Nihat Sapan

POLLEN CALENDAR OF ISPARTA, TURKEY

Pollen grains were identified using a Durham sampler in the atmosphere of Is parta during 1995 and 1996. During two years, a total of 15,660 pollen grains belonging to41 taxa, as well as unidentified pollen grains, were recorded. In 1995, 7357 pollen grains were identified and in 1996, 8303. Total pollen grains were 71% arboreal,25% non-arboreal plants, and 4% unidentified. In the region investigated, Pinus L., Cupressaceae, Gramineae, Platanus L., Quercus L., Artemisia L., Chenopodiaceae/Amaranthaceae, and Urticaceae were responsible for the greatest amounts of pollen. The pollen concentration reached its highest level in May.

Risk factors for wheezing in primary school children in Bursa, Turkey

Background Wheezing is the most common symptom of childhood respiratory tract illnesses. It is important not only for its associated acute morbidity, but also for the fact that early childhood wheezing confers a high risk for asthma. Epidemiological studies from various countries show that 10–15% of children <1 year of age and 25% of children <5 years of age have wheezing-associated respiratory tract illness, and one-third of these children develop asthma later in life. Methods In this retrospective study, we evaluated the association between a history of wheezing and prenatal, postnatal, familial, and environmental risk factors in 858 7-year-old children, randomly selected from seven primary schools in Bursa, Turkey, by means of an easy-to-understand questionnaire form. Among these children, 12.4% had a history of early transient wheezing, 7.1% had persistent wheezing, and 7.7% had late onset wheezing; 72.8% had no wheezing symptoms and 33.3% of children who experienced wheezing during the first 3 years of life had physician-diagnosed asthma. Results Notable risk factors associated with wheezing were as follows: male gender, lower socioeconomic status, premature birth, maternal smoking during pregnancy, bottle-feeding before 2 months of age, dampness and mold at home, hospitalization due to any respiratory illness in infancy, history of croup between 6 months and 5 years of age, frequent upper respiratory infections during the first 3 years of life, allergic eczema in the child, and any allergic disease in the mother or siblings. Conclusion This study shows that the high rates of reported wheezing in the 858 primary school children in Bursa are clearly attributable to important risk factors that have long been recognized and discussed by researchers worldwide, and this suggests that all efforts at primary prevention may be insufficient.

Airborne pollen calendar of the central region of Bursa (Turkey)

This report describes qualitatively and quantitatively the level of pollen in the atmosphere in the central region of Bursa. Turkey. In 1991, the season of maximum pollen concentration was from April to June, with a prevalence of arboreal pollen during the initial months, and of pollen from herbaceous plants in the latter months. During the year of research, 24 taxa of arboreal and 12 taxa of herbaceous pollen grains were collected and identified. In the region investigatedPinus, Cupressaceae/Taxaceae,Abies nordmanniana, Platanus orientalis, Olea europaea, Gramineae, Urticaceae, Chenopodiaceae/Amaranthaceae,Artemisia and Compositae were responsible for the greatest amounts of pollen. Some important allergenic pollens such asOlea europaea, Gramineae and Urticaceae were also found in high concentration. In this study, a pollen calendar for the region is presented.

A multi-center survey of childhood asthma in Turkey - I: The cost and its determinants

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

Airborne pollen grains in Yalova, Turkey, 2004

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.

Perceptions of Parents and Physicians Concerning the Childhood Asthma Control Test

In this study, airborne pollen grains of Yalova province were investigated using VPSS 2000 from January to December 2004. During studying period, a total of 22409 pollen grains/m3 which belonged to 46 taxa and 74 unidentified pollen grains were recorded. From the identified taxa, 26 belong to arboreal and 20 to non-arboreal plants. Total pollen grains consist of 80.50% arboreal, 19.17% non-arboreal plants and 0.33% unidentified pollen grains. In the investigated region, from arboreal plant taxa Platanus spp. (29.08%), Cupressaceae/Taxaceae (21.22%), Pinus spp. (7.34%), Alnus spp. (4.75%), Castanea spp. (3.03%), Quercus spp. (3.07%), Olea spp. (2.50%), Acer spp. (2.21%), Corylus spp. (1.41%) and Fagus spp. (1.15%), and from non-arboreal plant taxa Poaceae (10.01%), Asteraceae (2.86%), Plantago spp. (1.47%) and Artemisia spp. (1.11%) were responsible for the greatest amounts of pollen.

Evaluation of the need for routine preoperative latex allergy tests in children.

Background. The Childhood Asthma Control Test (C-ACT) has been proposed to be a simple, patient-based test that is able to reflect the multidimensional nature of asthma control. In this analysis, the aim was to evaluate the perceptions of physicians and caregivers concerning C-ACT and its predictive value for future asthma-related events. Method. In a multicenter prospective design, 368 children aged 4–11 years with asthma who were either well- or not well-controlled were included in the study. The study participants were evaluated during three visits made at 2-month intervals and the Turkish version of C-ACT was completed each month. Parents completed questionnaires concerning their perception of asthma (before and after the study) and the C-ACT (after the study). Physicians completed a survey about their perception of a control-based approach and the C-ACT. Results. The C-ACT scores increased from visit 1 to visit 3, with improvement seen in all domains of the test. At the end of the study period, the parents more strongly agreed that asthma could be controlled completely and that asthma attacks and nocturnal awakenings due to asthma were preventable (p < .05). Most of the parents reported that the C-ACT helped them to determine asthma treatment goals for their children and also that the C-ACT improved communication with their physicians. The physicians indicated that a control-centered approach was more convenient (95%) and simpler (94.5%) than a severity-centered approach and provided better disease control (93.4%). A higher C-ACT score was associated with a decreased risk of asthma attack and emergency department admittance in the 2 months following the administration of C-ACT. Conclusion. Our findings indicated that the C-ACT improved both parental outlook on asthma control and the communication between the physician and parents. There was a good correlation between the C-ACT score and the level of asthma control achieved, as described by the physician. Additionally the C-ACT score was predictive of future asthma-related events. These findings suggest that the C-ACT may have an important role in asthma management in the future.

Health-care conditions in elementary schools and teachers’ knowledge of childhood asthma

Background : Recently, there was a great increase in allergic reactions to latex and this brought relatively more concern to the latex allergy. In this prospective study we aimed to identify the frequency of latex allergy in preoperative patients, and tried to clarify whether it is necessary to perform latex allergy tests routinely in the preoperative period or not.

Bir İl Merkezinde 6-14 Yaş Grubu Çocuklarda ve Ailelerinde Görülen Besin Alerjisi ve Alerjik Hastalıkların Sıklığı

Background: For the adequate control of asthma in school-age children, it is recommended that teachers, school health personnel and administrators should have sufficient knowledge of how to manage asthma during school hours. Aim: To investigate asthma health care in elementary schools, and teachers’ knowledge of childhood asthma and its management. Methods: The extent of knowledge of childhood asthma in 2779 teachers in 141 elementary schools (children aged 6–14, grades 1–8) in Bursa, the fourth largest city in Turkey, was evaluated. Section I comprised questions about asthma health-care in schools, Section II teachers’ knowledge of the main characteristics of asthma and Section III (Likert Scale) teachers’ detailed knowledge of the signs, triggering factors, treatment and general knowledge of asthma. Results: The findings of Section I demonstrated that the organisation of health-care for asthma in schools was insufficient. Of the teachers questioned, 14·7% were not even aware and only 1% and 9·6% of the teachers had been made aware by school health personnel and school records, respectively, of asthmatic children. Only 27·3% of the teachers stated that they were responsible for the health of an asthmatic child. The majority of teachers (70%) said that asthmatic children could use the medication (e.g. inhalers) themselves. In Section II, there were between 44·1% and 75·5% correct answers, while in Section III this figure ranged from 3·3% to 78·4%. The correct answer rate was 60·4% for Sections II and III combined. The results of Sections II and III showed that the teachers’ knowledge of asthma was poor in many respects. Teachers who stated that they had asthma or had first-degree relatives with asthma, or those with 10 or more years’ experience provided significantly more correct answers in Sections II and III combined than did those without these characteristics (P<0·001). Conclusions: There is a need to improve and standardise health care for asthma (asthma management policies) in schools. The implementation of asthma education programmes for teachers and other staff responsible for pupils’ health should result in better control of this common disease.

Atopik dermatit tanı yaşının ek alerjik hastalık gelişimi üzerine etkisi

Bu calismada bir il merkezinde secilen 4 okulda okuyan 6-14 yas grubu cocuklarda ve ailelerinde besin alerjisi ve alerjik hastaliklarin sikliginin arastirilmasi amaclanmistir. Tanimlayici tipteki bu calisma Bursa il merkezinde yer alan secilmis 4 okulda gerceklestirilmistir. Bu okullarda 6-14 yas grubunda bulunan toplam 4195 cocuktan 3944 cocugun ebeveyni calismaya katilmayi kabul etmistir (katilim hizi %94’tur). Calismaya katilmayi kabul eden ogrencilerin ebeveynlerine cocuklarinda ve aile bireylerinde gorulen besin alerjisi ve alerjik hastaliklarin sikligini sorgulayan sorulardan olusan bir anket formu uygulanmistir. Calisma icin universite etik kurulundan ve milli egitim mudurlugunden yazili izin alinmistir. Ogrencilerin (n=3944) yasam boyu en az bir kez besin alerjisi bulgulari varligi (yasam boyu veya kumulatif prevalans) %13.4 (529), doktor tarafindan yasam boyu en az bir kez besin alerjisi tanisi konmasi %6.4 (253) olarak saptanmistir. Doktor tarafindan en az bir kez besin alerjisi tanisi konulan cocuklarin %29,6’sinin birinci derece aile yakinlarindan en az birinde (anne, baba, kardesler) besin alerjisi oykusu mevcuttur. Doktor tarafindan yasam boyu en az bir kez besin alerjisi tanisi konulan cocuklarin anne veya babasinda gorulen alerjik hastaliklar sirasiyla besin alerjisi %12,2, astim %10,7, alerjik rinit %9,1, alerjik konjonktivit %5,9, atopik dermatit %5,1; kardeslerindeki alerjik hastalik sikligi astim %10,7, alerjik rinit %9,5, besin alerjisi %9,1, alerjik konjonktivit %4,3 olarak saptanmistir. Bursa’da ailelerin doldurdugu anketlerle tespit edilen doktor tarafindan yasam boyu en az bir kez besin alerjisi tanisi konulan 6-14 yas grubu cocuklarda ve aile bireylerinde gorulen alerjik hastaligi tespit etmeye yonelik yapilan bu calisma alerjik hastalik seyrinde aile oykusunun son derece onemli oldugunu gostermektedir.