Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired hematopoietic stem cell disease that may lead to weakness and death of patients, if unrecognized and untreated. Although consensus guidelines were reviewed recently for the diagnostic screening of PNH with multi-parameter flow cytometry (FCM), until now, no study has investigated the efficiency of such clinical indications in older patients. Overall, 20 centers participated in the study and a total of 1,689 patients were included, 313 of whom were at geriatric age and 1,376 were aged 18 - 64 years. We evaluated the efficiency of consensus clinical indications for PNH testing using FCM in peripheral blood samples and compared the results of older patients and patients aged 18 - 64 years. PNH clones were detected positive in 7/313 (2.2%) of the older patients. Five (74.4%) of the patients with PNH clones had aplastic anemia, 1 had unexplained cytopenia, and 1 patient had myelodysplastic syndrome (MDS) with refractory anemia. PNH clones were not detected in any older patients who were screened for unexplained thrombosis, Coombs (-) hemolytic anemia, hemoglobinuria, and others (e.g., elevated lactate dehydrogenase (LDH), splenomegaly). We detected PNH clones in 55/1376 (4%) samples of the patients aged under 65 years. Forty-two (76.4%) patients with PNH clones had aplastic anemia, 2 patients had Coombs (-) hemolytic anemia, 3 patients had unexplained cytopenia, 1 patient had MDS with refractory anemia, 1 patient had hemoglobinuria, and 6 (10.9%) had others (e.g., elevated LDH, splenomegaly). PNH clones were not detected in any patients who were screened for unexplained thrombosis. There was no statistical difference between the geriatric population and patients aged 18 - 64 years in terms of clinical indications for PNH screening with FCM (p = 0.49). Our results showed that the current clinical indications for PNH screening with FCM were also efficient in older patients. We suggest that older patients with unexplained anemia, myelodysplastic syndrome with refractory anemia, and unexplained cytopenia should be screened for PNH with FCM to identify patients who would benefit from treatment.

: A decrease in the blood flow below a current level in the brain results in ischemia. Studies demonstrated that human trophoblast progenitor cells (hTPCs) contribute to the treatment of many disea...

Bu araştırmanın genel amacı, göreceli yaş etkisinin DEHB tanısı riskini artırıp artırmadığını tespit etmektir. Çalışmanın verileri, Konya'nın Karatay, Meram ve Selçuklu Rehberlik ve Araştırma Merkezlerinde 2011-2016 yıllarında DEHB tanısı konulan 408 öğrencinin doğum tarihi ve cinsiyet bilgilerinden oluşmaktadır. DEHB tanısı konulan öğrenciler, doğum ayların içinde bulunduğu üçer aylık çeyreklere göre kategorilere ayrılmıştır. DEHB tanısı konulan öğrenciler, doğum aylarına göre dört çeyrek gruba ayrılarak, gruplarda beklenen doğum sayısında anlamlı sapmalar olup olmadığı Ki- kare Uyum İyiliği Testi ile belirlenmiştir. DEHB tanısı konulan öğrencilerin cinsiyetlerine göre dağılımı, frekans ve yüzde hesapları ile belirlenmiştir. Sonuçta DEHB tanısı konulan tüm öğrencilerin doğum aylarının yılın çeyrek bölümlerine göre, beklenen değerden belirgin sapma gösterdiği; kızlar için sapma olmadığı, erkekler için sapmanın olduğu, göreceli yaş etkisinin yılın ikinci ve üçüncü çeyreğinde doğan erkek çocuklarda DEHB tanısı konulma olasılığını artırdığı ortaya çıkmıştır. Ayrıca, DEHB teşhisi konulan erkeklerin oranı kızlara göre 2.16 kat fazladır.

Introduction & objective: The Mini-Addenbrooke’s Cognitive Examination (M-ACE) is an easy-to-administer and quick screening test that assesses four basic cognitive areas, namely orientation, verbal fluency, memory, and visuospatial abilities, out of 30 points. The objective of this study is to introduce M-ACE to the Turkish cognitive science literature and evaluate its applicability in Turkish society in comparison with the Mini-Mental State Examination (MMSE). Materials & methods: A total of 90 native Turkish speakers aged 60 and over with at least 12 years of formal education, including 30 patients with mild cognitive impairment (MCI group), 30 patients with Alzheimer’s disease (AD group), and 30 healty control subjects (control group), who applied to the neurology outpatient clinic between November 2020 and November 2021, were included in this prospective study. All participants were underwent MMSE and the Turkish version of M-ACE by experienced neurologists. Results: The optimal M-ACE cut-off values were 24.5 for differentiating MCI from controls (90% sensitivity, 73% specificity), 23.5 for distinguishing AD from controls (97% sensitivity, 90% specificity), and 19.5 for differentiating MCI from AD (70% sensitivity, 80% specificity). Conclusion: Turkish version of the M-ACE is a valid tool for assessing cognitive impairments in the elderly population.