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Akcay A.,Istanbul Kanuni Sultan Suleyman Education and Research Hospital | Salcioglu Z.,Istanbul Kanuni Sultan Suleyman Education and Research Hospital | Oztarhan K.,Istanbul Kanuni Sultan Suleyman Education and Research Hospital | Tugcu D.,Istanbul Kanuni Sultan Suleyman Education and Research Hospital | And 6 more authors.
International Journal of Hematology | Year: 2014

The aim of the study is to assess the relationship between T2* magnetic resonance imaging (MRI) values and age, serum ferritin level, left ventricular ejection fraction (LVEF), splenectomy status, and to identify appropriate modifications to chelation therapy based on T2* MRI results of children with thalassaemia major. Sixty-four patients with thalassaemia major (37 girls/27 boys) older than 8 years of age were enrolled in the study. Based on the first T2* MRI, the patients' myocardial iron depositions were classified into three groups: T2* MRI <10 ms (high risk group), T2* MRI 10-20 ms (medium-risk group) and T2* MRI >20 ms (low-risk group). There was no significant relationship between T2* MRI value and ages, serum ferritin levels and splenectomy status of thalassaemia major patients. The mean LVEFs were 60, 75, and 72.5% in the high-, medium-, and low-risk groups, respectively ( P = 0.006). The mean cardiac iron concentrations calculated from the T2* MRI values were 4.96 ± 1.93, 1.65 ± 0.37, and 0.81 ± 0.27 mg/g in the high-, medium-, and low-risk groups, respectively. Chelation therapies were re-designed in 24 (37.5%) patients according to cardiac risk as assessed by cardiac T2* MRI. In conclusion, until recently, T2* MRI has been employed to demonstrate cardiac siderosis without a direct relationship with the markers used in follow-up of patients with thalassaemia. However, modifications of chelation therapies could reliably be planned according to severity of iron load displayed by T2* MRI. © The Japanese Society of Hematology 2014. Source


Oncu J.,Etfal Sokak | Oncu J.,Istanbul Sisli Etfal Education and Research Hospital | Iliser R.,Istanbul Sisli Etfal Education and Research Hospital | Kuran B.,Istanbul Sisli Etfal Education and Research Hospital
Journal of Back and Musculoskeletal Rehabilitation | Year: 2013

BACKGROUND AND OBJECTIVES: It has been known that tender points detected by ACR 1990 criteria alone might not describe the essence of fibromyalgia, so preliminary diagnostic ACR 2010 criteria was developed. Since there has been no clear evidence exist examining the concordance rates and sensitivity to treatment of these two criteria comparatively, we aimed to shed light on this ambiguity. MATHERIAL AND METHODS: One hundred patients with widespread pain were studied. Fulfillment of both criteria was determined at baseline, at 3th and 12th months. Sensitivity and specificity values were identified. The relationship between Fibromyalgia Impact Questionnaire and components of two criteria was detected by pearson correlation. And the concordance rate was evaluated by kappa coefficient. RESULTS: At the 1st visit (baseline), two criteria were concordant in 48.5% (n=49) of cases (κ=0.43[95%CI.0.22,0.58] ). However, the concordance was present in only 25(25%) of the subjects (κ=0.29[95%CI:0.12,0.36]) at the end of the study. After 1 year of follow-up, the sensitivity of ACR 2010 was higher than that of ACR 1990 (0.88; 0.56 respectively) (p< 0.05). CONCLUSION: ACR 2010 criteria is more sensitive than ACR 1990 both at first diagnosis and after 1 year of follow-up. So; it enables to diagnose and may give oppurtunity to treat more underdiagnosed FM patients. © 2013 - IOS Press and the authors. All rights reserved. Source

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