Distribution and Characterization of Aeroallergens in the Etiology of Allergic Rhinitis Patients in İstanbul Kartal Region

Aim:Allergic rhinitis (AR) is a common disease and the first step in its treatment is to determine the allergen responsible for its etiology and to take preventive measures. The aim of this study was to determine the distribution of aeroallergens in AR patients in İstanbul Kartal region and to investigate other factors affecting the severity of AR.Materials and Methods:The study was performed in a tertiary hospital on the Anatolian side of İstanbul among patients who were admitted to the allergy and clinical immunology outpatient clinic and diagnosed with AR. Data of patients were obtained from medical records retrospectively. Age, gender, concomitant atopic disease, family transition history, serum total IgE and serum eosinophil (Eo) levels were evaluated. Skin prick tests were performed with 25 allergens.Results:One hundred and sixty patients were included in our study. Ninety-six (65.8%) of the patients were female and the median age of the study population was 31 (18-75) years. Distribution of aeroallergens according to skin test results was as follows; D. pteronyssinus (78.1%), D. farinae (75.2%), Tyrophagus putrescentlae (59.6%), Acurus siro (57.5%), Lepidoglyphus destructor (40.4%), cereals mix (37.7%), and cat hair (33.6%). It was found that there was a significant increase in total IgE levels (p<0.001) consistent with the increase in serum Eo level.Conclusion:In our study, mite sensitivity has been found to be the most common allergen sensitivity in accordance with the geographic and climatic characteristics of the İstanbul region. Secondly, cat hair sensitivity and pollen (grasses mix) sensitivity were similarly high due to the increase in the number of domestic animals in the modern age. We think that our study contributes to the literature by examining the distribution of these allergens that cause AR and patients are guided to take preventive measures in this regard

Pulmonary Artery Agenesis: A Case Series

Pulmonary artery agenesis is a rare congenital abnormality in which atresia was encountered in the short segment of the right or left pulmonary arteries. It can be isolated or associated with cardiac abnormalities such as tetralogy of Fallot, septal defects or pulmonary stenosis.The majority of cases are diagnosed in childhood whereas some cases yield no symptoms until adulthood. We evaluated retrospectively 5 pulmonary artery agenesis cases diagnosed in our clinics between 1998-2010 with respect to the literature

Transbronchial Biopsy: Our Experience in 5 Year

Objective: Transbronchial biopsy (TBB) is an old diagnostic method applied via fiberoptic bronchoscopy. The diagnostic value and complication rate of the procedure were found to vary in previous studies. In present study, the diagnostic value of TBB was analysed. Methods: All medical files of 308 patients who underwent TBB between May 2010-May 2015 in our clinic were reviewed retrospectively. According to the final diagnoses, the diagnostic value and complication rates of TBB, the contribution of the additional samples of the same bronchoscopic session to the diagnoses, and the requirement of any additional invasive procedure were investigated. Results: Of all the patients, 63% were female and the mean age was 51 (17-85). Bronchoalveolar lavage was taken in 257 patients. Ten percent of the procedures could not reach lung parenchyma. TBB was diagnostic in 105 (34%) patients. Fifty (16%) patients were diagnosed via other samples of the same session, 15 (5%) resolved spontaneously, 28 (9%) were diagnosed via other clinical findings, 41 (14%) did not accept further invasive method or were lost-to follow-up. Sixty-nine (22%) underwent an additional invasive procedure. The most frequent final diagnosis was sarcoidosis and the diagnostic value of TBB was 49%. Diagnostic rate of TBB was lower in fibrotic interstitial lung diseases (ILD) and malignancy whereas higher in non-fibrotic ILD. No mortality was seen related to TBB, pneumothorax was seen in 6%; non-massive bleeding in 3%, respiratory failure in 0.3%. Conclusion: Transbronchial biopsy is a procedure having a higher diagnostic value in certain diseases and has an acceptable morbidity. When combined with other bronchoscopic samples, the need for further invasive methods decreases significantly

How Successful is Non-Invasive Ventilation Treatment that is Initiated in the Emergency Department in Cases of COPD Exacerbations with Acute Hypercapnic Respiratory Failure? Can We Predict Treatment Failure?

Objective: We aimed to investigate the success rate of non-invasive ventilation (NIV) in wards and the predictors of failure in cases of chronic obstructive pulmonary disease (COPD)-related acute hypercapnic respiratory failure (AHRF). Methods: The was a retrospective study conducted in a tertiary teaching hospital between May 2011 and 2013. Patients who were admitted to the emergency department (ED) because of COPD with AHRF were evaluated; 544 patients who initially received NIV in ED and were transferred to wards were included. Patient characteristics, baseline and follow-up pH values, and partial arterial carbon dioxide (PaCO2) values were recorded. Baseline pH values were categorized as severe (pH<7.26), moderate (pH≥7.26–7.30), and mild (pH≥7.30) acidosis. According to the in-hospital outcome, patients were classified in 2 groups: Group 1: home discharge, Group 2: death or intensive care unit transfer. Results: Treatment resulted in success in 477 (88%) patients. Albumin levels were significantly low and the mean Charlson index (CI) score was significantly high in Group 2. Admission pH and PaCO2 values did not affect the treatment outcome. Patients in Group 2 had higher PaCO2 and lower pH values as well as a lower level of decrease in PaCO2 values within 2 hours of treatment in ED. Similarly, higher PaCO2 and lower pH values at the end of the first day in wards were indicative of NIV failure (p<0.05). Conclusion: The success rate of NIV in wards in cases of AHRF is high. Patients with low albumin levels and higher CI scores have worse response to treatment. pH or PaCO2 values after a few hours of treatment and not the baseline pH or PaCO2 values are better predictors than the baseline pH and PaCO2 values

Idiopathic Chronic Eosinophilic Pneumonia: Retrospective Analysis of 17 Cases from a Single Center in Turkey

Objective: Idiopathic chronic eosinophilic pneumonia (ICEP) is a rare eosinophilic lung disorder with an unknown etiology and is characterized by subacute or chronic respiratory and general symptoms, alveolar and/or peripheral eosinophilia, and the accumulation of eosinophils in the lungs. We aimed to present diagnostic test results and follow-up outcomes of 17 patients who were diagnosed with ICEP in our hospital in light of literature. Methods: Between 2008 and 2013, we examined 17 cases of ICEP. We evaluated clinical and laboratory findings together with the long-term follow-up data. Results: The patients had a mean age of 40.8 years at presentation, and the female/male ratio was 0.8. The most common symptoms were cough (94%), shortness of breath (76%), and high fever (35%). Bronchoalveolar lavage eosinophil percentages of the patients ranged from 3% to 80%. Nine (53%) patients experienced recurrence. Six patients were maintained on low dose steroid due to repeating relapses. Among these patients, 7 (77.7%) had a total IgE level of above 500/IU/mL. Conclusion: Relapses are common in ICEP after the withdrawal of corticosteroid treatment or during dose reduction. We point out the importance of the close monitoring of patients for identifying relapse. A higher total IgE level during diagnosis may serve as a predictor of recurrence

Evaluation of the results of MOTAKK hepatitis C virus RNA genotyping and hepatitis delta virus external quality assessment programs during 2015-2016

Background/Aims: To evaluate the HCV RNA genotyping and HDV RNA tests that are performed in molecular microbiology laboratories in Turkey as part of a national external quality assessment programme, MOTAKK (Molekuler Tanida Kalite Kontrol) (English translation: Quality control in molecular diagnostics)