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Biomedical subjects

M Cetin

Publications and source records attributed to M Cetin.

At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

Premenstrual exacerbation and suicidal behavior in patients with panic disorder.

This study examined the relationship between premenstrual exacerbation and suicidal behavior in patients with panic disorder. Twenty-eight patients who reported a premenstrual exacerbation of panic disorder and 42 patients who reported never having an exacerbation were included in the study. The subjects completed a self-rating instrument assessing the 13 DSM-III-R panic symptoms on a 5-point scale (0 = absent, 1 = mild, 2 = moderate, 3 = severe, and 4 = very intense). They also completed the severity scale of the Clinical Global Impression. The Schedule for Affective Disorders and Schizophrenia (SADS) suicide subscale was used to rate the severity of active suicidality. We found that patients with premenstrual exacerbation of panic disorder had higher SADS suicidality scores than patients with panic disorder without premenstrual exacerbation. They were also more likely to be classified as suicidal than the others. It may be that premenstrual exacerbation is a risk factor for suicidal behavior independent of major depression in patients with panic disorder.

Adult↗
PubMedDate not supplied

Vitamin B12 absorption test and oral treatment in 14 children with selective vitamin B12 malabsorption.

Oral vitamin B12 (VB12) absorption was studied in 12 patients with selective VB12 malabsorption and in 6 age-matched healthy controls. Serum VB12 level was measured before and 3 h after oral administration of VB12 100 or 1000 micrograms. After administration of 1000 micrograms of VB12 an appreciable increase in the serum VB12 level was observed in patients as well as in controls. The mean of the increase in the serum VB12 level did not differ between patients and the controls (273 +/- 203 pg/mL, 180 +/- 71 pg/mL, respectively P > .05). Twelve patients previously treated by parenteral VB12 were switched to, and 2 newly diagnosed patients were started on, oral VB12 treatment of 1000 micrograms given every 2 weeks. Hematological parameters and serum VB12 levels remained stable after switching to oral therapy in the 12 patients. In the two newly diagnosed patients anemia was cured by orally administrated VB12. This study lends further support to the use of megadoses of VB12 as an alternative treatment for selective VB12 malabsorption.

Administration, Oral↗
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Oral treatment in selective vitamin B12 malabsorption.

PURPOSE: The efficacy of oral treatment with megadose vitamin B12 in a patient with selective vitamin B12 malabsorption is studied. PATIENTS AND METHODS: An 8-year-old boy with megaloblastic anemia due to selective vitamin B12 malabsorption is presented. His history was significant for anemia of 4 years duration, requiring transfusion on two occasions. On admission, the Hb was 7.9 g/dL, WBC 6 x 10(9)/L, mean corpuscular volume 124 fl, red cell distribution width 16.8%, platelets 156 x 10(9)/L, reticulocyte 0.04%, and the serum vitamin B12 level 87 pmol/L. There was proteinuria. Replacement treatment with oral B12 1,000 micrograms/daily was instituted. RESULTS: Reticulocytosis was observed on the third day of treatment, which was followed by a gradual increase in Hb level to 12 g/dL in 3 weeks. A Schilling test performed after a 5-day interruption of therapy was compatible with malabsorption. CONCLUSIONS: Our study suggests that the oral route is as effective as the parenteral route when vitamin B12 is given at a dose larger than that of parenteral therapy.

Administration, Oral↗
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Serum interleukin 1 alpha and interleukin 2 levels in patients with schizophrenia.

It has been suggested that altered interleukin (IL) regulation may be involved in the pathogenesis of schizophrenia. In this cross-sectional, case-controlled study, patients with schizophrenia and a control group of healthy subjects, matched by age, sex and body mass index, were evaluated. The levels of IL-1 alpha and IL-2 in blood serum were measured by enzyme-linked immunosorbent assay. The fasting serum IL-2 levels were significantly higher in patients with schizophrenia compared with the control subjects, but there was no difference between the fasting serum levels of IL-1 alpha in patients with schizophrenia and the control subjects. Our results suggest that patients with schizophrenia have altered IL-2, but not IL-1 alpha, regulation.

Adult↗
PubMedDate not supplied

Convulsion after blood transfusion in four beta-thalassemia intermedia patients.

Four children with beta-thalassemia intermedia ages 7 to 11 years developed a clinical picture characterized by headache, hypertension, convulsion, and cerebral hemorrhage after blood transfusion. Successive transfusions did not result in a similar picture. Factors responsible for this syndrome are discussed.

Cerebral Hemorrhage↗
PubMedDate not supplied

Familial selective vitamin B12 malabsorption (Imerslund-Gräsbeck syndrome) in a pool of Turkish patients.

Thirty-six patients with Imerslund-Gräsbeck syndrome are presented. The mean ages at presentation and diagnosis were 4.7 +/- 3.7 years and 7.2 +/- 4.2 years, respectively. The mean hemoglobin level was 5.8 +/- 2.2 g/dL, the mean cell volume was 104.9 +/- 11.6 fL, the white blood cell count was 4479 +/- 2022/mm3, and the serum vitamin B12 level was 96.9 +/- 73 pg/mL. At diagnosis, 5 of the 36 patients, aged 5 to 16 years, had neurologic symptoms. All the patients had severe megaloblastic changes in bone marrow precursor cells. Proteinuria was detected in 78% of them. Patients with proteinuria had a younger age of onset (P < 0.0001) and diagnosis (P < 0.001) compared with those without proteinuria. In all patients, vitamin B12 excretion unbound to intrinsic factor after a flushing dose of vitamin B12 was lower than normal, and there was no appreciable correction in urinary vitamin B12 excretion after binding of intrinsic factor. The impairment of vitamin B12 absorption studies in Schilling tests; however, showed great variation among patients. Serum haptoglobin values were close to zero in all patients, indicating the presence of that intravascular hemolysis in Imerslund-Gräsbeck syndrome. Variations among patients in the age of presentation, degree of impairment of vitamin B12 absorption, and presence or absence of proteinuria suggest a heterogeneity in etiology of Imerslund-Gräsbeck syndrome at the molecular level.

Adolescent↗
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Congenital hypoplastic anemia in six patients: unusual association of short proximal phalanges with mild anemia.

Six congenital hypoplastic anemia (CHA) patients from five families who have been followed from 2 months to 28 years are presented. Mild hypoplastic anemia in a 13-year-old girl was associated with clinodactyly of the fifth finger on both hands, shortness in the proximal phalanges on all fingers, and syndactyly between the second and third toes and short fourth toe on the right foot. These abnormalities, except for clinodactyly, have not been reported previously in CHA. In one of the five families genetic transmission was thought to be autosomal-dominant since both the father and the son had the disease. Therapy with corticosteroids was initiated in all patients at the ages of 3.5 months to 13 years. Complete or near-complete recovery of anemia was obtained.

Adolescent↗
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Necrotizing otitis externa, otitis media, peripheral facial paralysis, and brain abscess in a thalassemic child after allogeneic BMT.

Severe infection is one of the major complications in the early and late post-bone marrow transplantation period. The authors report a thalassemic child who developed necrotizing otitis externa and otitis media, a very rare complication after bone marrow transplantation, and then peripheral facial nerve paralysis and brain abscess in the early period of bone marrow transplantation despite antibacterial and antifungal prophylaxis. Necrotizing otitis media is characterized by necrosis and sloughing of considerable areas in the middle ear and adjacent tissues and is an unusual disorder because of today's antibiotics. Granulocytopenia and background ear tissue exposed to previous repeated otitis media attacks may be the predisposing factors in this case. The authors conclude that the children with previous histories of recurrent otitis media should be prepared and monitored very carefully during bone marrow transplantation because of the risk of necrotizing otitis media, especially in the granulocytopenic period.

Anti-Bacterial Agents↗
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Profile of bone marrow iron stores in childhood iron deficiency anemia.

To demonstrate the importance of bone marrow iron stores, we examined the complete hemogram, serum iron (SI), serum iron-binding capacity (SIBC), transferrin saturation (TS), serum ferritin and bone-marrow-stored iron in 31 children with iron deficiency (ID). The ages of the patients ranged from one to 14 years (mean 3.7 +/- 3.9). Laboratory findings of the 31 patients were as follows: hemoglobin (Hb) 8.5 +/- 2.4 g/dl, hematocrit (Hct) 27.8 +/- 6.3 percent, mean corpuscular volume (MCV) 58.6 +/- 8.6 fl, red blood cell count (RBC) 4 +/- 0.8 10(12)/L, red cell distribution width (RDW) 19.3 +/- 4.9, SI 17.2 +/- 9.3 microg/dl, SIBC 311 +/- 50.5 microg/dl, TS 5.5 +/- 2.8 percent and ferritin 6.7 +/- 7.3 ng/dl. In the bone marrow smears with iron stains, all patients' scores were zero for iron stores, which shows that bone-marrow-stored iron in childhood is easily affected. Because of the traumatic effect of bone marrow aspiration, it is recommended that it not be done routinely. The diagnosis of ID could be especially difficult in patients with low SI levels but normal SIBC levels and in patients with chronic inflammatory diseases. In those conditions, illustration of bone marrow stores could be of particular assistance for diagnosis of iron deficiency.

Adolescent↗
PubMedDate not supplied

Ultrastructural findings of bone marrow in a case with malignant osteopetrosis following successful allogeneic bone marrow transplantation.

A nine-month-old female patient suffering from malignant osteopetrosis was evaluated by light and transmission electron microscopic study before and following allogeneic bone marrow transplantation (BMT). Bone marrow specimens were obtained from iliac crest biopsies. Before BMT, the bone marrow had an irregular appearance and was filled with bridging bony trabeculae devoid of cells. Following BMT, the marrow had an almost normal appearance with no myelofibrosis and a relatively regular distribution of hematopoletic cells. The osteocytes were visible in their lacunae in the bone matrix. Presence of bone resorbing and bone forming cell together demonstrated that the bone was beginning to gain its normal dynamic structure. These findings were in accordance with the clinical, laboratory and radiological data which showed the beneficial effect of the therapy.

Bone Marrow↗
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Autoimmune hemolytic anemia with warm antibodies in children: retrospective analysis of 51 cases.

In this paper, research based on 51 children with a positive antiglobulin test is presented. Eighteen of the children had acute anemia and 33 had chronic anemia. Two clinical patterns were distinguished: an acute transient type and a prolonged chronic type. Corticosteroid therapy was effective in all acute cases but its results were variable in the chronic cases. The acute form was more frequent in young children, while chronic autoimmune hemolytic anemia (AIHA) occurred mainly among children at puberty. In the chronic form of the disease, it was sometimes necessary to add immunosuppressive drugs and in two cases to perform a splenectomy.

Acute Disease↗
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Allogeneic bone marrow transplantation for children with myelodysplastic syndrome.

Six children with myelodysplastic syndrome underwent allogeneic bone marrow transplantation (BMT) from their HLA-identical siblings. Ages ranged from six to 16 years. French-American British (FAB) diagnosis was refractory anemia with excess blasts (RAEB) in three, RAEB in transformation (RAEB-t) in one and chronic myelomonocytic leukemia (CMML) in two cases. Two patients had progressed to leukemia before BMT. All patients received busulfan and cyclophosphamide as a conditioning regimen. Antithymocyte globulin (ATG) was administered to two of them due to the multiple transfusion history. Graft versus host disease (GvHD) prophylaxis consisted of cyclosporine-methotrexate. Engraftment was documented in all patients except one who underwent a second infusion of bone marrow cells. She died in the early post-transplant period with pancytopenia and veno-occlusive disease of the liver. Two patients died from disease recurrence. Three patients are alive > 12 months post-transplant, two are in remission and one just relapsed at +16 months and is now being prepared for a second bone marrow transplant. The only significant factor for favorable outcome was short duration between diagnosis to transplant in the two patients in remission.

Adolescent↗
PubMedDate not supplied

Primary hemophagocytic lymphohistiocytosis in Turkish children.

Nineteen children with hemophagocytic lymphohistiocytosis (HLH) were studied in the Department of Pediatric Hematology, Hacettepe University. Patients were divided into two groups. Group 1: Thirteen patients were classified as having a genetic etiology (7 familial, 6 presumed familial) on the basis of an affected sibling and consanguinity. There was a history of consanguineous marriage in 13 of the families. Seven of them had a history of a sibling with HLH. Group 2: Six patients were diagnosed with sporadic HLH. The age at presentation for familial patients was 0.7-84 months (mean 21.9 +/- 24.9 months), and for sporadic cases it was 2.5-48 months (mean 22.7 +/- 19.8 months). The clinical and laboratory data of these two groups were similar at diagnosis. Thirteen cases were diagnosed premortem by bone marrow aspiration. Splenic biopsy was performed in 2 patients. Four patients were diagnosed by postmortem examination. Elevated LDH levels were found in all patients tested. No significant differences for clinical and laboratory data were found between the two groups.

Bone Marrow↗
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Secondary acute myeloblastic leukemia in a child with acute lymphoblastic leukemia treated with epipodophyllotoxins.

Etoposide is a semi-synthetic, topoisomerase active podophyllotoxin derivative which frequently causes deletions and rearrangements on chromosomes 11q23 and 11q22. It can cause therapy-related, acute myeloblastic leukemia in patients receiving the drug in a schedule-dependent manner. Here we present a case with acute lymphoblastic leukemia who developed secondary acute myeloblastic leukemia 28 months after the beginning of therapy which contained etoposide on an every-other-week schedule.

Acute Disease↗
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Bernard-Soulier-like functional platelet defect in myelodysplastic syndrome and in acute myeloblastic leukemia associated with trilineage myelodysplasia.

Platelet function was studied in a child with myelodysplastic syndrome (MDS: refractory anemia with an excess of blasts) and a child with acute myeloblastic leukemia (AML-M6) associated with trilineage myelodysplasia (TMDS). An acquired Bernard-Soulier-like platelet defect was considered in both patients with the findings of prolonged bleeding time and abnormally large platelets that failed to aggregate in response to ristocetin. In contrast to findings in von Willebrand's disease, the abnormal response of platelets to ristocetin could not be corrected by the addition of normal flesh plasma. The detection of abnormal platelet aggregation response to ristocetin may be a useful diagnostic finding for clonal disorders causing impaired platelet function in MDS and coexistent TMDS associated with AML. Further studies of ristocetin-induced platelet aggregation in a large number of these patients are required.

Adolescent↗
PubMedDate not supplied

Neurologic findings of vitamin B12 deficiency: presentation of 7 cases.

In this report, seven children, four males and three females, between the ages of five and 16 years with megaloblastic anemia and neuropsychiatric disorders are presented. Macrocytosis was identified in peripheral blood smears in all seven patients. Serum B12 levels were markedly reduced in four and were at the lower limit of normal in three patients. The Schilling test showed that B12 deficiency was due to specific cobalamin malabsorption in five and to inadequate dietary intake in two patients. Both neurological and hematological findings returned to normal after B12 replacement. This study shows that B12 deficiency should be considered in the differential diagnosis of neuropsychiatric disorders in children, including those with nonvegetarian habits, and that such patients should undergo a thorough hematological evaluation.

Adolescent↗