Non-Traumatic Subcapsular Spleen Hematoma in a Patient with Brucellosis

Brucellosis is a zoonotic disease. A characteristic clinical findings are fever, headache, arthralgia and splenomegali. Brucellosis occurs after direct contact with an infected animal or consumption of products of an infected animal. Subcapsular hematoma in the spleen is very rare complication of brucella infection. We report here, an 11 year old patient with brucellosis who admitted to our clinic with subcapsular non-traumatic spleen hematoma. Hematoma and clinical findings were resolved with doxicyclin and streptomycin combination. We emphasised that brucella infection should be keept in mind when non-traumatic subcapsular spleen hematoma occur

Invasive Pulmonary Aspergillosis in a Patient with Acute Lymphoblastic Leukemia

Fungal infections are common and life-threatening among immunosupressive patients.Invasive pulmonar aspergilloz (IPA) generally occurs when Aspergillus inhaled, but rarelywith the hematogen spread of dermal or gastrointestinal Aspergillus. We present here, IPA ina 58 year-old male patient with acute lymphoblastic leukemia (ALL). He was admitted to ourclinic with fatigue, weakness, pansitopenia, and with petechia. Supportive treatment,vincristine and prednisone was initiated. Chest roentgenogram was normal. Dyspnea andfever (39.5’C) were seen after 1 month of therapy. Thorax high resolution computerizedtomography was obtained and cavitary lesion was seen in the left upper-anterior segment oflung. Sputum and blood culture were negative. In spite of the empiric use of Meropenem 3gr/d, Vancomycin 2 gr/d and fluconazole 200 mg/d, fever was not turned to normal andclinical symptoms were not healed. On the fifth days of therapy amphotericin-B was initiatedand the other antibiotics were stopped after 3 days. General symptoms were healed on the 8thdays. Radiologic findings were improved partially after 20 days. The patient clinically is welland remains in remission and radiologic findings were turn to near normal after 10 monthsof treatment. We aimed to emphasis about treatment of empirical Amphotericin-B incritically ill patient with ALL

The Use Of Feiba In Hemophilia A Patient With Inhibitory And Sign Of Severe Intraabdominal Hemorrhage

The development of a factor VIII inhibitory is the most serious problem of Hemophilia A. High dose FVIII, recombinant FVIIa or FVIII inhibitor bypass activator (FEIBA) only or combined may use in the treatment of hemophilia with inhibitory. We present here 42 year-old male was admitted to our clinic with sign of shock, abdominal tenderness and image of mass. In laboratory, Hemoglobin was found 5 gr/dl, aPTT: 106 sec, FVIII: %0 and inhibitory level was found 14 BU. Abdominal computerized tomography was shown hemorrhage in abdominal cavity and in psoas muscle. In treatment; We used blood transfusion and 100 U/kgx2/d FEIBA along 4 days. General symptoms and signs was healed after 2 days and hematologic parameters turned to normal. Immune tolerans treatment program was planned for patient, later. FEIBA treatment is very useful in hemophilia patients suffered from hemorrhage and inhibitors in addition to supportive treatment

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

Checklist of the mites (Arachnida : Acari) of Turkey. Second supplement

As a suplement to the lists of the mites fauna of Turkey compiled by Ozkan et al. ( 1988 and 1994), a faunistic list of mites ( Arachnida: Acari) from Turkey is presented based on published data. The species are arranged alphabetically within orders and for each entrance the origin of reference to the published record is provided. Among the 504 taxa, 134 belong to the Gamasida, 2 to the Ixodida, 291 to the Actinedida, 7 to the Acaridida and 70 to the Oribatida

The Outcome Of Antracycline-Based Combination Chemotherapy In Metastatic Breast Cancer As A First-Line Treatment

In this study we evaluate the efficacy and safety of antracyclin based chemotherapy combination in 28 patients with untreated metastatic breast cancer. Overall response rate were achieved 78.5% of patients: Complete remisison in 3 (%10.7) patients, and partially remission in 19 (67.8%) cases. Whereas 3 (10.7%) patients achieved stabl disease, and 4 cases (14.2%) progressed. Grade III-IV neutropenia were found in 8 (28.5%) patients, and grade II trombocytopenia in one (3.5%). Other toxicity were nausea and vomiting, alopecia and skin ulceration in 18%, 24%, and 3.5% of patients, respectively. In conclusion; antracycline based therapy were found effectively and well well tolerabl treatment. This data were compatible with literature

Demographic Characteristicts Of Our Patients With Breast Cancer In Diyarbakir And Surrounding

Demographic properties of 115 patients with breast cancer, followed beetwen September 2001-December 2002, were evaluated according to theirs’ clinical and pathological features. Patients were classified regard to age, gender, stage (operabl vs metastatic breast cancer), pathologic features (histologic subtype, grade, size, hormon receptor status, lymph node status), type of treatment, surgical procedure, and site of metastasis. Of them 112 were female, and 3 male, madian age was 37 years. Of them 52% were operabl and 40% were metastatic breast cancer, whereas 8% were locally advanced breast cancer. Histologically; invasive ductal carsinoma, Medullary carsinoma, and tubulolobular carsinoma were found in 85%, 4.8%, and 3.6% of cases, respectivelly. Estrogen receptor (ER) were known in 41% of patients and progesteron receptor (PR) status in 39% of patients. In early breast cancer, modified radically mastectomy, lumpectomy, and simple mastectomy were done in 77%, 21% of patients and 1 patient, respectively. In metastatic breast cancer; site of metastasis were found to be bone, locally and regionally, liver, lung and pleura, and brain. Patients with metastatic breast cancer had recieved paliative radiation therapy (41%), only hormonal therapy (11%) and chemotherapy with or without of hormonal therapy ( 89%)

Ibrutinib: From Molecule to Medicine

İbrutinib: Molekülden İlacaBruton tirozin kinaz (BTK) inhibitörü Ibrutinib (PCI-32765), BTK üzerine irreversibl kovalan bağlanarak BCR aktivitesini yönlendiren yeni bir hedeflenmiş tedavi ajanıdır. Ibrutinib, kronik enfositik lösemi (KLL)'de tümör mikroçevresini hücresel moleküler elemanlar üzerinden myelosupresyona yol açmaksızın etkiler. Oral ibrutinib relaps/refrakter veya yeni tanı B-hücre malinitelerinde değişik klinik çalışmalarda test edilmektedir. KLL, mantle hücreli lenfoma (MCL) ve Waldenstrom makroglobulinemi (WM) hastalıklarında ibrutinib klinik çalışmaları devam etmektedir. Ibrutinib, klinik deneyimi özellikle relaps/refrakter KLL alanında progresyonsuz yaşam süresi (PFS) ve genel yaşam süresi (OS) iyileşmeleri ile birlikte hastalık kontrolü sağlamak amaçlı şekillenmiştir. Bu yazının amacı, ibrutinib tedavisinin farmakofizyolojik temellerine değinmek ve konu ile ilgili klinik çalışma deneyimlerini aktarmaktır. B-lenfoproliferatif hastalıkların tedavi şemaları, etkinliği artırmak ve hastaları gereksiz toksisiteden korumak üzerine odaklı olarak güncellenmeye devam edecektirBruton's tyrosine kinase (BTK) inhibitor Ibrutinib (PCI-32765) is a novel targeted-therapeutic agent modulating BCR, which serves as a covalent irreversible inhibitor of BTK. Ibrutinib significantly alters the composition of the tumor microenvironment in CLL, affecting soluble as well as cellular molecular elements without myelosupression. Ibrutinib is clinically developed as an orally administered anti-cancer agent with lead indications in relapse/refractory and in treatment-na&iuml;ve patients with B-cell malignancies as a single agent. the clinical activities of Ibrutinib as a drug were shown in the B-cell malignancies, especially in patients with CLL, mantle cell lymphoma (MCL), and Waldenstrom's macroglobulinemia (WM). Ibrutinib has generated the most extensive results so far in patients with CLL, predominately refractory or relapsed CLL where durable disease control as well as improved progression-free survival (PFS) and overall survival (OS) has been observed. the aim of this review is to outline the pharmacophysiological basis of Ibrutinib treatment as well as the current clinical experience based on the trials. the treatment algorithms of B-lymphoproliferative diseases will continue to be revised to a more personalized approach to treat with improved efficacy devoid of unnecessary toxicit