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    Assessment of anterior subcutaneous hypersignal on proton-density-weighted MR imaging of the knee and relationship with anterior knee pain
    (Elsevier Masson, Corporation Office, 2017) Ünlü, Elif Nisa; Turhan, Yalçın; Köş, Durdu Mehmet; Şafak, Alp Alper
    Purpose: The purpose of this study was to evaluate the prevalence of anterior subcutaneous hypersignal indicating edema on proton-density (PD)-weighted MRI of the knee and to determine whether reporting anterior edema is clinically relevant. Materials and methods: One hundred and ninety-one knee MRIs from 162 patients were reviewed for anterior subcutaneous edema. There were 92 men and 70 women with a mean age of 41.72 years +/- 13.92 (SD) (range, 15-80 years) years and a mean body weight of 75.94 kg +/- 12.54 (SD) (range, 50-130 kg). The MRI findings were compared with patient age, gender, body weight, history of repetitive microtrauma and clinical findings. Patellar and trochlear chondropathy, medial plica, joint effusion, synovitis, infrapatellar fat-pad signal intensity, suprapatellar fat-pad signal intensity with mass effect, quadriceps and patellar tendon abnormalities were also reviewed. Results: An anterior hypersignal on PD-weighted MRI was detected in 158/191 MR examinations (82.7%) and 104 (84.6%) of these cases had histories of anterior knee pain. No correlation between anterior pain and anterior edema was found (P = 0.42). Age (P < 0.0001), weight (P < 0.0001), and repetitive microtrauma (P = 0.001) were identified as significant variables associated with anterior edema. Conclusion: Anterior edema may be a physiological phenomenon or degenerative change related to patient age, weight, and knee movement or mechanics. It should not be reported as apathological finding on MRI unless clinical findings support regional infection or inflammation. (C) 2016 Editions francaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.
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    The Predictive Role of the Neutrophil/Lymphocyte Ratio in Survival with Multiple Myeloma: A Single Center Experience
    (Wiley, 2017) Öneç, Birgul; Okutan, Harika; Albayrak, Murat; Can, Esra Sarıbacak; Aslan, Vedat; Koluman, Başak Ünver; Köş, Durdu Mehmet
    BackgroundRecent studies have shown a positive correlation between tumor-related immune response markers and the poor outcome in solid tumors. In this study, we aimed to investigate the neutrophil/lymphocyte ratio (NLR) in multiple myeloma. To the best of our knowledge, this would be the second report concerning this topic. MethodsWe retrospectively reviewed the data for 52 multiple myeloma patients. The patients were grouped using the baseline NLR as NLR 1.72 and NLR > 1.72 using receiver operating characteristic analysis to determine a cut off. We compared the two groups in terms of both the known prognostic factors of the myeloma and the overall survival (OS). ResultsOur study showed that NLR is associated with C-reactive protein and 2 microglobulin (P = 0.02 and P = 0.001, respectively). The patients with NLR > 1.72 had significantly worse stages, performance status, and kidney functions. The whole group's OS was estimated as 35.1 months while the patients with lower NLR had better OS when compared with those with NLR > 1.72 (42.75 and 26.14 months, respectively, P: 0.04). ConclusionNeutrophil/lymphocyte ratio, which is associated with stage, performance status, and kidney functions, can be used in daily practice as a predictor for survival in multiple myeloma. Simply adding NLR to the routine charts may enrich our data for larger studies.
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    Severe Acidemia, Leukocytosis and Low Hematocrit Levels at Admission as Mortality Predictors of Elderly Intensive Care Unit Patients
    (Turkish Soc Medical & Surgical Intensive Care Medicine, 2019) Akbaş, Türkay; Taşçı, Elif Şenocak; Yılmaztepe, Hafize Titiz; Sönmez, Feruze Turan; Köş, Durdu Mehmet; Öneç, Birgül
    Aim: Rapid prediction of prognosis is helpful in reflecting the disease severity and patient mortality. This is especially important in critically ill elderly patients who have high mortality risk. This study aimed to investigate the effects of admission laboratory results and medical histories on the prediction of prognosis in critically ill elderly patients. Material and Methods: Patients who were >= 65 years and admitted to a medical intensive care unit (ICU) between 2011 and 2013 were retrospectively analyzed. Results: The study included 449 patients and mortality rate was 47.4%. Nonsurvivors had lower pH, HCO3 and albumin levels, and lower hematocrit and platelet counts, but higher aspartate aminotransferase, alanine aminotransferase, C-reactive protein (CRP), creatinine, phosphorus, magnesium and bilirubin levels, and higher leukocyte count than survivors. The rates of chronic kidney disease, being in a bedridden state and having cardiopulmonary resuscitation (CPR) before ICU admission were significantly high in nonsurvivors. Multivariate analysis showed that pH <7.20, albumin <= 2 gr/dL, low hematocrit and high CRP levels, high leukocyte count, bedridden state, and CPR were mortality predictors. After including the admission diagnoses and endotracheal intubation into the model, pH <7.20 (odds ratio [OR], 4.31; 95% confidence interval [CI], 1.59-11.70), albumin <= 2 gr/dL (OR, 3.61; 95% CI, 0.99-13.03), hematocrit level (OR, 0.94; 95% CI, 0.91-0.99) and leukocyte count (OR 1.06; 95% CI, 1.01-1.11) retained their prognostic importance for mortality. Conclusions: Severe acidemia, low albumin and hematocrit levels, and high leukocyte count at admission help clinicians to foresee the prognosis in severely ill elderly patients. They keep their importance even in the presence of other fundamental mortality predictors.
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    T-Cell Lymphoma Presenting with Auricular and Parotid Gland Involvement
    (Galenos Yayincilik, 2016) Öneç, Birgul; Koç, Alper; Ünlü, Elif Nisa; Ünlü, İlhan; Yaman, Hüseyin; Köş, Durdu Mehmet
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