Efficacy of high dose steroid treatment in pulmonary hemosiderosis

No Abstract [Med-Science 2018; 7(1.000): 243-244

The effect of serum vitamin D levels on anemia and iron parameters in children and review of the literature [Cocuklarda serum D vitamini duzeyinin anemi ve demir parametreleri uzerine etkisi ve literatur derlemesi]

Anemia, vitamin D and iron deficiency remains a major public health problem all over the world. Vitamin D is known for its crucial role in bone and mineral metabolism and is increasingly recognized to have extra-skeletal effects on cell proliferation and differentiation, immune function and anti-inflammatory effects. In addition, vitamin D is thought to have effect on iron metabolism and erythropoiesis. The aim of this research was to determine the effect of serum 25(OH) vitamin D (25D) on anemia and iron deficiency in childhood. A hundred and five patients aged between 1-18 years who were admitted Pediatric Hematology-Oncology and Pediatric Endocrinology out-patient clinic between January 2014 and November 2015 in Erzurum Regional and Research Hospital were enrolled in the study. The patients who had signs of infection/inflammation, chronic disease and thalassemia trait were excluded from the study. Data of patients, including gender, age, complete blood count, serum levels of 25D, iron, iron binding capacity and ferritin were retrospectively reviewed. In our study, the prevelance of anemia (11.1%, 27.8%, 11.9%, respectively, p=0.2), the prevelance of iron deficiency (33.3%, 38.9%, 33.3%, respectively, p=0.9), level of serum iron (67.7±35.3 µgr/dL, 63.2±31.9 µgr/dL, 67.5±33.7 µgr/dL, respectively, p=0.8), level of serum ferritin (26±18.9 mg/L, 24±16.4 mg/L, 22.5±18.1 mg/L, respectively, p=0.4) and index of transferrin saturation (26.7±19.1%, 22.5±13.2%, 25.5±19.7, respectively, p=0.7) was not different between 25D deficient, insufficient and normal groups. Our study has not shown an association between anemia, iron deficiency and vitamin D. We think that vitamin D has effect on iron metabolism and erythropoiesis through inflammation pathways and hepsidin. Further studies is needed to evaluate the relation between vitamin D and anemia/iron metabolism. [Med-Science 2016; 5(3.000): 821-5

Cerebral venous thrombosis occurring during oxymetholone therapy

Oxymetholone, an androgen analogue, is widely used in the treatment of Fanconi aplastic anemia (FAA). Androgen is known to cause cerebral venous thrombosis (CVT). A 9-year-old girl under monitoring with a diagnosis of FAA presented to our hospital with severe headache. She had been receiving oxymetholone therapy for 1 year. Neurological examination was normal. Superior sagittal sinus thrombosis was detected at magnetic resonance imagining (MRI) of the brain. The thrombosis was thought to be oxymetholone-related, and oxymetholone therapy was discontinued. The patient was started on enoxoparin therapy and the symptoms resolved. Control images 4 months later were normal. We think that the risk of venous thrombosis must be considered with administering oxymetholone therapy in patients with FAA. [Med-Science 2017; 6(3.000): 576-8

Assessment of physicians' knowledge in transfusion medicine in eastern part of Turkey

Transfusion of blood and blood components is one of the most common medical procedures in the developed world. Knowledge of physicians about blood transfusion is the most important determinant of their approach towards blood transfusion. In this study, we aimed to assess clinicians' basic knowledge regarding transfusion medicine through a questionnaire in a regional hospital. One hundred and one physicians including general practitioners, resident physicians, and specialists participated in the study. The participants were tested with a questionnaire consisting of 20 questions about transfusion medicine. Their scores were compared with regard to their departments, age and experience in medicine. The mean age of study population was 33.1±6 years. Of the total, 70 (69.3%) were male and the average year in medical practice was 7.3±5.8 years. Overall, 52% of the questions were correctly answered. The proportion of correct answers to the questions about basic knowledge, clinical use of blood, and transfusion reactions were as; 52.7%, 54.7%, and 47.3%, respectively. Thirty-four (33.7%) participants scored higher than 60 points, out of 100 points. The average score of total knowledge of participants about transfusion medicine was 52±10. The total knowledge scores of groups including internal departments, surgical departments, and emergency medicine were 55.7±10.2, 51.5±8.3, and 46±10.3, respectively and the differences between three groups were significant (p=0.001) . Also, a positive correlation has been shown between age, experience in medicine and total awareness score in transfusion medicine. The study yielded low/moderate levels of knowledge about transfusion medicine and it was concluded that additional education in transfusion medicine is necessary in all specialties and at each phases of medical practice. [Med-Science 2017; 6(2.000): 208-12

Hepcidin levels in children with chronic liver disease

Background/Aim: We aimed to analyze serum hepcidin level in children with chronic liver disease (CLD) and its relationship with serum cytokines level, liver function tests, hepatic iron content, and liver fibrosis. Patients and Methods: The study included 34 children with CLD, and 15 age- and gender-matched healthy children. Serum hepcidin, ferritin, iron level, interleukin-6 (IL-6), transforming growth factor-β (TGF-β ), total oxidant status (TOS), and antioxidant status (TAS) were studied in all patients and in the control group. Liver iron content (LIC) was measured from the liver biopsy specimen. Results: Serum ferritin levels were higher in patients with CLD than control group (100.1 ± 98.2 ng/mL vs 50.5 ± 32.2 ng/mL, P = 0.016). No significant difference was found in hepcidin levels. Hepcidin levels in children with CLD was positively correlated with ferritin (r = 0.75, P = 0.001), pediatric end-stage liver disease (PELD) score (r = 0.56, P = 0.001), TAS (r = 0.42,P = 0.02), but negatively correlated with albumin level (r = −0.45,P = 0.008). Transferrin saturation and hepcidin:ferritin ratio were significantly low in patients with severe fibrosis compared with patients with mild/without fibrosis (15.5 ± 5.5 vs 34.3 ± 30.1, P = 0.017 and 1 ± 0.5 vs 1.9 ± 1.4,P = 0.04, respectively). Conclusion: Serum hepcidin levels in children with CLD reflect both liver functions and TAS, and severe fibrosis is associated with low hepcidin:ferritin ratio in children with CLD