Role of Parameters in Whole Blood Analysis as in Indicator of Systemic Inflammation in Children with Rheumatic Valve Diseases.

PURPOSE: The most important cause of mortality and morbidity in acute rheumatic fever (ARF) is carditis and rheumatic heart disease (RHD). The aim of this study was to identify markers that may be indicators of chronic inflammation in whole blood analyses in pediatric patients with RHD who regularly received secondary deposilin prophylaxis. METHODS: In our study, 100 children with ARF aged between 4 and 18 years were followed up in the pediatric cardiology outpatient clinic of the patient group. The control group consisted of 100 healthy children of the same sex and age as the patient group. All children in the patient group regularly received deposilin prophylaxis every 21 days. Our study included many whole blood parameters that are reported in the literature to represent changes in chronic inflammatory diseases. These parameters were CRP, RDW, PDW, MPV and leukocyte subtypes, neutrophil, lymphocyte, monocyte counts and their ratios (neutrophil/lymphocyte, platelet/lymphocyte and monocyte/lymphocyte). RESULTS: Leukocyte count, lymphocyte count, basophil count, MLR and basophil count were significantly lower in the patient group than in the control group (p: 0.047, p: 0.023, p: 0.006). In addition, eosinophil count and RDW value were significantly higher in the patient group than in the control group (p: 0.043; p: 0.001). CONCLUSION: In our study, low leukocyte, lymphocyte, basophil, MLR and higher eosinophil counts indicated that RDW could be effectively used as a marker for regular depositilin prophylaxis in pediatric patients with RHD.

Is overweight/obesity a risk factor for atopic allergic disease in prepubertal children? A case-control study.

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 Vakif 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.

Serum catalase, thiol and myeloperoxidase levels in children passively exposed to cigarette smoke.

BACKGROUND: Free radicals found in cigarette smoke can harm all tissues and cellular structures in the human body. Passive smoking increases free radical production, leads to the depletion of antioxidants and increases oxidative stress which causes lipid peroxidation. Many studies have been conducted to determine the effects of passive smoking on antioxidant enzymes and lipid levels in adults, but pediatric studies on this topic are few. In our study, we compared the levels of antioxidants, oxidants, total and LDL cholesterol in children exposed to passive cigarette smoking with a healthy control group that was not exposed to passive smoking. METHODS: A total of 41 children (4-17 years of age, 24 girls and 17 boys) exposed to passive smoking and 18 healthy girls and 12 healthy boys were included in this study. Secondhand smoking was confirmed via measurement of the cotinine/creatinine ratio. Various sociodemographic characteristics of patients were recorded. The levels of catalase, thiol, myeloperoxidase were measured to determine the antioxidant and oxidant levels in children, while the levels of total cholesterol and LDL cholesterol were measured to determine the alterations in lipid profile. RESULTS: The groups were similar in regard to demographic characteristics. Myeloperoxidase levels were significantly higher in the passive cigarette smoking group compared to the non-exposure group; however, catalase and thiol levels were similar. In regard to lipid profile, the levels of total cholesterol and LDL cholesterol were also similar in those with and without exposure to passive smoking. CONCLUSIONS: Our findings suggest that the effects of passive smoking initially influence oxidants (MPO), but not antioxidants (thiol and catalase). However, it is apparent that passive smoking adversely affects oxidative balance in children and this may lead to the development of various diseases which could cause significant morbidity and mortality.

Serum oxidative stress parameters and paraoxonase-1 in children and adolescents exposed to passive smoking.

BACKGROUND: Exposure to secondhand smoke is too common in many countries. The mechanism of the detrimental effects of passive smoking on childhood health, however, is poorly described. The purpose of this study was therefore to examine the effect of passive smoking on total antioxidant status (TAS), total oxidant status (TOS), and paraoxonase-1 in children compared with healthy non-passive smokers. METHODS: This study included 40 children and adolescents passively exposed to cigarette smoke (as verified on urine cotinines) and 40 age- and gender-matched healthy controls not regularly exposed to cigarette smoke. TAS, TOS, and paraoxonase-1 were all measured, and the oxidative stress index (OSI) calculated for each child to determine the degree of oxidative stress. RESULTS: Age and gender distribution were not statistically different between the two groups (P = 0.619 and 0.712, respectively). Urine cotinine/creatinine was significantly higher in the passive smoking group (127.89 ± 57.14 ng/mL) compared with the controls (5.05 ± 16.66 ng/mL; P < 0.001). TAS was not different between the two groups (P = 0.767), but TOS and OSI were significantly higher for the passive smoke-exposed children (P < 0.001), and serum paraoxonase-1 was significantly lower than in the controls (P = 0.047). CONCLUSIONS: Secondhand smoke exposure is associated with increased oxidative stress and decreased paraoxonase-1 without any change in antioxidant status.

Vitamin D-containing supplements for children between 1-3 years of age: are they essential for bone health?

OBJECTIVE: We aim to evaluate how vitamin D-containing supplements affect the vitamin D status of children 1-3 years old and to assess the variation of the vitamin D concentrations across different seasons. METHODS-MATERIAL: This retrospective study included a review of medical reports of 1035 patients (aged 1-3 years) who presented to our hospital between October 2011 and October 2013. The children were divided into 3 groups: Group 1: those supplemented with vitamin D3 (400 IU/day), Group 2: those supplemented with multivitamins, which included 200-400 IU/day of vitamin D2 or D3, and Group 3, the controls: those not supplemented with vitamin D. The groups were compared as to their biochemical findings and variation of vitamin D status with over four seasons. RESULTS: Gender distribution was not statistically different between the three groups (p=0.38). The children who had taken vitamin D-containing supplements had significantly higher vitamin D levels compared with the children who were given no vitamin D supplementation (p<0.001). Children with no vitamin D supplementation had significantly lower calcium and phosphorus levels compared with Groups 1 and 2. Vitamin D levels were affected by vitamin D supplementation (f=16.125, p<0.001) but not by season (f=0.699, p=0.650). CONCLUSION: The children aged 1-3 years who did not receive vitamin D-containing supplements had insufficient vitamin D and low levels of calcium and phosphorus. Vitamin D levels were affected by vitamin D supplementation but not by season.