Browsing by Author "Simsek Y."
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Item Relevance between clinical status and exhaled molecules related to neutrophilic inflammation in pediatric cystic fibrosis(Institute of Physics Publishing, 2020) Toprak Kanik E.; Yilmaz O.; Ozdogru E.; Alper H.; Ulman C.; Kanik A.; Simsek Y.; Yuksel H.Introduction: Cystic fibrosis (CF) is characterized with chronic inflammation with neutrophil and related cytokines in airway secretions. We aimed to measure the levels of neutrophil related inflammatory markers as nitric oxide, IL-8, IL-17, leukotriene B4 and neutrophil elastase as well as e-cadherin in exhaled breath condensate (EBC), and to determine their relation with clinical findings. Methods: We consecutively enrolled cystic fibrosis patients into our clinics between the age of six and eighteen years who could cooperate for exhaled breath condensate to this case-control study (n = 30). The age and sex matched control group (n = 26) was enrolled. Spirometry was performed during the stable period and EBC samples were obtained for measurement of the markers. Results: The mean age of the subjects enrolled was 12.1(4.2) years and 40% were positive for P.Aeruginosa in sputum. Subjects who had P.Aeruginosa in sputum cultures had significantly lower FEV1, FVC and FEF 25/75 values compared to the ones without P.Aeruginosa (p = 0.002, p = 0.002 and p = 0.005 respectively). EBC neutrophil elastase levels were significantly higher in the CF patients compared to non-CF controls (3.11 4.71 versus 0.90 2.68, p = 0.04). Nitric oxide, IL-17, IL-8, e-cadherin, neutrophil elastase or leukotriene B4 levels in EBC of CF patients were not related to P.Aeruginosa s infection, FEV1 levels or hospital admission in the last year. Conclusion: In our study, neutrophil elastase levels in EBC are higher in CF patients compared to non-CF controls. This is independent of acute infection and is evidence to the persistence of neutrophilic lung injury. However, EBC NO, IL-8, IL-17, e-cadherin, neutrophil elastase and leukotriene B4 levels as inflammatory markers, are not correlated with disease progression or clinical findings. © 2020 IOP Publishing Ltd.Item Effect of subcutaneous immunotherapy on the natural course of allergic diseases in pediatric patients: A real-life cohort(Galenos, 2021) Yasar A.; Yilmaz O.; Simsek Y.; Alpdogan S.; Kunay B.; Yuksel H.Aim: Specific allergen immunotherapy (SIT) is the only disease-modifying therapy for allergic diseases. We aimed to examine the effect of subcutaneous specific allergen immunotherapy (SCIT) applications on the prognosis of asthma and allergic rhinitis in pediatric cases in real-life settings. Methods: The study was designed as a retrospective cohort study. Patients with asthma and/or allergic rhinitis aged between 5 and 18 years old were enrolled between 2010 and 2015. The groups who received SCIT and who did not receive were compared in terms of disease severity parameters in follow-up recorded in their files. Results: A total of 298 cases, among which 140 received subcutaneous specific allergen immunotherapy. The frequency of asthma, allergic rhinitis, and co-morbidity was similar between the two groups. In the first year of the follow-up, asthma symptoms severity was not significant between the two groups; however, both asthma and allergic rhinitis symptoms were significantly lower in the SCIT patients at the end of the third year of follow-up. While the follow-up rate for three years or more was 62% in the group that received subcutaneous specific allergen immunotherapy, it was 38% in the group that did not receive. Conclusion: These results showed that SIT is an effective treatment modality in real-life settings with low side effects in pediatric patients with uncontrolled asthma and allergic rhinitis despite medical treatment. © 2021 by The Medical Bulletin of İstanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayınevi.Item Maternal psychiatric status and infant wheezing: The role of maternal hormones and cord blood cytokines(John Wiley and Sons Inc, 2021) Yilmaz O.; Yasar A.; Caliskan Polat A.; Ay P.; Alkin T.; Taneli F.; Odabasi Cingoz F.; Hasdemir P.S.; Simsek Y.; Yuksel H.Rationale: Maternal psychosocial stress might be associated with development of allergic diseases in the offspring. Objectives: To evaluate the association of maternal depression and anxiety with ever wheezing and recurrent wheezing among infants and to assess the role of maternal hypothalamo-pituatary-adrenal axis changes and fetal immune response in this association. Methods: This study encompasses two designs; cohort design was developed to evaluate the association of prenatal depression with development of wheezing in infants while nested case–control design was used to assess the role of maternal cortisol and tetranectin and cord blood interleukin 13 and interferon γ. Results: We enrolled 697 pregnant women. Elementary school graduate mother (odds ratio [OR] = 1.5, p =.06), maternal smoking during pregnancy (OR = 3.4, p =.001), familial history of asthma (OR = 2.7, p <.001) increased the risk of ever wheezing. Elementary school graduate mother (OR = 2.6, p =.002), maternal smoking during pregnancy (OR = 4.8, p <.001) and familial history of asthma (OR = 1.7, p =.01) increased the risk of recurrent wheezing. Maternal previous psychiatric disease, or Edinburgh Postnatal Depression Scale or Spielberger State-Trait Anxiety Inventory scores were not associated with wheezing. Maternal tetranectin levels were significantly higher among never wheezers compared to the ever wheezers (264.3 ± 274.8 vs. 201.6 ± 299.7, p =.04). Conclusions: In conclusion, the major risk factors for ever wheezing and recurrent wheezing were maternal smoking, level of education and family history of asthma. However, maternal depression and anxiety were not determined as risk factors for wheezing. Maternal tetranectin carries potential as a biomarker for wheezing in the infant. © 2021 Wiley Periodicals LLC