RESUMO
BACKGROUND: Food allergies are the most common cause of anaphylaxis in children, and their incidence is increasing globally. The aim of this study was to determine the risk factors leading to food allergies in childhood. METHODS: Children with food allergies and non-atopic healthy children were compared using a questionnaire that included prenatal, neonatal, and postnatal risk factors. RESULTS: A total of 314 subjects, 155 patients and 159 healthy children for the control group, were enrolled in the study. The median age of patients with a food allergy at diagnosis was 6 months (1-156 months), and 71 patients (45.8%) were males. The median age of the control group was 12 months (1-61 months), and 67.0% were males. Older maternal age (P = 0.023), birth by caesarean section (P = 0.001), birth in the summer or autumn (P = 0.011), crowded housing (P = 0.001), damp houses (P = 0.001), being fed with breast milk and complementary food (P = 0.001), use of synthetic bedding (P = 0.024), and being the oldest child in the family (P = 0.001) were the considered risk factors for an immunoglobulin-E (IgE)-mediated food allergy. A low frequency of yoghurt consumption by mother (P = 0.001) and use of wool bedding (P = 0.018) were identified as risk factors for non-IgE-mediated food allergies. Low socioeconomic status (P = 0.001) played a protective role against both IgE- and non-IgE-mediated food allergies whereas breastfeeding played a protective role against IgE-mediated food allergies (P = 0.030). CONCLUSION: The most important aspect of this study was that it separately identified prenatal, neonatal, and postnatal risk factors for IgE- and non-IgE-mediated food allergies.
Assuntos
Cesárea , Hipersensibilidade Alimentar , Gravidez , Masculino , Recém-Nascido , Animais , Criança , Humanos , Feminino , Lactente , Fatores de Risco , Hipersensibilidade Alimentar/epidemiologia , Imunoglobulina E , Leite Humano , MãesRESUMO
Background: Several factors that increase the risk of severe food-induced anaphylaxis have been identified. Objective: We aimed to determine the demographic, etiologic, and clinical features of food-induced anaphylaxis in early childhood and also any other factors associated with severe anaphylaxis. Methods: We carried out a medical chart review of anaphylaxis cases from 16 pediatric allergy and immunology centers in Turkey. Results: The data of 227 patients with 266 food-induced anaphylaxis episodes were included in the study. The median (interquartile range) age of the first anaphylaxis episode was 9 months (6-18 months); 160 of these patients were boys (70.5%). The anaphylaxis episodes were mild in 75 cases (28.2%), moderate in 154 cases (57.9%), and severe in 37 cases (13.9%). The most frequent food allergens involved were cow's milk (47.4%), nuts (16.7%), and hen's egg (15.8%). Epinephrine was administered in only 98 (36.8%) of these anaphylaxis episodes. A logistic regression analysis revealed two statistically significant factors that were independently associated with severe anaphylaxis: the presence of angioedema and hoarseness during the anaphylactic episode. Urticaria was observed less frequently in patients who developed hypotension. In addition, confusion and syncope were associated with 25.9- and 44.6-fold increases, respectively, in the risk of concomitant hypotension. Conclusion: Cow's milk, nuts, and hen's egg caused the majority of mild and moderate-to-severe anaphylaxis episodes. The presence of angioedema and hoarseness in any patient who presents with a history of food-induced anaphylaxis should alert clinicians that the reaction may be severe. In addition, the presence of confusion, syncope, or stridor probably indicates concomitant hypotension.
Assuntos
Anafilaxia , Angioedema , Hipersensibilidade Alimentar , Hipotensão , Hipersensibilidade a Leite , Alérgenos , Anafilaxia/diagnóstico , Anafilaxia/epidemiologia , Anafilaxia/etiologia , Animais , Bovinos , Hipersensibilidade a Ovo , Feminino , Hipersensibilidade Alimentar/complicações , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/epidemiologia , Rouquidão , Humanos , Lactente , Masculino , Hipersensibilidade a Leite/complicações , Hipersensibilidade a Leite/diagnóstico , Hipersensibilidade a Leite/epidemiologia , Hipersensibilidade a Noz , Síncope , TurquiaRESUMO
BACKGROUND: Serum vitamin D levels have not been studied in children with seasonal allergic rhinitis (SAR). The aim of this study was to evaluate the vitamin D levels of children with SAR and to compare them to levels in healthy children during pollen season. METHODS: This study was conducted in 100 children with SAR and 100 healthy controls. Clinical and laboratory evaluations and vitamin D analyses of all the participants were performed between the months of April and July. Pollen sensitization was detected in the patient group using a skin prick test. 25(OH)D3 levels were compared between the patient and control groups. Associations among the patient 25(OH)D3 levels and their demographic, clinical, and laboratory characteristics were analyzed. RESULTS: Overall, 72% of the patients were male, the median age was 12.35 years (range: 6-17.8 years), and the median body mass index value was 19.15 (range: 13.6-27.8). There were no differences between the patients and healthy controls in terms of gender, age, or body mass index. The mean levels of 25(OH)D3 (20.78±6) in patients were higher than those of the controls (17.92±4). In the patient group, no associations were found among 25(OH)D3 levels, demographic characteristics, atopy test results, atopy history, severity of rhinitis, and the total four symptoms score (all P>.05). CONCLUSIONS: During pollen season, children with SAR may have higher vitamin D levels than healthy controls. The presence of asthma and/or atopic dermatitis in addition to SAR did not change this result.
Assuntos
Rinite Alérgica Sazonal/sangue , Vitamina D/análogos & derivados , Adolescente , Biomarcadores/sangue , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Rinite Alérgica Sazonal/complicações , Rinite Alérgica Sazonal/diagnóstico , Rinite Alérgica Sazonal/imunologia , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/etiologiaRESUMO
BACKGROUND: The cause and pathophysiology of PFAPA syndrome is unknown. The aim of this study was to determine all MEFV gene variants relevant to familial Mediterranean fever in children with PFAPA syndrome. METHODS: All MEFV gene variants were analyzed in patients with PFAPA syndrome. All patients were evaluated using the Gaslini scoring system. Serum immunoglobulin levels were also determined upon admission. RESULTS: We evaluated 64 patients with PFAPA syndrome. The median age at diagnosis was 37.5 (min-max: 6-96) months, and the percentage of male patients was 55.0%. The Gaslini diagnostic score for periodic fever was high in 81.0% of the patients. An MEFV gene mutation was found in 42 (66.0%) children. Mostly, heterozygous or compound heterozygous variants of the MEFV gene were found. Two patients were homozygous for R202Q. MEFV gene mutations were not detected in 22 (34.0%) patients. No significant differences in clinical or laboratory findings were observed between the two groups (p > 0.05), and there were no significant differences in period and duration of the fever episodes (p > 0.05). The fever of all 47 patients (100.0%) who received prednisolone during the episodes decreased within hours and did not recur. Eighteen of the patients using prednisolone underwent prophylaxis with colchicine, and the fever episodes of 9/18 (50.0%) patients using colchicine decreased within months. CONCLUSIONS: Most patients presenting with PFAPA syndrome have heterozygous MEFV gene mutations. Whether carrying a heterozygous MEFV gene is the primary cause of this syndrome requires further investigation.
Assuntos
Proteínas do Citoesqueleto/genética , Febre Familiar do Mediterrâneo/genética , Linfadenite/genética , Mutação , Faringite/genética , Estomatite Aftosa/genética , Anti-Inflamatórios/uso terapêutico , Biomarcadores/sangue , Criança , Pré-Escolar , Colchicina/uso terapêutico , Análise Mutacional de DNA , Febre Familiar do Mediterrâneo/sangue , Febre Familiar do Mediterrâneo/diagnóstico , Febre Familiar do Mediterrâneo/tratamento farmacológico , Feminino , Estudos de Associação Genética , Predisposição Genética para Doença , Glucocorticoides/uso terapêutico , Heterozigoto , Homozigoto , Humanos , Imunoglobulina G/sangue , Lactente , Linfadenite/sangue , Linfadenite/diagnóstico , Linfadenite/tratamento farmacológico , Masculino , Faringite/sangue , Faringite/diagnóstico , Faringite/tratamento farmacológico , Fenótipo , Prednisolona/uso terapêutico , Pirina , Estudos Retrospectivos , Fatores de Risco , Estomatite Aftosa/sangue , Estomatite Aftosa/diagnóstico , Estomatite Aftosa/tratamento farmacológico , Síndrome , Resultado do TratamentoRESUMO
BACKGROUND: Diagnosing hypersensitivity reactions that develop as a result of nonsteroidal anti-inflammatory drugs (NSAID) with a history is mostly misleading, and skin tests and/or provocation tests are needed for a definitive diagnosis. OBJECTIVE: To determine the frequency of actual NSAID hypersensitivity and whether there are any parameters in the history to predict NSAID hypersensitivity. In addition, to determine safe alternative drugs for children who are diagnosed with actual NSAID hypersensitivity. METHODS: Children with a history of NSAID hypersensitivity were evaluated by an allergist. Safe alternatives in children with a confirmed NSAID hypersensitivity were found by oral provocation tests. RESULTS: Sixty-four patients who were admitted with a suspicion of immediate-type reaction to NSAIDs were included in the study. The median age of the patients was 6 years old (range, 1-17 years), and 37 of the patients (57.8%) were boys. We performed skin tests for suspected NSAID in 35 patients (54.7%). Of these, two had positive results. Provocation tests were performed with 62 patients whose skin test results were negative or for whom skin tests were not available. During the provocation tests, 16 patients (25.8%) developed reactions. Low- and high-dose acetaminophen, nimesulide, and tolmetin sodium were used to find safe alternative drugs. Two patients developed reactions to high-dose acetaminophen but no reaction to nimesulide and tolmetin sodium. When statistically significant parameters were analyzed in a logistic regression model, the presence of multiple NSAIDs hypersensitivity in the patient history (odds ratio 26.6 [95% confidence interval, 1.47-481.63]; p = 0.026) and the emergence of a reaction within an hour (odds ratio 26.4 [95% confidence interval, 1.73-403.11]; p = 0.019) were found as the independent factors to predicted actual NSAID hypersensitivity. CONCLUSION: The emergence of a reaction within an hour of taking the drug and the presence of multiple NSAIDs hypersensitivity history increased the possibility of actual NSAID hypersensitivity. Nimesulide, low-dose acetaminophen, and tolmetin sodium could be used as safe alternative drugs in patients with multiple NSAIDs hypersensitivity.
Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade Imediata/diagnóstico , Adolescente , Criança , Pré-Escolar , Hipersensibilidade a Drogas/imunologia , Feminino , Humanos , Hipersensibilidade Imediata/imunologia , Imunoglobulina E/sangue , Imunoglobulina E/imunologia , Lactente , Masculino , Estudos Retrospectivos , Fatores de Risco , Testes CutâneosRESUMO
BACKGROUND: Smoking is the main preventable public health problem particularly for youth worldwide. The aim of the present study was to determine the prevalence of smoking habits among students at secondary and high schools, and to compare the findings with those of a study conducted 15 years ago in the same area. METHODS: In this cross-sectional study 6212 students (51.2% female; 48.8% male) were selected randomly from rural and urban areas in Samsun. All students completed a face-to-face questionnaire. RESULTS: The overall prevalence of smoking was 13.0% (male students, 18.1%; female students, 8.2%). The mean starting age of smoking was 14.1 ± 1.5 years. Prevalence of smoking was 15.7% in urban areas and 8.1% in rural areas. The most important factors for starting smoking were social group and families. Compared with a study conducted 15 years previously in the same area for male students, smoking prevalence was increased in rural, but decreased in urban areas. CONCLUSIONS: Smoking prevalence in students in Samsun was similar to that in a study conducted 15 years previously. It is important to use anti-smoking campaigns directly targeted at teenager and they should be fully informed of the harmful effects of smoking.
Assuntos
Previsões , Saúde Pública , População Rural , Fumar/epidemiologia , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , População Urbana , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Turquia/epidemiologiaRESUMO
BACKGROUND: Mean platelet volume has been frequently used as an inflammatory marker in various diseases associated with inflammation. In this study, we compared platelet parameter levels between preschool children with and without atopic eczema (AE). METHODS: Preschool children with AE and age-matched healthy children were included in the study. Complete blood count was assessed in children with AE while platelet parameters were compared between children with and without AE. RESULTS: One hundred twenty eight pediatric patients (78 boys, mean age: 14 months) diagnosed with AE and 128 healthy patients (71 boys, mean age: 12 months ) were included in the study. There were no statistically significant differences between the genders (p = 0.375) and ages (p = 0.273) of both groups. WBC (p = 0.952), Hb (p = 0.370), MCV (p = 0.314) and RDW values (p = 0.124), and platelet counts (p = 0.198) of both groups were similar. In the AE group, while the MPV value was found to be higher (p = 0.003), mean PDW value (p = 0.025) and PLT/MPV ratio were found to be lower (p = 0.021). In addition, there was no correlation between the severity of AE and MPV (rho; 0.1, p = 0.257), PDW (rho; -0.1, p = 0.269) and PLT/MPV (rho; 0.07, p = 0.432) ratio. CONCLUSIONS: In patients with AE, as a sign of inflammation, PDW value and PLT/MPV ratio decrease while MPV value increases. This study has also shown that there is no association between the severity of AE and platelet parameters.
Assuntos
Plaquetas , Dermatite Atópica/sangue , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Humanos , Lactente , MasculinoRESUMO
BACKGROUND: Atopic dermatitis is an itchy, inflammatory, chronic, or chronically relapsing skin disease. The disease occurs in people who have an "atopic tendency" or may appear as a clinical sign of primary immunodeficiency. OBJECTIVES: To determine the relation between severity of atopic dermatitis and hypogammaglobulinemia. METHODS: One hundred sixty pediatric patients with atopic dermatitis (98 boys and 62 girls, 1-60 months old, median age 14.5 months) and 95 healthy children (57 boys and 38 girls, median age 16 months; control group) were included in the study. In patients with atopic dermatitis, the severity of disease was determined by the SCORing Atopic Dermatitis index. Serum immunoglobulin levels of all patients and children in the control group were measured by nephelometry on admission. RESULTS: The incidence of hypogammaglobulinemia was higher in patients with atopic dermatitis than in the control group (P = .009). The main reason for this difference was the low level of IgG in the atopic dermatitis group (P = .024). Analysis of the relation between hypogammaglobulinemia and the severity of atopic dermatitis showed no statistically significant difference between the group with mild to moderate atopic dermatitis and the group with severe atopic dermatitis with respect to hypogammaglobulinemia (P = .859), IgG (P = .068), IgA (P = .410), and IgM (P = .776) values. CONCLUSION: Hypogammaglobulinemia was more frequent in patients with atopic dermatitis compared with the control group, mostly owing to the low IgG level. Hypogammaglobulinemia is not associated with the severity of atopic dermatitis.
Assuntos
Agamaglobulinemia/epidemiologia , Agamaglobulinemia/imunologia , Dermatite Atópica/epidemiologia , Dermatite Atópica/imunologia , Imunoglobulina G/sangue , Pré-Escolar , Eosinofilia/sangue , Feminino , Humanos , Imunoglobulina A/sangue , Imunoglobulina E/sangue , Imunoglobulina M/sangue , Lactente , Masculino , Estudos Prospectivos , Índice de Gravidade de Doença , Testes CutâneosRESUMO
Subglottic hemangioma is a rare but life- threatening condition which requires intervention. It generally starts proliferating in the first and second months of lifespan and whether there is a respiration problem or not, it causes biphasic stridor. Its diagnosis generally requires direct laryngoscopy or direct screening through bronchoscopy. This case report presents a 45-day-old girl who had subglottic hemangioma presenting with wheezing and stridor. Our case took propranolol with a dose of 2 mg/kg/day and within 48 h after the start of the treatment, obstructive symptoms started to alleviate considerably.
Assuntos
Hemangioma/tratamento farmacológico , Neoplasias Laríngeas/tratamento farmacológico , Propranolol/uso terapêutico , Vasodilatadores/uso terapêutico , Feminino , Hemangioma/fisiopatologia , Humanos , Lactente , Neoplasias Laríngeas/fisiopatologia , Propranolol/administração & dosagem , Sons Respiratórios/fisiopatologia , Resultado do Tratamento , Vasodilatadores/administração & dosagemRESUMO
We report a RAG2-deficient patient with severe combined immunodeficiency and hemophagocytic bone marrow aplasia with plasma cells after a nonconditioned transplantation from a fully matched sibling. After engraftment, disseminated BCGosis appeared because of graft versus host disease prophylaxis. On the 55th day, eosinophilia, neutropenia, and thrombocytopenia developed. Aplasia, hemophagocytic histiocytes, and plasma cells were found on his bone marrow with very high level of serum immunoglobulin E. We could not discriminate exactly whether BCGosis or alloimmune response is the cause of hemophagocytic aplasia with plasma cells. Despite the second hematopoietic stem cell transplantation with a reduced intensity conditioning regime, his marrow aplasia did not recover and he died. This case suggests that BCGosis might be associated with hemophagocytic marrow aplasia with plasma cells in an alloimmune reaction.
Assuntos
Vacina BCG/efeitos adversos , Doenças da Medula Óssea/etiologia , Proteínas de Ligação a DNA/genética , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Linfo-Histiocitose Hemofagocítica/etiologia , Proteínas Nucleares/genética , Imunodeficiência Combinada Severa/cirurgia , Vacina BCG/imunologia , Doenças da Medula Óssea/patologia , Humanos , Lactente , Linfo-Histiocitose Hemofagocítica/patologia , Masculino , Plasmócitos/patologia , Imunodeficiência Combinada Severa/genética , Condicionamento Pré-Transplante , Transplante Homólogo/efeitos adversosRESUMO
BACKGROUND: Foreign body aspiration (FBA) is one of the most important preventable causes of childhood mortality and morbidity. OBJECTIVE: The aim of this study was to define the clinical and radiological features of FBA and investigate the diagnostic value of various parameters used to diagnose FBA. METHODS: The medical records of 147 children who were admitted to the hospital with a diagnosis of suspected FBA were examined. The sensitivity and specificity of the parameters used for the diagnosis of FBA and their predictive values were calculated. RESULTS: Of the patients, 75.5% were younger than 3 years, and 61.2% were male. Peak incidence was found in 18 months. A negative bronchoscopy rate of 19.7% was found, and 92.6% of these patients were younger than 3 years. The parameter with the highest diagnostic value was the presence of aspiration history (the sensitivity and positive and negative predictive values were 97%, 89%, and 80%, respectively). No significant difference was found in the classic triad of FBA (sudden onset of cough, wheezing, and unilaterally decreased breath sounds) between patients with and without FBA. The specificity and positive predictive value of the classic triad were high, and the sensitivity and negative predictive value were low (85% and 78%, and 13% and 19%, respectively). CONCLUSIONS: Especially, male children younger than 3 years have an increased risk of FBA. Neither clinical symptoms nor the radiological findings alone are sufficiently specific and sensitive in diagnosing FBA. The most important factor for diagnosis is the presence of aspiration history.
Assuntos
Brônquios , Corpos Estranhos/diagnóstico , Corpos Estranhos/terapia , Traqueia , Broncoscopia , Criança , Pré-Escolar , Feminino , Corpos Estranhos/diagnóstico por imagem , Humanos , Lactente , Masculino , Valor Preditivo dos Testes , Radiografia , Sensibilidade e EspecificidadeRESUMO
Sodium nitroprusside (SNP) is one of the most widely used parenteral antihypertensive agents in severe hypertension management. Toxic epidermal necrolysis (TEN) is a rare, mostly drug-induced, severe muco-cutoneous reaction with various complications and high mortality. A fifteen years old girl who is on hemodialysis for chronic renal insufficiency and was hospitalized for emergency management of hypertension, developed a diffuse maculopapular rash within minutes after SNP infusion. In 72 hours, approximately 40% of the body surface was involved with skin detachment indicating epidermal necrolysis and a skin biopsy confirmed the diagnosis of TEN. To the best of our knowledge there is no report of an association of SNP and TEN in the English literature and the clinical data exemplifying consequent IgE and non-IgE mediated hypersensitivity reactions are scanty. With this report we wanted to present a rare complication of SNP infusion indicating another rare occurrence of sequential IgE and non-IgE mediated hypersensitivity reactions.
Assuntos
Anti-Hipertensivos/efeitos adversos , Nitroprussiato/efeitos adversos , Síndrome de Stevens-Johnson/etiologia , Adolescente , Feminino , HumanosRESUMO
BACKGROUND: It was reported that prevalence of red meat allergy in children was higher in our country than in western populations. However, the diagnosis of these patients is often delayed. The aim of the study was to present the clinical and laboratory characteristics of our red meat allergy patients. METHODS: The data were collected retrospectively from the files of children with red meat allergy. Also, 6 adults with red meat allergies were recorded in the families of the children. Patients with symptoms associated with red meat allergy and sensitive to beef or mutton in prick-to-prick tests were recorded. RESULTS: The median age of the 43 patients was 12 years (2-37), and 51% were male. Most of the patients were children (n=37, 86%). The median age was 10 years in children (2-17), and 54% were male. All of the children had dermatologic manifestations, 51% had respiratory symptoms, and 64% had anaphylaxis upon exposure to red meat. The anaphylaxis history was not associated with demographic, clinical and laboratory data. A total of 63% children had additional allergic diseases, and 75% of them were sensitive to both mutton and beef in prickto- prick tests. The median total IgE level of the children was 327 (20-3550) IU/mL, median eosinophil count was 210/mm < sup > 3 < /sup > (40-990) and mean vitamin D was 13.1 ± 1.2 mcg/L (n=27). Anaphylaxis occurred in 3 of 9 patients who received the open oral food challenge (OFC) test. After OFC, 3 patients continued to eat red meat without issues, and 1 patient was recommended to eat alternatives to red meat. CONCLUSIONS: Clinical and laboratory findings were heterogeneous in children with red meat allergy. Anaphylaxis risk seems to be higher than other food allergies. OFC test is more helpful in both diagnosis and alternative red meat selection compared to laboratory findings.
Assuntos
Anafilaxia , Hipersensibilidade Alimentar , Adolescente , Adulto , Alérgenos , Animais , Bovinos , Criança , Pré-Escolar , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/epidemiologia , Humanos , Imunoglobulina E , Masculino , Estudos Retrospectivos , Testes Cutâneos , Adulto JovemRESUMO
Herpes Simplex Virus Type 1 (HSV-1) is a ubiquitous pathogen. Other than known diseases, HSV-1 may have an important role in the pathogenesis of atopy by causing immortality of th2 cells. From June 1st to July 31st 2006, seventy five blood samples were collected from atopic children referred to the allergy clinic of the hospital. The bloods samples were used to detect HSV-1 IgG antibodies by Enzyme-Linked Immunosorbent Assay and Virus Neutralization Test. HSV-1 IgG antibody seroprevalence in atopic children was found high, 62.6% by Enzyme-Linked Immunosorbent Assay and 57.3% by Virus Neutralization Test. Thus Virus Neutralization Test sensitivity was 92.15% and specificity was 100% regarding to the Enzyme-Linked Immunosorbent Assay technic. Although Enzyme-Linked Immunosorbent Assay was more sensitive than Virus Neutralization Test, there was no significant difference between two technics (p > 0.05) in detecting HSV-1 IgG antibodies in serum.
Assuntos
Anticorpos Antivirais/sangue , Ensaio de Imunoadsorção Enzimática/métodos , Herpes Simples/imunologia , Hipersensibilidade Imediata/virologia , Imunoglobulina G/sangue , Testes de Neutralização/métodos , Linhagem Celular Tumoral , Criança , Pré-Escolar , Herpes Simples/epidemiologia , Herpesvirus Humano 1/imunologia , Humanos , Sensibilidade e Especificidade , Estudos Soroepidemiológicos , TurquiaRESUMO
Hematopoietic stem cell transplantation is a promising curative therapy for many combined primary immunodeficiencies and phagocytic disorders. We retrospectively reviewed pediatric cases of patients diagnosed with primary immunodeficiencies and scheduled for hematopoietic stem cell transplantation. We identified 22 patients (median age, 6 months; age range, 1 month to 10 years) with various diagnoses who received hematopoietic stem cell transplantation. The patient diagnoses included severe combined immunodeficiency (n=11), Chediak-Higashi syndrome (n=2), leukocyte adhesion deficiency (n=2), MHC class 2 deficiency (n=2), chronic granulomatous syndrome (n=2), hemophagocytic lymphohistiocytosis (n=1), Wiskott-Aldrich syndrome (n=1), and Omenn syndrome (n=1). Of the 22 patients, 7 received human leukocyte antigen-matched related hematopoietic stem cell transplantation, 12 received haploidentical hematopoietic stem cell transplantation, and 2 received matched unrelated hematopoietic stem cell transplantation. The results showed that 5 patients had graft failure. Fourteen patients survived, yielding an overall survival rate of 67%. Screening newborn infants for primary immunodeficiency diseases may result in timely administration of hematopoietic stem cell transplantation.
Assuntos
Transplante de Células-Tronco Hematopoéticas/métodos , Síndromes de Imunodeficiência/terapia , Síndrome de Chediak-Higashi/epidemiologia , Síndrome de Chediak-Higashi/terapia , Criança , Pré-Escolar , Feminino , Rejeição de Enxerto/epidemiologia , Doença Granulomatosa Crônica/epidemiologia , Doença Granulomatosa Crônica/terapia , Humanos , Síndromes de Imunodeficiência/epidemiologia , Lactente , Síndrome da Aderência Leucocítica Deficitária/epidemiologia , Síndrome da Aderência Leucocítica Deficitária/terapia , Linfo-Histiocitose Hemofagocítica/epidemiologia , Linfo-Histiocitose Hemofagocítica/terapia , Masculino , Imunodeficiência Combinada Severa/epidemiologia , Imunodeficiência Combinada Severa/terapia , Análise de Sobrevida , Turquia/epidemiologia , Síndrome de Wiskott-Aldrich/epidemiologia , Síndrome de Wiskott-Aldrich/terapiaRESUMO
OBJECTIVES: Allergic rhinitis (AR) occurs when the symptoms of rhinitis arise as a result of allergen-induced nasal mucosal inflammation. In the presence of rhinitis symptoms without infection or an allergic reaction in the nose, non-allergic rhinitis (NAR) is considered. Adults with these diseases have increased frequency of olfactory dysfunction. The aim of the present study is to assess olfactory function in children with AR and NAR. METHODS: A total of 77 children (aged six to 18 years) with AR and NAR were included in the study. The control group consisted of 45 healthy children. Sniffin' Sticks test was applied to both groups. The association between odor scores and demographic, clinical, and laboratory results was investigated. RESULTS: Forty two patients had allergic rhinitis. No significant difference was observed between patients with rhinitis and healthy controls with respect to odor scores. No association was observed between odor scores and the severity of rhinitis and the laboratory results of the patient groups. Odor identification and total odor scores of the patients with rhinitis lasting for longer than three years were significantly lower than those in the patient group with rhinitis lasting for one to three years. In the AR and control groups, the odor scores were found to increase with age. CONCLUSIONS: When compared with healthy children, children with allergic rhinitis and non-allergic rhinitis were not found to have reduced olfactory function. The duration of rhinitis may be associated with the olfactory dysfunction in children with rhinitis.
Assuntos
Transtornos do Olfato/etiologia , Rinite Alérgica/complicações , Rinite Alérgica/fisiopatologia , Rinite/fisiopatologia , Adolescente , Alérgenos , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Nariz/fisiopatologia , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/fisiopatologia , Rinite/complicaçõesRESUMO
BACKGROUND: The correct use of inhalation devices is essential for successful therapy. We aimed to evaluate the skills in the use of a spacer device with an metered-dose inhaler (MDI) and factors that influence this skill in asthmatic preschool children's caregivers. METHODS: The caregivers of 12-month-old to 72-month-old children were interviewed face-to-face and filled out questionnaires. To assess use of the spacer device, we asked the caregivers to verbally describe and demonstrate how they used the device. RESULTS: A total of 244 patients were included in the study, and 142 (58.2%) of the caregivers demonstrated every step for using the spacer device. The most frequently mistaken step was waiting for 30 seconds for the second puff after the first puff. When statistically significant and clinically important parameters were analyzed in a logistic regression model, the parameters satisfaction with the spacer device (odds ratio [OR] 29.9; 95% confidence interval [CI], 7.64 to 117.39; p < 0.001), a university graduate (OR 13.5; 95% CI, 3.36 to 54.8; p < 0.001), family monthly income of more than US$1500 (OR 5.3; 95% CI, 2.16 to 13.39; p < 0.001), device training provided by a clinical trainer (OR 12.3; 95% CI, 4.82 to 31.73; p < 0.001), regular follow-ups (OR 3.6; 95% CI, 1.57 to 8.47; p = 0.003), and the absence of a severe attack during the last year (OR 6.5; 95% CI, 2.64 to 16.43; p < 0.001) were found to be independent factors that affected the correct demonstration of the device. CONCLUSION: The factors most effective in the correct use of the MDI spacer device were satisfaction with the device, training having been given by a clinical trainer on this subject, and the caregiver being a university graduate.
Assuntos
Asma/epidemiologia , Competência Clínica/estatística & dados numéricos , Equipamentos e Provisões/estatística & dados numéricos , Asma/tratamento farmacológico , Cuidadores , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Inaladores Dosimetrados/estatística & dados numéricos , Educação de Pacientes como Assunto , Fatores Socioeconômicos , TurquiaRESUMO
BACKGROUND: Vitamin D (VitD) and its metabolites play important roles in the regulation of the respiratory and immune systems. The aim of this study was to examine serum 25(OH) vitamin D [25(OH)D] levels and VitD deficiency on the development of wheezing and clinical features. METHODS: This study was a prospective cross-sectional survey that included a total of 70 infants being followed in the Pediatric Immunology and Allergy Unit at Ondokuz Mayis University. Forty of these infants (patient group), ranging in age from 1 to 3 years, had been diagnosed as wheezy infants; 30 were age-and-gender matched healthy infants (control group). Prior to the study, blood samples were taken from both groups to determine their serum VitD, blood eosinophil, and serum immunoglobulin E (IgE) levels. RESULTS: The duration of breastfeeding was similar for both groups. The serum 25(OH)D levels of the patient group were significantly lower than those of the control group. Although there was a negative relationship between 25(OH)D level and IgE(log10) values for the wheezy infants with VitD deficiency, the control group had a negative relationship between VitD level and IgE(log10) . CONCLUSION: Serum 25(OH)D levels must be evaluated when following wheezy infants, and those with deficiency must be treated with VitD.
Assuntos
Sons Respiratórios/etiologia , Deficiência de Vitamina D/complicações , Vitamina D/sangue , Pré-Escolar , Estudos Transversais , Eosinófilos/imunologia , Feminino , Humanos , Imunoglobulina E/sangue , Lactente , Masculino , Estudos Prospectivos , Deficiência de Vitamina D/sangueRESUMO
BACKGROUND: The objective of this work was to determine the characteristics of allergic reactions that may occur after a bee sting and alternative treatment methods in Turkish beekeepers. METHODS: A written questionnaire was administered to beekeepers from the Ordu, Samsun, Sinop, Amasya, and Çorum provinces located in the Central Black Sea Region of Turkey. RESULTS: The study included 301 beekeepers, 295 (98%) of whom were male. Their mean age was 48.2 ± 11.5 years. The mean beekeeping duration was 15.3 ± 10.5 years. A total of 270 participants (89.9%) had a history of bee stings in the previous 12 months. Systemic reactions, large local reactions, and local reactions were seen in 21 (6.9%), 193 (64.1%), and 12 (4.0%) beekeepers, respectively. The face was the most frequently stung body site, and swelling generally occurred in the eyelids. The size of the swellings decreased within 12 to 24 hours in 259 (86.1%) beekeepers. The size of the swellings was 1 × 2 cm in diameter in 157 (52.2%) beekeepers. Natural protection against bee stings had developed by 12 months in 140 (46.5%) beekeepers. In total, 61.5% of the beekeepers applied alternative treatments (eg, garlic, onion water, yogurt), whereas 14.0% (3/21) were admitted to a hospital with a systemic reaction. In total, 10.6% and 14.2% of beekeepers were aware of adrenaline auto-injector and venom immunotherapy, respectively. CONCLUSION: This study indicates insufficient knowledge and attitudes among Turkish beekeepers regarding bee sting reactions.