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Öğe Association between allergic diseases and attention deficit hyperactivity disorder in childhood(Bilimsel Tip Yayinevi, 2015) Akyol, Sule Turan; Kilic, Mehtap; Guner, Sukru Nail; Karakurt, Melih Nuri; Akbas, Seher; Ozturk, Fadil; Sancak, RecepObjective: Attention Deficit Hyperactivity Disorder (ADHD) is a common childhood problem similar to allergic disorders. The aim of the study is to determine whether allergic disorders and atopy are associated with physician-diagnosed ADHD. Materials and Methods: This study was designed as a nested casecontrol study. One hundred sixty children were divided into three groups; 55 patients with ADHD, 55 children of healthy siblings of the study group and 50 unrelated healthy children. For each subject, an International Study of Asthma and Allergies in Children (ISAAC) questionnaire was completed. The total eosinophil count, total IgE levels were measured and skin prick tests were performed. Results: The prevalence of asthma was significantly higher in the ADHD group than the control group but was similar to the sibling group. Even though prevalence of rhinitis was significantly higher in ADHD group relative to the other groups, atopic rhinitis was similar in all groups. There were no significant differences for prevalence of eczema, elevated total IgE levels, eosinophil count and positive skin prick testing between any of the groups. Conclusion: The rhinitis seems to be a risk factor for ADHD while atopic status does not appear to be involved. Nasal obstruction and sleep disturbances due to rhinitis may affect the cognitive functions of individuals with ADHD. These individuals should be evaluated to determine whether or not (allergic) rhinitis accompanies ADHD.Öğe Characteristics of venom allergic reactions in Turkish beekeepers and alternative treatment modalities(Wiley-Blackwell, 2014) Celiksoy, Mehmet Halil; Sancak, Recep; Sogut, Ayhan; Guner, Sukru Nail; Korkmaz, AliBackground: The objective of this work was to determine the characteristics of allergic reactions that may occur after a bee sting and alternative treatment methods in Turkish beekeepers. Methods: A written questionnaire was administered to beekeepers from the Ordu, Samsun, Sinop, Amasya, and Corum provinces located in the Central Black Sea Region of Turkey. Results: The study included 301 beekeepers, 295 (98%) of whom were male. Their mean age was 48.2 +/- 11.5 years. The mean beekeeping duration was 15.3 +/- 10.5 years. A total of 270 participants (89.9%) had a history of bee stings in the previous 12 months. Systemic reactions, large local reactions, and local reactions were seen in 21 (6.9%), 193 (64.1%), and 12 (4.0%) beekeepers, respectively. The face was the most frequently stung body site, and swelling generally occurred in the eyelids. The size of the swellings decreased within 12 to 24 hours in 259 (86.1%) beekeepers. The size of the swellings was 1 x 2 cm in diameter in 157 (52.2%) beekeepers. Natural protection against bee stings had developed by 12 months in 140 (46.5%) beekeepers. In total, 61.5% of the beekeepers applied alternative treatments (eg, garlic, onion water, yogurt), whereas 14.0% (3/21) were admitted to a hospital with a systemic reaction. In total, 10.6% and 14.2% of beekeepers were aware of adrenaline auto-injector and venom immunotherapy, respectively. Conclusion: This study indicates insufficient knowledge and attitudes among Turkish beekeepers regarding bee sting reactions. (C) 2014 ARS-AAOA, LLC.Öğe Glucocorticoid Receptor-? Is Downregulated by Vitamin D Treatment in Children with Low Vitamin D Levels but Not in Allergic Asthma(Mary Ann Liebert, Inc, 2015) Guner, Sukru Nail; Sancak, Recep; Gulten, Sedat; Ozen, Ahmet; Kilic, Mehtap; Bedir, AbdulkerimBackground: Vitamin D (VitD) enhances the anti-inflammatory effects of glucocorticoids (GC) in vitro. It was hypothesized that VitD3 (colecalciferol) treatment could have an impact on the expression of glucocorticoid receptors (GRs) in a group of children with low VitD levels, with or without asthma. Methods: Asthmatic children and healthy controls, all with low serum VitD levels (25-hydroxyvitamin D [25(OH)D] level <30 ng/mL) were recruited. VitD3 treatment at a dose of 300,000 IU was given orally. Blood samples were obtained at admission and 1 month after the treatment to examine serum 25(OH)D levels and the relative gene expression (RGE) of GR-alpha and -beta in peripheral blood mononuclear cells. Results: Twenty-four children with asthma (M-age 11.1 +/- 2.1 years) and 14 healthy controls (M-age 11.5 +/- 1.7 years) were studied. The expression of GR-beta was significantly higher in the control group at baseline compared with those with asthma (p = 0.006). With VitD3 treatment, there was a decrease in GR beta expression at 1 month in the control group (p = 0.05), but not in the asthma group. When analyzing the change in the relative expression of GR beta (change in 1st month to baseline), the decrease in GR beta was significantly higher in the control group compared with the asthma group (p = 0.002). A negative correlation was detected between the change in the asthma control test score (ACT) and the change in 25(OH)D values (r = -0.51, p = 0.01). Conclusion: VitD3 supplementation led to a decrease in the expression of GR beta in control subjects with low baseline VitD levels, whereas no such change was observed in asthmatic children. Meanwhile, better asthma control was achieved by VitD3 treatment, possibly through mechanisms not related to GR expression.Öğe Is vitamin D insufficiency to blame for recurrent wheezing?(Wiley-Blackwell, 2014) Demirel, Soner; Guner, Sukru Nail; Celiksoy, Mehmet Halil; Sancak, RecepBackgroundVitamin D (VitD) and its metabolites play important roles in the regulation of the respiratory and immune systems. The aim of this study was to examine serum 25(OH) vitamin D [25(OH)D] levels and VitD deficiency on the development of wheezing and clinical features. MethodsThis study was a prospective cross-sectional survey that included a total of 70 infants being followed in the Pediatric Immunology and Allergy Unit at Ondokuz Mayis University. Forty of these infants (patient group), ranging in age from 1 to 3 years, had been diagnosed as wheezy infants; 30 were age-and-gender matched healthy infants (control group). Prior to the study, blood samples were taken from both groups to determine their serum VitD, blood eosinophil, and serum immunoglobulin E (IgE) levels. ResultsThe duration of breastfeeding was similar for both groups. The serum 25(OH)D levels of the patient group were significantly lower than those of the control group. Although there was a negative relationship between 25(OH)D level and IgE((log10)) values for the wheezy infants with VitD deficiency, the control group had a negative relationship between VitD level and IgE((log10)). ConclusionSerum 25(OH)D levels must be evaluated when following wheezy infants, and those with deficiency must be treated with VitD.Öğe Results of treatment in our patients with toxic epidermal necrolysis(Bilimsel Tip Yayinevi, 2014) Celiksoy, Mehmet Halil; Sancak, Recep; Sogut, Ayhan; Gusner, Sukru Nail; Paksu, Sukru; Ozturk, FadilObjective: Toxic epidermal necrolysis is a rare disease that has very high mortality and morbidity. Despite the high mortality rate of the disease, treatment is still controversial today. In this study, we discussed the treatment of patients who were treated and followed up due to the toxic epidermal necrolysis in our hospital. Materials and Methods: This is a s tudy of children diagnosed as toxic epidermal necrolysis in our hospital between January 2011 and April 2013. We retrospectively analyzed response to the treatment. Results: We followed five patients in this period with a clinical diagnosis of toxic epidermal necrolysis. The median age at diagnosis was nine years (min: 2, max: 15), and three of them were male. Toxic epidermal necrolysis occured in three of the patients after the use of anticonvulsants, in one of the patients after use of antibiotic and in one of the patients after the use of antihypertensive. Three of the patients were given combination of intravenous immunoglobulin (IVIG) (1 g/kg) with corticosteroid (1 mg/kg/day), two of the patients only were given IVIG (1 g/kg/day). In two patients, corticosteroid therapy was given for five days. In one case who was given corticosteroid therapy for seven days and with lesions more severe according to SCORTEN developed gram-negative sepsis in clinical follow. Especially patients developed toxic epidermal necrolysis after anticonvulsant showed more severe clinic and longer recovery period. Conclusion: Improvement was observed in all patients. When only IVIG therapy compared to corticosteroid plus IVIG treatment, there were no superiority to each other.Öğe Students' unchanging smoking habits in urban and rural areas in the last 15years(Wiley, 2016) Akca, Gulfer; Guner, Sukru Nail; Akca, Unal; Kilic, Mehtap; Sancak, Recep; Ozturk, FadilBackgroundSmoking is the main preventable public health problem particularly for youth worldwide. The aim of the present study was to determine the prevalence of smoking habits among students at secondary and high schools, and to compare the findings with those of a study conducted 15years ago in the same area. MethodsIn this cross-sectional study 6212 students (51.2% female; 48.8% male) were selected randomly from rural and urban areas in Samsun. All students completed a face-to-face questionnaire. ResultsThe overall prevalence of smoking was 13.0% (male students, 18.1%; female students, 8.2%). The mean starting age of smoking was 14.1 1.5years. Prevalence of smoking was 15.7% in urban areas and 8.1% in rural areas. The most important factors for starting smoking were social group and families. Compared with a study conducted 15years previously in the same area for male students, smoking prevalence was increased in rural, but decreased in urban areas. ConclusionsSmoking prevalence in students in Samsun was similar to that in a study conducted 15years previously. It is important to use anti-smoking campaigns directly targeted at teenager and they should be fully informed of the harmful effects of smoking.Öğe Toksik epidermal nekroliz tanısı alan olgularımızın tedavi sonuçları(2014) Güner, Şükrü Nail; Çeliksoy, Mehmet Halil; Sancak, Recep; Söğüt, Ayhan; Paksu, Şükrü; Öztürk, FadılGiriş: Toksik epidermal nekroliz, nadir görülmesine rağmen mortalite ve morbiditesi oldukça yüksek bir hastalıktır. Hastalığın mortalitesi yüksek olmasına rağmen, tedavisi günümüzde halen tartışmalıdır. Bu çalışmada hastanemizde toksik epidermal nekroliz nedeniyle izlenen hastaların tedavi sonuçları değerlendirildi. Gereç ve Yöntem: Toksik epidermal nekroliz tanısıyla hastanemizde Ocak 2011-Nisan 2013 yılları arasında karşılaştığımız çocuk hastaların verilen tedavilere cevapları dosya kayıtlarından retrospektif olarak incelendi. Bulgular: İki yıllık süre içinde toksik epidermal nekroliz tanısıyla beş çocuk olgu izlenmiştir. Olguların ortanca yaşı 9 yaş (en küçük: 2 yaş, en büyük: 15 yaş) olup, üç olgu erkekti. Üç olguda antikonvülzan kullanımı sonrası, bir olguda antibiyotik sonrası, bir olguda ise antihipertansif kullanımı sonrası toksik epidermal nekroliz tablosu gelişti. Üç olguda, beş gün süreyle 1 g/kg intravenöz immünglobulin (İVİG) ve 1 mg/kg/ gün dozunda kortikosteroid tedavisi kombine olarak verilirken, iki olguda, beş gün süreyle 1 g/kg/gün dozunda İVİG tedavisi tek başına verildi. İki hastamızda kortikosteroid tedavisi beş gün verildi. Bir hastamızda ise, kortikosteroid tedavisi yedi gün verildi. Hastalığın mortalitesini gösteren SCORTEN’e göre daha şiddetli lezyonları olan bu olgunun izleminde gram-negatif sepsis gelişti. Özellikle antikonvülzan sonrası toksik epidermal nekroliz gelişen olguların daha ağır seyrettiği ve iyileşme sürelerinin daha uzun olduğu gözlendi. Sonuç: Hastalarımızın tamamında iyileşme gözlendi. Tek başına İVİG tedavisinin, kortikosteroid ve İVİG kombinasyonu tedavisiyle kıyaslandığında tedavi uygulamalarının sonuçları arasında fark görülmedi.
