Fakülteler / Faculties
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Item Which has an Influence on Mean Platelet Volume: Allergic Rhinitis or Asthma?(2022) Senol, Handan Duman; Ozdogru, Emine Ece; Sancakli, Ozlem; Dogru, Mahmut; Tuncel, TubaAim: Bronchial asthma and allergic rhinitis are mediated by similar allergic inflammatory mechanisms. Platelets play a role in allergic reactions which are inflammatory processes. The mean platelet volume (MPV) is a marker of platelet activation. This study aimed to investigate MPV value differences between children with allergic rhinitis during symptomatic or asymptomatic periods to determine whether MPV is a useful indicator of inflammation in allergic rhinitis. Materials and Methods: The records of those patients with allergic rhinitis were analyzed retrospectively. Patients over two years of age who had complete blood count results from both their asymptomatic and the symptomatic periods were included in this study. Clinical characteristics (age, age at diagnosis, symptoms, and comorbid allergic diseases) and laboratory data (thrombocyte count, MPV, white blood cell count, eosinophil count, and percentage, immunoglobulin E level, and skin prick test results) were recorded from the patient files and the hospital registry system. Results: MPV values during the symptomatic periods were statistically significantly higher than those from the asymptomatic period (p<0.001) in all patients. When the patients were grouped according to having asthma or not, MPV was found to be higher in the symptomatic period compared to the asymptomatic period in the group with asthma, but there was no difference between these two periods in the group without asthma (p=0.017, p=0.102 respectively). Additionally, MPV levels were significantly higher in the asthma group during both the symptomatic and the asymptomatic periods (p=0.04, p=0.013, respectively). Conclusion: This study suggests that MPV cannot be used as an inflammation indicator in the symptomatic period for patients with allergic rhinitis. Asthma influences MPV values. It is recommended to conduct more detailed and prospective studies to show MPV inflammation in AR.Item Evaluation of the Impact of Environmental Changes on Asthma Control in Children, Access to Health Care, and Treatment Adherence in Early COVID-19 Lockdown(2022) Sancakli, Ozlem; Tuncel, Tuba; Akarcan, Sanem Eren; Kanik, Ali; Ozyurt, Gonca; 35383020Objective: During the coronavirus disease 2019 pandemic, lockdown measures and difficulties in accessing healthcare have impacted asthma management in children. This study aimed to determine the evaluation of the impact of environmental changes on asthma control in children, access to health care, and treatment adherence in early coronavirus disease 2019 lockdown. Materials and Methods: The study included children with asthma aged 6-11 years. A survey form was administered to the patients who visited the pediatric allergy outpatient clinic between June 1 and 30, 2020. The survey acquired demographic information about the children and their families as well as information about their asthma symptoms, how they reached healthcare services, and adherence. The childhood asthma control test was administered. The P values < .05 were considered significant. Results: The study included a total of 123 children (female/male : 48/75) with a mean age of 8.4 +/- 1.9 years. According to the mothers' self-report, it was found that 78% of the patients were not able to follow-up routinely, 19.5% were non-adherence to treatment, and 16.2% were poorly controlled asthma. It was found that, based on childhood asthma control test scores, asthma control was better during the pandemic lockdown period (P = .001). Asthma symptoms were better in 41.5% of the patients compared to the previous months and in 53.7% compared to the same period last year. Conclusion: Our study found that the children's asthma was controlled although most of them did not have their follow-up visits, and poorly controlled asthma was higher in older children in early coronavirus disease 2019 lockdown.Item The effects of maternal anxiety and attitudes on the adherence to inhaled corticosteroids in children with asthma(2021) Sancakli, Ozlem; Aslan, Asli Akin; 33938199Objective: Long-term inhaled corticosteroid (ICS) use in children with asthma causes serious concerns in parents, leading to treatment non-adherence. This study aimed to investigate the effect of maternal anxiety and attitudes on adherence to ICS therapy in children with asthma. Method: The patient group included the children with mild to moderate persistent asthma, aged 6-11 years. Healthy children in a similar age range were included as a control group. The patient group was divided into two categories (treatment adherent and non-adherent) according to the regularity of ICS use. All patients were assessed with Childhood-Asthma Control Test (C-ACT), and their mothers were assessed using Parent Attitude Research Instrument (PARI) and Beck's Anxiety Inventory (BAI). Results: A total of 156 children (age: 7.4 +/- 1.4 years, F/M: 71/85) with persistent asthma and 60 healthy children (age: 7.5 +/- 1.3 years, F/M:25/35) were included in the study. The rate of adherence in children with asthma was 52.6%. Mothers of non-adherent patients had significantly higher BAI scores than those of the adherent patients and controls (p < 0.001 and p < 0.001, respectively). The number of mothers who indicated that they did not have enough information about asthma and treatment was also higher in the non-adherent group. PARI subtest scores were not different between the adherent and non-adherent groups. Conclusions: In our study, it was found that mothers' anxiety levels and their knowledge about asthma and medications were associated with treatment adherence in children with asthma. Psychological and educational support to the families of children with asthma would improve their treatment adherence and efficacy. (C) 2021 Codon Publications. Published by Codon Publications.Item Tropicamide and anaphylaxis: A case report(2021) Sefi Yurdakul, Nazife; Sancakli, Ozlem; 0000-0003-2005-9256; 34667937; AAF-4678-2020A 6-month-old boy was brought to the ophthalmology outpatient clinic of our hospital by his parents with the suspicion of esotropia of his left eye. He was able to follow the objects, pupillary light reactions were normal, orthophoric in primary position with corneal light reflex (Hirschberg) test, ductions and versions were normal in all gaze positions. One drop of tropicamide (1%) was instilled in both eyes of the infant for cycloplegic retinoscopy and fundus examinations. After 10 min, anaphylaxis, respiratory and circulatory failure developed. He was immediately examined by the pediatrician, and emergency code was announced. At the 5th min of treatment, he regained consciousness, his respiratory and circulatory symptoms started to improve, and blood pressure returned to normal. In this case report, we aim to point out that tropicamide may rarely lead to life-threatening complicationsItem Clinical Features of Patients with Allergic Rhinitis and Evaluation of Adenoid Hypertrophy as a Comorbidity(2019) Sancakli, Ozlem; Belverenli, H.Objective: The nasal cavity is anatomically and functionally communicates with eyes, paranasal sinuses, nasopharynx, middle ear and lower airways. Therefore, comorbid diseases such as asthma, chronic sinusitis, adenoid hypertrophy allergic conjunctivitis are common in patients with allergic rhinitis. In our study, we aimed to evaluate the frequency of comorbid diseases, clinical features of patients who referred to our outpatient clinic with allergic rhinitis. Method: The study included children aged between 3-17 years who were diagnosed with moderate to severe allergic rhinitis between September 2015 and March 2016 in our pediatric allergy outpatient clinic. Patient files were retrospectively reviewed; comorbid diseases, family history, eosinophil percentage, total IgE level and allergy test results and the number of drugs used were recorded. In the first month of the treatment, visual analog scale was used to score the symptoms. P< 0.05 was considered significant in the statistical analysis. Results: A total of 106 patients (33 female, 73 male) with respective median ages of 7.25 and 5.13 years [range: 3.0-17.0, years] were included in the study. In 84.9% of our patients, skin test was positive, and in 69.8% of the patients the symptoms persisted for more than 2 years. The most common comorbid diseases were asthma (52.8%) and adenoid hypertrophy (30.2%). In our study, the incidence of adenoid hypertrophy was higher and total IgE levels were lower in the skin test-negative group (p=0.019, p=0.027). Conclusion: In our study, the most common comorbid diseases in patients with allergic rhinitis were asthma and adenoid hypertrophy, and in the skin test-negative group adenoid hypertrophy was more frequent.Item Comparison of Cross Reactions Between Cow's Milk and Other Mammals' Milk Using Skin Prick Test and Atopy Patch Test in Children with Atopic Dermatitis and Cow's Milk Allergy(2019) Sancakli, Ozlem; Yenigun, Ayse; Tuncel, TubaObjective: The use of other mammals' milk as an alternative treatment of cow's milk allergy is controversial due to their similar protein structures. In the present study, we aimed to investigate cross reactions with sheep's, goat, and camel's milks using skin prick test and atopy patch test in children with cow's milk allergy. Materials and Methods: Our study group was composed of patients with atopic dermatitis who were diagnosed with cow's milk allergy in our former study where we investigated the sensitivity of different diagnostic tests commonly used to determine cow's milk allergy. In all patients, cow's milk, sheep's milk, goat's milk and camel's milk were used for skin prick test and atopy patch test. The study data were analyzed with SPSS 20.0 for Windows. Results: Among the patients with cow's milk allergy, 15 (63%) had early-onset and 9 (37%) late-onset reactions with provocation tests. Seven (70%) of 10 children who were found skin prick test positive with cow's milk were shown to have a cross reaction against goat's and sheep's milk with skin prick test; 8 (88.8%) of 9 children who were found to be atopy patch test positive with cow's milk had a cross reaction against goat's milk, and 7 (66.6%) against sheep's milk. No patient with cow's milk allergy had a cross reaction with camel's milk with either skin prick test or atopy patch test. Conclusion: Our study demonstrated that a cross reaction occurs at a quite high rate between cow's milk, sheep's milk and goat's milk as revealed by both skin prick testing and atopy patch test, whereas there was no demonstrable cross reaction between cow's milk and camel's milk by either method.