Browsing by Author "Cevit O."

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    A multicenter survey of childhood asthma in Turkey - II: Utilization of asthma drugs, control levels and their determinants
    (2009) Soyer O.U.; Beyhun N.E.; Demir E.; Yildirim S.; Bingöl Boz A.; Altinel N.; Cevit O.; Karakaş T.; Anlar Y.; Söüt A.; Altintaş D.; Canitez Y.; Büyükdereli Z.; Sekerel B.E.
    Soyer OU, Beyhun NE, Demir E, Yildirim S, Bingöl Boz A, Altinel N, Cevit O, Karakaş T, Anlar Y, Söüt A, Altintaş D, Canitez Y, Büyükdereli Z and Sekerel BE. A multicenter survey of childhood asthma in Turkey - II: Utilization of asthma drugs, control levels and their determinants. Pediatr Allergy Immunol 2009: 20: 172-179. © 2008 The Authors Journal compilation © 2008 Blackwell Munksgaard Many surveys worldwide have consistently demonstrated a low level of asthma control and under-utilization of preventive asthma drugs. However, these studies have been frequently criticized for using population-based samples, which include many patients with no or irregular follow-ups. Our aim, in this study, was to define the extent of asthma drug utilization, control levels, and their determinants among children with asthma attending to pediatric asthma centers in Turkey. Asthmatic children (age range: 6-18 yr) with at least 1-yr follow-up seen at 12 asthma outpatient clinics during a 1-month period with scheduled or unscheduled visits were included and were surveyed with a questionnaire-guided interview. Files from the previous year were evaluated retrospectively to document control levels and their determinants. From 618 children allocated, most were mild asthmatics (85.6%). Almost 30% and 15% of children reported current use of emergency service and hospitalization, respectively; and 51.4% and 53.1% of children with persistent and intermittent disease, respectively, were on daily preventive therapy, including inhaled corticosteroids. Disease severity [odds ratio: 12.6 (95% confidence intervals: 5.3-29.8)], hospitalization within the last year [3.4 (1.4-8.2)], no use of inhaled steroids [2.9 (1.1- 7.3)], and female gender [2.3 (1.1-5.4)] were major predictors of poor asthma control as defined by their physicians. In this national pediatric asthma study, we found a low level of disease control and discrepancies between preventive drug usage and disease severity, which shows that the expectations of guidelines have not been met even in facilitated centers, thus indicating the need to revise the severity-based approach of asthma guidelines. Efforts to implement the control-based approach of new guidelines (Global Initiative for Asthma 2006) would be worthwhile. © 2008 Blackwell Munksgaard.
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    A multi-center survey of childhood asthma in Turkey - I: The cost and its determinants
    (2009) Beyhun N.E.; Soyer O.U.; Kuyucu S.; Sapan N.; Altintaş D.U.; Yüksel H.; Anlar F.Y.; Orhan F.; Cevit O.; Çokùras H.; Boz A.B.; Yaziciòlu M.; Tanaç R.; Şekerel B.E.
    Successful management of childhood asthma requires a thorough idea of the economic impact of asthma and its determinants, as policy makers and physicians inevitably influence the outcome. The aim of this study was to define the cost of childhood asthma in Turkey and its determinants. In April 2006, a multi-center, national study was performed where data regarding cost and control levels were collected. Asthmatic children (6-18 yr) with at least a 1-yr follow-up seen during a 1-month period with scheduled or unscheduled visits were included. The survey included a questionnaire-guided interview and retrospective evaluation of files. Cost and its determinants during the last year were analyzed. A total of 618 children from 12 asthma centers were surveyed. The total annual cost of childhood asthma was US$1597.4 ± 236.2 and there was a significant variation in costs between study centers (p < 0.05). Frequent physician visits [odds ratio (95% confidence intervals)] [2.3 (1.6-3.4)], hospitalization [1.9 (1.1-3.3)], asthma severity [1.6 (1.1-2.8)], and school absenteeism due to asthma [1.5 (1.1-2.1)] were major predictors of total annual costs (p < 0.05 for each). The comparable cost of asthma among Turkish children with that reported in developed countries suggests that interventions to decrease the economic burden of pediatric asthma should focus on the cost-effectiveness of anti-allergic household measures and on improving the control levels of asthma. © 2008 Blackwell Munksgaard.
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    Characteristics and prognosis of childhood atopic dermatitis: A multicenter study in Turkey
    (2010) Yuksel H.; Can D.; Reisli S.; Uzuner N.; Orhan F.; Cevit O.; Tahan F.; Canitez Y.; Kuyucu S.; Boz A.B.; Akcay A.; Yilmaz O.
    Background:Childhood atopic dermatitis (AD) is classically accepted as initial finding of atopic march; however, nonatopic cases do not follow this course. The aim of this study was to determine the characteristics and prognosis of AD in childhood in Turkey. Methods:The study included 531 children with AD that presented to pediatric allergy departments in 11 different regions of Turkey. Age at diagnosis, total serum and inhalant-specific immunoglobulin E (IgE) levels and allergen skin prick test results were recorded retrospectively. Clinical characteristics like additional allergic diseases at presentation or during follow-up were recorded as well as duration of follow-up. Results:Mean age at diagnosis was 37.8 ± 36.2 months. Mean IgE level was 318.3 ± 677.8 IU/ml (median 100 IU/ml). Skin prick tests yielded positive results in 47% of children. At presentation, 31.6% of children reported additional allergic disease, while 11.7% developed allergic disease during follow-up. Among all, 46.6% had additional allergic disease at any point. IgE levels were significantly higher in children with additional allergic diseases (p = 0.001). Allergen skin prick test positivity and family history of allergic diseases increased the risk of additional allergic diseases significantly (OR = 3.90, 95% CI = 2.3-6.6 and OR = 1.89, 95% CI = 1.3-2.8, respectively). Conclusions: Allergic sensitization is not present in all cases of AD. Coexistence of additional allergic diseases is not as high as expected but more common in children who have been demonstrated to have atopic sensitization with high IgE levels and allergen skin prick test positivity. Copyright © 2010 S. Karger AG.
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    The reliability and validity of Turkish version of Childhood Asthma Control Test
    (2012) Sekerel B.E.; Soyer O.U.; Keskin O.; Uzuner N.; Yazicioglu M.; Kiliç M.; Artaç H.; Ozmen S.; Can D.; Zeyrek D.; Cokugras H.; Canitez Y.; Aydogan M.; Kuyucu S.; Inal A.; Gurkan F.; Orhan F.; Yilmaz 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. © Springer Science+Business Media B.V. 2011.
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    Outcome of the Respiratory Syncytial Virus related acute lower respiratory tract infection among hospitalized newborns: A prospective multicenter study
    (Taylor and Francis Ltd, 2016) Alan S.; Erdeve O.; Cakir U.; Akduman H.; Zenciroglu A.; Akcakus M.; Tunc T.; Gokmen Z.; Ates C.; Atasay B.; Arsan S.; Anik A.; Turkmen M.K.; Erdogan Y.; Oygur N.; Kahvecioglu D.; Yildiz D.; Caner I.; Tekgunduz K.S.; Kurt A.; Yigit Y.; Bilgili G.; Bolat F.; Cevit O.; Ozlu F.; Satar M.; Ertugrul S.; Cakir B.; Unal S.; Iscan B.; Duman N.; Ergor S.N.; Yalaz M.; Celik I.; Celik U.; Hirfanoglu I.M.; Koc E.; Sivasli E.; Melekoglu N.A.; Kiray Bas E.; Bozkaya D.; Korkmaz A.; Ozdemir R.; Karadag A.; Ozer E.; Ilhan O.; Mutlu M.; Aslan Y.; Erener- Ercan T.; Cetinkaya M.; Sahin O.; Akin M.A.; Okumus N.; Demirel G.; Kilic A.; Turkoglu-Unal E.; Bulbul A.; Takci S.; Anuk-Ince D.; Ciftdemir N.A.; Acunas B.; Ozkan H.; Koksal N.; Okulu E.; Demir N.; Tuncer O.; Dizdar E.A.; Oguz S.; Dilmen U.
    Aim: To determine the incidence and outcomes of respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (ALRI) including morbidity, nosocomial infection and mortality among newborn infants who were admitted to the neonatal intensive care units (NICUs).Methods: A multicenter, prospective study was conducted in newborns who were hospitalized with community acquired or nosocomial RSV infection in 44 NICUs throughout Turkey. Newborns with ALRI were screened for RSV infection by Respi-Strip®-test. Main outcome measures were the incidence of RSV-associated admissions in the NICUs and morbidity, mortality and epidemics results related to these admissions.Findings: The incidence of RSV infection was 1.24% (n: 250) and RSV infection constituted 19.6% of all ALRI hospitalizations, 226 newborns (90.4%) had community-acquired whereas 24 (9.6%) patients had nosocomial RSV infection in the NICUs. Of the 250 newborns, 171 (68.4%) were full-term infants, 183 (73.2%) had a BW >2500 g. RSV-related mortality rate was 1.2%. Four NICUs reported seven outbreaks on different months, which could be eliminated by palivizumab prophylaxis in one NICU.Conclusion: RSV-associated ALRI both in preterm and term infants accounts an important percent of hospitalizations in the season, and may threat other high-risk patients in the NICU. © 2015 Taylor & Francis.