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    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. Selcuk
    Currently, 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.
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    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. Selcuk
    Objective: 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.
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    Ultrasound and shear wave elastography assessment of diaphragm thickness and stiffness in malnourished pediatric patients
    (Springer, 2024) Sinanoglu, M. Selcuk; Gungor, Sukru; Dag, Nurullah; Varol, Fatma Ilknur; Kenc, Senay; Gok, Emre
    Our objective was to obtain information about diaphragm muscle mass, strength, and quality using conventional US and US-based imaging method shear wave elastography (SWE) in pediatric patients with primary malnutrition. We also sought to evaluate the usability of SWE in the diagnosis and follow-up of sarcopenia. We evaluated the diaphragm thickness and stiffness of patients diagnosed with primary malnutrition in the pediatrics and pediatric gastroenterology outpatient clinic using US and US-based SWE. The data were compared with those of an age- and gender-matched healthy control group. The study included 115 volunteers. Of the cases included, 53 were healthy controls and 62 (54%) were patients with primary malnutrition. There was no significant difference between the groups in terms of age and gender (p = 0.891 and p = 0.923, respectively). The malnourished patient group had significantly lower diaphragm thickness and stiffness. There is a significant positive correlation between anthropometric measurement Z scores and diaphragm thickness and stiffness.Conclusion: Our study indicated that there was a reduction in the thickness of the diaphragm and a decline in its stiffness, which could be an indirect indicator of the quality and strength of the diaphragm muscle. These findings suggest that US and SWE evaluation of the diaphragm muscle may have the potential for use in the diagnosis and follow-up of sarcopenia. However, further comprehensive randomized controlled studies are needed to confirm this. What is Known: center dot Magnetic resonance imaging, computed tomography, and dual-energy x-ray absorptiometry are commonly used in the evaluation of sarcopenia. center dot The psoas and paraspinal muscles are commonly used in the evaluation of sarcopenia. What is New: center dot Ultrasound and shear wave elastography can be used in the evaluation of pediatric sarcopenia. center dot Diaphragm muscle can be used in the evaluation of pediatric sarcopenia.