Publications by authors named "Seda Altiner"

6 Publications

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Serum midkine level might be a diagnostic tool for COVID19 disease in pregnancy: From the disease severity, hospitalization and disease progression respects.

Cytokine 2022 01 30;149:155751. Epub 2021 Oct 30.

Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey; University of Health Sciences, Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey.

Background: New biomarkers for diagnosis and monitoring the COVID-19 disease are the most important topics to be studied recently. We aimed to investigate the association between midkine levels and disease severity in pregnant women with COVID-19.

Methods: Totally 186 pregnant women were participated in this study. 96 of them were healthy pregnant women, 90 of them were pregnant women with COVID19. Pregnant women were evaluated according to their trimesters. Serum midkine level, biochemical profile clinical and disease severity outcomes of pregnant women were obtained.

Results: Our results showed that pregnant women with COVID19 have significantly increased serum midkine level compared to healthy pregnant women (1.801 ± 0.977 vs 0.815 ± 0.294 ng/dL). According to the data among each trimester, it was shown that there were significant increase in serum midkine level during all pregnancy trimesters (1st trimester Control Group: 0.714 ± 0.148, COVID-19 group 1.623 ± 0.824, p < 0.0001; 2nd trimester Control Group: 0.731 ± 0.261, COVID-19 group 2.059 ± 1.146, p < 0.0001; 3rd trimester Control Group: 1.0 ± 0.35, COVID-19 group 1.723 ± 0.907, p = 0.001). Serum midkine levels were significantly different between disease severity subgroups of pregnant women with COVID19; moderate and severe/critic groups had significantly higher serum midkine level than mild group. There was also significant correlation between serum midkine level and severity status (p:0.0001, r: 0.468). The most striking results of serum midkine levels were corelation between length of hospitalization (p: 0.01, r: 0.430) and O saturation (p < 0.0001, r: -0.521). ROC curve analysis showed that serum midkine level might be a tool for predicting COVID-19 in pregnant women with COVID-19 (AUC: 0.912, 95% CI: [0.871, 0.952], p < 0.0001) CONCLUSION: Our data showed that there is an obvious relation between COVID19 progression and serum midkine level for the first time which might be used for monitoring the disease process.
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January 2022

Evaluation of the safety and efficacy of Advax as an adjuvant: A systematic review and meta-analysis.

Adv Med Sci 2021 Sep 22;67(1):10-17. Epub 2021 Sep 22.

Institute of Health Sciences, Interdisciplinary Food, Metabolism and Clinical Nutrition Department, Ankara University Faculty of Medicine, Ankara, Turkey; Department of Pathophysiology, Faculty of Medicine, Ankara University, Ankara, Turkey. Electronic address:

Purpose: Developing a vaccine with improved immunogenicity is still a growing priority for many diseases. Different types of adjuvants may be beneficial to initiate and maintain the long-lasting immunogenicity of vaccines. Evidence has shown that polysaccharide adjuvants are efficient in improving immunological mechanisms with their biocompatibility and biodegradability characteristics. In this study, we aimed to investigate the safety and efficacy of Advax an adjuvant derived from delta inulin.

Methods: A systematic research was performed in Pubmed, Web of Science, and Scopus databases for the following keywords; "Advax" OR "delta inulin" until December 14th, 2020. RevMan 5.4.1 software was used for cumulative meta-analysis and bias analysis. We also used GraphPad Prism 6 software for the figures.

Results: In the cumulative meta-analysis, it was found that seroconversion and geometric mean titers (GMT) levels significantly increased in Advax-adjuvanted group (mean difference: 12.31, 95% Cl [4.14, 20.47], p ​= ​0.003; 17.10, 95% Cl [4.35, 29.85], p ​= ​0.009, respectively). We also observed that Advax could be effective in improving immunogenicity by inducing T-cell responses and plasmablast generation in viral vaccines.

Conclusions: In this study, it was shown that Advax is a safe and well-tolerated adjuvant. Advax could be a potent adjuvant in increasing the protection and immunogenicity of different vaccines without safety issues. However, further studies are needed to verify these effects of Advax adjuvant.
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September 2021

Rapid Drug Desensitization with Chemotherapeutics (Platins, Taxanes, and Others): A Single-Center Retrospective Study.

Int Arch Allergy Immunol 2019 20;179(2):114-122. Epub 2019 Mar 20.

Department of Chest Disease, Division of Allergy and Clinical Immunology, Ankara University School of Medicine, Ankara, Turkey,

Background: Rapid drug desensitization (RDD) induces a temporary tolerance to chemotherapeutics that induce hypersensitivity reactions (HSRs).

Purpose: Our objective is to report our experience with RDD to platins, taxanes, etoposide, doxorubicin, and irinotecan.

Methods: The study was conducted as a retrospective chart review of patients with symptoms of HSRs to chemotherapeutics. HSRs were classified as grade I, II, or III, based on their severity. Skin prick/intradermal tests were performed with implicated chemotherapeutics. A 12-step RDD protocol was used.

Results: The study consisted of 38 women and 3 men (mean age 53.3 ± 11.6 years). Patients had ovarian (n = 13, 31.8%), breast (n = 10, 24.4%), colon (n = 7, 17%), lung (n = 4, 9.8%), and other cancers (n = 7; endometrial sarcoma, testicular cancer, uterine cancer, ampulla of Vater tumor, choledochal tumor, peritonitis carcinomatosa, and Merkel cell carcinoma, n = 1, respectively). Twenty-two patients experienced HSRs to platins, 15 to taxanes, and 4 to other chemotherapeutics (doxorubicin, irinotecan, and etoposide). A total of 122 RDDs (47 to platins, 52 to taxanes, 23 to other chemotherapeutics) were performed. In 25 (61%) patients no reactions occurred during RDD, but breakthrough reactions developed in 16 patients (39%) with platins (n = 11), taxanes (n = 3), doxorubicin (n = 1), and irinotecan (n = 1). RDD procedures could not be completed in only 2 patients with grade II breakthrough reactions to carboplatin and oxaliplatin.

Conclusion: In our experience, 98.3% of 122 RDDs were completed. We found that RDD was safe and effective in this the largest series of RDD with chemotherapeutics in our country.
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July 2019

Investigating the role of IL-33 in the pathogenesis of Behçet's Disease.

Acta Clin Belg 2017 Dec 17;72(6):434-438. Epub 2017 Apr 17.

a Faculty of Medicine, Department of Internal Medicine, Division of Allergy and Immunology , Ankara University , Ankara , Turkey.

Objectives: Behçet's disease (BD) is an inflammatory disease, characterized by oral aphthous lesions, recurrent uveitis, skin lesions, and genital ulcerations. Increased release of several cytokines may play a role in the inflammatory stages of BD. IL-33, a member of the IL-1 cytokine superfamily, plays an important role in inflammation. We analyzed serum IL-33 concentration in BD patients to assess its possible role in the pathophysiology of this disease.

Methods: The study included 54 BD patients, 31 with active BD and 23 with inactive BD as well as 18 matched healthy controls. Serum IL-33 levels were measured using an enzyme-linked immunosorbent assay (ELISA).

Results: The mean serum IL-33 levels were 4.84 ± 2.81 pg/ml in the BD patients (6.16 ± 2.94 pg/ml in the active stage and 2.86 ± 0.54 pg/ml in the inactive stage) and 2.88 ± 0.42 pg/ml in the healthy controls. Serum IL-33 levels were significantly higher in patients with BD compared with the healthy controls (p < 0.01). In active Behçet patients with arthritis the mean serum IL-33 level was higher but this finding was not statistically significant (p = 0.122).

Conclusion: IL-33 may play a significant role of in the pathogenesis of BD.
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December 2017

Rapid Drug Desensitization with Biologics: A Single-Center Experience with Four Biologics.

Int Arch Allergy Immunol 2016 4;171(3-4):227-233. Epub 2017 Jan 4.

Division of Immunology and Allergy, Department of Chest Diseases, School of Medicine, Ankara University, Ankara, Turkey.

Background: Rapid drug desensitization (RDD) induces a temporary tolerance to biologics which induce hypersensitivity reactions (HSRs). Data are limited regarding the use of RDD outside the USA. Our purpose was to report our data on RDD to rituximab, infliximab, cetuximab, and trastuzumab.

Methods: The study was conducted as a retrospective chart review of patients with symptoms of HSRs to biologics. HSRs were classified as grades I, II, and III, based on their severity. Skin-prick tests/intradermal tests (IDTs) were performed with the implicated biologics. The 12-step RDD protocol was used.

Results: The study group comprised 11 women and 6 men (mean age: 47 ± 11.7 years). Fourteen patients experienced HSRs to rituximab; 3 had HSRs to cetuximab, infliximab, and trastuzumab, respectively. HSRs to cetuximab, infliximab, and trastuzumab occurred during the first infusion and were all grade III. Twelve of the 14 patients with rituximab hypersensitivity had a reaction during the first infusion; 10 patients had grade II reactions and 4 had grade III reactions. Respiratory symptoms were the most frequent presentation of HSR. Skin tests with rituximab were performed on 10 patients; only 3 resulted in positive IDTs (with 1:100 dilutions) and the other tests were negative as were those performed with the other biologics. Of 96 RDDs, 89 desensitizations were performed with rituximab, 5 with cetuximab, 1 with infliximab, and 1 with trastuzumab. There were 12 (13.5%) breakthrough reactions, all of which were associated with rituximab and were less severe than the initial reactions.

Conclusion: RDD was found to be safe and effective in the largest case series of RDDs with biologics in our country, Turkey.
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February 2017

Potentially inappropriate prescribing according to the STOPP/START criteria for older adults.

Aging Clin Exp Res 2016 Aug 11;28(4):761-8. Epub 2015 Dec 11.

Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey.

Background: The aim of this study was to demonstrate the prevalence and possible predictors of potentially inappropriate medications (PIMs) and potentially prescription omissions (PPOs) according to the Screening Tool of Older Person's Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) criteria in geriatric patients.

Methods: A total of 374 patients (140 male, 234 female) aged ≥65 years were included. Comprehensive demographic and clinical data including age, gender, current diagnoses/medications, comorbid diseases and medical problems were noted.

Results: There were 154 (41.2 %) patients with at least one PIM. Most common PIMs were proton pump inhibitors for peptic ulcer disease (9.6 %), calcium-channel blockers (6.4 %) and anticholinergic/antispasmodic drugs (5.9 %) in chronic constipation. There were 274 (73.3 %) patients with at least one PPO. Most common PPOs were calcium-vitamin D supplement in osteoporosis (OP) (39.6 %), statin (22.5 %) and antiplatelet therapies (16.0 %) in diabetes mellitus (DM) with cardiovascular risk factors. PIM was independently associated with female gender (OR = 2.21, p = 0.003), number of medications (OR = 1.35, p < 0.001), Katz scores of daily life activities (OR = 0.87, p = 0.013) and OP (OR = 0.29, p < 0.001). PPO was independently associated with age (OR = 1.06, p = 0.009), Geriatric Depression Scale score (OR = 1.20, p = 0.007), DM (OR = 6.50, p < 0.001), chronic obstructive pulmonary disease (COPD) (OR = 5.29, p = 0.010), number of medications (OR = 0.88, p = 0.019), and incontinence (OR = 0.39, p = 0.043).

Conclusion: High prevalence of PIMs and PPOs were found in geriatric patients. Number of medications, female gender, and dependency were associated with PIM. Age, higher scores of Geriatric Depression Scale, DM, and COPD were related with PPOs.
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August 2016