Aim: The aim of the present study was to evaluate asthma in the elderly population, and compare disease characteristics between patients diagnosed <60 (aged asthma, early onset asthma) and ≥ 60 (elderly asthma) years of age. Method: Study was designed as prospective, multicenter, crosssectional type. Between October 2015 and 2017, a questionnaire was filled out to patients 60 years of age and over, that have been followed for asthma at least 3 months. Morisky Medication Adherence Questionnaire, and Asthma Control Test (ACT) was filled out and inhaler device technique assessment was performed. Results: In total 445 patients were analyzed and 399 included. Of the patients 331 (83%) were female. Half of the patients (50.4%) had an ACT score of >19, medication adherence was high in 24.8%, and inhaler device tecnique was correct in 37%. In total 147 (36.8%) patients were diagnosed ≥60 years of age. Figure 1 shows the comparison of disease characteristics between patients diagnosed <60 and ≥ 60 years of age. Conclusion: This is the first multicenter and largest study in Turkey that shows the characteristics of asthma in patients >60 years of age. Although elderly asthma patients more commonly have asthma related comorbidities, their education level, level of asthma control and medication adherence were higher. Patients with aged asthma were using more drugs, and had more asthma medication related side effects.
Alerjik hastalıkların tanısında en çok başvurulan tanı yöntemlerinden biri deri prik testleridir.Deri prik testinden sonra sistemik reaksiyon gelişme riski çok nadir olmasına rağmen ortaya çıktığında hayatı tehdit
National data on asthma characteristics and the factors associated with uncontrolled asthma seem to be necessary for every country. For this purpose, we developed the Turkish Adult Asthma Registry for patients with asthma aiming to take a snapshot of our patients, thereby assigning the unmet needs and niche areas of intervention. Case entries were performed between March 2018 and March 2022. A web-based application was used to record data. Study outcomes were demographic features, disease characteristics, asthma control levels, and phenotypes. The registry included 2053 patients from 36 study centers in Turkey. Female subjects dominated the group (n = 1535, 74.8%). The majority of the patients had allergic (n = 1158, 65.3%) and eosinophilic (n = 1174, 57.2%) asthma. Six hundred nineteen (32.2%) of the patients had obese asthma. Severe asthma existed in 670 (32.6%) patients. Majority of cases were on step 3–5 treatment (n: 1525; 88.1%). Uncontrolled asthma was associated with low educational level, severe asthma attacks in the last year, low FEV1, existence of chronic rhinosinusitis and living in particular regions. The picture of this registry showed a dominancy of middle-aged obese women with moderate-to-severe asthma. We also determined particular strategic targets such as low educational level, severe asthma attacks, low FEV1, and chronic rhinosinusitis to decrease uncontrolled asthma in our country. Moreover, some regional strategies may also be needed as uncontrolled asthma is higher in certain regions. We believe that these data will guide authorities to reestablish national asthma programs to improve asthma service delivery.
Abstract Background Oral immunotherapy (OIT) is a promising treatment for food allergies. Our aim was to establish the long‐term safety and efficacy of a novel red meat (RM) OIT in galactose‐alpha‐1,3‐galactose (alpha‐gal) allergy in adults. Methods Out of 20 patients with confirmed RM allergy, five (41.66%) underwent an early OIT, seven (58.33%) underwent a delayed protocol and eight patients who were not desensitized formed the patient control group. 15 and 27 day RM OIT for early‐onset and delayed‐onset alpha‐gal allergy were administered, respectively. Desensitized patients were recommended to continue eating at least 100 g RM every day for 6 months and every other day in the following 6 months. After a year, the consumption was recommended 2/3 times in a week. Patients were followed up with skin tests with commercial beef and lamb extracts, fresh raw/cooked beef and lamb and cetuximab and also with serum alpha‐gal specific Immunoglobulin‐E (sIgE) in the first and fifth years. Results All patients who underwent OIT became tolerant to RM. During the 5 year follow‐up, the median alpha‐gal sIgE concentration gradually decreased in nine patients who consumed RM uneventfully while remained unchanged in the control group ( p = .016). In two patients, rare tick bites acted as inducers of hypersensitivity reactions with concomitant elevation of alpha‐gal sIgE concentrations whereas one patient with low follow‐up alpha‐gal sIgE concentrations consumed RM uneventfully after frequent tick bites. Conclusions Our study showed the long‐term safety and efficacy of alpha‐gal OIT. Additionally, alpha‐gal sIgE seems to be a potential biomarker to monitor OIT.
Some drugs may cause false negative results by suppressing the reactivity of the skin prick tests (SPTs). The aim of this survey was to show whether escitalopram, fluoxetine and sertraline had any effect on the reactivity of SPT.Twenty-four patients who were admitted to the outpatient clinic of the Psychiatry Department at the Hacettepe University Hospital and planned to be treated by these antidepressants were included in the study between May and October 2008. SPTs with positive control (histamine), negative control and 3 common aeroallergens were performed in the beginning, at the first and fourth weeks. A questionnaire including 26 questions about respiratory symptoms and allergic diseases was filled in face to face by the fellow-in-training. The Visual Analog Scale (VAS) of current respiratory and nasal symptoms was recorded at all 3 visits.There were no statistically significant differences between the 3 mean diameters measured at 3 time points in addition to the mean diameters of the wheals between groups using escitalopram, sertraline and fluoxetine (p > 0.05). There was a statistically significant decrease between the VAS of nasal symptoms at the 3 visits (p < 0.05).Escitalopram, fluoxetine and sertraline do not seem to affect the reactivity of SPTs. Nasal symptoms might have been decreased due to both the allergic treatment suggested and the end of the pollen season.
The target of asthma treatment is full control according to Global Initiative for Asthma (GINA) criteria. Asthma Control Test (ACT) has also been recommended as a useful tool besides of GINA. There is not enough available data about the implementation of control criteria by pulmonologists in daily routine practice in our country and world. We aimed to evaluate the utilization of control criteria regarding GINA and ACT by pulmonologists. The questionnaire included data regarding age, gender, hospitals/regions, questioning the patients9 control status, GINA/ACT choice, the preference among GINA and ACT questions, control records, evaluation time, and if the survey caused awareness of asthma control evaluation for the physician. 286 pulmonologists filled the questionnaire (F:183/M:103), Majority of the physicians (78.37%) have been working in training and research hospitals. While 49.30% of the pulmonologists were evaluating the control status of all patients, 30.42 % of them were using GINA criteria, 7.62% ACT and 39.86% preferred both. Control status was recorded by 18.4 % of the physicians and 36.3%, and 37.02% of the participants stated that the questionnaire caused complete and partial awareness of asthma control questioning, respectively. We showed that GINA criteria were used more frequently than asthma control test by pulmonologists. Implementation of all questions of GINA was proportionally higher than ACT steps. Although there was no systematical approach to evaluate asthma control status by the pulmonologists, most of them were asking the frequency of day and night symptoms.
