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Öğe Amoxicillin/Clavulanic Acid-Induced Symmetric Drug-Related Intertrigious and Flexural Exanthema(Springernature, 2023) Alpagat, Gulistan; Baccioglu, Ayse; Dumanoglu, Betul; Yalim, Sumeyra Alan; Kalpaklioglu, Ayse Fusunbeta-Lactams, particularly penicillins, may cause several allergic reactions. We described symmetric drug-related intertriginous and flexural exanthema (SDRIFE) illness in this case, a rare instance of systemic contact dermatitis caused by amoxicillin/clavulanic acid that needs to be considered in the differential diagnosis. A 65-year-old male patient was admitted to our Allergy Outpatient Clinic because of increased blue-purple pigmentation on the flexural surfaces of the hip, forearm, axilla, and posterior face of the neck. The patient was receiving a combination of angiotensin receptor blocker (ARB) and hydrochlorothiazide diuretic medication for hypertension. The patient used an antibiotic containing amoxicillin three months ago; As a result, there was localized redness, itching, and black spotting without any systemic symptoms. Similarly, the patient reported that when he used amoxicillin for an upper respiratory tract infection eight months ago, he experienced similar side effects within 20 days and recovered when he applied corticosteroid ointment.Due to the symmetrical site involvement following the consumption of penicillin group antibiotics with a five-month gap and subsequent comparable reactions in our patient, SDRIFE was taken into consideration. The results of the skin punch biopsy identified Baboon Syndrome (SDRIFE). Treatment with topical corticosteroids and antihistamines began. Clinically speaking, SDRIFE is distinguished by significant erythema of the gluteal/perianal area and/or V-shaped erythema of the inguinal/perigenital area, symmetric involvement of at least one other intertriginous or flexural area, and the absence of systemic signs or symptoms. The possibility that the medication may have contributed to the patient's erythematous eruption in the flexural regions should be taken into account, and the patient should be advised to stop taking the medication and not use it again.Öğe Anaphylaxis After Consumption of Guar Gum-Containing Food: A Report of Two Cases(Springernature, 2022) Dumanoglu, Betul; Alpagat, Gulistan; Poyraz, Merve; Yalim, Sumeyra Alan; Baccioglu, AyseGuar gum is a food additive that acts as a thickening agent. Although the relationship between guar gum and occupational rhinitis/asthma has already been established, only very few cases of anaphylaxis were associated with guar gum ingestion. We present two examples of anaphylaxis induced by guar gum. Both cases were successfully treated with adrenaline. Moreover, serum-specific immunoglobulin E (IgE) with the culprit agent was detected in blood samples. To the best of our knowledge, here we present the first case of class 6 guar gum-specific IgE-positive anaphylaxis. This report aims to raise awareness of rare food additive allergies such as guar gum.Öğe Does serum leptin levels differ between patients with rhinitis of allergic versus nonallergic aetiology?(Wiley, 2021) Kalpaklioglu, Ayse Fusun; Baccioglu, Ayse; Yalim, Sumeyra AlanBackground Leptin may play a critical role in airway inflammation. However, it has rarely been evaluated in rhinitis with different aetiology. This study aimed to compare the serum leptin levels between allergic rhinitis (AR) and nonallergic rhinitis (NAR). Methods Patients with chronic rhinitis were classified due to skin prick (ALK-Abello/Madrid) and/or serum-specific immunoglobulin E tests (UniCAP 100-Pharmacia), against to aeroallergens if concordant with symptoms. Results A total of 398 patients with a mean age of 29.03 years were recruited and grouped as AR and NAR. Mean serum leptin levels were similar in patients with NAR and AR, as well as in patients with and without asthma, but were significantly higher in females than males in both groups. Also, leptin levels were significantly higher in obese than nonobese patients in AR. In correlation analysis, leptin levels were found to be correlated with female gender, older age, and high body mass index (BMI) in the whole group. Despite the higher total nasal symptom score (TNSS) in patients with AR compared with NAR, there was no association of leptin levels with TNSS, severity and seasonality of symptoms, and allergen sensitization. In logistic regression analysis, younger age and high serum leptin levels were found to be independent predictors for the diagnosis of AR. Conclusions We conclude that female patients with high BMI are more prone to AR probably due to immunological effects of adipose tissue, in addition to hormonal factors. This study showed that leptin measurement has limited value as a sole diagnostic tool to differentiate AR and NAR.Öğe Investigation of heart rate variability and heart rate turbulence in chronic hypotensive hemodialysis patients(SPRINGER, 2020) Yalim, Zafer; Demir, Mehmet Emin; Yalim, Sumeyra Alan; Alp, CaglarBackground Sudden cardiac death is the leading cause of cardiac-related death in hemodialysis patients. Hypotensive episodes in pre-, intra-, and post-dialytic periods can present serious clinical challenges that affect a patient's quality of life and prognosis. The aim of the present study was to evaluate cardiac autonomic control and arrhythmogenic risk by analyzing 24-h heart rate variability (HRV) and heart rate turbulence (HRT) in hypotensive hemodialysis patients. Methods A total of 79 patients on maintenance hemodialysis treatment, 39 normotensive and 40 with frequent hypotension episodes during non-dialysis periods, were included in the study. Dialysis-free periods were recorded with a 24-h Holter rhythm and ambulatory blood pressure monitor device. The time-domain parameters of HRV and HRT, including turbulence onset (TO) and turbulence slope (TS), were calculated. Results Values for SDNN (105.5 +/- 7.02, 127.6 +/- 6.2 p < 0.001), SDANN (95.1 +/- 5.9, 111.8 +/- 5.01 p < 0.001), and SDNN index (50.04 +/- 2.7, 55.6 +/- 3.7 p = 0.03), in the hypotensive group were significantly lower than in the normotensive group, respectively. Values for RMSSD (26.5 +/- 2.5, 27.3 +/- 2.7 p = 0.178), pNN50 (17 +/- 1.7, 55.6 +/- 3.7 p = 0.03), and TI (35.1 +/- 3.1, 34.7 +/- 2.6 p = 0.542) in both groups were not significantly different; however, there was a significant difference between HRT parameters, TO (- 1.8 +/- 0.37, - 2.4 +/- 0.39 p < 0.001) and TS (6.9 +/- 0.71, 8.2 +/- 0.97 p < 0.001), respectively, hypotensive and normotensive group. Conclusion Dialysis patients that experience frequent hypotensive episodes may also undergo significant changes in HRT and HRV which may be indicative of serious cardiac sequela. Thus, in such cases, a complete cardiologic evaluation is warranted.Öğe Mortality Trends from Ischemic Heart Disease in Turkey: 2009-2019(Kare Publ, 2022) Yalim, Zafer; Dogan, Nurhan; Yalim, Sumeyra AlanObjective: Cardiovascular diseases still play an important role in public health and epidemiology as the leading cause of death worldwide. Ischemic heart disease is the most common reason in this group. This study aims to analyze the latest trends in ischemic heart disease mortality rates in Turkey by age, gender, and region using the Turkish Statistical Institute mortality data and evaluate the results. Methods: We have obtained ischemic heart disease mortality data (2009-2019, in 12 regions) for Turkey from the mortality database of the Turkish Statistical Institute. Joinpoint analysis was used to estimate the annual percentage change and average annual percentage change to identify significant changes in trends. Results: The mean mortality rate for ischemic heart disease in Turkey was in an increasing trend from 2009 to 2019 (annual percentage change=1.7 (-0.8; 4.3), P = .166). This increase was more pronounced in women (annual percentage change = 2.2 (-0.7; 5.2), P=.121) compared to men (annual percentage change = 1.4 (-1.1; 3.9), P = .235). When the period between 2015 and 2019 was evaluated, it was determined that ischemic heart disease mortality was in a decreasing trend in the groups over 65 years of age. The death rate due to ischemic heart disease is almost 2 times higher in men than in women in Turkey, and this rate ratio is highest in the Istanbul region. Conclusion: Although ischemic heart disease mortality trends have decreased globally, our country's average is still on an increasing trend. However, significant decreases have been observed in ischemic heart disease mortality rates, especially in the group over 65 years of age, in the last 5 years.Öğe Rare Interstitial Pneumonia Due to the Use of Aripiprazol: A Case Report(2022) Alpagat, Gulistan; Baccıoğlu, Ayse; Yalim, Sumeyra Alan; Poyraz, Merve; Dumanoğlu, Betul; Kalpaklıoğlu, Ayse FusunIt is accepted that 2–3% of interstitial lung diseases (ILD) are due to drugs, and that 70% of drug-induced lung diseases are due to ILD. We present here the case of a 51-year-old female patient who had been taking aripiprazole for bipolar disorder for 3 years and had been undergoing asthma treatment for 2 years. ILD was considered based on the patient's clinic, a restrictive pattern in the pulmonary function test (PFT), a decreased carbon monoxide diffusion test, laboratory results, radiological findings and biopsy. The possible etiologies of infection, aspiration, heart failure, pet feeding status and exposure to haz-ardous respiratory substances were excluded. The suspected drug was discontinued and oral cortico-steroid treatment was started. Lung toxicity can devel-op with drug treatments, and so drug history should be questioned in detail and discontinued immediately in case of any doubt. ILD is rare, and if the drug is not suspected and continued, the disease may be-come chronic and progress to respiratory failure. We present this case to increase awareness of the disease.Öğe Starting as cold-induced anaphylaxis but following as urticaria(Wiley, 2022) Poyraz, Merve; Alpagat, Gulistan; Dumanoglu, Betul; Yalim, Sumeyra Alan; Baccioglu, Ayse; Kalpaklioglu, Ayse Fusun[Abstract No tAvailable]
