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Öğe Asthma as a Comorbid Disease in COVID-19(BILIMSEL TIP YAYINEVI, 2020) Baccioglu, Ayse; Bavbek, SevimSevere acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a novel coronavirus that causes coronavirus disease 2019 (COVID-19). In terms of asthma and COVID-19, there is also a risk of experiencing an asthma exacerbation triggered by coronavirus infection beyond the direct risk of the infection itself. As a comorbid disease, the prevalence of COVID-19 infection in asthma patients is not clear. In addition, the influence of asthma on the severity of COVID-19 has not been reported. The aim of this review was to summarize the reported worldwide data about the prevalence and the clinical characteristics of patients with asthma during COVID-19 infection.Öğe Change in Allergy Practice during the COVID-19 Pandemic(Karger, 2021) Ozturk, Ayse Bilge; Baccioglu, Ayse; Soyer, Ozge; Civelek, Ersoy; Sekerel, Bulent Enis; Bavbek, SevimBackground: International guidelines in asthma and allergy has been updated for COVID-19 pandemic and pandemic has caused dramatic changes in allergy and immunology services. However, it is not known whether specialty-specific recommendations for COVID-19 are followed by allergists. Objectives: By conducting this study, we aimed to determine the attitudes and experiences of adult/pediatric allergists on allergy management during COVID-19. Method: We used a 20-question survey to elicit data from allergists (residents and pediatric and adult allergists registered to the Turkish National Society of Allergy and Clinical Immunology) across Turkey via e-mail. We analyzed the data statistically for frequency distributions and descriptive analysis. Results: A total of 183 allergists participated in the survey. Telemedicine was used for management of asthma (73%), allergic rhinitis (53%), atopic dermatitis (51%), chronic urticaria/angioedema (59%), drug hypersensitivity (45%), food allergy (48%), venom allergy (30%), anaphylaxis (22%), and hereditary angioedema (28%). Thirty-one percent of the respondents discontinued subcutaneous immunotherapy (SCIT) during the COVID-19 pandemic. Thirty-four percent of the physicians reported interruption of systemic steroid use in asthma patients, and 25% of the respondents discontinued biological therapy. Conclusions: Allergists in Turkey have been using telemedicine at a high rate during the COVID-19 pandemic for asthma and rhinitis. The continuation rate of SCIT was low while the discontinuation rate of biologicals and systemic steroid use in asthma was high in Turkey.Our study results and learning from the experiences of other countries and specialties may help to optimize allergy practice and compatibility with international guidelines. (C) 2020 S. Karger AG, BaselÖğe Physicians' preference for controller medication in mild persistent asthma(W B Saunders Co Ltd, 2017) Bakirtas, Arzu; Kutlu, Ali; Baccioglu, Ayse; Erkekol, Ferda Oner; Bavbek, Sevim; Kalayci, OmerBackground: Although the asthma guidelines recommend inhaled corticosteroids(ICS) or leukotriene receptor antagonists-(LTRAs) for the treatment of mild persistent asthma, factors governing the physicians' preference are unknown. We aimed to investigate the preference of physicians for the controller medication and the factors governing their choice. Methods: A self-administered questionnaire composed of 16 questions that aimed to determine the preference of the physicians for the first choice controller medication in mild persistent asthma and physician and patient related factors that may be associated with this selection was e-mailed to the members of the Turkish National Society of Allergy and Clinical Immunology and distributed to participants in the 21st congress. Results: Of the 670 questionnaires, there were 51% participants and 336 of them were complete enough to be included in the analysis. Low dose ICS was preferred as the first choice controller medication for mild persistent asthma by 84.5% of the physicians. The reasons for physicians' preference were different for ICS and LTRA. In the logistic regression analysis, use of asthma guidelines (OR:3.5, 95%Cl:1.3-9.3, p = 0.01), alignment in guidelines (OR:2.9, 95%Cl:1.4-5.8, p = 0.002) and the opinion that it is a more effective (OR:2.3, 95%Cl:1.1-4.8, p = 0.02) were independently associated with ICS preference. Being a pediatrician (OR:5.4, 95%Cl: 2.7-10.5, p < 0.001) and the opinion that it has better patient compliance (OR:4.4, 95%CI: 1.6-12.0, p = 0.004) were independently associated with LTRA preference. Conclusion: Surveyed Turkish physicians, the majority of whom were specialists, preferred ICS over LTRA as controller medication in mild persistent asthma. Asthma guidelines, training background (pediatrician versus not) and perceived efficacy and patient compliance appeared to influence their preferences. (C) 2017 Published by Elsevier Ltd.Öğe Physicians' preference for controller medication in mild persistent asthma (conferenceObject)(Wiley-Blackwell, 2016) Bakırtaş, Arzu; Kutlu, Ali; Baccioglu, Ayşe; Erkekol, Öner Ferda; Bavbek, Sevim; Kalaycı, Ömer…Öğe Pros and Cons of Nebulizer Treatment in Asthma Exacerbation During the COVID-19 Pandemic(Bilimsel Tip Yayinevi, 2021) Ozturk, Ayse Bilge; Baccioglu, Ayse; Uysal Soyer, Ozge; Civelek, Ersoy; Sekerel, Bulent Enis; Bavbek, SevimNebulizers generate aerosols and may potentially transmit respiratory viral particles including SARS-CoV-2. There is a great concern about the use of a nebulizer in the treatment of asthma exacerbations in the hospital or home setting during the COVID-19 pandemic and its use is not recommended unless essential. However, aerosol therapy should not be avoided in obligatory indications. Therefore, indications of nebulizer use during the pandemic should be evaluated on an individual basis in case of a severe asthma attack, and infection control recommendations should be followed by clinicians while using nebulizers. In this article, we aimed to assess the safety in addition to the pro and con sides of nebulizer treatment in asthma exacerbation during the COVID-19 pandemic.Öğe Stepwise Approach in Asthma Revisited 2023: Expert Panel Opinion of Turkish Guideline of Asthma Diagnosis and Management Group(Aves, 2023) Çelik, Gülfem Elif; Aydın, Ömür; Damadoğlu, Ebru; Baççıoğlu, Ayşe; Özdemir, Seçil Kepil; Bavbek, Sevim; Ediger, DaneIntroduction of inhaled corticosteroids (ICS) has been the cornerstone of the long-term management of asthma. ICSs either alone or in combination with long-acting beta-2 agonists have been shown to be associated with favorable asthma outcomes. However, asthma con-trol is still reported to be below expectations all around the world. Research in the last decades focusing on the use of ICS/formoterol both as maintenance and as needed (maintenance and reliever therapy approach) showed improved asthma outcomes. As a result of recent developments, Turkish Asthma Guidelines group aimed to revise asthma treatment recommendations. In general, we recommend physi-cians to consider the risk factors for poor asthma outcomes, patients' compliance and expectations and then to determine a personalized treatment plan. Importantly, the use of short-acting beta-2 agonists alone as a symptom reliever in asthma patients not using regular ICS is no longer recommended. In stepwise treatment approach, we primarily recommend to use ICS-based controllers and initiate ICS as soon as possible. We define 2 different treatment tracks in stepwise approaches as maintenance and reliever therapy or fixed-dose therapy and equally recommend each track depending on the patient's risks as well as decision of physicians in a personalized manner. For both tracks, a strong recommendation was made in favor of using add-on treatments before initiating phenotype-specific treatment in step 5. A strong recommendation was also made in favor of using biologic agents and/or aspirin treatment after desensitization in severe asthma when indicated.Öğe Survey of physicians' attitudes toward the use of magnesium sulfate for acute asthma exacerbations in Turkey(Taylor & Francis Ltd, 2016) Baccioglu, Ayse; Bakirtas, Arzu; Erkekol, Ferda Oner; Kalayci, Omer; Bavbek, SevimBackground: Magnesium sulfate (MgSO4) is considered to be a well-tolerated, inexpensive, and effective medication for severe asthma exacerbations. We surveyed physicians who treat patients with asthma to evaluate the current knowledge and usage of MgSO4. Methods: A self-administered questionnaire was e-mailed to members of the Turkish National Society of Allergy and Clinical Immunology and was distributed to participants of its annual congress. Results: Of the 456 respondents (mean age: 36.53 +/- 9.11 years), 42.3% reported to use MgSO4 in asthma exacerbations in their practice, and 48.7% agreed that MgSO4 was included in asthma guidelines. The best known indication was that it was useful only in patients refractory to bronchodilators and systemic corticosteroids (67.7%). The two most common reasons to use MgSO4 were to shorten hospital stay (94.7%), and prevent admission to intensive care unit (80.3%). The respondents mostly used MgSO4 in the treatment of severe or life-threatening exacerbations. Thirty-nine percent believed that MgSO4 had no effect on discharge period, and 29% of them marked minor side effects. The most common reason for not using MgSO4 was inexperience (36.5%). Having an academic affiliation (OR=3.20, p<0.001), the number of asthmatic outpatients seen per month (OR=1.82, p=0.007), and more recent graduation from medical school (1991) (OR=0.23, p<0.001) were associated with the use of MgSO4 in the multivariate analysis. Conclusion: Even though the effect of MgSO4 in acute severe asthma is well known, only half of the physicians dealing with asthma patients have used it in their practice. Education and encouragement in this regard are necessary.