An iron hypersensitivity reaction can develop during infusion. Here we present four cases of Rapid Drug Desensitization (RDD) as an option for the treatment of these patients. Urticaria appeared in the second hour of an IV iron sucrose infusion (ISI) performed 8 years previously in case 1 and drug provocation with IV ferric carboxymaltose was performed, but urticaria developed on the arm where the drug was administered immediately after infusing 60 cc. Case 2 developed tongue swelling and shortness of breath within minutes of the IV ISI. Case 3 developed shortness of breath within three minutes after the first dose of IV ISI. Case 4 with iron deficiency anemia reported swelling in the throat, lips and shortness of breath after taking an unknown oral iron therapy. On the 14th day of oral ferrous sulfate therapy, the patient presented with pruritus and skin eruptions occurring 2 hours after drug ingestion. Fifteen RDDs were successfully performed in these cases.
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TUBA ERDOĞAN ,
Özlem GÖKSEL ,
Gamze KIRKIL , Tuğba Aslı ÖNYILMAZ,
Füsun YILDIZ ,
Bilun GEMİCİOĞLU ,
Evrim Eylem AKPİNAR ,
Elif YILMAZEL UÇAR ,
Eylem SERCAN ÖZGÜR ,
Ömür AYDIN ,
İ.Kıvılcım OĞUZÜLGEN ,
Gül KARAKAYA ,
Ali Fuat KALYONCU
OBJECTIVES: Asthma is a global problem and chronic condition that persists through patient’s entire life, during which the possibility ofa surgical procedure is common. An accurate clinical and functional evaluation of respiratory functions and asthma control is neededin patients undergoing surgical procedures and requiring general anesthesia. The aim of this study was to disclose any possible relationbetween postoperative complications and some pre- and postoperative factors.MATERIALS AND METHODS: In this prospective cross-sectional study, randomly selected 111 asthmatic patients who presented to 10different tertiary centers were included. The patients were evaluated at three different periods; any day between 1-7 days before surgery,and postoperative third and seventh to tenth days.RESULTS: Among the patients included in the study, 86 (77.5%) were women and mean age was 52.2±13.8 years. General anesthesiawas the most common anesthesia type (89.2%), and 33.3% of patients had had a thoracoabdominal surgery. There was a statisticallysignificant difference between pre- and postoperative third-day values, including ACT scores (22.2±3.16 and 21.59±3.84, respectively;p<0.001); forced expiratory volume during the first second (84.92±19.12 and 78.26±18.47, respectively; p<0.001); peak flow rate(79.51±21.12 and 70.01±19.72, respectively; p<0.001); and SaO2 (96.95±1.82 and 95.8±3.32, respectively; p<0.001). Bronchospasmand pain were the most common complications during the postoperative period.CONCLUSION: Controlled asthma under treatment steps 1-2-3 does not cause any serious postoperative pulmonary complications(PPCs). Therefore, achieving an optimal control level of asthma during the preoperative period must be considered the “gold standard”to reduce the risk of PPCs in asthmatic patients.
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Bilun GEMİCİOĞLU ,
Dilşad MUNGAN ,
Sevim BAVBEK ,
Füsun YILDIZ ,
Mehmet POLATLI ,
Sibel NAYCI ,
Ferda Öner ERKEKOL ,
Hatice TÜRKER ,
Hakan GÜNEN ,
Güngör ÇAMSARI ,
Öznur ABADOĞLU ,
Arif ÇIMRIN ,
A. Berna DURSUN ,
Özlem GÖKSEL ,
Seçil Kepil ÖZDEMİR ,
Şermin BÖREKÇİ ,
Ömür AYDIN ,
Birsen OCAKLI ,
Aygün GÜR ,
Arzu BAYGÜL ,
Zeynep MISIRLIGİL
OBJECTIVES: A multicenter trial was designed to validate the “Assessment Tools for Asthma (ATA)” questionnaire, a newly developedquestionnaire, which evaluates both asthma control and risk factors associated with asthma control with a single instrument.MATERIALS AND METHODS: This cross-sectional study involved 810 cases from 14 clinics in 9 Turkish cities. The ATA questionnaire and Asthma Control Test (ACT) were administered. The Visual Analog Scale (VAS) was used to evaluate the control status of 100randomized cases. ATA is an eight-item physician-administered questionnaire. It comprises the following two sections-ATA1, assessessymptomatic control criteria, and the remaining section, queries the flre-up of asthma, control of comorbidities, treatment adherence,and inhaler technique.RESULTS: The mean scores for ATA1, ATA total, VAS, and ACT were 24.7±14.8, 53.8±19, 7.1±3, and 18.8±5.5, respectively. According tothe ATA questionnaire, among all patients, 34.3% had controlled, 18.8% had partly controlled, and 46.9% had uncontrolled asthma. Furthermore, 16.6% patients had flre-ups between visits, 96.4% patients had uncontrolled comorbidity, 17% patients had irregular asthmatreatment, and only 8.4% patients used the incorrect inhaler technique. The ATA questionnaire showed internal consistency (Cronbach’salpha coeffiient=0.683). ACT, ATA1, and two specialists’ evaluations using VAS correlated strongly with the ATA total scores (Spearmancorrelation coeffiient (r) values: 0.776, 0.783, and 0.909, respectively; p-values: p<0.001, p<0.001, and p<0.001, respectively). According to Receiver Operating Characteristic analysis, the cut-off value of ATA was 50 (sensitivity=84.4%, specifiity=82.40%).CONCLUSION: The validated ATA questionnaire may be a practical tool for physicians in asthma management.
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