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  1. Ana Sayfa
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Yazar "Kokuludag, Ali" seçeneğine göre listele

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  • Küçük Resim Yok
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    AN ADULT PATIENT PRESENTED WITH EXTREMELY ELEVATED SERUM IGM, MASSIVE SPLENOMEGALY AND RECURRENT LOWER RESPIRATORY TRACT INFECTIONS
    (Springer/Plenum Publishers, 2014) Aksakal, Sengul; Cogulu, Ozgur; Onay, Huseyin; Sin, Aytul; Hekimgil, Mine; Gokmen, Nihal Mete; Kokuludag, Ali; Ardeniz, Omur
  • Küçük Resim Yok
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    Arthritis as a presenting symptom in a hypogammaglobulinemic patient with thymectomy
    (Springer Heidelberg, 2007) Ardeniz, Omur; Vatansever, Sezgin; Musabak, Ugur; Aksu, Kenan; Sin, Aytul; Kokuludag, Ali
  • Küçük Resim Yok
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    Complement consumption during cardiopulmonary bypass: comparison of Duraflo II heparin-coated and uncoated circuits in fully heparinized patients
    (Sage Publications Ltd, 1996) Hamulu, Ahmet; Discigil, Berent; Ozbaran, Mustafa; Calkavur, Tanzer; Kara, Erkan; Kokuludag, Ali; Buket, Suat; Bilkay, Onol
    Heparin attachment to synthetic surfaces is one means of improving the biocompatibility of clinically used cardiopulmonary bypass (CPB) circuits. To assess the effect of heparin-coated circuits on complement consumption during CPB, 40 patients undergoing elective myocardial revascularization were prospectively randomized either to a group in which a completely Duraflo II heparin-coated circuit was used for perfusion (heparin-coated Group, n = 20 patients) or to a control group (n = 20 patients) in which an uncoated, but otherwise standard circuit was used. Full systemic heparinization was induced (activated clotting time, 480 seconds) in all the patients included in the study, regardless of which perfusion circuit was used. The two groups did not differ significantly in terms of bodyweight, aortic crossclamp and extracorporeal circulation times. No patient had difficulty in weaning from bypass and the postoperative period was uneventful in all patients. Concentrations of C3 and C4 were found to be within the 'normal' range in the prebypass period in both groups. There were no significant intergroup differences with regard to C3 and C4 consumption during CPB. We conclude that Duraflo II heparin-coated circuits have no effect in reducing complement consumption during CPB in fully heparinized patients.
  • Küçük Resim Yok
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    DELAYED DIAGNOSIS OF NIJMEGEN BREAKAGE SYNDROME IN AN ADULT PATIENT PRESENTING WITH RECURRENT INFECTIONS
    (Springer/Plenum Publishers, 2014) Koc, Zeynep P.; Karaca, Emin; Gokmen, Nihal M.; Sin, Aytul Z.; Gulbahar, Okan; Kokuludag, Ali; Ardeniz, Omur
  • Küçük Resim Yok
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    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
    (Karger, 2012) Gokmen, Nihal Mete; Ersoy, Ramazan; Gulbahar, Okan; Ardeniz, Omur; Sin, Aytul; Unsel, Mehmet; Kokuludag, Ali
    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 mu g/ml, p < 0.0001) and IgG4 (0.07 vs. 1.92 mu g/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 (C) 2012 S. Karger AG, Basel
  • Küçük Resim Yok
    Öğe
    Diagnostic Value of Specific IgE Analysis in Latex Allergy
    (Karger, 2012) Unsel, Mehmet; Mete, Nihal; Ardeniz, Omur; Sin, Aytul; Gulbahar, Okan; Kokuludag, Ali
    Background: The precision of the methods used to diagnose latex allergy is of great importance due to false-positive results. Neither the skin prick test (SPT) nor the latex-specific IgE assay has 100% diagnostic accuracy. We analysed the diagnostic value of latex-specific IgE by the first-ever concomitant use of the SPT and nasal provocation test (NPT). Methods: Twenty-seven latex-sensitive patients (group 1), 46 aeroallergen-sensitive patients (group 2a) and 33 healthy subjects (group 2b) participated in the study. All groups underwent an SPT with latex and aeroallergens and an NPT with latex. Latex-specific IgE and total IgE levels were measured by the ImmunoCAP assay. Results: Latex-specific IgE was positive in 92.6, 30.4 and 9.1% of groups 1, 2a and 2b, respectively. The 11 aeroallergen-sensitive patients in group 1 and all of the patients in group 2a were predominantly sensitised to pollens (grass, weed and tree) and reacted to a lesser degree to house dust mite, moulds and animal dander. Combined pollinosis was remarkably more prevalent in patients with positive latex-specific IgE in group 2a than in those with negative latex-specific IgE (p = 0.001). The NPT was positive in 84.6% of group 1 and negative in all control subjects. The sensitivity, specificity, negative predictive value and positive predictive value of the latex-specific IgE assay were 90.9, 72.2, 96.3 and 50%, respectively. Conclusion: The high rate of false-positive results for latex-specific IgE by ImmunoCAP should be taken into account when making a diagnosis of latex allergy in patients with pollinosis, especially in those sensitised to more than one pollen species. Copyright (C) 2012 S. Karger AG, Basel
  • Küçük Resim Yok
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    Misleading Allergens in the Diagnosis of Latex Allergy: Profilin and Cross-Reactive Carbohydrate Determinants
    (Karger, 2018) Gurlek, Feridun; Unsel, Mehmet; Ardeniz, Omur; Koc, Zeynep Peker; Gulbahar, Okan; Sin, Aytul Zerrin; Kokuludag, Ali; Gokmen, Nihal Mete
    Background: It has been suggested that latex-specific IgE analysis may lead to false-positive results, especially in patients with pollen allergy. In the present study, the reasons underlying clinically irrelevant latex-specific IgE positivity were investigated. Methods: Thirty patients with latex allergy (group 1), 89 patients sensitised to aeroallergens (group 2a), and 98 healthy individuals without allergy (group 2b) were enrolled. Participants from all 3 groups were subjected to skin prick tests with aeroallergens including latex, latex-specific IgE analysis (ImmunoCAP), and nasal provocation test with latex. All cases demonstrating positive latex-specific IgE also underwent specific IgE tests (ImmunoCAP) with latex profilin, birch pollen profilin, peach lipid transfer protein, and pineapple bromelain as cross-reactive carbohydrate determinants. Results: Comparison of the atopic and healthy control groups showed that the rate of positive latex-specific IgE was significantly higher in group 2a. Latex profilin-, birch pollen profilin-, and bromelain-specific IgE were remarkably higher in group 2a. Conclusion: False positivity to latex-specific IgE in ImmunoCAP analysis may be observed in approximately 19% of patients with pollen allergy. Profilins and bromelain are the main contributors to clinically irrelevant positive latex-specific IgE. (C) 2018 S. Karger AG, Basel.
  • Küçük Resim Yok
    Öğe
    The Prevalence of Hypersensitivity Reactions to Antirheumatic Biological Agents and Results of the Skin Tests: Experience of a Tertiary Referral Allergy Center in Turkey
    (Bilimsel Tip Yayinevi, 2020) Dalgic, Ceyda Tunakan; Zihni, Figen Yargucu; Bulut, Gokten; Kokuludag, Ali; Sin, Aytul Zerrin
    Objective: The use of biological agents (BAs) has increased dramatically for inflammatory diseases and this increase has led to a rise in hypersensitivity reactions (HSRs). The symptoms and diagnostic tools for HSRs are not standardized. We aimed to analyze the prevalence of HSRs to anti-rheumatic BAs and to evaluate the usefulness of skin tests (STs) as a diagnostic tool. Materials and Methods: Our study was conducted at the Ege University Medical Faculty, Department of Internal Medicine, Division of Allergy and Clinical Immunology and Division of Rheumatology, Izmir, Turkey. Four hundred sixty patients who received BAs between Jan 1st, 2015, and Jan 1st, 2016, were reviewed in this retrospective cross-sectional study. The prevalence of HSRs was retrospectively evaluated. Ten patients with HSRs were evaluated with STs containing commercially available culprit drugs. The data was collected from hospital records. The age, sex, atopic diseases, primary rheumatic diseases, and anti-rheumatic therapies of the patients were recorded. Results: Two hundred fifty patients were treated with rituximab (RTX), 45 with infliximab, 40 with tocilizumab (TOC), 36 with golimumab, 35 with etanercept, 34 with abatacept, 15 with certolizumab, and 5 with adalimumab. Fifty reactions with RTX and two reactions with TOC were infusion-related (IRRs). Ten HSRs were observed. Eight patients had immediate (7 immediate systemic reactions and 1 local injection site reactions), and 2 had late-onset cutaneous reactions. We detected the ratio of IRRs as 11.3%, immediate HSRs as 1.73%, IgE-mediated reactions as 1.08%, and anaphylaxis as 0.86%. STs were positive in 5 of 8 patients with immediate HSRs. Four of them had anaphylaxis, and remarkably, 3 of these had positive STs. None of the ten patients had high levels of specific IgE and only four had atopic diseases. Total IgE levels were not high and specific IgE levels were not positive in the presence of HSR to BAs (p=0.039). Conclusion: Five of the 8 (62.5%) patients with immediate reactions had positive STs, which suggested IgE-mediated reactions. The prevalence of HSRs to BAs was less than the ones mentioned in the literature.
  • Küçük Resim Yok
    Öğe
    RHEUMATOID ARTHRITIS, SCLEROSING CHOLANGITIS AND RECURRENT THYMOMA IN AN ADULT CVID PATIENT
    (Springer/Plenum Publishers, 2014) Ozdemir, Rabia Bilge Ozgul; Mete, Nihal; Sin, Aytul; Gulbahar, Okan; Kokuludag, Ali; Hekimgil, Mine; Ardeniz, Omur
  • Küçük Resim Yok
    Öğe
    Vitamin D deficiency in the absence of enteropathy in three cases with common variable immunodeficiency
    (Karger, 2008) Ardeniz, Omur; Avci, Cigir Biray; Sin, Aytul; Ozgen, Gokhan; Gunsar, Fulya; Mete, Nihal; Gulbahar, Okan; Kokuludag, Ali
    Background: Common variable immunodeficiency (CVID) is characterized by hypogammaglobulinemia and a defect in antibody production. Herein we describe 3 patients diagnosed with CVID in whom vitamin D deficiency was detected in the absence of enteropathy. Methods: Biochemical and immunological analysis, serum osteocalcin, parathyroid hormone, 25-OH vitamin D, 1,25(OH) 2 vitamin D, vitamin A, vitamin E, urinary calcium, and deoxypyridinoline measurements were carried out. Vitamin D receptor (VDR) expression was examined in the peripheral blood mononuclear cells and hair follicles by reverse transcriptase polymerase chain reaction. VDR gene polymorphism was evaluated by high-performance liquid chromatography. Results: None of the patients presented nutrient deficiencies other than vitamin D. Two of them were free of osteomalacia-related symptoms. VDR expression was found to be lower in the peripheral blood mononuclear cells and hair follicles when compared to the control group. Conclusions: Patients with CVID may present asymptomatic vitamin D deficiency. Vitamin D and VDRs play an important role in the innate immune system and modulate Toll-like receptor-related responses. Delay in diagnosis may predispose these patients not only to irreparable bone loss but also to infections, and autoimmune and malignant disorders, thus emphasizing the importance of prompt intervention. Copyright (C) 2008 S. Karger AG, Basel.

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