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Öğe Allergic and autoimmune disorders in families with selective IgA deficiency(2017) Erkoçoğlu, Mustafa; Metin, Ayşe; Kaya, Ayşenur; Özcan, Celal; Akan, Ayşegül; Kocabaş, Can NaciBackground/aim: IgA deficiency is the most common human primary immunodeficiency. The prevalence of allergic disorders and autoimmunity is thought to be increased in selective IgA deficiency (sIgAD). However, it is currently unclear if these disorders coincide within these families. We aimed to evaluate the frequency of allergic and autoimmune disorders in children with sIgAD and their first degree relatives (FDRs). Materials and methods: The study included 81 children diagnosed with sIgAD and 274 of their FDRs. The presence of allergic and autoimmune disorders was evaluated and serum antithyroglobulin and antithyroid peroxidase levels were measured in both patients and their first-degree relatives. Results: The mean age of the patients was 9.9 ± 3.9 years. Among the patients with sIgAD, 45.7% of them had at least one allergic disorder and 17.3% of them had at least one autoimmune disorder. The frequencies of asthma, allergic rhinitis, and eczema in the FDRs of sIgAD patients were 10.9%, 9.1%, and 7.7%, respectively. Among their FDRs, 14.6% had autoimmunity, compared to an estimate of 5% in the general population. Conclusion: Increased frequency of allergic and autoimmune disorders in patients with sIgAD and their FDRs suggests a possible common predisposing genetic component for sIgAD and autoimmunity in these families.Öğe Anaphylaxis: Turkish national guideline 2018(Bilimsel Tıp Yayinevi, 2018) Orhan, Fazıl; Civelek, Ersoy; Şahiner, Ümit Murat; Arga, Mustafa; Can, Demet; Çalışkaner, Ahmet Zafer; Çetinkaya, Feyzullah; Erkoçoğlu, MustafaAnaphylaxis is an acute and potentially fatal systemic reaction that sould be recognized and managed by all helthcare professionals. This is the first national guideline of Turkish National Society of Allergy and Clinical Immunology on diagnosis and management of anaphylaxis. The guideline is prepared by Anaphylaxis Interest Group with the incorporation of 20 allergy/immunology specialists and the epidemiology, etiology, pathophysiology, symptoms and signs, diagnosis/differentials, and acute and long-term management of anaphylaxis are reviewed in detail.Öğe The association of obesity and obesity-related conditions with carotid extra-medial thickness in children and adolescents(Wiley, 2016) Bekdaş, Mervan; Kaya, E.; Dağıstan, Emine; Göksügür, Sevil Bilir; Demircioğlu, Fatih; Erkoçoğlu, Mustafa; Dilek, MustafaBackground: Carotid extra-medial thickness (EMT) and carotid intima-media thickness (cIMT) provide information concerning vascular changes. Objectives: In this study, we aimed to evaluate the association between carotid EMT and obesity and its metabolic complications in children. Methods: The study included 38 obese subjects and 30 age-matched and sex-matched healthy controls aged between 7 and 17 years. For all subjects, complete blood count, fasting blood glucose, serum insulin, aspartate aminotransferase, alanine aminotransferase, HDL cholesterol, total cholesterol and triglyceride levels were measured. The carotid EMT and cIMT were measured by an expert radiologist in all patients. Results: Body mass index (BMI) (28.8 +/- 3 vs. 18.1 +/- 2.2, p<0.001), total cholesterol (167.9 +/- 34.8 mg dL(-1) vs. 150.5 +/- 28.1 mg dL(-1), p = 0.029), homeostatic model assessment of insulin resistance (HOMA-IR) (4.3 vs. 1.7, p<0.001), cIMT (0.51 +/- 0.08 mm vs. 0.45 +/- 0.06 mm, p<0.001) and carotid EMT (0.74 +/- 0.11 mm vs. 0.64 +/- 0.1 mm, p<0.001) were significantly higher in obese subjects than in controls, while HDL cholesterol (41.6 +/- 6.5 mg dL(-1) vs. 49.5 +/- 7.5 mg dL(-1), p<0.001) was lower in obesity group. Among the obese subjects, the HOMA-IR values (4.7 vs. 3.6, p = 0.027), cIMT (0.54 +/- 0.07 mm vs. 0.49 +/- 0.07 mm, p = 0.039) and carotid EMT (0.79 +/- 0.1 mm vs. 0.7 +/- 0.1 mm, p=0.013) were significantly higher in postpubertal children compared with prepubertal children. BMI, cut-off values of HOMA-IR and cIMT were significantly associated with increased carotid EMT (p<0.001, p = 0.023 and p<0.001, respectively). The only independent risk factor affecting carotid EMT was BMI (p<0.001). Conclusion: We have found that carotid EMT is associated with cIMT, obesity and insulin resistance and the assessment of carotid EMT may provide additional information concerning early vascular disease.Öğe Bart sendromu: Aplazia cutis ve distrofik epidermolizis büllosa(2016) Dilek, Mustafa; Bilir, Sevil Göksügür; İldeş, Elif Nur; Göksügür, Nadir; Bekdaş, Mervan; Erkoçoğlu, Mustafa; Demircioğlu, FatihOtuz dokuz haftalık 3080 g olarak doğan erkek bebekte yapılan fizik muayenede her iki bacakta dizden başlayan ve ayakların da dâhil olduğu alanda cilt epitelinin olmadığı, solda daha fazla olmakla birlikte, ellerde büllöz lezyonlar görüldü. Takibinde küçük travmalarla yeni büllöz lezyonların oluştuğu izlendi. El tırnaklarında distrofik görünüm olması, Aplazia cutis ve distrofik epidermolizis büllosa birlikteliği ile Bart Sendromu tanısı konuldu. Antibiyotik ve antifungal tedavi sistemik ve lokal olarak uygulandı. Yüzeyel epitelizasyonun yeterli görüldüğü 5. haftasında aileye bakım eğitimleri verilerek taburcu edildi. Bart sendromu; cildin konjenital lokalize yokluğu (aplasia cutis), epidermolizis bülloza ve distrofik tırnak değişiklikleri ile karakterize genetik bir hastalıktır. Aplasia cutis'in epidermolizis büllosa ile birlikte bulunmasını açıklayacak birçok hipotez ortaya atılmıştır. En çok kabul gören ise prenatal dönemde ekstremitelerin sürtünmesi sonucu ortaya çıkan intrauterin bül formasyonlarına bağlı cilt kaybı durumudurÖğe Can we prevent childhood asthma?(Wiley-Blackwell, 2016) Erkoçoğlu, Mustafa; Serpen, Ali Fuat; Doğru, Mahmut; Topal, Erdem; Bekdaş, Mervan; Dilek, Mustafa; Demircioğlu, Fatih[No Abstract Available]Öğe Clinical and etiologic evaluation of the children with chronic urticaria(Ocean Side Publications Inc, 2016) Azkur, Dilek; Civelek, Ersoy; Toyran, Müge; Mısırlıoğlu, Emine Dibek; Erkoçoğlu, MustafaBackground: Chronic urticaria (CU) is a skin disorder defined as daily or almost daily exhibition of pruritic and transient wheals that last for >6 weeks. CU is divided into two subtypes: chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU). Objectives: To evaluate the clinical features, possible causes, associated findings, and laboratory results of different subtypes of CU in children according to a new classification. Methods: In this study, we evaluated the clinical features, laboratory investigations, and provocation tests of children with different subtypes of CU according to a new classification. Results: Two hundred and twenty-two children (59.9% girls) were enrolled in the study. Of the study patients, 59.9% and 40.1% were diagnosed as having CSU and CIndU, respectively. Antithyroid antibody levels were positive in 7.1% of the patients with CSU, 32.8% of the children had positive 14C-urea breath test results, and 6.5% of the patients had positive stool examination results for parasites. Autologous serum skin test results were positive in 53.5% of the patients with CSU. Of the patients with CIndU, 77.5% had symptomatic dermographism, 16.8% had cold urticaria, 2.2% had cholinergic urticaria, 2.2% had solar urticaria, and 1.1% had aquagenic urticaria. Conclusion: Children with CSU represent the majority of patients with CU, and more than a half of these patients might have autoimmune urticaria. Symptomatic dermographism was the most common type of CIndU.Öğe Clinical and Etiological evaluation of the children with chronic urticaria(Wiley-Blackwell, 2016) Azkur, Dilek; Civelek, Ersoy; Toyran, Müge; Erkoçoğlu, Mustafa; Mısırlıoğlu, Dibek Emine[No Abstract Available]Öğe Comparison of histopathological effects of thymoquinone and local nasal corticosteroids in allergic rhinitis in a rabbit model(Karger, 2016) Yurttaş, Veysel; Şereflican, Murat; Erkoçoğlu, Mustafa; Dağlı, Muharrem; Terzi, Elçin Hakan; Fırat, Tülin; Seyhan, SinanBackground/Aims: In this study, we aimed to evaluate the histopathological effects of thymoquinone treatment of the nasal mucosa in a rabbit model of allergic rhinitis, and we compared its effects with those of nasal mometasone furoate. Methods: A total of 24 male New Zealand rabbits were used. The animals were randomly assigned to one of four groups. Group 1 received no treatment, while group 2 underwent ovalbumin (OVA) sensitization only. Group 3 was the study group; after OVA sensitization, the rabbits were treated with intranasal thymoquinone. The group 4 rabbits received mometasone furoate for 7 days after OVA sensitization. Mucosal structures were stained with hematoxylin and eosin, while toluidine blue was used to stain mast cells. Apoptosis was evaluated using a TUNEL assay. Results: In the positive control groups, including the thymoquinone and intranasal mometasone furoate groups, intraepithelial and submucosal inflammation and goblet cell hypertrophy were significantly decreased compared to group 2 (p < 0.001). The cilial structure was normal, as was the chondrocyte structure in both treatment groups. Conclusion: This is the first study to evaluate the histopathological effects of thymoquinone in an allergic rhinitis model. Thymoquinone reduced allergic inflammation and may be valuable for treating allergic rhinitis. However, additional studies are needed. (C) 2016 S. Karger AG, BaselÖğe The etiology and clinical features of anaphylaxis in a developing country: a nationwide survey in Turkey(Allergy Immunol Soc Thailand,, 2017) Civelek, Ersoy; Erkoçoğlu, Mustafa; Akan, Ayşegül; Özcan, Celal; Kaya, Ayşenur; Tokaç, MahmutBackground: Despite the increasing frequency of anaphylaxis, there is inadequate information on the etiology and clinical features in various countries, regions and age groups, especially in developing countries. Objective: Our aim is to assess the etiology and clinical findings of anaphylaxis in Turkey. Gathering reliable data about the etiology and clinical findings of anaphylaxis in the general population will decrease the related morbidity and mortality. Method: We obtained the names and phone numbers of individuals who had been prescribed an epinephrine auto-injector with a diagnosis of anaphylaxis from ministry of health. Demographic data, clinical history of the first episode of anaphylaxis including the triggering agent, clinical findings, course of hospitalization, and the management of anaphylaxis were obtained by phone survey. Results: A total of 843 patients with a mean age of 21.4 +/- 17.3 years were evaluated. There was a significant male predominance among children younger than 10 years of age but a female predominance in older subjects. The most common causes of anaphylaxis were foods(40.1%) in children and bee venom(60.8%) in adults. The biphasic reaction rate was 4.3% and the median length of stay at an emergency department was 4.0 hours. Almost 60% of the patients had recurrent anaphylaxis episodes. Only 10.7% of the cases were prescribed an epinephrine auto-injector at their first anaphylaxis episode and only 59.2% of the patients were referred to an allergist during discharge from the emergency department. Conclusions: In Turkey, bee venom was the most common cause of anaphylaxis, followed by food and drug. While more than a half of patients reported recurrent attacks; only 10% had been prescribed epinephrine auto-injector kit after their first episode. Strategies to improve the anaphyalxis management are therefore urgently required.Öğe Excessive food elimination by pediatricians in food allergic infants and their mothers(Wiley, 2017) Melek, Efnan; Büyüktiryaki, Betül; Nacaroğlu, Tekin; Dut, Raziye; Soyer, Özge Uysal; Erkoçoğlu, MustafaIntroduction: The prevalence of food allergy (FA) has increased in recent decades. Food allergy has different clinical presentations based on the immunological mechanisms. Objectives: In this study, we aimed to determine the clinical approach of the pediatricians for the diagnosis and management of the FA. One hundred and seventy pediatricians from different cities of Turkey fulfilled a questionnaire including 24 multiple-choice or fill-in-the-blank questions.Öğe Griscelli Syndrome presented with Status Epilepticus and Hemophagocytic Lymphohistiocytosis(2017) Demircioğlu, Fatih; Aydın, Hilal; Erkoçoğlu, Mustafa; Önay, Hüseyin; Dağıstan, EmineA 12-month-old female infant was referred to our hospital with prolonged fever and status epilepticus. Her weight and height were below the 5th percentile for age. Physical examination revealed marked hypotonia, fever, pallor, partial albinism with silvery gray hair, and hepatosplenomegaly (Figure 1A). Laboratory investigations showed anemia, thrombocytopenia, hypofibrinogenemia, hyperferritinemia, and hemophagocytosis at bone marrow examination (Figure 1B). Lymphocyte subsets and serum immunoglobulin levels were normal. Hair examination showed irregularly scanty melanin pigments (Figure 1C). Electroencephalographic study revealed encephalopathic findings, including decreased background activity with continuous slow wave discharges. Brain magnetic resonance imaging showed diffuse cerebral involvement (Figure 2). RAB27A encoding gene C.149delG mutation was detected. We diagnosed Griscelli syndrome (GS) with hemophagocytic lymphohistiocytosis (HLH). She received the HLH-2004 treatment protocol. The patient showed complete hematological response to treatment and was discharged after 1 month with persistent neurological involvement. Although bone marrow transplantation is the only curative therapy for GS, we did not plan bone marrow transplantation due to the severe neurological sequela. The patient died due to progressive disease after 6 months.Öğe Harlequin Ichthyosis treated with acitretin(Galenos Yayıncılık, 2015) Dilek, Mustafa; Göksügür, Sevil Bilir; Akçabelen, Yunus Murat; Tuman, Bengü Altunay; Göksügür, Nadir; Bekdaş, Mervan; Erkoçoğlu, Mustafa; Demircioğlu, FatihHarlequin ichthyosis is a genodermatosis characterized by an extreme thickening of the fetal skin. It is the most severe form of autosomal recessive congenital ichthyosis. Massive, horny shell of dense scales and contraction abnormalities of the eyes, ears and mouth are the main characteristics of the affected newborns. Harlequin ichthyosis was uniformly fatal. Intense supportive care with appropriate topical treatment and systemic retinoid therapy in the neonatal period has changed the fate of patients. Here, we represent a Harlequin ichthyosis case which was successfully treated with acitretin.Öğe Hemophagocytic Lymphohistiocytosis Griscelli Syndrome Presented with Status Epilepticus and(2017) Demircioğlu, Fatih; Aydin, Hilal; Erkoçoğlu, Mustafa; Onay, Hüseyin; Dağistan, Emine-Öğe Histopathological effects of intranasal phototherapy and nasal corticosteroids in allergic rhinitis in a rabbit model(Elsevier Science Sa, 2015) Yurttaş, Veysel; Şereflican, Murat; Erkoçoğlu, Mustafa; Terzi, Elçin Hakan; Kükner, Aysel; Oral, MesutAllergic rhinitis is one of the most common health problems and has a major effect on quality of life. Although new-generation antihistamines and nasal steroids are the main treatment options, complete resolution cannot be obtained in some patients. Besides common side effects such as nasal irritation and epistaxis, the use of these drugs is controversial in some patients, such as pregnant or breastfeeding women. These findings highlight the need for new treatment options. Although phototherapy has been successfully used in the treatment of atopic dermatitis, which is an IgE-mediated disease and shares several common pathogenic features with allergic rhinitis, there are limited studies about its role in the treatment of allergic rhinitis. In this study, we aimed to evaluate and compare the histopathological effects of intranasal phototherapy (Rhinolight) and nasal corticosteroid treatment on the nasal mucosa in allergic rhinitis in a rabbit model and we found that both treatment options significantly reduced inflammation in the nasal mucosa without increasing apoptosis of mucosal cells. (C) 2015 Elsevier B.V. All rights reserved.Öğe İnfantil hemanjiom ve oral propranolol tedavisi(2015) Dilek, Mustafa; Bekdaş, Mervan; Göksügür, Sevil Bilir; Demircioğlu, Fatih; Karataş, Zehra; Erkoçoğlu, Mustafaİnfantil hemanjiom bebeklik döneminin en sık görülen selim tümörüdür. Tedavi endikasyonları arasın - da; havayolu tıkanıklıkları, ülserasyon, enfeksiyon, görme bozukluğu, emme bozukluğu gibi fonksiyon kayıplarına yol açması durumları sayılabilir. İnfantil hemanjiomun tedavisinde kortikosteroidler uzun yıllardır ilk tercih olmakla beraber son yıllarda oral propranolol de kullanılmaya başlanmıştır. Yüzün sağ tarafında geniş hemanjiomu bulunan 3 aylık hastada, propranolol tedavisi ile belirgin iyileşme sağlanmış ve güncel tedavi ile ilgili çalışmalar tartışılmıştır.Öğe The knowledge and attitudes of patients about epinephrine autoinjector use in Turkey(Wiley-Blackwell, 2016) Kaya, Ayşenur; Erkoçoğlu, Mustafa; Civelek, Ersoy; Toyran, Müge; Akan, Ayşegül[No Abstract Available]Öğe Neutrophil/lymphocyte and C-reactive protein/mean platelet volume ratios in differentiating between viral and bacterial pneumonias and diagnosing early complications in children(Saudi Med J, 2014) Bekdaş, Mervan; Göksügür, Sevil Bilir; Saraç, Esma G.; Erkoçoğlu, Mustafa; Demircioğlu, FatihObjectives: To test the usability of neutrophil/lymphocyte (N/L) and C-reactive protein/mean platelet volume (CRP/MPV) ratios for the differential diagnosis of bacterial versus viral pneumonia, and the early diagnosis of complications related to pneumonia. Methods: This retrospective study was conducted on 31 patients diagnosed with bacterial pneumonia and 21 patients diagnosed with viral pneumonia from January 2011 to December 2012 in the Department of Pediatrics, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey. We investigated the clinical characteristics, radiological, and laboratory findings of patients from their medical records. Results: The female/male ratio of patients with bacterial was 1.0/1.8, and with viral pneumonias was 1.0/2.0. The mean patient age was 59+/-51 months. There was a statistically significant difference in the neutrophil/lymphocyte ratio (2.7 versus 0.6, p<0.001) and CRP/MPV ratio (11.0 versus 9.3, p<0.001) in the cases with bacterial pneumonia versus those who had viral pneumonia. Nine of the patients were identified as having complications. There was a statistically significant difference in the N/L ratio (3.5 versus 1.2, p=0.01) and CRP/MPV ratio (11.1 versus 3.9, p=0.001) in the cases that developed complications compared with those that did not. When the neutrophil/lymphocyte and CRP/MPV ratios were used jointly, the diagnosis of bacterial pneumonia could be correctly estimated in 28 (90.3%) cases (odds ratio [OR]=0.06, 95% confidence interval [CI]: 0.01-0.29, p<0.001) and pneumonia-related complications were predicted in 8 (88.9%) cases (OR=13.5, 95% CI: 1.5-118.1, p=0.005). Conclusions: It was observed that the combined use of N/L and CRP/MPV ratios might be used in both the differential diagnosis of bacterial versus viral pneumonia, and the prediction of complications.Öğe Obezitesi Olan ve Olmayan Astımlı Çocuklarda Vitamin D Düzeyleri(2016) Erkoçoğlu, Mustafa; Çapanoğlu, Murat; Civelek, Ersoy; Kaya, Ayşenur; Giniş, Zeynep; Toyran, Müge; Misirlioğlu, Emine DibekGiriş: Astım ve obesite dünya genelinde milyonlarca insanı etkileyen önemli toplumsal sağlık sorunlarındandır. Son yıllarda vitamin D'nin allerjik hastalıkların ve obezitenin prevelansında etkisi olabileceği ileri sürülmüştür. Bu çalışmada vitamin D düzeyleri ile astım, obezite varlığı ve astım şiddeti arasındaki ilişki araştırılmıştır.Gereç ve Yöntem: Çalışmaya 119 olgu dahil edildi. Yaş ve cinsiyete göre eşleştirilmiş dört çalışma grubu oluşturuldu: Obezite ve astımı olanlar Grup I (n:34), normal kilolu astımlılar Grup II (n:28), astımı olmayan obez hastalar Grup III (n:30), normal kilolu ve astımı olmayan kontrol grubu Grup IV (n:27) olarak kabul edildi. Bulgular: Serum 25 hidroksi vitamin D düzeyleri açısından dört grup karşılaştırıldığında aralarında fark saptanmadı. Hastalar astım şiddetlerine göre serum vitamin D düzeyleri açısından karşılaştırıldığında gruplar arasında fark saptanmadı.Sonuç: Sonuç olarak, çalışmamızda serum 25 hidroksi vitamin D düzeyleri ile astım, obezite ve atopi varlığı arasında ilişki saptanmamıştır.Öğe Polen gıda allerjisi sendromu(2017) Kurt, Özlem Kar; Erkoçoğlu, Mustafa; Kurt, MevlütPolen gıda allerjisi sendromuPolen gıda allerjisi sendromu, bir aeroallerjen ve bir bitki-türevi antijeni arasında, IgE antikorlarının aracılık ettiği tip I çapraz reaksiyondur. Esas semptomlar, sistemik semptomlar olmaksızın, tipik olarak dudak veya ağızda uyuşma, dudak, dil, damak ve farinkste kaşıntı, karıncalanma ve şişme gibi lokalize oral semptomlardan oluşur. Mevsimsel allerjik rinit, astım ya da her ikisinin bulunduğu hastalarda daha sık görülmektedir. Çoğu hastada hafif semptomlar olması, gıdalardan kaçınılması ile düzelmesi nedeniyle gerçek sıklığı bilinmemektedir. Bu derlemede polen gıda allerjisi sendromunun özellikleri ile tanı ve tedavi yaklaşımlarını mevcut literatürler eşliğinde tartışmayı amaçladık.Öğe Pollen food allergy syndrome(Turkish Assoc Tuberculosis & Thorax, 2017) Kurt, Özlem Kar; Erkoçoğlu, Mustafa; Kurt, MevlütPollen food allergy syndrome, is a type I cross-reaction mediated by IgE antibodies between an aeroallergen and a plant-derived antigen. Main symptoms are typically consist of localized oral symptoms such as numbness of the lip or mouth, itching, tingling and swelling of lips, tongue, palate and pharynx without systemic symptoms. Patients with seasonal allergic rhinitis, asthma or both more frequently experience pollen food allergy syndrome. Because most patients have mild symptoms and the improvement by avoiding food, the true incidence is unknown. In this review, we aimed to discuss characteristics, diagnosis and treatment of pollen food allergy syndrome according to existing literature.
