Early prognostic markers to predict unsuccessful pregnancy in dairy cattle.

This study aimed to investigate maternal serum levels of some angiogenic factors and certain proteins in dairy cattle for (1) early prediction of unsuccessful fertilization and (2) early detection of possible pregnancy failures (early EM) after positive insemination Serum samples were collected from the same cattle at three distinct time points: 30 days before artificial insemination (B-AI), on the day of artificial insemination (AI), and 30 days after artificial insemination (A-AI). As a result of the pregnancy examination, the cows were divided into two main groups according to whether they were pregnant. The results showed that leucyl/cystinyl aminopeptidase (LNPEP) concentration was significantly decreased B-AI and Secreted frizzled-related proteins (SFRP-3), Vascular Endothelial Growth Factor (VEGF) and LNPEP levels were significantly decreased on day of AI, while PRL level was increased, and these data have prognostic significance as early indicator of the risk of potentially failed pregnancy. Additionally, a significant decrease in LNPEP, SFRP3, and VEGF levels, along with an increase in PRL levels was also observed in A-AI. These results suggest that these biomarkers can be used as a screening test to monitor the course of pregnancy. There were no significant differences in serum levels of Insulin-Like Growth Factor 2 (IGF-2), Tissue inhibitors of metalloproteinases (TIMP-1), angiopoietin (ANG), Endoglin (ENG), Fibroblast growth factor (FGF), Inhibine-A (INH-A) and Transforming growth factors-ß1 (TGF-ß1) between the evaluated periods neither unsuccessful nor the successful pregnancy groups. This is the first study reporting that the maternal serum levels of LNPEP, SFRP3, VEGF, and PRL have important roles in pregnancy success and may indicate whether insemination outcome will be successful B-AI and predict the risk of unsuccessful pregnancy after AI in dairy cattle. The increase in such studies will allow the development of more specific, practical, and applicable markers.

Effect of topical sildenafil on wound healing and oxidative stress in rats.

BACKGROUND: In this study, the effects of topical sildenafil applications on oxidative damage levels and antioxidative metabolism and their contribution to wound healing and treatment were investigated. MATERIALS AND METHODS: A total of 24 healthy male rats aged 16-18 weeks, each weighing 200-250 g, were randomly divided into three groups: Group A received a saline solution, Group B received an epithelializing cream, and Group C received sildenafil cream. Following skin preparation and anesthesia, 6 mm diameter punch biopsies created wounds on the rats' backs. The treatment protocol involved daily topical dressing for seven days, after which tissue and blood samples were collected for analysis. Tissue samples underwent histopathological examination, while malondialdehyde (MDA) levels, superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase activities in wound tissue and blood samples were measured. RESULTS: The wound surface area created by the punch decreased in all groups by the end of the seventh day; However, the degree of wound healing differed in favor of the sildenafil cream group. Histopathologically, according to Greenhalgh's Modified Wound Healing Scoring System, all findings were graded. In the Anova test, the differences between glutathione peroxidase, catalase, and malondialdehyde levels in the serum and tissue of rats was statistically significant (P < 0.05), whereas superoxide dismutase levels were not statistically significant (P > 0.05). In the Bonferroni test, the serum CAT levels between groups A and C (P = 0.003), between groups B and C (P = 0.035), and the serum MDA levels between groups A and B (P = 0.018) and between groups A and C (P = 0.001) were found to be significant statistically. By the way, the results between tissue CAT levels in the B and C groups (P = 0.020) and between tissue GPx levels (P = 0.001) in all groups were also significant statistically. CONCLUSIONS: The study findings indicated that topical application of sildenafil led to noteworthy alterations in serum and tissue antioxidative metabolism as well as oxidative damage levels among rats with induced wounds. Sildenafil may be useful in wound treatment; it has been concluded that it is capable of directing new studies to be carried out.

Longitudinal Growth Trajectories in Children with Cow's Milk Allergy: Effects of Elimination Diet and Post-Termination Period.

INTRODUCTION: The primary dietary approach for managing cow's milk allergy (CMA) is the elimination diet. We aimed to compare the growth patterns of children with CMA during and after the elimination diet with healthy peers and identify influencing factors. METHODS: We compared 74 CMA children with age-matched healthy peers. Anthropometric data were collected during the third month of cow's milk elimination (CME) diet (T1), 3 months after diet cessation (T2), and after ≥3 months of normal diet (T3). Control group measurements coincided. Nutrient intake was assessed by a 3-day record, and patient laboratory results were noted at T3. RESULTS: CMA children had consistently lower weight-for-age (WFA) and height-for-age (HFA) z-scores than controls. WtHt z-score of patients was lower than those of the healthy group at T2. HC z-scores of patients were lower than those of the healthy group at T0, T2, and T3. At T3, the HFA z-score of the CME group demonstrated a negative correlation with the duration of the elimination diet (p = 0.045). Inadequate intake of energy, vitamins A, E, B1, B6, C, folic acid, magnesium, and iron was significantly higher in CMA children (p < 0.05). T3 WFA z-score correlated positively with fiber, vitamin B1, magnesium, and iron intake (p < 0.05). T3 WtHt showed a positive moderate correlation with energy, protein, vitamin E, vitamin B1, vitamin B2, vitamin B6, calcium, magnesium, phosphor, iron intake (p < 0.05). CONCLUSIONS: Post-elimination diet, children with CMA need sustained monitoring and potentially micronutrient supplementation to match healthy peers' growth.

The effectiveness of an education program based on healthcare transition in adolescents with asthma: A randomized controlled trial.

BACKGROUND: Adolescents diagnosed with asthma make a transition to adult care when they reach a certain age. Besides, these adolescents need specialized education for them to become autonomous, competent, and adult patients and gain the necessary knowledge and skills related to their disease. In this study, by using a prospective randomized controlled trial design, we evaluated the effectiveness of an education program based on healthcare transition provided to adolescents diagnosed with asthma. METHODS: After obtaining the consent of adolescents and their parents, 52 adolescents aged between 14 and 18 years who were diagnosed with asthma were randomly assigned to the intervention group (individual four face-to-face and six online education sessions) or the control group (standard care). The primary outcome was the differences between the Transition Readiness Assessment Questionnaire (TRAQ) scores of the two groups. The secondary outcomes included the differences between the Self-Efficacy Scale for Children and Adolescents with Asthma and Mind the Gap scores of the two groups. The outcomes were measured at two different time points: baseline (first assessment; Week 0) and immediately after the intervention (last assessment; Week 12). RESULTS: In the initial evaluations, there was no significant difference between the groups in terms of the primary or secondary outcomes (p > .05). In the final assessments, the TRAQ (Z = -4.740, p < .001) and Self-Efficacy Scale for Children and Adolescents with Asthma (t = 6.344, p < .001) scores of the intervention group were found to be significantly higher than the scores of the control group, while their Mind the Gap Scale scores were significantly lower (t = 6.146, p < .001). CONCLUSION: It was determined that the educational intervention integrated with pediatric care based on readiness for transition from pediatric care to adult care was effective in increasing the transition readiness and self-efficacy of the adolescents. The study was registered at ClinicalTrials.gov with the ID code NCT05550922.

Seasonal variation in the expression pattern of heat shock protein 70 and 90 in Common carp (Cyprinus carpio) from Karatas Lake, Burdur, Türkiye.

Organisms have evolved defense mechanisms to protect themselves from stressful conditions. The expression of heat shock proteins is considered a valid indication of protection from the adverse effects of hostile conditions. In this study, we used immunohistochemistry to investigate the seasonal effects of some abiotic factors on heat shock protein 70 and 90 (HSP70 and HSP90) expression in the liver, gills, and muscle tissues of 24 Common carp (Cyprinus carpio) caught in Karatas Lake (Burdur, Türkiye) using gillnets of various mesh sizes. We also measured some physicochemical parameters on-site at sampling time and took water samples for further analyses of other physicochemical parameters and heavy metals. Immunostaining for HSP90 was stronger than for HSP70 in both liver and gill samples. Liver and gill structures exhibited significant seasonal differences in HSP70 and HSP90 immunoreactivity, and the same was true for immunostaining for HSP70 and HSP90 in muscle samples. Some physicochemical properties seemed to vary considerably between seasons, with Fe, Mn, and Zn levels tending to exhibit changes throughout the seasons. However, these levels were considered acceptable for human health. In conclusion, this study suggests that substantial changes in HSP70 and HSP90 expression may be essential for seasonal adaptation and tolerance. Further research on fish HSPs would greatly contribute to aquaculture, which is essential for meeting food requirements.

The Effect of House Dust Sensitization on Skin Sebum and Moisture in Children with Allergic Respiratory Diseases.

This study aimed to investigate the levels of skin moisture and sebum in children with a house dust allergy without skin symptoms. This was a case-control study involving children, aged 0-18 years, who were being followed up for an allergic airway disease in a pediatric allergy clinic. Age, gender, hemogram parameters, and IgE values were evaluated. The skin moisture and sebum percentages of the patients and control group were measured by a non-invasive bioimpedance method using a portable digital skin moisture and sebum measurement device on the cubital fossa. The median value of the skin moisture percentage in the house dust mite allergy-positive patient group was significantly lower than that in the house dust mite allergy-negative patients and the control group (p < 0.001). The house dust mite allergy-positive patient group had the lowest skin sebum content. However, there was no statistical significance among the groups in terms of skin sebum percentage (p = 0.102). In the study, children with a house dust allergy were found to have lower levels of skin moisture and sebum. The regular use of moisturizers for children with a house dust allergy should be kept in mind as an effective solution to protect the skin barrier and reduce skin symptoms.

Síndrome DRESS inducido por ácido valproico en una niña que respondió a la ciclosporina con análisis de HLA / Valproic acid-induced DRESS in a child responding to cyclosporine with HLA analysis

El síndrome de erupción medicamentosa con eosinofilia y síntomas sistémicos (drug reaction with eosinophilia and systemic symptoms, DRESS), también conocido como síndrome de hipersensibilidad inducida por medicamentos, es una reacción rara potencialmente mortal que causa una erupción grave y que puede provocar insuficiencia multiorgánica. Como con otras erupciones medicamentosas graves, los linfocitos T específicos para un medicamento tienen una función crucial en el síndrome DRESS. El modelo de hapteno/pro-hapteno, el modelo de interacción farmacológica y el modelo alterado de repertorio de péptidos son tres modelos diferentes desarrollados para describir la relación/interacción entre un medicamento o sus metabolitos y el sistema inmunitario. Analizamos nuestra experiencia con el tratamiento con ciclosporina en un caso de síndrome DRESS resistente a esteroides causado por ácido valproico en una niña y sus resultados clínicos, de laboratorio y de antígeno leucocitario humano (HLA).

Drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug-induced hypersensitivity syndrome, is a potentially life-threatening rare reaction that causes a severe rash and can lead to multiorgan failure. As in other severe drug eruptions, drug-specific T lymphocytes play a crucial role in DRESS. The hapten/pro-hapten model, pharmacological interaction model, and altered peptide repertoire model are three different models developed to describe the relationship/interaction between a medication or its metabolites and the immune system. We discuss our experience with cyclosporine treatment in a steroid-resistant DRESS syndrome caused by valproic acid in a girl, as well as her clinical, laboratory, and human leukocyte antigens (HLA) study results

Valproic acid-induced DRESS in a child responding to cyclosporine with HLA analysis. / Síndrome DRESS inducido por ácido valproico en una niña que respondió a la ciclosporina con análisis de HLA.

Drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug-induced hypersensitivity syndrome, is a potentially life-threatening rare reaction that causes a severe rash and can lead to multiorgan failure. As in other severe drug eruptions, drug-specific T lymphocytes play a crucial role in DRESS. The hapten/pro-hapten model, pharmacological interaction model, and altered peptide repertoire model are three different models developed to describe the relationship/interaction between a medication or its metabolites and the immune system. We discuss our experience with cyclosporine treatment in a steroid-resistant DRESS syndrome caused by valproic acid in a girl, as well as her clinical, laboratory, and human leukocyte antigens (HLA) study results.

El síndrome de erupción medicamentosa con eosinofilia y síntomas sistémicos (drug reaction with eosinophilia and systemic symptoms, DRESS), también conocido como síndrome de hipersensibilidad inducida por medicamentos, es una reacción rara potencialmente mortal que causa una erupción grave y que puede provocar insuficiencia multiorgánica. Como con otras erupciones medicamentosas graves, los linfocitos T específicos para un medicamento tienen una función crucial en el síndrome DRESS. El modelo de hapteno/pro-hapteno, el modelo de interacción farmacológica y el modelo alterado de repertorio de péptidos son tres modelos diferentes desarrollados para describir la relación/interacción entre un medicamento o sus metabolitos y el sistema inmunitario. Analizamos nuestra experiencia con el tratamiento con ciclosporina en un caso de síndrome DRESS resistente a esteroides causado por ácido valproico en una niña y sus resultados clínicos, de laboratorio y de antígeno leucocitario humano (HLA).

Effect of early childhood cow's milk elimination diet on eating behaviours, nutrition and growth status at age 2-6 years.

BACKGROUND: The present study aimed to investigate the eating behaviour, nutritional status and growth of Caucasian children in ages 2-6 years who had a diet because of cow's milk protein allergy (CMA) [immunoglobulin (Ig)E-mediated and/or non-IgE-mediated] in early childhood. METHODS: In this cross-sectional, case-control study, the cow's milk elimination (CME) group comprised children aged 0-2 years who were receiving a CME diet because of CMA, as confirmed by an oral food challenge test, and had reintroduced cow's milk for at least ≥ 3 months. The control group never had a restricted diet. Eating behaviour and children's growth was assessed. A 3-day food record was taken to determine the macronutrient and micronutrient intake of the children. Data on the children's socio-demographic, infant nutrition and family allergy history were collected from their medical records and face-to-face interviews with mothers. RESULTS: In total, 62 children with a median age of 32 months were recruited for the study. The total scores of food avoidance and satiety responsiveness in the CME group (n:31) were higher than in the controls (n = 31) (p = 0.036 and 0.006, respectively). Weight-for-age and height-for-age are statistically lower in the CME group than in the control group (p < 0.001). A significant difference between groups in terms of dairy intake was recorded (p = 0.011). In the CME group, the current frequency of adequate energy, vitamin B1, folic acid, vitamin C and calcium intake was significantly lower than in the control group (p < 0.05). CONCLUSIONS: Dietary interventions because of CMA at age 0-2 years can affect children's nutritional habits and parental-reported assessment of children's eating behaviours, resulting in growth restriction with insufficient micro/macronutrients and/or dairy products at the age of 2-6 years.

Efficacy of sodium hyaluronate in relieving nasal symptoms of children with intermittent allergic rhinitis: a randomized controlled trial.

PURPOSE: Nasal irrigation is recommended as add-on therapy in patients with intermittent allergic rhinitis (AR). We aimed to evaluate the clinical efficacy of adding hyaluronic acid (HA) or normal saline solution (NSS) to nasal corticosteroid (NC) therapy as add-on therapy in improving quality of life and reducing nasal symptom scores of children with intermittent AR compared to NC therapy. METHOD: In this 28-day long, open-label, randomized controlled trial, one puff of NC was administered once a day through both nostrils of 76 children with SAR (6-12 years old), whose Total Nasal Symptom Score (TNSS) was ≥ 4. Twenty-six patients received NC only (Group 1); 24 patients received NSS (Group 2), and 26 patients received HA (Group 3) twice a day by means of nasal douche device. Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) and TNSS were measured as subjective parameters, and nasal eosinophil count (NEC) in nasal cytology, nasal airflow (NAF), and resistance were measured as objective parameters. RESULTS: No significant difference was found in post-treatment between groups in terms of TNSS, PRQLQ, and NEC values. Mean values of post-treatment left NAF of the groups were significantly different (p = 0.030), and the mean value of Group 3 was the highest (mean ± SD = 247.62 ± 155.8 ccm/sn). In comparing pre- and post-treatment intragroup mean total NAR (TNAR) values, a statistically significant decrease was recorded only in group three (p = 0.025). CONCLUSION: The addition of HA to NC as an adjunct therapy in children with intermittent AR has limited beneficial effects in our study and deserves further investigation. TRIAL REGISTRY: The clinical trial registration number ID:NCT04752956.

Is Oral Food Challenge as Safe Enough as It Seems?

BACKGROUND: Oral food challenges (OFCs) assist in the diagnosis of food allergies and are essential to determine whether an allergy has been outgrown. During the OFC, a medical procedure e introduces foods suspected to be allergenic orally in increasing doses. Mild skin reactions such as urticaria or rarely serious life-threatening reactions such as anaphylaxis may develop. OBJECTIVE: In this study, we aimed to retrospectively evaluate the clinical and laboratory characteristics of patients who experienced anaphylaxis during open OFCs in a tertiary care children's hospital. METHODS: Patients who underwent OFCs to confirm the presence of a food allergy or to assess tolerance status at the University of Health Sciences, Ankara, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Pediatric Allergy and Immunology Outpatient Clinic between 1 January 2013 and 1 February 2016, were included in the study. Patients' data were obtained retrospectively from electronic medical records and challenge chart reviews. RESULTS: A total of 623 OFCs were performed during the period studied. Nine patients (1.4%) between 13 and 67 months of age (mean age: 38.3 months) developed anaphylaxis during their OFC. CONCLUSION: OFCs should be performed in a hospital or outpatient office under medical supervision that is adequate for anaphylaxis intervention by an allergy specialist. Close observation of objective and subjective symptoms is essential during the challenge because there are no laboratory tests that can predict an anaphylactic diagnosis or the severity of the reaction.

The knowledge, attitudes and practices of healthcare workers on drug hypersensitivity reactions in children: A tertiary centre experience from Turkey.

INTRODUCTION: Adverse drug reactions are an important public health concern that affects doctor and dentist prescriptions and healthcare workers' practice. We planned to evaluate the knowledge, attitudes and practices of healthcare workers in our country about drug hypersensitivity reactions in paediatric patients and to determine the risk factors that may affect them. METHOD: This study was carried out in a capital-located university hospital. Healthcare workers authorized to intervene in children (0-18 age group), including medical doctors, nurses, and dentists, were enrolled in the study. The study questionnaire was developed by paediatric allergy and immunology specialists and paediatric nurses by considering the other studies on the same subject. RESULTS: Three hundred fifty-four (88.5%) out of 400 healthcare workers, whose study survey was distributed, returned to us by filling the questionnaire. According to the groups of the profession, there was a statistically significant difference between the average of correct answers given to the questions evaluating knowledge levels (P < .001). The doctors' knowledge score (M ± SD 18.6 ± 2.1) was the highest. The general attitudes of healthcare workers towards drug hypersensitivity reactions in children were similar and were positive (P < .053). However, general practice patterns were significantly different (P < .001). Nurses were observed to practice more positively than doctors and dentists. As the healthcare worker gets older, his practice score increased by 0.546; on the other hand, being a resident reduced the score from the practice score by 3.770. CONCLUSION: Our results suggest that advanced training programmes must be provided for healthcare workers in learning drug hypersensitivity reactions, particularly in paediatric patients.

Quality of life of Turkish children and families of Caucasian origin with atopic dermatitis.

INTRODUCTION AND OBJECTIVES: To determine the quality of life (QoL) in Caucasian children with atopic dermatitis (AD) and their families and possible factors that might impact their QoL. MATERIALS AND METHODS: In this cross-sectional study, 83 children aged 2-7 with AD and their families were enrolled as the study group, and 83 age-matched healthy children were included as controls. All patients in the AD and control groups were sorted into two age-based groups: (1) 2-4 and (2) 5-7 years of age. The parents of all children completed the Turkish version of the Pediatric Quality of Life Inventory (PedsQL).The Family Impact Scale for Dermatological Diseases (FIS-DD) was administered to the study group. Disease severity was evaluated with the Patient-Oriented Scoring Atopic Dermatitis (PO-SCORAD) scale. RESULTS: In both age groups, a negative correlation between the PedsQL and the FIS-DD scores (p < 0.001) was found. A positive correlation was found between the PO-SCORAD and FIS- DD scores among the second age group (p = 0.011). In the first age group, AD patients with comorbid allergic diseases had higher FIS-DD scores than those without any other allergic problems (p = 0.007). CONCLUSIONS: We suggest that considering family QoL may positively contribute to the treatment of pre-school age AD children.

Quality of life of Turkish children and families of Caucasian origin with atopic dermatitis

INTRODUCTION AND OBJECTIVES: To determine the quality of life (QoL) in Caucasian children with atopic dermatitis (AD) and their families and possible factors that might impact their QoL. MATERIALS AND METHODS: In this cross-sectional study, 83 children aged 2-7 with AD and their families were enrolled as the study group, and 83 age-matched healthy children were included as controls. All patients in the AD and control groups were sorted into two age-based groups: (1) 2-4 and (2) 5-7 years of age. The parents of all children completed the Turkish version of the Pediatric Quality of Life Inventory (PedsQL). The Family Impact Scale for Dermatological Diseases (FIS-DD) was administered to the study group. Disease severity was evaluated with the Patient-Oriented Scoring Atopic Dermatitis (PO-SCORAD) scale. RESULTS: In both age groups, a negative correlation between the PedsQL and the FIS-DD scores (p < 0.001) was found. A positive correlation was found between the PO-SCORAD and FIS- DD scores among the second age group (p = 0.011). In the first age group, AD patients with comor­bid allergic diseases had higher FIS-DD scores than those without any other allergic problems (p = 0.007). CONCLUSIONS: We suggest that considering family QoL may positively contribute to the treat­ment of pre-school age AD children

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A More Comfortable Method of Skin Prick Testing in Children Ages 0-2 to Decrease Symptoms of Pain.

BACKGROUND: Skin prick testing (SPT) is the best initial diagnostic method for individuals of all ages who have potential allergies. AIM: We aimed to investigate if recent breastfeeding has any effect on reducing the pain of children before SPT. DESIGN: Prospective, randomized, single-blinded study. SETTINGS: Academic hospital specialized in pediatrics. PARTICIPANTS/SUBJECTS: Sixty-four out of seventy-five children requiring SPT within ages 0-2 were included. METHODS: All participants in this study were breastfed children, and that group assignment randomized them to the control group (n = 32) if children breastfed 30-90 min. prior to arriving for SPT, and study group of children (n = 32) who were also breastfed 30-90 minutes prior to arriving for SPT who were then breastfed again just prior to the beginning of the SPT. The FLACC pain scale was used to test the sensitivity of all children for pain before, during, and 15 minutes after the SPT. The effect of breastfeeding on the pain score and the duration of crying were compared among groups. RESULTS: Both groups were similar according to age, gender, and other socio-demographic characteristics (p > .05). The percentage of children that cried during SPT was significantly higher in the control group than the study group (p = .002). The FLACC pain scale values were significantly lower in the study group (p < .001). CONCLUSION: Recent breastfeeding before SPT is correlated with less crying by possibly reducing the perceived pain of children ages 0-2.

The peripheral blood inflammatory patterns in the control levels of asthma in children.

OBJECTIVE: Asthma is the most common chronic inflammatory disease of childhood, but there are no useful and easily accessible laboratory tests routinely used in the diagnosis and follow-up of this disease in children. Therefore, this study aimed to investigate the roles of white blood cell (WBC) count, platelet count, mean platelet volume (MPV), and eosinophil percentage as full blood count inflammatory markers in evaluating the control level and follow-up of asthma in the pediatric age group. METHODS: A retrospective review of patient records and files of 3,580 patients diagnosed with asthma at the University of Health Sciences in Ankara, Turkey was performed. Patients who met inclusion/exclusion criteria were divided into two groups based on the asthma control level: controlled and uncontrolled. Laboratory data were compared according to the asthma control levels, drug use status, and atopy status of the patients. RESULTS: A total of 348 patients between 4 and 18 years of age, who were followed-up with the diagnosis of asthma, were included in this study. A significant difference was found between the controlled and uncontrolled groups of asthma patients in terms of the eosinophil percentage (mean ± SD, respectively; 3.493 ± 2.24; 4.992 ± 3.43; p = .003). When patients were grouped according to their asthma control levels and atopy status, only the eosinophil percentages were different in the logistic regression analysis (odds ratio = 1.276, 95% confidence interval = 1.113-1.462). CONCLUSION: Our study showed that the percentage of eosinophils can be used as an asthma control parameter, but additional prospective studies would be desirable to confirm our results.

Interaction between childhood vocal fold nodules and allergic diseases.

OBJECTIVES: Vocal fold nodules (VFNs) are benign lesions at the junction of the anterior and middle third of the vocal folds. Although VFNs are often a result of vocal cord trauma due to vocal abuse, childhood allergic diseases, and medications may be a cause. We aimed to investigate the association of detected VFNs with allergic diseases in childhood patients with vocal abuse. METHODS: This is a prospective, cross-sectional, case-control study. Caucasian children in ages 3-12, who speak loud, vocal abuse confirmed with Turkish Children's voice handicap index-10 (TR-CVHI-10) above 9 were enrolled to the study. 33 children with VFN were included as the study group and age-matched 26 healthy children without VFN were included as the control group. Children questioned and tested for allergic diseases with Allergometric tests. RESULTS: Asthma was detected in 42.4% of the study group and absent in the control group. The history of inhaler or nasal steroid use was positive in 30.3% of the study group and 7.7% of the control group (p = 0.032). Dysphonia and the presence of allergic diseases were determined as independent risk factors for the study group (p = 0.001; 0.021, respectively). The median values of blood lymphocyte counts were significantly different among study and control groups (2900 µl vs 2335 µl, respectively; p = 0.04). CONCLUSION: Investigating allergic diseases, especially asthma, for success in the treatment of pediatric patients with VFNs is of utmost importance.

Assessment of thiol/disulphide homoeostasis and ischaemia-modified albumin and their relationship with disease severity in children with chronic urticaria.

BACKGROUND: The pathogenesis chronic urticaria (CU) hasn't been fully understood. In recent years, it has been shown that thiol-disulphide homoeostasis, as an antioxidant system, plays important roles in both healthy individuals and various diseases. In different ischaemia-reperfusion states, high oxidative stress causes ischaemia-modified albumin (IMA) generation. AIM: To investigate thiol/disulphide balance and IMA level in children with CU and their association with disease severity. METHODS: Thirty children with CU and 20 healthy children as controls, aged 1-18 years, were included in this cross-sectional study. In all subjects, total thiol, native thiol, disulphide levels and IMA levels were measured in plasma by spectrophotometry. Disulphide/native thiol, disulphide/total thiol and native thiol/total thiol ratios were calculated. The disease severity was rated by Urticaria Activity Score (UAS). RESULTS: In the children with CU, the levels of native thiol (375.56 ± 56.22 µmol/L) and total thiol (415.69 ± 54.75 µmol/L) were significantly lower than the control group (475.20 ± 71.87 and 511.20 ± 73.73 µmol/L, respectively) (p = 0.000, p = 0.000). The ratio of native/total thiol * 100 was lower in patients than the control group (p = 0.002). IMA was significantly higher in the patient group than control group (p = 0.000). No significant correlation was found between UAS and thiol/disulphide homoeostasis (p > 0.05). The disulphide levels, disulphide/native thiol and disulphide/total thiol levels were found to be higher in patients with positive family history for autoimmune disorders than those without (p < 0.05). CONCLUSION: In children with CU, impaired thiol/disulphide homoeostasis and increased IMA suggest that oxidative stress may play role in the disease pathogenesis.