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Background and objective This study aims to evaluate clinical and radiological findings and treatment outcomes of the patients with PIBO. Methods One hundred fourteen children were enrolled. Initial demographic and clinical findings were evaluated. Pre- and post-treatment clinical and radiological findings were compared. Results The median age of the patients at initial pulmonary injury was 7,2 months, the median age at diagnosis was 17.5 months. Persistent wheezing was the most common complaint. Thirty-five patients had mechanical ventilation history. 82,5% of patients had clinical improvement. Bronchiectasis, atelectasis, hyperinflation and air trapping in HRCT improved significantly with treatment. Post-treatment Bhalla scores decreased from 8.3 to 6.5 (p= 0,001). Improvement was observed in radiological and clinical findings after treatment. Conclusions This study is one of the largest studies in the literature and one of the few studies that evaluate clinical and radiological outcomes of patients with PIBO.

Background: Published data on the correlations of bronchoscopy findings with microbiological, radiological, and pulmonary function test results in children with noncystic fibrosis (CF) bronchiectasis (BE) are unavailable. The aims of this study were to evaluate relationships between Bronchoscopic appearance and secretion scoring, microbiological growth, radiological severity level, and pulmonary function tests in patients with non-CF BE. Methods: Children with non-CF BE were identified and collected over a 6-year period. Their medical charts and radiologic and bronchoscopic notes were retrospectively reviewed. Results: The study population consisted of 54 female and 49 male patients with a mean age of 11.7 ± 3.4 years. In the classification according to the bronchoscopic secretion score, Grade I was found in 2, Grade II in 4, Grade III in 9, Grade IV in 17, Grade V in 25, and Grade VI in 46 patients. When evaluated according to the Bhalla scoring system, 45 patients had mild BE, 37 had moderate BE, and 21 had severe BE. Microbial growth was detected in bronchoalveolar lavage fluid from 50 of the patients. Forced expiratory volume in 1 s (FEV(1)) and functional vital capacity decreased with increasing bronchoscopic secretion grade (P = 0.048 and P = 0.04), respectively. The degree of radiological severity increased in parallel with the bronchoscopic secretion score (P = 0.007). However, no relationship was detected between microbiological growth rate and radiological findings (P = 0.403). Conclusions: This study showed that bronchoscopic evaluation and especially scoring of secretions correlate with severe clinical condition, decrease in pulmonary function test, worsening in radiology scores, and increase in microbiological bacterial load in patients. Flexible endoscopic bronchoscopy should be kept in mind in the initial evaluation of non-CF BE patients.

Objectives It is unclear whether body weight status (underweight/normal weight/overweight/obese) is associated with allergic disease. Our objective was to investigate the relationship between body weight status (body mass index; BMI) and atopic allergic disease in prepubertal children, and to compare children with atopic allergic diseases with non atopic healthy children. Methods A prospective cross sectional study of 707 prepubertal children aged 3–10 years was performed; the participants were 278 atopic children with physician-diagnosed allergic disease (allergic rhinitis and asthma) (serum total IgE level >100 kU/l and eosinophilia >4%, or positivity to at least one allergen in skin test) and 429 non atopic healthy age- and sex-matched controls. Data were collected between December 2019 and November 2020 at the Pediatric General and Pediatric Allergy Outpatient Clinics of Bezmialem Vakıf University Hospital. Results Underweight was observed in 11.6% of all participants (10.8% of atopic children, 12.2% of healthy controls), and obesity in 14.9% of all participants (18.0% of atopic children, 12.8% of controls). Obese (OR 1.71; 95% CI: 1.08–2.71, p=0.021), and overweight status (OR 1.62; 95% CI: 1.06–2.50, p=0.026) were associated with an increased risk of atopic allergic disease compared to normal weight in pre-pubertal children. This association did not differ by gender. There was no relationship between underweight status and atopic allergic disease (OR 1.03; 95% CI: 0.63–1.68, p=0.894). Conclusions Overweight and obesity were associated with an increased risk of atopic allergic disease compared to normal weight among middle-income and high-income pre pubertal children living in Istanbul.

Objective: This study aims to evaluate clinical and radiological findings and treatment outcomes of the patients with PIBO. Methods: One hundred fourteen children were enrolled. Initial demographic and clinical findings were evaluated. Pre- and post-treatment symptoms, radiological findings and scores, the number of admissions to the hospital and PICU were compared. Results: Seventy-three patients were male. The median age of the patients at initial pulmonary injury was 7.2 months, the median age at diagnosis was 17.5 months and the median interval from initial injury to diagnosis was 8.5 months. Thirty-five patients had mechanical ventilation history. Persistent wheezing was the most common complaints. The most common radiological findings were peribronchial thickening and air-trapping. Sixty-eight patients were treated with inhaled corticosteroid (IC), systemic corticosteroid (SC) and azithromycin (AZT) combination. 25 patients were treated with only IC, 14 with IC and AZT, and 7 with IC and SC. 82,5% of patients had clinical improvement. Chronic respiratory failure occurred in 11 patients, and three patients died. Bronchiectasis, atelectasis, hyperinflation and air trapping in HRCT improved significantly. Bhalla scores decreased from 8.3 to 6.5 (p= 0,001). IC, SC and AZT combination was effective than the other treatments. Conclusions: This study is one of the largest studies in the literature and one of the few studies that evaluate clinical and radiological outcomes. We found that IC, AZT and SC combination is clinically and radiologically effective in patients with PIBO.

INTRODUCTION: Human paraoxonase-1 (PON1) is one of the endogenous antioxidant molecules working against oxidative stress. We aimed to investigate serum PON1 activity in children with acute bronchiolitis.

Aim Atopic dermatitis is a chronic, itchy, inflammatory skin disease that progresses with exacerbations. This study was planned to determine how atopic dermatitis affects the quality of life of patients and their families. Material and methods One hundred twenty patients with atopic dermatitis, as diagnosed using the Hanifin Rajka diagnostic criteria, and their families were included in the study. The patients were divided into two groups as active and remission. Disease severity was classified as mild, moderate, and severe according to the SCORAD index. Total IgE, peripheral eosinophil counts, and allergy skin tests were performed. Literate patients completed the Childrens' Dermatology Life Quality Index by themselves. The Infants' Dermatology Life Quality Index was completed by their families. Also, the Family Dermatological Quality of Life Index was completed by one of the parents for each patient. Results Among the 120 patients who participated in the study, 76 (63.33%) were male and 44 (36.66%) were female. The mean age was 4.36±3.52 years. The quality of life survey scores were statistically significantly lower in the remission group compared with the active group (p 0.05). At least one allergen susceptibility was detected in 65% of the patients who underwent allergy skin tests. Conclusion Quality of life was affected negatively in patients with atopic dermatitis and their families. In this study, the quality of life survey results were found to be higher in the active group and the group with a high SCORAD index compared with the remission group and the group with a low SCORAD index. Based on this finding, we can conclude that quality of life is negatively affected by high disease activity.

Background The present study aims to assess psychiatric diagnoses in children with psychogenic and functional breathing disorders (PFBD), which consist of children with psychogenic cough, throat-clearing tics, and sighing dyspnea, and compare them to a control group without any diagnosis of chronic medical problems. Methods The participants consist of 52 children with PFBD and 42 children without any chronic medical problems. Psychiatric diagnoses were assessed via semistructured psychiatric interviews in both groups. Results The two groups did not differ on age (PFBD group 11.25 ± 2.61, control group 11.17 ± 2.58; t = 0.14, P = .88) or sex (48.1% of the PFBD group were female, 61.9% of the control group were female; χ2 = 1.79, P = .18). 55.8% of the PFBD group and 28.6% of the control group had at least one psychiatric diagnosis according to the semistructured interviews (χ2 = 6.99, P = .008). The most common psychiatric diagnoses in the PFBD group were attention deficit hyperactivity disorder (ADHD; 17.3%), tic disorders, (15.4%), and specific phobia (15.4%). 11.5% of the cases in the PFBD group were diagnosed with somatic symptom disorder and more than half of the patients (n = 27 (51.9%)) showed clinical characteristics of tic disorders. Conclusion Psychiatric diagnoses are common in children with PFBD, and teamwork involving child psychiatrists may be essential for the management of children with PFBD.

Introduction Postinfectious bronchiolitis obliterans is characterized by persistent symptoms and signs of obstructive pulmonary disease following acute bronchial injury. It usually occurs with persistent wheezing and cough as a result of severe viral infections. The aim of this study was to investigate the socio-demographic characteristics, treatment status, and clinical response of our cases of postinfectious bronchiolitis obliterans. Methods The records of 102 patients with postinfectious bronchiolitis obliterans who were followed-up in our clinic were retrospectively reviewed. Sociodemographic characteristics, treatments, pre-treatment and post-treatment complaints, pulmonary function tests, clinical status, radiological changes were evaluated. Results 68.6% (n = 70) of our patients were male. The mean age of the patients at the time of the study was 88.8 ± 53.5 months, and the age of diagnosis was 34.3 ± 36.4 months. The mean period from the first complaints to the date of diagnosis was 22.8 ± 33.8 months. 59% (57) of the patients had a history of smoking in one of their parents. In 62.7% of the cases, the first lower respiratory tract infection was bronchopneumonia and 36.3% was in the acute bronchiolitis. Before the diagnosis, 35 patients had intensive care hospitalization (34.3%). Persistent cough (90.2%), wheezing (96.1%), shortness of breath (91.2%) and purulant cough (75%) were the most frequent findings. When treatments of the patients were evaluated; inhaled corticosteroids were 92.2%, 6 months azithromycin 69.6%, 6 months oral steroid 61.8%. 11 patients (10.8%) needed oxygen and 10 patients (9.8%) required Bilevel Positive Airway Pressure (BPAP) support. Before and after treatment of 49 patients, lung CTs were evaluated by radiologist and modified Bhalla scores were calculated. Pre-treatment mosaism and peribronchial thickening were detected in all patients. There were bronchiectasis 67.3%, atelectasis 91.8%, hyperinflation 81.6%, air trapping 98% of patients. Post-treatment radiological evaluation revealed mosaism 93.9%, peribronchial thickening 100%, bronchiectasis 51%, atelectasis 65.3%, hyperinflation 69.4%, air trapping 87.8%. The mean Bhalla score was 9.1 ± 4.1 before the treatment and it was found to be 6.8 ± 4.6 after treatment. Discussion and Conclusion Postinfectious bronchiolitis obliterans is a rare condition with obstruction findings. It occurs as a result of immune mechanisms after severe lung infection, especially at a young age. In this study, we aimed to present sociodemographic characteristics, clinical features and especially response to long-term sterolid and azithromycin treatment in patients with bronchiolitis obliterans.

Allergic rhinitis is the type 1 hypersensitivity reaction of the nasal mucosa and its primary mediator is Ig E. It is most frequently observed in children and adolescents. Our purpose in this study is to investigate the impact of allergy on hearing functions in children with perineal allergic rhinitis (house dust mite allergy). 50 perineal allergic rhinitis (house dust mite allergy) patients (33 male, 17 female patients, aged between 6 and 15, average age 10.4) and 20 control patients (12 male, 8 female, aged between 6 and 15, average age 11.2) underwent high frequency pure tone audiometry, acoustic reflex, otacoustic emission (OAE) and auditory brainstem potentials to assess their auditory functions. No statistically significant difference was detected between the study group and the control group with respect to their hearing thresholds (250-16,000 Hz). No statistically significant difference was detected as a result of the comparison between the study group and control group in terms of their signal-noise ratios at Distortion Product OAE in all frequencies (996-8,004 Hz). No statistically significant difference was detected between the study group and the control group in terms of the 1st, 3rd and 5th wave latencies and 1-3, 3-5 and 1-5 inter-peak values. This study is the first study where the audiological functions of the pediatric perineal allergic rhinitis (house dust mite allergy) patients were assessed. No significant difference was detected between the group of pediatric perineal allergic rhinitis (house dust mite allergy) patients and the control group with respect to their audiological functions.

Recurrent meningitis is an uncommon life-threatening condition. Here, the case of a 6-year-old boy is reported who had two episodes of meningitis with an IgG3 subclass deficiency. The boy had aseptic meningitis at the age of 3 years, followed by bacterial meningitis at the age of 4 years. Primary immunoglobulin deficiencies are a group of disorders associated with an increased incidence and/or severity of infection. Recurrent infections, sinusitis, bronchitis, and pneumonia are the most frequently observed illnesses in patients with IgG subclass deficiencies, of which an IgG3 subclass deficiency is the most common, especially in adults. Although cases of recurrent viral or bacterial meningitis have been reported, herein a patient is presented with recurrence of aseptic and bacterial meningitis 1 year after the initial episode. Some researchers recommend that all children with episodes of recurrent meningitis should be screened for primary immunoglobulin or complement deficiencies.

OBJECTIVE We assessed the association of breast-feeding and timing of solid food introduction with childhood obesity. METHODS The children were grouped according to the duration of breast-feeding (0-1, 2-6, 7-12, 13-18, and 19-24 months) and the age at which solid foods were introduced (

Although treatment with oral corticosteroids can cause reactivation of latent Mycobacterium tuberculosis (TB) infection in purified protein derivative (PPD)-positive individuals with no evidence of clinical disease, little is known about the effects of inhaled corticosteroids in this respect.This study was undertaken to assess whether inhaled corticosteroid (CS) therapy reactivates latent TB infection in PPD-positive asthmatic children.We studied 32 PPD skin test-positive (or =10 mm) children [age (mean +/- SD), 7.9 +/- 4.1 years] with no family history and no evidence of TB infection on chest radiograms who were receiving inhaled budesonide for the treatment of asthma. They were further evaluated with thorax computed tomography (CT) and erythrocyte sedimentation rate and closely observed for an additional 9 months.At enrollment the mean diameter of PPD reaction was 12.8 +/- 2.7 mm. The mean duration of inhaled CS treatment and the mean cumulative CS dose were 9.8 +/- 7.6 months and 275 +/-199 mg, respectively. Thorax CT studies revealed mediastinal lymph nodes in 7 of the 32 patients. There was no significant difference between children with and without mediastinal lymph nodes according to age, gender, size of PPD skin testing, erythrocyte sedimentation rate and duration and cumulative CS dose of inhaled budesonide therapy before study. A second thorax CT was obtained 9 months later in those 7 patients with lymphadenopathy (additional mean cumulative CS dose, 222.57 mg). There was no change in the size of their lymph nodes.Long term inhaled budesonide therapy appears to be safe in PPD-positive asthmatic children.

Introduction: This study compared the frequency of antibiotic usage and the number of asthma episodes before and after the diagnosis and treatment of pediatric asthma patients who were followed up by specialists. Subjects and Methods: Included in this study were 334 patients (211 males and 123 females) of 2-16 years of age who were diagnosed with asthma and followed up for at least 1 year in our clinic. The frequency of antibiotic usage and the number of asthma episodes in the year prior to diagnosis and treatment were compared to these same variables after 1 year of follow-up by specialists. Results: The median age was 84 months (range: 24-192) and 212 (63%) children were at school or in day care centers. Atopy and a family history of asthma were present in 200 (60%) of the patients, and 137 (41%) reported that at least one member of their household smoked. Antibiotics were used a median number of 7 times [interquartile range (IQR) = 6] in the year before the asthma diagnosis, and 2 times (IQR = 3) during the year after treatment (p < 0.001). The mean number of asthma episodes before diagnosis, i.e. 4 (IQR = 8) was reduced to 0 (IQR = 2) in the year after treatment when the patients were followed up by specialists (p < 0.001). Conclusion: This study shows that appropriate diagnosis and treatment of childhood asthma significantly reduce the frequency of antibiotic usage and the number of asthmatic episodes.

Background: Although sublingual immunotherapy (SLIT) has been demonstrated to be a safe and efficient treatment in children with seasonal allergic rhinitis (AR), there is little evidence on the efficacy of SLIT with house-dust-mite (HDM) extract in children with isolated perennial AR. Objectives: We sought to assess the clinical efficacy and safety of HDM-SLIT in children with isolated allergic rhinitis-conjunctivitis mono-sensitized to HDM without asthma symptoms. Methods: Twenty-two children (aged 5-10 years) with perennial AR and conjunctivitis symptoms mono-sensitized to Dermatophagoides pteronyssinus and Dermatophagoides farinae were enrolled. During a 2 months run-in period, symptom and medication scores, lung functions, bronchial hyperreactivity, nasal provocation and skin prick tests were evaluated. Subjects were randomized to active or placebo using a double-blind method. A total of eighteen subjects were randomised to receive either active SLIT or placebo for 12 months. Daily symptom and medication scores, baseline lung functions, bronchial hyperreactivity, nasal provocation and skin prick tests were recorded and re-evaluated at the end of treatment. Results: After one year of treatment, no significant differences were detected in the between groups and within group comparisons based on total rhinitis symptom/medication scores (p > 0.05). Skin reactivity to Dermatophagoides pteronyssinus was significantly reduced in HDM-SLIT compared to placebo group (p = 0.018). A significant reduction in nasal sensitivity was observed in SLIT group after one year treatment when compared to baseline (p = 0.04). Total conjunctivitis symptoms were reduced significantly in both active and lacebo group at the end of treatment compared to baseline. The proportion of patients with nonspecific bronchial hyperreactivity increased to almost 3-fold in placebo group compared to baseline. Conclusion: HDM-SLIT was not superior to placebo in reducing isolated rhinoconjunctivitis symptoms within 12 months of treatment. However, HDM-SLIT has a modulating effect on allergen-specific nasal and skin reactivity in isolated perennial AR children. Clinical Trial Registration: The trial was registered at Anzctr.org.au number, ACTRN1261 3000315718. (C) 2013 Elsevier Ltd. All rights reserved.

We aimed to describe the risk factors of airway involvement and to investigate the contribution of bronchoscopy in the bacteriologic diagnosis of tuberculosis. Airway involvement was more often present in patients with resistance to tuberculosis therapy than in the patients having bronchoscopy performed at initial presentation. Addition of bronchoalveolar lavage to the diagnostic workup increased the mycobacteriologic yield statistically.

Aims: The objective of this study is to determine the effects of the long-term treatment with inhaled fluticasone propionate on osteocalcin, cortisol levels, and bone mineral status in children with asthma. Methods: This cross-sectional study examined 230 prepubertal children with asthma (aged 6–11) who had intermittently used inhaled fluticasone propionate for at least 5 years at a mean daily dose of 200 µg (range: 200–350 µg). Serum osteocalcin, cortisol, and bone mineral density (BMD) of the lumbar spine were obtained from each participant. The control group consisted of gender- and age-matched children (n = 170) who were newly diagnosed with asthma and who were not being treated with corticosteroid. Results: The average age (±SEM) was 8.9 ± 0.7 years, their mean (±SEM) daily steroid dose was 180.3 ± 55.0 µg, with 236.5 ± 17.2 g total steroid use during treatment. Between the study and the control groups, no significant differences were observed in cortisol, osteocalcin levels, and BMD (p > 0.05). Conclusion: Long-term treatment with inhaled fluticasone propionate (100 µg twice daily) revealed no negative effects on serum osteocalcin, cortisol levels, and BMD in children with asthma.

WOS: 000290468600008, PubMed ID: 21501995, Objective: Salbutamol has previously been shown to increase the UT dispersion (aid), which may be associated with high risk of cardiac arrhythmia in asthmatics. Cardiac effects of salbutamol occur in dose-related manner and salbutamol dose given by metered-dose inhaler (MDI) during acute asthma attack is commonly lower than the dose given by nebulizer. This prospective cohort study aimed to assess the effect of salbutamol given by MDI on QTd in the course of moderate acute asthma attack. Methods: Thirty-two children, between 5-15 years of age, who were able to perform spirometric maneuvers and salbutamol administration by MDI through the spacer, were enrolled. Salbutamol was administered at a dose of 50 mu g/kg three times at 15-20 minute intervals. Clinical features, spirometric parameters and QT measurements from the standard electrocardiograms were studied at baseline and 15 minute after the third inhalation of salbutamol. The relation between the continuous variables was evaluated by using paired Student's t-test. Results: Overall, treatments were well-tolerated, significant improvement of pulmonary index scores and spirometric parameters were observed after treatment. No significant difference was observed between the pre and post-treatment values in QTd (30.4 +/- 5.6 ms; 33.7 +/- 6.2 ms, p=0.086) and corrected QTd (38.8 +/- 6.4 ms; 40.7 +/- 7.7 ms, p=0.18). Conclusion: Salbutamol administered using metered dose inhaler showed satisfying clinical improvement with notably lower doses than the dose given by nebulizer and does not affect ventricular repolarization in children with moderate acute asthmatic attack. (Anadolu Kardiyol Derg 2011; 11:232-6)

Hidrosefali degisik hastalik durumlarinda ortaya cikan ventrikullerde genisleme ve beyin omurilik sivisi basincinin artmasi ile belirgin bir bulgudur Beyin omurilik sivisi akimini duzeltmek icin en sik uygulanan yontem ventrikulo peritoneal sant vasitasiyla beyin omurilik sivisinin periton icine bosaltilmasidir Sant kullaniminda en sik karsilasilan komplikasyon enfeksiyon veya tikanmaya bagli olarak santin islev bozuklugudur Kendiliginden kolon perforasyonu nadir gorulen bir komplikasyondur Bu yazida yenidogan doneminde hidrosefali saptandiktan sonra ventrikulo peritoneal sant uygulamasi yapilan ve sant kateterinin anusten ciktigi gorulen iki olguyu sunduk ve iki olgu nedeni ile hidrosefalik cocuklarda ventrikulo peritoneal sant komplikasyonlarini ve bunlarin icerisinde kolon delinmesinin onemini tartismayi amacladik Turk Ped Arfl 2013; 48: 255 8

In this cross-sectional study, we aimed to compare anteroposterior (AP) spine and total body bone mineral density (BMD) measurements of children with asthma treated with long-term inhaled budesonide (n = 52, mean age 6.4+/-2.2yr, M/F = 22/30) (Group I) with those of asthmatic children who had never received treatment with inhaled corticosteroids (Group II) (n = 22, mean age 6.8+/-2.2, M/F = 10/12). Boys and girls were comparable for age, weight, height, cumulative corticosteroid (CS) dosage, duration of disease and inhaled corticosteroid (ICS) treatment within each group. The mean total accumulated dosage of budesonide for children in Group I was 154.0+/-135.3mg (mean daily dosage = 419+/-154 microg) and the mean treatment duration was 13.0+/-9.8 months. The two groups were comparable with respect to age, gender, weight, height, Tanner's stage and duration of disease. There was no significant difference between subjects in the two groups for total (p = 0.214) and (AP) spine BMD results (p = 0.661), respectively. Our results provide additional support for the safety of ICS therapy on bone density of asthmatic children.

Background: This study aims to evaluate the children with chronic cough and to analyze their etiological factors according to the age groups. Method: Five hundred sixty-three children with chronic cough were included. The last diagnosis were established and were also emphasized according to the age groups. Results: The mean age was 5.4 ± 3.8 years (2-months–17-years) and 52 % of them were male. The most common final diagnosis from all the participants were: asthma (24.9 %), asthma-like symptoms (19 %), protracted bacterial bronchitis (PBB) (11.9 %), and upper airway cough syndrome (9.1 %). However, psychogenic cough was the second most common diagnosis in the subjects over 6 years of age. Conclusion: Asthma and asthma-like symptoms were the most common diagnosis in children. Different age groups in children may have a different order of frequencies. Psychogenic cough should be thought of in the common causes especially in older children.