Publications by authors named "D Ediger"

27 Publications

  • Page 1 of 1

Rootstocks with Different Vigor Influenced Scion-Water Relations and Stress Responses in Ambrosia Apple Trees ( var. Ambrosia).

Plants (Basel) 2021 Mar 24;10(4). Epub 2021 Mar 24.

Summerland Research and Development Centre, Agriculture and Agri-Food Canada, Summerland, BC V0H 1Z0, Canada.

In recent years, awareness has been raised around the benefits of diversifying rootstocks, in order to enhance tree health and sustain apple fruit production under the influence of climate change. However, performances of many rootstocks under stresses remain unclear. This study aimed to set the first step towards a much-needed comprehensive evaluation on water relationships and stress responses of scion-rootstock systems for the popular apple cultivar Ambrosia ( var. Ambrosia), because its production and horticultural knowledge had been largely limited to the Malling 9 rootstock (M.9). Five rootstocks were evaluated in a greenhouse water deficit experiment and at the onset of heat stress in a field trial in Summerland, British Columbia, Canada. Multiple stress indicators of leaves and fruits were analyzed to elucidate water use strategies and drought resistance mechanisms. The rootstocks led to differences in scion vigor, and stomatal and photosynthetic characteristics. The largest semi-dwarfing Geneva 202 (G.202) demonstrated more water use and higher stress susceptibility. Large dwarfing Geneva 935 (G.935) and Malling 26 (M.26) showed more stringent stomatal control and reduced water use under stresses, typical of a drought-avoidance strategy. The smallest large dwarfing M.9NIC29 and the small dwarfing Budagovsky 9 (B.9) led to smaller and denser stomata. B.9 demonstrated the most stable water status and drought tolerance. The study suggested that scion stress responses were influenced by rootstock vigor and tree water use strategies. It implied the necessity of vigor-specific irrigation management for alleviating stresses and achieving production goals of different rootstocks.
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http://dx.doi.org/10.3390/plants10040614DOI Listing
March 2021

Fatigue: A forgotten symptom of asthma.

Clin Respir J 2021 Mar 29. Epub 2021 Mar 29.

Section of Immunology and Allergy Diseases, Department of Chest Diseases, Medical Faculty, Uludağ University, Bursa, Turkey.

Objective: Fatigue is a common symptom frequently reported in many disorders but little is known about the prevalence of fatigue in asthma. The objective of this study was to determine the prevalence of fatigue in asthmatic patients, the effect of fatigue on asthma quality of life and the relationship between fatigue and anxiety/depression MATERIALS AND METHODS: This prospective cross-sectional study was conducted in Uludağ University Faculty of Medicine, Department of Immunology and Allergic Diseases outpatient clinic from June 2019 to December 2019. Fatigue was assessed using the Checklist Individual Strength-Fatigue (CIS-Fatigue), psychological distress was assessed using the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) and quality of life were assessed using the Asthma Quality of Life Questionnaire (AQLQ).

Results: In the present study, a total of 168 patients are included with an average age of 43.8 ± 4.3 years. Nearly 64.8% of patients had controlled asthma and (35.2%) patients had uncontrolled asthma. Fatigue (CIS-Fatigue ≥ 27 points) was detected in 62.6% of patients and associated with asthma-related quality of life, asthma control, dyspnea, depression and anxiety (P < 0.05). However, the degree of lung function impairment and asthma severity were not associated with fatigue.

Conclusions: Fatigue as a symptom is common in asthmatic patients and correlates with asthma-related quality of life, asthma control, dyspnea, depression and anxiety. Future studies are needed to better understand the physical, psychological, behavioural and systemic factors that precipitate or perpetuate fatigue in asthma.
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http://dx.doi.org/10.1111/crj.13356DOI Listing
March 2021

Guillain-Barré Syndrome in a Patient With Minimal Symptoms of COVID-19 Infection.

Muscle Nerve 2020 09 4;62(3):E54-E57. Epub 2020 Jul 4.

Department of Neurology, Uludag School of Medicine, Uludag University, Bursa, Turkey.

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http://dx.doi.org/10.1002/mus.26992DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300697PMC
September 2020

Academic Life in Emergency Medicine (ALiEM) Blog and Podcast Watch: Infectious Diseases.

Cureus 2020 Apr 15;12(4):e7674. Epub 2020 Apr 15.

Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, USA.

The Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) Series and Approved Instructional Resources - Professional (AIR-Pro) Series were created in 2014 and 2015, respectively, in response to the growing need to curate online educational content as well as create a nationally available curriculum that meets individualized interactive instruction criteria for emergency medicine (EM) trainees. These two online series identify high-quality educational blog and podcast content using an expert-based approach. The AIR series is a continuously building curriculum originally based on the Council of Emergency Medicine Directors (CORD) testing schedule. In September 2019, 61 blog posts and podcasts published within the previous 12 months and relevant to infectious diseases were evaluated by eight attending physicians using the ALiEM AIR scoring instrument. In this review, we summarize the accredited posts on infectious diseases meeting our a priori quality criteria per evaluation by the reviewers.
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http://dx.doi.org/10.7759/cureus.7674DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7228787PMC
April 2020

Trends of sensitization to aeroallergens in patients with allergic rhinitis and asthma in the city of Bursa, South Marmara Sea Region of Turkey

Turk J Med Sci 2020 04 9;50(2):330-336. Epub 2020 Apr 9.

Section of Immunology and Allergy Diseases, Department of Dermatology, Bursa City Hospital, Bursa, Turkey

Background/aim: Allergic rhinitis (AR) and asthma are the most common allergic disorders worldwide. Aeroallergens are critical causative factors in the pathogenesis of these disorders and sensitization to aeroallergens differs in various countries and regions. Identification of the most common aeroallergen sensitization is crucial in the diagnosis and management of AR and asthma. We examined the distribution of aeroallergen sensitizations detected by skin prick tests (SPTs) in adult patients with AR and/or asthma in the city of Bursa.

Materials And Methods: Five hundred forty-five patients who underwent a SPT and were diagnosed with rhinitis and/or asthma in the Uludağ University Faculty of Medicine’s Department of Immunology and Allergic Diseases Outpatient Clinic from March 2018 to August 2018 were retrospectively evaluated. SPTs with standard extracts including house dust mites, pollens, molds, animal dander, and latex were performed for patients.

Results: A total of 545 patients were included and most of the patients (270; 49.5%) were between 30 and 49 years of age. The prevalence of atopy was 57.9%. The most common aeroallergens detected in SPTs were Dermatophagoides farinae (50%) and D. pteronyssinus (44%), followed by grass-rye mix (43%), grass mix (38.6%), olive (33.2%), and wheat (32.3%). The sensitization to olive pollen was higher in cases of mild asthma (52%), while sensitization to D. farinae was higher in patients with mild and moderate asthma (54.5%, 54.2%) (P < 0.05) .

Conclusions: Our study revealed that house dust mite was the most common sensitizing aeroallergen in patients with AR and asthma while pollens were the most common allergen in patients with only AR. The sensitization to grass and olive pollen was higher in cases of mild asthma than moderate and severe. Regional allergy panels may provide important clinical clues for characteristics and courses of allergic diseases.
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http://dx.doi.org/10.3906/sag-1908-139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164753PMC
April 2020

[Evaluation of asthma awareness among teachers in Bursa].

Tuberk Toraks 2018 Jun;66(2):150-155

Division of Immunology and Allergic Diseases, Department of Chest Diseases, Faculty of Medicine, Uludag University, Bursa, Turkey.

Introduction: The purpose of this study was to elucidate the asthma knowledge level of primary-secondary school teachers in Bursa, and factors associated with this subject.

Materials And Methods: In our study 1812 teachers from 64 randomly selected primary schools in Bursa were included.

Result: It was known by the vast majority of participants that asthma symptoms, asthma is not a contagious disease and may be familial, medications taken by inhalation. It was known by 64.1% of the teachers that asthmatic children do not mind doing sports. Approximately one of the two teachers knew that the medication were not addictive.

Conclusions: The knowledge level of the teachers was related to female gender and age. We think that an asthma education program is needed for Turkish teachers to increase their understanding about what asthma is, its impact and how to meet the needs of a child with asthma to achieve improved wellbeing and school attendance.
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http://dx.doi.org/10.5578/tt.67040DOI Listing
June 2018

Long-Term Omalizumab Treatment: A Multicenter, Real-Life, 5-Year Trial.

Int Arch Allergy Immunol 2018 17;176(3-4):225-233. Epub 2018 May 17.

Medical Department, Novartis Pharmaceuticals, Istanbul, Turkey.

Background: Omalizumab has demonstrated therapeutic benefits both in controlled clinical trials and real-life studies. However, research concerning the long-term effects and tolerability of omalizumab is needed. The main objective of this study was to evaluate the effectiveness and tolerability of treatment with omalizumab for up to 5 years.

Methods: A multicenter, retrospective, chart-based study was carried out to compare documented exacerbations, hospitalizations, systemic steroid requirement, FEV1, and asthma control test (ACT) results during 1 year prior to omalizumab treatment versus at 1, 3, and 5 years of treatment. Adverse events and reasons for discontinuation were also recorded at each time point.

Results: Four hundred and sixty-five patients were enrolled in the study. Outcome variables had improved after the 1st year and were sustained after the 3rd and 5th years of treatment with omalizumab. Omalizumab treatment reduced the asthma exacerbation rate by 71.3% (p < 0.001) at 1 year, 64.3% (p < 0.001) at 3 years, and 54.8% (p = 0.002) at 5 years. The hospitalization rate also decreased; by the 5th year of the treatment no patients were hospitalized. ACT results had also improved significantly: 12 (p < 0.001) at 1 year, 12 (p < 0.001) at 3 years, and 12 (p = 0.002) at 5 years. Overall, 12.7% of patients reported adverse events (most of these were mild-to-moderate) and the overall dropout rate was 9.0%.

Conclusion: Omalizumab had a significant effect on asthma outcomes and this effect was maintained over 5 years. The drug was found to be generally safe and treatment compliance was good.
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http://dx.doi.org/10.1159/000488349DOI Listing
July 2018

Venom allergy, risk factors for systemic reactions and the knowledge levels among Turkish beekeepers.

Asia Pac Allergy 2018 Apr 11;8(2):e15. Epub 2018 Apr 11.

Section of Immunology and Allergy Diseases, Department of Chest Diseases, Medical Faculty, Uludağ University, Bursa 16110, Turkey.

Background: Allergic reactions developing after bee sting can be severe and life-threatening. According to epidemiological data, serious systemic reactions range between 1.2%-3%, and this is 2-3 times higher (6%) in beekeeping. In different beekeepers' populations, risk factors of systemic reactions have been investigated and diverse results have been found.

Objective: The aim of this study is to evaluate the level of knowledge of beekeepers about venom allergy, epidemiological data, systemic reaction rates, risk factors for systemic reactions, and the rate of emergency admissions after bee sting.

Methods: With the collaboration of Uludağ University Beekeeping Development Research Center and Beekeepers Association, a questionnaire consisting of 19 questions was applied to 242 beekeepers in Bursa and Yalova. Two hundred twenty-one beekeepers who completed the questionnaire were involved in the study.

Results: The mean age of the beekeepers was 49.9 years (range, 18-75 years). The systemic reaction to bee sting in beekeepers was 37.6%. Allergic rhinitis was found to be a risk factor for systemic reaction. Although 80% of the beekeepers recognized that bee venom could be lethal, only 60% of the beekeepers were aware of immunotherapy, and only 30% were aware of the adrenaline auto-injector drug.

Conclusion: Similar to previous studies, we found that the systemic response to the bee sting in beekeepers was higher compared to normal population. Considering the occupational exposure to bee venom and thus higher risk, the awareness of venom allergy in this high risk population was low, and they were poorly informed about the treatment options.
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http://dx.doi.org/10.5415/apallergy.2018.8.e15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5931922PMC
April 2018

(Un)Awareness of allergy.

World Allergy Organ J 2011 Nov 18;4(11):170-8. Epub 2011 Nov 18.

Department of Immunology and Allergic Diseases, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey.

Background: Allergy is associated with considerable morbidity.

Objective: The aim of this multicenter study was to provide insight into allergy knowledge and perceptions among the population.

Methods: During the World Allergy Day, several allergy clinics conducted public meetings to encourage the awareness of and education in allergy. At the beginning, participants filled out a questionnaire to assess their knowledge about what is allergy and to determine by whom those symptoms are cared.

Results: A total of 256 participants (187 women/69 men, mean age, 31.2 ± 12.5 years) completed the survey. Of the 202 participants with symptoms, 58.9% had physician-diagnosed allergic disease. Among the 19 symptoms evaluated, 56.5% of the symptoms were recognized as related with allergy, and this increased in compliance with education level (r = +0.427; P < 0.001) but not with diagnosed allergy (P = 0.34). Sneezing was the most common symptom thought to be related with allergy-related symptom (77.5%), whereas loss of smell was the least one (37.9%). Participants were more likely to be cared by an allergologist (72.9%) followed by other specialties, when experiencing allergy.

Conclusions: Increasing the awareness for allergic symptoms is the key not only for the diagnosis but also for the optimal treatment. Therefore, education is an important component of prevention and control of allergic diseases.
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http://dx.doi.org/10.1097/WOX.0b013e31823842bcDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488905PMC
November 2011

Prevalence of aspirin-exacerbated respiratory disease in patients with asthma in Turkey: a cross-sectional survey.

Allergol Immunopathol (Madr) 2012 Jul-Aug;40(4):225-30. Epub 2011 Sep 1.

Ankara University, School of Medicine, Department of Chest Diseases, Division of Immunology and Allergy, Turkey.

Background: There are no country-based data focused on aspirin (ASA)-exacerbated respiratory disease (AERD) in Turkey.

Objective: To assess the prevalence of AERD in adult patients with asthma.

Methods: A structured questionnaire was administered via face-to-face interview by a specialist in pulmonology/allergy at seven centres across Turkey.

Results: A total of 1344 asthma patients (F/M: 1081/263: 80.5%/19.5%, mean age: 45.7 ± 14.2 years) were enrolled. Atopy rate was 47%. Prevalence of allergic rhinitis, chronic rhinosinusitis/rhinitis, and nasal polyposis (NP) were 49%, 69% and 20%, respectively. Of 270 patients with NP, 171 (63.3%) reported previous nasal polypectomy and 40 (25%) had a history of more than three nasal polypectomies. Aspirin hypersensitivity was diagnosed in 180 (13.6%) asthmatic patients, with a reliable history in 145 (80.5%), and oral ASA provocation test in 35 (19.5%) patients. Clinical presentations of ASA hypersensitivity were respiratory in 76% (n=137), respiratory/cutaneous in 15% (n=27), and systemic in 9% (n=16) of the patients. Multivariate analysis indicated that a family history of ASA hypersensitivity (p: 0.001, OR: 3.746, 95% CI: 1.769-7.929), history of chronic rhinosinusitis/rhinitis (p: 0.025, OR: 1.713, 95% CI: 1.069-2.746) and presence of NP (p<0.001, OR: 7.036, 95% CI: 4.831-10.247) were independent predictors for AERD.

Conclusion: This cross-sectional survey showed that AERD is highly prevalent among adult asthmatics and its prevalence seems to be affected by family history of ASA hypersensitivity, history of rhinosinusitis and presence of NP.
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http://dx.doi.org/10.1016/j.aller.2011.05.015DOI Listing
November 2012

The relationships of serum prealbumin levels with parameters that indicate severity of disease and emphysema pattern in patients with stable chronic obstructive pulmonary disease.

Eurasian J Med 2010 Dec;42(3):105-10

Department of Pulmonary Disease, Medical Faculty, Uludag University, Bursa, Turkey.

Objective: Malnutrition, which is a complication frequently observed in chronic obstructive pulmonary disease (COPD) and negatively affects prognosis, has become a parameter that must be monitored. Even though various methods are applied to assess malnutrition, biochemical parameters, especially serum prealbumin levels, are useful.

Materials And Methods: The relationships between serum prealbumin levels, which we used as an indicator of malnutrition, with the severity of disease and the parameters predicting emphysema in stable COPD patients with no additional health problems were determined in this prospective study.

Results: One hundred stable COPD patients were evaluated prospectively. Serum prealbumin levels had a negative correlation with the total number of hospitalizations due to acute exacerbation, total hospitalization time, and average number of annual hospitalizations, whereas it showed a positive correlation with FEV1 and FEV1/FVC% values. Serum prealbumin levels were positively correlated with the length of the line connecting the costophrenic sinus to the dome of the diaphragm, which is used to assess the presence of emphysema and was negatively correlated with retrosternal distance. Also, in COPD patients with low prealbumin levels, while the FEV1 and FEV1/FVC% values and the length of the line connecting the costophrenic sinus to the diaphragm dome significantly decreased, the retrosternal distance dramatically increased compared to COPD patients with normal prealbumin levels.

Conclusion: Serum prealbumin levels were convenient for monitoring malnutrition in COPD, were correlated with spirometric and anamnestic data indicating the severity of COPD, and were useful in distinguishing the subtype of COPD due to its decrease in the presence of emphysema.
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http://dx.doi.org/10.5152/eajm.2010.31DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261256PMC
December 2010

Phytoplankton distribution during two contrasted summers in a Mediterranean harbour: combining automated submersible flow cytometry with conventional techniques.

Environ Monit Assess 2011 Feb 11;173(1-4):1-16. Epub 2010 Mar 11.

Laboratoire de Microbiologie, Géochimie et Ecologie Marines, CNRS UMR6117, Centre d'Océanologie de Marseille, Université de la Méditerranée, Case 901, 163 Avenue de Luminy, 13288, Marseille cedex 09, France.

Automated in situ flow cytometry, high-pressure liquid chromatography (HPLC), optical microscopy and fluorometry were combined to monitor phytoplankton over two summer periods (2005 and 2006). In 2006, temperature was higher and nutrients lower than in 2005, generating differences in the phytoplankton assemblages (i.e., abundance and structure). Pigment-size classes based on daily HPLC analysis provided evidence for higher proportions of picoplankton and nanoplankton with higher biomass in 2005 and a dominance of microplankton with lower biomass in 2006, the latter with lower specific diversity, as evidenced by weekly microscopy analyses. Total chlorophyll a estimations from fluorometry measurements recorded every 30 min were higher in 2005 than in 2006, as for the HPLC chlorophyll a concentrations. An automated in situ flow cytometer (Thyssen et al., J Plankton Res 30(9):1027-1040, 2008a) sampled seawater every 30 min. Data analysis yielded the resolution of seven clusters based on light scatter and fluorescence. In 2006, an increase in abundance of the largest cells was observed, confirming pigment and microscopy data. The results suggest that the ecosystem was on a constant renewing process in summer 2005 due to a strong wind event and on a highly productive and recycling way in summer 2006 due to stratification of the upper water layer. Automated submersible flow cytometry confirms to be a powerful tool providing high-resolution data by monitoring phytoplankton at the single cell level. This technology gives access to the shape of the light scatter and fluorescence signals generated by each cell passing through a laser beam and that are linked to size, structure and pigment content of the target cell. When combined with conventional techniques, it further improves our understanding of phytoplankton assemblages.
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http://dx.doi.org/10.1007/s10661-010-1365-zDOI Listing
February 2011

Immune thrombocytopenia associated with pulmonary tuberculosis.

J Infect Chemother 2010 Feb;16(1):42-4

Department of Pulmonary Medicine, School of Medicine, University of Uludag, Bursa, Turkey.

Many hematological abnormalities, such as pancytopenia, anemia, and leukocytosis, can be associated with tuberculosis (TB). Immune thrombocytopenic purpura (ITP) is an extremely rare event in TB. We report a 46-year-old male patient who was admitted to hospital with a history of weight loss, combined with hemoptysis, fever, cough, sputum, general malaise, and night sweats. Physical examination revealed a body temperature of 38.8 °C, and petechiae distributed over the lower extremities. Laboratory findings were as follows: erythrocyte sedimentation rate, 84 mm/h; white blood cells, 7070/mm3; hemoglobin, 11.7 g/dl; and platelet count, 4000/mm3. On Ziehl-Neelsen stain of sputum, acid-fast bacilli were observed. Antituberculosis therapy was started, together with prednisolone, 0.5 mg/kg per day, from the day of admission. He was treated successfully with the steroid and antituberculous drugs.
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http://dx.doi.org/10.1007/s10156-009-0003-6DOI Listing
February 2010

Evaluation of thyroid hormone levels and somatomedin-C (IGF-1) in patients with chronic obstructive pulmonary disease (COPD) and relation with the severity of the disease.

Tuberk Toraks 2009 ;57(4):369-75

Uludağ Universitesi Tip Fakültesi, Göğüs Hastaliklari Anabilim Dali 16050, Bursa, Turkey.

Chronic obstructive pulmonary disease (COPD) has recently become a significant cause of mortality and morbidity. In the present study, we aimed to investigate the relationship between the severity of the disease and levels of serum thyroid hormones and somatomedin-C [Insulin-Like Growth Factor (IGF-1)]. Sixty one COPD cases (group 1) were enrolled. Control group (group 2) consisted of 20 healthy individuals. Blood samples were obtained for the analysis of arterial blood gases and hormone levels and respiratory function tests were performed on the same day. Measured hormone levels were compared between group 1 and group 2. Among thyroid hormone levels, there was no significant difference in thyroid stimulating hormone and free T3 between group 1 and 2 whereas free T4 levels were significantly higher in group 1 (p< 0.01). Additionally, mean IGF-1 levels were significantly lower in group 1 (p< 0.005). When three groups, classified according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, were compared, significant differences were observed between mild-moderate COPD cases and severe patients with respect to free T3 and IGF-1 levels (p< 0.05). Hormone levels in COPD patients change depending on the severity of the disease. In the future hormone therapies can use for the COPD treatments. Further studies with larger sample sizes are required to confirm our conclusions.
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March 2010

Frequency of atopy and allergic disorders among adults with Type 1 diabetes mellitus in the southern Marmara region of Turkey.

J Endocrinol Invest 2008 Mar;31(3):211-5

Division of Endocrinology and Metabolism, Konya Education and Research Hospital, Konya, Turkey.

Aim: Autoimmune disorders are considered to be associated with a Th1 immune response whereas allergic diseases with a Th2 response. Studies mainly performed on children revealed conflicting results regarding the association of atopy/allergic disease and autoimmune disorders. Therefore, we aimed to investigate the prevalence of allergic diseases in adult Type 1 diabetic patients.

Methods: Eighty-nine Type 1 diabetic patients and 64 controls were enrolled into the study. Skin-prick test and European Community Respiratory Health Survey questionnaire were performed on all cases. Patients who gave at least one positive answer to questions about asthma in the questionnaire underwent pulmonary function test and methacholine challenge test.

Results: Patients' mean age were similar in diabetic patients and controls (28.2+/-8.9 and 28.1+/-5.2 yr; respectively). In skin-prick test, the rate of positive response to at least one allergen was not significantly different in diabetes (29.2%) and in the control group (31.3%). In European Community Respiratory Health Survey questionnaire, diabetic patients waked up by an attack of cough more than controls did. The rate of physician-diagnosed asthma was similar in both groups. There was no difference between the 2 groups based on the answers of other questions about asthma and other allergic diseases such as allergic rhinitis, eczema, and drug allergy.

Conclusion: We found that atopy frequencies were similar in an adult population of Type 1 diabetic patients and controls. Although asthmatic symptom prevalence is increased in diabetic patients, the incidence of current asthma was similar in both groups.
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http://dx.doi.org/10.1007/BF03345592DOI Listing
March 2008

Clinical effectiveness of nebulised budesonide in the treatment of acute asthma attacks.

Tuberk Toraks 2006 ;54(2):128-36

Department of Allergic Chest Diseases, Faculty of Medicine, Uludağ University, Bursa, Turkey.

Nebulized budesonide (NB) might offer topical anti-inflammatory activity and be an alternative to systemic corticosteroid (SC) in the treatment of acute asthma. The aim of this study was to compare the effect of NB with SC on lung function and clinical findings of adult patients with acute asthma. Thirty patients admitted to clinic with asthma attack (F/M: 26/4; mean age: 47.1 +/- 2.1 years) were enrolled to the study. The patients were randomized into three groups; Group I were treated with NB alone (4 mg/day), Group II SC alone (1 mg/kg/day methylprednisolone), Group III NB plus SC. Pulmonary functions and respiratory symptom scores were measured and recorded before and during 7 days of study. Spirometric parameters significantly improved in all groups at 7th day significantly (p< 0.05) without a difference among groups (p> 0.05). FEV(1) % levels increased significantly at the first day of study in Group I and III (p< 0.05), but didn't change in Group II until 5th day of study. The mean symptom scores decreased significantly at the second day in Group I (p< 0.05), and at the 4th day in other groups. NB with or without SC improved successfully airway obstruction and symptoms in patients hospitalized with acute asthma attack as the 1st treatment day in comparison with SC alone and this effect lasted for 7 days. Regarding the superior safety profile and comparable efficacy with SC, NB might be an alternative to the patients with moderate-severe asthma attacks.
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October 2006

Matrix metalloproteinase-9 (MMP-9) elevated in serum but not in bronchial lavage fluid in patients with lung cancer.

Tumori 2006 Mar-Apr;92(2):149-54

Department of Chest Diseases, Uludag University School of Medicine, Bursa, Turkey.

Aims And Background: Matrix metalloproteinase (MMP) family member MMP-9 degrades type IV collagen, which is one of the main constituents of the basement membrane. MMP-9 is closely associated with the invasive and metastatic potential of most types of lung cancer. In this study we investigated the levels of MMP-9 in serum and bronchial lavage fluid from lung cancer patients and compared them with the levels in patients with nonmalignant lung disease. We also attempted to clarify the possible relationship between serum and bronchial lavage fluid MMP-9 levels and histopathology, staging and metastasis of lung cancer.

Study Design: The study group consisted of 34 patients with lung cancer. The control group comprised 21 patients with nonmalignant lung disease. MMP-9 levels in serum and bronchial lavage fluid were evaluated by ELISA.

Results: MMP-9 levels in serum samples from the group with malignant disease were significantly higher than those from the control group (P <0.05). Bronchial lavage MMP-9 levels did not differ significantly between the two groups (P > 0.05). Serum MMP-9 levels were two-fold higher than those in bronchial lavage, but there was no correlation between bronchial lavage and serum levels in both groups (r = 0.18, P > 0.05). In the group with malignant disease, MMP-9 levels in serum and bronchial lavage fluid did not show any relationship with histopathological type and tumor stage. There was a statistically significant correlation between serum MMP-9 levels and local tumor stage in smoking non-small cell lung cancer (NSCLC) patients (r = 0.33, P < 0.05). Karnofsky scores of lung cancer patients were inversely correlated with MMP-9 levels of serum (r = -0.39, P < 0.05) but not of bronchial lavage fluid.

Conclusion: From our data it can be concluded that MMP-9 levels of serum but not of bronchial lavage fluid can be helpful in differentiating between malignant and benign lung diseases, and are related to the local stage in NSCLC patients and general clinical status of lung cancer patients.
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June 2006

The evaluation of soluble Fas and soluble Fas ligand levels of bronchoalveolar lavage fluid in lung cancer patients.

Tuberk Toraks 2005 ;53(2):127-31

Department of Chest Diseases, Faculty of Medicine, Uludağ University, Bursa, Turkey.

Fas-Fas Ligand (FasL) is one of the major mediator system that activates programmed cell death. Cleavage of membranebound FasL by a metalloproteinase-like enzyme resulted in the formation of soluble FasL (sFasL). sFasL as well as the transmembrane form of FasL binds to Fas and transduces apoptotic signal in Fas-expressing cells. It's suggested that soluble Fas (sFas) and sFasL has an impact on tumor progress and immune escape feature of tumor cells from the host immune system. Since Fas antigen expression in the lungs has been localized to alveolar and bronchial epithelial cells, in this study we aimed to investigate the sFas (pg/mL) and sFasL levels (pg/mL) of bronchoalveolar lavage (BAL) fluid in lung cancer patients. Study population was consisted of 27 patients with lung cancer (mean age 62.9 +/- 10.7 years, 25 control subjects (mean age 47.9 +/- 13.9 years). BAL was performed under local anesthesia, on the unaffected lung of patients; either subsegments of right middle or lingula. BAL sFas and sFasL were evaluated by using ELISA method. The mean levels of sFas was 60.8 +/- 56.8 in lung cancer patient and 39.5 +/- 25.9 in control subjects (p> 0.05). The mean levels of sFasL was 51.6 +/- 39.2 in cancer patient and 41.2 +/- 27.4 in control subjects (p> 0.05). In conclusion, although we did not observe any significant difference between two groups, higher BAL levels of sFas and sFasL levels in lung cancer patients than control subjects, made us thought that apoptosis might have a role development and progression of lung cancer.
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October 2005

Airway inflammation in nasal polyposis: immunopathological aspects of relation to asthma.

Clin Exp Allergy 2005 Mar;35(3):319-26

Department of Allergic Diseases, School of Medicine, Ankara University, Ankara 06530, Turkey.

Background: Nasal polyposis (NP) is a chronic inflammatory disorder of the upper respiratory tract, which is often coexist with asthma. However, the pathogenesis of especially in patients with NP is still a matter of debate.

Objective: To better understand the immunopathologic mechanism involved in this relationship, we investigated the inflammatory cell profiles in bronchial and nasal tissues of patients with NP alone and with concomitant asthma.

Methods: Seventeen patients with NP (six male, 11 female, age range: 19-63, mean age: 38.29+/-13.27 years) were selected for the study. Subjects were divided into two groups based on the presence of asthma or bronchial hyper-responsiveness (BHR). NP without BHR (Group 1) (n=8), NP and asthma or BHR (Group 2) (n=9). All patients underwent atopy evaluation including detailed history, skin prick test (SPT), total and specific IgE determination in sera. None of the subjects had taken inhaled, nasal or oral corticosteroids for at least 1 month before the study. Respiratory symptoms of asthmatic patients were controlled with only short acting beta(2)-agonist inhaler drugs as needed. NP tissue, nasal and bronchial mucosa biopsies were taken from all patients using fiberoptic endoscopy. CD3, CD8, CD16, CD68, AA1 (mast cell tryptase), human leucocyte antigen-DR (HLA-DR) and eosinophil peroxidase (EPO) expressing cells in specimens were determined by immunohistochemical methods. Positively staining inflammatory cell types were counted. Subepithelial lamina propria and periglandular areas were separately evaluated.

Results: No significant difference was found in polyp tissue, nasal and bronchial CD3(+), CD8(+), CD16(+), CD68(+), AA1(+), HLA-DR(+) and EPO(+) positive cells between groups. There were significantly higher numbers of CD8(+), CD16(+), HLA-DR(+), EPO(+) cells in the polyp tissue and nasal mucosa vs. the bronchial mucosa in all groups (P<0.05). However, CD8(+) cells were significantly increased in the polyp tissue and bronchial mucosa of patients with NP alone when compared with the patients with both asthma and NP (P<0.05). CD3(+), CD68(+) and CD16(+) cell counts were tended to be higher within the nasal polyp tissue of patients with isolated NP compared with counts within nasal and bronchial mucosa of patients with NP and asthma. Also, patients with isolated NP showed more HLA-DR(+) cells in the nasal polyp tissue and nasal mucosa than those of patients with NP and asthma. Immunoreactivity for EPO(+) eosinophils within the nasal and bronchial mucosa was more prominent in patients with NP and asthma compared with patients with NP alone. The number of EPO(+) eosinophils within the polyp tissue, nasal and bronchial mucosa was higher in the skin prick test negative (SPT -ve) group than the SPT positive (SPT +ve) ones.

Conclusions: Our results demonstrate that infiltration of inflammatory cells in the nasal and the lower airways do not remarkably differ between patients with NP alone who has no evidence of BHR and asthmatic patients with NP. However, patients with SPT-ve NP reveal more intense eosinophilic inflammation in the entire respiratory mucosa.
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http://dx.doi.org/10.1111/j.1365-2222.2005.02194.xDOI Listing
March 2005

An unusual way of tracheal stoma cleaning could end up with foreign body aspiration in a laryngectomized patient.

Tuberk Toraks 2005 ;53(1):62-5

Department of Chest Diseases, Faculty of Medicine, Uludağ University, Bursa, Turkey.

We report a case of a laryngectomized patient who accidentally aspirated a wooden stick through his tracheal stoma in highly unusual circumstances. He was in a habit of cleaning secretions of upper airway with a wooden stick covered with cotton on the tip soaked in olive oil, via tracheostomy. After applying topical aerolized lidocaine spray through the tracheostomy stoma a flexible video-brochoscopy was performed and a tree twig over 11 cm in length was removed. The patient's symptoms were resolved by a bronchoscopy. With experience and availability of accessories, the removal of the foreign body using flexible bronchoscope under local anesthesia can be performed safely and successfully. This case suggests that the physicians and otolaryngologists should educate their laryngectomized patients about stomal care and discuss any potential life-threatening situation they might encounter.
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June 2005

Risk factors determining allergic airway diseases in Turkish subjects.

J Asthma 2002 Aug;39(5):383-90

Department of Chest Diseases, Ankara University School of Medicine, Turkey.

With regard to changes in life-style after the 1980s, the reflection of environmental factors on the evolution of allergic airway disease (AAD) has not yet been analyzed in Turkey. In this trial, we aimed to determine the factors related to AAD in Turkish subjects. Patients diagnosed as having asthma and/or rhinitis with positive skin prick tests (SPTs) were accepted as members of the "atopic group" (n = 235). Subjects demonstrated to have negative SPTs and no clinical evidence of any atopic disorder were accepted as members of the "nonatopic control group" (n = 84). Data obtained from a questionnaire applied cross-sectionally to the study groups were compared for risk factor analysis. According to the results of univariate analysis, nonatopic controls were found to have been born in villages more frequently than those in the atopic group (14.3% vs. 4.7%, p = 0.02). Atopic group members had lived in apartments during childhood more frequently than nonatopic controls (53.6% vs. 38%, p = 0.04). A topic group members, particularly the asthmatics, had lower sibship size (< or = 1 sibling) (41.3% vs. 16.7%, p = 0.0003) and nonatopic subjects had higher sibship size (> or = 3 siblings) (73.8% vs. 43.4%, p < 0.0001). The rate of maternal atopy was higher in the atopic group (24.7% vs. 9.5%, p = 0.02). Place of birth, sibship size, and atopic status of the mother, but not house type, were found to be significant in the multivariate analysis. As a conclusion, rural life-style seems to have a protective effect on the development of atopy in Turkey. On the contrary, factors directly or indirectly related to urban life-style during early childhood were found to be associated with the allergic airway diseases.
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http://dx.doi.org/10.1081/jas-120004031DOI Listing
August 2002

Clinical features and atopy profile in Turkish subjects with analgesic intolerance.

J Asthma 2002 Apr;39(2):101-6

Ankara University School of Medicine, Department of Chest Diseases, Division of Allergic Diseases, Turkey.

The factors underlying analgesic intolerance (AI), particularly the role of ethnic characteristics, are readily not clear. In this trial, we aimed to assess the predictive features of AI in Turkish subjects. One hundred and ninety patients with AI were enrolled into the study conducted in our tertiary care clinic. The types of drug causing adverse reaction(s) and types of reaction(s) were recorded. The presence of atopy was assessed by skin prick tests. According to the results, the most frequently intolerated analgesic was acetyl salicylic acid (72.1%), followed by nonsteroidal anti-inflammatory drugs (68.4%) and paracetamol (15.8%). Urticaria/angioedema (52.6%) and asthmatic response (40.5%) were the most common reactions to analgesics. Compared with the general adult population of Turkey, the rate of atopy was found be higher in patients with AI and asthma (25% vs. 45%, p = 0.004) but comparable in patients with AI but no atopic disorder (25% vs. 29.2%, p> 0.05). In conclusion, subjects exhibiting intolerance to analgesics have particular features in our population; the presence of atopy in these subjects seems to be associated with the coexistent asthma rather than the drug allergy itself.
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http://dx.doi.org/10.1081/jas-120002191DOI Listing
April 2002

Severity and associated risk factors in adult asthma patients in Turkey.

Ann Allergy Asthma Immunol 2000 Aug;85(2):134-9

Ankara University, Faculty of Medicine, Department of Allergy, Turkey.

Background: The prevalence of asthma of varying severity and associated risk factors are unknown in Turkey.

Objective: The study investigated the distribution of asthma severity, the factors having roles in asthma severity, and the relationship between serum eosinophil cationic protein (ECP) levels and disease severity.

Methods: Three hundred patients with asthma (73 male, 227 female) were enrolled in the study. The patients were surveyed for their smoking habits, educational levels, household incomes, asthma duration, occupations, and accompanying diseases. ECP levels were also determined in certain patients representing different disease severities (n: 76) and in a control group (n: 9).

Results: Patients were classified as mild intermittent (n: 14, 5%), mild persistent (n: 220, 73%), moderate (n: 44, 15%), and severe asthma (n: 22, 7%). Cigarette consumption and educational status were similar in all groups. A longer duration of disease and an older population predominated in patients with moderate and severe asthma. Analgesic sensitivity was seen in 7%, 10%, 6%, and 31% of mild intermittent, mild persistent, moderate and severe asthma patients, respectively, with the highest ratio in severe asthma (P < .05). Nasal polyps were significantly higher in severe asthmatics. Atopy was diagnosed in 85%, 57%, 56% and 10% of mild intermittent, mild persistent, moderate and severe asthma patients, respectively. ECP levels were significantly higher in moderate and severe asthma patients.

Conclusions: Mild asthma was the most common clinical presentation and was associated with atopy. The factors associated with severe asthma included prolonged asthma duration, advanced age, nonatopy, analgesic intolerance and nasal polyps. ECP levels also reflected disease severity.
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http://dx.doi.org/10.1016/S1081-1206(10)62453-2DOI Listing
August 2000

The use of nimesulide in patients with acetylsalicylic acid and nonsteroidal anti-inflammatory drug intolerance.

J Asthma 1999 Dec;36(8):657-63

Ankara University Faculty of Medicine, Department of Allergy, Turkey.

Intolerance or idiosyncrasy to acetylsalicylic acid (ASA) and other nonsteroidal anti-inflammatory drugs (NSAIDs) is a crucial problem because these drugs are frequently used in medical treatment. In this study, we tested whether nimesulide, a selective cyclooxygenase-2 (COX-2) inhibitor, might be a valid alternative for patients with histories of adverse reaction to ASA or NSAIDs. A single-blind, placebo-controlled oral challenge procedure was applied to 60 adult patients (19 male, 41 female; with a mean age of 40.31 +/- 10.44 years, range 20-68 years) with a reliable history of ASA/NSAIDs-intolerance. According to history, the clinical presentations of intolerance were urticaria/angioedema in 32 patients, anaphylactoid reaction in 2 patients, respiratory reaction in 19 patients, and respiratory and cutaneous reaction in 7 patients. Atopy was confirmed by means of skin prick test with inhalant allergens. Oral challenge protocol was started with 25 mg of nimesulide and the remaining 75 mg was given 1 hr later. During the challenge procedure, blood pressure, pulse, nasoocular, pulmonary, and cutaneous symptoms were monitored. Of the 60 patients tested, 55 (91.7%) tolerated the drug with no adverse reaction. Only five (8.3%) patients demonstrated a positive response to oral challenge. The clinical presentations of intolerance to nimesulide were urticaria/angioedema in three patients, mild rhinitis in one patient, and mild dyspnea in one patient. The atopy prevalence was higher, with a ratio of 41.7%, in patients with ASA/NSAIDs intolerance than that of the healthy adult population in Turkey (p < 0.05). We believe that nimesulide can be used as an alternative drug for patients with ASA/NSAIDs intolerance.
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http://dx.doi.org/10.3109/02770909909055417DOI Listing
December 1999

The prevalence of allergic diseases and atopy in Ankara, Turkey: a two-step population-based epidemiological study.

J Asthma 1999 May;36(3):281-90

Ankara University Faculty of Medicine, Department of Allergic Diseases, Turkey.

To assess the prevalence of allergic diseases and atopy in adults, a two-step population-based epidemiological study was undertaken in Ankara, the capital city of Turkey. In step 1, a screening questionnaire adapted from the European Community Respiratory Health Survey (ECRHS) was applied in a cross-sectional manner. In step 2, a nested case-controlled design study was conducted and subjects were evaluated in the clinical setting for history, physical examination, skin prick tests (SPTs), and serum total IgE and phadiotop measurements. According to the results, self-reported current asthma prevalence in step 1 was lower compared with that in step 2 (3% vs. 7%, p < 0.05). The prevalences of food and drug allergy were 6.2% and 3.9%, respectively, in step 1, but were not demonstrated in any of the subjects in step 2. The overall prevalence of atopy was 25% after step 2 evaluation. In conclusion, allergic disorders are not uncommon in our adult population; however, sole application of a screening questionnaire appeared to be ineffective in revealing the accurate figures of asthma, and food or drug allergy.
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http://dx.doi.org/10.3109/02770909909075412DOI Listing
May 1999

world at play.

Phys Sportsmed 1975 Jan;3(1):115-118

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http://dx.doi.org/10.1080/00913847.1975.11948137DOI Listing
January 1975