/- 86.20) (p = 0.001). D-dimer was not significantly different between groups. In group I, lacunar syndrome (LACS), and in group II, partial and total anterior circulation syndrome (PACS + TAGS) were more common (p = 0.013, p = 0.001, respectively). In group II, Scandinavian Stroke Scale scores were lower than those in group I (group I = 45.2 +/- 14, group II = 35.4 +/- 18.9, p = 0.02). In conclusion, activation of coagulation, demonstrated by increment F1+2, is more abundant in the stroke patients with NVAF than in the stroke patients with sinus rhythm. Our results also showed that activation of the hemostatic system might be related to stroke subtype and stroke severity. It is suggested that the oral anticoagulation treatment as prophylaxis is important in the prevention of stroke in patients with NVAFÖğe An interesting presentation of intrathoracic extramedullary hematopoiesis in a patient with thalassemia intermedia(Blackwell Publishing Ltd, 2003) Turgut, B; Pamuk, GE; Vural, Ö; Demir, M; Ünlü, E; Çelik, H; Çakir, BExtramedullary hematopoiesis (EMH) occurs as a compensatory mechanism for bone marrow dysfunction in severe thalassemia. In addition to the more common locations, such as liver, spleen and lymph nodes, a mass of EMH may occasionally occur in the thorax. Intrathoracic EMH is usually asymptomatic. A 69-year-old woman who initially presented with hematuria, dysuria, and left inguinal pain was found to have paravertebral masses in the thorax. Histopathologic examination of a CT-guided needle aspiration biopsy of the masses showed the presence of trilineage hematopoiesis. We present this unusual case, in which EMH was diagnosed by chance in an elderly patient with no symptoms related to thalassemia.Öğe Metastatic squamous cell carcinoma of the skin in chronic myeloid leukaemia(Blackwell Publishing Ltd, 2003) Pamuk, GE; Turgut, B; Vurul, Ö; Demir, M; Tek, M; Altaner, SHydroxyurea is a ribonucleotide diphosphate reductase inhibitor used in the treatment of patients with myeloproliferative disorders. Hydroxyurea has some dermatological side-effects. It has recently been recognized that hydroxyurea can induce squamous cell and basal cell carcinomas of skin. We present the case of an elderly man with chronic myeloid leukaemia who was treated with hydroxyurea for 4 years, with good control of his disease. However, in addition to the appearance of various skin lesions and cutaneous squamous cell carcinoma after 3 years of therapy, he was found to have a metastatic squamous cell carcinoma after 4 years. Hydroxyurea was discontinued, and he underwent surgery and radiotherapy. The patient subsequently died of ventricular fibrillation. We present this case to draw attention to the association between hydroxyurea and secondary skin cancers and to emphasize the need for dermatological examination before and during the course of hydroxyurea therapy.Öğe Nocardiosis in a patient with primary anti-phospholipid syndrome(Springer Heidelberg, 2006) Soy, M; Oktun, MT; Tunçbilek, N; Ermantas, N; Ökten, Ö; Altinay, G; Turgut, BAntiphospholipid syndrome is an autoimmune disease that is characterised by tendency to thrombosis, obstetrical and hematological complications. Corticosteroids may be useful for therapy of some features of this syndrome, such as thrombocytopenia. Nocardia is an important opportunistic infectious agent in immunocompromised hosts, i.e. in patients taking corticosteroids. It is important to be aware of these rare complications, which are correlated with the prognosis. In this paper, we report a patient with primary antiphospholipid syndrome treated by corticosteroid, who developed disseminated nocardiosis.Öğe Pulmonary alveolar proteinosis in a patient with acute lymphoid leukemia regression after G-CSF therapy(Taylor & Francis Ltd, 2003) Pamuk, GE; Turgut, B; Vural, Ö; Demir, M; Hatipoglu, O; Ünlü, E; Altaner, SPulmonary alveolar proteinosis (PAP) is the intra-alveolar accumulation of periodic-acid schiff (PAS) positive material. PAP is one of the underrecognized causes of pulmonary infiltrates in patients with hematologic malignancies. Here, we present a patient with acute lymphoid leukemia (ALL) in first remission that developed fever and diffuse pulmonary infiltrates during the neutropenic stage of consolidation chemotherapy. The histopathologic examination of bronchoalveolar lavage (BAL) fluid and transbronchial biopsy specimen demonstrated the presence of PAS-positive eosinophilic material. Empirical antibiotherapy and granulocyte-colony stimulating factor (G-CSF) were given. After the correction of neutropenia with G-CSF, the patient's fever disappeared, acute phase reactants decreased, pulmonary infiltrates resolved. We present this case because it was the first patient in whom the correction of neutropenia with G-CSF was followed by resolution of PAP.Öğe A rare cause of acute abdomen(H G E Update Medical Publ Ltd., 2001) Hatipoglu, AR; Karakaya, K; Karagülle, E; Turgut, BSplenic infarction is a rare disorder. We have treated 4 patients during the last year. Abdominal pain in the left upper quadrant was the common complaint. Other complaints were fever, nausea and vomiting. Computed tomography showed infarcted areas in the spleen in all of the patients. S plenectomy was applied to three of the patients with recurring symptoms. The other patient had the first episode treated medically. Pulmonary embolism in one and surgical wound infection occurred in another patient during postoperative follow-up for nine (range: 4-14) months.Öğe Rituximab-induced acute thrombocytopenia in a patient with prolymphocytic leukemia(Wiley, 2005) Pamuk, GE; Donmez, S; Turgut, B; Demir, M; Vural, O[Abstract Not Available]Öğe Scleroderma in a patient with X-linked agammaglobulinaemia(Taylor & Francis As, 2004) Pamuk, ÖN; Pamuk, GE; Turgut, B; Çakir, N[Abstract Not Available]Öğe Thrombosis in systemic lupus erythematosus(Springer-Verlag, 2003) Pamuk, GE; Turgut, B; Vural, Ö; Demir, M; Soy, M; Bozkurt, G; Çelik, HThrombosis in the venous or arterial system is quite common in systemic lupus erythematosus (SLE). We describe a young female patient whose first presentation was in the form of deep venous thrombosis of the right lower extremity. Her family history for thrombosis was positive and further studies revealed her to have SLE. Genetic studies showed that she had thrombophilic mutations of factor V, prothrombin and methylene tetrahydrofolate reductase genes. Her therapeutic response to anticoagulant therapy was satisfactory. The presence of inherited thrombophilic mutations must be searched for in SLE patients with thrombosis, especially in cases with a positive family history.
