İlgen Şaşmaz

Effects of atorvastatin on lipid profile and coagulation parameters

Abstract Background: Hypercholesterolemia is an important risk factor for coronary artery disease (CAD) and is associated with impaired endothelial function, hypercoagulability, and increased platelet activation. The ability of statins to reduce the mortality and morbidity associated with CAD may not be due entirely to their lipid-lowering effects. Objective: The aim of this study was to determine the effects of atorvastatin on lipid profile and coagulation parameters. Methods: Adults with documented hypercholesterolemia who did not respond to dietary intervention alone and had not been treated pharmacologically were enrolled. In accordance with the criteria of the American Heart Association guidelines, patients began therapy with atorvastatin 10 mg/d. Total cholesterol (TC), low-density and high-density lipoprotein cholesterol (LDL-C and HDL-C), triglycerides (TG), fibrinogen, prothrombin time (PT), activated partial thromboplastin time (aPTT), clot retraction time (CRT), and tissue plasminogen activator (t-PA) levels were determined at baseline and at week 12 of treatment. Results: A total of 8 men and 11 women (mean age, 57.2 ± 10.0 years; range, 43–77 years) were included in the study. Significant reductions from baseline in TC (baseline, 259.5 ± 29.3 mg/dL; week 12, 186.2 ± 39.9 mg/dL; −28%) and LDL-C (baseline, 177.5 ± 24.5 mg/dL; week 12, 115.6 ± 35.0 mg/dL; −34%) were observed at the end of the study ( P P > 0.05). CRT was shortened but remained within the normal range ( P P Conclusions: The data from this study suggest that treatment with atorvastatin decreases t-PA levels and CRT as well as lipid levels. The reduction in t-PA and CRT may be a result of improvements in previously impaired endothelial function and coagulation.

Cardiac mucormycosis in a child with severe aplastic anemia: a case report.

Mucormycosis is an uncommon, severe, life-threatening fungal infection in the immunocompromised host. Mucormycosis with aplastic anemia is seen rarely. Only a few cases of cardiac mucormycosis with aplastic anemia have been reported in the literature. The authors present a case with severe aplastic anemia that did not respond to classic and immunosuppressive treatment for disease and developing invasive cardiac mucormycosis despite empiric treatment for febrile neutropenia.

Juvenile Myelomonocytic Leukemia (JMML)

Ya z›fl ma Ad re si/Ad dress for Cor res pon den ce Dr. Barbaros Şahin Karagün, Çukurova Üniversitesi Tıp Fakültesi, Pediatrik Hematoloji-Onkoloji Anabilim Dalı, Adana, Türkiye Tel.: +90 322 338 60 60 E-posta: drbkaragun@yahoo.com.tr Ge liş ta ri hi/Re cei ved: 24.09.2013 Ka bul ta ri hi/ Ac cep ted: 21.01.2014 Çukurova Üniversitesi Tıp Fakültesi, Pediatrik Hematoloji-Onkoloji Anabilim Dalı, Adana, Türkiye Barbaros Şahin Karagün, İlgen Şaşmaz, Bülent Antmen, Yurdanur Kılınç The Journal of Pediatric Research 2014;1(3):118-26 DO I: 10.4274/jpr.09797

Serial urological interventions including circumcision in a hemophilic child with inhibitors.

Hemophilia patients sometimes need careful treatment of urgent serious bleedings and management of some surgeries. Development of inhibitor has some impact on the management of these situations. Here a case of patient of hemophilia A is presented in whom urological surgery resulted in inhibitor development and a second operation with bypass agent.

Recurrent cerebral stroke in a thalassemic patient

Hematol Oncol Stem Cell Ther 1(2) April 2008 hemoncstem.edmgr.com 136 T halassemia major (TM) is a congenital hemot lytic disorder caused by decreased production of globin chains. It is known that there is a hight er than normal incidence of thromboembolic events in TM. Silent infarctions have also been documented. hromboembolic events occur at a signiicantly higher incidence statistically in the presence of other hypert coagulability factors, and prophylactic antithrombotic therapy has been suggested in these patients. Several etiologic factors may play a role in the pathogenesis of the hypercoagulable state in thalassemia. We report a case of TM associated with a methylenetetrahydrofot late reductase (MTHFR) mutation in which recurrent cerebral stroke was noted during follow up.

Deferasirox in children with transfusion-dependent thalassemia or sickle cell anemia: a large cohort real-life experience from Turkey (REACH-THEM)

To evaluate the long‐term efficacy and safety of deferasirox therapy in a large observational cohort of children with transfusion‐dependent thalassemia (TDT) and sickle cell anemia (SCA) in Turkey.

Şiddetli Hemofili A Hastalarında Sınırlanmış Eklem Açıklığı ile İlişkili Atrofik Kaslarda Su İçi Egzersizlerin Etkisi: Bir Pilot Çalışma

Amac: Hemofili tekrarlayan kanama ataklarina sekonder olarak kas- iskelet sorunlarina neden olmaktadir. Bu calismada, su ici egzersizlerinin, kas ve eklem problemleri olan siddetli hemofili A hastalarinda etkilerinin arastirilmasi amaclanmistir. Materyal ve Metod: Proflaksi alan, siddetli hemofili A hastasi (n=11) duzenli olarak egzersiz uygulamasina alinmistir. Bulgular: Calismaya katilan hastalarin, sag bacaklarinda ust bacak, orta bacak ve calf cevrelerinde (42.0 ± 2.4, 43.0 ±2.1 ; 37.1 ±1.9, 39.0 ±1.8; 28.1 ± 1.4, 28.9 ±1.3 respectively) (mean ± SE), sol bacaklarinda ust ve orta bacak cevrelerinde (36.9 ± 1.5 , 38.9 ± 1.5 ; 41.2 ± 2.2 , 42.9 ± 2) egzersiz oncesi degerlerine gore istatistiksel olarak anlamli farklilik bulunmustur (p

The usage of remifentanil and alfentanil in alleviating pain and anxiety during bone marrow aspiration in pediatric patients

Abstract Aims: To investigate the efficacy and safety of remifentanil and alfentanil compared with local anesthesia in providing analgesia and sedation during bone marrow aspiration procedures. Methods: Seventy-four children who underwent a diagnostic bone marrow aspiration were included in this study. Patients were assigned to one of 3 treatment groups (remifentanil, alfentanil and local anesthesia). Vital signs, sedation, pain scores, and somatic responses were recorded during and after bone marrow aspiration procedure. Results: There were no statistical differences between pain scores of the remifentanil group and the alfentanil group. Pain scores were significantly higher in the local anesthesia group compared with the other groups. None of the patients in the study had deep sedation, hypotension, bradycardia, hypoxemia, or respiratory depression. Conclusions: Remifentanil and alfentanil are effective in children and can be used safely in bone marrow aspiration procedure.