Increased erythrocyte aggregation as an indicator for an aggressive clinical course in Behçet's disease: a prospective study

OBJECTIVE—Changes in blood rheology, especially increased erythrocyte aggregation (EA) might play an important part in the development of arterial and venous thrombotic lesions. A prospective study was designed to evaluate EA in patients with Behçet's disease (BD) and to see if this parameter is predictive for the future development of vascular complications, such as deep vein thrombosis of various organ systems and uveitis.
METHODS—EA was measured by a photometric Myrenne aggregometer in 38 patients with BD at the time of initial diagnosis and in 40 age and sex matched healthy controls (HC).
RESULTS—During a median follow up period of 13.5 months, 13 patients developed vascular-ocular complications (eight deep vein thrombosis, nine uveitis, and four both deep vein thrombosis and uveitis). Patients were further divided into two groups: BD-a with mucocutaneous symptoms and arthritis only; BD-b with associated vascular-ocular complications. EA values at high shear rate (M) and at low shear rate (M1) were compared among the groups.
CONCLUSION—EA values at M and M1 were significantly higher in BD-b than BD-a and HC (p<0.001). These results suggest that determination of EA rates might be useful to identify subgroups who are likely candidates for developing vascular-ocular complications in BD and management of factors known to affect blood rheology might be beneficial.

 Keywords: erythrocyte aggregation; Behcet's syndrom

Short and long term effects of granulocyte colony-stimulating factor during induction therapy in acute myeloid leukemia patients younger than 65: Results of a randomized multicenter phase III trial

PubMedID: 20673585This prospective multicenter phase III clinical trial was designed to assess efficacy and safety of G-CSF as an adjunct to de novo AML remission induction therapy (www.clinicaltrials.gov. NCT00820976). Patients' characteristics were similar in both arms. G-CSF improved severity and duration of leukopenia. Three-year OS were similar (25.6 ± 5.1% vs. 31.8 ± 5.6%) in both arms except for patients with myeloblastic features. Significant factors for better survival were the use of G-CSF (p= 0.049), female sex (p= 0.05) and single induction cycle (p< 0.001) in multivariate analysis. Female patients performed better than male patients. Better survival obtained among female AML patients needs to be validated within the context of cytogenetic analysis. © 2010 Elsevier Ltd.The authors are indebted to the efforts of all the institutions who participated in the trial and their data management teams. Also the authors would like to thank to all physicians including Dr. Semra Dundar, who died in 2005, and their patients for this collaborative effort. Filgrastim was supplied by Roche, This study was partially supported by the Turkish Academy of Sciences. Monitoring and statistical analysis were performed by an independent clinical research organization (OMEGA, Ankara, Turkey). And a special thank you to the following hospitals and investigators that participated in this trial: Akdeniz University, Antalya, Turkey (L. Undar); Ankara University, Ankara, Turkey (M.B., M.O., O. l., G.G., A.U., H.A., E.A.); Cukurova University, Adana, Turkey (S.P.); Dokuz Eylul University, Izmir, Turkey (B. Undar); Ege University, Izmir, Turkey (S. Cagirgan); Erciyes University, Kayseri, Turkey (A. Unal, M. Cetin); Gulhane Military University, Ankara, Turkey (A. U. Ural, C. Beyan); Hacettepe University, Ankara, Turkey (S. Dundar, O.O., Y.B.); Inonu University, Malatya, Turkey (I. Aydogdu); Istanbul University of Cerrahpasa, Istanbul, Turkey (B. Ferhanoglu); Istanbul University of Istanbul, Istanbul, Turkey (D. Sargin, Sevgi Kalayoglu-Besisik); Marmara University, Istanbul, Turkey (M.B.); Osmangazi University, Eskisehir, Turkey (Z. Gulbas); Uludag University, Bursa, Turkey (A.T., R.A., F.O., T.O.). Contributions : M.B. provided the conception and design of the study, or acquisition of data, or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content and final approval of the version to be submitted; M.O., E.A.S. and A.T. provided the conception and design of the study, or acquisition of data, or analysis and interpretation of data and final approval of the version to be submitted; R.A. and T.O. provided the drafting the article or revising it critically for important intellectual content and final approval of the version to be submitted and O.O, M.B., S.P., Y.B., O.I., F.O., G.G., A.U. and H.A. provided the final approval of the version to be submitted

Selectin adhesion molecules in Behçet's disease

OBJECTIVES—The pathogenesis of Behçet's disease (BD) is closely related to endothelial cells, leucocyte functions and autoimmunity. The aim of this study was to investigate circulating selectin adhesion molecules, which are known to play a significant part in the immune response especially by regulating interactions of the leucocytes with endothelium, in BD.
METHODS—Plasma E-, L-, and P-selectin concentrations were evaluated in 11 patients with widespread BD (group I), 10 cases with merely mucocutaneous involvement (group II) and 15 age and sex matched healthy control subjects. The patients were newly or previously diagnosed cases not taking any drug for BD.
RESULTS—Plasma concentrations of all selectins were significantly higher in group I compared with group II. E-selectin and P-selectin were significantly increased in each subgroup of patients compared with the healthy controls. L-selectin concentrations were higher than the controls only in group I.
CONCLUSIONS—Increases in the selectins in BD may be a direct consequence of the leucocyte, endothelium and platelet activations observed during the disease process. However, abnormal/increased selectin expression to various triggers should also be considered. More prominent increases in patients with extensive disease suggest that circulating selectin concentrations are related to disease severity.


The Plasma Levels Of Prostanoids And Plasminogen Activator Inhibitor-1 In Primary And Secondary Thrombocytosis

An elevated platelet count is a common finding in both hospitalized and ambulatory patients. Thrombosis and bleeding complications are more frequently observed in patients with clonal thrombocytosis than secondary thrombocytosis. The aim of this study was to investigate the behaviors of plasminogen activator inhibitor type 1 (PAI-1), the inhibitor of fibrinolysis; and thromboxane A2 and 6-keto-PGF1 alpha, the products of endoperoxides, in 16 patients affected with clonal thrombocytemia as compared with 16 patients with reactive thrombocytosis and 15 normal controls. In the clonal thrombocytemia group, plasma levels of PAI-1 antigen and activity were significantly higher than both reactive thrombocytosis and control group. Plasma levels of 6-keto-PGF1 alpha were significantly higher in the clonal thrombocytemia group than the other two groups and also higher in the reactive thrombocytosis group than the control group, which was also significant. This study confirms that arachidonate metabolism is frequently deranged in patients with thrombocytosis and hypofibrinolysis due to increased PAI-1 plasma levels as shown in the clonal thrombocytosis group. This may explain the thrombotic tendency in myeloproliferative disorders.WoSScopu

Management of chronic diseases and healthcare use among the elderly in Turkey and Turkish migrants

Erdsiek F, Aksakal T, Padberg D, et al. Management of chronic diseases and healthcare use among the elderly in Turkey and Turkish migrants. In: 16th World Congress on Public Health 2020. Public Health for the future of humanity: analysis, advocacy and action. European Journal of Public Health. Vol 30. Oxford: Oxford Univ Press; 2020: V814

Antibiotikanutzung bei Menschen mit türkischem Migrationshintergrund:Wissen, Einstellungen und Interaktion mit ÄrztInnen und ApothekerInnen

Erdsiek F, Aksakal T, Ozcebe H, et al. Antibiotikanutzung bei Menschen mit türkischem Migrationshintergrund – Wissen, Einstellungen und Interaktion mit ÄrztInnen und ApothekerInnen. Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)). 2019;(01):5-71.ZIEL DER ARBEIT: Kulturelle Aspekte der Medikamentennutzung in der Türkei können aufgrund ausgeprägter transnationaler Beziehungen das Nachfrageverhalten von Menschen mit türkischem Migrationshintergrund in Deutschland beeinflussen. Über die Antibiotikanutzung in dieser Bevölkerungsgruppe ist allerdings wenig bekannt. Die Studie untersucht, wie sich das Nachfrageverhalten von Menschen mit türkischem Migrationshintergrund und die Interaktion mit dem Gesundheitssystem im Zusammenhang mit der Antibiotikanutzung gestalten, welche Einstellungen zugrunde liegen und wie diese mit vorhandenem Hintergrundwissen zusammenhängen. METHODIK: Mit einem qualitativen Ansatz wurden Handlungslogiken und das Verhalten von türkeistämmigen Erwachsenen in Deutschland untersucht. Dazu wurden leitfadengestützte Fokusgruppeninterviews mit türkeistämmigen Erwachsenen und Experteninterviews mit HausärztInnen und ApothekerInnen durchgeführt und inhaltsanalytisch ausgewertet. ERGEBNISSE: Während bei jüngeren Menschen eine positive, aber vorsichtige Haltung gegenüber der Einnahme von Antibiotika vorliegt, finden sich bei Älteren teilweise übersteigerte Erwartungen an die Wirksamkeit, die auf fehlendes Faktenwissen zurückgehen. Insgesamt nehmen die TeilnehmerInnen eine passive Patientenrolle in der Interaktion mit HausärztInnen ein, wodurch bestehende Informationslücken teils nicht geschlossen werden. SCHLUSSFOLGERUNGEN: Ältere Menschen mit türkischem Migrationshintergrund haben teils unrealistische Erwartungen an die Wirksamkeit von Antibiotika. In Zusammenhang mit einer passiven Patientenrolle werden Informationsbedarfe und -bedürfnisse nicht befriedigt, was die Arzt-Patient-Beziehung belasten kann. Eine Anpassung der Kommunikation und eine migrationssensible Informationsvermittlung sind daher notwendig

EFFECT OF DESMOPRESSIN (DDAVP) ON PROTEIN-C AND PROTEIN-C INHIBITORS IN UREMIA

The effect of desmopressin (DDAVP) on protein C (PC) and PC inhibitors was investigated in 7 uremic predialysis patients, 7 hemodialysis patients and 7 controls. Significant decrease in PC activity was observed in all groups after DDAVP administration. Desmopressin did not influence PC antigen and two well-known PC inhibitors, plasminogen activator inhibitor-3 and alpha1-antitrypsin. Thus, it is suggested that DDAVP-induced decrease in PC activity is not related to the changes in PC inhibitors; further studies are needed to clarify the precise mechanisms of the effect of DDAVP on PC in uremia