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1.
Allergy Asthma Proc ; 42(4): 350-356, 2021 07 01.
Article in English | MEDLINE | ID: mdl-34187627

ABSTRACT

Background: Hymenoptera venom allergy is an immunoglobulin (Ig) E mediated hypersensitivity reaction to Hymenoptera venoms. Obvious identification of the culprit insect that causes the clinical symptoms and, hence, the accurate selection of venom for curative treatment, is of great importance for the effectiveness and safety of venom immunotherapy. Objective: In this study, the contribution of component-resolved diagnostics (CRD) is evaluated in the diagnosis of Hymenoptera venom allergy. Method: Ninety-three patients from four different centers in Turkey were included in the study. Conventional tests, including prick and intradermal skin tests, with commercial venom extracts and serum specific IgE (sIgE) levels for whole venoms were performed. An sIgE analysis for venom allergen components, including rApi m 1, rApi m 2, rApi m 10, rVes v 1, rVes v 5, were evaluated by immunoblotting. Results: In conventional test results, 17 of 35 patients with bee venom allergy were positive to honey bee venom, whereas 18 patients were positive to bee and wasp venoms. In 28 of 35 patients with bee venom allergy, the diagnosis was confirmed with CRD. CRD revealed a sensitivity of 80% in patients with bee venom allergy. According to conventional tests, 7 of 24 patients with vespid venom allergy demonstrated sensitivity only to Vespula species, whereas 17 patients revealed double positivity. The total diagnostic sensitivity of Ves v 1 and Ves v 5 was calculated as 87.5%. Ten of 23 patients with a history of hypersensitivity to both venoms showed double sensitivity with CRD; one patient had cross-reactivity, one patient was found to be sensitive only to bee venom, and, eight patients were sensitive only to Vespula species. Eleven patients had an uncertain history in terms of the culprit insect type and six of them had double sensitivity in CRD. Conclusion: CRD seemed to be more helpful in diagnosing vespid venom allergy than bee venom allergy. It can also discriminate clinically significant sensitizations from irrelevant ones.


Subject(s)
Bee Venoms , Hymenoptera , Hypersensitivity , Insect Bites and Stings , Allergens , Animals , Arthropod Venoms , Humans , Hymenoptera/immunology , Hypersensitivity/diagnosis , Immunoglobulin E , Insect Bites and Stings/diagnosis , Wasp Venoms
2.
Clin Respir J ; 11(2): 210-223, 2017 Mar.
Article in English | MEDLINE | ID: mdl-26073091

ABSTRACT

BACKGROUND AND AIMS: To evaluate asthma phenotypes in patients with asthma from different regions of Turkey. METHODS: A total of 1400 adult asthmatic patients (mean (SD) age: 44.0 (13.9) years, 75% females) from 14 centers across Turkey were included in this study and a standard questionnaire was applied between the time period of February 2011-January 2012. RESULTS: The disease onset ≥ 40 years of age was higher percentage in obese vs. normal/overweight patients and nonallergic vs. allergic patients (P < 0.01). The percentage of patients who had FEV1 values over 80% was higher in allergic than nonallergic and normal/overweight than obese patients (P < 0.01). Uncontrolled asthmatics have more severe disease (P < 0.01). There were more frequent hospital admissions in nonallergic and uncontrolled asthmatics (P < 0.01). Chronic rhino-sinusitis was the leading comorbid disorder in normal/overweight and allergic asthma, while gastroesophageal reflux disorder was more frequent in nonallergic and uncontrolled asthma (P < 0.01). Asthma control rate was the highest (39.0%) in patients from Marmara region among all geographical regions (P < 0.05). CONCLUSION: In conclusion, our findings revealed existence of clinical/trigger related phenotypes based on BMI, allergic status, control level and geographical region with more frequent respiratory dysfunction and/or adverse health outcomes in uncontrolled, obese and nonallergic phenotypes.


Subject(s)
Asthma/epidemiology , Asthma/therapy , Obesity/complications , Adult , Comorbidity , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Phenotype , Risk Factors , Surveys and Questionnaires , Turkey/epidemiology
3.
Inflammation ; 38(2): 616-22, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25028101

ABSTRACT

Interleukin 8 (IL-8) is used to evaluate the severity of inflammation in the airways. The aim of this study was to evaluate patients with chronic obstructive pulmonary disease (COPD) for the presence of upper respiratory tract involvement by questioning patients regarding nasal symptoms and by measuring levels of IL-8 in nasal lavage material. A total of 47 COPD patients and 23 healthy controls were enrolled in this study. Pulmonary function tests were performed for all participants who were asked to complete a Sinonasal Outcome Test-20 (SNOT-20) questionnaire on the same day, as a measure of quality of life. Median IL-8 level in nasal lavage specimens of COPD patients with stable disease was higher than that of healthy controls. An increase in cigarette pack-years was significantly associated with an increase in nasal IL-8 levels. Similarly, IL-8 levels correlated positively with stage of COPD. A significant link between number of visits to the emergency department and stage of disease was observed. Patients with COPD had a significantly higher mean SNOT-20 severity score compared to healthy controls. Proper management of sinonasal disease may help to decrease the number of COPD attacks and consequently improve quality of life.


Subject(s)
Interleukin-8/metabolism , Nasal Lavage Fluid/chemistry , Pulmonary Disease, Chronic Obstructive/pathology , Adult , Aged , Aged, 80 and over , Female , Humans , Inflammation/immunology , Inflammation/pathology , Male , Middle Aged , Nasal Lavage , Quality of Life , Severity of Illness Index , Smoking/epidemiology , Surveys and Questionnaires
4.
Am J Rhinol Allergy ; 25(6): 411-5, 2011.
Article in English | MEDLINE | ID: mdl-22185746

ABSTRACT

BACKGROUND: Aspirin (acetylsalicylic acid [ASA]) hypersensitivity is frequent in patients with nasal polyps (NPs) and is called aspirin exacerbated respiratory disease, previously known as Samter's syndrome. However, studies evaluating the prevalence of ASA hypersensitivity in patients with NPs using the oral aspirin provocation test (APT) are quite limited. This study was designed to determine the prevalence of ASA hypersensitivity and factors associated with ASA hypersensitivity in patients with NPs. METHODS: Sixty-eight patients with NPs with or without asthma were recruited. Extension of NPs was evaluated by endoscopic examination/paranasal CT. A 2-day, single-blind placebo-controlled APT was used to detect ASA hypersensitivity. RESULTS: APT was performed in 53 (21 women/ 32 men) patients (mean age, 39.34 ± 1.76 years). APT resulted positive in 12 patients (22.6%) of whom 3 (25%) had no history of ASA hypersensitivity. Of the positive APTs, three were isolated rhinitis and nine had classic responses. APT was negative in 41 patients (77.4%) although three (7.3%) had a history of ASA hypersensitivity. History of ASA hypersensitivity and prolonged duration of NPs were associated with positive APT (p < 0.05). Advanced NP with multiple operations was also correlated with APT positivity but was not statistically significant. Presence of asthma was associated with age, female gender, NP duration, and ASA hypersensitivity history (p < 0.05), but not with smoking, atopy, NP extension, and positive APT. CONCLUSION: ASA hypersensitivity is quite common in patients with NP. Patients with extensive and long-term NP with multiple polyp operations require evaluation for the presence of ASA hypersensitivity in terms of chronic management and future risks of the disease.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Aspirin/adverse effects , Asthma, Aspirin-Induced/epidemiology , Nasal Polyps/epidemiology , Adolescent , Adult , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Aspirin/administration & dosage , Confounding Factors, Epidemiologic , Disease Progression , Endoscopy , Female , Humans , Male , Middle Aged , Nasal Polyps/physiopathology , Nasal Polyps/therapy , Prevalence , Recurrence
5.
Tuberk Toraks ; 59(3): 291-311, 2011.
Article in English | MEDLINE | ID: mdl-22087528

ABSTRACT

Asthma still has high morbidity and cost despite all advances in pathogenesis, diagnosis and treatment. Although asthma can be controlled with proper diagnosis and treatment, the low rates of control in our country and in the world can not be attributed to the variable course of the disease and patients' psycho-social behaviours for chronic disease. In this context, Turkish Thoracic Society (TTS) has decided to update Asthma Diagnosis and Management Guide latest published in 2000. National data were collected, compiled and prepared by authors, and final form given by the TTS Asthma and Allergy Study Group, after presenting to consultant individuals and institutions. In June 2009, the National Asthma Management and Prevention Guideline were published in Turkish. In this paper, we aimed to present the national guide in English with its basics and individual differences.


Subject(s)
Anti-Asthmatic Agents/therapeutic use , Asthma/prevention & control , Practice Guidelines as Topic , Asthma/diagnosis , Asthma/epidemiology , Cost of Illness , Humans , Quality of Life , Risk Factors , Turkey/epidemiology
6.
Ann Allergy Asthma Immunol ; 100(6): 576-82, 2008 Jun.
Article in English | MEDLINE | ID: mdl-18592822

ABSTRACT

BACKGROUND: In the prevention of latex allergy, knowledge levels and risk determination for latex allergy of medical students gain importance. OBJECTIVES: To evaluate the latex allergy knowledge levels of sixth-year medical students and their latex allergy risk. METHODS: Students completed a questionnaire that assessed basic knowledge of latex allergy and that evaluated latex-related symptoms and latex exposure. The specialty branch students were going to choose in the Medical Specialty Examination was also asked. Skin prick tests (SPTs) with latex and inhalant allergens and patch tests with latex-related products were then performed. Finally, students were asked again about any changes in branch selection after learning their individual risks. RESULTS: Two hundred twenty sixth-year students were enrolled. Forty-four percent of the students gave the right answer for description of latex. Correct identification of at least 1 latex-related product used outside and inside hospitals was 55.5% and 95.5%, respectively. The prevalence of latex sensitization was 4.4% according to SPT results. The positivity of SPT to any inhalant allergen was 35% (n = 64). None of the students changed their mind about their specialty branch after learning their latex allergy risk. CONCLUSIONS: Last-year medical students have a remarkably low latex allergy knowledge level, which imposes a serious professional risk. Training strategies based on the benefit to this risk group and reevaluation are strongly recommended before graduation from medical school.


Subject(s)
Education, Medical , Health Knowledge, Attitudes, Practice , Latex Hypersensitivity/epidemiology , Specialization , Students, Medical/statistics & numerical data , Adult , Female , Humans , Hypersensitivity/diagnosis , Latex Hypersensitivity/diagnosis , Latex Hypersensitivity/prevention & control , Male , Prevalence , Risk Assessment , Skin Tests , Students, Medical/psychology , Surveys and Questionnaires , Turkey/epidemiology
7.
Ann Allergy Asthma Immunol ; 95(1): 33-7, 2005 Jul.
Article in English | MEDLINE | ID: mdl-16095139

ABSTRACT

BACKGROUND: Cyclooxygenase-2 (COX-2) inhibitors are reported to be well tolerated in patients with analgesic intolerance (AI). However, limited data are available about the long-term tolerability of these drugs. OBJECTIVE: To determine the long-term tolerability of COX-2 inhibitors in patients with Al. METHODS: Patients with AI who previously underwent single-masked, placebo-controlled oral provocation tests and were found to tolerate nimesulide, meloxicam, rofecoxib, or celecoxib were interviewed regarding the long-term use and tolerability of these drugs. RESULTS: Of 87 patients, 61 (70%) had used the recommended COX-2 inhibitor(s). Of the 61 users, 54 (89%) tolerated the drug(s) well and 7 (11%) reported adverse events. Three patients reporting adverse events were rechallenged with the responsible COX-2 inhibitor, and their results were found to be negative. CONCLUSIONS: Long-term use of COX-2 inhibitors was tolerated well by most patients with AI, and placebo-controlled oral provocation tests, as a single test, seemed to predict tolerability. Furthermore, self-reported positive reactions in the long-term should also be confirmed with rechallenge tests for definite diagnosis.


Subject(s)
Cyclooxygenase Inhibitors/adverse effects , Drug Hypersensitivity/diagnosis , Prostaglandin-Endoperoxide Synthases/metabolism , Adult , Analgesics, Non-Narcotic/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Controlled Clinical Trials as Topic , Cyclooxygenase 2 , Cyclooxygenase 2 Inhibitors , Female , Humans , Male , Membrane Proteins
8.
Respir Med ; 99(8): 1032-7, 2005 Aug.
Article in English | MEDLINE | ID: mdl-15950145

ABSTRACT

Exposure to cockroach has been identified as an important source of indoor allergens in patients with asthma and allergic rhinitis. We evaluated the relationship between cockroach sensitivity and other allergens in patients with asthma. A total of 114 patients, defined asthma according to GINA, were enrolled in this study. A questionnaire including age, sex, duration of asthma, history of cockroach presence at home, and total IgE, blood eosinophil count, pulmonary function tests, standard skin prick test additional cockroach and shrimp allergen were performed. There were 84 (73.7%) female and 30 (26.3%) male patients with a mean age of 38.1+10.1 years. The average duration of asthma was 7.7+7.2 years. Sixty five (57%) patients were determined atopic and 49 (43%) nonatopic. Pollen allergen was the most common allergen in 59 (51.8%) patients with asthma, and second common allergen was mite allergen in 43 (37.7%) patients. Cockroach sensitivity were detected in 23 (20.2%) of 114 all asthmatics and 23 (35%) of atopic asthmatics. High rates of house-dust-mite allergy (73.9%) was determined in patients with cockroach sensitivity (P<0.05), while we found no relationship with other allergens. There was no difference for cockroach sensitivity between rural and urban population. Cockroach sensitivity was more common in mild bronchial asthmatics and a female predominance was observed. In addition, there was no association between shrimp and cockroach sensitivity. As a result, a high rate of cockroach sensitivity alone or with mite sensitivity was seen in patients with bronchial asthma in Turkish population. Because of cross-reactivity between mites and cockroach, cockroach sensitivity should be investigated in patients with house-dust-mite allergy. In addition, a high rate of cockroach sensitivity, in terms of IgE sensitization, may be important for the development of new sensitizations.


Subject(s)
Allergens/immunology , Asthma/immunology , Cockroaches/immunology , Dermatophagoides pteronyssinus/immunology , Adult , Animals , Antigens, Dermatophagoides/immunology , Bronchial Provocation Tests , Eosinophils/immunology , Female , Humans , Immunoglobulin E/blood , Leukocyte Count , Male , Methacholine Chloride , Middle Aged , Pollen/immunology , Rural Health/statistics & numerical data , Severity of Illness Index , Skin Tests , Turkey , Urban Health/statistics & numerical data
9.
J Asthma ; 42(2): 127-31, 2005 Mar.
Article in English | MEDLINE | ID: mdl-15871445

ABSTRACT

Intolerance reactions to acetyl salicylic acid (ASA) and nonsteroidal anti-inflammatory drugs (NSAIDs) are common and caused by inhibition of COX-1 enzyme. Therefore, drugs that selectively inhibit COX-2 enzyme may be safe in these subjects. In this study, we evaluated the tolerability of celecoxib, a selective COX-2 inhibitor, in patients with analgesic intolerance. The eligible study population consisted of patients with a history of urticaria/angioedema, naso-ocular symptoms, bronchospasm, and/or anaphylactoid reaction induced by ASA and/or NSAIDs. A single-blind, placebo-controlled oral challenge test was performed in the hospital setting. On 2 separate days, 1/4 and 3/4 divided doses of placebo and celecoxib (Celebrex 200 mg, Pfizer, Turkey) were given with 2-hour intervals. Seventy-five subjects (mean age: 38.2 +/- 1.4 years; F:M: 55:20) were included in the study. Twenty-one subjects had asthma. No reaction was observed with placebo or celecoxib provocation. Although celecoxib seems to be a safe alternative drug in our study group, considering its serious adverse events reported in the literature, the drug should be recommended for patients with analgesic intolerance only after being tested by an experienced allergist.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Aspirin/adverse effects , Cyclooxygenase Inhibitors/therapeutic use , Drug Hypersensitivity , Prostaglandin-Endoperoxide Synthases/drug effects , Pyrazoles/therapeutic use , Sulfonamides/therapeutic use , Adult , Anaphylaxis/chemically induced , Bronchial Spasm/chemically induced , Celecoxib , Cyclooxygenase 2 , Cyclooxygenase 2 Inhibitors , Female , Humans , Male , Membrane Proteins , Rhinitis/chemically induced , Single-Blind Method , Treatment Outcome , Urticaria/chemically induced
10.
J Asthma ; 42(10): 843-6, 2005 Dec.
Article in English | MEDLINE | ID: mdl-16393722

ABSTRACT

BACKGROUND: The diagnosis of asthma is based on the presence of symptoms. Lung function measurements such as forced expiratory volume in one second (FEV1), peak expiratory flow (PEF) variability and airway hyperresponsiveness support the clinical diagnosis. However, asthma is still an under- or overdiagnosed disease. OBJECTIVES: The aim of this study was to identify which test(s) is the most valuable for making the diagnosis of asthma by using patients with asthma-like symptoms as a reference population. METHODS: One hundred patients admitted to an asthma outpatient clinic of an education and research hospital and 23 non-smoking healthy control subjects were included in this study. An asthma questionnaire, spirometric tests, monitoring of PEF variability during two weeks, non-specific bronchial challenge test with methacoline, skin prick tests (SPT) with common aeroallergens, measurements of serum total IgE and blood eosinophil counts were applied to all cases. RESULTS: Sixty of one hundred patients were diagnosed with asthma, whereas the 40 remaining participant were accepted as pseudoasthma due to a diagnosis of another cause for their symptoms. The sensitivity and specificity of the methacholine challenge test was 96.5% and 78.4%, respectively. While the most sensitive test was a methacholine challenge test, the most specific test was the reversibility test. The test with the highest correlation of a positive result and asthma was the reversibility test. However, the highest correlation with a negative result was found with the methacholine challenge test. SPT positivity, serum total IgE and eosinophilia had low sensitivity and moderate specificity. The most specific question was "have you had an attack of shortness of breath that came on during the day when you were at rest at any time?", whereas the most sensitive question was "have you had an attack of shortness of breath that came on following strenuous activity at any time?" In addition, the questions "have you had an attack of shortness of breath that came on following strenuous activity at any time?" and "have you woken up with an attack of wheezing at any time?" had significant correlation with the results of the methacholine challenge test. CONCLUSIONS: We have shown that the methacholine challenge test is the most valuable diagnostic tool for asthma. In addition, there is a significant correlation between the methacholine challenge test and some patient symptoms.


Subject(s)
Asthma/diagnosis , Surveys and Questionnaires , Adult , Airway Obstruction/diagnosis , Asthma/blood , Bronchial Provocation Tests , Diagnosis, Differential , Eosinophils , Female , Humans , Immunoglobulin E/blood , Leukocyte Count , Male , Middle Aged , Peak Expiratory Flow Rate , Skin Tests , Spirometry
11.
Mikrobiyol Bul ; 38(1-2): 27-32, 2004.
Article in Turkish | MEDLINE | ID: mdl-15293899

ABSTRACT

Approximately one third of all community acquired pneumonia cases are caused by Legionella pneumophila, Mycoplasma pneumoniae and Chlamydophila pneumoniae (previously, Chlamydia pneumoniae) which are known as bacterial atypical pneumonia agents. Serological tests are used commonly for laboratory diagnosis of these agents. The aim of this study was to evaluate the causative role of bacterial atypical pneumonia agents in clinically diagnosed pneumonia patients. Acute and convalescent serum samples were collected from a total of 65 clinically diagnosed adult pneumonia patients in order to evaluate IgM and IgG positivities against L. pneumophila, M. pneumoniae and C. pneumoniae. IgM and IgG were evaluated by enzyme immunoassay (ELISA) for L. pneumophila and M. pneumoniae, and by indirect fluorescent antibody (IFA) method for C. pneumoniae. In acute serum samples, 4 (6.2%) M. pneumoniae IgM positivity in addition to 3 (4.6%) L. pneumophila IgG, 3 (4.6%) M. pneumoniae IgG and 62 (95.4%) C. pneumoniae IgG positivity were detected. In convelescent serum samples, 3 (4.6%) L. pneumophila, 1 (1.5%) M. pneumoniae, 3 (4.6%) C. pneumoniae IgM positivity and 4 (6.2%) L. pneumophila with 1 (1.5%) M. pneumoniae IgG positivity were detected in addition to acute sample positivities. According to these serological data, totally 16 (24.6%) of the patients were infected by bacterial atypical pneumonia agents. These results show that bacterial atypical pneumonia agents are important etiological factors for community acquired pneumonia.


Subject(s)
Antibodies, Bacterial/blood , Chlamydophila pneumoniae/immunology , Legionella pneumophila/immunology , Mycoplasma pneumoniae/immunology , Pneumonia, Bacterial/microbiology , Acute Disease , Chlamydophila Infections/diagnosis , Community-Acquired Infections/diagnosis , Community-Acquired Infections/microbiology , Convalescence , Enzyme-Linked Immunosorbent Assay , Fluorescent Antibody Technique, Indirect , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Legionnaires' Disease/diagnosis , Pneumonia, Bacterial/diagnosis , Pneumonia, Mycoplasma/diagnosis
12.
Tuberk Toraks ; 52(1): 14-8, 2004.
Article in Turkish | MEDLINE | ID: mdl-15143367

ABSTRACT

In this study, the correlation between distant metastases and metastatic organ-specific abnormalities in patients with lung cancer was evaluated. There were 197 patients who have lung cancer with distant metastases in this study. 141 (71.5%) of them were nonsmall cell lung cancer and 56 (28.5%) of them were small cell lung cancer. While one site of liver, brain and bone metastases were detected in 128 (64.9%) patients, remainders (69 patients, 35.1%) had surrenal, renal, pancreatic, skin, lung, thyroid, abdominal lymph node metastases. Organ-specific symptoms, findings on physical examination and abnormalities in laboratory data were detected in 121 (56.5%), 45 (21%) and 52 (24.2 %) patients, respectively. Sensitivity of predilection of organ-specific symptoms for bone, liver and brain metastases were 67%, 43% and 74% and specificity were 86%, 90% and 76%, respectively. We concluded that organ-specific abnormalities were not so effective to predict metastases in lung cancer. We considered that this result could be due to retrospective analysis and not included enough patients.


Subject(s)
Carcinoma, Non-Small-Cell Lung/epidemiology , Carcinoma, Small Cell/epidemiology , Lung Neoplasms/epidemiology , Bone Neoplasms/epidemiology , Bone Neoplasms/etiology , Bone Neoplasms/secondary , Brain Neoplasms/epidemiology , Brain Neoplasms/etiology , Brain Neoplasms/secondary , Carcinoma, Non-Small-Cell Lung/etiology , Carcinoma, Non-Small-Cell Lung/secondary , Carcinoma, Small Cell/etiology , Carcinoma, Small Cell/secondary , Female , Humans , Liver Neoplasms/epidemiology , Liver Neoplasms/etiology , Liver Neoplasms/secondary , Lung Neoplasms/etiology , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Metastasis , Neoplasm Staging/methods , Predictive Value of Tests , Retrospective Studies , Sensitivity and Specificity , Turkey/epidemiology
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