Serum 25-hydroxyvitamin D levels in children with recurrent wheezing and relation to the phenotypes and frequency of wheezing.

SUMMARY: Background. Recurrent wheezing may be related to various reasons. There is a lack of knowledge about the effect of vitamin D status in the children with recurrent wheezing. The aim of this study is to compare the level of vitamin D between recurrent wheezing children and healthy controls, and to investigate the relationship between vitamin D status and the clinical parameters of recurrent wheezing in preschool children. Methods. One hundred-ten children followed up in our hospital with recurrent wheezing were included in the study. The control group included fifty children without wheezing episodes. The serum 25-hydroxyvitamin D (25OHD) level was measured. The patients with recurrent wheezing were grouped according to their vitamin D status as "deficient group" and "non-deficient group (Vitamin D level is insufficient and normal)". We investigated the relationship between vitamin D status and the clinical and laboratory parameters of children with recurrent wheezing. Results. Mean 25OHD level was 21.66 ± 8.13 ng/mL (5.6-53) in the study group and 25.36 ± 10.17 ng/mL (6-59) in the control group. The difference was statistically significant (p = 0.015). When the patients with recurrent wheezing were compared according to their vitamin D status, number of hospitalizations, number of positive sensitivity, percentage of eosinophil, serum IgE levels, Asthma Predictive Index positivity and wheezing phenotypes were not found to be different between groups. However, the duration of wheezing, the number of wheezing episodes and systemic glucocorticoid need in the previous year, and the total number of wheezing episodes were significantly higher in the deficient group (p < 0.05). The serum 25OHD level was negatively correlated with the duration of wheezing (r: -0.238; p: 0.012), total number of wheezing episodes (r: -0.436; p: 0.001), number of wheezing episodes in the previous year (r: -0.395; p: 0.001), and systemic glucocorticoid need in the previous year (r: -0.324; p: 0.001). Conclusions. Mean 25OHD levels were lower in patients with recurrent wheezing than in healthy controls. The duration of illness and number of wheezing episodes were correlated with vitamin D levels. An evaluation of the serum levels of vitamin D and supplementation if needed should be recommended in patients with recurrent wheezing, especially in those with long-term and frequent wheezing episodes.

The effect of nebulised magnesium sulphate in the management of childhood moderate asthma exacerbations as adjuvant treatment

BACKGROUND: After the bronchodilator effect of magnesium was shown, the use of magnesium in treatment of asthma exacerbations became common. With the results of recent studies, the use of intravenous magnesium in severe asthma exacerbations took its place. We aimed to examine the effects of adding isotonic magnesium sulphate instead of isotonic saline into nebulised salbutamol on the Modified Pulmonary Index Score (MPIS) and the hospitalisation rate in moderate asthma exacerbations. METHODS: Our study population included 100 children age between 3 and 15 years with asthma admitted to emergency department due to moderate asthma exacerbations. The patients were randomised to placebo or magnesium, with 50 patients in each arm. All patients received 1mg/kg of systemic methylprednisolone at the beginning of treatment and thereafter received either nebulised salbutamol (0.15mg/kg/dose) and 1ml magnesium sulphate (15%)+1.5ml isotonic saline on three occasions at roughly 20min intervals (Magnesium group) or nebulised salbutamol (0.15mg/kg/dose) and 2.5ml isotonic saline mixture on three occasions at roughly 20min intervals (Placebo group). The MPIS of patients on 0th min, 20th min, 40th and 120th min were calculated and compared. The primary outcome was to compare MPIS values at the end of 120th min. RESULTS: Both groups have similar demographic, allergic characteristics and baseline MPIS scores. When the MPIS scores in the 120th min and admission rates in the 200th min, there was no significant difference between the two groups. CONCLUSIONS: The use of nebulised magnesium sulphate in moderate asthma exacerbation as adjuvant treatment showed no benefit to standard treatment in our study

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The effect of nebulised magnesium sulphate in the management of childhood moderate asthma exacerbations as adjuvant treatment.

BACKGROUND: After the bronchodilator effect of magnesium was shown, the use of magnesium in treatment of asthma exacerbations became common. With the results of recent studies, the use of intravenous magnesium in severe asthma exacerbations took its place. We aimed to examine the effects of adding isotonic magnesium sulphate instead of isotonic saline into nebulised salbutamol on the Modified Pulmonary Index Score (MPIS) and the hospitalisation rate in moderate asthma exacerbations. METHODS: Our study population included 100 children age between 3 and 15 years with asthma admitted to emergency department due to moderate asthma exacerbations. The patients were randomised to placebo or magnesium, with 50 patients in each arm. All patients received 1mg/kg of systemic methylprednisolone at the beginning of treatment and thereafter received either nebulised salbutamol (0.15mg/kg/dose) and 1ml magnesium sulphate (15%)+1.5ml isotonic saline on three occasions at roughly 20min intervals (Magnesium group) or nebulised salbutamol (0.15mg/kg/dose) and 2.5ml isotonic saline mixture on three occasions at roughly 20min intervals (Placebo group). The MPIS of patients on 0th min, 20th min, 40th and 120th min were calculated and compared. The primary outcome was to compare MPIS values at the end of 120th min. RESULTS: Both groups have similar demographic, allergic characteristics and baseline MPIS scores. When the MPIS scores in the 120th min and admission rates in the 200th min, there was no significant difference between the two groups. CONCLUSIONS: The use of nebulised magnesium sulphate in moderate asthma exacerbation as adjuvant treatment showed no benefit to standard treatment in our study.

Clinical features of potato sensitivity in children with allergic disease.

BACKGROUND AND OBJECTIVE: Although potato is greatly consumed all over the world, adverse reactions to potato are uncommon. Our aim is to describe the clinical features of potato sensitivity in allergic children. MATERIALS AND METHODS: Forty children with sensitivity to potato were followed up in the Pediatric Immunology and Allergy Clinic of our hospital were included in the study. These patients were retrospectively evaluated from January 2012 to December 2013. RESULTS: Forty children aged between 6 months and 10 years (mean 2.9±3.2, median:1.5 years) were enrolled of whom 26 were male (65%). Thirty three of these children had presented eczema, nine wheezing, seven urticaria and/or angioedema, six rhinitis, four subjects had experienced anaphylaxis, and two vomiting or other gastrointestinal complaints. In 38 (95%) patients, skin prick tests detected sensitivity to other allergens besides potato. The most frequently identified sensitivities were to food sensitivities (82.5%). In addition sensitivity to house dust mite, cat dander, pollens, A. Alternata and cockroaches in skin prick tests were documented in nine, six, five, four and four patients, respectively. Latex sensitivity was not detected in any patient. Five (38.5%) out of 13 patients over the age of three showed sensitivity to pollen. CONCLUSIONS: Potatoes sensitivity is mostly seen in children with atopic dermatitis. In children with atopic eczema should be asked whether the increase in complaints with potatoes. Mostly potato sensitivity is combined with other food allergies. Therefore potato should be included in the test in patients with atopic eczema and food allergy.

Single high dose atorvastatin does not ameliorate endothelial function and large arterial stiffness in dyslipidemic patients without atherosclerosis.

BACKGROUND: Many studies show that statins have beneficial effects on atherosclerotic risk factors and markers such as flow mediated dilatation (FMD). However, studies on early effects of statins on endothelial function of non atherosclerotic humans are limited. AIM: The purpose of this study was to determine whether a single high dose of atorvastatin could improve endothelial function and large arterial stiffness in statin naive dyslipidemic non-atherosclerotic patients. MATERIALS AND METHODS: Thirty statin naïve dyslipidemic non-atherosclerotic patients from Cardiology Outpatient Clinic were enrolled. Arterial stiffness and endothelial function of patients were evaluated by assessing the finger photoplethysmography and the flow-mediated dilatation (FMD) of the brachial artery before and 24 hour after oral administration of 80 mg atorvastatin. RESULTS: Stiffness indices and FMD 24 hours after administration of 80mg atorvastatin did not differ from baseline measurements (6.89 +/- 1.90 vs. 7.06 +/- 2.37 p : NS and 9.13 +/- 6.07 vs. 9.80 +/- 6.34 p : NS). CONCLUSIONS: Although it is widely accepted that statins improve endothelial function, evidences of early effect might largely be associated with endothelial injury. Our study suggests that beneficial early effects of statins might not be applicable to patients without atherosclerosis.

Improvement of accommodation with anti-oxidant supplementation in visual display terminal users.

OBJECTIVE: To determine the antioxidant supplementation effect on accommodation among VDT users. DESIGN: A double blind randomized placebo controlled study. Registered under ClinicalTrials.gov Identifier No. NCT00877201. PARTICIPANTS AND CONTROLS: Fourty right eyes of 40 healthy VDT users (30 females, 10 males, mean age: 43.8±2.8 years, range: 40-49 years). 20 subjects (15 females, 5 males; mean age: 44.0±2.7 years, range: 40-49 years). METHODS: Subjects were required to take an antioxidant supplement, 20 age and sex matched subjects (15 females, 5 males; mean age: 43.6±3.1 years, range: 40-49 years) were required to take placebo medication for 4 weeks. RESULTS: The mean of the change in accommodation power was significantly higher in the group receiving antioxidant supplements (0.20±0.50 Diopter(D)) compared to the placebo group (-0.12±0.48(D)) (p<0.05). CONCLUSIONS: Antioxidant supplementation was observed to improve accommodation in Japanese Visual Display Terminal (VDT) Users.