Gül Karakaya

Asthma and allergic diseases in schoolchildren: third cross-sectional survey in the same primary school in Ankara, Turkey

We investigated prevalence and determinants of asthma and allergic diseases in a cross‐sectional survey of schoolchildren aged 6–14 in 2002. This was the third of a series of cross‐sectional surveys, conducted in 1992 and 1997, in the same school in Ankara, Turkey. Questionnaire including information on house characteristics, dietary habits, past and current exposures and diseases were distributed to 1064 children (523 boys, 541 girls) and filled by the parents at home. Percentage of children having a pet was significantly higher (1992: 7.9, 1997: 22.9, 2002: 21), but that of passive smoking was significantly lower (1992: 74, 1997: 64, 2002: 64.1) in 1997 and 2002 when compared with 1992. Current prevalence percentage of asthma (1992: 8.3, 1997: 9.8, 2002: 6.4), wheeze (1992: 11.9, 1997: 13.3, 2002: 6.4), hay fever (1992: 15.4, 1997: 14.1, 2002: 7.2), and eczema (1992: 4, 1997: 4.3, 2002: 1.8) were significantly lower in 2002 compared with 1992. Multiple logistic regression analysis model for current wheeze included ingestion of cows milk (no regular ingestion: reference, ORs and 95% CIs, <1 glass/day: 0.5, 0.3–1.0; at least 1 glass/day: 0.3, 0.2–0.7), ingestion of red meat (2.2, 1.2–3.8), and currently holding a dog (6.1, 1.6–23.4). Multiple logistic regression analysis model for current hay fever included ingestion of red meat (1.8, 1.1–2.9) and fathers education (none of the parents finished secondary school: reference, secondary school to university: 0.5, 0.2–1.0). Our findings suggested that current prevalence of asthma and allergic diseases decreased among schoolchildren in Ankara, in the last 10 yr, and ingestion of milk and red meat could have a role in the occurrence of asthma and hay fever. Detailed assessment of dietary habits is required to test this hypothesis.

Aspirin 300 mg/day is effective for treating aspirin‐exacerbated respiratory disease

Aspirin desensitization (AD) treatment at doses of up to 1300 mg/day improves outcomes in aspirin‐exacerbated respiratory disease (AERD). The aim of this study was to investigate the efficacy of aspirin 300 mg/day in the treatment of patients with AERD.

Association between asthma, rhinitis and NSAID hypersensitivity in chronic urticaria patients and prevalence rates.

Background: The coexistence of allergic diseases and chronic urticaria (CU) is not uncommon. Our aim was to show the prevalence of allergic diseases in chronic urticaria patients and whether possible risk factors precipitate the development of these conditions. Methods: The data of 953 patients diagnosed with CU in our adult allergy clinic between January 1991 and June 2006 were retrospectively evaluated. Results: The mean ages of the CU patients with and without non-steroidal anti-inflammatory drug hypersensitivity (NSAIDH) were 39.0 ± 11.8 and 36.7± 12.3, respectively (p = 0.014). There was a female predominance in both groups (74.6 and 68.2%, respectively, p = 0.06). Apparently, some conditions occurred significantly more often in CU patients with NSAIDH compared to those without NSAIDH: 16.4 and 8.4% for asthma (p < 0.001), 4.2 and 0.8% for nasal polyps (p < 0.01), 20.8 and 7.3% for antibiotic hypersensitivity (p < 0.001), 21.6 and 12.3% for metal sensitization (p < 0.01), and 8 and 0.6% for familial NSAIDH (p < 0.001), respectively. Dermographism was more common in CU patients without NSAIDH compared to those with NSAIDH (29.4 and 21.2%, respectively; p < 0.05). NSAIDH increased the risk of asthma and rhinitis development [odds ratios: 52.9 (18.1–154.6) and 5.2 (2.0–13.4)]. Conclusion: Based on our data, the incidence rates of asthma, nasal polyps, antibiotic hypersensitivity, metal sensitization and familial NSAIDH are increased in patients with CU with NSAIDH compared to those with CU only. Coexistence of NSAIDH and CU increases the risk of developing asthma and rhinitis.

Bee and bee products allergy in Turkish beekeepers: determination of risk factors for systemic reactions

BACKGROUND The prevalence of allergic reactions due to bee stings in beekeepers varies in different regions of the world. The aim of this study was to evaluate the characteristics of sting reactions and the risk factors for developing systemic reactions in Turkish beekeepers. METHODS A self-administered questionnaire was distributed to 1250 beekeepers to be completed in seven different cities of Turkey. A total of 494 (39.6 %) questionnaires were returned. RESULTS There were 444 subjects (89.9 %) with a history of sting exposure in the previous 12 months. Systemic reactions were present in 29 subjects (6.5 %) and nine (2 %) reactions were anaphylactic. Fifty-five percent of beekeepers reported more than 100 bee stings in the previous year. When systemic reactions were controlled by age and duration of beekeeping in a logistic regression model, seasonal rhinitis (OR: 4.4, 95 % CI: 1.2-11.5), perennial rhinitis (OR: 4.6, 95 % CI: 1.2-18.2), food allergy (OR:7.0, 95 % CI: 2.0-25.0), physician-diagnosed asthma (OR: 8.0, 95 % CI: 2.5-25.6), having an atopic disease of any type (OR: 3.3, 95 % CI: 1.2-8.7) and having two or more atopic diseases (OR: 10.9, 95 % CI: 3.5-33.8) were significantly associated with systemic reactions due to bee sting in the previous 12 months. CONCLUSION The incidence of systemic reactions in Turkish beekeepers is low, which might be due to the protective effect of a high frequency of bee stings. The risk of systemic reactions increases approximately three-fold when one atopic disease is present and eleven-fold when two or more concurrent atopic diseases are present with respect to no atopic disease.

The natural course of atopy determined by skin prick tests in patients with bronchial asthma and/or rhinitis

BACKGROUND The skin prick test (SPT) is the cheapest, most widely used and practical method for the diagnosis of allergic diseases. The results of repeat test might show variations due to aging. OBJECTIVE To perform repeat SPTs to determine possible changes in the atopy rate in general as well as changes in the allergen spectrum of atopic patients occurring over time and to identify the factors that could affect this change. METHODS A total of 222 patients who received a diagnosis of bronchial asthma and/or persistent rhinitis in our Adult Allergy Unit and who attended follow-up visits in the outpatient unit over a 2-year period were enrolled. SPT with 10 visit common aeroallergens were performed at the first and the second test was performed after an interval of at least 2 years. RESULTS The mean age was 36.4 +/- 11.4 years and 77.5 % of the patients were women. The mean interval between the two tests was 43.4 +/- 20.0 (minimum = 24-maximum = 105) months. Repeat tests showed that the atopy rate decreased from 58.6 % to 47.7 %; sensitivity rates to 10 allergens also decreased. These differences were statistically significant (p <0.05). CONCLUSION The atopy rate determined by SPTs tends to decrease over time. The most important factor affecting this decrease is time itself.

Seasonal Rhinitis, Clinical Characteristics and Risk Factors for Asthma

Background: The aim was to determine the clinical characteristics of patients with seasonal rhinitis (SR) and to disclose differences in the treatment of SR between an adult allergy clinic and other clinics over time. Methods: A retrospective study was conducted based on clinical records of 774 out of 955 patients diagnosed with SR in an adult allergy clinic between 1 January 1991 and 31 December 2003. Results: The mean age of the patients was 29.1 ± 9.29 years and 62.7% were female. The most common major complaints of the patients were nasal symptoms in 82.3%. The mean duration of the disease was 6.76 ± 6.8 years. The patients were symptomatic with a mean of 3.5 ± 1.7 months a year, mostly during the period between April and July. Skin prick tests were positive in 685 patients (90.3%), where the most common sensitivity was against timothy grass (85.1%). The most common accompanying allergic diseases were food hypersensitivity in 14%, bronchial asthma in 13.4%, and drug allergy and/or intolerance in 9.6%. Although the use of specific immunotherapy and short-acting sedative antihistamines decreased over time, the use of nasal steroids and long-acting nonsedative antihistamines tended to increase before admission to our clinic. Older age (OR: 1.77, 95% CI: 1.06–2.94), presence of familial atopy (OR: 1.72, 95% CI: 1.04–2.85), respiratory symptoms (OR: 2.10, 95% CI: 1.75–2.50), ocular symptoms (OR: 0.77, 95% CI: 0.61–0.98) and metal allergy (OR: 0.25, 95% CI: 0.07–0.89) were associated with the development of asthma in patients with SR. Conclusion: SR lasts approximately 3.5 months and the main cause in Ankara, Turkey is grass pollen sensitivity. Patients with any other allergic conditions make up 39.8% of the patients. SR patients are referred to allergy clinics quite late, which might be due to SR not being considered as a serious disease.

Asthma and Allergic Diseases in School Children from 1992 to 2007 with Incidence Data

Background. Information about change in the prevalence of asthma and allergic diseases and factors related with these diseases would be beneficial in decreasing the burden of these diseases. Objective.To assess (i) change in prevalence of asthma and allergic diseases; (ii) factors associated with asthma and wheeze; and (iii) incidence of asthma and wheeze. Methods. A questionnaire was administered to children aged 7–12 years in first five grades in the same primary school in 1992 (n: 1036), 1997 (n: 738), 2002 (n: 621), and 2007 (n: 422) and filled by the parents. A second survey in 2007 (n: 474, in eight grades) was conducted in the same schoolchildren, 6 months apart, to assess the incidence of asthma and wheeze and the associated factors. Results. Comparison of 1992, 1997, 2002, and 2007 surveys revealed that prevalence of asthma (8.3%, 9.8%, 6.4%, 3.3%, respectively), wheeze (11.9%, 13.3%, 6.4%, 3.1%, respectively), hay fever (15.4%, 14.1%, 7.2%, 3.1%, respectively), and eczema (4.0%, 4.3%, 1.8%, 1.2%, respectively) were significantly lower in 2002 and 2007 compared with that in 1992. Percentage of passive smoking decreased after 1992 (74.0%, 64.0%, 64.1%, and 65.5%, respectively). Incidence of asthma and wheeze in 2007 surveys were 0.9/100 and 1.1/100, respectively. After the adjustment for age and gender, infection in the past, family atopy, and presence of atopic disease (eczema or hay fever) were associated with asthma and wheeze. Maternal smoking and lack of breast feeding were associated with asthma. Male gender, pet ownership in the past, lack of health insurance coverage, snoring, and wood or coal used as fuel were associated with wheeze. Conclusions. Decreased prevalence of asthma and allergic diseases in the last 10 years could be related to decreased rate of passive smoking. Lower socioeconomic status and lack of breast feeding could increase the risk of asthma in children.

The “physician on call patient engagement trial” (POPET): measuring the impact of a mobile patient engagement application on health outcomes and quality of life in allergic rhinitis and asthma patients

In this prospective, multicenter, randomized, controlled, double‐blind study, we investigated the impact of a mobile patient engagement application on health outcomes and quality of life in allergic rhinitis (AR) and asthma patients.

Immediate-type hypersensitivity reactions to proton pump inhibitors: usefulness of skin tests in the diagnosis and assessment of cross-reactivity.

Data are limited about the value of skin tests in the diagnosis of proton pump inhibitor (PPI)‐induced hypersensitivity reactions and the cross‐reactivity between PPIs. We aimed to assess the role of skin testing in the diagnosis of PPI‐related immediate hypersensitivity reactions and the cross‐reactivity patterns among PPIs.

Metamizole intolerance and bronchial asthma

BACKGROUND Metamizole is one of the pyrazolone drugs used widely in Turkey. The aim of this survey was to determine the clinical features of metamizole intolerant patients and to find out if there was any difference between the ones with or without bronchial asthma. METHODS A total of 264 patients with metamizole intolerance were enrolled in the survey. Patients having bronchial asthma were accepted as group I (n = 133) and the ones without bronchial asthma as group II (n = 131). A standard questionnaire was used to collect the data. RESULTS The mean age of the patients were 41.8 11.8 and 39.2 12.2 for groups I and II respectively and 99 (79.4 %) and 99 (75.6 %) were females in the same order. There was no significant difference between groups I and II when the rates of personal atopy, familial atopy and familial analgesic intolerance were compared. The most common reactions appearing after metamizole ingestion was bronchospasm (75.9 and 9 %) and urticaria (25.6 and 64.9 %) (for groups I and II, respectively and p < 0.05). Aspirin cross-reactivity was significantly more common in group I. At least one safe alternative analgesic was determined for all the patients who have not been able to use any analgesic. CONCLUSIONS Metamizole intolerance seems to be as important as aspirin intolerance in Turkey. The clinical features in general appear to be similar for metamizole and aspirin intolerant asthmatics.