Browsing by Author "Şimşek Y."

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    Results of standardized device education in asthmatic children and their families; [Astimli çocuklarda ve ailelerinde standart cihaz eǧitiminin sonuçlari]
    (Turkiye Klinikleri, 2014) Şimşek Y.; Türkeli A.; Yilmaz O.; Okkali Z.; Yüksel H.
    Objective: Inhalation is an efficacious and advatageous route of drug application. Therefore, systemic side effects decrease while treatment efficacy increases. However, use of inhalation devices requires specific skills therefore children need to be prescribed these devices according to their neuromotor development. Delivery of drug dose requires technically correct device use. Bu In this study, we aimed to determine the influence of standardized practical inhalation device education on correct device use as well as asthma symptomatology and control. Material and Methods: Thirty two children (6-12 ages) were enrolled in the study. Discus use skills were scored before and after receiving standard practical education. Asthma symptom score and asthma control questionnaire (ACQ) were also evaluated before education and at the end of first month after education. Results: Average discus use skill scores were 4.9±1.32 and 7,6±0.59 pre- and post-education respectively (p<0.001). Frequency of correct performance on the most commonly skipped step, that is "holding the breath for five seconds", increased from 34.4% to 87.5% (p<0,001). Average asthma symptom score was determined as 5.8±3.4 pre-education and 0.43±0.89 post-education (p<0.001). Average ACQ score decreased significantly post-education compared to pre-education (1.27±0.99 vs 0.11±0.22) (p<0.001). Conclusion: Education significantly improves the wrong application of discus use. This is associated with a significant improvement in asthma symtom score and asthma control. Therefore, device use education needs to be an essential component of treatment and follow up of asthmatic children. © 2014 by Türki ye Klinikleri.
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    Significant changes in trans-epithelial barrier proteins of adenoid tissue with atopic status in children
    (AVES, 2020) Yılmaz Ö.; Şimşek Y.; İnan S.; Buga Ö.; Eskiizmir G.; Pınar E.; Kanık E.; Yüksel H.
    OBJECTIVES: Adenoid tissue is important in local immune response and epithelial barrier dysfunction of this tissue may contribute to allergies. The aim of this study was to evaluate the relationship between the status of cross-epithelial barrier elements in adenoid tissue lymphoepithelium and inhalant allergen sensitization. MATERIALS AND METHODS: Children aged 5-15 years, who underwent adenotonsillectomy, participated in this study. All subjects underwent skin prick testing with environmental inhalant allergens. Occludin, ZO1, e-cadherin, β-catenin, desmoglein, desmoplakin, and connexon-43 were stained immunohistochemically in the adenoid tissues obtained and scored by H-score. RESULTS: We enrolled 76 children, 14 among whom were sensitized to environmental allergens. Among the zonula occludens proteins, median H-scores for occludin, claudin, and ZO-1 were significantly lower in the atopic compared to the nonatopic group respectively (p<0.001). Similarly, median H-scores for e-cadherin and β catenin proteins of the zonula adherens were significantly lower in the atopic group (p<0.001). Both desmoglein and desmoplakin H-scores were significantly lower in the atopic group [60 (50-100) vs 280 (260300), p<0.001 and 105 (87.5-120) vs 280 (67.25-300), p<0.001 respectively]. Moreover, connexin-43 protein of the gap junction was significantly lower in the atopic group (p<0.001). CONCLUSION: Adenoid tissue, which is the initial point of contact of inhalant allergens demonstrates epithelial barrier junctional protein, changes in children with inhalant allergen sensitization without clinical allergic disease symptoms. Therefore, it may be concluded that epithelial barrier function plays an important role in the development of allergen sensitization versus tolerance. © 2020 by Turkish Thoracic Society.
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    Comparative Evaluation of Clinical, Spiro/Oscillometric and Tomographic Parameters as a Global Assessment of Children with Cystic Fibrosis
    (Galenos Publishing House, 2023) Kanık E.T.; Yılmaz Ö.; Kanık A.; Özdoğru E.E.; Şimşek Y.; Alper H.H.; Yüksel H.
    Aim: The aim of our study was to compare clinical severity scores and classic spirometry with impulse oscillometry (IOS) results and thoracic high resolution computed tomography (HRCT) scores in children with cystic fibrosis (CF) in order to determine the utility of the latter approach in patient follow-up. Materials and Methods: CF patients over 6 years of age were included. Shwachman-Kulczycki score, underclassical spirometry and IOS were performed when not in acute exacerbation. Thoracic HRCT images obtained within the previous 6 months were evaluated using the Bhalla scoring system. Results: The mean age of the children studied (n=30) was 12.1±4.2 years and 40% were female. Pseudomonas aeruginosa (P. aeroginosa) was isolated from sputum cultures of 40% of the patients. Patients with forced expiratory volume in one second (FEV1) below 80% exhibited significantly higher (resistance) R5, R10 values and significantly lower (reactance) X5 values on IOS (p=0.03, 0.027, 0.006, respectively). Patients with P. aeruginosa had significantly lower FEV1, forced vital capacity, and forced expiratory flow (25-75) values in classic spirometry when compared with patients without P. aeruginosa (p=0.002, p=0.002, and p=0.005, respectively). P. aeruginosa-positive patients showed significantly higher R5 and lower X5 values (p=0.047, 0.046, respectively). Bhalla scoring, bronchiectasis weight, peribronchial thickening, mucous plaques, saccularization, bronchial division, mosaic pattern parameters in groups with P. aeroginosa growth and/or FEV1 <80%; was found to be significantly more serious than the non-reproductive group (p<0.005, respectively). Again, in the group with P. aeroginosa growth, Shwachman-Kulczycki score was found to be significantly lower (p=0.001). No significant correlation was found between thoracic score data such as bronchiectasis weight and mosaic pattern presence and IOS values. In addition, in the group with high clinical score of Shwachman Kulczycki, resistance values such as R5 R10 R15 which are IOS parameters, and FEV1 were found above 80% (p=0.016, p=0.037, p=0.042, 0.004, respectively). Conclusion: IOS and tomographic scoring can be used safely in early detection of impairment in lung function. Further studies are needed to evaluate the utility of IOS in the clinical monitoring of children with CF who are not compliant with spirometry maneuvers. © Copyright 2023 by Ege University Faculty of Medicine, Department of Pediatrics and Ege Children’s Foundation The Journal of Pediatric Research, published by Galenos Publishing House.