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Öğe Treatment of Anaphylaxis(Springer International Publishing Ag, 2020) Cingi, Cemal; Muluk, Nuray Bayar[Abstract No tAvailable]Öğe The Aetiology of Anaphylaxis(Springer International Publishing Ag, 2020) Cingi, Cemal; Muluk, Nuray Bayar[Abstract No tAvailable]Öğe Symptoms and Findings for Anaphylaxis(Springer International Publishing Ag, 2020) Cingi, Cemal; Muluk, Nuray Bayar[Abstract No tAvailable]Öğe Risk Factors for Anaphylaxis(Springer International Publishing Ag, 2020) Cingi, Cemal; Muluk, Nuray Bayar[Abstract No tAvailable]Öğe Pathophysiology of Anaphylaxis(Springer International Publishing Ag, 2020) Cingi, Cemal; Muluk, Nuray Bayar[Abstract No tAvailable]Öğe What is vasomotor rhinitis?(Springer International Publishing, 2020) Arslan, İbrahim; Bayar Muluk, Nuray; Milkov, MarioThe use of the term "vasomotor rhinitis" has been abandoned in many countries and guidelines because it assumes a mechanism of vascular changes which do not exist. The condition previously described by the term VMR is a form of neurogenic nonallergic rhinitis. Nonallergic rhinitis (NAR) encompasses rhinitis symptoms without allergic sensitisation or infectious aetiology. Two major subtypes exist: an eosinophilic inflammatory endotype including nonallergic rhinitis with eosinophilia (NARES), local allergic rhinitis (LAR) and NSAID-exacerbated respiratory disease (N-ERD) and a neurogenic endotype which includes gustatory rhinitis, rhinitis of the elderly and idiopathic rhinitis. This second endotype includes what was called VMR. Vasomotor rhinitis therefore can be defined as a nonallergic type of rhinitis not connected to allergic responses, infective agents, anatomical anomaly, systemic disorders or drug misuse. The diagnosis is made after excluding other potential diagnoses and after negative allergy testing. There may be multiple causes. In this chapter, VMR will be defined as an essential, chronic, nonallergic pattern of rhinitis in which cutaneous allergy testing is negative, there is no rise in serum IgE and nasal cytology fails to show evidence of inflammation. In this chapter, VMR is reviewed in detail. © Springer Nature Switzerland AG 2021.Öğe Vertigo and Dizziness in Children(Springer International Publishing, 2021) Mete, Utku; Muluk, Nuray Bayar; Vicini, ClaudioIt is unusual for a child or adolescent patient to complain of vertigo. However, in adults it is more commonly seen. Research conducted using a survey methodology has found a yearly incidence of 23% for dizziness in general and 5% for vestibular vertigo, in particular [1]. A study which recently assessed the frequency of diagnoses coded using ICD-9 and relating to problems with balance and the vestibular apparatus considered records from more than 560,000 consultations with paediatricians stretching over 4 years. These showed that unspecified dizziness occurred in a mere 0.4%, peripheral symptoms in 0.03% and central vestibulopathy in 0.02% of encounters [2, 3]. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.Öğe Thyroid nodules and cancer during pregnancy and the postpartum period(Springer International Publishing, 2022) Fethallah, Başat; Muluk, Nuray Bayar; Manole, FeliciaThyroid disorders occur in approximately 5% of pregnant women. Untreated thyroid disease in the mother makes an adverse outcome in pregnancy more likely to occur and may harm the newborn, but treatment can mitigate these consequences. Levothyroxine is frequently used as a treatment for hypothyroidism. In pregnant women, the treatment dose is generally higher than in nonpregnant patients. Hyperthyroid disease in pregnant women is typically treated by means of antithyroid agents, but caution is needed, since methimazole has an association with congenital defects and propylthiouracil raises the risk of toxicity to the liver in the mother. It is advised that pregnant women in the initial trimester be administered propylthiouracil, which can later be converted to methimazole treatment to decrease the likelihood of liver damage. The aim of treating under-or overactivity of the thyroid in pregnant women is to reach a euthyroid state as rapidly as possible and ensure this remains so for the entire pregnancy. Currently, intervention is not recommended in pregnant women suffering from autoimmune thyroiditis nor isolated hypothyroxinemia, provided there are no signs of hypothyroidism. It is usually safe practice to delay treating thyroid nodules or low-grade thyroid carcinoma until the end of pregnancy [1]. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.Öğe Rhinosinusitis during pregnancy and the postpartum period(Springer International Publishing, 2022) Kubat, Gözde Orhan; Şahin, Caner; Muluk, Nuray BayarRhinitis and sinusitis are common diseases in which everyone may be affected at least once or more. Rhinitis is a condition that causes loss of efficiency and large economic expenses in patients [1]. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.Öğe Recent combination therapy options for allergic rhinitis(Springer International Publishing, 2020) Kef, Kemal; Bayar Muluk, Nuray; Konstantinidis, Iordanis; Scadding, Glenis K.Treatment should be initially preventive through allergen and pollutant avoidance as much as possible. For pollen allergy, it is beneficial to stay away from outdoor activities during the seasons with high pollen density and not to open doors and windows in the morning and evening hours when pollen levels are highest. If the patient has outdoor activities, it is better to remove the clothes upon entering the home, have a shower and wash the hair. Air conditioners should have a pollen filter working by recirculating the room air. Nasal pollen filters and balms can reduce symptoms by about a third. There can be significant improvement in few patients by allergen avoidance alone. Most need additional pharmacotherapy. Those with uncontrolled symptoms may be candidates for allergen-specific immunotherapy (AIT). Pharmacotherapy does not change the course of the disease; medications only prevent or reduce symptoms. AIT has been shown to reduce symptoms even after discontinuation, to decrease progression from AR to asthma and to reduce new sensitisations. In this chapter, recent combination therapy options for allergic rhinitis are reviewed. © Springer Nature Switzerland AG 2021.Öğe Otitis Media in Infants(Springer International Publishing, 2021) Atan Şahin, Özlem Naciye; Muluk, Nuray Bayar; Arısoy, Ayşe EnginAcute otitis media (AOM) is one of the most frequent infections in children. It is a burden due to its increased associated doctor visits, antibiotic needs, increased surgery, and potential contribution to hearing and speech complications. Acute otitis media has been shown in all ages but is mostly found in infants and young children. The attack rate for AOM peaks between 6 and 18 months of age. In the United States (US), nearly 80% of children less than 2 years of age have at least one episode of AOM annually, and most continue to have episodes through age 5 years [1]. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.Öğe Local allergic rhinitis: A new allergic rhinitis phenotype(Springer International Publishing, 2020) Özdoğru, Emine Ece; Bayar Muluk, Nuray; Rondon, CarmenLocal allergic rhinitis (LAR) describes a condition in which a patient has clear symptoms suggestive of allergic rhinitis and has a nasal eosinophilic inflammation with local specific IgE to a specific allergen but is negative on testing for systemic atopy. A considerable number of cases with rhinitis, in which SPT is negative and sIgE is undetectable, do in fact produce a positive response to the nasal allergen challenge (NAC). This phenotypical manifestation of AR is known as LAR. LAR affects the entire age range from children to adults, across the world, and symptoms may range from mild to severe. Despite the negative effects of LAR on patients' quality of life and the way symptoms may quickly deteriorate, it is generally underdiagnosed. LAR persists as a condition in its own right. It is not merely a precursor to systemic AR. There are many common elements between AR and LAR, such as positive NAC, the presence of features indicating a type 2 inflammatory response in the nose (e.g. sIgE in secretions from the nose) and an increased risk of becoming asthmatic. In this chapter, we reviewed LAR in all aspects. © Springer Nature Switzerland AG 2021.Öğe How should rhinitis be managed during pregnancy?(Springer International Publishing, 2020) Kar, Murat; Bayar Muluk, Nuray; Negm, HeshamThe rhinological impacts on pregnancy include rhinitis of pregnancy, nosebleeds and particular tumours, e.g. pyogenic granuloma. These conditions have been written about previously. There are also case reports that have appeared from time to time, concerning how rhinosinusitis may interact with pregnancy. Pregnancy rhinitis is a condition in which the nose becomes congested in the final month or 2 months before delivery, but with no further indications of infection within the respiratory tract and no allergic response and with complete resolution in less than 2 weeks after giving birth. Diagnosing and managing rhinitis, sinusitis and nosebleeds in pregnant women is a particularly difficult task for ENT specialists. On one hand, disorders of the nose and sinuses, when not adequately treated, present risks to the quality of life of the woman and endanger the pregnancy, and on the other hand, data regarding the safety aspects from properly controlled trials are simply lacking. In this chapter, rhinitis during pregnancy is reviewed. © Springer Nature Switzerland AG 2021.Öğe Anesthesia for Rhinoplasty(Springer International Publishing, 2019) Demir, Necdet; Muluk, Nuray Bayar; Velentin, Peter TomazicNasal innervation is performed through either the mucosal (internal) or skin (external) part of the nose. Externally, the nose is innervated with the ophthalmic and maxillary nerves and the nerves to the superior tip are furnished through the infratrochlear, supratrochlear, and external nasal branch of the anterior ethmoid nerves. The infraorbital nerve furnishes both the inferior and lateral nose regions, which extend to eyelids. The naso-sinus cavity can be categorized into three parts: (1) lateral walls, (2) nasal septum, and (3) the cribriform plate. The anterior and posterior ethmoid nerves provide nerve endings to the lateral nasal wall and the posterior nasal cavity is innervated by the sphenopalatine ganglion. The septum is furnished with nerve endings from the anterior and posterior ethmoid nerves and the sphenopalatine ganglion, while the olfactory nerve supplies the cribriform plate (cranial nerve I). Nasal anesthetic block can be acquired using topical and infiltration methods. Topical ointments can be used as an aerosol or swabbed in the nasal cavity using a cotton-tipped applicator. These methods numb the sphenopalatine, nasopalatine, and the anterior and posterior ethmoid nerves. If required, the external nose can be numbed by anesthetizing the anterior ethmoid, the infraorbital, and/or the nasopalatine nerves. Often, it is necessary to reduce anxiety during a nasal block. Sometimes topical or internal anesthesia may be necessary for children or uncooperative patients. Other times, deep sedation may be required depending on the patient. © Springer Nature Switzerland AG 2020.Öğe Allergic rhinitis during pregnancy(Springer International Publishing, 2022) Muluk, Nuray Bayar; Cingi, Cemal; Scadding, GlenisWhilst she is pregnant, a woman may develop an atopic disorder for the first time, such as rhinitis, urticaria, angioedema, or allergic eczema, or she may already have such a condition. However, whereas there has been extensive investigation of asthma during pregnancy, other atopic conditions during this period have been somewhat neglected by researchers [1]. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.Öğe Alar Base Surgery(Springer International Publishing, 2019) Koç, Bülent; Muluk, Nuray Bayar; Choi, Ji YunThe concept of narrowing the nasal alar base is external wedge excision technique in correction of the excess alar flare while hiding the incision in the alar-facial groove. Weir first described the alar base resection in 1892. In 1931, Joseph and Milstein described narrowing the nostril base and vestibular floor. In 2007, Foda described the combined alar base excision technique for nasal base narrowing in cases of a wide alar base with excessive nasal flare. The alar base plays an important role in the overall appearance and balance of the nose. The alar base, however, is not often evaluated independently during nasal examinations at the time of surgery. As a result, it is one of the most frequently encountered imperfections during secondary rhinoplasty. Deformities of the nasal alar base are a common finding in secondary rhinoplasty. Although some are recognized easily, many deformities are subtle and will be identified only during a detailed examination by the surgeon. A primary deformity that does not occur at the beginning or develops as a secondary deformity, for example, excessive flaring, may develop after reconstruction of the tip projection. When narrowing the alar base, a limited resection is preferred to a comprehensive, since resecting additional alar tissue is simple while having to reconstruct a stenotic alar is a complicated process. In this chapter, alar base surgery is discussed in all aspects. © Springer Nature Switzerland AG 2020.Öğe Acute Tonsillopharyngitis in Children(Springer International Publishing, 2021) Demir, Necdet; Muluk, Nuray Bayar; Chua, DennisTonsillopharyngitis can be defined as a condition in which the pharynx and/or palatine tonsils become acutely infected and is accompanied by sore throat, difficulty swallowing, pyrexia and lymphadenopathy in the cervical region. It can be diagnosed clinically, diagnosis being confirmed microbiologically or via the rapid antigen test [1]. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
