Browsing by Author "Aktas, A"

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    Urticarial Vasculitis Successfully Treated With Omalizumab
    Ermertcan, AT; Aktas, A; Öztürk, F; Temiz, P
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    Cytokine Expression Before and After Aspirin Desensitization Therapy in Aspirin-Exacerbated Respiratory Disease
    Aktas, A; Kurt, E; Gulbas, Z
    Aspirin exacerbated respiratory disease (AERD) is induced by acetylsalicylic acid (ASA) and/or nonsteroidal antiinflammatory drugs (NSAIDs). Effects of desensitization on many mediators have been examined previously, but few studies addressed the influence of desensitization on T lymphocytes and T lymphocyte-derived cytokines. This study was performed to examine peripheral blood lymphocyte (PBL) cytokine expression in aspirin-sensitive patients who have asthma before and after aspirin desensitization. In this study, the release of interleukin-2 (IL-2), interleukin-4 (IL-4), and interferon-gamma (IFN-gamma) by CD4+ T lymphocytes prior to aspirin desensitization were also measured at intracellular levels, and expression of these cytokines after 1 month aspirin desensitization was evaluated. Twelve patients with AERD were included in the study. Two different control groups were formed, one consisted of 15 healthy people and second 12 aspirin tolerant asthmatic (ATA) patients using aspirin. A blood sample was collected prior to desensitization, and the tests were repeated by taking a second blood sample 1 month after the 4-day desensitization treatment. The proportion of lymphocytes secreting IFN-gamma in the study group was 15.61 +/- 4.40 % before desensitization and 15.08 +/- 5.89 % after desensitization. The rate of IFN-gamma secreting CD4+ T lymphocytes was 20.51 +/- 4.41 % in the normal control group and 16.07 +/- 5.7 % in the ATA group (p = 0.021). The ratio of CD4+ T lymphocyte secreting IFN-gamma was reduced in patients with AERD before desensitization compared to normal control group (p = 0.040). The levels of IL-2, IL-4, and the subsets of lymphocyte were not different before and after desensitization compared to control groups.
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    Factors confusing the diagnosis of laryngopharyngeal reflux: the role of allergic rhinitis and inter-rater variability of laryngeal findings
    Eren, E; Arslanoglu, S; Aktas, A; Kopar, A; Ciger, E; Önal, K; Katilmis, H
    The objective of the study was to determine the inter-rater variability in assessment of laryngeal findings and whether diagnosing laryngopharyngeal reflux based on the laryngeal findings and history alone without considering allergic rhinitis leads to the overdiagnosis and overtreatment of laryngopharyngeal reflux. Patients with positive and negative skin prick tests were recruited from an allergy clinic in a tertiary teaching university hospital. All subjects completed the Reflux Symptom Index (RSI) and underwent laryngeal examinations by three physicians blinded to the skin prick test results and the Reflux Finding Score (RFS) was determined. RFS > 7 or RSI > 13 was considered reflux positive. Fleiss' kappa (kappa) was used to measure inter-rater agreement. The inter-rater agreement was low for pseudosulcus vocalis (kappa = 0.078), ventricular obliteration (kappa = 0.206), diffuse laryngeal edema (kappa = 0.204), and posterior laryngeal hypertrophy (kappa = 0.27), intermediate for laryngeal erythema/hyperemia (kappa = 0.42) and vocal fold edema (kappa = 0.42), and high for thick endolaryngeal mucus (kappa = 0.61). Although the frequency of allergy was high, there was no significant difference between allergy-positive and laryngopharyngeal reflux-positive patients. On logistic regression analysis, thick endolaryngeal mucus was a significant predictor of allergy (p = 0.012, odds ratio 0.264, 95 % confidence interval 0.093-0.74). The laryngeal examination for reflux is subject to marked inter-rater variability and allergic laryngitis was not misdiagnosed as laryngopharyngeal reflux. The presence of thick endolaryngeal mucus should alert physicians to the possibility of allergic rhinitis/laryngitis.
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    Heavy metal levels in several fish species from Turkey
    Ergonul, B; Aktas, A; Günç, P; Kundakçi, EA
    In this research, heavy metal (lead, arsenic, mercury, and cadmium) levels in edible muscle tissues of four different species of fish (flathead grey mullet [Mugil cephalus L., 1758], European pilchard [Sardina pilchardus W. 1792], gilt-head [sea] bream [Sparus aurata L., 1758], and European seabass [Dicentrarchus labrax L., 1758]) caught from Izmir Bay, open (Aegean) sea, and Karaburun fish farm (Izmir Bay) were determined. Mean heavy metal levels of all species of fish ranged below the upper limits as established by the Turkish Food Codex except Cd for three samples, and merely 2 % percent of all samples exceeded the corresponding thresholds. Values recorded in this study were markedly lower than most data from the literature from other areas of Turkey.
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    Diagnosis of allergic rhinitis: inter-rater reliability and predictive value of nasal endoscopic examination: a prospective observational study
    Eren, E; Aktas, A; Arslanoglu, S; Kopar, A; Ciger, E; Özkul, Y; Önal, K; Katilmis, H
    ObjectiveTo determine the inter-rater reliability of nasal endoscopic findings and the feasibility of diagnosis of allergic rhinitis based solely on symptoms and nasal endoscopy. DesignProspective observational study. SettingUniversity Teaching hospital. ParticipantsOne hundred and eight patients were referred from the allergy clinic included in the study. Main outcome measuresPredictive value of symptoms and nasal endoscopic examination to diagnose allergic rhinitis and inter-rater reliability of the examination were evaluated. ResultsLogistic regression analysis of patient symptoms and nasal examination findings revealed no significant predictive power for any of the symptoms or examination findings. The Fleiss coefficient of the three raters was calculated. Inter-rater variability among the three physicians demonstrated that mucosal oedema (=0,48, P<0.001), polypoid degeneration of the inferior turbinate tail (=0.48, P=0.01), nasal polyps (=0.96, P<0.001) and nasal septal deviation (=0.65, P=0.01) showed significant inter-rater agreement. A low coefficient (0.29) was found, and the inter-rater variability among physicians in interpreting the characteristics of nasal secretions was significant (P=0.04). The inter-rater variability among the three physicians suggested that turbinate hypertrophy (=0.31) and turbinate colour (=0.38) showed no significant inter-rater agreement. ConclusionsPatient symptoms and nasal endoscopy findings do not provide reliable diagnosis of allergic rhinitis. Turbinate colour and hypertrophy are believed to be related to allergic rhinitis; however, these were subject to marked inter-rater variability in this study.
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