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Biomedical subjects

Cengiz Beyan

Publications and source records attributed to Cengiz Beyan.

35 records · Page 2Linked to original sources
PubMed2004

The effects of desflurane on human platelet aggregation in vitro.

In view of the possible antiplatelet effects of general anesthetics, we investigated the in vitro effects of desflurane, a new inhalation agent, on platelet aggregation. For 15 patients who underwent elective operations, blood was sampled with desflurane induction before and after anesthesia but prior to surgery so that platelet aggregation in the drawn blood could be tested before desflurane anesthesia and again after exposure to the anesthetic. Platelet aggregation was measured with a whole-blood aggregometer. Adenosine diphosphate (ADP), collagen, and ristocetin were used as aggregating agents. Our results showed that aggregation in response to ADP, collagen, or ristocetin was not inhibited in patients who received desflurane anesthesia. This study with an in vitro model showed that desflurane had no influence on platelets in clinically relevant doses.

Adenosine Diphosphate↗
PubMed2003

An uncommon cause of fever in the elderly: late-onset systemic lupus erythematosus.

Infections, tumors and multisystem disease are common causes of fever of unknown origin (FUO) in the elderly. Late-onset systemic lupus erythematosus (LO-SLE) is a very rare cause of FUO in elderly patients. Serositis and musculoskeletal manifestations are common, but fever as an initial manifestation in LO-SLE is rare. We present two patients with LO-SLE who manifested fever as an initial symptom. Fever was the only symptom for 2 months in the first case and for 3 months in the second. In conclusion, in geriatric patients who have fever, LO-SLE should be considered in the differential diagnosis.

Aged↗
PubMed2003

Itraconazole is not effective for the prophylaxis of fungal infections in patients with neutropenia.

Fungal infections are a major problem among patients with hematological malignancies. To evaluate the efficacy of itraconazole (200 mg twice daily) in the prophylaxis of fungal infections in neutropenic patients, we conducted a prospective trial. A total of 61 patients with acute leukemia (113 cytotoxic chemotherapy episodes) were enrolled in the study. One patient in the itraconazole group was excluded because itraconazole was not taken due to gastrointestinal hemorrhage. Because the duration of neutropenia (neutrophil count, <0.5 x 10(9)/l) did not reach 7 days, 3 (1 patient) and 13 (4 patients) cytotoxic chemotherapy episodes in the itraconazole and control groups, respectively, were excluded. After these exclusions, the study population consisted of 31 patients (54 cytotoxic chemotherapy episodes) who had taken itraconazole and 24 patients (43 cytotoxic chemotherapy episodes) who had not taken itraconazole. Prophylactic treatment was initiated on the first day of chemotherapy and was continued until the end of the neutropenic period (absolute neutrophil count, >1 x 10(9)/l) unless a systemic fungal infection was documented or suspected. Thirteen episodes (24%) in the itraconazole group and 7 episodes (16%) in the control group proceeded to intravenous amphotericin B (P > 0.05). Fungal infections occurred in 9 episodes (17%) in the itraconazole group and in 5 episodes (12%) in the control group (P > 0.05). Overall mortality was five deaths in the itraconazole group and two in the control group. These deaths were not due to clinically documented fungal infection. In our study, efficacy of itraconazole in the prophylaxis of fungal infections in neutropenic patients was not detected.

Adult↗
PubMed2003

Effect of plateletpheresis on complete blood count values using three different cell separator systems in healthy donors.

The aim of this study is to investigate changes of CBC values after plateletpheresis in healthy and volunteer donors by using three different cell separator systems. The platelets were collected from 95 donors using the COBE Spectra, from 87 donors using the Fenwal CS-3000 Plus, and from 83 donors using the Fresenius AS-204. After plateletpheresis, white blood cells (WBC), hemoglobin (HGB), hematocrit (HCT), and platelets (PLT) were decreased significantly. When we used the COBE Spectra, the drop in the values of HGB and HCT was significantly less than for the other devices. It is recommended that hematological parameters should be monitored carefully in donors who are supposed to undergo long-term regular apheresis, and to prevent the occurrence of an artificial anemia, which is likely to happen. Selection of cell separator systems should be based on this possibility.

Blood Cell Count↗
PubMed2002

Spironolactone: is it a novel drug for the prevention of amphotericin B-related hypokalemia in cancer patients?

OBJECTIVE: Nephrotoxicity is the major adverse effect of amphotericin B (AmB), often limiting administration of full dosage. Selective distal tubular epithelial toxicity seems to be responsible for the profound potassium wasting that is a major clinical side effect of treatment with AmB. Potassium depletion also potentiates the tubular toxicity of AmB. This study was designed to assess the ability of spironolactone to reduce potassium requirements and to prevent hypokalemia in neutropenic patients on AmB treatment. METHODS: In this study 26 patients with various hematological disorders were randomized to receive either intravenous AmB alone or AmB and oral spironolactone 100 mg twice daily when developing a proven or suspected fungal infection. RESULTS: Patients receiving concomitant AmB and spironolactone had significantly higher plasma potassium levels than those receiving AmB alone (P = 0.0027). Those patients receiving AmB and spironolactone required significantly less potassium supplementation to maintain their plasma potassium within the normal range (P = 0.022). Moreover, urinary potassium losses were significantly less in patients receiving AmB and spironolactone than those receiving AmB alone (P = 0.040). CONCLUSION: This study showed that spironolactone can reduce potassium requirements and prevent hypokalemia by reducing urinary potassium loss in neutropenic patients on AmB treatment.

Amphotericin B↗
PubMed2002

Lack of platelet aggregation abnormality in Hodgkin's disease.

A high risk of venous thromboembolism or an increased bleeding tendency has been reported in patients with clinically diagnosed or occult cancer. That is why, in this study, the presence of platelet dysfunction in patients with newly diagnosed Hodgkin's disease was investigated. Platelet aggregation studies were performed in 31 patients with a mean age of 27.53+/-2.75 years and in 31 healthy volunteers with a mean age of 24.37+/-3.21 years. None of the patients had a history or a finding of bleeding diathesis or thromboembolism. A Lumi-Dual platelet aggregometer (Chrono-Log Corporation, Model 450) was used for platelet aggregation in platelet-rich plasma. Platelet aggregation responses were evaluated with ADP, collagen, epinephrine, and ristocetin. No significant difference could be found when compared with the results of healthy volunteers. In five of the patients, a primary, but not a secondary, response to ADP (2 microg/ml) was obtained (p < 0.02). Platelet dysfunction was not found in patients with newly diagnosed Hodgkin's disease in this study. One of the various pathogenic mechanisms of tumour-related thrombosis or haemorrhagic diathesis may play a role in oncological patients; for this reason, each patient should be investigated individually.

Adenosine Diphosphate↗
PubMed2002

Facial paresis after fludarabine treatment for advanced chronic lymphocytic leukaemia.

This case report discusses a case with advanced-stage chronic lymphocytic leukaemia (CLL) that presented with facial paresis after fludarabine treatment. A 68-year old patient with CLL (Rai classification, stage IV) was admitted to Gülhane Military Medical Academy for treatment. Fludarabine, 30 mg/m2 daily for 5 days, was given. Right facial paresis was observed at day 8 after administration of fludarabine. The general and psychiatric condition of the patient in myelosuppression did not permit aetiological investigation for paresis. Thereafter, the patient died due to septic shock. Possible aetiological reasons why the patient being treated for advanced-stage CLL had facial paresis after the administration of fludarabine ended are discussed.

Aged↗
PubMed2002

Total skin electron beam therapy for cutaneous T-cell lymphoma: Turkish experience with translational technique.

Mycosis fungoides is the most common form of cutaneous T-cell lymphoma. In our department, between January 1995 to January 2001, we treated eleven patients with mycosis fungoides by total body skin electron irradiation to evaluate its influence. According to our knowledge, our department is the only center in Turkey capable of applying total skin electron beam therapy. Total skin electron beam therapy was applied by using the "translational technique". Daily doses (4 Gray) were given in a total of seven fractions according to the conventional fractionation scheme. There were 6 patients with stage I disease, 3 patients with stage II and 2 patients with stage IV disease. Except stage IV patients, we obtained good cutaneous results. According to our observation, in early stage mycosis fungoides total body skin electron irradiation can provide good cutaneous response, but for stage IV only moderate pallation can be obtained.

Aged↗
PubMed2002

Severe hyperglycemia as a complication of big ICE chemotherapy in a patient with acute myeloblastic leukemia.

BACKGROUND: Big ICE chemotherapy (consisting of Idarubicin, high dose Cytosine arabinoside and Etoposide), has proven its efficacy in the treatment of patients with relapse/refractory acute myeloblastic leukemia. In this case report, we present a patient developing the complication of severe hyperglycemia following administration of big ICE because of a relapse of acute myeloblastic leukemia. CASE REPORT: When a 41-year-old woman with acute myeloblastic leukemia in relapse was treated using the big ICE protocol, because of lack of efficacy of other chemotherapy regimens. On the 7th day and 9th day of chemotherapy, glycemia was 13.2 mmol/l and 25.8 mmol/l, respectively. Hyperglycemia was controlled with continuous regular insulin infusion and neutralization of parenteral nutrition solution with regular insulin. After the regulation of the glycemia, regular insulin was injected four times daily. Following days, hematological remission was obtained and requirement of insulin becomes less and glycemia decreased to the normal levels. CONCLUSION: Severe hyperglycemia/diabetes mellitus likely due to chemotherapy may develop in patients with acute leukemia. This may have a negative effect on mortality and morbidity. For this reason, these patients should be followed closely.

Adult↗
PubMedDate not supplied

Total parenteral nutrition delays platelet engraftment in patients who undergo autologous hematopoietic stem cell transplantation.

OBJECTIVES: One of the major challenges in the post-transplant period is nutrition. In this prospective, non-randomized study, total parenteral nutrition (TPN) was given to 31 patients and partial parenteral nutrition (PPN) was given to 30 patients undergoing autologous hematopoietic stem cell transplantation for solid tumors or hematologic malignancies to compare the effects of these parenteral nutrition modalities on post-transplant hematological engraftment, blood chemistry, and supportive therapy requirements. METHODS: All patients in the TPN group and 17 patients in the PPN group received growth factor in the post-transplant period. Both groups did not differ with respect to sex, age, and reinfused CD34(+) cell numbers. RESULTS: After transplantation body mass index and body weight decreased significantly in both groups (P < 0.001). Whereas serum albumin concentrations did not decrease significantly in the TPN group, it fell markedly in the PPN group at the end of parenteral nutrition (P = 0.019). After parenteral nutrition, blood chemistry was also remarkable for serum urea and glucose levels, which were elevated significantly in the TPN group (P < 0.001 and P = 0.03, respectively). Patients receiving TPN had a higher incidence of positive microbial cultures and clinical infection than did patients receiving PPN (64.5% versus 40%, P = 0.05). The most striking result was a delay in platelet engraftment for the TPN group compared with the PPN group (15.54 and 12.93 d, respectively; P = 0.014). This difference was also noted in patients using growth factor in the PPN group (P = 0.017). Parallel to these results, platelet transfusion requirement increased in the TPN group compared with the PPN group (1.93 versus 1.16 U, P = 0.004). Both groups were unremarkable for leukocyte recovery and red blood cell transfusion requirement. CONCLUSIONS: Consequently, TPN has some pitfalls of hyperglycemia, infection tendency, delayed platelet engraftment, and increased platelet transfusion requirement. Therefore, it should not be used as a standard nutrition support for patients undergoing autotransplantation.

Adolescent↗