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Öğe Anaphylaxis in Turkish children: a multi-centre, retrospective, case study(WILEY, 2011) Orhan, F.; Canitez, Y.; Bakirtas, A.; Yilmaz, O.; Boz, A. B.; Can, D.; Kuyucu, S.Background Anaphylaxis is a serious and potentially lethal systemic reaction affecting more than one organ or system. Objective We aimed to describe the demographic characteristics, clinical features, causes, settings, and administered therapy in Turkish children. Methods This retrospective, case note study included all children referred to the outpatient clinics of the Pediatric Allergy Departments of the participating study centres from 1 July 1999 to 30 June 2009 for investigation of anaphylaxis or who were seen by us at the moment of the reaction during the same period and who met the clinical criteria of anaphylaxis. Results Two hundred and twenty-four cases of anaphylaxis were reported in 137 children (88 boys, P = 0.0001). The mean +/- SD age at the referral was 7.7 +/- 4.2 years (range: 4 months-17 years). Ninety-eight episodes (43.8%) occurred at home. The symptoms were cutaneous in 222 (99.1%) episodes, respiratory in 217 (96.9%), neuro-psychiatric in 118 (52.7%), cardiovascular in 92 (41.1%), and gastrointestinal in 88 (39.3%). Biphasic reaction was reported in seven episodes (3.1%, 95% CI: 1.5-6.3). Death occurred in one case (0.4%, 95% CI: 0.08-2.4). Treatment was available in 158 episodes (70.5%). Of them, 148 (93.7%) received antihistamines, 132 (83.5%) corticosteroids, 51 (32.3%) epinephrine, and 17 (10.8%) beta-2-mimetics. The causative agents were foods in 86 (38.4%) episodes, hymenoptera venom in 84 (37.5%), drugs and medications in 47 (21.0%), and latex in 5 (2.2%). In two episodes (0.9%), the causative agent was unidentified. Allergy to the trigger was known prior to anaphylaxis in 116 (51.8%) episodes. An epinephrine autoinjector had been prescribed for 70 children (51.1%). Conclusions and Clinical Relevance Anaphylaxis was seen significantly more in boys. Most of the reactions occurred at home. Foods were the most frequent cause. Epinephrine, the first-line treatment of anaphylaxis, was administered in only a third of the children.Öğe Influence of education on primary care physicians' knowledge on childhood allergy as a systemic disease and the atopic march(ELSEVIER DOYMA SL, 2011) Yilmaz, O.; Reisli, I.; Tahan, F.; Orhan, F.; Boz, A. B.; Yuksel, H.Background: There are many educational events for physicians in different countries covering one or some of the allergic diseases. Most of these educational events have been reported to improve care by the physicians. The aim of this study was to determine the baseline knowledge of general practitioners (GP) regarding the systemic nature of childhood allergy and atopic march, and to assess the influence of an educational event on this baseline knowledge. Methods: Two hundred and two GPs from five different cities in Turkey who attended education seminars were enrolled. All GPs were received the questionnaire both before and after the seminar. The questionnaire had statements about the systemic nature of childhood allergies and the atopic march, and GPs were asked to mark their degree of agreement as (completely true, partially true, wrong). Results: Mean age of GPs was 38.6 +/- 6.0 years. Mean duration after graduation from medical faculty was 13.9 +/- 6.5 years. There was significant improvement in answers after education. The statement "Frequency of allergic rhinitis and asthma is not as high as expected in children with atopic dermatitis" was regarded "wrong" by 60.9% but increased to 94.3% after the education (p < 0.001). Systemic nature of allergy was approved by 72.8%, which increased to 99% after the education (p < 0.001). Adrenalin as first line treatment in anaphylaxis treatment was appreciated by a higher number of GPs with the education (p<0.001). Conclusion: Many GPs lack updated information about the systemic nature of paediatric allergic diseases and a single educational event may improve their knowledge significantly. (C) 2010 SEICAR Published by Elsevier Espana, S.L. All rights reserved.Öğe The Reliability and Validity of Turkish Version of Childhood Asthma Control Test(SPRINGER, 2012) Şekerel, B. E.; Soyer, O. U.; Keskin, O.; Uzuner, N.; Yazıcıoğlu, M.; Kılıç, M.; Artaç, H.; Özmen, S.; Can, D.; Zeyrek, D.; Çokuğraş, H.; Canıtez, Y.; Aydoğan, M.; Kuyucu, S.; İnal, A.; Gürkan, F.; Orhan, F.; Yılmaz, O.; Boz, A. B.; Tahan, F.; Cevit, O.Introduction The reliability and validity of Turkish version of Childhood Asthma Control Test (C-ACT). Purpose The management of asthma is an important as well as difficult issue of physician's daily practice particularly in busy clinical settings. C-ACT was created to identify asthma control levels in children aged 4-11 years. Our aim was to evaluate the reliability, validity and responsiveness of C-ACT in a Turkish sample of children with asthma. Method In this multicenter study, 368 children were enrolled. C-ACT was completed every month by parents and patients who were evaluated in 3 visits within 2 month intervals. At each visit, physicians interpret the control level and decided for the treatment step as established in GINA guidelines. Results The internal consistency reliability of the Turkish version of C-ACT (C-ACT1 to C-ACT5) was found to be 0.82, 0.83, 0.82, 0.82 and 0.80, respectively (reliability statistics, Cronbach's alpha). Test-retest reliability was 0.71. There was significant correlation between C-ACT and physician's assessment of asthma control at visit 1 (r = 0.65, P < 0.001). Conclusions Turkish version of C-ACT is an accurate and reliable tool to evaluate asthma control in children aged 4-11 years. Its widespread use may facilitate appropriate assessment of asthma control and may lead to decrease the number of uncontrolled patients.
