Nihat Sapan

Background. Respiratory colonization with Pseudomonas aeruginosa is associated with increased morbidity and mortality in cystic fibrosis (CF) patients. This study aims to assess the clinical characteristics and associated factors of CF infants under two years of age with P. aeruginosa colonization in Türkiye. Method. Of the 1637 patients registered in the Cystic Fibrosis Registry of Türkiye in 2019, 284 patients under two years of age were included in this retrospective cross-sectional study. Patients were classified into two groups: those with P. aeruginosa colonization (Group 1) and those without (Group 2). Cystic fibrosis transmembrane conductance regulator (CFTR) gene functions were categorized according to CFTR mutation functional class. Results. Twenty-three patients (8.1%) were categorized as Group 1 and 262 participants (91.9%) were classified as Group 2. Infants with P. aeruginosa colonization (Group 1) were more likely to have minimal CFTR function compared with those without colonization (87% vs. 39.8%, p = 0.017). In addition, both Staphylococcus aureus colonization (47.8% vs. 7.3%, p < 0.001) and methicillin-resistant S. aureus positivity (17.4% vs. 6.1%, p = 0.042) were observed more commonly in Group 1. There were no statistical differences between the groups in terms of age at diagnosis, gender, mean z-scores of weight and height, newborn screening test positivity, sweat chloride test results, and pancreatic insufficiency (p > 0.05). Univariate logistic regression analysis did not identify significant associated factors for P. aeruginosa colonization. Conclusions. Our findings suggest that minimal CFTR function and S. aureus colonization are associated with P. aeruginosa colonization in CF patients under two years of age. Further studies are needed to investigate associated factors for early P. aeruginosa colonization, eradication treatment effectiveness, and longitudinal outcomes of in CF patients under two years of age.

Objective: Asthma is the most common chronic disease of childhood. The goal of asthma treatment is to achieve complete control of the damage. This study aimed to investigate the control status of children diagnosed with asthma aged 4-18 years, using asthma control tests, and the factors affecting this control.Methods: 500 asthmatic children aged 4-18 years were included in the study. Patients were assessed using the C-ACT in the 4-11 age group and the ACT in the 12-18 age group. Patients with asthma aged 4-11 years were classified as under-controlled based on the C-ACT results between 20 and 27 points, and as uncontrolled if they scored 19 or below. Patients with asthma aged 12-18 years were classified as well-controlled based on the ACT results between 20 and 25 points and poorly controlled if they scored 19 or below. To compare the vitamin D levels of the patients, the vitamin D levels of 100 children aged 4-18 years without any chronic disease were recorded retrospectively. Results: Of the cases, 55.6% (n=278) were male and 44.4% (n=222) were female. When evaluated in general, the median age at diagnosis was 7.2 years (minimum=1, maximum=16). According to the results of C-ACT, 51.7% (n=151) of the cases with asthma in the 4-11 age group were under control, and according to the results of ACT, 58.7% (n=122) of the cases between the ages of 12-18 were well controlled. Number of emergency visits; median=2 in the 4-11 age group (minimum=1, maximum=30), median=2 in the 12-18 age group (minimum=1, maximum=20) (p>0.05). Use of antibiotics at least once in the past year was significantly higher in the 4-11 age group (n=259, 88.70%) than in the 12-18 age group (n=156, 75%) (p<0.001). Asthma-related school absences (median=3, min=0, max=30) were significantly higher in the 12-18 age group than in the 4-11 age group (median, min=0, max=40) (p = 0.007). There was no significant difference in serum 25-OH-vitamin D levels between asthma and controls in either age group.Conclusion: In our study, a significant portion of the cases were uncontrolled despite regular follow-up and treatment. The low rate of influenza vaccination in asthmatic children and the higher-than-expected rate of smoking at home suggest a lack of education on this topic. No significant difference was found between asthmatic patients’ and controls’ vitamin D levels.

Food allergies are more prevalent in childhood and can result in life-threatening reactions. Although prevalence rates vary among populations, studies have shown that the global prevalence of food allergies ranges from 1% to 10%. The most common food allergens include milk, eggs, wheat, peanuts, tree nuts, fish, and shellfish. This study aimed to evaluate the allergen profile of children diagnosed with IgE-mediated food allergies who were admitted to the Pediatric Allergy Outpatient Clinic at Bursa Uludağ University Faculty of Medicine Hospital between June 2015 and June 2020. Among the patients, 63.6% were male, and the mean age at the time of presentation was 3.06 years. The majority (80.4%) presented with dermatological symptoms, and 10.2% experienced food-induced anaphylaxis. Atopy-related conditions were observed in 39.8% of the patients, with atopic dermatitis being the most common coexisting allergic disease frequently associated with IgE-mediated food allergies. Skin prick tests and serum-specific IgE analyses revealed that eggs and milk were the most prevalent allergens, respectively. Other commonly identified allergens included hazelnuts, peanuts, and walnuts. Management strategies involved a combination of dietary elimination and pharmacological treatment tailored to the individual patient's condition. This study underscores the importance of early identification of food allergies and the implementation of appropriate treatment strategies. Accurate diagnosis, avoidance of allergenic foods, and timely therapeutic interventions are essential for safeguarding patient health and preventing adverse allergic reactions.

The unfavorable effects of air pollution on respiratory health have been shown in many studies. Exposure to air pollution can lead to developing asthma and losing control over existing asthma. In this study, we aimed to evaluate the investigation of indoor air pollution in children with asthma. 130300 measurement data obtained from all participants’ home environments (29 patients diagnosed with asthma and 13 controls) were compared. The BLATN BR-SMART Multi-function Air Quality Monitor measured PM_2.5, CO₂, and formaldehyde (HCHO) levels. The age and sex distributions of the patients and controls were similar. The median age of asthmatic patients was 14 years (IQR: 9), and the median age of controls was 13 years (IQR: 9). The number of household members in the homes of asthmatic patients (median: 4, IQR: 1) was significantly higher than the controls (median: 3, IQR: 1) (p=0.035). Asthmatic patients’ houses were closer to the highway than the controls (p=0.019). The frequency of homes being closer than 100 meters to the main road was higher in asthmatics (n=17, 65.4%) than in controls (n=3, 23.1%) (p=0.019). Based on all measurements, indoor CO₂ and HCHO levels in the asthmatic patient group were higher than in the controls. Although the PM_2.5 levels were also higher in asthmatic patients, this difference was statistically insignificant. According to indoor air pollution parameters throughout the day, PM_2.5 levels were found to be higher in asthmatic patients, especially between 18.00 and 06.00, when the number of people in the house was the highest. Indoor PM_2.5, CO₂, and formaldehyde levels in patients with asthma were higher than controls. Management of environmental factors along with medical treatment is also essential to achieve better asthma control.

Objective: There are few studies investigating the impact of the COVID-19 pandemic on patients using omalizumab. In this study, it was aimed to investigate the effects of the COVID-19 pandemic on our patients who have been treating with omalizumab.Material and Methods: From two centers, a total of 20 patients participated in the study. A questionnaire, consisting of 45 questions prepared by our department, and a visual analogue scale (0: minimum, 10: maximum) were applied face-to-face to the patients.Results: It was observed that six patients (30%) did not continue their omalizumab treatment during the pandemic period. While 90% (n=18) of the patients were wearing masks, 85% (n=17) stated that they paid attention to social distance. In our study, the frequency of COVID-19 infection in patients using omalizumab was 10% (n=2). With the pandemic, while our patients’ working-study habits were affected negatively (n=10, 50%), their appetite increased (n=8, 40%), and it was noted that there have been changes in their sleep patterns (n=8, 40%).Conclusion: The COVID-19 pandemic has significantly affected our patients’ treatments and follow-ups. Our results support the argument that the use of omalizumab does not increase the risk of SARS-CoV-2 infection.

Many studies have shown that increased health literacy (HL) improves the management of chronic diseases. Data on the HL levels of adolescents with asthma are limited. In this study, we aimed to inv...

Background:Several factors that increase the risk of severe food-induced anaphylaxis have been identified.Objective:We aimed to determine the demographic, etiologic, and clinical features of food-induced anaphylaxis in early childhood and also any other factors associated with severe anaphylaxis.Methods:We carried out a medical chart review of anaphylaxis cases from 16 pediatric allergy and immunology centers in Turkey.Results:The data of 227 patients with 266 food-induced anaphylaxis episodes were included in the study. The median (interquartile range) age of the first anaphylaxis episode was 9 months (6‐18 months); 160 of these patients were boys (70.5%). The anaphylaxis episodes were mild in 75 cases (28.2%), moderate in 154 cases (57.9%), and severe in 37 cases (13.9%). The most frequent food allergens involved were cow's milk (47.4%), nuts (16.7%), and hen's egg (15.8%). Epinephrine was administered in only 98 (36.8%) of these anaphylaxis episodes. A logistic regression analysis revealed two statistically significant factors that were independently associated with severe anaphylaxis: the presence of angioedema and hoarseness during the anaphylactic episode. Urticaria was observed less frequently in patients who developed hypotension. In addition, confusion and syncope were associated with 25.9- and 44.6-fold increases, respectively, in the risk of concomitant hypotension.Conclusion:Cow's milk, nuts, and hen's egg caused the majority of mild and moderate-to-severe anaphylaxis episodes. The presence of angioedema and hoarseness in any patient who presents with a history of food-induced anaphylaxis should alert clinicians that the reaction may be severe. In addition, the presence of confusion, syncope, or stridor probably indicates concomitant hypotension.