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Öğe Can we predict patients that will not benefit from invasive mechanical ventilation? A novel scoring system in intensive care: the IMV Mortality Prediction Score (IMPRES)(Tubitak Scientific & Technological Research Council Turkey, 2019) Özlü, Tevfik; Pehlivanlar Küçük, Mehtap; Kaya, Akın; Yarar, Esra; Kirakli, Cenk; Şengören Dikiş, Özlem; Kefeli Çelik, HaleBackground/aim: The present study aimed to define the clinical and laboratory criteria for predicting patients that will not benefit from invasive mechanical ventilation (IMV) treatment and determine the prediction of mortality and prognosis of these critical ill patients. Materials and methods: The study was designed as an observational, multicenter, prospective, and cross-sectional clinical study. It was conducted by 75 researchers at 41 centers in intensive care units (ICUs) located in various geographical areas of Turkey. It included a total of 1463 ICU patients who were receiving invasive mechanical ventilation (IMV) treatment. A total of 158 parameters were examined via logistic regression analysis to identify independent risk factors for mortality; using these data, the IMV Mortality Prediction Score (IMPRES) scoring system was developed. Results: The following cut-off scores were used to indicate mortality risk: <2, low risk; 2-5, moderate risk; 5.1-8, high risk; >8, very high risk. There was a 26.8% mortality rate among the 254 patients who had a total IMPRES score of lower than 2. The mortality rate was 93.3% for patients with total 1M PRES scores of greater than 8 (P < 0.001). Conclusion: The present study included a large number of patients from various geographical areas of the country who were admitted to various types of ICUs, had diverse diagnoses and comorbidities, were intubated with various indications in either urgent or elective settings, and were followed by physicians from various specialties. Therefore, our data are more general and can be applied to a broader population. This study devised a new scoring system for decision-making for critically ill patients as to whether they need to be intubated or not and presents a rapid and accurate prediction of mortality and prognosis prior to ICU admission using simple clinical data.Öğe Can nasal nitric oxide be a biomarker to differentiate allergic and non-allergic rhinitis?(Springer, 2021) Kalpaklıoğlu, Ayşe Füsun; Baççıoğlu, Ayşe; Yalim, S. A.Background: Nasal nitric oxide (nNO), a noninvasive indicator for eosinophilic airway inflammation, has not been adequately studied in different types of rhinitis. The aim of this study was to compare nNO levels between allergic (AR) and non-allergic rhinitis (NAR). Patients were included based on their chronic nasal symptoms. Total nasal symptoms score (TNSS) were evaluated. nNO was measured transnasally with a flow of 5 ml/s from the nostril with an NO analyzer (NIOX MINO; Aerocrine, Sweden). Results were evaluated as parts per billion (ppb). Results: Four hundred forty-three patients (277 F/166 M)-337 with AR (76%) and 106 with NAR (24%)-were assessed. Patients with AR had significantly higher TNSS, more severe disease, and longer duration of disease compared to NAR group. Allergic rhinitis had significantly higher nNO levels than NAR (370 ppb vs 290 ppb) (p = 0.001). Likewise, significant differences were observed in female gender, in patients with BMI >= 25 kg/m(2) and those without sinusitis between the two groups. When nNO were further evaluated in comorbid asthma, patients with AR w/o asthma had the highest TNSS and had significantly higher nNO level (p < 0.001). NAR+A group, with the longest duration of rhinitis, was significantly older and had the lowest nNO level (p < 0.001). Conclusions: This study showed that nNO levels were significantly higher in AR patients than NAR. Although there is no recommended standard threshold for nNO, this study confirmed the utility of nNO in differentiating AR and NAR in addition to its known fast and non-invasive advantages.Öğe Body Composition in Patients with Stable Chronic Obstructive Pulmonary Disease: Comparison with Malnutrition in Healthy Smokers(Aves, 2014) Baççıoğlu, Ayşe; Gülbay, Banu Eris; Acican, TuranObjective: Although malnutrition (body mass index (BMI)<18.5kg/m2) has been associated with impaired health status in patients with chronic obstructive pulmonary disease (COPD), the effects of body composition (body fat and protein percentage) in patients with COPD have not been clearly demonstrated. Materials and Methods: A total of 180 stable patients with COPD at the stages of moderate, severe, very severe, and 50 healthy subjects were included in this prospective study. All subjects underwent a clinical evaluation, spirometry tests, anthropometric measurements and blood analysis. Results: Frequency of underweight was higher in COPD (11.7%) patients than the control group (8%). The frequency of underweight increased as the severity of COPD worsens. There was body decomposition (protein or fat depletion) in not only all underweight patients but also some normal/overweight COPD patients, as well as in the healthy subjects. Deterioration in FEV1 (L), and FEV1/FVC was more evident in underweight patients with protein and fat depletion compared to normal/overweight patients (p=0.004, and p=0.005). Inspiratory and expiratory respiratory muscle power was lower in underweight patients with depletion than in normal/overweight patients (p=0.02, and p=0.01). DLCO and DLCO/VA were significantly lower in underweight patients than in normal/overweight patients (p=0.003, and p=0.004), they were also lower in normal/overweight patients with depletion than in normal/overweight patients with no depletion (p=0.01, and p=0.07). Normal/overweight patients with protein depletion had the most frequent number of exacerbations than others (p=0.04). Conclusion: These results show that the body decomposition is important in patients with COPD. Assessment of body composition should be a part of nutritional assessment besides BMI in patients with COPD.Öğe Blood Patch Pleurodesis in the Treatment of Persistant Air Leakage in Langerhans Cell Histiocytosis; A Case Report(Derman Medical Publ, 2013) Baççıoğlu, Ayşe; Günal, Nesimi; Kalpaklıoğlu, Füsun; Dural, Koray; Özpolat, BerkantPulmonary langerhans cell histiocytosis is a rare reactive disorder with unclear pathogenesis. 16-year-old male patient complained about shortness of breath induced with exercise, non-productive cough, and intermittent chest pain for one year. Pulmonary function tests were in restrictive nature. There were multiple air cysts in lung parenchyma smaller than one cm and minimal pneumothorax on the left hemithorax in high resolution computed tomography of thorax. There was no hypoxemia in arterial blood gas analysis, and no pulmonary hypertension in echocardiography. Pulmonary langerhans cell histiocytosis was diagnosed with clinical features and typical radiographic appearance. Existence of multisystem langerhans cell histiocytosis was excluded thorough a detailed history, comprehensive physical examination, and baseline radiographic, blood and urine tests. He was recommended to quit smoking and close follow-up was planned. A tube thoracostomy was performed for left sided total pneumothorax one month later, and blood patch pleurodesis was done due to persistent air leakage with a successful outcome. As far as we know this is the first case report of pulmonary langerhans cell histiocytosis who was treated with autologous blood pleurodesis in the literature.Öğe Assessment of quality of life in patients with nonallergic rhinitis compared to allergics in relation with nasal provocation test(Bilimsel Tip Yayinevi, 2012) Kavut, Ayşe Baççıoğlu; Kalpaklıoğlu, FüsunObjective: Allergic-rhinitis (AR) is an IgE-mediated disease with negative effects on quality-of-life (QoL). Despite suggestive symptoms of AR, nonallergic-rhinitis (NAR) is a chronic condition with unclear characteristics and pathophysiology. The objective of this study was to assess the effect of exposure to allergen on rhinitis symptoms and QoL in patients with NAR. Materials and Methods: Patients with NAR (n=25), AR (n=16), and control group (n=10) were compared, regarding generic (SF-36), and specific (MiniRQLQ) QoL, Epworth-Sleepiness-Scale (ESS) and nasal-provocation-test (NPT) with house-dustmite. Results: NPTs were resulted positive in all AR, in 52% of NAR patients and none in control group (p between AR&NAR: < 0.001). Before NPT, social, physical and emotional role domains of SF-36 were lower in NAR group than control group, whereas patients with AR had impairment only in social scores. NAR group had impairment in the general, activity limitation, practical problems and nasal symptoms of MiniRQLQ, while patients with AR had impairment in the general and nasal symptom scores of MiniRQLQ. Results of EUS were similar and in normal levels in all groups. After NPTs, the only change in QoL questionnaires was the impairment in the energy score of SF-36 in NAR group compared to others (p=0.02). Conclusion: This study showed the impact of rhinitis on QoL was more prominent in NAR patients than AR. Furthermore, after exposure to allergen, rhinitis symptoms devepoed in some of the patients with NAR may be a reflection of atopy. The impact of NPT with allergen on QoL was negligible.Öğe A Rare Presentation of Coeliac Disease; Intractable Itching with Recurrent Heart Attack and Dermatitis Herpetiformis(Bilimsel Tip Yayinevi, 2021) Alan Yalim, Sümeyra; Dumanoğlu, Betül; Poyraz, Merve; Alpagat, Gülistan; Baççıoğlu, Ayşe; Kalpaklıoğlu, Ayşe FüsunCoeliac disease (CD) is a systemic disease of the unwarranted immune reaction to gluten and is associated with a 10% increased risk of cardiovascular disease. Here we present a patient with recurrent myocardial ischemia and intractable itching who was eventually diagnosed with CD. A 53-year-old man presented to the allergy department due to intractable itching that was resistant to antihistamine therapy. In addition, despite successful percutaneous intervention with stent implantation to the right coronary artery, there was an ST segment elevation with myocardial infarction (MI) in the lower wall that had occurred three times. After dermatitis herpetiformis was reported as a result of the biopsy performed from the lesions, duodenal biopsy confirmed the diagnosis of CD. Diagnosis of CD with atypical presentation can be difficult. Cardiovascular risk is increased in patients with celiac disease compared to the normal population. Itching is an important symptom that needs to be evaluated in detail, even without the typical gastrointestinal manifestations of CD.Öğe Evaluation of Knowledge About Anaphylaxis in Dentistry and Medical Faculty Students; Need for More Training(Bilimsel Tip Yayinevi, 2021) Baççıoğlu, Ayşe; Kalpaklıoğlu, Ayşe Füsun; Cimşir, DilekObjective: Anaphylaxis is a serious reaction that needs rapid intervention. However, some healthcare professionals may have inadequate knowledge about anaphylaxis to manage this situation. The aim of this study was to evaluate the level of knowledge about anaphylaxis in dentistry students (DS) in comparison with medical school ones (MS). Materials and Methods: Students were recruited from the Dentistry (n=81) and Medical (n=144) Faculties of the University Hospital. The level of knowledge about anaphylaxis was evaluated by using a questionnaire with 26 items that was used previously. Results: The overall response rate was 89.9%. One tenth of the study group had ever encountered a case with anaphylaxis, but 2.8% of them stated that they had involved in the treatment by themselves. Almost all of the participants stated that allergy might be a life-threatening reaction. Additionally, 43.3% reported that they had epinephrine in their department. DS knew less than MS about the primary use of epinephrine after assessing the airway, breathing and circulation in the treatment of anaphylaxis, and even in suspicious cases (59.3% vs. 98.6%, and 42% vs. 94.4%, all p<0.001). DS had significantly less knowledge about anaphylaxis treatment and epinephrine application than medical ones (all p <0.001). Furthermore, the information of that the minimum duration for readministration of epinephrine as 10 minutes was known by the half of MS, and one fourth of DS (p<0.001). The appropriate follow-up duration of patients with anaphylaxis was unknown in half of DS, and one fifth of MS (p<0.001). Even though MS had a higher rate of knowledge about the responsible and closest department dealing with anaphylaxis than dental students (p=0.02), DS were more aware of referring the patient with anaphylaxis to an allergy clinic (77.8% vs. 62.9%, p<0.001). Almost all MS had heard about the epinephrine auto-injector, in contrast to one third of the DS (p<0.001). Most of the participants, but mainly the MS knew that anaphylaxis could be diagnosed clinically. The case questions about diagnosis of anaphylaxis related to local anesthetic and beta-lactam antibiotic use were answered correctly in a higher rate in MS than DS (p=0.01 and p<0.001), whereas the rate of correct diagnosis of anaphylaxis following a bee sting was similar between the groups. Conclusion: This study showed the gaps about the diagnosis and management of anaphylaxis not only in MS, but also in dentistry ones. It is possible to encounter a case of anaphylaxis for every student during clinical practice in the future. Thus, education about anaphylaxis should be included in the national dentistry core education programme and be improved in the medical school as well.Öğe Evaluation of Patients with Fibrotic Interstitial Lung Disease: Preliminary results from the Turk-UIP Study(Aves, 2021) Benan, Müsellim; Nesrin, Moğulkoç; Oğuz, Uzun; Fatma, Tokgoz Akyil; Haluk, Türktaş; Özlem, Özdemir Kumbasar; Gulfer, OkumusOBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF. MATERIAL AND METHODS: The study included the patients with the usual interstitial pneumonia (UIP) pattern or possible UIP pattern on thorax high-resolution computed tomography, and/or UIP pattern, probable UIP or possible UIP pattern at lung biopsy according to the 2011 ATS/ERSARS/ALAT guidelines. Demographics and clinical and radiological data of the patients were recorded. All data recorded by researchers was evaluated by radiology and the clinical decision board. RESULTS: A total of 336 patients (253 men, 83 women, age 65.8 +/- 9.0 years) were evaluated. Of the patients with sufficient data for diag-nosis (n=300), the diagnosis was IPF in 121 (40.3%), unclassified idiopathic interstitial pneumonia in 50 (16.7%), combined pulmonary fibrosis and emphysema (CPFE) in 40 (13.3%), and lung involvement of connective tissue disease (CTD) in 16 (5.3%). When 29 patients with definite IPF features were added to the patients with CPFE, the total number of IPF patients reached 150 (50%). Rate of male sex (p<0.001), smoking history (p<0.001), and the presence of clubbing (p=0.001) were significantly high in patients with IPE None of the women <50 years and none of the men <50 years of age without a smoking history were diagnosed with IPE Presence of at least 1 of the symptoms suggestive of CTD, erythrocyte sedimentation rate (ESR), and antinuclear antibody (FANA) positivity rates were significantly higher in the non-IPF group (p<0.001, p=0.029, p=0.009, respectively). CONCLUSION: The rate of IPF among patients with fibrotic ILD was 50%. In the differential diagnosis of IPF, sex, smoking habits, and the presence of clubbing are important. The presence of symptoms related to CTD, ESR elevation, and EANA positivity reduce the likelihood of IPF.Öğe Pros and Cons of Nebulizer Treatment in Asthma Exacerbation During the COVID-19 Pandemic(Bilimsel Tip Yayinevi, 2021) Öztürk, Ayşe Bilge; Baççıoğlu, Ayşe; Uysal Soyer, Özge; Civelek, Ersoy; Şekerel, Bülent 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 Type 2 Respiratory Insufficiency, Pulmonary Hypertension, and Obstructive Sleep Apnea Syndrome that Developed in Morquio Syndrome(Aves, 2014) Gülhan, Pınar Yıldız; Ekici, Aydanur; Ekici, Mehmet; Çimen, DilayMucopolysaccharidosis type IVA (Morquio syndrome) is a multisystemic autosomal recessive transitive disease induced by an N-acetylgalactosamine 6 sulfatase (GALNS) gene defect, progressing with lysosomal stock failure. The accumulation of chondroitin 6 sulfate and keratin sulfate is observed in the tissues due to GALNS deficiency. We presented a case in which Morquio syndrome was successfully treated with noninvasive mechanical ventilation in accordance with the literature. The case had obstructive sleep apnea syndrome (OSAS) induced by an obstruction that emerged as a result of type 2 respiratory insufficiency resulting from throcal deformity, inspiratory muscle weakness, pulmonary hypertension, and the accumulation of diffuse mucopolysaccharide in the upper respiratory tract.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 Elderly and aged asthma have different characteristics: results of a multicenter study(Tubitak Scientific & Technological Research Council Turkey, 2024) Damadoğlu, Ebru; Öztürk Aktaş, Özge; Gemicioğlu, Bilun; Yılmaz, Nafiye; Bozkuş, Fulsen; Ayhan, Vehbi; Kalpaklıoğlu, Ayse FüsunBackground/ aim: Characteristics of asthma in the elderly population is not well-known. The aim of the present study was to evaluate asthma in the elderly population, to compare disease characteristics between patients diagnosed <60 (aged asthma) and >= 60 (elderly asthma) years of age. Materials and methods: The study was a prospective, multicenter, cross-sectional type. A questionnaire was filled out to patients 60 years of age and over, that have been followed for asthma for at least 3 months. Asthma Control Test (ACT), eight-item Morisky Medication Adherence Scale (MMAS-8) was filled out, inhaler device technique was assessed. Results: A total of 399 patients were included from 17 tertiary care centers across the country. Mean age was 67.11 years and 331 (83%) were female. The age at asthma diagnosis was >= 60 in 146 (36.6%) patients. Patients diagnosed >= 60 years were older (p < 0.001), had higher education level (p < 0.001), more commonly had first -degree relative with asthma (p = 0.038), asthma related comorbidities (p = 0.009) and accompanying rhinitis/rhinosinusitis (p = 0.005), had better asthma control (p = 0.001), were using less controller medications (p = 0.014). Inhaler technique was correct in 37% of the patients with no difference in between the groups. Treatment compliance was better in elderly asthma patients (p < 0.001). In the multivariate logistic regression analysis, having well -controlled asthma (odds ratio = 1.61, CI = 1.04-2.51), and high medication adherence rate (odds ratio = 2.43, CI = 1.48-4.0) were associated with being in the elderly asthma group. Conclusion: The characteristics of asthma are different among patients aged 60 years and over which seems to be related to onset age of asthma. In our cohort, the elderly asthma patients had higher education level, and treatment adherence and asthma control was better. Patients diagnosed >= 60 years of age did not have more severe disease.Öğe Vitamin D Levels in Patients with Allergic and Non-Allergic Rhinitis(Bilimsel Tip Yayinevi, 2022) Kalpaklıoğlu, Ayşe Füsun; Alpagat, Gülistan; Baççıoğlu, Ayşe; Alan Yalim, Sümeyra; Dumanoğlu, Betül; Poyraz, MerveObjective: Allergic and non-allergic rhinitis are quite similar from a clinical viewpoint and allergen sensitivity seems to be the important relevant difference between them. However, the role of vitamin-D (vit-D) as an immunomodulator hormone and on rhinitis phenotypes is not clear. We aimed to investigate the relation between vit-D levels and patients with rhinitis as allergic (AR) and non- allergic (NAR). Materials and Methods: This was a retrospective research of 228 patients whom were diagnosed at a tertiary hospital between 2012 and 2016. Rhinitis was diagnosed as AR if nasal symptoms were accompanied with skin prick test (SPT) positivity, and NAR if they were relevant with negative SPT. The clinical history of the patients and the symptoms were recorded. Serum total IgE tests were performed using an allergen detection system (UniCAP, Phadia, Uppsala, Sweden), and vit-D levels were measured with the 25-hydroxy-vit-D (25-OH vit-D) kit in the Elecsys 2010 analyzer (Roche Diagnostics, Germany). Results: A total of 228 patients (AR=170 and NAR=58) with a mean age of 31.06 +/- 11.58 yrs were included. The mean age and ratio of female gender were significantly higher in NAR (p=0.03), whereas obesity was significantly higher in AR patients (p=0.01). Duration of rhinitis in NAR was longer than in AR (p=NS). Serum total IgE levels were significantly higher in AR than NAR, whereas mean levels and ratio of vit-D deficiency were similar between the groups. Levels of vit-D were significantly lower in females than males only in the AR group (p<0.001). Patients with NAR had mostly severe vit-D deficiency (<10 ng/mL), and those with AR had mostly non-severe vit-D deficiency (11-19 ng/mL). There was no relationship between vit-D deficiency and allergen sensitization, but there was a negative correlation of vit-D levels and female gender in the AR group (p<0.001). Conclusion: The present study showed no association between serum vit-D level and allergen sensitization in adult patients with allergic and nonallergic rhinitis.Öğe Characteristics of Adverse Reactions and Compliance in Patients who Underwent Allergen-Specific Subcutaneous Immunotherapy; Ten-Year Real-Life Data(Bilimsel Tip Yayinevi, 2022) Baççıoğlu, Ayşe; Kalpaklıoğlu, Ayşe Füsun; Poyraz, Merve; Alan Yalım, Sümeyra; Dumanoğlu, Betül; Alpagat, GülistanObjective: Allergen-specific subcutaneous immunotherapy (SCIT) is known as the best therapeutic method that may alter the natural course of allergic diseases, compared to pharmacological and avoidance options. However, some problems such as adverse reactions (ARs), inconvenience, and high costs of a prolonged course of therapy may prevent patients from completing the therapy. The objective of this study was to evaluate the evidence for the potential barriers against the benefits of SCIT in adult patients. Materials and Methods: An observational study between 2009 and 2019 was performed at the Allergy Clinic of a tertiary hospital. The data of 166 adult patients who underwent SCIT for allergic rhino-conjunctivitis (ARC), and/or asthma or hymenoptera venom anaphylaxis using conventional schedules with standard allergen extracts were evaluated. Results: SCIT indications were ARC (63%), ARC and asthma (19.3%), and venom anaphylaxis (17.5%). The standardized allergen extracts used were grass pollen (59%), house dust mite (19.9%), and hymenoptera venom (17.5%). The frequency of SCIT-related ARs was 7.4% per injection, and 42.2% per patient. Local ARs were more frequent than systemic ARs (SAR)s. The majority of the SARs were composed of anaphylaxis and generalized urticaria, which were mostly of moderate severity with no deaths. SARs were more common in women, in patients with high injection numbers, and in patients under SCIT with cat allergen or multiple allergens. Most of the SARs occurred immediately after injection, and in the initial phase, whereas the delayed-type of SARs was common in patients with pollen SCIT. Three patients under cat SCIT discontinued treatment due to SARs of immediate and moderate/severe type. Ratios of SARs of venoms were insignificantly higher than aeroallergens. SARs with house dust mite SCIT were rare. Rates of patients' compliance to SCIT were similar between the allergen extracts, with an average of 70%. The most common causes of non-compliance were non-adherence, leaving the current residence, difficulty in obtaining the allergen extracts, and ARs. The frequencies of local and moderate ARs were higher in compliant patients, whereas systemic and severe ARs were higher in non-compliant ones. In the regression model, it was found that ARs increased and patient compliance decreased as the number of injections increased. Conclusion: This study in the real-life setting for a decade showed that less than half of the patients that underwent SCIT had developed ARs, which were generally local and of moderate severity. In conclusion, these results indicated that each allergen of SCIT had different characteristics of ARs, and the moderate incidence of ARs was not a problem regarding compliance with SCIT. Therefore, SCIT may be preferred in indications of allergy, and has a tolerable balance of ARs and safety.Öğe The Effect of Internet Addiction on Asthma Control and Medication Adherence(Bilimsel Tip Yayinevi, 2022) Kalpaklıoğlu, Ayşe Füsun; Baccıoğlu, Ayşe; Dumanoğlu, Betül; Poyraz, Merve; Yalım, Sümeyra Alan; Alpagat, GülistanObjective: Internet addiction has recently become a prevalent health problem. Although many studies indicate a link between internet addiction and various diseases, no studies have examined its consequences on asthma control or medication adherence. The purpose of this study was to determine how internet addiction affects asthma control and medication adherence. Materials and Methods: Study participants were grouped as asthmatics and healthy controls whom were aged between 18 and 77. Asthma control test (ACT) and medication adherence report scale (MARS-5) were fulfilled by asthma patients, whereas short version of Young Internet Addiction Test (s-IAT) was applied to all participants. Pulmonary function test was performed to all subjects. Results: Forty-nine healthy volunteers and 54 asthmatic subjects were enrolled. Age and gender profiles within the study groups were similar. There was no significant difference in means of problematic and pathological (s-IAT >= 31) s-IAT scores between asthma and control groups (24.1% and 20.4%, p=0.41), as well as between asthma patients with controlled and uncontrolled ACT scores (24.1% and 24%, p=0.99), and those with and without medication adherence (16.7% and 27.8%, p=0.50). s-IAT scores were found to be linked to higher educational level (p=0.01, r=0.37), and better FEV1 (p=0.04, r=0.27) in asthmatic patients. In addition, MARS-5 was correlated with older age (p=0.02, r=0.29), and low FEV1 (p=0.01, r= -0.35). Conclusion: Internet addiction did not seem to directly affect asthma control or medication adherence. However, it appeared to be associated with a high level of education and FEV1.Öğe Therapeutic Treatment with Abdominal Adipose Mesenchymal Cells Does Not Prevent Elastase-Induced Emphysema in Rats(2020) Gülhan, Pınar Yıldız; Ekici, Mehmet Savaş; Ekici, Aydanur; Niyaz, Mehmet; Gülhan, Muhammet; Ercin, Mustafa Emre; Aksoy, NurkanOBJECTIVES: Emphysema and chronic bronchitis have different pathophysiologies but both are significant components of chronic obstructive lung disease (COPD). The levels of Matrix metalloproteinase (MMP)-9 in the bronchoalveloar lavage fluid (BALF) and in serum indicate the presence of emphysema. Intratracheal administration of elastase has been used to create a rat model of emphysema. Adipose tissue-derived mesenchymal stem cells (MSC) have been postulated to prevent or reverse emphysema, however, this has not been examined in the rat model of elastase-induced emphysema. MATERIALS AND METHODS: In this study, 31 Wistar albino rats aged 6–8 weeks and weighing 250–300 g were assessed. On day 1, the animals were treated intratracheally with 0.5 mL saline (control group, n=10), i.e., 0.5 mL saline solution containing 0.1 IU porcine pancreatic elastase (PPE) (Elastase group, n=12) or PPE plus MSC (Elastase-MSC group, n=9) was adminstered per animal. MSCs suspended in serum were injected via the caudal vein on day 21. At least 106 cells were injected. All animals were sacrificed on day 42 and the emphysema index (EI) was calculated, along with measuring the BALF and serum MMP-9 concentrations. RESULTS: Porcine pancreatic elastase induced a significant degree of emphysema in the PPE groups as compared to the control group, which was determined by the EI index (p=0.008). This was not reversed by MSC treatment. The EI remained significantly low in comprison with the controls (p=0.001) and measured no different from the Elastase-treated animals. There was no statistically significant difference between the BALF and serum MMP-9 levels between the control and treatment groups. CONCLUSION: Our findings suggest that therapeutic treatment with adipose tissue-derived MSC in rats has no effect on emphysema or on MMP9 expression, which is a known marker of emphysema.Öğe Mortality prediction ability of phycians in intensive care units of Turkey (MOPAP)(TURKISH ASSOC TUBERCULOSIS & THORAX, 2020) Pehlivanlar Kucuk, Mehtap; Ozlu, Tevfik; Kucuk, Ahmet Oguzhan; Kaya, Akin; Kirakli, Cenk; Sengoren Dikis, Ozlem; Kefeli Celik, HaleIntroduction: Intensive care physicians are increasingly involved in decision making about the prognosis of intensive care unit ICU patients. With this study; we aimed to evaluate the power of clinician foresight at prediction of mortality in patient at triage to intensive care and patient follow-up. Materials and Methods: This study was conducted in ICUs located in various geographical regions of Turkey between January 1, 2017-April 30, 2017. The clinical research was planned as observational, multicenter, cross-sectional. Results: A total of 1169 intubated patients were followed in 37 different ICU. At the beginning of the follow-up we asked the physician who will follow the patient in the ICU to give a score for the probability of survival of the patients. Scoring included a total of 6 scores from 0 to 5, with the "0" the worst probability "5" being the best. According to this distribution, only 1 (0.9%) of 113 patients who were given 0 points survived. Three (6.1%) of 49 with the best score of 5 died. Survival rates were significantly different in each score group (r: -0.488; p< 0.001). After the combined mortality estimation scores based on the clinical observations of the physicians (0 and 1 point score was combined as non-survive, 4 and 5 score was combined as survived) 320 of the 545 patients were estimated to be dead and 225 were predicted survival. Sensitivity and spesifity of scoring system to predict mortality was 91.56% (95% Cl: 87.96-94.37), 76.89% (95% CI: 70.82-82.23) respectively. Conclusion: In this study, we concluded that the physicians who follow the patients in the ICU can predict the poor prognosis at the time of admission and the high mortality rate. The physician's opinion on mortality estimation should be considered in intensive care mortality scoring in addition to other laboratory and clinical parameters.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 "Whole" vs "fragmented" approach to EAACI pollen season definitions: A multicenter study in six Southern European cities(WILEY, 2020) Hoffmann, Tara Maria; Sahin, Aydan Acar; Aggelidis, Xenophon; Arasi, Stefania; Barbalace, Andrea; Bourgoin, Anne; Bregu, BlerinaBackground The adequate definition of pollen seasons is essential to facilitate a correct diagnosis, treatment choice, and outcome assessment in patients with seasonal allergic rhinitis. A position paper by the European Academy of Allergy and Clinical Immunology (EAACI) proposed season definitions for Northern and Middle Europe. Objective To test the pollen season definitions proposed by EAACI in six Mediterranean cities for seven pollen taxa. Methods As part of the @IT.2020 multi-center study, pollen counts for Poaceae, Oleaceae, Fagales, Cupressaceae, Urticaceae (Parietaria spp.), and Compositae (Ambrosia spp., Artemisia spp.) were collected from January 1 to December 31, 2018. Based on these data, pollen seasons were identified according to EAACI criteria. A unified monitoring period for patients in AIT trials was created and assessed for feasibility. Results The analysis revealed a great heterogeneity between the different locations in terms of pattern and length of the examined pollen seasons. Further, we found a fragmentation of pollen seasons in several segments (max. 8) separated by periods of low pollen counts (intercurrent periods). Potential monitoring periods included often many recording days with low pollen exposure (max. 341 days). Conclusion The Mediterranean climate leads to challenging pollen exposure times. Monitoring periods for AIT trials based on existing definitions may include many intermittent days with low pollen concentrations. Therefore, it is necessary to find an adapted pollen season definition as individual solution for each pollen and geographical area.Öğe Effect of internet addiction on asthma control and medication adherence(WILEY, 2020) Kalpaklioglu, A. F.; Baccioglu, A.; Dumanoglu, B.; Cimsir, Oksuzer D.; Poyraz, M.Objective: Internet addiction has recently become a prevalent health problem. Although many studies indicate a link between internet addiction and various diseases, no studies have examined its consequences on asthma control or medication adherence. The purpose of this study was to determine how internet addiction affects asthma control and medication adherence. Materials and Methods: Study participants were grouped as asthmatics and healthy controls whom were aged between 18 and 77. Asthma control test (ACT) and medication adherence report scale (MARS-5) were fulfilled by asthma patients, whereas short version of Young Internet Addiction Test (s-IAT) was applied to all participants. Pulmonary function test was performed to all subjects. Results: Forty-nine healthy volunteers and 54 asthmatic subjects were enrolled. Age and gender profiles within the study groups were similar. There was no significant difference in means of problematic and pathological (s-IAT ≥ 31) s-IAT scores between asthma and control groups (24.1% and 20.4%, p=0.41), as well as between asthma patients with controlled and uncontrolled ACT scores (24.1% and 24%, p=0.99), and those with and without medication adherence (16.7% and 27.8%, p=0.50). s-IAT scores were found to be linked to higher educational level (p=0.01, r=0.37), and better FEV1 (p=0.04, r=0.27) in asthmatic patients. In addition, MARS-5 was correlated with older age (p=0.02, r=0.29), and low FEV1 (p=0.01, r= -0.35). Conclusion: Internet addiction did not seem to directly affect asthma control or medication adherence. However, it appeared to be associated with a high level of education and FEV.
