TR Dizin İndeksli Yayınlar Koleksiyonu / TR Dizin Indexed Publications Collection
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14365/4
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Article Citation - WoS: 2Citation - Scopus: 2A New Scoring System for the Evaluation of Ibrutinib-Associated Arrhythmias in Chronic Lymphocytic Leukemia: the ACEF Score(Turkish Society of Hematology, 2024-05-30) Ugur, Mehmet Can; Bilgir, Oktay; Dogdus, Mustafa; Koyuncu, İlhan; Senoz, Oktay; Koyun, Emin; Koyuncu, BetulAmaç: Kardiyak dokuda Bruton tirozin kinaz inhibisyonu, stres sırasında dokunun korunmasından sorumlu olan PI3K-AKT sinyal yolunun inhibisyonuna neden olur. Bu nedenle aritmi riskinde bir artış vardır. Bu çalışma, yaş, kreatinin ve ejeksiyon fraksiyonu komponentlerini temel alan ve basit bir puanlama sistemi olan Yaş-Kreatinin-Ejeksiyon Fraksiyonu (ACEF) skoru ile bu riskin tahmin edilebilmesini araştırmaktadır. Gereç ve Yöntemler: Kronik lenfositik lösemi (KLL) tanısı alan ve en az 1 yıldır ibrutinib tedavisi alan hastalar ekokardiyografi ve Holter elektrokardiyografi ile değerlendirildi ve sonuçlar tedavi almayan KLL hastalarından oluşan kontrol grubuyla karşılaştırıldı. ACEF skoru, yaş/sol ventriküler ejeksiyon fraksiyonu+1 (kreatinin >2,0 mg/dL ise) formülüyle hesaplandı. Bulgular: Hastaların aritmi gelişimi değerlendirildiğinde paroksismal atriyal fibrilasyon (PAF) dışındaki aritmi türleri açısından kontrol ve ibrutinib grupları arasında istatistiksel olarak anlamlı bir fark bulunmadı. PAF, ibrutinib kullanmayanlar ile kullananlar arasında %8’e karşı %22 (p=0,042) oranında meydana gelmekteydi. İbrutinib kullanan hastalarda ACEF skorunun >1,21 olması, PAF gelişimini %77 duyarlılık ve %75 özgüllükle öngörmekteydi (eğri altındaki alan: 0,830, %95 güven aralığı: 0,698-0,962, p<0,001). Sonuç: ACEF skoru, KLL tanısı alan ve ibrutinib başlanması planlanan hastalarda PAF gelişimini öngören bir risk skoru olarak kullanılabilir.Article Hypermetabolic Axillary Lymph Nodes Associated With Covid-19 Vaccination in Breast Cancer Management(Galenos Publishing House, 2023-06-01) Taşçı, Cengiz; Dirican, Ahmet; Sözbilen, Ethem Murat; Pehlivan, F.S.; Serter, Selim; Selim, SerterA 42-year-old female patient diagnosed with invasive ductal breast ca underwent18F-fluorodeoxyglucose (FDG) positron emission tomography/ computed tomography (PET/CT) scan for staging, 1.5 cm diameter hypermetabolic lesion was observed in the lower inner quadrant of the right breast that was compatible with primary tumor [maximum standardized uptake value (SUVmax ): 10.5]. No pathological18F-FDG uptake was observed in lymph nodes whose fatty hilum was seen in the right axilla. However, in the left axilla and left deep axilla, hypermetabolic lymph nodes with a maksimum diameter of 19 mm and fatty hilum were observed (SUVmax: 8.0). In a detailed CT evaluation, these lymph nodes have thicker walls than the ones in the right axilla. The patient was questioned again and coronavirus disease-2019 (COVID-19) vaccination history (with BNT162b2, COVID-19 mRNA vaccine) was determined that was administrated to the left arm 5 days ago. Tru-cut biopsy was performed from the left aksillary lymph nodes and proved to be reactive lymphoid tissue and there was no primary or metastatic tumor in these axillary lymph node tissues. The patient was given neoadjuvant chemotherapy 4.5 months after the first18F-FDG PET/CT, and the second was performed for the treatment response evaluation. Significant regression was determined from the findings. The patient underwent right total mastechtomy. She was being followed up with adjuvant chemotherapy and radiotherapy. In conclusion, hypermetabolic lymph nodes in the axillas should be interrogated for vaccination in patients with breast cancer. Hypermetabolic lymph nodes observed on the same side of the vaccinated arm in the 18 F-FDG PET/CT scan may be related to vaccine-induced reactive lymph node enlargement. Lymph node metastasis may be excluded, especially if there are hypermetabolic lymph nodes with preserved fatty hilum in the contralateral axilla on the same side as the vaccinated arm. Active lymph nodes reactive to the vaccine become inactive after a while. © 2023 by the Turkish Society of Nuclear Medicine.