Publications by authors named "Mehmet Berktas"

8 Publications

  • Page 1 of 1

Treatment Options for Cow's Milk Protein Allergy: A Modeling Analysis.

Clinicoecon Outcomes Res 2020 17;12:307-315. Epub 2020 Jun 17.

Cukurova University Medical School, Allergy and Immunology Department, Adana, Turkey.

Purpose: Cow's milk protein allergy (CMPA) is one of the most common food allergies in early childhood. We aimed to evaluate clinical and economic outcomes of the amino-acid formula (AAF) and extensively hydrolyzed formula (eHF) based treatment of CMPA by using data available from Turkey and otherwise from literature.

Materials And Methods: A theoretical model was developed to evaluate AAF and eHF for CMPA treatment in terms of the number of children tolerating formula or experiencing an allergic reaction or withdrawing formula due to taste or other palatability features and CMPA related direct medical costs from the payer perspective.

Results: We estimated that 13,000 children are diagnosed with CMPA in 1 year in Turkey. For the children receiving AAF, it is estimated that 83.7% tolerate AAF until the 24th month, and the total cost for the children tolerating AAF is estimated at 20.6 million€. The average cost per child tolerating AAF until the 24th month is estimated at 1895€. On the other hand, 48.7% are estimated to tolerate eHF until the 24th month, and the total cost for the children tolerating eHF is estimated at 12.3 million€ and the average cost per child tolerating eHF until the 24th month is estimated at 1940€.

Conclusion: The analysis revealed that the management of CMPA is associated with the economic burden on the healthcare system in Turkey. Treatment of CMPA with AAF seems to provide better clinical outcomes (high tolerability and less withdrawal due to taste or an allergic reaction) and to be an option with economic benefits when Turkey-specific conditions are considered.
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June 2020

Effects of 3-monochloropropane-1,2-diol (3-MCPD) and its metabolites on DNA damage and repair under in vitro conditions.

Food Chem Toxicol 2016 Mar 31;89:1-7. Epub 2015 Dec 31.

Center of Toxicology Science & Research, Medical School, University of Crete, Heraklion, Crete, Greece.

3-monochloropropane-1,2-diol (3-MCPD) is a food contaminant that occurs during industrial production processes and can be found mainly in fat and salt containing products. 3-MCPD has exhibited mutagenic activity in vitro but not in vivo, however, a genotoxic mechanism for the occurrence of kidney tumors has not so far been excluded. The main pathway of mammalian 3-MCPD metabolism is via the formation of β--chlorolactatic acid and formation of glycidol has been demonstrated in bacterial metabolism. The aim of this study was to investigate genotoxic and oxidative DNA damaging effects of 3-MCPD and its metabolites, and to provide a better understanding of their roles in DNA repair processes. DNA damage was assessed by alkaline comet assay in target rat kidney epithelial cell lines (NRK-52E) and human embryonic kidney cells (HEK-293). Purine and pyrimidine base damage, H2O2 sensitivity and DNA repair capacity were assessed via modified comet assay. The results revealed in vitro evidence for increased genotoxicity and H2O2 sensitivity. No association was found between oxidative DNA damage and DNA repair capacity with the exception of glycidol treatment at 20 μg/mL. These findings provide further insights into the mechanisms underlying the in vitro genotoxic potential of 3-MCPD and metabolites.
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March 2016

The Evolution of Sagittal Spinal Alignment in Sitting Position During Childhood.

Spine (Phila Pa 1976) 2015 Jul;40(13):E787-93

*Department of Orthopaedics and Traumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey; and †Yeditepe University Pharmacoepidemiology and Pharmacoeconomics Research Center, Istanbul, Turkey.

Study Design: This is a cross-sectional descriptive study.

Objective: The purposes of this study are to describe normative data of the sagittal plane in the sitting position within the pediatric population and document the evolution of sagittal alignment during the growth.

Summary Of Background Data: Surgical procedures addressing the deformity aim to make the maximal correction on the coronal and transverse planes and to restore the physiological curves on the sagittal plane. Prerequisite for sagittal plane reconstruction is to know the physiological values.

Methods: Children between 3 and 17 years of age, followed by pediatrics unit for nonskeleton disease with lateral radiographs of the entire spine and pelvis on sitting positions, were included to the study. Children with history of surgery or disease that may affect spine development were excluded. Children were evaluated in 4 age groups (3-6, 7-9, 10-12, and 13-17 yr) in terms of spinal sagittal alignment on sitting position.

Results: Of the screened, 124 children (49 girls, 75 boys) were included. Descriptive statistics of all possible segmental angles were summarized. Thoracic kyphosis and lumbar lordosis values were lower on sitting position than on standing position. Thoracic segmental angulations steadily increased from T1-T2 to midthoracic segments and then decreased in caudal direction. Moreover, lumbar segmental angulations steadily increased in cephalocaudal direction. Sacral slope, L4-S1 angulation, and T1-T12 and T1-S1 distance tend to increase as the age increases.

Conclusion: Sagittal spinal alignment in the sitting position is different than that in the standing position and it changes as the child grows. There is a statistically significant difference between different age groups, especially at the cervicothoracic, thoracolumbar, and lumbosacral junctions. These findings should be taken into consideration for young nonambulatory patients who require spinal instrumentation and/or fusion.

Level Of Evidence: 2.
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July 2015

Comparison of methods for the extraction of DNA from formalin-fixed, paraffin-embedded archival tissues.

Int J Med Sci 2014 27;11(5):494-9. Epub 2014 Mar 27.

2. Pharmacoeconomy and Pharmacoepidemiology Research Center (PEPIRC), Yeditepe University, Istanbul, Turkey.

Aim: Discussing a protocol involving xylene-ethanol deparaffinization on slides followed by a kit-based extraction that allows for the extraction of high quality DNA from FFPE tissues.

Methods: DNA was extracted from the FFPE tissues of 16 randomly selected blocks. Methods involving deparaffinization on slides or tubes, enzyme digestion overnight or for 72 hours and isolation using phenol chloroform method or a silica-based commercial kit were compared in terms of yields, concentrations and the amplifiability.

Results: The highest yield of DNA was produced from the samples that were deparaffinized on slides, digested for 72 hours and isolated with a commercial kit. Samples isolated with the phenol-chloroform method produced DNA of lower purity than the samples that were purified with kit. The samples isolated with the commercial kit resulted in better PCR amplification.

Conclusion: Silica-based commercial kits and deparaffinized on slides should be considered for DNA extraction from FFPE.
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November 2014

Efficacy and safety of valsartan and amlodipine single-pill combination in hypertensive patients (PEAK study).

Turk Kardiyol Dern Ars 2013 Jul;41(5):406-17

Novartis Pharmaceuticals, İstanbul, Turkey.

Objectives: This study was designed to assess the safety, compliance and efficacy of amlodipine (Aml) and valsartan (Val) single-pill combination (SPC) in a large hypertensive patient population.

Study Design: This is a non-interventional, observational, open label study conducted in 166 centers in Turkey with a 24-week follow-up period.

Results: Of the 1184 enrolled patients, two-thirds were female (62.2%). The mean age was 57.7±11.3 years, and 26.1% of the patients were older than 65 years. The majority of patients (82.3%) were overweight or obese. During the course of the study, 150 (12.7%) patients experienced a total of 174 adverse events (AEs). The overall mean (SD) compliance rate was determined to be 96.9 (0.2)%. The most commonly reported AE was edema, with a new-onset edema incidence of 6.7%. In the entire group, Aml/Val SPC significantly reduced both systolic and diastolic blood pressure (BP), with a reduction of 29.6±0.9 / 14.7±0.6 mmHg (for each, p<0.001).

Conclusion: As a result of the low incidences of AEs and new-onset edema, the safety profile of Aml/Val SPC proved to be optimal. Aml/Val SPC reduced BP efficiently and met the needs of most patients to achieve the targets. Aml/Val SPC seems to be a beneficial option for effective BP control, which is a key factor influencing cardiovascular outcome.
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July 2013

The efficacy and safety of triple vs dual combination of angiotensin II receptor blocker and calcium channel blocker and diuretic: a systematic review and meta-analysis.

J Clin Hypertens (Greenwich) 2013 Mar 14;15(3):193-200. Epub 2012 Dec 14.

Department of Pharmacology, Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Many hypertensive patients require ≥2 drugs to achieve blood pressure targets. This study aims to review and analyze the clinical studies conducted with dual or triple combination of angiotensin II receptor blockers (ARBs), calcium channel blockers (CCBs), and diuretics. Medical literature between January 1990 and April 2012 was reviewed systematically and data from eligible studies were abstracted. Data were analyzed using random-effects models. Of the 224 studies screened, 7563 eligible patients from 11 studies were included. Triple combinations of ARBs (olmesartan or valsartan), CCBs (amlodipine), and diuretics (hydrochlorothiazide) at any dose provided more blood pressure reduction in office and 24-hour ambulatory measurements than any dual combination of these molecules (P<.0001 for both). Significantly more patients achieved blood pressure targets with triple combinations (odds ratio, 2.16; P<.0001). Triple combinations did not increase adverse event risk (odds ratio, 0.96; P=.426). Triple combinations at any dose seem to decrease blood pressure more effectively than dual combination of the same molecules without any remarkable risk elevation for adverse events. Further prospective studies evaluating the efficacy and safety of triple combinations, especially in the form of single pills, are required.
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March 2013

Protective effect of grape seed extract against ischaemia/reperfusion injury in a rat epigastricflap model.

J Plast Reconstr Aesthet Surg 2010 Apr 25;63(4):705-10. Epub 2009 Feb 25.

1st Plastic & Reconstructive Surgery Clinic, Ankara Training and Research Hospital, Ankara, Turkey.

Proanthocyanidins are potent natural antioxidants which belong to a class of polyphenols. Proanthocyanidin-rich extracts are prepared from grape seeds. The effect of grape seed proanthocyanidin extract (GSPE) on the viability of abdominal skin flaps exposed to warm ischaemia and subsequent reperfusion were studied in 40 male Wistar rats. In the control group (group I; n=20), rats were fed with standard, non-purified rat diet, and the study group received GSPE 100 mgkg(-1) per day 1 week prior to surgery and 1 week following surgery. Abdominal island flaps were elevated in both the groups and subjected to 8h of warm ischaemia, followed by reperfusion. Mean flap survival areas in groups I (control group) and II (treatment group) were calculated to be 58.3%+/-11.72 and 81.0%+/-11.88, respectively. Flap survival on day 7 was significantly higher in group II compared to group I (p<0.01). Histopathological semi-quantitative analysis of the specimens revealed infiltration by polymorphonuclear leucocytes, oedema formation and necrosis in group I, whereas neo-vascularisation and fibrosis were the prominent findings in group II.
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April 2010