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Öğe Anaphylaxis Management for Dentists: Knowledge and Preparedness(Bilimsel Tip Yayinevi, 2020) Celik, Velat; Ozdemir, Pinar Gokmirza; Beken, Burcin; Yucal, Melike; Yazicioglu, MehtapBackground: Anaphylaxis is not common in dentistry, but poor anaphylaxis management may lead to mortality. Objective: The aim of this study was to evaluate dentists' knowledge and preparedness to manage anaphylaxis. Materials and Methods: The study was designed as an online survey. It included questions about anaphylaxis management practices and the availability of equipment and medications in dental facilities. An online survey link was sent to members of the Turkish Dental Association (TDA). Results: A total of 952 TDA members responded to the survey. Fifty-seven point seven percent of dentists knew that adrenaline is the first choice drug to treat anaphylaxis. Fifty-two point four percent of dentists knew that intramuscular injection is the correct route of administration and 41.7% of dentists knew the correct dose to treat anaphylaxis. Only 15.3% of responding dentists answered all three questions correctly. Dentists who had previously been trained in the diagnosis and treatment of anaphylaxis performed better on questions about the first-choice drug, administration route, and dosage, when compared to untrained dentists (p<0.05). Of the responders, only 4.9% of dental facilities possessed complete medications and equipment capabilities to treat anaphylaxis. Conclusion: The majority of responding dentists did not seem to be aware of anaphylaxis management and did not have adequate equipment and medications for treatment of anaphylaxis in their dental facilities. There is an urgent need for undergraduate and postgraduate education programs to increase dentists' ability to manage anaphylaxis. The availability of emergency anaphylaxis medication and equipment in dental facilities should be ensured.Öğe Do traditional fermented foods protect against infantile atopic dermatitis(Wiley, 2019) Celik, Velat; Beken, Burcin; Yazicioglu, Mehtap; Ozdemir, Pinar Gokmirza; Sut, NecdetBackground: Environmental and dietary factors during pregnancy may affect development of infantile atopic dermatitis (AD). This study analyzed whether maternal consumption of selected Turkish fermented foods (FF) and other factors during pregnancy affect the development of AD during the first 2 years of life. Methods: Eighty-four children with physician-diagnosed AD (aged between 2 and 24 months) and mothers, and 56 similarly aged, healthy children and mothers were studied. Physician-administered questionnaires retrospectively surveyed maternal consumption of FF during pregnancy. The intake frequency of 8 selected Turkish FF was classified as either (1) daily or (2) less than daily. Other possible demographic and environmental risk factors were also analyzed. Results: Daily maternal consumption of yogurt, fermented olive, and cheese in the control group was significantly higher than the AD group (P < 0.001, P = 0.017, and P = 0.011, respectively). Exposure to environmental tobacco smoking (ETS) was more common in the AD group than the control group (P = 0.025). In multivariate logistic regression analysis, maternal ETS exposure during pregnancy was associated with increased risk of infantile AD, and daily consumption of yogurt was associated with a reduced risk (odds ratio [OR]: 2.60, 95% confidence interval [CI]: 1.11-6.1, and OR: 0.22, CI: 0.09-0.54, respectively). The diversity of consumed FF during pregnancy was found to have a protective effect against infantile AD (OR: 0.27, CI: 0.14-0.53). Conclusions: Daily maternal intake of yogurt and diversity of consumed Turkish FF during pregnancy may reduce the risk of AD. Maternal tobacco smoke exposure is associated with increased risk of infantile AD.Öğe Does Drug Allergy Workup in Children Satisfy Their Parents?(Karger, 2022) Ozdemir, Pinar Gokmirza; Celik, Velat; Beken, Burcin; Arcanli, Ibrahim; Yazicioglua, MehtapIntroduction: Although drug allergy workup for pediatric patients (skin and drug provocation tests [DPT]) is performed, the procedures are troublesome, painful, and time-consuming. The aim of this study was to assess parents' perception of and satisfaction with their child's drug allergy workup. Further, to evaluate parents' tendency to use the tested drug following a negative DPT and the consequences of re-exposure. Methods: Parents of children that underwent drug allergy workup from January 2017 to August 2020 in the Pediatric Allergy Department of Trakya University Medical Faculty were included. Satisfaction levels were assessed via a telephone questionnaire (3 open-ended, 7 multiple-choice questions). Satisfaction was scored on a Likert scale (1: very unsatisfied and 5: very satisfied). Results: A total of 102 parents participated the study. Fifty-two (51%) of patients were male, and median age was 6.2 years and a median time interval between admission and test appointment of 1 month; 16.7% had a positive drug allergy workup, with 88.3% reporting being satisfied (56.9%) or very satisfied (31.4%) with the workup. Satisfaction levels were inversely related to the time between admission and test appointment (rho: -0.254, p = 0.01), with 8.2% reporting they did not use the tested drug when necessary despite a negative result. The tested drug was used by 35 individuals (41.1%), 33 (94.2%) tolerating without reaction. Conclusion: Most parents were satisfied with the workup, but levels were inversely related to the admission and procedure time interval. Drug allergy workup should be performed as soon as possible to relieve parents' anxiety and achieve more patient satisfaction.Öğe Internet addiction and anxiety in asthmatic children after the first year of the COVID-19 pandemic(Galenos Publ House, 2023) Ozdemir, Pinar Gokmirza; Celik, Velat; Beken, Burcin; Ucar, Ozge Turkyilmaz; Kaplan, Sibel; Yazicioglu, MehtapObjective: Studies have revealed that people with asthma have a higher risk of anxiety during the COVID-19 pandemic. The relationship between internet addiction and anxiety has long been known, but to our knowledge, no studies have combined anxiety in asthmatic children and adolescents with internet use. This study investigated the relationship between anxiety levels and internet use in asthmatic children and adolescents during the late stage of the COVID-19 pandemic. Method: A multicenter survey was conducted in February -March 2021, enrolling 78 asthmatic patients and 44 healthy controls. Anxiety was assessed with the State -Trait Anxiety Inventory for Children (STAI-C) for children aged 9-12 and with the State -Trait Anxiety Inventory (STAI) for adolescents aged 13-18. Internet use was assessed with the Internet Addiction Scale for Adolescents (IASA). Results: Anxiety scores did not differ between patients and controls. The average time spent on the internet increased markedly (over three -fold) during the pandemic period compared to the pre -pandemic period (from 2.1 +/- 1.5 [0-6] hours per day to 6.9 +/- 3.5 [0-18] hours per day (p<0.001 in all participants). There was no difference in the IASA scores between the patients and controls. There was a correlation between the IASA and STAI state and trait (STAI [S] and STAI [T]) scores in the 13-18 year group (r=0.28, p=0.03, and r=0.34 p=0.01, respectively). Conclusion: Problematic internet use has more impact on anxiety in adolescents than asthma during the late stage of the COVID-19 pandemic. We suggest that internet addiction should be kept in mind when evaluating anxiety in asthmatic adolescents during their follow-up.Öğe Local allergic rhinitis: a pediatric perspective(Turkish J Pediatrics, 2020) Beken, Burcin; Eguiluz-Gracia, Ibon; Yazicioglu, Mehtap; Campo, PalomaLocal allergic rhinitis (LAR) is a differentiated rhinitis phenotype defined by perennial or seasonal rhinitis symptoms without systemic atopy. The diagnosis can be made by a positive response to the nasal allergen challenge (NAC) (the gold standard for diagnosis) in the absence of skin prick test and/or serum allergen-specific immunoglobulin E. Clinical and epidemiological studies have demonstrated that LAR affects individuals from different countries, races, and age ranges. Several studies have shown that the onset of nasal symptoms occurs during childhood in a significant proportion of LAR individuals. Evidence of LAR has been growing, especially in pediatric and Asian populations. A review of the literature reveals that most LAR studies of pediatric populations have appeared in the last three years. The prevalence of LAR in children ranges from 3.7% to 66.6%, and similar to what has been observed in adults, prevalence is higher in Western countries. Publications have shown that LAR in children can be either seasonal or perennial, and diagnosis of LAR confirmed by NAC have been reported with numerous allergens (house dust mites, pollens, molds, and dander). These findings illustrate that LAR is an important differential diagnosis in children with presumed non-allergic rhinitis, and a through review of the very recent literature can contribute to the clinical identification and diagnosis of LAR in children with no evidence of systemic atopy, as well as update readers' knowledge of the topic.Öğe Maternal anxiety and internet-based food elimination in suspected food allergy(Wiley, 2019) Beken, Burcin; Celik, Velat; Ozdemir, Pinar Gokmirza; Sut, Necdet; Gorker, Isik; Yazicioglu, MehtapBackground Food allergy is associated with stress, anxiety, and impairment in quality of life in both children and families. This study aimed to assess the anxiety of mothers in the case of suspected food allergy in their children and the influence of Internet usage on their levels of anxiety and food elimination. Methods Ninety-two patients aged 0-2 years presented at a pediatric allergy department following either a physicians' presumptive diagnosis or family's suspicion of food allergy (Group 1) and 99 healthy controls (Group 2) were evaluated. The clinical diagnosis of food allergy was confirmed or excluded by oral food challenge (OFC). The validated Turkish version of Spielberger State-Trait Anxiety Inventory (STAI) was applied to the mothers of both groups on admission and to Group 1 3 months after OFC. Results The state and trait anxiety (STAI-S and STAI-T) scores were significantly higher in Group 1 than Group 2 (P < 0.001, z = 5.410, and P = 0.021, z = 2.304, respectively). Seventy-nine mothers (85.9%) had been eliminating foods on admission. Thirty-seven (40.2%) mothers had eliminated foods on their own. The performance of food allergy-related Web searches was significantly higher among mothers who eliminated foods by themselves than those who did not (P = 0.004, chi(2) = 8.391, df = 1). The second STAI-S score was significantly lower among mothers whose children's food allergy diagnosis was excluded than confirmed (effect size = 1.06 (95% CI: 0.56-1.57), P = 0.001, z = 3.442). Conclusion It is important to make a correct food allergy diagnosis with a detailed allergy work-up, including OFC, to avoid anxiety and not cause unnecessary food elimination.Öğe Obsessive compulsive symptoms in mothers of children with atopic dermatitis(Termedia Publishing House Ltd, 2023) Celik, Velat; Beken, Burcin; Gorker, Isik; Ozdemir, Pinar Gokmirza; Sut, Necdet; Yazicioglu, MehtapIntroduction: Maternal stress, depression and anxiety are associated with atopic dermatitis (AD) in offspring. How- ever, the relationship between maternal obsessive compulsive symptoms (OCS) and AD in their children is unclear.Aim: To investigate whether maternal OCS are associated with AD in offspring.Material and methods: A total of 75 children with AD diagnosed by the paediatric allergist and 76 healthy children and their mothers were included in the study. A Turkish version of the Maudsley Obsessive Compulsive Inventory (MOCI-T) was used to assess OCS of mothers in both groups.Results: Total MOCI-T score and slowness, doubt, and rumination subscale scores were higher in the AD group than in the healthy group (p = 0.007, p = 0.001, p = 0.012 and p = 0.011, respectively) but washing/cleaning and checking subscale scores did not reach a statistically significant difference (p = 0.203 and p = 0.053, respectively). There was no correlation between SCORing Atopic Dermatitis (SCORAD) and MOCI-T/subscales scores.Conclusions: Our study provides evidence for associations between maternal OCS and infantile AD. The findings support recommendations for psychosocial support of mothers of children with AD.Öğe Oxcarbazepine-induced Stevens-Johnson syndrome: a pediatric case report(Oxford Univ Press, 2017) Beken, Burcin; Can, Ceren; Orencik, Aysegul; Can, Nuray; Yazicioglu, MehtapStevens-Johnson syndrome (SJS) and toxic epidermal necrolysis are two rare but life-threatening diseases characterized by detachment of epidermis, bullous skin lesions and mucous membrane erosions. Anti-epileptic drugs are highly suspected to be the causative agents. Although carbamazepine (CBZ) is the most associated anti-epileptic drug, oxcarbazepine (OXC), which is a monohydrated derivative of CBZ, is proposed to be safer because of the different metabolism of the two drugs. Herein, we report a case of SJS induced by oxcarbazepine. A 6-year-old boy with benign rolandic epilepsy, admitted to our hospital with generalized maculopapular rash after starting oxcarbazepine. The diagnosis of SJS was made with cytotoxic skin lesions and mucous membrane involvement. After discontinuing of the drug and topical corticosteroid initiation, the lesions were improved. We report this case to attract attention to the serious side effect of this anti-epileptic drug.Öğe Quercetin Improves Inflammation, Oxidative Stress, and Impaired Wound Healing in Atopic Dermatitis Model of Human Keratinocytes(Mary Ann Liebert, Inc, 2020) Beken, Burcin; Serttas, Riza; Yazicioglu, Mehtap; Turkekul, Kader; Erdogan, SuatBackground: Atopic dermatitis (AD) is a common inflammatory skin disease with complex pathogenesis. Natural flavonoids exhibit strong anti-inflammatory and antioxidant properties in many human diseases. In this study, the potential bioactive effect of quercetin, a polyphenolic plant-derived flavonoid, on the AD model of human keratinocytes was evaluated. Methods: Immortalized human HaCaT keratinocytes were treated with interleukin (IL) -4, -13, and tumor necrosis factor-alpha to mimic AD features in vitro. Then effects of quercetin on inflammation, oxidative stress, and wound healing were assessed. Results: Pretreatment of the cells with 1.5 mu M of quercetin significantly reduced the expression of AD-induced IL-1 beta, IL-6, IL-8, and thymic stromal lymphopoietin, while it strongly enhanced the expression of superoxide dismutase-1 (SOD1), SOD2, catalase, glutathione peroxidase, and IL-10. Quercetin promoted wound healing by inducing epithelial-mesenchymal transition, which was supported by the upregulation of Twist and Snail mRNA expression. Unexpectedly, quercetin pretreatment of AD-induced cells upregulated the mRNA expression of occludin and E-cadherin, while downregulating matrix metalloproteinase 1 (MMP1), MMP2, and MMP9 expression. The pretreatment inhibited AD-induced phosphorylation of extracellular signal-regulated kinase 1/2/mitogen-activated protein kinase (ERK1/2 MAPK) and the expression of nuclear factor-kappa B (NF-kappa B), but it did not alter signal transducer and activator of transcription 6 (STAT6) phosphorylation. Conclusion: Quercetin may serve as a potential bioactive substance for atopic dermatitis-related symptoms through anti-inflammatory and antioxidant activities along with its acceleration of wound healing via ERK1/2 MAPK and NF-kappa B pathways.Öğe Relationship between arginase genes polymorphisms and preschool wheezing phenotypes(Wiley, 2021) Gokmirza Ozdemir, Pinar; Eker, Damla; Celik, Velat; Beken, Burcin; Gurkan, Hakan; Yazicioglu, Mehtap; Sut, NecdetBackground The association between arginase I (ARG1) and arginase II (ARG2) genes and asthma has been reported in previous studies, but associations between polymorphisms in ARG genes and preschool wheezing (PSW) phenotypes are still unknown. Objective To examine the association between genetic variation in ARG1 and ARG2 genes and PSW phenotypes. Methods We enrolled 83 patients and 86 healthy controls. The patient group included two subgroups: episodic wheezing (EW) (n = 42, median age 41 months) and multiple-trigger wheezing (MW) (n = 41, median age 39 months). We genotyped six single nucleotide polymorphisms (SNPs) in ARG1 and six SNPs in ARG2. Eighteen haplotypes for ARG1 and 31 haplotypes for ARG2 were constituted, and the distributions of SNPs and haplotypes in patients and controls were analyzed. Results The frequency of the homozygote cytosine-cytosine (CC) genotype of ARG1 rs2781667T>C SNP and the ARG1 haplotype 4 in the MW group was significantly higher than the EW group (p = .002; odd ratios [OR]: 5.25; confidence interval [CI]: 1.9-14.51 and p < .001; OR: 7.77; CI: 2.54-23.74, respectively). The frequency of the ARG1 haplotype 5 was significantly higher but the frequency of ARG1 haplotype 9 was significantly lower in the all patients than in the healty controls (p = .019; OR: 10.34; CI: 1.28-83.53 and p = .015; OR: 0.093; CI:0.01-0.74, respectively). The frequency of the ARG1 haplotype 2 was significantly higher in the EW group than in the MW group (p = .014; OR: 5.68; CI: 1.48-21.8). Conclusion Variations in ARG1 may potentially be related to phenotypes and risk of PSW.Öğe Residents and interns in the 3 university hospitals: their knowledge of and attitudes to drug allergy(Asia Pacific Assoc Allergy, Asthma & Clinical Immunology, 2020) Ozdemir, Pinar Gokmirza; Kizilca, Ozgur; Aylanc, Hakan; Celik, Velat; Beken, Burcin; Akbulut, Simge Dilan; Yazicioglu, MehtapBackground: Previous studies revealed there are many gaps in the awareness and knowledge regarding the diagnosis and management of drug allergy (DA) among various health-care professionals. Objective: To assess the knowledge, attitudes, and practices towards DA among residents and interns of 3 university hospitals in the region of Trakya (Thrace), Turkey. Methods: A cross-sectional survey was conducted at university hospitals of 3 cities in the Trakya region: 1. Trakya University Medical Faculty, Edirne (n = 405), 2. Namik Kemal University Medical Faculty, Tekirdag (n = 114), and 3. Canakkale 18 Mart University Medical Faculty, Canakkale (n = 111). A Turkish questionnaire was developed based on previous published studies. Results: The majority of participants (67%) had not received education on DA as a separate subject during their medical education. Less than a third (28.3%) of all respondents were satisfied with their knowledge concerning patients with clinical signs of DA. Of the 6 knowledge questions on DA, the average score for the study was 3.51 out of 6 (58.5%). Residents had a higher knowledge score (3.93 +/- 1.1) compared with interns (3.05 +/- 1.2) (p < 0.001). The lowest percentage of correct answers were in response to questions on laboratory confirmation of drug-related anaphylaxis (14.5%) and the possibility of penicillin toleration in patients with a history of penicillin allergy (11.8%). The majority of participants (92%) believe that medical doctors should be educated in DA. There were no significant correlations between taking DA histories and the frequency during daily practice of encountering patients. Conclusion: Our study revealed that DA knowledge and attitudes are not at satisfactory level among respondents, and we concluded the importance and necessity of reinforcement of DA education in pre- and postgraduate education of medical doctors.Öğe Successful Desensitization of a Patient with Possible IgE-Mediated Anaphylactic Reaction to FVIII/VWF Concentrate(Mary Ann Liebert, Inc, 2019) Beken, Burcin; Celik, Velat; Ozdemir, Pinar Gokmirza; Eren, Tuba; Yazicioglu, MehtapBackground: Type 3 von Willebrand disease (VWD) is a severe bleeding disorder with a prevalence of 1:1 million live births. There are several von Willebrand factor (VWF) replacement products used in the treatment of acute bleeding episodes or as prophylaxis. Patients who receive multiple transfusions have an increased risk of developing antibodies against these products. These antibodies can lead to life-threatening anaphylactic reactions. Previous studies have identified immune complex formation and complement activation as the trigger for anaphylaxis, rather than IgE. IgE-mediated anaphylaxis against VWF concentrates has not yet been published. Case: A 4-year-old female patient with type 3 VWD was referred to our hospital because of an anaphylactic reaction during FVIII/VWF concentrate (Immunate (R)) infusion. She had previously received FVIII/VWF concentrate (Haemate P (R)) infusions 8 times without any complications. She did not have antibodies against VWF and FVIII, and serum IgA level was normal. Since she needed factor replacement therapy as a result of a growing hematoma on her scalp, we performed skin prick and intradermal tests 2 days after the reaction. The prick test, with FVIII/VWF (Immunate), was negative, but the intradermal test was positive. We administered a 12-step desensitization protocol with FVIII/VWF concentrate (Immunate) successfully without any reactions. Conclusion: Anaphylactic reaction to factor replacement products is a major problem for patients with VWD, especially type 3 VWD requiring multiple factor infusions. We achieved a successful desensitization with FVIII/VWF concentrate in a patient who had an anaphylactic reaction during the infusion of this product. Our patient is important since she represents the first case of IgE-mediated anaphylaxis against VWF concentrate reported in the literature.Öğe Think Twice before Interpreting the Skin Prick Test as Age, Body Mass Index, and Atopy Affect Reaction Time and Size(Karger, 2021) Beken, Burcin; Celik, Velat; Gokmirza Ozdemir, Pinar; Yazicioglu, MehtapIntroduction: The skin prick test (SPT) is a reliable method to confirm sensitization in IgE-mediated allergic diseases; however, it has been reported to be affected by several personal and environmental factors. Our objective was to determine the factors affecting the skin reactivity to histamine and allergens and investigate whether it differs according to age in terms of reading time. Methods: A total of 500 patients, aged 4 months-18 years, were enrolled in the study. Wheal and flare reaction sizes were documented as the mean of the longest and the midpoint perpendicular diameter in the 5th, 10th, 15th, and 20th min. Skin reactivity was compared between children >24 and <= 24 months of age. Results: We found larger histamine and allergen wheal sizes in children >24 months than the ones <= 24 months of age (p < 0.001 and p = 0.007, respectively). The duration of maximum histamine reactivity was 15 min for children >24 months whereas 10 min for children <= 24 months of age. The number of children losing their histamine reactivity after 15 and 20 min was significantly higher in the smaller age-group. Multiple regression analysis revealed a larger histamine reactivity in children >24 months of age, having obesity, and having allergen sensitization (p = 0.002, p = 0.003, and p = 0.018, respectively). Conclusion: It seems more accurate to evaluate SPT after 10 min in children <= 24 months of age. Cutoff values and ideal measurement time according to individual factors such as age, body mass index, or atopy are needed. (c) 2021 S. Karger AG, Basel
