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Öğe Desensitization effect of preseasonal seven-injection allergoid immunotherapy with olive pollen on basophil activation: The efficacy of olive pollen-specific preseasonal allergoid immunotherapy on basophils(2012) Gokmen N.M.; Ersoy R.; Gulbahar O.; Ardeniz O.; Sin A.; Unsel M.; Kokuludag A.Background: It has previously been demonstrated that subcutaneous immunotherapy with allergoids positively affects clinical and immunological parameters even after 7 preseasonal injections. However, its effect on basophil activation remains unclear. We investigated the effect of preseasonal allergoid immunotherapy on basophils and concomitantly assessed its clinical and immunological efficacy in olive pollen-monosensitized patients. Methods: This study enrolled 437 consecutive patients with respiratory allergy and positive skin prick tests (SPTs); 212 (48.5%) patients were sensitized to olive pollen, and 33 (7.5%) patients were sensitized to olive pollen only. Of these patients, 23 received preseasonal immunotherapy with an olive pollen allergoid. The olive pollen-specific basophil activation, the titrated nasal provocation test, the nasal symptom score, and olive pollen-specific IgE, IgG1 and IgG4 levels were evaluated before immunotherapy and 8 months after the end of immunotherapy in the follow-up visit. Results: In comparison to baseline evaluation, 7 preseasonal injections of an allergoid resulted in a significant decrease in the percentage of basophils expressing CD63 (29 vs. 7%, respectively, p < 0.0001) and a significant increase in the titrated nasal provocative dose (1/10 vs. 1/1, respectively, p < 0.01). SPT induration diameters caused by an olive pollen extract decreased (12 mm at baseline vs. 5.5 mm at follow-up, p < 0.005), as did nasal symptom score (7 at baseline vs. 3 at follow-up, p < 0.01). Olive pollen-specific IgE (17.5 vs. 50 kU/l, p < 0.012), IgG1 (0.16 vs. 2.9 µg/ml, p < 0.0001) and IgG4 (0.07 vs. 1.92 µg/ml, p < 0.0001) levels significantly increased. Conclusions: Immunotherapy with 7 preseasonal injections of an olive pollen allergoid decreases olive pollen-specific basophil activation over 8 months, an effect observed in vitro and in vivo. Copyright © 2012 S. Karger AG, Basel.Öğe The knowledge and considerations of the physicians regarding the inhaler devices in asthma and COPD: The INTEDA-1 study [Asti{dotless}m ve koah tedavisinde kullani{dotless}lan inhaler cihazlar hakki{dotless}nda hekimlerin bilgi düzeyleri ve görüşleri: INTEDA-1 Çali{dotless}şmasi{dotless}](Ankara University, 2013) Çalişkaner A.Z.; Öztürk C.; Ceylan E.; Pekcan S.; Yilmaz Ö.; Öztürk S.; Can C.; Şener O.; Yilmaz Turay Ü.; Koç N.; Ersoy R.The knowledge and considerations of the physicians regarding the inhaler devices in asthma and COPD: the INTEDA-1 study Introduction: The present paper was aimed at indicating and discussing the possible problems related to inhaler devices by considering the knowledge and practices of the physicians regarding the inhalation therapies. Materials and Methods: The present study is a prospective, cross-sectional survey carried out by Turkish Respiratory Society Inhalation Therapy Group between February 2010 and February 2011 with a participation of ten individual centres. Seven inhaler devices that were available on the market in the country were assessed. The data on the problems that 684 clinicians actively attending patients with respiratory disorders experienced in daily clinical practice or their evaluations of their patients were obtained through the questionnaire. Results: The respondents, most of whom were pulmonologist (37.5%), and pediatrist (38.1%), had been,on average, 11.6 years in profession. The source of information on inhalers and administration techniques were reported to be mainly the internet and patient leaflets. Of the participants only 18.5% reported to have had adequate knowledge of inhaler devices and proper administration techniques. Most of the participants stated that they themselves provided the instructions of administration and that the method was often verbal explanation. The physicians believed that although approximately 60% of the patients used the drug correctly, 40.7% made critical mistakes to have adverse effects on the therapeutic outcome. The most important criteria on which the physians lay greater emphasis in choosing the inhaler devices were the physical capability, skills and age of the patients. Conclusion: The awareness of proper use of inhaler devices is a fundamental prerequisite for effective inhalation therapy has been improved in physicians. The results of the present study have shown that more effort is required for professional training. Assisting the physicans with medical personnel for training of the patients and educational motivation are required.Öğe New-onset type II diabetes mellitus, hyperosmolar non-ketotic coma, rhabdomyolysis and acute renal failure in a patient treated with sulpiride [5](2005) Toprak Ö.; Cirit M.; Ersoy R.; Üzüm A.; Özümer Ö.; Çobanoglu A.; Tanrisev M.; Güleç D.; Çetinkalp Ş.[No abstract available]Öğe Tests used for the diagnosis of drug allergies: Review [İlaç allerjilerinin tanisinda kullanilan testler](Turkiye Klinikleri, 2008) Mete Gökmen N.; Ersoy R.The diagnosis of a drug allergy is mainly based on a very detailed history and physical examination. In addition, several in vitro or in vivo tests can be performed to demonstrate sensitization to a certain drug. In vivo tests are skin tests and provocation tests. While prick tests and intradermal tests are used for the diagnosis of IgE-mediated allergic reactions, patch and photopatch tests are preferred for the diagnosis of delayed type reactions. If immediate type allergic reactions such as urticaria, angioedema, rhinitis, conjunctivitis, bronchospasm, or hypotension occur soon after drug use, the prick test and the intradermal test should be performed. The gold standard for the diagnosis of drug allergy is the combination of relevant history and challenge test with the suspected drug. In vitro tests, used for the diagnosis of patients with drug allergy, are drug-specific IgE, the lymphocyte transformation test and allergen induced mediator release tests. Specific IgE has a lower sensitivity and a higher specificity than skin tests. However, it is much more expensive than skin tests. The lymphocyte transformation test (LTT) is used to determine drug sensitivity mediated by T cells. Allergen-induced mediator release assays analyze the mediator, which are released from effector cells, most probably basophiles, when stimulated in vitro with serial dilutions of the putative allergens. Release of Cys-LT produced in vitro by isolated peripheral blood leukocytes after drug allergen stimulation, is measured by the cellular antigen stimulation test (CAST) technique. Flow cytometric basophile activation test (BAT) detects the enhancement of the percent expression of surface CD63 and CD203c markers. This technique is increasingly used in the in vitro diagnosis of drug allergy. In this review, in vitro and in vivo tests used to detect drug sensitization are discussed. Copyright © 2008 by Türkiye Klinikleri.
