The aim of this study was to evaluate and compare the frequency of atopy and allergic disease in ... more The aim of this study was to evaluate and compare the frequency of atopy and allergic disease in all groups of primary immunodeficiency (PID) patients. The study was done on 318 patients with PID between the ages of 6 months and 18 years. The patients and their parents were questioned regarding their histories of asthma and allergic disease. Within the study group, 82.4% of the patients had antibody deficiency, 10.4% combined immunodeficiency, 6.6% phagocyte number or function defect, and 0.6% complement deficiency. Patients with selective immunoglobulin (Ig)A deficiency had a more significant history of ever wheezing compared to those with IgG subclass deficiency (p=0.022). The frequency of current wheezing was higher in patients with antibody deficiency than in patients with combined immunodeficiency (p=0.049). In conclusion, patients with antibody deficiency, especially those with selective IgA deficiency, should be evaluated regarding asthma and allergic diseases if recurring re...
Antibody deficiency comprises a heterogeneous group of disorders characterised by the body&am... more Antibody deficiency comprises a heterogeneous group of disorders characterised by the body's inability to mount an effective antibody response to pathogens. Although it has been reported that asthma and allergic disease are frequent in antibody deficiencies, there are no data that evaluate and compare bronchial hyperreactivity (BHR) in all groups of antibody deficiencies. In this study, we aimed to evaluate and compare the frequency of BHR in patients with different antibody deficiencies. The study was carried out on 113 patients between ages 5 and 18 diagnosed with antibody deficiencies. The patients and their families were questioned on their history of asthma and allergic diseases. Allergic skin prick tests and non-specific bronchial provocation test with methacholine was done for all patients. Complete blood count and serum total IgE levels were measured. The mean age of the patients was 10.8 ± 3.8 years and 66.4% were male. Within the study group 41.6% of the patients had selective IgA deficiency, 24.8% had IgG subclass deficiency, 14.2% had partial IgA deficiency, 10.6% had common variable immunodeficiency, 6.2% had transient hypogammaglobulinaemia and 2.7% X-linked agammaglobulinaemia. In total group, 42.5% had bronchial hyperreactivity with methacholine challenge test. BHR was more significant in both patients with selective IgA deficiency and partial IgA deficiency compared to those with IgG subclass deficiency (P=0.041 and P=0.038, respectively). BHR was high in antibody deficiencies, especially selective IgA deficiency compared to IgG subclass deficiency.
Background Because of the rise in the frequency, food allergies (FA) and consequently anaphylaxis... more Background Because of the rise in the frequency, food allergies (FA) and consequently anaphylaxis (A) are becoming public health problems. The conciousness about prevention, diagnosis and therapy has to be improved, especially among primary care physicians ( ...
Perhaps the phrase "until the cows come home," which first appeared in 1829, applies to preterm i... more Perhaps the phrase "until the cows come home," which first appeared in 1829, applies to preterm infants. More evidence is mounting that cow's milk can induce an inflammatory reaction resulting in NEC and is eerily similar based on cytokine profiles to food proteininduced enterocolitis. Just like the cow left to graze for months before returning, providers should consider delaying introduction of cow's milk in preterm infants.
Common upper respiratory tract viruses are the most frequent and important causes of asthma exace... more Common upper respiratory tract viruses are the most frequent and important causes of asthma exacerbations in both children and adults. Prospective epidemiologic studies report that up to 80% of childhood exacerbations are associated with viral upper respiratory tract infections. The study group consisted of 104 children with asthma aged 3-17 years who received treatment for asthma exacerbations in our clinic between September 2009 and 2010. Nasopharyngeal and nasal swabs were obtained from all patients during an acute attack, and from the control group (31 subjects). These specimens were investigated for the presence of viral respiratory pathogens using a real-time multiplex PCR method. The patients were compared for the presence of respiratory pathogens and factors related to the severity of the asthma exacerbation. A pathogenic respiratory virus was detected in 53.8% of patients in the acute exacerbation group. The most commonly encountered viral agent was Rhinovirus (35.6%). Patients who had an acute exacerbation with or without a detectable viral pathogen were compared according to the severity of the exacerbation, the need for systemic steroids, and hospitalization rates. No statistically significant difference was found. Although viral upper respiratory tract infections are the most common cause of asthma exacerbations, the severity level of the exacerbation seems to be independent of whether a respiratory virus has been detected.
International Archives of Allergy and Immunology, 2013
Several studies have demonstrated a relationship between asthma and obesity. However, the results... more Several studies have demonstrated a relationship between asthma and obesity. However, the results have been conflicting with regard to the relationship between fractional exhaled nitric oxide (FeNO), used as a marker of airway inflammation in asthmatic patients, and obesity. We aimed to evaluate the association of FeNO with obesity and obesity-related metabolic complications in asthmatic and nonasthmatic children. The study population included children aged between 6 and 17 years and consisted of 4 groups: obese asthmatics (n = 52), normal-weight asthmatics (n = 49), obese nonasthmatics (n = 51) and normal-weight nonasthmatics (n = 42). FeNO measurement and spirometry were performed for all patients. To evaluate the metabolic complications, serum lipids, glucose and insulin levels were measured. Insulin resistance (IR) was estimated by the homeostasis model assessment, HOMA-IR. All participants were evaluated for the presence of metabolic syndrome (MS). The mean age for the 194 subjects participating in the study was 11.6 ± 2.5 years. The FeNO level of asthma patients with MS was not different from those without MS (14.5 ± 8.0 and 16.7 ± 8.7, respectively, p = 0.449). In the nonasthmatic group, subjects with MS had a higher FeNO level than subjects without MS (12.5 ± 5.1 and 17.3 ± 8.3, respectively, p = 0.014). Spearman's rank correlation coefficients revealed a positive correlation between FeNO and body mass index (BMI; p = 0.049, r(2): 0.204) in the nonasthmatic group and after multivariate regression analysis, BMI still persisted as an independent risk factor for FeNO. We found a positive correlation between BMI and FeNO level which suggests a link between obesity and increased airway inflammation in nonasthmatic children.
Background: Adherence to clinical practice guidelines for management of cardiovascular disease (C... more Background: Adherence to clinical practice guidelines for management of cardiovascular disease (CVD) is suboptimal. The purposes of this study were to identify practice patterns and barriers among U.S. general internists and family physicians in regard to cardiovascular risk management, and examine the association between physician characteristics and cardiovascular risk management.
Anaphylaxis is a potentially life-threatening condition. There are limited data about the etiolog... more Anaphylaxis is a potentially life-threatening condition. There are limited data about the etiology and the clinical characteristics in developing countries. This study aimed to investigate the clinical characteristics of anaphylaxis patients attending our pediatric allergy clinic. We conducted a prospective analysis of patients who were admitted to our allergy clinic for anaphylaxis from 2010 to 2012. Ninety-six patients were evaluated during the study period. The mean age was 7.4 ± 5.2 years. Venom, food, and drugs were the most common causative agents responsible for 31 (32.3%), 30 (31.3%), and 26 (27.1%) of the cases, respectively. Foods implicated most frequently were peanuts and nuts (n = 9; 30.0%), cow's milk (n = 7; 23.3%), and egg white (n = 6; 20.0%). The clinical manifestations during anaphylaxis in order of frequency were cutaneous (97.9%), respiratory (86.5%), gastrointestinal (42.7%), neurological (37.5%), and cardiovascular symptoms (30.2%). A biphasic course was noticed in five cases (5.2%). Of the 91 patients, 79 (86.8%) received H1-antihistamines, 73 (80.2%) received corticosteroids, 40 (44.4%) received adrenaline, 38 (41.8%) received fluid replacement therapy, 18 (19.8%) received β2-mimetics, and 8 (8.8%) received H2-antihistamines. According to severity, 7.3% of patients had mild, 59.4% had moderate, and 33.3% had severe anaphylaxis. Food and bee venom allergy were the most common etiologies. Adrenaline, the first-line treatment of anaphylaxis, was administered in only 44.4% of our cases.
Objective: Children with COVID-19 are reported to get the infection from an adult contact, with m... more Objective: Children with COVID-19 are reported to get the infection from an adult contact, with minimal secondary transmission from children. Children do not appear to be efficient transmitters of infection. Common symptoms in adults infected with COVID-19 include fever, dry cough and fatigue. The symptoms in children are more atypical than in adults, and coughing is lighter. Methods: Children aged 0-18 who was admitted to the emergency department from March 20 to September 15, 2020 and had confirmed diagnosis of COVID-19 with a positive real-time reverse-transcriptase polymerase chain reaction (RT-PCR) were included in the study. Results: RT-PCR tests were done in 835 children with suspected SARS-CoV-2 infection and the test was positive in 178 (21.3%) children. The most common symptoms at the onset of illness were fever (67.4%), headache (41.1%), cough (36.6%), sore throat (25.7%), fatigue (22.9%), myalgia (22.9%) and diarrhea (20.6%). One hundred and seven (61.1%) of the patients were infected by close contact with family members diagnosed with COVID-19, 35 (20%) of the patients were infected via close contact with non-family members diagnosed with COVID-19, 11 (6.3%) of the patients had a history of exposure in an epidemic area, including wedding hall, condolence house and shopping center and 23 (13.1%) of the patients with unknown source of infection. Conclusion: COVID-19 infection is seen to be milder and cause less hospitalizations and patient deaths in children. Crowded indoor environments are the main centers of the spread of the outbreak and children are unlikely to be the main source of infection of the pandemic.
The aim of this study was to evaluate and compare the frequency of atopy and allergic disease in ... more The aim of this study was to evaluate and compare the frequency of atopy and allergic disease in all groups of primary immunodeficiency (PID) patients. The study was done on 318 patients with PID between the ages of 6 months and 18 years. The patients and their parents were questioned regarding their histories of asthma and allergic disease. Within the study group, 82.4% of the patients had antibody deficiency, 10.4% combined immunodeficiency, 6.6% phagocyte number or function defect, and 0.6% complement deficiency. Patients with selective immunoglobulin (Ig)A deficiency had a more significant history of ever wheezing compared to those with IgG subclass deficiency (p=0.022). The frequency of current wheezing was higher in patients with antibody deficiency than in patients with combined immunodeficiency (p=0.049). In conclusion, patients with antibody deficiency, especially those with selective IgA deficiency, should be evaluated regarding asthma and allergic diseases if recurring re...
Antibody deficiency comprises a heterogeneous group of disorders characterised by the body&am... more Antibody deficiency comprises a heterogeneous group of disorders characterised by the body's inability to mount an effective antibody response to pathogens. Although it has been reported that asthma and allergic disease are frequent in antibody deficiencies, there are no data that evaluate and compare bronchial hyperreactivity (BHR) in all groups of antibody deficiencies. In this study, we aimed to evaluate and compare the frequency of BHR in patients with different antibody deficiencies. The study was carried out on 113 patients between ages 5 and 18 diagnosed with antibody deficiencies. The patients and their families were questioned on their history of asthma and allergic diseases. Allergic skin prick tests and non-specific bronchial provocation test with methacholine was done for all patients. Complete blood count and serum total IgE levels were measured. The mean age of the patients was 10.8 ± 3.8 years and 66.4% were male. Within the study group 41.6% of the patients had selective IgA deficiency, 24.8% had IgG subclass deficiency, 14.2% had partial IgA deficiency, 10.6% had common variable immunodeficiency, 6.2% had transient hypogammaglobulinaemia and 2.7% X-linked agammaglobulinaemia. In total group, 42.5% had bronchial hyperreactivity with methacholine challenge test. BHR was more significant in both patients with selective IgA deficiency and partial IgA deficiency compared to those with IgG subclass deficiency (P=0.041 and P=0.038, respectively). BHR was high in antibody deficiencies, especially selective IgA deficiency compared to IgG subclass deficiency.
Background Because of the rise in the frequency, food allergies (FA) and consequently anaphylaxis... more Background Because of the rise in the frequency, food allergies (FA) and consequently anaphylaxis (A) are becoming public health problems. The conciousness about prevention, diagnosis and therapy has to be improved, especially among primary care physicians ( ...
Perhaps the phrase "until the cows come home," which first appeared in 1829, applies to preterm i... more Perhaps the phrase "until the cows come home," which first appeared in 1829, applies to preterm infants. More evidence is mounting that cow's milk can induce an inflammatory reaction resulting in NEC and is eerily similar based on cytokine profiles to food proteininduced enterocolitis. Just like the cow left to graze for months before returning, providers should consider delaying introduction of cow's milk in preterm infants.
Common upper respiratory tract viruses are the most frequent and important causes of asthma exace... more Common upper respiratory tract viruses are the most frequent and important causes of asthma exacerbations in both children and adults. Prospective epidemiologic studies report that up to 80% of childhood exacerbations are associated with viral upper respiratory tract infections. The study group consisted of 104 children with asthma aged 3-17 years who received treatment for asthma exacerbations in our clinic between September 2009 and 2010. Nasopharyngeal and nasal swabs were obtained from all patients during an acute attack, and from the control group (31 subjects). These specimens were investigated for the presence of viral respiratory pathogens using a real-time multiplex PCR method. The patients were compared for the presence of respiratory pathogens and factors related to the severity of the asthma exacerbation. A pathogenic respiratory virus was detected in 53.8% of patients in the acute exacerbation group. The most commonly encountered viral agent was Rhinovirus (35.6%). Patients who had an acute exacerbation with or without a detectable viral pathogen were compared according to the severity of the exacerbation, the need for systemic steroids, and hospitalization rates. No statistically significant difference was found. Although viral upper respiratory tract infections are the most common cause of asthma exacerbations, the severity level of the exacerbation seems to be independent of whether a respiratory virus has been detected.
International Archives of Allergy and Immunology, 2013
Several studies have demonstrated a relationship between asthma and obesity. However, the results... more Several studies have demonstrated a relationship between asthma and obesity. However, the results have been conflicting with regard to the relationship between fractional exhaled nitric oxide (FeNO), used as a marker of airway inflammation in asthmatic patients, and obesity. We aimed to evaluate the association of FeNO with obesity and obesity-related metabolic complications in asthmatic and nonasthmatic children. The study population included children aged between 6 and 17 years and consisted of 4 groups: obese asthmatics (n = 52), normal-weight asthmatics (n = 49), obese nonasthmatics (n = 51) and normal-weight nonasthmatics (n = 42). FeNO measurement and spirometry were performed for all patients. To evaluate the metabolic complications, serum lipids, glucose and insulin levels were measured. Insulin resistance (IR) was estimated by the homeostasis model assessment, HOMA-IR. All participants were evaluated for the presence of metabolic syndrome (MS). The mean age for the 194 subjects participating in the study was 11.6 ± 2.5 years. The FeNO level of asthma patients with MS was not different from those without MS (14.5 ± 8.0 and 16.7 ± 8.7, respectively, p = 0.449). In the nonasthmatic group, subjects with MS had a higher FeNO level than subjects without MS (12.5 ± 5.1 and 17.3 ± 8.3, respectively, p = 0.014). Spearman's rank correlation coefficients revealed a positive correlation between FeNO and body mass index (BMI; p = 0.049, r(2): 0.204) in the nonasthmatic group and after multivariate regression analysis, BMI still persisted as an independent risk factor for FeNO. We found a positive correlation between BMI and FeNO level which suggests a link between obesity and increased airway inflammation in nonasthmatic children.
Background: Adherence to clinical practice guidelines for management of cardiovascular disease (C... more Background: Adherence to clinical practice guidelines for management of cardiovascular disease (CVD) is suboptimal. The purposes of this study were to identify practice patterns and barriers among U.S. general internists and family physicians in regard to cardiovascular risk management, and examine the association between physician characteristics and cardiovascular risk management.
Anaphylaxis is a potentially life-threatening condition. There are limited data about the etiolog... more Anaphylaxis is a potentially life-threatening condition. There are limited data about the etiology and the clinical characteristics in developing countries. This study aimed to investigate the clinical characteristics of anaphylaxis patients attending our pediatric allergy clinic. We conducted a prospective analysis of patients who were admitted to our allergy clinic for anaphylaxis from 2010 to 2012. Ninety-six patients were evaluated during the study period. The mean age was 7.4 ± 5.2 years. Venom, food, and drugs were the most common causative agents responsible for 31 (32.3%), 30 (31.3%), and 26 (27.1%) of the cases, respectively. Foods implicated most frequently were peanuts and nuts (n = 9; 30.0%), cow's milk (n = 7; 23.3%), and egg white (n = 6; 20.0%). The clinical manifestations during anaphylaxis in order of frequency were cutaneous (97.9%), respiratory (86.5%), gastrointestinal (42.7%), neurological (37.5%), and cardiovascular symptoms (30.2%). A biphasic course was noticed in five cases (5.2%). Of the 91 patients, 79 (86.8%) received H1-antihistamines, 73 (80.2%) received corticosteroids, 40 (44.4%) received adrenaline, 38 (41.8%) received fluid replacement therapy, 18 (19.8%) received β2-mimetics, and 8 (8.8%) received H2-antihistamines. According to severity, 7.3% of patients had mild, 59.4% had moderate, and 33.3% had severe anaphylaxis. Food and bee venom allergy were the most common etiologies. Adrenaline, the first-line treatment of anaphylaxis, was administered in only 44.4% of our cases.
Objective: Children with COVID-19 are reported to get the infection from an adult contact, with m... more Objective: Children with COVID-19 are reported to get the infection from an adult contact, with minimal secondary transmission from children. Children do not appear to be efficient transmitters of infection. Common symptoms in adults infected with COVID-19 include fever, dry cough and fatigue. The symptoms in children are more atypical than in adults, and coughing is lighter. Methods: Children aged 0-18 who was admitted to the emergency department from March 20 to September 15, 2020 and had confirmed diagnosis of COVID-19 with a positive real-time reverse-transcriptase polymerase chain reaction (RT-PCR) were included in the study. Results: RT-PCR tests were done in 835 children with suspected SARS-CoV-2 infection and the test was positive in 178 (21.3%) children. The most common symptoms at the onset of illness were fever (67.4%), headache (41.1%), cough (36.6%), sore throat (25.7%), fatigue (22.9%), myalgia (22.9%) and diarrhea (20.6%). One hundred and seven (61.1%) of the patients were infected by close contact with family members diagnosed with COVID-19, 35 (20%) of the patients were infected via close contact with non-family members diagnosed with COVID-19, 11 (6.3%) of the patients had a history of exposure in an epidemic area, including wedding hall, condolence house and shopping center and 23 (13.1%) of the patients with unknown source of infection. Conclusion: COVID-19 infection is seen to be milder and cause less hospitalizations and patient deaths in children. Crowded indoor environments are the main centers of the spread of the outbreak and children are unlikely to be the main source of infection of the pandemic.
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Papers by Celal Özcan