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ABSTRACT: We studied retrospectively the factors affecting the product quality in 459 donor granulocyte apheresis procedures from 420 donors for 71 neutropenic patients from 2004 to 2010 in a single center. The counts of the granulocyte and platelet collected were measured to evaluate the product quality. The data was analyzed to determine a possible relationship between product quality and several parameters including gender, preleukapheresis neutrophil count, type of anticoagulation and separator type and mode of the apheresis system. We found that collection of better granulocyte is possible from a donor in a single procedure by changing anticoagulation type and separator mode during apheresis.
Transfusion and Apheresis Science 05/2012; 47(1):107-11. · 1.25 Impact Factor
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Annals of Hematology 05/2011; 91(2):303-4. · 2.62 Impact Factor
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Leukemia research 12/2010; 34(12):e317-9. · 2.36 Impact Factor
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ABSTRACT: Blood centers without fixed appointments for collecting blood often experience nonconstant donor arrival rates, which vary due to time-of-day, day-of-week, etc. When a constant workforce size is employed in such blood centers, there is either idle personnel, or donor satisfaction is compromised due to long waiting times, or both conditions alternate over time. Consequently, a method to obtain adaptive workforce requirements might be valuable. This study utilized the Two-Step Cluster method and the Classification and Regression Trees method in succession to identify both daily and hourly donor arrival patterns at Hacettepe University Hospitals' Blood Center. A serial queuing network model of the donation process was then employed for each of the identified donor arrival patterns. By considering and accommodating variations in the donor arrival patterns, required workforce sizes and their decomposition among process steps were predicted to achieve predetermined target values of expected waiting times and to balance workforce utilizations in the blood donation processes. Although a blood center is considered for the proposed methodology, the approach is general and applications in various operations of healthcare organizations are possible.
Journal of Medical Systems 05/2010; 36(2):579-94. · 1.13 Impact Factor
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ABSTRACT: Myeloid sarcoma, formerly termed granulocytic sarcoma or chloroma, consists of neoplastic granulocytic precursors and myeloblasts. Isolated chloromas (granulocytic sarcomas) are rare tumors. Spinal complications of chloromas, such as cord compression secondary to epidural tumor or cauda equine syndrome have been described but are rare. We herein report two cases with spinal granulocytic sarcomas in non-leukemic patients. The case of a previously healthy 22-year-old man diagnosed with multiple spinal granulocytic sarcomas with no evidence of bone marrow or other hematological involvement is described. And, a 43-year-old woman diagnosed cervical spinal granulocytic sarcoma with no evidence of bone marrow or other hematological involvement is described. The tumor was totally removed by microsurgery. The histopathological examination was consistent with granulocytic sarcoma. Granulocytic sarcoma should be considered in the differential diagnosis of an epidural mass in patients with or without acute leukemia, because early diagnosis followed by appropriate combined chemotherapy and radiation may obviate surgical intervention and eventually prevent leukemic transformation.
Internal Medicine 01/2010; 49(22):2493-7. · 0.94 Impact Factor
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ABSTRACT: Iron deficiency anemia (IDA) is a frequent disorder. Also, it may be a sign of underlying serious diseases. Iron deficiency points to an occult or frank bleeding lesion when occurred in men or postmenopausal women. In this study, we aimed to evaluate the diagnostic yield of endoscopy in patients with IDA and to define predictive factors of gastrointestinal (GI) lesions causing IDA. Ninety-one patients (77 women, 14 men; mean age: 43 years) who were decided to have esophago-duodenoscopy and/or colonoscopy for iron deficiency anemia were interviewed and responded to a questionnaire that included clinical and biochemical variables. The endoscopic findings were recorded as GI lesions causing IDA or not causing IDA. Endoscopy revealed a source of IDA in 18.6 % of cases. The risk factors for finding GI lesions causing IDA were as follows: male gender (p= 0.004), advanced age (> 50 years) (p= 0.010), weight loss (over 20% of total body weight lost in last 6 month) (p= 0.020), chronic diarrhea (p= 0.006), change of bowel habits (p= 0.043), epigastric tenderness (p= 0.037), raised carcinoembryonic antigen (CEA) level (normal range: 0-7 ng/mL) (p= 0.039), < 10 gr/dl hemoglobin (Hb) level (p=0.054). None of these risk factors had been present in 21 (23%) women younger than 51 years. In this group, no patient had any GI lesion likely to cause IDA (negative predictive value= 100%). In multivariate analysis, advanced age (p=0.017), male gender (p< 0.01) and weight lost (p=0.012) found that associated with GI lesions in all patients. It may be an appropriate clinical approach to consider these risk factors when deciding for gastrointestinal endoscopic evaluation in iron deficiency anemia.
International journal of medical sciences 01/2010; 8(1):30-8. · 2.24 Impact Factor
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ABSTRACT: Clinical and epidemiologic observations have led to the concept of a procoagulant state in type 2 diabetes. This study aimed to determine the coagulation status in type 2 diabetic patients using rotation thromboelastography (ROTEM), which measures the interactive dynamic coagulation process. For this purpose, 51 (30 women, 21 men) type 2 diabetic patients (mean age, 56.1 years) and 40 age-matched, sex-matched and body-mass-index-matched healthy individuals were enrolled. Twenty-seven of the diabetic group had diabetic vascular complications. ROTEM using different activators for the intrinsic and extrinsic systems of coagulation cascade (intrinsic TEM-INTEM, extrinsic TEM-EXTEM, FIBTEM) was used to measure the coagulation time (CT), clot formation time (CFT), alpha angle (alpha) and maximum clot firmness (MCF). No significant difference was found in the prothrombin time, partial thromboplastin time, thrombin time, fibrinogen and platelet count between the two groups. INTEM-CT and INTEM-CFT and EXTEM-MCF were significantly higher in the diabetic group compared with controls (P = 0.012, P = 0.007 and P = 0.029, respectively). INTEM alpha in the diabetic group was significantly lower than the controls (P = 0.001). All other parameters, including INTEM-MCF, EXTEM-CT, EXTEM-CFT, EXTEM-alpha, FIBTEM-CT, FIBTEM-CFT, FIBTEM-MCF and FIBTEM-alpha, were similar between the two groups. Taking into account these data, we conclude that there is subtle activation of the extrinsic pathway with a concomitant decrement in the intrinsic pathway of the coagulation cascade in type 2 diabetes. The exact underlying mechanisms leading to these changes, and their consequences with regard to diabetic complications, remain to be determined.
Blood Coagulation and Fibrinolysis 11/2006; 17(7):545-9. · 1.24 Impact Factor
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ABSTRACT: We sought to assess the effects of blood donation on different echocardiographic parameters in healthy volunteers.
A total of 101 healthy male volunteers were evaluated by echocardiography before and immediately after a 500-mL blood donation. In addition to traditional Doppler indices of left ventricular filling, Doppler tissue, color flow propagation, strain (epsilon), and epsilon rate were measured.
There was a statistically significant decrease in mitral peak E and A values after blood donation (E wave 0.85 +/- 0.12 vs 0.79 +/- 0.14 cm/s, P = .01; A wave 0.65 +/- 0.10 vs 0.60 +/- 0.12 cm/s, P = .05). Mitral color flow propagation velocity was not affected (560 +/- 123 vs 571 +/- 132 mm/s, P = not significant). There were no significant differences in the Doppler tissue parameters of peak systolic, and early and late diastolic velocities after blood donation (Sm 13.5 +/- 4.6 vs 13.3 +/- 4.9 cm/s, P = not significant; Em 15.5 +/- 4.9 vs 15.9 +/- 5.1 cm/s, P = not significant; and Am 14.1 +/- 3.9 vs 14.1 +/- 3.5 cm/s, P = not significant, respectively). The peak systolic decreased significantly (-28 +/- 8% vs -21 +/- 4%, P = .03) whereas the peak systolic rate was not affected (1.5 +/- 0.35 vs 1.4 +/- 0.40 s(-1), P = not significant).
In healthy male volunteers, preload reduction induced by a 500-mL blood donation does not affect the color propagation velocity, rate, and Doppler tissue velocities.
Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography 01/2006; 18(12):1260-5. · 2.98 Impact Factor
