All procedures in this study involving human participants were performed in accordance with the 1964 Helsinki Declaration and its later amendments. Etik Kurul Onayı: Etik kurul onayı İstanbul Yeni Yüzyıl Üniversitesi, Fen Bilimleri, Sosyal ve Girişimsel Olmayan Sağlık Bilimleri Araştırmaları Etik Kurulu'ndan (Sayı: 2020/04-05) alınmıştır. İnsan katılımcıların katıldığı çalışmalardaki tüm prosedürler, 1964 Helsinki Deklarasyonu ve daha sonra yapılan değişiklikler uyarınca gerçekleştirilmiştir.
Background Ifosfamide (IFO) is an alkylating agent used to treat broad range of malignancies. One of the life-threatening toxic effects is reversible neurotoxicity. In this report; we presented a case report of ifosfamide induced encephalopathy (IIE) in a child with osteosarcoma in order to emphize that it is important to continue ifosfamide treatment as well as the importance of this potentially fatal complication. Case report Following the 20th week of ifosfamide treatment, the patient's follow-up with the diagnosis of osteosarcoma developed neurological findings. Laboratory analyzes before and after ifosfamide infusion were normal. No pathological findings were seen on MR imaging. Hypoglycemia, electrolyte disturbances, encephalitis, meningitis, metastasis and posterior reversible encephalopathy syndrome (PRES) were not considered. Electroencephalography was found compatible with neuronal hyperexcitability originating from the left hemisphere. With the diagnosis of ifosfamide induced encephalopathy, prophylaxis with methylene blue was received before the next infusion of ifosfamide. Neurological findings were not observed in the patient's follow-up. Conclusion Patients who develop IIE can continue their treatment protocol with methylene blue prophylaxis and supportive therapy.
Stroke is a rapid onset of focal or global loss of cerebral function and is the most common cause of mortality and morbidity in adulthood cancer and heart disease patients. Although it has been reported that mean platelet volume (MPV) values may be an independent risk factor for the severity and prognosis of stroke, the results of previous studies are inconsistent. The aim of the present study was to determine the MPV values of ischemic stroke patients which reflects the activity and function of platelets and to observe its effect on clinical outcomes. Method: Sixty-two acute ischemic stroke patients were recruited for the study. Clinical information, MPV, platelet, white blood cell (WBC) and neutrophil, CRP and troponin-T levels were obtained. Results: The mean ± standard deviation age was 72.4±12.6 years. At the end of the study, 28 patients were discharged and 34 patients passed away. The frequency of bilateral stroke was higher in deceased patients (p=0.005). In addition, platelet counts were significantly higher in discharged patients (p=0.016). At first admission, MPV values were 10.59±1.01 fL in discharged patients and 11.29±1.12 fL in deceased patients (p=0.029). At the end of the study, MPV values were measured as 11.46±1.28 fL in deceased patient sand 10.47±0.74 fL in discharged patients (p<0.001). WBC and neutrophil counts, troponin-T and CRP values were not significantly different between deceased and discharged patients (p>0.05). Conclusion: Our study indicated that MPV and platelet levels may be associated with mortality in acute ischemic stroke patients and can be used as prognostic markers.
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