The SARS-CoV-2 spike protein mRNA-based vaccines have prevented countless mortality and morbidity, and have an excellent risk/benefit ratio. However, various adverse events may rarely occur after the BNT162b2 vaccine, like any other medical intervention. The COVID-19 itself and the spike protein produced endogenously by mRNA vaccines may have immunological, microenvironmental, prothrombotic, and neoplastic effects. As a contribution to the published report, we would like to share our experience regarding four cases in which myeloid neoplasms emerged following the vaccination. Conclusions: There is no doubt that vaccination could continue along the lines of established universal recommendations. Meanwhile, all hematological adverse events must be closely monitored and reported. Further efforts should be focused on the probable pathobiological mechanisms and causalities of spike protein-related toxicity and clonal myeloid disorders.

Aim to investigate whether the MAPH score, which is a new score that combines blood viscosity biomarkers such as mean platelet volume (MPV), total protein and hematocrit, can be used to predict thrombus burden in ST-segment elevation myocardial infarction (STEMI) patients. Methods A total of 473 consecutive patients with STEMI were included in the study. Intracoronary tirofiban/abciximab infusion was applied to patients with thrombus load ≥3 and these patients (n = 71) were defined as the patient group with high thrombus load. MPV, age, hematocrit and total protein values of the patients were recorded. High shear rate (HSR) and low shear rate (LSR) were calculated from total protein and hematocrit values. Cut-off values were determined for high thrombus load by using Youden index, and score was determined as 0 or 1 according to cut-offs. The sum of the scores was calculated as the MAPH score. Results The mean age of the patients included in the study was 59.6 ± 12.6 (n = 354 male, 74.8%). There was no difference between the groups in terms of gender, HT and DM ( P = .127, P = .402 and P = .576, respectively). In the group with high thrombus load; total protein, MPV and hematocrit values were higher ( P < .001, P = .001 and P = .03, respectively). Comparison of receiver operating characteristic (ROC) curve analysis revealed that the MAPH score had better performance in predicting higher thrombus load than both other self-containing parameters and HSR and LSR. Conclusion The MAPH score may be a new score that can be used to determine thrombus burden in STEMI patients.

ÖzBu çalışma ile Kilis'te çalışan Suriyeli sığınmacıların sosyo-ekonomik yapısı araştırılmıştır. Araştırma sonuçlarına göre, Suriye'de iç savaşın başladığı tarihten itibaren Kilis'e önemli sayıda sığınmacı gelmiştir. Bu sığınmacıların çoğu şehir merkezinde yaşamakta ve çalışmak durumundadır.Şehir merkezinde yaşayan sığınmacıların önemli bir kısmı yaşamını sürdürebilmek için çeşitli işlerde çalışmak zorundadırlar.Araştırma sonuçlarına göre; sığınmacıların %79'u çifte vatandaş olmak istemektedir. Suriye'deki iç savaş biterse %79 sığınmacı geri dönmek istemekte, diğer bir ifade ile %21'lik kısım Türkiye'de kalmak istemektedir. Sığınmacıların yaklaşık %44'ü Türk vatandaşı ile evlenmek istemektedir. Sığınmacıların yaklaşık %57'si eğitimini Kilis'te sürdürmek istemektedir. Çalışan sığınmacıların yaklaşık %68'i Devletten yardım almamaktadır. Sığınmacıların %60'ı iyi bir iş bulduğunda Türkiye'ye yerleşmeyi düşünmektedir. Anahtar Kelimeler: Suriyeli Sığınmacılar, Ekonomik Analiz, Kilis AbstractWhit this study, socio-economic structure of Syrian refugees has been investigated. According to the results, a considerable amount of refugees came to the province of Kilis after the beginning of civil war in Syria. Most of those refugees are living and working in the city center.Most of them have to work in various positions in order to live on.Results show that 79% of refugees want to obtain dual citizenship. 79% of refugees want to go back when civil war is over in Syria. In other words 21% of people want to reside in Turkey. 44% of people wish for marriage with a citizen of Turkey. 57% of refugees want to continue their education process. 68% of people do not receive aid from Turkish government. 60% of people plan to reside in Turkey if they will get a sufficient job opportunity.

Stent thrombosis (ST) is a complication that can occur in patients undergoing percutaneous intervention and can seriously affect mortality and morbidity (1, 2). It occurs most often as ST-elevation myocardial infarction (STEMI), and the best treatment method is early reperfusion (3). As a result of the widespread use of drug-eluting stents (DESs), a decrease in the rates of acute and subacute thrombosis and in late and very late thrombosis with new-generation DESs have been noted (4-6). The underlying mechanisms of ST are underexpansion, malaposition, positive remodeling, neoatherosclerosis, stent fracture, and corner dissections (7-10). Calcification of the lesion also increases the risk of complications (11). Insufficient duration of dual antiaggregant use or the emergence of clopidogrel resistance, long stent use, common atherosclerotic disease, and the high number of stents used are among the mechanisms responsible for ST (12). Increased inflammatory markers such as C-reactive protein and white blood cell count are laboratory parameters that can be detected in patients with ST (13,14). Because triglyceride (TG)/high density lipoprotein (HDL) cholesterol (HDL-C) ratio (TG/HDL-C) was an independent predictor of cardiovascular events and all-cause mortality in acute coronary syndrome (ACS) after coronary revascularization and the atherogenic index of plasma (AIP), logarithmically transformed ratio of TGs to HDL-C, is superior to TG/HDL-C in studies, we aimed to examine the relationship between AIP and ST on the basis of this hypothesis (15-17).

Introduction Tyrosine kinase inhibitors (TKis) and Bruton's TKi (BTKis) constitute broadly used antitumor drug groups with almost completely tolerable and manageable side-effect profiles. Mainly side effects are cardiovascular and gastrointestinal for the TKi group. Hypophosphatemia is documented frequently in many studies with TKis but rarely mentioned with ibrutinib use up to the present. Case report A 61-year-old patient with the diagnosis of chronic lymphocytic leukemia had hypophosphatemia-related complaints and symptoms when ibrutinib use was preferred for his second relapse of the disease. After drug discontinuation, we started ibrutinib again with an alternating dose. We managed to control hypophosphatemia, and the patient has been following up for 2 years in remission status without any support or a second drug need. Management and outcome We have presented here a chronic lymphocytic leukemia case that developed mild–severe hypophosphatemia associated with ibrutinib use. By using an alternating dose of ibrutinib, we managed to control the disease and drug side effects. Discussion TKis and BTKis are widely in use for different indications. Hypophosphatemia is rare but it can cause drug discontinuation or change if it is not manageable. It is mentioned that hypophosphatemia can be seen due to a common group effect with the mechanism of causing secondary hyperparathyroidism and renal tubulopathy. In our case, we could explain the side effect of hypophosphatemia with secondary hyperparathyroidism and renal tubulopathy. Prospective, large-group studies are needed to explain the hypophosphatemia and other side effects of ibrutinib and new BTKis in detail.