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Öğe Age related risk factors associated with severity of atopic dermatitis in children(2019) Celiksoy, Mehmet Halil; Topal, Erdem; Demir, OsmanAim: Atopic dermatitis is a chronic, relapsing, and pruritic dermatitis, which generally develops in early childhood, and has a characteristic age-dependent distribution. To review age related risk factors associated with severity of atopic dermatitis in children. Material and Methods: The medical records of 206 pediatric patients with the diagnosis of atopic dermatitis between August 2015 and August 2017 were reviewed retrospectively. Results: The study included two hundred six patients who were diagnosed with atopic dermatitis (118 males, 88 females, median age: 20 months). The disease was found to have a more severe course in patients who were breastfed for less than six months, who were exposed to cigarette smoke, who had a food allergen and a history of atopy in the family (p<0.047, 0.046, 0.032, 0.012, respectively) in the 0-2 age group. The disease was found to have a more severe course in patients who had aeroallergen sensitivity, high serum total IgE level, who had eosinophilia, and low socioeconomic level (p<0.016, 0.023, 0.038, 0.032, respectively) in the patient older than 2 years old. Conclusion: While parental atopy and diet determine the severity of the disease in the early period of life, environmental factors have a more obvious role in later periods.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 Characteristics of persistent diaper dermatitis in children with food allergy(Wiley, 2019) Celiksoy, Mehmet Halil; Topal, Erdem; Okmen, Zeynep Haziroglu; Alatas, Cem; Demirtas, Mehmet SemihBackground/Objectives Diaper dermatitis is often caused by irritant contact occurring beneath the diaper of an infant, and it is aggravated by factors such as dampness, friction, urea, and feces. Food-allergic patients are known to exhibit various skin lesions ranging from urticaria to eczema. This study aims to determine the relationship between persistent diaper dermatitis and food allergy. Methods A retrospective chart review was conducted of pediatric patients with a diagnosis of persistent diaper dermatitis between August 2015 and November 2017. Results The study included 157 patients diagnosed with persistent diaper dermatitis (67 male, 72 female; median age: 13 months). Diaper dermatitis was more common and included the whole perineum in children who had multiple food allergies (P = 0.001). In children with multiple food allergies, the course of diaper dermatitis was more severe, and the condition did not respond to topical treatment (P = 0.025). A longer elimination diet was required for patients with Type I reactions and persistent diaper dermatitis (P = 0.018). In patients with Type II and mixed reactions, diaper dermatitis was more diffuse and covered the whole perineum (P = 0.025). In patients with Type II and mixed reactions, diaper dermatitis was more severe and did not respond to topical treatment (P = 0.025). Conclusions Persistent diaper dermatitis lasting longer than a month may be associated with food allergy. The diaper rash may also be the only indicator of the food allergy. Elimination of the responsible food may allow these patients to recover from persistent diaper dermatitis.Öğe Chronic granulomatous disease; Three different clinical presentation(2017) Celiksoy, Mehmet Halil; Koker, Mustafa Yavuz; Sensoy, Gulnar; Ceyhan, Meltem; Belet, Nursen; Yildiran, AlisanChronic granulomatous disease is an inherited disorder of nicotinamide-adenine dinucleotide phosphate oxidase and results in a defect in intracellular killing of ingested microorganisms characterized by recurrent life threatening bacterial and fungal infections. The disease is classified by mutations in specific subunits of the NADPH oxidase enzyme. There are one X-linked and four autosomal recessive forms of disease. The organisms cultured from lesion of patients with chronic granulomatous disease are generally catalase-producing including Staphylococci, Escherichia coli, Serratia; or fungi such as Aspergillus species. Recurrent or serious infections usually lead to diagnosis of disease in early childhood. We report three male patients who were diagnosed 5, 10, 13 years old, respectively and showed different clinical presentation.Öğe COMPARISON OF PERIPHERAL BLOOD LYMPHOCYTE SUBPOPULATIONS AND RECENT THYMIC EMIGRANTS IN PATIENTS WITH ATAXIA TELANGIECTASIA AND AGE-MATCHED HEALTHY CHILDREN(Springer/Plenum Publishers, 2014) Celiksoy, Mehmet Halil; Topal, Erdem; Yildiran, Alisan[Abstract Not Available]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 Demographics and clinical characteristic of patients diagnosed with hen’s egg allergy(2019) Topal, Erdem; Arga, Mustafa; Celiksoy, Mehmet Halil; Kaynak, Mustafa Sinan; Duman, Yücel; Demirtas, Semih; Alatas, Cem; Tonbul, Hayrettin; Dalkilic, Huri MaralAim: To assess the demographics, clinical characteristics and natural course of patients diagnosed with hen’s egg allergy.Material and Methods: Patients who were diagnosed with hen’s egg allergy were included in this study. The patients’ medical records were analyzed to collect demographic and clinical data.Result: 88 patients diagnosed with hen’s egg allergy were included in the study. 46 (52.3%) of the patients were male, their median age was 33 months and their median follow-up period was 18 months. 44 (50%) of the patients had comorbid atopic disease. 49 (55.7%) of the children’s parents had a diagnosis of atopic disease, while 5 (5.7 %) had a diagnosis of food allergy. In terms of the patients’ clinical symptoms, 86 (97.7%) had cutaneous symptoms, 16 (18.2%) had gastrointestinal system symptoms, 13 (14.8%) had respiratory system symptoms. In the follow-up, 43 (48.9%) of the patients were found to develop tolerance. When the patients allergic to egg white and those allergic to egg yolk were compared in terms of clinical findings, atopic eczema exacerbation was found to be more frequent (p=0.012) in patients allergic to egg white; while urticaria (p=0.005) and cough (p=0.012) were found to be more frequent in patients allergic to egg yolk.Conclusion: In clinical presentations that develop as a result of egg allergy, the most frequent symptoms are dermatological, gastrointestinal system and respiratory system symptoms, respectively. However, while atopic eczema exacerbations are more frequent in patients allergic to egg white, symptoms related with respiratory tract are more common in patients allergic to egg yolk. Keywords: Allergy; Cow’s Milk; Persistence; Predictive Factors; Tolerance.Öğe The Effect of Serum Vitamin D Level on Allergic Rhinitis Symptoms in Children(Mary Ann Liebert, Inc, 2021) Okmen, Zeynep Haziroglu; Celiksoy, Mehmet Halil; Topal, ErdemBackground: Allergic rhinitis (AR) is a chronic disease that is becoming increasingly common worldwide and has a negative impact on school performance, work performance, and quality of life. The aim of this study was to investigate the effect of vitamin D on the symptoms of AR in children. Methods: Serum vitamin D levels of children with AR and age-matched healthy controls were compared using the high-pressure liquid chromatography method. The relationship between serum vitamin D levels and symptoms and severity of AR was then examined. Results: The study included 137 patients diagnosed with AR (76 males, 61 females; median age: 11 years). Serum vitamin D levels were lower in the patient group than in the control group (P = 0.001), lower in all aeroallergen groups (mites, pollen, and multiple inhalants) than in the healthy control group (P = 0.001), and lower in both the perennial AR group and the seasonal AR group than in the control group (P = 0.001). Spearman correlation analysis showed that there was no correlation between symptom score and vitamin D level (r(s) = -0.099; P = 0.25). Conclusions: We found no correlation between serum vitamin D level and symptoms and severity of AR. Serum vitamin D levels were lower in children with AR than in healthy children.Öğe Effects of modifying visual inhaler spacer usage instructions on correct usage rate of untrained users(Wiley, 2020) Topal, Erdem; Arga, Mustafa; Ozmen, Hakan; Dogru, Mahmut; Alatas, Cem; Mustu, Elif Busra; Celiksoy, Mehmet HalilBackground Pressurized metered-dose inhalers (pMDIs) used with spacers are considered the method of choice for delivery of inhaled drugs in preschool-age children. The aim of this study was to determine the effects of modifying the visual inhaler spacer usage guidelines on the correct usage rate. Methods The parents and caregivers of patients <6 years old who were prescribed inhalers with spacers for the first time were included in our study. The participants were randomly divided into a modified visual inhaler spacer usage guidelines group and an unmodified visual inhaler spacer usage guidelines group. All study participants underwent face-to-face interviews and completed questionnaires. Results A total of 510 participants with a median age of 31 (range, 20-46) years were included in this study. The modified visual guidelines group included 254 (49.6%) participants, and the unmodified visual guidelines group included 256 (50.4%) participants. One hundred sixty-five (65.2%) of the 254 participants in the modified visual guidelines group correctly demonstrated the inhaler spacer technique. In contrast, only 21 (8.2%) of the 256 participants in the unmodified visual guidelines group correctly demonstrated the inhaler spacer technique (p < 0.001). When comparing the inhaler spacer usage steps between the 2 groups, the modified visual guidelines group demonstrated the steps more correctly and more quickly (p < 0.001). Conclusion The current visual inhaler spacer usage guidelines are insufficient. We believe that improving the visual inhaler spacer usage guidelines, in particular, will increase the correct usage rate and decrease the number of usage errors.Öğe Independent predictive factors for the persistence and tolerance of cow's milk allergy(Wiley, 2019) Topal, Erdem; Celiksoy, Mehmet Halil; Arga, Mustafa; Kaynak, Mustafa Sinan; Duman, Yucel; Demirtas, Semih; Alatas, CemBackground Cow's milk protein allergy (CMPA) is usually transient, with most children tolerating ingested cow's milk by 3 years of age. This study aimed to determine factors that promote or hindering the development of tolerance to CMPA. Methods A logistic regression model was used to determine independent risk factors associated with tolerance and persistence of CMPA. Result A total of 178 children diagnosed with CMPA were included in the study. The patients' median age was 32 months (minimum-maximum, 14 to 144 months), and their median follow-up period was 30 months (minimum-maximum, 12 to 54 months). In the follow-up, CMPA persisted in 62 (34.8%) patients. The patients were divided into 2 groups according to patient's age. Group I was <3 years old and group II was >= 3 years old. The factors independently associated with the persistence of CMPA for group I were as follows: comorbid food allergies (p = 0.021), the presence of an immunoglobulin E (IgE)-mediated reaction (p = 0.001), and respiratory system symptoms (ie, tachypnea) (p = 0.036). The presence of gastrointestinal-related discomfort (p = 0.001) was an independent risk factor associated with the development of tolerance. The presence of comorbid food allergies (p = 0.03) was the only independent predictive factor for CMPA persistence for group II. Conclusion The prognosis in cases of CMPA, a food allergy, is good, with tolerance developing over time. The presence of IgE-mediated CMPA, respiratory-related symptoms (ie, tachypnea), and the presence of comorbid food allergies have negative effects on tolerance.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 Prevalence of atopic diseases in children with papular urticaria(Codon Publications, 2021) Celiksoy, Mehmet Halil; Ozmen, Abdullah Hakan; Topal, ErdemBackground: Papular urticaria is a hypersensitivity reaction characterized by chronic and recurrent papular erythema. It occurs as a result of the bites of mosquitoes, fleas, bed bugs, and other insects; and it is generally seen in children. This study examines the prevalence of atopic diseases in patients with papular urticaria. Methods: The medical records of 130 pediatric patients with the diagnosis of papular urticaria between August 2017 and August 2019, whose disease progression was followed in two ter-tiary care centers, were reviewed retrospectively. The patients were divided into two groups: under 5 and above 5 years old. The prevalence of the atopic disease in children with papular urticaria was compared with those in age-matched controls without papular urticaria. Results: The study included 130 patients who were diagnosed with papular urticaria (64 mates, 66 females, median age: 60 months). The prevalences of atopic disease, recurrent wheezing, and atopic dermatitis were higher in the group under 5 years old with papular urticaria than in the same-age control group (p=0.001, 0.002, and 0.001, respectively). The prevalences of atopic disease, asthma, allergic rhinitis, and atopic dermatitis were higher in the group above 5 years old with papular urticaria than in the same-age control group (p=0.001, 0.001, 0.001, and 0.007, respectively). Conclusions: Many children with papular urticaria are atopic children. These patients should be assessed not only in terms of papular urticaria but also in terms of comorbid atopic diseases. (C) 2021 Codon Publications. Published by Codon Publications.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 Role of IgA and IgM in severity of atopic dermatitis Response(Elsevier Science Inc, 2015) Celiksoy, Mehmet Halil; Topal, Erdem; Sancak, Recep[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.
