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Öğe Acquired atopic disease after liver transplantation in children; similarities to and differences from adults: a preliminary study(Lippincott Williams & Wilkins, 2014) Topal, Erdem; Catal, Ferhat; Selimoglu, Mukadder Ayse; Karabiber, Hamza; Kilic, Talat; Baskiran, Adil; Senbaba, ElifObjective The aim of this study was to determine the similarities and differences in the frequency and follow-ups of newly diagnosed atopic diseases after liver transplantation in pediatric and adult patients. Materials and methods Patients who underwent liver transplants between 2005 and 2013 and who are still alive were enrolled in the study. Patients who came for checkups filled out a survey evaluating atopic diseases. Those who had an atopic disease before transplantation were excluded from the study. Results A total of 165 patients were enrolled in this study; 114 (69.1%) were males and 29 (17.6%) were children. The average transplantation age was 40.8 (0.3-67) years, and the most frequent reason for transplantation was chronic viral hepatitis. In 22 patients, atopic diseases [allergic rhinitis in nine patients (5.5%), asthma in six patients (3.9%), atopic eczema in six patients (3.9%), food allergy in six patients (3.9%), and drug allergy in one patient (0.6%)] developed after transplantation. Atopic diseases after transplantation were more common in children (P=0.03). When the atopic diseases were examined on a case-bycase basis, there were no differences between children and adults with respect to asthma (P=0.284), allergic rhinitis P=1.0), or atopic eczema (P=0.284), but food allergy (P=0.009) and peripheral eosinophilia (P=0.002) were more common in children. The periodicity of allergic diseases after transplantation (P=0.192) and total IgE levels (P=0.086) were similar. Conclusion Atopic diseases developed after liver transplantation and had a greater impact on children than adults. Therefore, after undergoing liver transplantation, patients should be monitored closely for signs of atopic diseases. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.Öğe Approach to drug allergy in family physicians(Bilimsel Tip Yayinevi, 2014) Celiksoy, Mehmet Halil; Sogut, Ayhan; Topal, Erdem; Catal, Ferhat; Sahin, Mustafa Kursat; Sahin, Gulay; Sancak, RecepObjective: Allergic reactions that occurring as a result of drug allergy can result in anaphylaxis, even death. These reactions often evaluated by the primary care physicians. Primary care physicians who often encounter with drug allergy reactions should be able to evaluate the patients with drug allergy, if necessary, make first emergency intervention, and refer patients to an allergy specialist for further evaluation and treatment. In this study, we aimed to measure general approach and the level of knowledge family physicians about allergic reactions occurred after the drug allergy. Materials and Methods: Two hundred and five family physicians who work in the region of Malatya and Samsun participated in this study. We interviewed face-to-face with family physicians about drug allergy. After that, family physicians completed a questionnaire previously prepared by allergy specialists about drug allergy. Results: The median age was 38 years old (min: 24, max: 61), median length of professional experience was 13 (min: 1, max: 35) years old and 124 (60.5%) of participants were male gender. 90.2% of family physicians in this study expressed to encounter with drug allergy before. 52.2% of them explained to cut medication in case of allergic reaction that developed after drug intake and to refer patients to allergy specialist for further investigation. 39.5% of the participants didn't know that a systemic reaction will be able to occur after local drug using. 56.6% of family physicians stated that they needn't to cut responsible medication in mild drug reactions and only 35.1% of them knew that severe drug reactions can be fatal. Only 31.7% of participants explained that adrenaline is the first option when anaphylactic reaction occurs after drug allergy. Conclusion: The knowledge of primary care physicians about treatment and management of patients with drug allergy is insufficient. Therefore, it will be useful to be educated the primary care physicians about drug allergies.Öğe Assessment of skills using a spacer device for a metered-dose inhaler and related independent predictive factors in caregivers of asthmatic preschool children(Wiley-Blackwell, 2016) Topal, Erdem; Celiksoy, Mehmet Halil; Catal, Ferhat; Sinanoglu, Muhammed S.; Karakoc, Habib Tadayyon Einaddin; Sancak, Recep; Ozturk, FadilBackgroundThe correct use of inhalation devices is essential for successful therapy. We aimed to evaluate the skills in the use of a spacer device with an metered-dose inhaler (MDI) and factors that influence this skill in asthmatic preschool children's caregivers. MethodsThe caregivers of 12-month-old to 72-month-old children were interviewed face-to-face and filled out questionnaires. To assess use of the spacer device, we asked the caregivers to verbally describe and demonstrate how they used the device. ResultsA total of 244 patients were included in the study, and 142 (58.2%) of the caregivers demonstrated every step for using the spacer device. The most frequently mistaken step was waiting for 30 seconds for the second puff after the first puff. When statistically significant and clinically important parameters were analyzed in a logistic regression model, the parameters satisfaction with the spacer device (odds ratio [OR] 29.9; 95% confidence interval [CI], 7.64 to 117.39; p < 0.001), a university graduate (OR 13.5; 95% CI, 3.36 to 54.8; p < 0.001), family monthly income of more than US$1500 (OR 5.3; 95% CI, 2.16 to 13.39; p < 0.001), device training provided by a clinical trainer (OR 12.3; 95% CI, 4.82 to 31.73; p < 0.001), regular follow-ups (OR 3.6; 95% CI, 1.57 to 8.47; p = 0.003), and the absence of a severe attack during the last year (OR 6.5; 95% CI, 2.64 to 16.43; p < 0.001) were found to be independent factors that affected the correct demonstration of the device. ConclusionThe factors most effective in the correct use of the MDI spacer device were satisfaction with the device, training having been given by a clinical trainer on this subject, and the caregiver being a university graduate.Öğe A case of acute generalised exanthematous pustulosis (AGEP) induced by amoxicillin-clavulanic acid(Bilimsel Tip Yayinevi, 2014) Senbaba, Elif; Catal, Ferhat; Topal, Erdem; Ermistekin, Halime; Varol, Fatma Ilknur; Akpolat, NusretAcute generalised exanthematous pustulosis (AGEP) is a rare skin reaction characterized by sterile, small pustules on the erythematous background. Drugs, especially antibiotics are major caustic factors in etiology. The diagnosis of disease is made by the scoring system which determined by European Severe Cutaneous Adverse Reactions (EuroSCAR)s' working group. The four-year-old patient applied with the complaint of numerous pustular skin eruptions on the erythematous background and had the history of amoxicillin-clavulanic acid treatment which was given two days ago. The biopsy samples were taken from pustular lesions. The diagnosis of AGEP was made according to EuroSCAR score, evaluating clinical feature and the histopatological examination of the biopsy sample. In this presentation, we aimed to emphasize that AGEP can rarely be seen in childhood age and to review the clinical properties, diagnosis and treatment of disease.Öğe Delayed severe systemic reaction (anaphylaxis) after subcutaneous immunotherapy injections: case report(Bilimsel Tip Yayinevi, 2013) Senbaba, Elif; Catal, Ferhat; Topal, Erdem; Ermistekin, Halime; Yildirim, Nurdan; Sinanoglu, M. SelcukCurrently, allergen specific immunotherapy is administered to allergic rhinitis or asthmatic patients with uncontrolled symptoms despite medical treatment and avoidance of environmental allergens. Local or systemic reactions can occur after subcutaneous immunotherapy. Although almost all severe systemic reactions are reported to begin within 30 minutes after administration of injections, late onset reactions could be seen. Our case was 15 years old female patient with asthma whose complaints could not controlled by medical treatment and subcutaneous immunotherapy with Dermatophagoides farinae extract that she was sensitized was administered to her. Severe systemic reaction (anaphylaxis) has developed in the patient within fourth hours of post-injection observation period at the maintenance dose of 0.8 mL. We want to emphasize that severe late onset systemic reactions are rare but could occur after subcutaneous immunotherapy injections.Öğe Demographic and systemic manifestations of patients diagnosed with ataxia-telangiectasia(Bilimsel Tip Yayinevi, 2014) Catal, Ferhat; Topal, Erdem; Celiksoy, Mehmet Halil; Ermistekin, Halime; Kutluturk, Kazim; Yildirim, Nurdan; Sinanoglu, Muhammed SelcukObjective: Ataxia-telangiectasia is rare, an autosomal recessive, neurodegenerative disorder characterized by progressive cerebellar ataxia, cutaneous and conjunctival telangiectasia, immunodeficiency, and increased risk of malignancy. In this study, we aim to determinate demographics, neurological, dermatological and immunological manifestation of children diagnosed with ataxia-telangiectasia in our clinics. Materials and Methods: We did a retrospective medical chart review of pediatric allergy and immunology database for children diagnosed with ataxiatelangiectasia in Inonu and Ondokuz Mayis University Faculty of Medicine between 2006 and 2013. Results: Ataxia-telangiectasia was diagnosed in 25 patients. The mean age was 10.08 +/- 4.14 (died children were included) and 16 (64%) of the patients were male. The mean follow up period was 5.32 +/- 3.84 years. Ataxia was the first sign of disease which was noticed by the parents and median diagnosis age was 4 years old (min: 1.5, max: 12). Neurological and dermatological manifestations were seen in all patients. Also immunological manifestations were seen in 85% of all patients. The most frequent neurologic sign was ataxia and present in all patients, followed by dysmetria (96%), dysarthria (92%), bradykinesia (80%) and ocular apraxy (60%), respectively. Telangiectasia was present in all patients and the most frequent localization was conjunctiva. Pigmentary anomalies were present in 17 (68%) patients, molluscum contagiosum in 2 (8%) patients and verruca in 1 (4%) patient. The most frequent form of immunologic deficiency was IgA deficiency (80%) which was followed by Ig G deficiency (60%) and lymphopenia (12%). Growth failure was present in 96% of patients and head circumference was under -1 SD in 56% of patients. In follow up, 5 (20%) patients had experienced recurrent otitis media, 18 (% 72) patients had experienced recurrent pulmonary infection. Bronchiectasis was developed in 7 (28%) patients and hemophagocytic sendrome was developed in one patient. Seven patients died (three due to non-Hodgkin lymphoma, two due to pulmonary infection, one due to hemophagocytic sendrome and one due to acute lymphoblastic leukemia). Conclusion: Ataxia and telenjiectasia were the most frequent signs of the disease and followed by immunological and pigmentary anomalies. Therefore, ataxia telenjiectasia should be consider in diagnosis if the patients who have dermatological signs such as telangiectasia and pigmentary anomalies and growth failure with ataxia.Öğe Developing anaphylaxis to egg after liver transplantation: a case report(Bilimsel Tip Yayinevi, 2014) Senbaba, Elif; Catal, Ferhat; Topal, ErdemFood allergy has been increasingly reported in children who had orthotopic liver transplantation. The exact mechanism of post-liver transplantation allergies remains to be elucidated. Children are at risk for the development of food allergy for the first year of transplantation and immunosuppression with tacrolimustreated patients. 11-month-old patient that underwent transplantation of liver at the month of 5 due to giant cell hepatitis, consulted to our pediatric emergency department after 15 minutes with body itching, redness, swelling of the lips, and rapid breathing, cough after 10 minutes of eating egg. The patient was diagnosed as anaphylaxis, and then injected epinephrine intramusculer. After 4 weeks, the patient whose clinical findings improved, 5 x 5 mm induration (negative control 0 mm, positive control, 6 x 6 mm) of white egg were detected in the skin prick test. Our aim of presenting this fact is to emphasize the necessity to closely monitor the patients especially in the age group of infants with hepatic transplant for the development of food allergies.Öğe Hospital-based multicenter study in Turkey: The atopic effect on the progress of viral pneumonia(European Respiratory Soc Journals Ltd, 2015) Bahceci, Semiha; Can, Demet; Girit, Saniye; Catal, Ferhat; Sen, Velat; Pekcan, Sevgi; Yuksel, Hasan[Abstract Not Available]Öğe Measuring the primary care physician's knowledge about diagnosis and treatment of cow's milk allergy and adrenaline auto injector usage(Bilimsel Tip Yayinevi, 2014) Topal, Erdem; Catal, Ferhat; Ozdemir, Ramazan; Karadag, Ahmet; Yildirim, Nurdan; Ermistekin, Halime; Sinanoglu, M. SelcukObjective: Cow's milk allergy is the most common form within the food allergy its prevalence increased recent years in children. In this study, we aim to determine the primary care physician's knowledge about diagnosis of cow's milk allergy, treatment and adrenaline auto injector usage. Materials and Methods: One hundred twenty-six voluntary primary care physicians who are working in Malatya city were included in the study. Interview with each participant were carried out and cow's milk allergy form which was prepared previously was filled in. Results: The median age was 42 (26-62), median length of professional experience was 16 (2-39) years and 89 (70.6%) of participant were male gender. The mean examined patient number by primary care physicians was 37.4 (+/- 14.6) for each day and the mean examined patient number whose age was under 3 years was 8.5 (+/- 4.5). Of the 25.4 percent of primary care physicians did not have knowledge about skin prick test, serum specific Ig E level and/or oral challenge test for diagnosis of cow's milk allergy. Although 73% of participant knew the elimination milk and dietary product from infant who was considered to have allergy to cow's milk and mother, only 13.5% of them knew the prescribe hypoallergenic formula for infant with cow's milk allergy. 64.3% of participant knew the prescribe the adrenaline auto injector in case of anaphylaxis due to cow's milk. Knowledge of adrenaline auto injector use, appropriate side for injection and dose were 34%, 34.1% and 30.2%, respectively. There was no significant effect of primary care physicians's age and length of professional experiences on the knowledge of cow's milk allergy and adrenaline autoinjector usage. Conclusion: The knowledge of primary care physician about diagnosis of cow's milk allergy, treatment and adrenaline auto injector usage are insufficient. Therefore it should be useful to training programs about these topics for primary care physician.Öğe Nasal saline as a placebo in a rhinosinusitis study(Dove Medical Press Ltd, 2014) Karadag, Ahmet; Catal, Ferhat[Abstract Not Available]Öğe Nasal saline as a placebo in chronic rhinosinusitis(Elsevier Science Bv, 2014) Karadag, Ahmet; Catal, Ferhat[Abstract Not Available]Öğe Neopterin Levels and Indoleamine 2,3-Dioxygenase Activity as Biomarkers of Immune System Activation and Childhood Allergic Diseases(Korean Soc Laboratory Medicine, 2019) Unuvar, Songul; Erge, Duygu; Kilicarslan, Bilge; Bag, Harika Gozde Gozukara; Catal, Ferhat; Girgin, Gozde; Baydar, TerkenBackground: Although Th2 immune activation is predominant in allergic diseases, neopterinlevels and indoleamine 2,3-dioxygenase (IDO)-1 activity (kynurenine:tryptophan ratio), which reflect Th1 immune activity, increase with interferon-gamma (IFN-gamma) stimulation. We investigated neopterin, tryptophan, and kynurenine levels as biomarkersof the Th1 immune system activation and changes in IDO-1 activityin children with asthma, allergic rhinitis, and atopic dermatitis, as well as the relationship between these biomarkers and the total IgE level, age, and disease severity. Methods: We divided 205 children (80 girls and 125 boys, four months to 17 years old) into four groups: controls, patients with asthma, patients with allergic rhinitis, and patients with atopic dermatitis. Peripheral venous blood samples were collected. Neopterin levels were determined by an enzyme immunoassay. Tryptophan and kynurenine levels were analyzed using HPLC. IDO-1 enzyme activity was calculated using tryptophan and kynurenine levels. IgE levels were measured. The Mann-Whitney U test, Kruskal-Wallis test, and Conover post-hoc method were used for statistical analysis. Results: Neopterin, tryptophan, and kynurenine levels were higher and IgE levels and IDO-1 enzyme activity were lower in patients with asthma and allergic rhinitis than in controls (P<0.05). Patients with atopic dermatitis showed higher neopterin, tryptophan, and kynurenine levels, higher IDO-1 activity, and lower IgE levels thancontrols (P<0.05). Conclusions: The Th1/Th2 balance is disrupted in children with allergic diseases, concomitant with increased Th1-mediated immune response activation and reduced IgEproduction, which is promoted by Th2-type cytokines.Öğe Oral Provocation Test with Banana: A Rare Cause of Anaphylaxis in a Four Year Old Child(Şişli Etfal Hastanesi Tıp Bülteni, 2016) Demirtaş, Mehmet Semih; Topal, Erdem; Catal, FerhatÖz: Amaç: Besin alerjisi çocuklarda anafilaksinin en sık nedenidir ve çalışmalar son yıllarda besin alerjisinin sıklığının arttığını göstermektedir. Besinler arasında, meyveler nadiren anafilaksi nedeni olarak yer almaktadır. Muz alerjisi erişkinler içinde anaflaksi nedenleri içinde saptanmış olmasına rağmen, çocuklarda bildirilen muz anaflaksisi olguları oldukça azdır. Bu olgu sunumunda muz alımı sonrasında gelişen bir anaflaksi olgusu tartışıldı. Olgu: Dört yaşındaki erkek hasta, muz alımı sonrası vücudunda yaygın kaşıntı, ürtikeryal döküntü ve göz kapaklarında şişlik ile başvurdu. Tanının kesinleştirilmesi amacıyla yapılan muz ile oral provokasyon testinde ürtikeryal papül saptandı. Muz verildikten 10 dakika sonra gövdesinde ürtiker, göz kapaklarında şişlik ve hırıltı şikayeti gelişti, dinlemekle bilateral ronküs mevcuttu ve hastanın ölçülen tansiyonu normaldi. Hastaya anafilaksi tanısı konuldu ve 0.01 mg/kg dan IM adrenalin, nebulizatör ile kısa etklili beta 2 agonist ve anti histaminik tedavisi verildi. İzlemde bulguları düzelen hasta antihistaminik ve 3 günlük oral metilprednizolon tedavisiyle taburcu edildi. Hastaya önerilerde bulunuldu ve adrenalin otoenjektör reçete edilip kullanımı gösterildi. Sonuç: Nadir de olsa çocuklarda muz ile anafilaksi gelişebilmektedir. Bu nedenle tanı amaçlı yapılacak oral provokasyonlar deneyimli merkezlerce yapılmalı ve gelişebilecek reaksiyonlara karşı gerekli önlemler alınmalıdır. Başlık (İngilizce): Dört yaşındaki bir çocukta nadir bir anafilaksi nedeni: Muz ile oral provokasyon testi Öz (İngilizce): Objective: Food allergy is the most common cause of anaphylaxis in children and recent studies suggest that the prevalence of food allergies has increased. Among foods, fruits are rarely the cause of anaphylaxis. Although banana allergy has been identified among the causes anaphylaxis in adults, the incidence of banana anaphylaxis reported in children is very rare. In this case report a patient who developed anaphylaxis after banana ingestion was discussed.Case: A 4-year-old boy male patient admitted with widespread itching, swelling of the eyelids, urticarial rash in body following exposure to banana. In oral provocation test performed in order to confirm the diagnosis made with banana, urticarial papules were detected. Urticaria, swelling of the eyelids and wheezing complaints occured in the body in 10 minutes after banana was given. Bilateral rhonchus was presented in auscultation and the blood pressure of the patient measured was normal. The patient was diagnosed with anaphylaxis and 0.01 mg / kg IM epinephrine nebulizer with short-acting beta 2 agonists and antihistaminic treatment were given. The patient who recovered during follow-up was discharged with antihistaminics and 3-day oral methylprednisolone therapy. Recommendations were made to patient and adrenaline auto-injector was prescribed and its use was described. Conclusion: Although rare, children may develop anaphylaxis with bananas. Therefore, oral provocations for diagnostic purposes should be performed by experienced centers and necessary precautions should be taken against the reactions that may occur.Öğe The Platelet Parameters as Inflammatory Markers in Preschool Children with Atopic Eczema(Clin Lab Publ, 2015) Topal, Erdem; Celiksoy, Mehmet Halil; Catal, Ferhat; Karakoc, Habib Tadayyon Einaddin; Karadag, Ahmet; Sancak, RecepBackground: Mean platelet volume has been frequently used as an inflammatory marker in various diseases associated with inflammation. In this study, we compared platelet parameter levels between preschool children with and without atopic eczema (AE). Methods: Preschool children with AE and age-matched healthy children were included in the study. Complete blood count was assessed in children with AE while platelet parameters were compared between children with and without AE. Results: One hundred twenty eight pediatric patients (78 boys, mean age: 14 months) diagnosed with AE and 128 healthy patients (71 boys, mean age: 12 months) were included in the study. There were no statistically significant differences between the genders (p = 0.375) and ages (p = 0.273) of both groups. WBC (p = 0.952), Hb (p = 0.370), MCV (p = 0.314) and RDW values (p = 0.124), and platelet counts (p = 0.198) of both groups were similar. In the AE group, while the MPV value was found to be higher (p = 0.003), mean PDW value (p = 0.025) and PLT/MPV ratio were found to be lower (p = 0.021). In addition, there was no correlation between the severity of AE and MPV (rho; 0.1, p = 0.257), POW (rho; -0.1, p = 0.269) and PLT/MPV (rho; 0.07, p = 0.432) ratio. Conclusions: In patients with AE, as a sign of inflammation, PDW value and PLT/MPV ratio decrease while MPV value increases. This study has also shown that there is no association between the severity of AE and platelet parameters.Öğe The prevalence and severity of reaction during the oral food challenge(Bilimsel Tip Yayinevi, 2014) Topal, Erdem; Catal, Ferhat; Senbaba, Elif; Varol, Fatma Ilknur; Sinanoglu, Muhammed Selcuk; Yildirim, Nurdan; Ermistekin, HalimeObjective: The diagnostic gold standard of food allergy is the oral food challenge. Oral food challenge may induce allergic reactions, ranging from mild cutaneous symptoms to severe, potentially life-threatening reaction. Our aim was to investigate the prevalence and severity of reactions during oral food challenge. Materials and Methods: A retrospective charts review of children undergoing oral food challenge at the our Allergy Clinic between September 2012 and September 2013 was performed. Results: A total of 63 oral food challenges were included the study. Most frequently involved foods were cow's milk, pistachio nut and egg. Oral food challenge were carried out to confirm the diagnosis in 50 (79.4%) patients and were carried out to demonstrate the development of food tolerance in 13 (20.6%). 13/63 (20.6%) were positive. Twelve patients were defined mild reactions and one patient was anaphylaxis. There were no significant differences between the oral food challenge negative group and oral food challenge positive group in terms of sex, age at the time of oral food challenge, concomitant atopic disease, history of IgE mediated food allergy, peripheral eosinophils per cent, serum specific gE and total IgE (p>0.05). But there was a positive correlation between the size of skin prick test and oral food challenge positivity (rho: 0.307, p=0.019). Conclusion: The majority of reactions during oral food challenge were mild. The size of skin prick test was the risk factor for the development of reaction during oral food challenge. Therefore, oral food challenge should be done by the experts and size of skin prick test should be taken into consideration before oral food challenge.Öğe Relationship between hypogammaglobulinemia and severity of atopic dermatitis(Elsevier Science Inc, 2014) Celiksoy, Mehmet Halil; Topal, Erdem; Sancak, Recep; Catal, Ferhat; Sogut, AyhanBackground: Atopic dermatitis is an itchy, inflammatory, chronic, or chronically relapsing skin disease. The disease occurs in people who have an atopic tendency or may appear as a clinical sign of primary immunodeficiency. Objectives: To determine the relation between severity of atopic dermatitis and hypogammaglobulinemia. Methods: One hundred sixty pediatric patients with atopic dermatitis (98 boys and 62 girls, 1-60 months old, median age 14.5 months) and 95 healthy children (57 boys and 38 girls, median age 16 months; control group) were included in the study. In patients with atopic dermatitis, the severity of disease was determined by the SCORing Atopic Dermatitis index. Serum immunoglobulin levels of all patients and children in the control group were measured by nephelometry on admission. Results: The incidence of hypogammaglobulinemia was higher in patients with atopic dermatitis than in the control group (P = .009). The main reason for this difference was the low level of IgG in the atopic dermatitis group (P = .024). Analysis of the relation between hypogammaglobulinemia and the severity of atopic dermatitis showed no statistically significant difference between the group with mild to moderate atopic dermatitis and the group with severe atopic dermatitis with respect to hypogammaglobulinemia (P = .859), IgG (P = .068), IgA (P = .410), and IgM (P = .776) values. Conclusion: Hypogammaglobulinemia was more frequent in patients with atopic dermatitis compared with the control group, mostly owing to the low IgG level. Hypogammaglobulinemia is not associated with the severity of atopic dermatitis. (C) 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.Öğe Sleep patterns of young children with newly diagnosed atopic dermatitis(Termedia Publishing House Ltd, 2017) Dogan, Derya Gumus; Canaloglu, Sinem Kortay; Kivilcim, Meltem; Kum, Yunus Emre; Topal, Erdem; Catal, FerhatIntroduction: Even though atopic dermatitis (AD) most often begins in the first year of life, it is not well known whether sleep disturbances occur following the onset of the disease or whether they develop later. Aim: To determine the sleep patterns of young children already diagnosed with AD in comparison to a control group by using a validated questionnaire, the Brief Infant Sleep Questionnaire (BISQ). Material and methods: Forty-six children with a new diagnosis of AD and 60 healthy children, aged 3-36 months, participated in the study. Their sleep behaviors were assessed using the BISQ along with a structured sociodemographic data form. Results: It was found that when compared with healthy children, children with AD did not have decreased daily total sleep duration (p = 0.1); however, it was found that they woke up more frequently at night (52.2% vs. 40%, p = 0.4) and they stayed awake significantly longer than 60 min when they woke up (41.3% vs. 11.7%, p < 0.05). In addition, mothers of children with AD reported that their children had three times as many sleep problems compared to the reports of mothers of healthy children. Conclusions: The findings of this study showed that sleep disturbance was more common in young children with already diagnosed AD, and the BISQ provided a practical way to assess the sleep patterns. The use of a screening tool to enable early identification and treatment of childhood sleep problems among patients with AD should be encouraged.Öğe An Unusual Cause of Chronic Abdominal Pain: Gallbladder Ascariasis(Galenos Yayincilik, 2014) Almis, Habip; Catal, Ferhat; Karadag, AhmetAscariasis which is created by Ascaris lumbricoides is one of the most common helminthic infections. Ascariasis is more frequently seen in children than adults, developing more serious complications. Gallbladder ascariasis is one of the rare clinical type of ascariasis. In this paper we present a 9-year-old male patient which was diagnosed with gallbladder ascariasis while he was being examined due to his chronic abdominal pain and we aimed to highlight this rare type of ascariasis.Öğe An Unusual Cause of Chronic Abdominal Pain: Gallbladder Ascariasis (vol 1, pg 226, 2014)(Galenos Yayincilik, 2015) Almis, Habip; Catal, Ferhat; Karadag, Ahmet; Sigirci, Ahmet[Abstract Not Available]Öğe The value of the clinical history for the diagnosis of immediate nonsteroidal anti-inflammatory drug hypersensitivity and safe alternative drugs in children(Ocean Side Publications Inc, 2016) Topal, Erdem; Celiksoy, Mehmet Halil; Catal, Ferhat; Sayan, Yekbun Gamze; Sancak, RecepBackground: Diagnosing hypersensitivity reactions that develop as a result of nonsteroidal anti-inflammatory drugs (NSAID) with a history is mostly misleading, and skin tests and/or provocation tests are needed for a definitive diagnosis. Objective: To determine the frequency of actual NSAID hypersensitivity and whether there are any parameters in the history to predict NSAID hypersensitivity. In addition, to determine safe alternative drugs for children who are diagnosed with actual NSAID hypersensitivity. Methods: Children with a history of NSAID hypersensitivity were evaluated by an allergist. Safe alternatives in children with a confirmed NSAID hypersensitivity were found by oral provocation tests. Results: Sixty-four patients who were admitted with a suspicion of immediate-type reaction to NSAIDs were included in the study. The median age of the patients was 6 years old (range, 1-17 years), and 37 of the patients (57.8%) were boys. We performed skin tests for suspected NSAID in 35 patients (54.7%). Of these, two had positive results. Provocation tests were performed with 62 patients whose skin test results were negative or for whom skin tests were not available. During the provocation tests, 16 patients (25.8%) developed reactions. Low- and high-dose acetaminophen, nimesulide, and tolmetin sodium were used to find safe alternative drugs. Two patients developed reactions to high-dose acetaminophen but no reaction to nimesulide and tolmetin sodium. When statistically significant parameters were analyzed in a logistic regression model, the presence of multiple NSAIDs hypersensitivity in the patient history (odds ratio 26.6 [95% confidence interval, 1.47-481.63]; p = 0.026) and the emergence of a reaction within an hour (odds ratio 26.4 [95% confidence interval, 1.73-403.11]; p = 0.019) were found as the independent factors to predicted actual NSAID hypersensitivity. Conclusion: The emergence of a reaction within an hour of taking the drug and the presence of multiple NSAIDs hypersensitivity history increased the possibility of actual NSAID hypersensitivity. Nimesulide, low-dose acetaminophen, and tolmetin sodium could be used as safe alternative drugs in patients with multiple NSAIDs hypersensitivity.
