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Altıntaş, Alara

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Alara

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Altıntaş

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Altıntaş, Alara

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2021 - 20237

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Now showing 1 - 7 of 7
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    Brain abscess caused by Eikenella corrodens in an immunocompetent child: case report and literature review
    (Georg Thieme Verlag Kg, 2022) Karaaslan, Ayse; Cetin, Ceren; Suslu, Hikmet Turan; Akin, Yasemin; N/A; Altıntaş, Alara; Undergraduate Student; School of Medicine; Koç University Hospital; N/A
    Objective Eikenella corrodens is a slow-growing, fastidious, non-motile, facultative anaerobic, Gram-negative bacillus that is commonly found in the human oropharynx. Although many cases have been reported in the adult population, only few cases of brain abscesses caused by E.corrodens have been reported in children so far. Methods: Here, we reported the case of a 29-month-old female with complaints of weakness in the right leg twice in the past 3 weeks. Imaging studies revealed a brain abscess in the left parietofrontal lobe. The patient underwent surgery for abscess drainage, microbiological samples were obtained and empirical antibiotic treatment was started. Abscess culture showed the growth of E.corrodens. The bacteria were found to be sensitive to ceftriaxone; hence, the therapy was continued for 46 days with ceftriaxone. A final computed tomography showed the resolution of the abscess. The patient's clinical condition improved and she was discharged without any sequelae. Conclusion: Brain abscess should be considered when patients present with neurological deficits. As far as we know, there are only six reported cases of brain abscesses only due to E.corrodens in the pediatric population. Since it is a slow-growing pathogen, early diagnosis and treatment are crucial for patient survival. This case supports the combination of surgical drainage and antibiotics for treatment.
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    Responses to hypoxia: how fructose metabolism and hypoxia-inducible factor-1a pathways converge in health and disease
    (Springer Nature, 2023) Kanbay, Mehmet; Çöpür, Sidar; Altıntaş, Alara; Yavuz, Furkan; Faculty Member; Researcher; Undergraduate Student; Undergraduate Student; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 110580; 368625; N/A; N/A
    Purpose of Review: Oxygen is critical for the high output of energy (adenosine triphosphate) generated by oxidative phosphorylation in the mitochondria, and when oxygen delivery is impaired due to systemic hypoxia, impaired or reduced delivery of red blood cells, or from local ischemia, survival processes are activated. Recent Findings: One major mechanism is the activation of hypoxia-inducible factors (HIFs) that act to reduce oxygen needs by blocking mitochondrial function and stimulating glucose uptake and glycolysis while also stimulating red blood cell production and local angiogenesis. Recently, endogenous fructose production with uric acid generation has also been shown to occur in hypoxic and ischemic tissues where it also appears to drive the same functions, and indeed, there is evidence that many of hypoxia-inducible factors effects may be mediated by the stimulation of fructose production and metabolism. Unfortunately, while being acutely protective, these same systems in overdrive lead to chronic inflammation and disease and may also be involved in the development of metabolic syndrome and related disease. The benefit of SGLT2 inhibitors may act in part by reducing the delivery of glucose with the stimulation of fructose formation, thereby allowing a conversion from the glycolytic metabolism to one involving mitochondrial metabolism. Summary: The use of hypoxia-inducible factor stabilizers is expected to aid the treatment of anemia but, in the long-term, could potentially lead to worsening cardiovascular and metabolic outcomes. We suggest more studies are needed on the use of these agents.
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    Evaluation of patients treated for the symptomatic congenital cytomegalovirus infection
    (AVES, 2022) Çetin, Ceren; Karaaslan, Ayşe; Akın, Yasemin; Altıntaş, Alara; Undergraduate Student; School of Medicine; N/A
    Objective: Our current knowledge for the management of symptomatic congenital cytomegalovirus (CMV) infections is limited to few studies. In our study, we aimed to present the data of our patients, who were treated for the diagnosis of symptomatic congenital CMV infections. Material and Methods: A total of 19 patients with the diagnosis of congenital CMV infection treated at our tertiary center hospital between 2015-2021 were retrospectively included in the study. Antiviral treatment (ganciclovir/valganciclovir) was administered to all patients for six months. Results: Five (26.4%) patients were diagnosed with congenital CMV infection within the first three weeks of life. Treatment indications were hearing loss in 12 (63.2%) patients, central nervous system involvement in 7 (36.8%) patients and cholestasis in 6 (31.6%) patients. Six patients had more than one indication. There was no case with eye involvement. Six (31.6 %) patients had pathological findings in cranial imaging and 8 (42.1%) patients had pathological findings in abdominal imaging. Median blood CMV PCR was 1.538 IU/mL (IQR= 850-9.961) and median urine CMV PCR was 425.585 copies/mL (IQR= 111.370-10.105.585). As the side effect of treatment, neutropenia developed in two patients (10.5%). However, no permanent side effect of the treatment was observed. Mean follow-up period was 16.63 ± 8.1 months. Seven (36.8%) patients had chronic sequela of the disease (hearing loss and central nervous system involvement). Conclusion: Ganciclovir/valganciclovir treatment is safe for the treatment of congenital CMV infections./ Öz: Giriş: Semptomatik konjenital sitomegalovirüs (CMV) enfeksiyonlarının yönetimine ilişkin mevcut bilgilerimiz az sayıda çalışmayla sınırlıdır. Çalışmamızda semptomatik konjenital CMV enfeksiyonu tanısı ile tedavi edilen hastalarımızın verilerini sunmayı amaçladık. Gereç ve Yöntemler: Üçüncü basamak hastanemizde 2015-2021 yılları arasında tedavi edilen konjenital CMV enfeksiyonu tanısı ile toplam 19 hasta retrospektif olarak çalışmaya dahil edildi. Tüm hastalara altı ay süreyle antiviral tedavi (gansiklovir/valgansiklovir) uygulandı. Bulgular: Beş (%26.4) hastaya yaşamın ilk üç haftasında konjenital CMV enfeksiyonu tanısı kondu. Tedavi endikasyonları 12 (%63.2) hastada işitme kaybı, 7 (%36.8) hastada merkezi sinir sistemi tutulumu ve 6 (%31.6) hastada kolestaz idi. Altı hastada birden çok endikasyon mevcuttu. Göz tutulumu olan olgu yoktu. Altı (%31.6) hastada kraniyal görüntülemede patolojik bulgular, 8 (%42.1) hastada abdominal görüntülemede patolojik bulgular saptandı. Medyan kan CMV polimeraz zincir reaksiyonu (PCR) 1.538 IU/mL (IQR= 850-9.961) ve medyan idrar CMV PCR’si 425.585 kopya/ mL’dir (IQR= 111.370-10.105.585). Tedavinin yan etkisi olarak iki hastada (%10.5) nötropeni gelişti. Ancak tedavinin kalıcı bir yan etkisi gözlenmedi. Ortalama takip süresi 16.3 ± 8.1 aydı. Yedi (%36.8) hastada hastalığın kronik sekeli (işitme kaybı ve merkezi sinir sistemi tutulumu) vardı. Sonuç: Gansiklovir/valgansiklovir tedavisi konjenital CMV enfeksiyonlarının tedavisinde hem güvenli hem de etkilidir.
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    Semptomatik konjenital sitomegalovirüs enfeksiyonu nedeniyle tedavi edilen hastaların değerlendirilmesi
    (Aves Yayincilik, Ibrahim Kara, 2022) Cetin, Ceren; Karaaslan, Ayse; Akin, Yasemin; N/A; Altıntaş, Alara; Undergraduate Student; School of Medicine; Koç University Hospital; N/A
    Objective: Our current knowledge for the management of symptomatic congenital cytomegalovirus (CMV) infections is limited to few studies. In our study, we aimed to present the data of our patients, who were treat-ed for the diagnosis of symptomatic congenital CMV infections.Material and Methods: A total of 19 patients with the diagnosis of con-genital CMV infection treated at our tertiary center hospital between 2015-2021 were retrospectively included in the study. Antiviral treat-ment (ganciclovir/valganciclovir) was administered to all patients for six months.Results: Five (26.4%) patients were diagnosed with congenital CMV in-fection within the first three weeks of life. Treatment indications were hearing loss in 12 (63.2%) patients, central nervous system involvement in 7 (36.8%) patients and cholestasis in 6 (31.6%) patients. Six patients had more than one indication. There was no case with eye involvement. Six (31.6 %) patients had pathological findings in cranial imaging and 8 (42.1%) patients had pathological findings in abdominal imaging. Median blood CMV PCR was 1.538 IU/mL (IQR= 850-9.961) and median urine CMV PCR was 425.585 copies/mL (IQR= 111.370-10.105.585). As the side effect of treatment, neutropenia developed in two patients (10.5%). However, no permanent side effect of the treatment was observed. Mean follow-up period was 16.63 +/- 8.1 months. Seven (36.8%) patients had chronic sequela of the disease (hearing loss and central nervous system involvement).Conclusion: Ganciclovir/valganciclovir treatment is safe for the treat-ment of congenital CMV infections./ Öz: Giriş: Semptomatik konjenital sitomegalovirüs (CMV) enfeksiyonlarının yönetimine ilişkin mevcut bilgilerimiz az sayıda çalışmayla sınırlıdır. Çalışmamızda semptomatik konjenital CMV enfeksiyonu tanısı ile tedavi edilen hastalarımızın verilerini sunmayı amaçladık. Gereç ve Yöntemler: Üçüncü basamak hastanemizde 2015-2021 yılları arasında tedavi edilen konjenital CMV enfeksiyonu tanısı ile toplam 19 hasta retrospektif olarak çalışmaya dahil edildi. Tüm hastalara altı ay süreyle antiviral tedavi (gansiklovir/valgansiklovir) uygulandı. Bulgular: Beş (%26.4) hastaya yaşamın ilk üç haftasında konjenital CMV enfeksiyonu tanısı kondu. Tedavi endikasyonları 12 (%63.2) hastada işitme kaybı, 7 (%36.8) hastada merkezi sinir sistemi tutulumu ve 6 (%31.6) hastada kolestaz idi. Altı hastada birden çok endikasyon mevcuttu. Göz tutulumu olan olgu yoktu. Altı (%31.6) hastada kraniyal görüntülemede patolojik bulgular, 8 (%42.1) hastada abdominal görüntülemede patolojik bulgular saptandı. Medyan kan CMV polimeraz zincir reaksiyonu (PCR) 1.538 IU/mL (IQR= 850-9.961) ve medyan idrar CMV PCR’si 425.585 kopya/mL’dir (IQR= 111.370-10.105.585). Tedavinin yan etkisi olarak iki hastada (%10.5) nötropeni gelişti. Ancak tedavinin kalıcı bir yan etkisi gözlenmedi. Ortalama takip süresi 16.3 ± 8.1 aydı. Yedi (%36.8) hastada hastalığın kronik sekeli (işitme kaybı ve merkezi sinir sistemi tutulumu) vardı.
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    Maternal stress and neonatal nutrition during the COVID-19 era
    (DOC Design and Informatics, 2022) N/A; N/A; N/A; N/A; N/A; N/A; N/A; Altıntaş, Alara; Bayram, Gökhan Yavuz; Coşkuntürk, Ali; Çelik, Ebru; Gürsoy, Tuğba; Aydın, Nuri Efe; Sarıoğlu, Sebile; Undergraduate Student; Undergraduate Student; Undergraduate Student; Faculty Member; Faculty Member; Undergraduate Student; Undergraduate Student; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; N/A; 116631; 214691; N/A; N/A; N/A
    Objective: COVID-19 pandemic has put a tremendous amount of stress on people, which can negatively affect nursing. Previous studies showed that perceived stress and cortisol levels in the postpartum period correlate with the LATCH scores, which is a simple tool to assess the pattern of nursing. Likewise, greater prenatal anxiety was associated with a shorter breastfeeding duration. We aimed to evaluate whether pregnant women were under extra stress due to the COVID-19 pandemic and if this stress affected their breastfeeding patterns and anthropometric measures of the neonates. Methods: Pregnant women giving birth to healthy neonates were included. Coronavirus Anxiety Scale (CAS) and Beck Anxiety Inventory (BAI) were used to assess the anxiety levels of the mothers, and LATCH breastfeeding assessment tool was used to assess the nursing. The results of these scales and anthropometric measures of the neonates were recorded. Results: Only one mother showed coronavirus-specific anxiety. Therefore, further analysis was done based on the Beck Anxiety (BA) levels of the mothers. CAS and BA scores were positively correlated (p< 0.001, r=0.444), indicating that coronavirus-specific anxiety increased with increasing general anxiety. None of the variables changed depending on the anxiety levels of the mothers, except for the % weight gain at day five (p=0.020, r=-0.248). Even though anxiety seemed to show a small effect on weight loss during the first neonatal days, percent weight gain results did not seem to correlate with the anxiety levels in later stages (first month of life). Furthermore, LATCH scores of the infants on day one were positively correlated with BA scores of the mothers (p=0.045, r=0.175). Conclusion: COVID-19 seemed to have no additional effect on the stress levels of the mothers. The more the mothers have anxiety, the more they may stress about the well-being of their infants, which can improve their nursing pattern.
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    Hypofractionated frameless gamma knife radiosurgery for large metastatic brain tumors
    (Springer, 2021) Samancı, Mustafa Yavuz; Şişman, Uluman; Altıntaş, Alara; Sarıoğlu, Sebile; Sharifi, Samira; Atasoy, Ali İhsan; Bölükbaşı, Yasemin; Peker, Selçuk; Faculty Member; Undergraduate Student; Undergraduate Student; Undergraduate Student; Undergraduate Student; Other; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 275252; N/A; N/A; N/A; N/A; N/A; 216814; 11480
    Hypofractionated stereotactic radiosurgery has become an alternative for metastatic brain tumors (METs). We aimed to analyze the efficacy and safety of frameless hypofractionated Gamma Knife radiosurgery (hfGKRS) in the management of unresected, large METs. All patients who were managed with hfGKRS for unresected, large METs (> 4 cm(3)) between June 2017 and June 2020 at a single center were reviewed in this retrospective study. Local control (LC), progression-free survival (PFS), overall survival (OS), and toxicities were investigated. A total of 58 patients and 76 METs with regular follow-up were analyzed. LC rate was 98.5% at six months, 96.0% at one year, and 90.6% at 2 years during a median follow-up of 12 months (range, 2-37). The log-rank test indicated no difference in the distribution of LC for any clinical or treatment variable. PFS was 86.7% at 6 months, 66.6% at 1 year, and 58.5% at 2 years. OS was 81% at 6 months, 63.6% at one year, and 50.7% at 2 years. On the log-rank test, clinical parameters such as control status of primary cancer, presence of extracranial metastases, RTOG-RPA class, GPA group, and ds-GPA group were significantly associated with PFS and OS. Patients presented with grade 1 (19.0%), grade 2 (3.5%) and grade 3 (5.2%) side effects. Radiation necrosis was not observed in any patients. Our current results suggest that frameless hfGKRS for unresected, large METs is a rational alternative in selected patients with promising results.
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    PublicationOpen Access
    Thyrotoxic hypokalemic periodic paralysis: case report
    (Emergency Medicine Physicians Association of Turkey (EPAT), 2022) Akın, Seydahmet; Aladağ, Nazire; Keskin, Özcan; Altıntaş, Alara; Undergraduate Student; School of Medicine
    Thyrotoxic Hypokalemic Periodic Paralysis (THPP) is a rare hereditary disorder which is characterized by thyroid hormone elevation, low blood potassium level and recurrent acute muscle weakness. Basic pathology is thought to be the increase in activity in the sodium-potassium pump (Na+/K+ATPase). Here we report the case of a 31-year-old male that presented with weakness in his legs, and inability to walk. The patient had elevated thyroid hormone levels (FT3 and FT4) and lower TSH levels, lower serum potassium levels, and recurrent acute muscle weakness. The diagnosis was made to be Thyrotoxic Hypokalemic Periodic Paralysis precipitated after intense physical activity. THPP is a reversible medical emergency. Early diagnosis, and rapid treatment is lifesaving. Although rare, THPP must be considered as a differential diagnosis in patients presenting with hypokalemia and paralysis.