The Incidence of Ototoxicity in Patients Using Iron Chelators.

OBJECTIVE: In this study, we aimed to detect the incidences of ototoxicity in patients with hemoglobinopathies taking deferoxamine (DFO), deferiprone, and deferasirox using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) scale to obtain more objective data. MATERIALS AND METHODS: Fifty-five transfusion-dependent patients were evaluated in this study. The NCI CTCAE scale was used to assess ototoxicity levels. The average ferritin and hemoglobin levels, the type of iron chelator, and the duration of therapy of all the patients were recorded. RESULTS: Ototoxicity was observed in 15 patients (31.9 %), all of whom were taking DFO. The median age was 19.5 (6-43) in patients without ototoxicity and 29 (16-50) in those with ototoxicity; this difference was statistically significant (p<0.05). The median ferritin and pre-tx Hb levels were 1391 ng/mL and 9.06 mg/dL, respectively, in patients with ototoxicity and 986.7 ng/mL and 9.24 mg/dL, respectively, in those without ototoxicity; these differences were not significant (p>0.05). Ototoxicity was not observed in the eight patients who used only deferasirox and deferiprone. CONCLUSION: The ototoxicity incidence with DFO at doses below 50 mg/kg/day was 27.3%. Deferiprone and deferasirox were not associated with ototoxic effects in patients taking these drugs.

Anaphylaxis induced by lentil inhalation.

Anaphylaxis is a rapid onset serious allergic reaction which may be fatal. Foods are the most common allergens leading to anaphylaxis especially for childhood. Most of the food-induced anaphylactic reactions take place after ingestion of the allergic food and only a few cases exist with anaphylactic reactions induced by inhalation of foods such as peanut, soybean and lupine. The case we present is unusual in that an 8 1/2-year-old boy developed anaphylaxis with the inhalation of steam from boiling lentils.

The relationship between serum selenium levels and frequent wheeze in children.

As an antioxidant, selenium stimulates Th1 immune response against viral infections, and may play a role in the pathogenesis of frequent wheeze due to respiratory viral infections during the first year of life. We investigated the level of selenium in children with frequent wheeze who had no atopic diseases and no family history of atopy to determine whether selenium has an effect on the severity of the diseases. Sixty-one children with frequent wheeze who were in the asymptomatic period and had had no infectious disease for two months and an equal number of age- and sex-matched children, as a control group, without atopy or allergy or systemic diseases were enrolled in the study. In the study group, we determined the levels of serum selenium, total IgE, mixed specific IgE, and total eosinophil count, and we performed epidermal prick tests. Serum selenium levels were (mean and SEM) 61.95 +/- 1.23 microg/L in the study group and 72.71 +/- 1.28 microg/L in the control group (p < 0.001), and there was a negative correlation between the serum selenium levels and number of wheeze attacks during the previous year (r = -0.655; p < 0.001). As a result, selenium may play a role in the progression of respiratory infections during childhood and can be accepted as a risk factor for development of wheezing.

Complementary and alternative medicine in children with asthma.

BACKGROUND: The popularity of complementary and alternative medicine (CAM), particularly for chronic conditions such as asthma, is growing rapidly, but little is known about its use in asthmatic children. OBJECTIVE: To evaluate the extent, characteristics, and possible predictors of CAM use in a group of Turkish children with asthma. METHODS: The parents of asthmatic children were invited to participate in a questionnaire-based survey of 13 worldwide and 5 local methods of CAM. Current asthma treatment, asthma exacerbations, emergency admittances and hospitalizations due to exacerbations, and parental education levels were investigated as predictors that influenced the use of CAM. RESULTS: Of the 304 asthmatic children (mean +/- SEM age, 10.5 +/- 0.2 years; range, 1-16 years), 49% (n = 150) had used some form of CAM previously, and 38% had used CAM within the previous year. The most popular forms of CAM were quail eggs (79%), herbal medicine (31%), Turkish wild honey (26%), speleotherapy (5%), and royal jelly (5%). The respondents learned about CAM through friends (61%), relatives (25%), the media (9%), and physicians (6%). Age, sex, and mother's and father's education levels were insignificant between the groups that used and did not use CAM (P = 0.40, P = 0.18, P = 0.15, and P = 0.09, respectively). The use of regular asthma treatment, the use of inhaled corticosteroids, asthma exacerbations, emergency admittances, and treatment score were significantly high in the CAM group (P = 0.006, P = 0.03, P = 0.008, P = 0.02, and P = 0.02, respectively). A significantly high percentage of respondents in the CAM group had considered using CAM for their child's asthma in the future (P = 0.001). CONCLUSIONS: Asthmatic children in whom the disease is not well controlled are more likely to use CAM as complementary therapy.