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    Change in Allergy Practice during the COVID-19 Pandemic
    (Karger, 2021) Ozturk, Ayse Bilge; Baccioglu, Ayse; Soyer, Ozge; Civelek, Ersoy; Sekerel, Bulent Enis; Bavbek, Sevim
    Background: 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, Basel
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    Characteristics of asthma in an older adult population according to sex and control level: why are asthma symptoms in older women not well-controlled?
    (Taylor & Francis Ltd, 2024) Karadogan, Dilek; Yilmazel Ucar, Elif; Yavuz, Yasemin; Baccioglu, Ayse; Ozturk, Ayse Bilge; Bozkurt, Nurgul; Kavas, Murat
    ObjectiveThe older adult population in Turkey has increased by 22.6% in the last 5 years, and the characteristics of such patients with asthma remain uninvestigated. Therefore, we aimed to evaluate the characteristics of older adults with asthma according to sex and asthma control status to provide an in-depth overview of asthma in this population in Turkey.MethodsThe data of older adults (age 65 years and over) with asthma were obtained from a multicenter, cross-sectional asthma database registry (Turkish Adult Asthma Registry, TAAR) funded by the Turkish Thoracic Society. Comparisons were made based on sex and asthma control levels using the Global Initiative for Asthma (GINA) Asthma Symptom Control Questionnaire.ResultsOf the 2053 (11.5%) patients registered with the TAAR, 227 were older adults (median age, 69 (8), women, 75.8% (n = 172)). Of these, 46.5% (n = 101) had obesity to some degree. Compared with men, women had lower education, income levels, and employment rates. Additionally, women exhibited a higher prevalence of obesity, hypertension, and thyroid gland disease than men. Being female (OR: 2.99; 95% CI: 1.307-6.880), the presence of gastroesophageal reflux disease (OR: 2.855; 95% CI: 1.330-6.130), and a predicted forced expiratory volume in the first-second value lower than 80% (OR: 2.938; 95% CI: 1.451-5.948) were associated with poorly controlled asthma.ConclusionsHerein, older adults comprised 11.5% of adult patients with asthma. Being female poses a disadvantage in terms of both asthma prevalence and control in the older adult asthmatic population owing to the prevalence of comorbidities and socioeconomic sex-related distinguishing factors.
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    Inhaler Steroid Use Changes Oral and Airway Bacterial and Fungal Microbiome Profile in Asthma Patients
    (Karger, 2024) Oguzulgen, Kivilcim; Ozturk, Ayse Bilge; Bacceoglu, Ayse; Aydin, Omur; Koeycue Buhari, Gozde; Damadoglu, Ebru; Oner Erkekol, Ferda
    Introduction: The full spectrum of bacterial and fungal species in adult asthma and the effect of inhaled corticosteroid use is not well described. The aim was to collect mouthwash and induced sputum samples from newly diagnosed asthma patients in the pretreatment period and in chronic asthma patients while undergoing regular maintenance inhaled corticosteroid therapy, in order to demonstrate the bacterial and fungal microbiome profile. Methods: The study included 28 asthmatic patients on inhaler steroid therapy, 25 steroid-naive asthmatics, and 24 healthy controls. Genomic DNA was isolated from induced sputum and mouthwash samples. Analyses were performed using bacterial primers selected from the 16S rRNA region for the bacterial genome and panfungal primers selected from the 5.8S rRNA region for the fungal genome. Results: Dominant genera in mouthwash samples of steroid-naive asthmatics were Neisseria, Haemophilus, and Rothia. The oral microbiota of asthmatic patients on inhaler steroid treatment included Neisseria, Rothia, and Veillonella species. Abundant genera in induced sputum samples of steroid-naive asthma patients were Actinomyces, Granulicatella, Fusobacterium, Peptostreptococcus, and Atopobium. Sputum microbiota of asthma patients taking inhaler steroids were dominated by Prevotella and Porphyromonas. Mucor plumbeus and Malassezia restricta species were abundant in the airways of steroid-naive asthma patients. Choanephora infundibulifera and Malassezia restricta became dominant in asthma patients taking inhaled steroids. Conclusion: The oral and airway microbiota consist of different bacterial and fungal communities in healthy and asthmatic patients. Inhaler steroid use may influence the composition of the oral and airway microbiota.
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    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, Sevim
    Nebulizers 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.