Browsing by Author "Erdem, Atilla"

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    A Multi-Center Study on the Efficacy of Eltrombopag in Management of Refractory Chronic Immune Thrombocytopenia: A Real-Life Experience
    (2019) Erdem, Atilla; Tıp Fakültesi
    Objective: The aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP). Materials and methods: A total of 285 chronic ITP patients (187 women, 65.6%; 98 men, 34.4%) followed in 55 centers were enrolled in this retrospective cohort. Response to treatment was assessed according to platelet count (/mm3) and defined as complete (platelet count of >100,000/mm3), partial (30,000-100,000/mm3 or doubling of platelet count after treatment), or unresponsive (<30,000/mm3). Clinical findings, descriptive features, response to treatment, and side effects were recorded. Correlations between descriptive, clinical, and hematological parameters were analyzed. Results: The median age at diagnosis was 43.9±20.6 (range: 3-95) years and the duration of follow-up was 18.0±6.4 (range: 6-28.2) months. Overall response rate was 86.7% (n=247). Complete and partial responses were observed in 182 (63.8%) and 65 (22.8%) patients, respectively. Thirty-eight patients (13.4%) did not respond to eltrombopag treatment. For patients above 60 years old (n=68), overall response rate was 89.7% (n=61), and for those above 80 years old (n=12), overall response rate was 83% (n=10). Considering thrombocyte count before treatment, eltrombopag significantly increased platelet count at the 1st, 2nd, 3rd, 4th, and 8th weeks of treatment. As the time required for partial or complete response increased, response to treatment was significantly reduced. The time to reach the maximum platelet levels after treatment was quite variable (1-202 weeks). Notably, the higher the maximum platelet count after eltrombopag treatment, the more likely that side effects would occur. The most common side effects were headache (21.6%), weakness (13.7%), hepatotoxicity (11.8%), and thrombosis (5.9%). Conclusion: Results of the current study imply that eltrombopag is an effective therapeutic option even in elderly patients with chronic ITP. However, patients must be closely monitored for response and side effects during treatment. Since both response and side effects may be variable throughout the follow-up period, patients should be evaluated dynamically, especially in terms of thrombotic risk factors.
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    Lomber intervertebral nörol foramenin mikroanatomisi
    (Sağlık Bilimleri Enstitüsü, 2002) Dolgun, Habibullah; Erdem, Atilla; Tıp
    Anatomy of Lumbal Intervertebral Neural Foramina Abstract Introduction Despite the facility in determination of intraforaminal and extraforaminal disc herniations and advances in the surgical procedures applied in this area.there has been limited number of studies concerning the anatomy and variations. Thus, this study aims at scrutinizing the microanatomy of the region. Methods: To serve this end, lumbar arteries of 10 male and 5 female cadavers were filled with colored latex, and lumbar foramen were examined under operative microscope. Median vertical diameter and transverse diameter of the foramen were measured Results: Lumbar foramen is branched into three main passages composed of connective tissue from posterior to anterior. The smallest passages located in the back and has the artery and the vein running through. Conclusions: Lumbar foramen is branched into three main passages composed of connective tissue from posterior to anterior, the smallest passages located 27in the back and has the artery and the vein running through, through the other two passages located in the front, however, a vein, an artery, a nerve and fat tissue were observed in this study the origins of the lumbar arteries, the branches of which run through the foramen have also been studied. 28