An effective treatment strategy for Felty syndrome (FS) has not been developed so far.In this article, three cases with FS, who responded to different treatment modalities, have been presented.Case 1 was a 52-year-old male patient who initially received methotrexate, and then, he was switched to granulocyte colony-stimulating factor (G-CSF) and cyclosporine treatment when his neutropenia was further deteriorated.The patient needed monthly doses of G-CSF for nearly 6 months, and his steroid dose was increased.Afterwards, his neutropenia improved with cyclosporine, methotrexate, and hydroxychloroquine combination treatment.Case 2 was a 78-year-old female patient who was started on leflunomide, hydroxychloroquine, and 60 mg methylprednisolone.Case 3 was a 69-year-old female patient who was first treated with 32 mg methylprednisolone, G-CSF, and then with cyclosporine.Neutropenia of both patients improved, and their health status normalized at 2 months.Different treatment strategies have been tried for the management of FS; disease-modifying anti-rheumatic drugs have been used successfully alone or in combination with G-CSF.As seen in the last case, it should be kept in mind that patients can present predominantly with symptoms of infection or hematologic disorders.
Objective: We aimed to evaluate the prognostic significance of the aspartate aminotransferase(AST) / alanine aminotransferase (ALT) named as (De Ritis) ratio in patients hospitalized in the intensive care unit with the diagnosis of upper gastrointestinal (GI) bleeding. Method: We retrospectivelyanalyzed the clinical and laboratory data of 243 patients admitted with upper GI bleeding to the intensive care unit of our tertiary hospital between January 2018 and April 2022. The potential prognostic parameters between survivors and non-survivors groups and then between low De Ritis and High De Ritis groups were compared. The effect of the De Ritis ratio on in-hospital mortality was investigated by logistic regression analysis. Results: Of the two hundred andforty-three patients hospitalized with upper GI bleeding, 65.8% were male. The mean age of the patients was 68.6±11.56. The cut-off value for low and high De Ritis groups was selected as 1.57,which value seperated second tertile and third tertile of the patient population.İn hospital mortality rate was 13.1%. While albumin level was higher in the low De Ritis group, ALT, AST, and INR values were higher in the high De Ritis group. No statistically significant correlation was found between these two groups in terms of mortality. Moreover, De Ritis ratio did not show a significant difference between survivors and non-survivors (p=0.058). Conclusion: It was concluded that the rate of De Ritis is not an independent predictive factor for mortality in patients with upper GI bleeding. But, more prospective and randomized studies are needed to evaluate clearly the prognostic value of the De Ritis ratio in upper GI bleeding patients. Keywords: De Ritis ratio, aspartate aminotransaminase, alanineaminotransaminase, upper gastrointestinal bleeding, mortality
Objective: To demonstrate the distribution of ABO, and Rh blood groups in the blood, and blood products donated by volunteered blood donors living in Sakarya Province in Turkey. Methods: Data of blood, and blood products donated by volunteered blood donors who presented to Sakarya University between January 2009, and September 2013 were retrospectively analyzed. Blood typing was performed with EDTA-added blood samples using tube agglutination method, and gel card agglutination techniques in an automated blood grouping device. Results: According to our results distribution of blood groups among our study participants was as follows:0 Rh(+) 30.2%; 0 Rh(-) 5.6%; A Rh(+) , 38.1%; A Rh(-), 6.2%; B Rh(+),10.5%; B Rh(-), 2.1%; AB Rh(+), 6.2%, and AB Rh(-), 1.3% . In our study blood typing results without considering Rh factor were detected in respective percentages of patients were as follows: A ,44.3%; 0, 35.7%; B, 12.5%, and AB, 7.5%. Rates of Rh (+) (84.9%), and Rh (-) (15.1%) were also calculated as indicated. Conclusion: Generally, in compliance with data in Turkey, in our study blood group A had a markedly higher while rates of blood groups B, and AB had the lowest incidence rates. We think that this study will contribute to the establishment of databank of Distribution of Blood Groups in Turkey.
e12564 Background: Patients with oligometastatic disease achieve long-term survival with multimodality treatment strategies. However, little attention has been paid to the effect of adjusting systemic therapy after local therapy in clinical studies. The aim of this study was to investigate the effects of changing or continuing the same treatment regimen following local therapy on survival parameters. Methods: Out of 350 metastatic breast cancer patients, treated between 2012 and 2016, 43 patients (12%) with oligometastatic disease were included in our study. Oligometastasis was defined as < 5 metastatic sites in the same or different organs. Results: At a median follow-up of 32 months (7–53 months), 29 (67.4 %) patients had died. The one- and two-year overall survival (OS) rates were 95% and 78%, respectively, and the one- and two-year progression-free survival (PFS) rates were 77% and 51%, respectively. Following stereotactic body radiotherapy (SBRT) to oligometastatic sites, systemic treatment protocols were changed in 28 (65.1%) patients, while systemic treatment was continued unchanged in 15 (34.9%) patients. Changes to systemic treatment were significantly higher in patients with two organ metastases compared to patients with one organ metastasis ( p= 0.04). In the univariate analysis, estrogen receptor (ER) status and triple negative disease were significantly predictive of OS. The ER status and the number of metastatic organs were identified as significant predictors of PFS. In the multivariate analysis, only age emerged as a significant independent predictor of OS, while the number of initial organs involved and triple negative disease were significant factors for PFS. Conclusions: A hybrid treatment strategy is associated with higher survival rates in oligometastatic breast cancer patients. Post-SBRT systemic treatment change had no significant impact on OS and PFS in this study.
In this paper, generalized Fermi–Walker derivative, generalized Fermi–Walker parallelism and generalized non-rotating frame concepts are given for Frenet frame, Darboux frame and Bishop frame for any curve in Euclidean space. Being generalized, non-rotating frame conditions are analyzed for each frames along the curve. Then we show that Frenet and Darboux frames are generalized non-rotating frames along all curves and also Bishop frame is generalized non-rotating frame along planar curves in Euclidean space.
In this paper, generalized Fermi derivative, generalized Fermi parallelism, and generalized non-rotating frame concepts are given along any curve on any hypersurface in Eⁿ⁺¹ Euclidean space. The generalized Fermi derivative of a vector field and being generalized non-rotating conditions are analyzed along the curve on the surface in Euclidean 3-space. Then a correlation is found between generalized Fermi derivative, Fermi derivative, and Levi-Civita derivative in E³. Then we examine generalized Fermi parallel vector fields and conditions of being generalized non-rotating frame with the tensor field in E⁴. Generalizations have been made in Eⁿ.
Aim: We aimed to investigate the effects of diabetes treatment modalities on haematological parameters and leukocyte formula in patients with type 2 diabetes mellitus.Materials and Methods: The study included 102 patients with type 2 diabetes, out of which 51 receiving insulin treatment and 51 receiving oral antidiabetics (OAD). Hemogram data of insulin and OAD treated groups were compared.Results HbA1c levels were 11.12 ± 2.09 mg/dl in insulin group and 7.94 ± 2.1 mg/dl in OAD group p=0.001. Platelet counts were 27866.67 ± 77693 109/L before treatment and 258941.18 ± 69068.2 109/L in OAD group at six months, p: 0.015 whereas; 293011.76 ± 73711.21 109/L before treatment and 289492.86 ± 82631.49 109/L in insulin group at six months p: 0.821. Monocyte counts were 0.47 ± 0.12 109/L before the treatment and 0.57 ± 0.12 109/L in mix insulin therapy subgroup at six months, p:0.004; monocyte percentage was % 6.11 ± 1.74 before the treatment and %7.51 ± 2.57 in mix insulin subgroup at six months p:0.039; Basophiles counts were 0.1 ±  0.02 109/L before treatment and 0.09 ± 0.04 109/L in intensive insulin therapy subgroup at six months, p: 0.005; Lymphocyte and basophils counts were significantly decreased at six months insulin treatment as compared to the pretreatment values.Conclusion: This study showed that, glucose control effects; blood indices HbA1C, basophiles, eosinophils, platelets and lymphocytes counts.
