Propylthiouracil, methimazole ve bunların kombine kullanımlarının diffüz toksit guatr üzerine etkileri

Bu tezin, veri tabanı üzerinden yayınlanma izni bulunmamaktadır. Yayınlanma izni olmayan tezlerin basılı kopyalarına Üniversite kütüphaneniz aracılığıyla (TÜBESS üzerinden) erişebilirsiniz.5. ö Z E T : Bu çalışmada diffüz toksik guatr ( Graves-Basedow.) ' lx hii- pertiroidizmi olan olgularda klinik ve laboratuar bulgular üzerine? propylthiouracil ( PTU ), methimazole ( MMI ) ve bu ikisinin kom bine olarak uygulanmasının etkileri araştırılmıştır. İlaçlar eşde>- ğer dozda tutulmuş, 13 hastaya kombine, 11 hastaya PTU ve 11 hasta ya da MMI sağaltımı uygulanmıştır. Seçilen parametreler; yakınmalar, genel klinik bulgular, T3, T4, T3 / T4 oranı, beyaz kan hücresi. ( BKH, lökosit ) sayımı, polimorf nükleuslu lökosit ( PNL ) yüzdesi, lenfosit yüzdesi", PNL / L oranı, nabız sayısı ve boyun çevresi ( gu atr büyüklüğü; ). dür. Yakınma ve bulgular her üç uygulama türünde de süreyle doğru sal olarak azalmışlar ve kümeler arasında ayrım ortaya çıkmamıştır. T3 ve T4 değerleri de hemen hemen benzer şekildi etkilenmiş, ancak PTU ' in T4' ün T31 e çevresel dönüşümüne neden olduğu ves dolayısıyla az bir fark da olsa T3 * üi daha çabuk düşürdüğüi gözlen miştir. Ayrıca kombine uygulama sırasında etkinin sonradan azaldığı gözlenmiş ve olası bir ilaç etkileşimi düşünülmüştür. PTU, BKH sayısını, istatistik olarak anlamlı olmamakla^ bir likte, diğer kümedekilere göre biraz düşürmüştür ( p 0.05 ). PTU, PNL sayısını düşürmüş, MMI artırmıştır. PNL yüzdesinde dü'şme> en sü>- rekli olarak kombine sağaltım uygulanan kümede görülmüştür. Bu da: İlaçların olası bir additif toksisite gösterdiğini düşündürmüştür ( ancak p 0.05 )« MMI kullanılan kümede lenfosit yüzdesinde hafif bir azalma olmuş ve bunun MMI ' ün İmmünosuppressi'f etkisine bağlı olabileceği düşünülmüştür ( p 0.05 ). PTU uygulanan kümede ise^ len fosit yüzdesinde hafif bir artış olmuş ( ancak p 0.05 ) ve^ bu PNL yüzdesindeki düşmeye sekonder olarak değerlendirilmiştir. en- 51 - Nabız azalması her üç kümede de süreyle doğrusaldır ves kümes ler arasında ayrım yoktur. Boyun çevresi ( guatr büyüklüğü! ), üç kümede de değişmemiş tir. Sonuçta} PTU ve MME arasında pratik yararı olabilecek bir et ki ayrımı saptanmadığı gibi bunların kombine olarak uygulanmasının bir üstünlüğü de gözlenmemiştir. Tersine, kombine kullanım sırasın da olası bir ilaç etkileşimi söz konusudu

Bacteremia Caused by Chryseobacterium indologenes in a Patient with High Grade Non-Hodgkin Lymphoma

We report a case of bacteremia caused by Chryseobacterium indologenes in a patient who was treated due to the non-Hodgkin lymphoma and developed neutropenia and fever. According to the antimicrobial susceptibility test result, ciprofloxacin was added to the treatment. On the 10th day of the treatment a good response was achieved and the patient discharged after complete recovery

Addition of thalidomide (t) to oral melphalan/prednisone (mp) in patients with multiple myeloma: Initial results of a randomized trial from the Turkish myeloma study group.

Bu çalışma, 05-08 Aralık 2009 tarihleri arasında New Orleans[Luisana]’da düzenlenen düzenlenen 51. Annual Meeting of the American-Society-of-Hematology’da bildiri olarak sunulmuştur.Amer Soc Hemato

Evolution of clinical characteristics of patients with paroxysmal nocturnal hemoglobinuria treated with eculizumab in turkey: a multicenter retrospective analysis

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare X-linked genetic disorder. On the contrary to its name, it is a multisystemic disease and various symptoms other than hemoglobinuria could be occurred. It could be life threatening especially because of thromboembolic events. In the last decade, a terminal complement inhibition with eculizumab approved with promising results for PNH patients. We conducted this study to evaluate the long term experience of eculizumab therapy from Turkey for the first time. Our cohort included 138 patients with PNH treated with eculizumab between January 2008 and December 2018 at 28 centers in Turkey. Laboratory and clinical findings at the time of diagnosis and after eculizumab therapy were recorded retrospectively. The median age was 39 (range 18-84) years and median granulocyte PNH clone size was 74% (range 3.06-99.84%) at the time of diagnosis. PNH with bone marrow failure syndrome was detected in 49 patients and the rest of 89 patients had classical PNH. Overall 45 patients (32.6%) had a history of any prior thrombotic event before eculizumab therapy and only 2 thrombotic events were reported during the study period. Most common symptoms are fatigue (75.3%), hemoglobinuria (18.1%), abdominal pain (15.2%) and dysphagia (7.9%). Although PNH is commonly related with coombs negativity, we detected coombs positivity in 2.17% of patients. Seven months after the therapy, increased hemoglobin level was seen and remarkably improvement of lactate dehydrogenase level during the treatment was occurred. In addition to previous studies, our real life data support that eculizumab is well tolerated with no serious adverse events and improves the PNH related findings

A Multi-Center Study on the Efficacy of Eltrombopag in Management of Refractory Chronic Immune Thrombocytopenia

Objective: The aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP). Materials and Methods: A total of 285 chronic ITP patients (187 women, 65.6%; 98 men, 34.4%) followed in 55 centers were enrolled in this retrospective cohort. Response to treatment was assessed according to platelet count (/mm3) and defined as complete (platelet count of >100,000/mm3), partial (30,000-100,000/mm3 or doubling of platelet count after treatment), or unresponsive (<30,000/mm3). Clinical findings, descriptive features, response to treatment, and side effects were recorded. Correlations between descriptive, clinical, and hematological parameters were analyzed. Results: The median age at diagnosis was 43.9±20.6 (range: 3-95) years and the duration of follow-up was 18.0±6.4 (range: 6-28.2) months. Overall response rate was 86.7% (n=247). Complete and partial responses were observed in 182 (63.8%) and 65 (22.8%) patients, respectively. Thirty-eight patients (13.4%) did not respond to eltrombopag treatment. For patients above 60 years old (n=68), overall response rate was 89.7% (n=61), and for those above 80 years old (n=12), overall response rate was 83% (n=10). Considering thrombocyte count before treatment, eltrombopag significantly increased platelet count at the 1st, 2nd, 3rd, 4th, and 8th weeks of treatment. As the time required for partial or complete response increased, response to treatment was significantly reduced. The time to reach the maximum platelet levels after treatment was quite variable (1-202 weeks). Notably, the higher the maximum platelet count after eltrombopag treatment, the more likely that side effects would occur. The most common side effects were headache (21.6%), weakness (13.7%), hepatotoxicity (11.8%), and thrombosis (5.9%). Conclusion: Results of the current study imply that eltrombopag is an effective therapeutic option even in elderly patients with chronic ITP. However, patients must be closely monitored for response and side effects during treatment. Since both response and side effects may be variable throughout the follow-up period, patients should be evaluated dynamically, especially in terms of thrombotic risk factors.PubMedWoSScopu