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Öğe Comparison of the "ProDect BCS RV CHIP" assay with the combination of shell vial cell culture and immunofluorescence antibody test for the detection of respiratory viruses(Elsevier Science Bv, 2007) Cicek, Candan; Gulen, Figen; Karatas, Eylem; Demir, Esen; Tanac, Remziye; Bacakoglu, Feza; Bilgic, AltinayIn the present study, a multiplex reverse transcriptase polymerase chain reaction combined with a chip hybridization assay (ProDect BCS RV CHIP) was evaluated as an alternative to the combination of immunofluorescent antibody test and shell vial cell culture considered as gold standard for the detection of respiratory viruses. Among 100 specimens, 40 were positive using the combination of immunofluorescent antibody test and shell vial cell culture assay in which 9 of them were infected by two different viruses (27 parainfluenza virus type 3, 10 adenovirus, 9 respiratory, syncytial virus. 2 influenza type B, and 1 influenza type A). ProDect BCS RV CHIP detected only 10 positive specimens in which one of them was infected by two different viruses (5 respiratory syncytial virus, 3 parainfluenza virus type 3, 2 adenovirus, and I influenza virus type B). The sensitivity. specificity, PPV. NPV and diagnostic accuracy of ProDect BCS RV CHIP were 25.0%, 100%, 100%, 66.6%, and 70.0%, respectively, compared to the combination of shell vial cell culture and immunofluorescent antibody test. As a result, the specificity of ProDect BCS RV CHIP is high. however. the sensitivity (25%) of the assay is not sufficient for routine laboratory use. (C) 2007 Elsevier B.V. All rights reserved.Öğe Cut-Off Values of Specific IgE and Skin Prick Test to Predict Oral Food Challenge Positivity in Children with Cow's Milk Allergy(AVES, 2022) Gunaydin, Nursen Cigerci; Akarcan, Sanem Eren; Gulen, Figen; Bal, Cem Murat; Tanac, Remziye; Atasever, Mesude; Demir, EsenObjective: The cut-off values for the skin prick test diameters and cow's milk-specific IgE measurements are used to predict the result of the oral food challenge test for the diagnosis of cow's milk allergy. This study aimed to determine the diagnostic values of skin prick test and cow's milk-specific IgE according to age groups and compare the diagnostic powers of these 2 methods. Materials and Methods: In total, 153 children who had a preliminary diagnosis of cow's milk allergy were evaluated. Group A (n = 90) consisted of cow's milk allergy patients whose diagnosis was confirmed by a positive oral food challenge or a history of anaphylaxis. Group B (n = 63) was composed of patients with a negative oral food challenge. The demographic, clinical, and laboratory findings of 2 groups were compared. Results: The cut-off points for cow's milk-specific IgE and cow's milk-skin prick test were determined as >2.12 kUA/L and >5 mm, respectively. The area under the curve was 0.844 for cow's milk-skin prick test (sensitivity 73%, specificity 84%) and 0.745 for cow's milk-specific IgE (sensitivity 67%, specificity 86%). The diagnostic power of skin prick test was determined to be higher when compared to cow's milk-specific IgE (P=.02). According to the predicted probability curves, decision points for cow's milk-specific IgE and cow's milk-skin prick test with 95% probability were determined as follows, respectively: for <= 24 months: 22 kUA/L, 11.3 mm; for >24 months: 44.1 kUA/, 15.1 mm. The lowest cut-off value with a positive predictive value of 95% and a specificity of 96% was found in patients <1-year-old (>3.3 kUA/L) Conclusion: The use of high probability diagnostic values of communities for specific IgE and skin prick test along with a significant clinical history may provide accurate and rapid diagnosis of cow's milk allergy and facilitate patient follow-up.Öğe Early diagnosis effects the prognosis in children with atypical wheeze(Turkish Pediatrics Assoc, 2020) Severcan, Ezgi Ulusoy; Demir, Esen; Gulen, Figen; Bilgin, Raziye Burcu Guven; Tanac, RemziyeAim: Recurrent wheezing is a common problem in preschool children. It is classified into two groups because there can be many reasons for wheeze: typical and atypical. the aim of this study was to identify the general features of atypical wheezy children. Material and Methods: Three hundred two children who presented to our clinic between 2000 and 2015 for three or more wheezing attacks and were diagnosed as having an underlying disease such as bronchiectasis, foreign body aspiration, recurrent aspiration pneumonia, cystic fibrosis, bronchopulmonary dysplasia, congenital anomalies, and tuberculosis, were included in the study. Results: in this study, 127 (42.1%) girls and 175 (57.9%) boys were evaluated. the diagnostic distribution of the patients was as follows: bronchopulmonary dysplasia (21.9%), bronchiolitis obliterans (16.6%), bronchiectasis (14.5%), bronchiolitis obliterans + primary immunodeficiency (12.3%), cystic fibrosis (10.3%), bronchiectasis + primary immunodeficiency (7.9%), recurrent aspiration pneumonia (3.6%) and foreign body aspiration (3.3%), and other diseases (9.6%). Mosaic oligemia, bronchiectasis, atelectasis, bronchiolectasis, and small airway disease were the most distinct findings on high-resolution lung tomography. When the patients were evaluated clinically, radiologically, and according to pulmonary functions after an average period of 40 months, it was seen that 9.2% deteriorated, 33.9% regressed, and 56.7% remained stable. Presentation to hospital after the first attack occurred earlier in patients with bronchopulmonary dysplasia, bronchiolitis obliterans and bronchiolitis obliterans + primary immunodeficiency compared with patients with bronchiectasis, bronchiectasis + primary immunodeficiency, and cystic fibrosis. When presentation time and outcomes were evaluated, it was found that 63.4% of patients who presented to hospital early (0-6 months) and 7.5% of patients who presented late (after 5 years) had regression. Conclusion: Recurrent wheezy children must be promptly evaluated for an underlying disease. Early diagnosis and treatment influence the prognosis.Öğe Effects of Cow's Milk Components, Goat's Milk and Sheep's Milk Sensitivities on Clinical Findings, and Tolerance Development in Cow's Milk Allergy(Kare Publ, 2021) Gunaydin, Nursen Cigerci; Severcan, Ezgi Ulusoy; Akarcan, Sanem Eren; Bal, Cem Murat; Gulen, Figen; Tanac, Remziye; Demir, EsenObjective: Cow's milk (CM) contains some proteins capable of causing an allergic reaction in a sensitized individual and one of the most common causes of food allergy in childhood. Most of the patients will develop tolerance by the age of 3. In this study, we aimed to evaluate sensitivity to CM allergen components as well as goat's milk (GM) and sheep's milk (SM) cross reactions in cow's milk allergic (CMA) patients and to figure out the risk factors for tolerance non-development. Methods: This is a retrospective cross-sectional study including 66 patients for IgE-mediated CMA with mean age of 38 months. We evaluated the patients in two groups: Group 1 (n=50): Patients who have no tolerance in oral food challenge test; Group 2 (n= 16): Patients who were found tolerant to CM after elimination diet. CM-sIgE, alpha-lactalbumin (ALA)-sIgE, beta-Lactoglobulin (BLG)-sIgE, casein (CAS)-sIgE, GM-sIgE, and SM-sIgE, skin prick tests with CM and GM, and eosinophils in peripheral blood were all compared between two groups. Results: In the whole group, GM-sIgE and SM-sIgE were positive in 84.8% and ALA-sIgE, BLG-sIgE, and CAS-sIgE were positive in, respectively, 69.7%, 62.7%, and 77.3% of the patients. Two groups were similar in terms of age at onset and diagnosis, gender, median elimination period, total IgE levels, CM-sIgE, and eosinophilia (p>0.05). Mean wheal diameters of CM and GM in SPT (p<0.001), GM-sIgE (p=0.03), and SM-sIgE (p=0.01) were significantly higher in Group 1. There was a positive correlation between CM-sIgE and total IgE (p=0.001), eosinophilia percentage (p=0.04), CM wheal diameter in SPT (p=0.001), CAS-sIgE (p<0.001), GM-sIgE (p<0.001), and SM-sIgE (p<0.001) in Group 1. Patients with respiratory symptoms and history of anaphylaxis had higher CM-SPT, CM-sIgE, CAS-sIgE, GM-sIgE, and SM-sIgE (p<0.05) levels. Gastrointestinal and skin symptoms showed no relation with laboratory findings. Tolerance was not developed in any patient with a history of anaphylaxis. Conclusions: As with CM-sIgE levels and high induration diameters in SPT, high CAS-sIgE, SM-sIgE, and GM-sIgE levels are also risk factors for persistence of CMA; anaphylaxis, as a first reaction, may also be a risk factor. High CM-sIgE, CAS-sIgE, SM-sIgE, and GM-sIgE levels are associated with respiratory symptoms.Öğe Effects of volatile substance abuse on the respiratory system in adolescents(Novamedia, 2011) Buker, Halime S. C.; Demir, Esen; Yuncu, Zeki; Gulen, Figen; Midyat, Levent; Tanac, RemziyeAim: Inhalant abuse is a prevalent and often overlooked form of substance abuse in adolescents. Chronic inhalant abuse can damage respiratory, cardiac, renal, hepatic, and neurologic systems. This study aims to determine the physiologic effects of inhaling solvents on the respiratory functions. Methods: The general health status of the subjects was assessed by history taking, physical examination and a questionnaire which was designed to show the severity of respiratory symptoms. Spirometry, ventilation/perfusion scintigraphy, and high resolution computed tomography (HRCT) were performed to assess pulmonary functions and anatomy. Results: Thirty-one male volatile substance abusers and 19 control subjects were included in the study. The mean age of onset of inhalant use was 14.6 +/- 2.2 (9-18) years and duration of drug use was 3.7 +/- 1.7 years. The most common respiratory symptoms in volatile substance abusers were nasal congestion (45.2%), sputum (38.7%), exercise intolerance (32.3%) and cough (22.6%). Results of spirometric studies showed 12 (41.4%) subjects with low FVC values < 80% of predicted, indicative of restrictive ventilatory pattern in the study group. Although the difference was not statistically significant, restrictive ventilatory pattern was higher in the study group. There was no statistically significant correlation between restrictive ventilatory pattern and the age of onset/duration/frequency of inhalant abuse, respiratory symptoms and scintigraphic abnormalities. Subjects who had restrictive pattern in their pulmonary function tests were more likely to have abnormal findings at HRCT (p < 0.01). Conclusion: This study has shown a positive correlation between volatile substance abuse and the development of restrictive ventilatory pattern, but more comprehensive studies are needed for more precise conclusions.Öğe Efficacy of pollen immunotherapy in seasonal allergic rhinitis(Wiley, 2007) Can, Demet; Tanac, Remziye; Demir, Esen; Gulen, Figen; Veral, AliBackground:The efficacy of subcutaneous pollen immunotherapy has been documented in published double-blind, placebo-controlled studies related to treatment of seasonal allergic rhinitis. In the present study, subjective (symptom scores) and objective (nasal peak inspiratory flow, nasal smear, nasal biopsy) parameters were used to study the efficacy of pollen immunotherapy. Methods: Forty-eight patients (32 male), mean +/- SE age 13.6 +/- 2.8 years allergic to grass-pollen participated in the present study. Patients were divided into three groups: group I, 24 patients who did not receive pollen immunotherapy; group II, 12 patients who received the build-up phase of pollen immunotherapy; and group III, 12 patients who had just finished pollen immunotherapy. With regard to objective and subjective parameters these three groups were compared. Results:When group I was compared to groups II and III, the patients who had not received any immunotherapy were found to have a high daytime nasal symptoms score (P < 0.01), high daytime eye symptoms score(P < 0.01) and high night-time symptoms score (P < 0.01). In objective parameters, it was found that group I had low nasal peak inspiratory flow (P < 0.05), and a high eosinophil count in nasal smears (P < 0.05) and peripheral blood (P < 0.05). It was also demonstrated that there was an increased eosinophil infiltration (P < 0.01) and mast cell infiltration (P < 0.05) in nasal biopsy in group I. There was no significant difference between group II and group III according to these results (P > 0.05). Conclusions: Immunotherapy leads to a better clinical and histopathological prognosis in children with seasonal allergic rhinitis.Öğe Eponym - Scimitar syndrome(Springer, 2010) Midyat, Levent; Demir, Esen; Askin, Memnune; Gulen, Figen; Ulger, Zulal; Tanac, Remziye; Bayraktaroglu, SelenScimitar syndrome is a rare congenital anomaly, characterized by partial or complete anomalous pulmonary venous drainage of the right or left lung into the inferior vena cava. The syndrome is commonly associated with hypoplasia of the right lung, pulmonary sequestration, persisting left superior vena cava, and dextroposition of the heart. The pathogenesis of the syndrome is unclear, but it seems to originate from a basic developmental disorder of the entire lung bud early in embryogenesis. Two main forms of scimitar syndrome have been described. Signs and symptoms can start during infancy (infantile form) or beyond (childhood/adult form). The infantile form generally presents within the first 2 months of life with tachypnea, recurrent pneumonia, failure to thrive, and signs of heart failure. The diagnosis of scimitar syndrome is usually made based on the characteristic chest X-ray films and can be confirmed by angiography; however, it is now done mostly by transthoracic or transesophageal echocardiography, noninvasive computed tomography, or magnetic resonance angiography. Fetal echocardiography using three-dimensional power Doppler imaging permits prenatal diagnosis. Most frequently, patients are asymptomatic in the absence of associated abnormalities and can be followed conservatively. For patients with congestive heart failure, repeated pneumonia, or pulmonary-to-systemic blood flow ratios greater than 1.5 and pulmonary hypertension, it is important to reroute the anomalous right pulmonary veins and repair the associated cardiac defects in order to avoid progression to right ventricular failure. The triad of respiratory distress, right lung hypoplasia, and dextroposition of the heart should alert the clinician to think of scimitar syndrome.Öğe The Fc gamma RIIa polymorphism in Turkish children with asthma bronchial and allergic rhinitis(Pergamon-Elsevier Science Ltd, 2007) Gulen, Figen; Tanac, Remziye; Altinoz, Serdar; Berdeli, Afig; Zeyrek, Dost; Koksoy, Huseyin; Demir, EsenObjective: The aim of the present study was to evaluate the Fc gamma RIIa polymorphism in Turkish children with atopic asthma and allergic rhinitis. Design and methods: In this study, 372 atopic children (192 asthma bronchial, 180 allergic rhinitis) between ages of 5 and 16 years old (11.3 +/- 2.9) who were followed at Aegean University Paediatric Allergy and Pulmonology Outpatient Clinics and 234 healthy subjects as the control group were included. The evaluation of subjects included routine biochemical blood analysis and allergic workup based on the following laboratory determinants. The Fc gamma RIIa polymorphism was determined using the polymerase chain reaction method. Results: Distribution of RI 3 1 R genotype was significantly different among patient groups compared to controls (for asthmatic children OR: 2.64 95%CI: 1.22-5.79, p=0.006; for allergic rhinitis OR: 2.58 95%CI: 1.18-5.71, p=0.009). Frequency of 131R allele was significantly different among patient groups compared to controls (for asthmatic children OR: 1.66 95%CI: 1.22-2.26, p=0.0007; for allergic rhinitis OR: 1.93 95%CI: 1.42-2.63, p=0.00001). Conclusion: This study shows that Fc gamma RIIa gene 131R allele represents an important genetic risk factor for bronchial asthma and allergic rhinitis susceptibility. (c) 2007 Published by The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.Öğe Fc gamma RIIIa-V/F 158 polymorphism in Turkish children with asthma bronchiale and allergic rhinitis(Blackwell Publishing, 2008) Zeyrek, Dost; Tanac, Remziye; Altinoz, Serdar; Berdeli, Afig; Gulen, Figen; Koksoy, Huseyin; Demir, EsenFc receptors (FcR) play an important role in immune regulation. This might be linked to the variability in immune response, therefore relating to the pathogenesis of atopic diseases. The aim of the present study was to evaluate the Fc gamma RIIIa gene polymorphism in Turkish children with asthma and allergic rhinitis. The study included 364 atopic children (184 bronchial asthma, 180 allergic rhinitis) and 234 healthy subjects as the control group, aged between 5 to 16 years. Patients were recruited from outpatient clinics of allergy and general pediatric care. Plasma IgE concentrations were measured by immunoassays and skin prick test was done in children with atopic diseases. The Fc gamma RIIIa gene polymorphism was determined using the polymerase chain reaction method. Distribution of V158V genotype was significantly different among patient groups compared to controls (for asthmatic children OR: 5.33, 95% CI: 2.80-10.23, p < 0.001; for allergic rhinitis OR: 3.25, 95% CI: 1.75-6.07, p = 0.001). Distribution of 158 V allele was significantly different among asthmatic children (OR: 2.20, 95% CI: 1.65-2.92, p < 0.001) and allergic rhinitis patients (OR: 1.77, 95% CI: 1.32-2.35, p < 0.001) compared to healthy controls. Our study shows that the V158V genotype in Fc gamma RIIIa gene polymorphism may be a genetic risk factor for the development of atopic diseases.Öğe Identifying wheezing phenotypes in a pediatric Turkish cohort(Taylor & Francis Ltd, 2022) Severcan, Ezgi Ulusoy; Bal, Cem Murat; Gulen, Figen; Tanac, Remziye; Demir, EsenObjective Characterization of wheezing phenotypes in children might help to identify the underlying mechanisms through which asthma occurs. In our study, we aimed to describe wheezing phenotypes in Turkish children and to identify risk factors according to phenotypes. Methods 651 wheezy children were evaluated and 5 wheezing phenotypes were described according to age of onset, atopy and persistence at 6 years of age and risk factors were identified. Results Distribution of wheezing phenotypes was transient early wheeze (TEW)(34.9%) non-atopic wheeze (NAW) (18%), atopic wheeze (AW) (22.3%), intermediate onset wheeze (IOW) (11.1%), late onset wheeze (LOW) (11.7%). LOW, AW, and IOW were associated with, father's, sibling's and family's atopy (p:0.001) whereas LOW and AW were associated with mother's asthma and atopy as well as family's asthma (p < 0.05). Atopic dermatitis and allergic rhinitis were common of patients with LOW, AW, and IOW (p < 0.05). Infection was the major trigger for TEW and NAW whereas multiple triggers were common of AW, LOW, and IOW. Allergens were mostly associated with AW, IOW and LOW. Aeroallergen-specific IgE positivity was mostly with AW, IOW, and LOW phenotype. Skin prick tests showed multiple allergen sensitivity in IOW, LOW groups and mostly single allergen in AW phenotype. Modified asthma predictive index (mAPI) positivity was high in all groups except TEW and NAW. Conclusions With this study we classified five wheeze phenotypes and found that atopy and family's atopy history, maternal asthma were strongly associated with AW, LOW, and IOW phenotypes which were usually effected by allergens or multiple triggers.Öğe Is the usage of intranasal glucocorticosteroids alone in allergic rhinitis sufficient?(Ocean Side Publications Inc, 2006) Can, Demet; Tanac, Remziye; Demir, Esen; Gulen, Figen; Veral, AliRecently, it is claimed that the usage of the intranasal glucocorticosteroids alone, instead of H-1-antihistamines + intranasal glucocorticosteroids, reduces the complaints in moderate-to-severe seasonal allergic rhinitis (SAR). This study aims to evaluate the efficacy of the intranasal glucocorticosteroids alone during the pollen season by using objective and subjective parameters. Twenty-four patients (mean age, 12.17 +/- 2.26 years) with SAR sensitive to pollen are included in this study. The patients were divided into two groups randomly. Twelve patients in group I were given H-1-antihistamine (loratadine) + intranasal glucocorticosteroid (mometasone furoate), and 12 patients in group II were given only intranasal glucocorticosteroid (mometasone furoate) for 12 weeks. To evaluate the results, subjective parameters (daytime nasal symptoms score, daytime eye symptoms score, and nighttime symptoms score) and objective parameters (nasal smear, nasal peak inspiratory flow [NPIF], and nasal biopsy) are used. With regard to the baseline data, it was observed that both groups had a significant decrease in total symptom score (p < 0.01), a significant increase in NPIF values (p < 0.01), and a significant decrease in the number of eosinophils in both nasal smear and biopsy (p < 0.01) after treatment. Comparing groups I and II in terms of treatment success, the improvement in daytime nasal symptoms score (p < 0.01 versus p < 0.01), daytime eye symptoms score (p < 0.01 versus p < 0.01), and total symptom score (p < 0.versus p < 0.01) was not different. However, there was a significant improvement in nighttime symptoms score between groups I and II (p < 0.01 versus p > 0.05). Furthermore, NPIF and nasal biopsy findings did not differ between groups (p > 0,05). The usage of H-1-antihistamine + intranasal glucocorticosteroid has no superiority over the administration of intranasal glucocorticosteroid alone for treatment of SAR in pollen season. However, this finding needs to be confirmed in larger series studies.Öğe A multi-center survey of childhood asthma in Turkey - I: The cost and its determinants(Wiley, 2009) Beyhun, Nazim E.; Soyer, Ozge U.; Kuyucu, Semanur; Sapan, Nihat; Altintas, Derya U.; Yuksel, Hasan; Anlar, Fehmi Y.; Orhan, Fazil; Cevit, Oemer; Cokugras, Haluk; Boz, Aysen B.; Yazicioglu, Mehtap; Tanac, Remziye; Sekerel, Buelent E.Successful management of childhood asthma requires a thorough idea of the economic impact of asthma and its determinants, as policy makers and physicians inevitably influence the outcome. The aim of this study was to define the cost of childhood asthma in Turkey and its determinants. In April 2006, a multi-center, national study was performed where data regarding cost and control levels were collected. Asthmatic children (6-18 yr) with at least a 1-yr follow-up seen during a 1-month period with scheduled or unscheduled visits were included. The survey included a questionnaire-guided interview and retrospective evaluation of files. Cost and its determinants during the last year were analyzed. A total of 618 children from 12 asthma centers were surveyed. The total annual cost of childhood asthma was US$1597.4 +/- 236.2 and there was a significant variation in costs between study centers (p < 0.05). Frequent physician visits [odds ratio (95% confidence intervals)] [2.3 (1.6-3.4)], hospitalization [1.9 (1.1-3.3)], asthma severity [1.6 (1.1-2.8)], and school absenteeism due to asthma [1.5 (1.1-2.1)] were major predictors of total annual costs (p < 0.05 for each). The comparable cost of asthma among Turkish children with that reported in developed countries suggests that interventions to decrease the economic burden of pediatric asthma should focus on the cost-effectiveness of anti-allergic household measures and on improving the control levels of asthma.Öğe One case, two "firsts": first successful double lung and first pediatric lung transplantation in Turkey(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2010) Oezbaran, Mustafa; Turhan, Kutsal; Yagdi, Tahir; Guelen, Figen; Oezcan, Coskun; Engin, Cagatay; Midyat, Levent; Cagirici, Ufuk; Nart, Deniz; Nalbantgil, Sanem; Demir, Esen; Tanac, Remziye; Askar, FatmaWe report the first successful double-lung transplantation in all age groups as well as the first lung transplantation in the pediatric age group in our country. A 14-year-old male who was oxygen dependent for the last three years was diagnosed with septic lung disease and bronchiolitis obliterans. He was followed-up by the "heart and lung transplantation group" of our hospital for approximately one year under non-invasive mechanical ventilatory support while on the lung transplantation waiting list. A sequential double lung transplantation was performed on April 08, 2009. He is now on his 11th month postoperatively and is healthy.Öğe Oral and dental manifestations of young asthmatics related to medication, severity and duration of condition(Blackwell Publishing, 2006) Ersin, Nazan Kocatas; Gulen, Figen; Eronat, Nesrin; Cogulu, Dilsah; Demir, Esen; Tanac, Remziye; Aydemir, SohretBackground: The aim of this study was to investigate the caries risk of asthmatics in relation to dental plaque indices, salivary flow rate, pH and buffer capacity, saliva composition and salivary levels of Streptococcus mutans compared with healthy subjects and also to evaluate these parameters within different groups of asthmatics according to their medication, duration and severity of the disease. Methods: The study group composed of 106 asthmatics and 100 healthy controls with the same age and social background aged between 6 and 19-years-old. For dental examinations, World Health Organization criteria and for plaque indices the Silness and Loe plaque index was used. All data were analyzed using t-test, chi(2)-test, Spearman rank correlation, Kruskal- Wallis, Mann-Whitney U-tests and Logistic Regression Anaylsis with Forward Stepwise Likelihood ratio method. Results: A statistically significant decrease in the salivary flow rate and pH were found in the asthmatic group. The children in the asthmatic group aged between 6 and 10 years had significantly higher caries prevalence compared with the control group at the same age. There was a negative correlation between the duration of medication and the salivary pH and a positive correlation between duration of illness and the salivary levels of S. mutans in the asthmatics. Conclusions: It was found that asthma, through its disease status and its pharmacotherapy, carries some risk factors including decreased salivary flow rate and pH for caries development. It was also demonstrated that the duration of medication and illness had significant influences on the risk of caries in asthmatics.Öğe Oral Immunotherapy for Cow's Milk Allergy: Five Years' Experience from a Single Center in Turkey(Galenos Yayincilik, 2020) Demir, Esen; Gunaydin, Nursen Cigerci; Gulen, Figen; Tanac, RemziyeBackground: Oral immunotherapy for cow's milk allergy is an effective treatment option because of its ability to increase the threshold for clinical reactions. Aims: To present our experience of oral immunotherapy for cow's milk allergy in the pediatric allergy outpatient clinic, and to evaluate the long-term efficacy of oral immunotherapy and risk factors for adverse reactions during oral immunotherapy. Study Design: Single-center retrospective cohort study. Methods: Forty-two patients with Immunoglobtilin-E-mediated cow's milk allergy who complied with the oral immunotherapy protocol were evaluated in this study. the treatment consisted of a rapid escalation phase with an oral food challenge step that included milk doses. During the build-up phase, increasing quantities of cow's milk were administered until the patient was able to consume 200 mL of cow's milk daily. Results: the mean age of starting the oral immunotherapy was 40.2 +/- 3.2(range. 36-156) months. and 54.8% (n=23) of the patients were males. the mean duration of the build-up phase was 18.1 +/- 5.6 (range. 9-41) weeks, and the mean maintenance phase was 29.1 +/- 11.6 range. 12-63) months. During the oral immunotherapy, 36 adverse reactions (78% mild and 22%; moderate) occurred in 16 (38%) patients. There were no differences in the age of starting the oral immunotherapy (p=0.19), cow's milk-specific Immunoglobulin-F, levels (p=0.17), and cumulative provocative doses of oral food challenges (p=0.78) between the mo groups of patients with and without adverse reactions. the wheal diameters to cow's milk were higher in the group with adverse reactions (p=0.03). There was no difference in the oral immunotherapy onset age between patients with and without a history of anaphylaxis (p=0.38). the patients with a history of anaphylaxis had more adverse reactions (p-0.04) and a higher number of reactions during the oral immunotherapy (p=0.01), and a higher mean duration of the up-dosing phase (p=0.04) compared with patients without anaphylaxis. Conclusion: Oral immunotherapy is a treatment option in patients with cow's milk allergy because of its high efficacy. Adverse reactions occur in about 40% of cases and are mostly mild. It should be administered with caution to patients with a history of anaphylaxis and a higher wheal diameter to cow's milk in the skin prick test.Öğe Parainfluenza type 3 outbreaks in Izmir children, Turkey(Royal Soc Medicine Press Ltd, 2007) Guelen, Figen; Gcek, Candan; Kurugol, Zafer; Demir, Esen; Zeyrek, Dost; Oezdemir, Rahmi; Tanac, Remziye; Karatas, TubaThe present study was aimed to investigate characteristics of lower respiratory tract infections caused by parainfluenza type 3 viruses. Nasopharyngeal smears were taken from 178 patients with lower respiratory infections for the diagnosis of respiratory syncytial virus, adenovirus, influenza and parainfluenza viruses between December 2004 and April 2005. Parainfluenza type 3 was isolated from the viral specimens of 96 (53.9%) patients and it was noticeable that the parainfluenza type 3 outbreak occurs during winter. Obviously, improving the aetiological diagnosis of viral infections might avoid unnecessary therapy, antibiotics in particular, and would allow for preventive isolation of infected patients.Öğe Retrospective Cross-sectional Analysis of Factors Associated with Asthma in a Pediatric Cohort from Turkey(Georg Thieme Verlag Kg, 2022) Severcan, Ezgi Ulusoy; Bal, Cem Murat; Tanac, Remziye; Gulen, Figen; Demir, EsenZUSAMMENFASSUNGÖğe Scimitar Syndrome associated with partial anomalous pulmonary venous draining into superior vena cava(Springer, 2010) Demir, Esen; Askin, Memnune; Midyat, Levent; Gulen, Figen; Ulger, Zulal; Tanac, Remziye; Bayraktaroglu, SelenScimitar syndrome is a rare congenital cardiopulmonary malformation characterized by hypoplasia of the right lung and drainage of the right pulmonary veins into the vena cava inferior. It may also be associated with cardiac dextroversion and anomalies of the tracheobronchial system, cardiovascular system, and diaphragm. Some cases are asymptomatic with others diagnosed in early-childhood period with pulmonary hypoplasia and other associated malformations. We present here a patient whose venous return of the middle and lower lobes of the right lung is into the superior vena cava, which is a very unusual finding for this disorder.Öğe A successful desensitization protocol for horse-derived antithymocyte globulin in severe aplastic anemia(Wiley, 2015) Demir, Esen; Gunaydin, Nursen Cigerci; Karadas, Nihal; Gulen, Figen; Tanac, Remziye; Yilmaz, DenizBackgroundHorse antithymocyte globulin (h-ATG) (ATGAM((R))) is the first choice of treatment in very severe patients with aplastic anemia who do not have any HLA matched sibling donor. h-ATG is a heterologous serum that may cause anaphylaxis. Alternative treatment strategies must be planned in case of hypersensitivity. Desensitization must be considered in patients without an alternative treatment of choice. We aimed to present the h-ATG desensitization protocol and consider its effectiveness in patients with aplastic anemia who are hypersensitized with h-ATG and do not have an alternative treatment of choice. MethodsSkin prick tests were performed with non-diluted solution in eight very severe patients with aplastic anemia who are followed up in Ege University Children's Hospital. Although skin prick test was found negative in these eight patients, different dilution h-ATG intradermal tests were performed and found positive in all patients. h-ATG desensitization program was started to these hypersensitized patients. ResultsDesensitization program was started to six male and two female very severe patients with aplastic anemia whose ages were between seven and 19yr (median: 12.9yr). All of the patients completed the desensitization program. While local reaction was seen in two patients, systemic reaction was seen in one patient and late reaction was seen in one patient during and after desensitization program. ConclusionA successful desensitization program with h-ATG in children with aplastic anemia is presented. Even though there is not an exposure before to such high allergy potential heterologous serum, skin tests should be performed and desensitization must be started to patients who are hypersensitized to h-ATG. As the expected effectiveness of the treatment is so much, the desensitization protocol can be carried out safely and effectively with trained stuff although allergic reactions can be seen.Öğe A successful desensitization protocol for horse-derived antithymocyte globulin in severe aplastic anemia(Wiley, 2015) Demir, Esen; Gunaydin, Nursen Cigerci; Karadas, Nihal; Gulen, Figen; Tanac, Remziye; Yilmaz, DenizBackgroundHorse antithymocyte globulin (h-ATG) (ATGAM((R))) is the first choice of treatment in very severe patients with aplastic anemia who do not have any HLA matched sibling donor. h-ATG is a heterologous serum that may cause anaphylaxis. Alternative treatment strategies must be planned in case of hypersensitivity. Desensitization must be considered in patients without an alternative treatment of choice. We aimed to present the h-ATG desensitization protocol and consider its effectiveness in patients with aplastic anemia who are hypersensitized with h-ATG and do not have an alternative treatment of choice. MethodsSkin prick tests were performed with non-diluted solution in eight very severe patients with aplastic anemia who are followed up in Ege University Children's Hospital. Although skin prick test was found negative in these eight patients, different dilution h-ATG intradermal tests were performed and found positive in all patients. h-ATG desensitization program was started to these hypersensitized patients. ResultsDesensitization program was started to six male and two female very severe patients with aplastic anemia whose ages were between seven and 19yr (median: 12.9yr). All of the patients completed the desensitization program. While local reaction was seen in two patients, systemic reaction was seen in one patient and late reaction was seen in one patient during and after desensitization program. ConclusionA successful desensitization program with h-ATG in children with aplastic anemia is presented. Even though there is not an exposure before to such high allergy potential heterologous serum, skin tests should be performed and desensitization must be started to patients who are hypersensitized to h-ATG. As the expected effectiveness of the treatment is so much, the desensitization protocol can be carried out safely and effectively with trained stuff although allergic reactions can be seen.
