Browsing by Author "Merter, Mustafa"

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Decreased Bone Mineral Density and Associated Factors in Severe Haemophilia a Patients: a Case-Control Study
(Wiley, 2019) Ekinci, Omer; Demircioglu, Sinan; Dogan, Ali; Merter, Mustafa; Yildiz, Saliha; Demir, Cengiz
Introduction Haemophilia patients may exhibit lower levels of bone mineral density (BMD) than the general population for a variety of reasons. Aim We aimed to investigate decreased BMD in people with severe adult haemophilia A (PWH) living in eastern Turkey, and to evaluate the related potential risk factors. Methods The study included 41 PWH and 40 healthy volunteers. Dual-energy x-ray absorptiometry (DXA) was used to measure the BMD. Blood tests and body mass index (BMI) were recorded. The Functional Independence Score in Hemophilia (FISH) test was used to measure functional ability status. Results There was a significant difference between the PWH and control groups with respect to femoral neck and total hip BMD (in g/cm(2)), but the difference for lumbar spine was not significant (P = .017, P < .001, P = .071, respectively). In PWH, patients under 50 years of age, 19.4% were found to have "lower than expected" BMD levels for their age, while 27.8% showed "low normal" levels. In PWH, osteoporosis was found in 60% of the patients over 50 and osteopenia in 20%. Vitamin D insufficiency and deficiency were present in 63.4% of the PWH, significantly higher than the control group (37.5%; P < .001). Conclusion The results indicated that the decrease in BMD was significantly greater in patients with severe haemophilia A than in the normal healthy population. This reduction was correlated with BMI, vitamin D and low functional ability status. However, in multivariate analysis, none of these was a strong independent risk factor.
Evaluation of Transfusion Transmitted Infections and Distribution of Abo and Rh Blood Groups in Donors in Eastern Turkey
(2019) Demir, Cengiz; Dogan, Ali; Demircioğlu, Sinan; Gurbuz, Ali Fuat; Kara, Osman; Merter, Mustafa; Ekinci, Ömer
Aim: Knowledge of blood group distribution and blood serology in a given region is critical for the proper functioning of blood banksand also for delivering the blood products to need owners. We aimed to determine the distribution rates of ABO and Rh blood groupsand the incidence of transfusion-transmitted infections in the healthy donors in our region.Materials and Methods: A total of 108,368 healthy individuals were participated in this study. Incidence of HBsAg, anti-HCV, anti-HIV-1/2 and syphilis along with blood group distribution were evaluated retrospectively.Results: Of the blood donors, 98,901(% 91.24) were male and 9,467 (%8.76) were female. Frequency of O, A, B, and AB blood groupdistribution in the donor population were 31.2%, 44.0%, 16.2%, and 8.6%, respectively. Of the blood donors, 95,039 (87.7%) were Rhpositive and 13,229 (12.3%) were Rh negative. A total of 1,685 donors (1.55%) tested positive for HBsAg, 102 (0.09%) for anti-HCV, 23(0.022%) for anti-HIV-1/2, and 58 (0.05%) tested positive for syphilis.Conclusion: The ABO and Rh blood antigens distribution rates found in our study were similar for male and female and resembledthe overall rates for Turkey. When looking at the annual analysis of the donor group, we observed a significant decrease of HbsAgtest positivity over a seven-year-period (p values for time periods 2008-2009, 2010-2011, 2012-2013, 2014-2015 were 0.016, 0.02,0.001, and 0.003 respectively). We believe that our results will be useful for the creation of a database on blood group distributionand the seroprevalence of infectious agents.
Spleen Stiffness Measurement by Using Shear-Wave Elastography as a Predictor of Progression To Secondary Myelofibrosis
(Lippincott Williams & Wilkins, 2021) Ekinci, Omer; Ozgokce, Mesut; Turko, Ensar; Merter, Mustafa
Objective Polycythemia vera (PV) and essential thrombocythemia (ET) are chronic myeloproliferative diseases that can transform to secondary myelofibrosis (SMF). In this study, we evaluated spleen stiffness using shear-wave elastography (SWE) as a predictor of progression to SMF. Methods Participants were grouped as healthy volunteers (HVs), PV/ET patients, and SMF patients. Participants' spleen sizes, spleen stiffness values, bone marrow fibrosis degrees, and the other parameters were evaluated. Spleen stiffness values and spleen sizes were compared between groups. Results Of the 121 participants included in this study, 52 patients were HVs, 52 patients were PV and/or ET patients, and 17 patients were SMF patients. In terms of age and sex, there was no difference between groups. Splenic parenchymal stiffness median values by using SWE were found to be 0.82 m/s in HVs, 1.41 m/s in PV/ET patients, and 2.32 m/s in SMF patients (P < 0.001). In terms of median length of the spleen, the difference between groups was significant (P < 0.001). In addition, we found a significant positive correlation between spleen stiffness and bone marrow fibrosis degree (P < 0.001, r = 0.757). However, in multivariate analysis, there was no strong independent risk factor for spleen stiffness. Conclusion In this study, we showed that measurement of spleen stiffness using SWE can distinguish SMF from PV/ET patients and HVs. Therefore, we believe that SWE may be used as a noninvasive and easily accessible method to check the fibrotic progression of bone marrow in PV and ET patients to monitor the transformation to SMF, and enables to detect fibrosis in early phase.
Therapeutic Plasma Exchange in Gastric Signet Ring Cell Carcinoma Presenting as Microangiopathic Hemolytic Anemia: a Rare Case Report
(Wiley, 2022) Candar, Omer; Ekinci, Omer; Merter, Mustafa; Aslan, Mehmet; Aras, Ibrahim
Microangiopathic hemolytic anemia (MAHA) defines a group of disorders characterized by the formation of microthrombi in capillaries and arterioles and the fragmentation of erythrocytes that pass through. Cancer-related MAHA is a rare but serious condition that is encountered in patients diagnosed with a malignancy. This clinical picture is thought to be linked to certain tumor characteristics; particularly, adenocarcinoma histology, vascular invasion, and bone marrow infiltration. MAHA is most commonly associated with tumors of gastric, prostate, and breast origin. The optimal treatment is not clear; however, there is evidence for the importance of promptly starting an effective antineoplastic regimen and it was also reported that administering therapeutic plasma exchange (TPE) therapy for immunocomplex removal could be beneficial for patients with symptoms of bleeding and thrombosis. Here, we present a case that presented a picture of MAHA secondary to gastric signet-ring cell adenocarcinoma (SRCC). The clinical picture was initially evaluated as thrombotic thrombocytopenic purpura and the patient benefited significantly from the TPE treatment administered before the adenocarcinoma diagnosis was confirmed. In this period, epistaxis stopped, platelet count increased from 25 x 10(9)/L to 162 x 10(9)/L, fragmented erythrocyte rate in the peripheral smear decreased by more than 75% and other laboratory findings of hemolysis (LDH, bilirubin, etc.) significantly improved.