What is Bone Marrow? Stem Cell Therapy

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The bone marrow is found in the cavities in the center of the long bones in your body. Blood cells are produced in the bone marrow. White blood cells (WBC) fight infection. Red blood cells (RBC) carry oxygen and platelets (PLT) help to clot formation to prevent bleeding.
What is a stem cell?
Stem cells are self-renewing and differentiating cells that are not present in any cell other than living organisms. Stem cells, when needed, differentiate them from the next to the cells, allowing the development, maturation and proliferation of the cells.
Stem cells are called embryonic stem cells, adult stem cells and induced pluripotent stem cells. Hematopoietic stem cells from adult stem cells are used in stem cell transplantation. Stem cells are also of great interest in non-hematological areas. In particular, stem cell therapies that are applied experimentally in cardiological and neurological diseases are the leading.
Stem cells are new immature blood cells. All blood cells begin as a stem cell. Thus, with stem cell transplantation, we can regenerate your blood cell formation skills. Stem cells tend to remain in the bone marrow, where the body can become any type of blood cell, but some are involved in the general circulation in blood vessels.
Stem Cell Transplantation is applied in the treatment of diseases?

Multiple myeloma
Various organ cancers,
Inadequate functioning of bone marrow,
Hereditary anemias,
Immune deficiencies
It is applied in the treatment of hereditary metabolic diseases.

How to obtain Stem Cells?
The stem cell can be obtained from bone marrow, peripheral blood or cord blood. Stem cell harvesting from the bone marrow is performed under general or local anesthesia with a special needle by entering the donor’s hip bone once. Stem cell harvesting from peripheral blood is performed by transferring the stem cells located in the bone marrow into the bloodstream and then collecting with the apheresis device by applying a special drug called growth factor to the donor. Although bone marrow is used as a stem cell source in the first transplants in history, 75% of the patients have peripheral blood stem cell transplantation.
If the stem blood from the cord blood is born, the baby is collected in the blood bag in 2-4 minutes with the help of the injector after the cord is cut. The collected stem cells are stored at 80 ° C-196 ° C using programmed or mechanical freezing methods by adding DMSO to the cryoprotectant substance under sterile conditions.
For more information about Koç University Hospital Bone Marrow Transplantation Center, click on the link.

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What is Thalassemia Mediterranean Anemia?

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In humans, oxygen is transported through hemoglobin (Hb), which also gives the blood its red color. The main hemoglobin in adults consists of two alpha and two beta, four different globin chains and named as Hb A. Thalassemia (Mediterranean Anemia) is a genetic disease caused by the loss or disappearance of one or more globin chains. Since hemoglobin is produced incorrectly in this disease, red blood cells containing this hemoglobin are destroyed and anemia is formed. Anemia can occur in very severe forms, ranging from very mild laboratory changes to deaths in the womb.
Mediterranean anemia is studied in two main groups as alpha and beta thalassemia. The Mediterranean basin of the world is common in parts of the Middle East, India and Far East Asia. Thalassemia is seen in regions where malaria is common in the world because it protects human against malaria in thousands of years of human evolution. In our country, it is more common in Thrace and Mediterranean Region.
What are the symptoms and signs of Mediterranean Anemia?

Jaundice in the eyes,
There may be complaints of bloating in the abdomen.
Spleen and liver can grow in patients.
Changes in the face and head bones due to persistent anemia in their severe forms (protrusion in the forehead and cheekbones, etc.).
Growth retardation can be seen in heavy forms in children.
Diabetes, goiter and other hormonal disorders can be seen due to iron accumulation.
Heart failure, liver damage, and the corresponding feet, swelling of the abdomen can be seen.
Gallbladder stones are common because increased jaundice will increase.

How is the diagnosis of Mediterranean Anemia?
Diagnosis is made by blood count, peripheral smear, hemoglobin electrophoresis. Genetic tests can also be diagnosed, but it is not widely used routinely because of the difficulty in transport. Mediterranean anemia can be very confused with iron deficiency anemia due to the similarities of blood count and complaints. Iron deficiency anemia should be excluded especially in differential diagnosis.
Mediterranean Anemia Types:
Mediterranean Anemia has multiple subtypes, but the most important subtypes are alpha and beta thalassemia where alpha and beta chains are affected. Electrophoresis is not diagnostic in alpha thalassemia and the diagnosis is made by genetic or clinical findings.
The most common clinical forms of thalassemia;
Thalassemia Carrier: It is the most common patient group and these patients continue their life with mild anemia. They don’t need a blood transfusion. Children born to mother and father who are carriers of Mediterranean anemia may be at higher risk of developing severe anemia.
Thalassemia Intermedya: They do not need a blood transfusion at the beginning of life but they are anemic enough to require blood transfusions in certain periods of their lives.
Thalassemia Major: It is the most severe form of mediterranean anemia that needs blood transfusions from the first year of life.
How is Mediterranean Anemia treated?
There is no need for any treatment in patients with thalassemia if the patient does not have complaints and anemia is not deep. In patients without iron deficiency, it is important in this patient group that iron accumulation does not cause iron problems.
The undesirable effects of thalassemia occur due to chronic deep anemia and the iron accumulated in the body due to the blood given in the treatment of this anemia. Bone changes due to anemia, heart failure, the formation of blood outside the bone marrow (the size of the spleen) is problematic, while the iron given in the blood can accumulate in the organs, causing dysfunction in the glands that produce liver, heart and hormones. Therefore, the removal of iron from the body is of vital importance in patients undergoing routine blood transfusions. For this purpose, drugs that bind and bind iron in the body have been developed.
In order to prevent iron accumulation, it is important to monitor the iron accumulation in the body and to monitor the heart and hormone status. The gall bladder stone or spleen is very enlarged and a very frequent blood transfusion is required. In the selected patient group suitable for treatment, bone marrow transplantation is a solution that can completely cure the disease if there is also a donor.
How to prevent Mediterranean Anemia?
Thalassemia is a genetic disease and passed on to parents. Being a carrier of thalassemia is not an obstacle to marriage. If both parents are thalassemia carriers, children may be sick, carrier or normal. These couples can have a 25% probability of having a normal, 50% have a carrier like themselves and 25% have a child with thalassemia major. If one of the parents is a carrier and the other is healthy, the child will be a carrier of thalassemia of 50%. Blood and hemoglobin electrophoresis is used to screen new couples in our country. In the children of risky couples, genetic samples were taken from the prenatal placenta and amniotic fluid for diagnostic purposes.

Does the Prevalence of Reflux in Children Increase?

Attention if you have weight loss and unrest!
Does the frequency of reflux in children increase?
The reflux problem, which is thought to be an adult problem, can occur even in infants. Research shows that around 15 percent of all children have reflux. Yeditepe University Hospital Pediatric Health and Diseases, Child Gastroenterology Specialist Assoc. Dr. Meltem Uğraş points out that children with discomfort, nausea and especially weight loss should also be evaluated for reflux.
Reflux is the result of the loss of stomach contents to the esophagus due to the slackness in the valve between the esophagus and the stomach. Recently, the increase in signs of reflux in children of all age groups is important. This problem can reduce the quality of life of children and parents, as well as treatment of asthma, esophageal damage, recurrent otitis media and pneumonia can prepare for different diseases such as. Allergies and food allergies in particular can damage the esophagus and cause reflux symptoms. As the development process of infants continues, reflux is more common.
Reflux of children due to difficulty in gaining weight Yeditepe University Hospital Child Health and Diseases, Child Gastroenterologist Specialist Assoc. Dr. Meltem Uğraş states, however, that the development of children can also be affected. In addition, the acid escaping from the stomach to the esophagus, tissue damage and small wounds can lead to the risk of developing anemia.
Symptoms can be mixed
Complaints related to reflux can vary in infants and children. For example, nausea, vomiting and weight loss are observed in infants, but vomiting does not occur in children, but chest burning, hoarseness and slowing in development occur. In general, many of the symptoms are similar to different diseases, Assoc. Dr. Meltem Uğraş speaks: Ta Unless the underlying cause is found in the upper respiratory tract infections that develop with reflux, the child may be exposed to long and recurrent antibiotic treatments. In addition, complaints such as chest pain or compression can also be confused with heart-related diseases. Therefore, it is important to be vigilant about the symptoms of reflux and to consult a physician immediately. Dolayısıyla

Patient history is important in diagnosis
Asserting that the most important factor in the diagnosis of the disease is taking the child’s detailed history. Dr. Meltem Uğraş said, den We use various methods developed for the diagnosis of reflux and we do not approach each child with the same method. Some children only listen to complaints, while the clinical situation of some of them, depending on the severity of the complaint we use endoscopic or radiological methods.
Treatment begins with lifestyle change
In the treatment of reflux disease, first of all, some changes in life style need to be done. In dairy children, changing the contents of the food (intensification) is often one of the measures to be taken when feeding a small amount and raising the head while lying. In older children, orange juice, chocolate, mint-like foods that may cause reflux, and after the dinner need to reduce the intake of fluid. In addition, problems such as constipation, obesity, which leads to increased intraabdominal pressure, not to wear too tight clothes, to sit at the table while eating, eat frequently and a small amount of food, to eat 1.5-2 hours before bedtime and to raise the head while lying other measures that can be taken. Child Health and Diseases Specialist Assoc. Dr. Meltem Uğraş said, çık In accordance with the child, drugs can be used to regulate the movement of the digestive system and to decrease the stomach acid and to strengthen the valve functions. This treatment can last for about 4-6 months. However, surgery can be an option in very rare cases, which cannot improve despite long-term treatment. Ancak
Symptoms indicating reflex
• Frequent nausea, vomiting • Rejection of feeding (bottle) • Grouching • Restlessness • Frequent crying spells • Recurrent cough • Recurrent otitis media • Slow development
• Burning in the chest • Pain in the mouth • Loss of dental brightness • hoarseness • Slowening in development • Common upper respiratory tract infection • Common ear diseases • Common pneumonia / pneumonia