The clinicopathological features and survival of Castleman disease: a multicenter Turkish study.

OBJECTIVE: In this study, we aimed to investigate the clinicopathological features and survival of CD, which is quite rare and has many unknowns. PATIENTS AND METHODS: This study was conducted by retrospectively evaluating patients diagnosed with CD in six different centers in Turkey. RESULTS: The median age of 33 patients included in the study was 49 and 51.5% (n = 17) of these patients were women. 18 (54.5%) patients were in the hyaline vascular subtype and most of the patients were UCD (n = 20, 60.6%). The most common involvement region was head and neck (n = 19, 57.5%). The UCD group was younger than the MCD group (p=0.027). Visceral lymph node involvement was higher in MCD than in UCD (p=0.001). Similarly, it was observed that there was more hepatomegaly (p=0.035) and splenomegaly (p=0.013) in the MCD group. During the median 19.5 months follow-up period, there were no patients who died. CONCLUSIONS: It was observed that UCD and MCD are different clinical entities. Promising survival times can be achieved with surgical and systemic treatments in both subtypes of this extremely rare disease. However, this result should be supported by well-designed prospective comprehensive studies.

The predictive effect of initial complete blood count of intensive care unit patients on mortality, length of hospitalization, and nosocomial infections.

OBJECTIVE: The mean platelet volume (MPV) can be used as an indicator of platelet activation. However, it has been shown that the platelet/lymphocyte ratio (PLR) can provide useful predictive information about inflammation and aggregation pathways. The neutrophil/lymphocyte ratio (NLR) may also be helpful as a marker of systemic or local inflammation. The main objective of this study evaluated to unselected critically ill patients the relationship of initial MPV, NLR, and PLR with mortality, length of hospitalization, and the risk of developing nosocomial infections in ICU patients. PATIENTS AND METHODS: In this retrospective study, we evaluated consecutive patients at our tertiary nine-bed ICU. One hundred seventy-three patients who were followed up during a 1-year period were included. RESULTS: MPV levels were found to be higher in patients who died in the hospital (p = 0.05). In addition, there was a significant positive correlation between expected mortality rate and MPV among non-survivors (p = 0.009). NLR levels were higher among non-survivors, but this difference was not statistically significant (p = 0.435). PLR levels were similar between non-survivors and survivors (p = 0.173). The initial NLR and PLR were significantly higher in patients with nosocomial infections. NLR and PLR had a significant positive correlation with length of hospitalization (p = 0.006 and p = 0.027, respectively). CONCLUSIONS: In our study, we found that high PLR and NLR may be indicators for the development of nosocomial infections. Moreover, the length of hospitalization may be prolonged in patients with high PLR and NLR.

Prognostic significance of flow cytometry findings in Turkish adult acute leukemia patients.

OBJECTIVE: Several factors are known to affect prognosis of acute leukemia such as age, high leukocyte count, cytogenetic abnormality, performance status and recurrent leukemia. We aimed to investigate the association between cell surface markers and prognostic determinants such as recurrence at 6 and 12 months and survival at 6, 12 and 18 months in acute leukemia patients. PATIENTS AND METHODS: A total of 142 patients, 101 with acute myeloid leukemia (AML) and 41 with B-cell acute lymphoblastic leukemia (B-ALL) were included. The effects of surface markers on survival and recurrence rates were evaluated retrospectively. RESULTS: In AML patients, CD5+ and CD34+ immunophenotypes and in ALL patients cCD22+, CD34+ and CD49f + CD19+ immunophenotypes were positive prognostic indicators. In AML patients CD7 expression, and in ALL patients CD5+, CD7+ and CD117+ immunophenotypes and >90% CD45 expression were negative prognostic indicators. CONCLUSIONS: This study demonstrates that flow cytometry, a common diagnostic tool in acute leukemia, may also have prognostic value in acute leukemia in the future.

The predictive value of epidemiological characteristics, clinical and laboratory findings in adult lymphadenopathy etiology.

OBJECTIVE: Our aim was to determine the presence or absence of malignant etiology in the epidemiological, clinical and laboratory results of patients undergoing lymph node biopsies. PATIENTS AND METHODS: This study was carried out between January 2013 and April 2014. We enrolled a total of 150 adult patients who had lymph node biopsies. 73 of these were females (48.7%) and 77 were males (51.3%). The epidemiological characteristics, clinical and laboratory findings were evaluated and compared with the pathological results. RESULTS: Leukopenia (p=0.05) thrombocytopenia (p=0.03) and increased lactate dehydrogenase levels (p=0.01) were found to be associated with the malignancy. In the cervical, submandibular, axillary and inguinal areas lymphadenopathy was generally seem to be benign while the rate of malignancy was higher in the intra-abdominal and supraclavicular regions. In those cases who had a lymph node index of below 2 there was a higher rate of malignancy (p=0.04). In cases which lymphadenopathy accompanied by splenomegaly has been found associated with malignancy (p=0.009). No association with regards to malignancy was found with the erythrocyte sedimentation rate, C-reactive protein and hepatomegaly. CONCLUSIONS: According to the results of the study five variables including cytopenia, lactate dehydrogenase levels, splenomegaly, lymph node index below 2, intra-abdominal and supraclavicular lymphadenopathy were concluded to be the most suitable means of predicting malignant etiology.

The effect of alpha lipoic acid on rat kidneys in methotrexate induced oxidative injury.

OBJECTIVE: The purpose of this study is to determine the antioxidant and anti-inflammatory effects of alpha lipoic acid (ALA) on methotrexate (MTX) induced kidney injury in rats. MATERIALS AND METHODS: Thirty-two rats were equally divided into four groups; control, ALA, MTX and MTX with ALA groups. A single dose of MTX (20 mg/kg) was administered to make kidney injury to groups 3 and 4, intraperitoneally. The ALA was administered intraperitonealy in groups 2 and 4 and the other groups received saline injection for five days. On the sixth day the blood samples and kidney tissues were obtained for the measurement of TNF-α, IL-1ß, malondialdehyde, glutathione, myeloperoxidase and sodium potassium-adenosine triphosphatase levels and histological examination. RESULTS: Administration of MTX caused a decrease in tissue GSH, and Na+, K+-ATPase activity significantly. A significant increase in tissue MDA and MPO activities were also seen. The pro-inflammatory cytokines (TNF-α, IL-ß) were increased in the MTX group significantly. ALA treatment reversed all biochemical indices as well as histopathological alterations induced by MTX administration. CONCLUSIONS: MTX made oxidative damage on kidneys of rat and it was partially prevented by anti-inflammatory and antioxidant effects of ALA treatment.

Evaluation of serum levels of zinc, copper, and Helicobacter pylori IgG and IgA in iron deficiency anemia cases.

OBJECTIVE: Iron deficiency anemia (IDA) is the most common form of anemia. Impaired intake absorption and blood loss are the main factors in the etiology. Impaired absorption can be caused by a decrease in trace elements such as copper and zinc, which are found in the structure of enzymes that coordinate iron metabolism or act as a catalyst for them, and the existence of Helicobacter pylori (H. pylori), which inhibits iron absorption in the stomach. Serum levels of zinc, copper, and H. pylori antibodies were measured in IDA cases, and correlations with IDA were evaluated. PATIENTS AND METHODS: The study group was composed of 115 IDA cases who were followed at hematology outpatient clinics, and the control group was composed of 92 gender- and age-matched healthy individuals. Patients were diagnosed with iron deficiency anemia according to hemoglobin, serum ferritin, and iron levels and total iron-binding capacity. Serum zinc, copper, H. pylori immunoglobulin A (HpIgA) and immunoglobulin G (HpIgG), vitamin B12, and folic acid levels were examined in the blood specimens collected. RESULTS: No statistically significant difference in zinc and copper serum levels between the study and control groups was observed (p > 0.05 for both groups). Although no difference was observed between the HpIgG levels of the two groups, patients with IDA had a statistically significant increase in HpIgA levels (p < 0.05). Pearson's correlation analysis showed that the zinc levels of the IDA group did not have a correlation with any parameters (p < 0.05 for all). Copper levels had a positive correlation with only the HpIgA level in the IDA group (r = 0.222, p = 0.017). CONCLUSIONS: Trace elements and H. pylori infection did not have a correlation with IDA. Elevated levels of HpIgA and positive correlation of HpIgA with copper levels were observed. The literature review clearly suggests that several points require further explanation, and extensive research with larger samples is required.

A forgotten screening test for iron deficiency anemia: oral iron absorption test.

OBJECTIVE: In this study, we aimed to investigate the iron absorption defects using the oral iron absorption test (OIAT) in patients with iron deficiency anemia (IDA). MATERIALS AND METHODS: Forty-six patients with IDA which nonresponder to oral iron treatment were included in the study. OIAT was started at 8 a.m. after an overnight fast; 52.8 mg of elemental iron were given orally as 160 mg of iron sulfate. Iron levels of all participants were analyzed at baseline and at the 3rd hour of the study. RESULTS: Compared to baseline; serum iron levels whose serum iron levels exceed 91 mcg/ dl in 40(%87) patients. Further investigations in 6 patients revealed that 4 patients had chronic atrophic gastritis with helicobacter pylori infection; while the remaining 2 patients did not have any prominent. CONCLUSIONS: This study demonstrated that OIAT is a good index for the evaluation of absorption defects and can be a screening clinical test of IDA.

Diffuse plasma cell infiltration of liver detected initially at diagnosis of multiple myeloma.

Liver involvement in mutiple myeloma (MM) is not commonly encountered. In this report, we describe a patient who was diagnosed with IgG kappa type MM. A liver biopsy revealed monoclonal plasma cell infiltration. Hepatomegaly was the sole finding in physical examination and the liver function tests were not disturbed.

On the use of crushed shells of apricot stones as the upper layer in dual media filters.

The use of crushed shells of apricot stones instead of anthracite coal in dual-media filters is investigated. Turbidity removal efficiencies were measured for several filtration rates in dual media filters composed of shells of apricot stones above silica sand and anthracite coal above silica sand. Backwash (fluidization) experiments were carried out using sieved fractions of crushed shells of apricot stones to establish curves of expansion versus backwash velocity at 25 degrees C. Such curves can be used in the design of filters employing this material. It is believed that the use of such a locally available and cheaper alternative filter medium would be of interest in many small water and wastewater treatment systems around the world.