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Öğe A comparative evaluation of clinical and laboratory findings and treatment costs for sublingual and subcutaneous immunotherapy in children with allergic rhinitis and asthma(Wiley, 2018) Eren, Seçil; Gülez, Nesrin; Karkıner, Canan Şule; Kanık, Esra Toprak; Bahçeci, Semiha; Karaman, Sait; Nacaroğlu, Hikmet Tekin; Akçal, Ömer; Genel, Ferah; Can, Demet[Abstract Not Available]Öğe Awareness and knowledge of children with asthma who treated with subkutan immunotherapy(Behçet Uz Çocuk Hastalıkları ve Cerrahisi Eğitim ve Araştırma Hastanesi, 2021) Akçal, Ömer; Taşkırdı, İlke; Özen, Selime; Akay Hacı, İdil; Kaya, Mehmet Şirin; Toprak Kanık, Esra; Karaman, Sait; Bahçeci Erdem, Semiha; Nacaroğlu, Hikmet Tekin; Karkıner, Canan Şule; Can, DemetObjective: Asthma is one of the most common chronic diseases of childhood. Many studies have shown that education positively affects asthma control and patients' quality of life. In this study, it was aimed to measure the awareness levels of children who have been under observation for a long time and who underwent Allergen Specific Immunotherapy (AIT). Methods: Patients with asthma, asthma & allergic rhinitis and/or rhinoconjunctivitis who received subcutaneous AIT between July 2019 and December 2019 were included in our prospective case-control study. A questionnaire was applied to each patient, in which both the levels of awareness related to their disease and AIT, as well as their knowledge of the allergens and prevention measures they were sensitive to were measured. The results were examined. Age, gender, type of allergic diseases, allergen type, AIT time were evaluated statistically. Results: 82 cases (48 boys and 34 girls) were included in the study. The number of patients who know the name of the disease correctly is 68 (82.9%); The number of patients who knew allergens to be sensitive was found to be 47 (57.3%). It was observed that 15%-72% of the cases had information about asthma disease. Age, gender and diseases of the patients were not statistically different. Conclusion: In our study, it was observed that our children were highly aware of especially about sports and environmental protection methods. It is essential to raise awareness of patients and parents for increase treatment success and control the asthma.Öğe CD4+CD25+CD127loFOXP3+ cell in food allergy: Does it predict anaphylaxis?(Codon Publications, 2023) Bahçeci Erdem, Semiha; Genel, Ferah; Nacaroğlu, Hikmet Tekin; Karaman, Sait; Ünsal Karkıner, Canan Şule; Sürücü, Murat; Can, DemetBackground: Food allergy (FA), hence the incidence of food anaphylaxis, is a public health problem that has increased in recent years. There are still no biomarkers for patients with FA to predict severe allergic reactions such as anaphylaxis. Objective: There is limited information on whether regulatory T (Treg) cell levels are a biomarker that predicts clinical severity in cases presenting with FA, and which patients are at a greater risk for anaphylaxis. Methods: A total of 70 children were included in the study: 25 who had IgE-mediated cow’s milk protein allergy (CMPA) and presented with non-anaphylactic symptoms (FA/A?), 16 who had IgE-mediated CMPA and presented with anaphylaxis (FA/A+) (a total of 41 FA cases), and a control group consisting of 29 children without FA. The study was conducted by performing CD4+CD25+CD127loFOXP3+ cell flow cytometric analysis during resting at least 2 weeks after the elimination diet to FA subjects. Results: When the FA group was compared with healthy control subjects, CD4+CD25+CD127loFOXP3+ cell rates were found to be significantly lower in the FA group (p < 0.001). When the FA/A? and FA/A+ groups and the control group were compared in terms of CD4+CD25+CD127loFOXP3+ cell ratios, they were significantly lower in the FA/A? and FA/A+ groups compared to the control group (p < 0.001). Conclusions: Although there was no significant difference between the FA/A+ group and the FA/ A? group in terms of CD4+CD25+CD127loFOXP3+ cells, our study is important, as it is the first pediatric study we know to investigate whether CD4+CD25+CD127loFOXP3+cells in FA p redict anaphylaxis.Öğe Characteristics of the patients followed with the diagnosis of common variable immunodeficiency and the complications(Termedia Publishing House Ltd., 2019) Erdem, Semiha Bahçeci; Gülez, Nesrin; Genel, Ferah; Karaman, Sait; Nacaro?lu, Hikmet TekinIntroduction: In this study, we aimed to retrospectively evaluate the clinical and laboratory findings and complications of 28 common variable immunodeficiency (CVID) patients. Material and methods: The clinical features and laboratory data of 28 CVID patients were evaluated. Results: Nineteen patients were male. In 53.5% of the cases, complications included inflammatory bowel disease, cytopenia, bronchiectasis, granulomatous lymphocytic interstitial lung disease (ILD) and asthma. In their immunological evaluations, IgG, IgM, and IgA mean values were 474.8 ±214.1 mg/dl; 56.7 ±41.9 mg/dl; 35.3 ±58.2 mg/dl, respectively, and the vaccine response was positive in 64.2% of the cases. In all age groups, absolute lymphocyte counts, naive (CD19+IgD+27-), nonswitch (CD19+IgD-27+) memory B cells were numerically higher when compared to the data of healthy children; however, although switch memory (CD19+IgD+27+) B cells were proportionally low in the 4-8 and 12-18 age groups, they were low both numerically and proportionally in the 8-12 age group. No statistically significant difference was found between the cases with complications and without complications. But the cases with pulmonary complications were compared within the group, the CD8 ratio was high but the IgA level was low in patients with bronchiectasis and CD3 was numerically and proportionally low in the cases with ILD compared to others. According to the Paris classification, 11/27 (40.7%) of the cases, 3/27 (11.1%) of them and 13/27 (48.2%) of them were evaluated as MB0, MB1, and MB2, respectively. Conclusions: In genetic studies, TACI (trans-membrane activator and calcium-modulating cyclophilin ligand interactor – TNFRSF13B) mutation was found positive in 25% of the cases.Öğe Effects of anatolian propolis and hypertonic saline combination nasal spray on allergic rhinitis symptoms: a prospective, multicenter study(2024) Cingi, Cemal; Bayar Muluk, Nuray; Çukurova, İbrahim; Dündar, Rıza; Osma, Üstün; Bal, Cengiz; Zirek, Alaattin; Budak, Ali; Resuli, Ali Seyed; Selimoğlu, Asif; Tanuğur Samancı, Aslı Elif; Karaoğullarından, Ayşe; Yılmaz, Begüm; Arslan, Bengi; Sizer, Bilal; Cihan, Celalettin; Koca, Çiğdem Fırat; Avcı, Deniz; Aydenizöz, Doğukan; Ünver, Ethem; Alaskarov, Elvin; Gülmez, Emrah; Gündoğan, Fatih; Günay, Gözde; Çetiner, Hasan; Güngör, Hilal; Salcan, İsmail; Gündoğan, Mahmut Emre; Akbay, Makbule Özlem; Akdağ, Mehmet; Kaplama, Mehmet Erkan; Yaşar, Mehmet; Koparal, Mehtap; Kar, Murat; Altıntaş, Mustafa; Torun, Mümtaz Taner; Bozan, Nazım; Sarı, Neslihan; Susaman, Nihat; Küçük, Nurten; Erdoğan, Osman; Gül, Osman; Sancaklı, Özlem; Kundi, Pınar; Budak, Rezzan Okyay; Karaman, Sait; Taşar, Soner; Demir, Songül; Belli, Şeyda; Yağcı, Tarık; Bilici, Taylan; Çelik, Turgut; Yıldırım, Yavuz Sultan Selim; Atayoğlu, Ali Timuçin; Irkan, Reşat Kubilay; Zorlu, Duygu; Can, DemetObjectives: This study aimed to evaluate how Rhinapi nasal spray affects symptoms of allergic rhinitis. Methods: In this prospective, multicenter, observational study, 10,000 patients (comprising 5028 males and 4972 females) exhibiting symptoms of allergic rhinitis (namely, nasal discharge, sneezing, nasal itching, and nasal obstruction) from different centers in different regions of Turkey were enrolled in the study between March 2022 and March 2023. All the patients wanted to participate in the study and were administered Rhinapi one puff to each nostril three times a day, for a period of 3 weeks. Total symptom scores, quality of life (QoL) scores, and otolaryngological examination scores were evaluated before and 3 weeks after treatment. Results: The scores for discharge from the nose, sneezing, nasal pruritus, and blockage of the nose all indicated improvement when compared to pre-medication and post-medication. This difference achieved statistical significance (P < .001). The mean total symptom score fell following treatment (P < .001): whilst the score was 11.09 +/- 3.41 before administering Rhinapi; after administration, the average score was 6.23 +/- 2.41. The mean QoL scores also altered after medication (P < .001), improving from a mean value of 6.44 +/- 1.55 to a mean of 7.31 +/- 1.24. Significant improvement was also noted in the scores for conchal color and degree of edema after the treatment had been administered (P < .001). Conclusion: The study demonstrates that Rhinapi nasal spray decreases total symptom scores, and results in improved QoL and otolaryngological examination scores. Propolis spray may be recommended for patients with allergic rhinitis alongside other treatments.Öğe Inherited classical and alternative pathway complement deficiencies in children: A single center experience(Shiraz University of Medical Sciences, 2018) Genel, Ferah; Bahçeci Erdem, Semiha; Gülez, Nesrin; Karaman, Sait; Nacaro?lu, Hikmet Tekin; Skattum, Lillemor; Truedsson, LennartBackground: Primary complement deficiencies are rare diseases. Objective: To retrospectively evaluate the clinical and laboratory findings and complications of patients to increase awareness of pediatricians about complement deficiencies, which are rarely encountered. Methods: In this study, the clinical and immunological characteristics of 21 patients who consulted the Immunology Department of our hospital between 2003 and 2017 and were diagnosed with classical or alternative pathway complement deficiency were obtained from the file records. Results: Ten patients with C1 inhibitor deficiency, four patients with factor I deficiency, three patients with properdin deficiency, two patients with C8 deficiency, one patient with C1q deficiency, and one patient with C4B deficiency were assessed. The mean age of the patients at diagnosis was 11.4±4.7 years, the age of onset of symptoms was 7.9±3.9 years, and the follow-up period was 6.7±3.9 years. Fourteen cases had a similar medical history in the family. All patients with C1q, factor I, properdin, C8, and C4B deficiencies presented with an infection, and vasculitic rash was present in two patients with factor I deficiency. In addition, immune complex glomerulonephritis was present in one patient with factor I deficiency. Meningococcal, Haemophilus influenzae type B, and pneumococcal vaccines were administered and prophylactic antibiotic treatment was initiated in all patients except patients with C1 inhibitor deficiency. Conclusions: Early diagnosis of complement deficiencies can facilitate prevention of life-threatening complications such as severe bacterial infections by considering prophylactic antibiotics and vaccines. In patients with C1 inhibitor deficiency, achieving an acurate early diagnosis will assist in the management and timely treatment of life-threatening attacks such as upper airway obstruction and improve outcomes.Öğe Markers of inflammation and tolerance development in allergic proctocolitis(Sociedad Argentina de Pediatría, 2018) Nacaroğlu, Hikmet Tekin; Bahçeci Erdem, Semiha; Durgun, Ersin; Karaman, Sait; Erdur, Cahit Barış; Ünsal Karkıner, Canan Şule; Can, DemetBackground. Today, as a result of an increase in the frequency of food protein-induced allergic proctocolitis (FPIAP), there is a need for studies not only to enlighten the pathophysiology of the disease but also to determine simple, non-invasive markers in both diagnosis, and evaluation of the development of tolerance. No study has been found in the literature about the place of neutrophil/ lymphocyte ratio (NLR) and mean platelet volume (MPV), which are easy to calculate and non-invasive markers. Objectives. The purpose is to determine the relation between NLR and MPV with the diagnosis and development of tolerance in children with FPIAP. Methods. In this retrospective cross-sectional study, clinical, demographic symptoms and laboratory findings of patients, monitored with FPIAP diagnosis in allergy and gastroenterology clinics, were acquired from the patient record system. Hemogram values at the time of diagnosis were compared with the values of healthy children of the same age and gender. Results. Among 59 patients diagnosed with FPIAP, males constitute 47.4% and females constitute 52.6%. MPV and platelet crit (PCT) values were significantly high when compared to the control group (n:67) in FPIAP cases (p <0.001). Also, MPV and PCT values were significantly high in non-tolerance developing cases when compared to developing ones (p=0.01). Conclusions. Contrary to NLR, MPV and PCT values have been considered to be good markers in predicting prognosis in cases with FPIAP since they are quick, cost effective and easy to calculate.Öğe Nadir bir anafilaksi nedeni: Soğuk maruziyeti(Dr Behçet Uz Çocuk Hastalıkları ve Cerrahisi, 2018) Topal, Sevgi; Bahçeci, Semiha; Karaman, Sait; Nacaroğlu, Hikmet Tekin; Karkıner, Canan Sule; Can, DemetFiziksel ürtikerin bir formu olan soğuk ürtikeri, cildin soğuk ile teması sonrası mast hücrelerinden histamin ve diğer proinflamatuvar mediatörlerin salınımı ile oluşmaktadır (1). Tüm fiziksel ürtikerler arasında soğuk ürtikeri semptomatik dermografizmden sonra ikinci sıklıktadır (2,3). Soğuğa maruziyet histamin ve diğer proinflamatuvar mediyatörlerin salınımı ile ürtiker ve/veya anjioödem gelişimine neden olabilmektedir (2,4). Tipik olarak soğuk hava, soğuk sıvı ve nesneler ile temas sonrası dakikalar içinde semptomlar ortaya çıkmaktadır. Semptomların ortaya çıkması 2 saate kadar uzayabilir (3). Deri temas yüzeyi daha geniş olduğunda (soğuk suda yüzme vb.) jeneralize ürtiker, dispne, taşikardi, hipotansiyon, bilinç kaybı gibi yaşamı tehdit edebilen sistemik reaksiyonlar gelişebilmektedir (4). Genellikle yalnızca deriyle temas eden bölgede bulgu verir. Semptomların ortalama süresi 4,8-7,9 yıl arasında değişmektedir (3). Soğuk ürtiker sıklığı yaklaşık %0,05 olarak tahmin edilmektedir (3,5). Fiziksel ürtiker çeşitleri içindeki oranı coğrafik özelliklere bağlı olarak değişebilmekte ve sıklığı %5,2 - %33,8 arasındadır (5). Çocuklarda soğuk ile tetiklenen anaflaksi ise çok nadirdir ve literatürde olgu sunumu şeklinde yer almaktadır. Aşağıda soğuk su ile anaflaksi gözlenen iki çocuk olgu sunulmuştur.Öğe Yumurta allerjisi olan olgularda kızamık-kızamıkçık-kabakulak aşılaması öncesi aşı ile deri prick testi gerekli mi? Aşı güvenle yapılabilir mi?(Dr. Behçet Uz Çocuk Hastalıkları ve Cerrahisi, 2017) Bahçeci, Semiha; Nacaroğlu, Hikmet Tekin; Arı, Hatice Feray; Karaman, Sait; Karkıner, Canan Şule; Toprak Kanık, Esra; Can, DemetAmaç: İçerisinde yumurta proteini bulunan kızamık-kızamıkçık-kabakulak aşısının (KKK) yumurta alerjisi olan hastalarda doğrudan uygulanması önerilmesine karşın literatürde aşı uygulaması sırasında anaflaksi gözlenen olguların bulunması nedeniyle bu konu hem hekim hem de ailelerde sıkıntılara neden olmaktadır. Bu çalışmada, kliniğimizde yumurta alerjisi nedeniyle izlenen, KKK aşı uygulanmış hastalarda aşı sonrası reaksiyon sıklığının ve aşı uygulaması öncesi aşı ile deri prick test uygulamasının gerekliliğinin değerlendirilmesi amaçlanmıştır.Yöntem: Retrospektif kesitsel çalışmamızda Eylül 2013-Mayıs 2015 tarihleri arasında yumurta alerjisi tanısı ile izlenip, KKK aşısı uygulanmış olan 82 hasta değerlendirildi. Bulgular: Tanı anında yaş ortalaması 8,34±7,1ay olan 82 hastanın %37,8'i (n=31) kız idi. Tanısal dağılımına göre hastalar değerlendirildiğinde, %68,3'ü (n=56) atopik dermatit, %8,5'i (n=7) ürtiker/anjioödem, %18,3'ü (n=15) reaktif havayolu hastalığı, %4,9'u (n=4) anafilaksi olarak değerlendirilmişti. KKK aşı uygulaması öncesi %21'ine (n=17) aşı ile deri prick test uygulanmıştı. Anafilaksi tanısı ile izlenen 2 olgu dışında aşı tam doz yapılmış olup, olguların hiçbirinde KKK aşısı uygulaması sonrasında reaksiyon gözlenmemişti. Sonuç: Yumurta alerjili hastalarda KKK aşısı sonrası herhangi bir reaksiyon gözlenmemiştir. Bu hastalarda diğer sağlıklı çocuklardan farklı reaksiyonlar gözlemediğimiz için KKK aşısının diğer aşıların yapıldığı merkezlerde, aşı ile teste ve bölünmüş dozlara gerek kalmadan uygulanmasında sakınca olmadığını düşünüyoruz.
