The Efficacy of High-Dose Methylprednisolone versus Intravenous Immunoglobulin G Therapy in Patients with Idiopathic Thrombocytopenic Purpura.

TEZ10695Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2014.Kaynakça (s. 80-84) var.viii, 85 s. : res. (bzs. rnk.), tablo ; 29 cm.Amaç: İTP trombositlere karşı oluşan otoantikorların neden olduğu edinsel bir hastalıktır. İTP tedavisinin başlıca amacı, majör kanamayı önlemek için güvenli bir trombosit sayısı elde etmektir. Çalışmamızda akut dönemde başvuran İTP hastalarının acil tedavisinde, YDMP ile İVİG etkinliğini karşılaştırmayı amaçladık. Gereç ve Yöntem: Çalışmaya 1977-2014 yılları arasında Çukurova Üniversitesi Hematoloji Kliniğine başvuran, yeni İTP tanısı alan veya daha önce İTP tanısıyla izlenmekte olup akut atak ile başvuran ve trombosit sayısı 0,05). YDMP verilen grupta yanıta kadar geçen sürenin daha kısa olduğu saptandı (p0,05). Sonuç: Erişkin İTP?lilerde akut trombositopenik dönemde ve uzun süreli remisyon sağlanmasında YDMP, İVİG ve KS tedavisine göre daha etkili bir tedavidir.Aim: ITP is an acquired disease, which develops by autoantibodies that are formed against platelets. Main purpose of the ITP treatment is to obtain adequate platelet count in order to avoid major bleeding. In our study, we aimed to compare the effectiveness of the HDMP and IVIG in ITP patients during their emergency treatments. Methods and Materials: The study includes 140 patients consisting of newly diagnosed or chronic ITP patients with an acute attack and had applied our outpatient department in Çukurova University Medical School in between 1977 and 2014. Patients with a platelet count 0,05) . It was observed that the duration of the response of the HDMP applied group was shorter (p<0,05) . Also, response rate of the HDMP applied group was statistically significantly higher (p<0,05) . It was identified that the initial treatment does not effect the response type. Remission rate of the HDMP treatment was 69,6%. It was identified that the remission was long-termed among all of patients who showed the response. Maximum long-termed remission was observed at the HDMP treatment applied group. There was not observed any statistically significant difference, while comparing as the recurrence and the splenectomy (p<0,05) . Discussion: HDMP is a more effective treatment method than IVIG and CS treatment for the adult patients who have ITP at its acute thrombocytopenic period

Seasonal Association of Immune Thrombocytopenia in Adults

Saydam, Guray/0000-0001-8646-1673; GURKAN, EMEL/0000-0002-3060-4054WOS: 000362846400002PubMed: 26740892Background: Immune thrombocytopenia (ITP) is an autoimmune disorder. It is characterized by thrombocytopenia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogenesis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied. Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP. Study Design: Descriptive study. Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hospitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Relation between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated. Results: The study included 165 patients (124 female, mean age=42.8 +/- 16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resistant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149). Conclusion: This is the first study showing seasonal association of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Mediterranean climate is seen

Seasonal Association of Immune Thrombocytopenia in Adults

Background: Immune thrombocytopenia (ITP) is an au-toimmune disorder. It is characterized by thrombocyto-penia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogen-esis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied.Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP.Study Design: Descriptive study.Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hos-pitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Rela-tion between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated.Results: The study included 165 patients (124 female, mean age=42.8±16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resis-tant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149).Conclusion: This is the first study showing seasonal as-sociation of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Medi-terranean climate is seenBackground: Immune thrombocytopenia (ITP) is an au-toimmune disorder. It is characterized by thrombocyto-penia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogen-esis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied.Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP.Study Design: Descriptive study.Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hos-pitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Rela-tion between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated.Results: The study included 165 patients (124 female, mean age=42.8±16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resis-tant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149).Conclusion: This is the first study showing seasonal as-sociation of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Medi-terranean climate is see

Seasonal Association of Immune Thrombocytopenia in Adults

Background: Immune thrombocytopenia (ITP) is an autoimmune disorder. It is characterized by thrombocytopenia due to thrombocyte destruction mediated by autoantibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogenesis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied. Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP. Study Design: Descriptive study. Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hospitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Relation between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated. Results: The study included 165 patients (124 female, mean age=42.8±16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resistant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149). Conclusion: This is the first study showing seasonal association of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Mediterranean climate is seen

Seasonal Association of Immune Thrombocytopenia in Adults

Background: Immune thrombocytopenia (ITP) is an au-toimmune disorder. It is characterized by thrombocyto-penia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogen-esis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied.Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP.Study Design: Descriptive study.Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hos-pitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Rela-tion between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated.Results: The study included 165 patients (124 female, mean age=42.8&plusmn;16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resis-tant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149).Conclusion: This is the first study showing seasonal as-sociation of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Medi-terranean climate is seenBackground: Immune thrombocytopenia (ITP) is an au-toimmune disorder. It is characterized by thrombocyto-penia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogen-esis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied.Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP.Study Design: Descriptive study.Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hos-pitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Rela-tion between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated.Results: The study included 165 patients (124 female, mean age=42.8&plusmn;16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resis-tant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149).Conclusion: This is the first study showing seasonal as-sociation of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Medi-terranean climate is see

Evaluation of whole blood thiamine pyrophosphate concentrations in critically ill patients receiving chronic diuretic therapy prior to admission to Turkish intensive care units: A pragmatic, multicenter, prospective study.

Background/Objectives: Thiamine plays a pivotal role in energy metabolism. The aim of the study was to determine serial whole blood TPP concentrations in critically ill patients receiving chronic diuretic treatment before ICU admission and to correlate TPP levels with clinically determined serum phosphorus concentrations. Subjects/Methods: This observational study was performed in 15 medical ICUs. Serial whole blood TPP concentrations were measured by HPLC at baseline and at days 2, 5 and 10 after ICU admission. Results: A total of 221 participants were included. Of these, 18% demonstrated low TPP concentrations upon admission to the ICU, while 26% of participants demonstrated low levels at some point during the 10-day study period. Hypophosphatemia was detected in 30% of participants at some point during the 10-day period of observation. TPP levels were significantly and positively correlated with serum phosphorus levels at each time point (P < 0.05 for all). Conclusions: Our results show that 18% of these critically ill patients exhibited low whole blood TPP concentrations on ICU admission and 26% had low levels during the initial 10 ICU days, respectively. The modest correlation between TPP and phosphorus concentrations suggests a possible association due to a refeeding effect in ICU patients requiring chronic diuretic therapy

Vaccination status of COVID-19 patients followed up in the ICU in a country with heterologous vaccination policy: A multicenter national study in Turkey

Objective: Vaccination against severe acute respiratory syndrome coronavirus-2 (SARS-2) prevents the development of serious diseases has been shown in many studies. However, the effect of vaccination on outcomes in COVID-19 patients requiring intensive care is not clear. Methods: This is a retrospective multicenter study conducted in 17 intensive care unit (ICU) in Turkey between January 1, 2021, and December 31, 2021. Patients aged 18 years and older who were diagnosed with COVID-19 and followed in ICU were included in the study. Patients who have never been vaccinated and patients who have been vaccinated with a single dose were considered unvaccinated. Logistic regression models were fit for the two outcomes (28-day mortality and in-hospital mortality). Results: A total of 2968 patients were included final analysis. The most of patients followed in the ICU during the study period were unvaccinated (58.5%). Vaccinated patients were older, had higher Charlson comorbidity index (CCI), and had higher APACHE-2 scores than unvaccinated patients. Risk for 28-day mortality and in-hospital mortality was similar in across the year both vaccinated and unvaccinated patients. However, risk for in-hospital mortality and 28-day mortality was higher in the unvaccinated patients in quarter 4 adjusted for gender and CCI (OR: 1.45, 95% CI: 1.06–1.99 and OR: 1.42, 95% CI: 1.03–1.96, respectively) compared to the vaccinated group. Conclusion: Despite effective vaccination, fully vaccinated patients may be admitted to ICU because of disease severity. Unvaccinated patients were younger and had fewer comorbid conditions. Unvaccinated patients have an increased risk of 28-day mortality when adjusted for gender and CCI