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1. ALLERGY AND IMMUNOLOGY-
OVERWIEV
ARZU DIDEM YALCIN, MD.
University of Medical Science
Internal Medicine, Allergy and Clinical Immunology.
ANTALYA TRAINING AND RESEACRH HOSPITAL

5. Konuşma planı
0 1. Çevre bakanlığı ile ortak yaptığımız polenizasyon ve
iklim değişimine bağlı Astım Seyri üzerine
projelerimiz.Bulgularımızın sonucuna bağlı olarak ne
gibi önlemler alınabilir?
0 2. Antalyadaki Astım Prevalansı çalışmalarımız.
0 3. ITU Mimarlik fakültesi ile ortaklaşa yapılan Astımlı
Hastalara yönelik Sağlıklı kentsel tasarım projemizin
sonuçları ve hastalara Önerilerimiz.

9. 0 The prevalence of asthma, allergic rhinitis, and allergic eye
disease is 8.2%, 10.8% and 7.5%, respectively, in Antalya, a
city on the south coast of Turkey .
0 In Antalya, high levels of pollen allergens occured mostly
from April to June. During these months meteorological
conditions of the city are windy with low humidity, without
rain, and lukewarm temperatures, all of which are
contributing factors for seasonal allergies.
1. Yalcin AD,et al Prevalance of allergic asthma, rhinitis and conjunctivitis in over 16 year old individuals in
Antalya . Turkiye Klinikleri J Med Sci 2010; 30(3):888-94.
(2009- IPCRG World Conference,SPAIN, ORAL PRESENTATION).
2. Yalcin AD, et al.Pollen aero allergens and the climate in Mediterranean region and allergen sensitivity in
allergic rhinoconjunctivitis and allergic asthma patients. Med Sci Monit 2013;19(2):102-10.
(2012-WORLD ASTMA, CANADA ,ORAL PRESENTATION).
3. Yalcin AD, et al. Evaluation Of Patients Receiving Spesific Immunotherapy In Antalya.
(2011- IPCRG World Conference, HOLLAND, ORAL PRESENTATION)

13. 0 Several studies have investigated the association
between pollen exposure and asthma emergency
admissions, but only two have investigated the effect of
airborne allergens on consultations for Allergic rhinitis.
0 This is study is a project of Environmental Ministery .
0 We evaluated the effects of climate change and airbone
pollination. on the clinic cases of allergic
rhinoconjunctivitis and allergic asthma patients. A year
Later, we evaluated the same effects again. We searched
for whether there was a change in the monthly clinic
visits according to the climate change.

14. Table I. Demographics for the patient group (n=866)
Number of
patients
Percentage
%
SEX
Male 294 33.9
Female 572 66.1
AGE
10-19 179 20.7
20-29 192 22.2
30-39 203 23.4
40-49 155 17.9
50-59 83 9.6
60+ 54 6.2

15. CLINICAL VISIT NUMBERS PER MONTH
January 59 6.8
February 92 10.6
March 86 9.9
April 104 12.0
May 152 17.6
June 127 14.7
July 55 6.4
August 40 4.6
September 48 5.5
October 24 2.8
November 40 4.6
December 39 4.5

16. Table II. Skin prick test results for patients (n=866) and % positivity to different allergens.
Test x ± SD (mm)
Minimum maximum
size(mm)
Positive Result
Number of patients Percentage of patients
Positive control 11,15±3,79 1 - 24 863 99.6
Negative control 0,17±1,03 2 - 10 23 2.6
GRASS MIX 5,86±4,03 1 - 30 703 81.2
holcuslanatus 4,14±4,08 3 - 23 512 59.1
dactylisglomerata 4,75±4,40 3 – 26 594 68.6
loliumperenne 4,56±4,29 1 - 28 568 65.6
phleumpratense 3,46±3,76 3 – 21 452 52.2
poapratensis 3,54±3,92 2 – 24 459 53.0
festucapratensis 3,15±3,74 2 – 19 416 48.0
BARLEY MIX 4,09±4,20 2 - 30 516 59.6
hordeumvulgare 2,78±3,65 3 – 20 366 42.3
triticumsativum 2,61±3,54 2 – 20 351 40.5
secalecereale 2,32±3,63 2 – 22 316 36.5
avenasativa 2,32±3,35 2 – 18 319 36.8
WEED MIX 3,35±3,39 1 – 21 471 54.4
artemissiavulgaris 3,26±3,21 3 – 14 477 55.1
urticadioica 2,45±2,99 2 – 12 372 42.9
plantagolanceolata 2,65±3,15 3 – 18 396 45.7
taraxacumofficianele 2,46±3,33 3 – 20 353 40.8

17. TREE MIX 3,22±3,46 3 - 21 433 50.0
alnusglutinosa 2,40±3,19 3 – 18 337 38.9
corylusavellana 2,42±3,50 3 – 44 326 37.6
populusalba 2,52±3,12 3 – 13 366 42.3
salixcaprea 2,69±3,08 2 – 11 397 45.8
betulaverricosa 2,12±2.99 3 – 10 307 35.4
pinussilvestris 1,45±2,68 3 – 10 207 23.9
quereusrobur 2,58±3,03 3 – 10 386 44.6
robininapseudoacacia 0,17±1,03 2 – 10 23 2.6
oleaauropeae 3,57±3,48 3 – 18 491 56.7
EPITHELIAL ALLERGENS
dog 3,30±3,14 2 – 10 486 56.1
cat 2,91±3,26 3 – 15 415 47.9
horse 0,08±0,71 4 – 9 10 1.1
FUNGAL ALLERGENS
alternaria 3,38±3,18 2 – 18 496 57.3
aspergillusfumigatus 3,36±3,17 3 – 19 493 56.9
MITE MIX
D. pteronyssinus 3,88±3,69 3 – 36 532 61.4
D. farinae 3,95±4,54 3 – 45 517 59.7
P. germanica 0,07±0,70 4 – 11 9 1.0
P. america 0,03±0,39 3 – 8 4 0.5
Blatella germanica 2,73±3,32 3 - 35 457 52.8

18. AGE
Corylusavellana
X±Sd (mm)
Aspergillus
fumigatus
X±Sd (mm)
Dpteronyssinus
X±Sd (mm)
Plantagolanceola
ta
X±Sd (mm)
<40 2.21±3.14 3.59±3.12 4.12±3.78 3.00±3.49
40+ 2.82±4.09 2.93±3.23 3.42±3.47 2.19±2.90
Independen
t-samples t-
test
p=0.02 p=0.004 p=0.008 p=0.001

19. Table V: Monthly pollination ratios
March
April
May
June
July
August
Septem
ber
October
Novemb
er
Decemb
er
January
Februar
y
Total
Total%
Pinaceae 62.1 125.9 56.2 24.5 3.1 0.0 1.6 1.3 0.6 0.4 0.0 0.0 275.7 19.0
Cupressace
ae
84.9 8.2 2.7 1.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 65.3 162.2 11.2
Gramineae 0.6 4.0 202.9 78.6 51.1 22.9 13.4 1.8 0.4 0.0 0.0 0.0 375.7 25.9
Ericaceae 0.0 0.0 0.2 0.0 0.0 0.0 0.0 0.0 0.6 0.0 0.0 0.0 0.7 0.1
Chenopodi
aceae
Amarantha
ceae
0.0 0.0 0.0 7.4 17.8 3.2 0.8 3.0 0.0 0.0 0.0 0.0 32.1 2.2
Unidentifie
d
104.4 155.2 110.1 87.8 41.0 19.6 29.5 31.6 5.2 5.9 3.3 8.0 601.5 41.5
Total 252.0 293.3 372.1 199.3 113.0 45.6 45.3 37.7 6.7 6.3 3.3 73.3 1447.9 100.0
Total % 17.4 20.3 25.8 13.8 7.8 3.2 3.1 2.6 0.5 0.4 0.2 5.1 100.0

21. Allergens Most common on
…
%
Grass mix (n:703) May (n:115),
June(n:97)
30,2
Barley mix (n:516) May (n:94), June
(n:89)
35,5
Weed mix (n:471) May (n:71), June
(n:71)
30,1
Tree mix (n:433) May (n:77), June
(n:77)
35,6
The most commonly detected months of the allergens

23. YALCIN AD, BASARAN S. THE EFFECTS OF CLIMATE AND AERO ALLERGENS CHANGES IN
ALLERGIC RHINOCONJUNCTIVITIS AND ALLERGIC ASTHMA PATIENTS IN
MEDITERRANEAN REGION BETWEEN 2011 AND 2012. MED SCI MONITOR 2013.

24. 0 The aim of this study is to emphasize urban and
health relationship by being healthy in urban life,
describing “healthy urban parameters” especially in
urban areas dominated by climate. During the period
of March 2011 and February 2012, we examined 982
patients with allergic rhinoconjunctivitis and allergic
asthma.
0 In Antalya during March, 2010 and February, 2011
number of clinical visits were 12%, 17.6% in April and
May consequently. A year later nurber of clinical visits
were found as 11% in both months. We concluded that
there was a significant decrease in the number of
monthly clinical visits in April and May compared to
the previous year. We assumed that, evaluating
synchronized climate reports, the factor for this is the
declining of wind speed.We think this might be
correlated with wind speed .

28. Dincer E, Cevik O, Yalcin AD. Healthy City Research from both clinical and
urban planning perspectives: Antalya Case as a a Mediteranian Coastal City.
(2013-EAACI, Italy).
0 300 controlled allergic asthma patients were studied. 51% of the
controlled patients are having allergic symptoms less than 5 years. 17%
of the patients complained about highway, 6% of the patients
complained about agricultural areas, %5 of the patients complained
about industrial areas and 1% of the patients complained about tourism
areas as urban facilities. 42% of the studied patients live in high-income
(wealthy) residential areas though 28% of the patients live in low-
income residential areas. 44% of the patients live in houses which have
100-150m² living area, 32% of the patients live in houses which have
80-100m² living area. 59% of the buildings were built before less than
15 years and 95% of the buildings are concrete. 45% of the patients
work in tourism areas, 7% of them work in industrial areas and 5% of
the patients work in agricultural areas. 28% of the studied patients are
either not working or housewives.

29. We found profession, building age, building type and building material
have effects on allergens which patients are sensitive to. The older the
building are, the more symptoms are seen in patients with allergic
rhinoconjunctivitis and allergic asthma.
0 Patients who live in buildings which are older than 20 years, have
allergic symptoms for medium (p:0.016) and long (p: 0.049)
term. Patients who live in buildings which are 0-10 years old
have allergic symptoms in fall (p:0.009) and Winter (p: 0.000),
and patients who live in buildings which are 0-15 years old have
allergic symptoms in Summer (p:0.009). Patients who live in
wood houses have allergic symptoms mostly in Winter (p:
0.000). While patients who are disturbed by noise have allergic
symptoms for short (p: 0.031) and medium (p:0.026) terms, long
term patients are commonly disturbed by cockroaches (p: 0.023)
and wall cracks (p: 0.025) in their living areas. Moreover
smoking has an effect on allergic symptoms for short (p: 0.027)
and long (p:0.002) term patients.

30. Bilgilendirme kartları örneklerimiz

34. PROF.DR. LUDWIG G. STRAUSS, Clinical Cooperation Unit Nuclear Medicine,
German Cancer Research Center, Im Neuenheimer Feld 280, 69120,
Heidelberg, Germany.

35. Thank you
Prof. Dr. Tse Wen CHANG, Ph.D. (Taiwan)
Prof.Dr. Philipp Albert Shnabel(Germany)
Prof. Dr. Saadet GUMUSLU, Ph.D.
Prof. Dr. Reginald M GORCZYNSKI, MD, PhD. (Canada)
Prof.Dr. Olcay YEGIN, MD.
Prof. Dr. Ludwig G. STRAUSS, MD (Germany)
Prof.Dr. Felix HERTH, MD, PhD. (Germany)
Gizem Esra PARLAK MSc.
Dr. Atil BISGIN, MD, PhD (Sweden)
Prof. Dr. Hasan Huseyin POLAT, MD.
Dr. Emel SAHIN, PhD.
Assoc. Prof. Dr. Sukran KOSE, MD.
Nilgün (Sekretary)
Arzu Didem Yalcin ,MD adidyal@yahoo.com

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