ASSOCIATIONS OF THYROID VOLUME AND FUNCTION WITH CHILDHOOD OBESITY.

CONTEXT: The links between obesity and thyroid function or thyroid volume in children are still controversial with limited available data. OBJECTIVE: This study aimed to examine thyroid function and volume in obese Turkish school-age children in comparison to normal-weight children. DESIGN: Cross-sectional study. SUBJECTS AND METHODS: One hundred obese children (47 boys, 53 girls; mean age 10.34±2.79 years) with a body mass index (BMI) above 95th percentile, and 100 normal-weight children (42 boys, 58 girls; 10.34±2.79 years) were included. The study parameters were BMI z score (Z-BMI), body surface area (BSA), thyroid volume, free thyroxine (fT4) and thyroid stimulating hormone (TSH) levels. RESULTS: The mean TSH and fT4 levels did not show a significant difference between obese and normal-weight children (p>0.05). The mean thyroid volume was higher in obese children (6.46±5.84 and 4.64±1.44, respectively; p=0.043). fT4 correlated negatively with Z-BMI in both normal-weight and obese children (r=-0.285, p=0.004 and r=-0.289, p=0.004, respectively). Thyroid volume, on the other hand, correlated positively with Z-BMI, again in both normal-weight and obese children (r=0.657, p<0.001 and r=0.444, p<0.001, respectively). Similar associations were found for BSA. CONCLUSIONS: Thyroid volume correlated positively and fT4 correlated negatively with Z-BMI and BSA, in both obese and normal-weight school-age children, whereas TSH appears to be independent of these parameters.

Sublingual immunotherapy to house dust mite in pediatric patients with allergic rhinitis and asthma: a retrospective analysis of clinical course over a 3-year follow-up period.

BACKGROUND AND OBJECTIVE: Specific allergen immunotherapy is believed to be the only treatment able to change the natural history of allergic airway diseases. Sublingual immunotherapy (SLIT) is especially preferred because of its easy application and safety. The aim of this study was to describe the effect of SLIT in pediatric patients who have allergic airway disease. METHODS: Children with asthma and rhinitis who were allergic to house dust mite were evaluated. The effect on clinical course of 3 years of SLIT with 50% Dermatophagoides pteronyssinus and 50% Dermatophagoides farinae in a standardized extract was assessed retrospectively. RESULTS: The records of 39 patients (23 boys, 16 girls) were studied. The mean (+/- SD) age for starting SLIT was 8.8 +/- 2.3 years. The mean number of acute asthma attacks at the onset of the disease was 8.18 +/- 3.05. The mean number of attacks after 3 years of SLIT was 0.44 +/- 0.79. There was a statistically significant difference in the number of acute asthma attacks before and after therapy (P < .001). Complete clinical remission of asthma was recorded in 37 (95%) patients. Similarly, complete clinical remission of allergic rhinitis was recorded in 32 (82%) patients. CONCLUSION: This retrospective study shows that SLIT is effective in children who have allergic airway disease which cannot be controlled effectively with allergen avoidance measures only.

Acute effect of nebulized budesonide in asthmatic children.

The acute anti-inflammatory effects of inhaled steroids at high doses and their use at home and as emergency treatment of acute asthma attacks in children have been evaluated in many clinical studies. However very little is known about their additional bronchodilator response to systemic steroids plus nebulized salbutamol in the early management in children. Asthmatic patients aged between 5-15 years were investigated in a double-blind, placebo-controlled fashion. Both the study group (Group I) and the control group (Group II) received three consecutive doses of nebulized salbutamol (0.15 mg/kg/dose) and one dose of parenteral methylprednisolone (1 mg/kg/dose, intramuscularly). After this treatment, nebulized budesonide (1 mg/dose) was administered to patients in the study group and placebo (nebulized saline) was administered to patients in the control group. Pulmonary index scoring and peak flow meter was performed to both groups before and after the treatment. There were twelve patients in Group I (mean age: 7.90 +/- 2.34 years) and fourteen patients in Group II (mean age: 9.36 +/- 2.55 years). There was no difference between the two groups with respect to age (p = 0.1421), gender (p = 1.000) and inhaled steroid prophylaxis rate (p = 0.2177). No statistically significant difference was detected between the two groups with respect to the pulmonary index score (p = 0.3528). Yet, there was a statistically significant difference between the two groups with respect to the increase in PEFR (p = 0.0155). The positive acute effect of nebulized budesonide in addition to systemic steroids and nebulized salbutamol in improving the spirometric indices in asthmatic children is an encouraging finding for further investigations of its routine use in the pediatric emergency department.

The association between delayed type hypersensitivity reaction to Mycobacterium tuberculosis and atopy in asthmatic children.

BACKGROUND: It has been postulated that there is an inverse association between mycobacterium tuberculosis infection and atopy. We aimed to investigate if there is a similar relation in our study group, consisting 252 asthmatic children. METHODS: In tuberculin testing indurations greater than or equal to 5 mm were accepted as positive. The most common aeroallergens were used in skin prick testing and reactions > or = 3 mm were accepted as positive. RESULTS: In 139 patients PPD was negative, where as in 113 patients PPD was positive. Among the PPD (-) patients skin prick test was positive in 64 % (n = 89). Among the PPD (+) patients skin prick test was positive in 71 % (n = 80). As the two groups were compared for having positive skin prick test reactions no statistically significant difference was detected between them (p = 0.283). CONCLUSIONS: Tuberculin reactivity is not inversely associated with atopy in asthmatic children.

The association between delayed type hypersensitivity reaction to Mycobacterium tuberculosis and atopy in asthmatic children

Background: It has been postulated that there is an inverse association between mycobacterium tuberculosis infection and atopy. We aimed to investigate if there is a similar relation in our study group, consisting 252 asthmatic children. Methods: In tuberculin testing indurations greater than or equal to 5 mm were accepted as positive. The most common aeroallergens were used in skin prick testing and reactions ≥ 3 mm were accepted as positive. Results: In 139 patients PPD was negative, where as in 113 patients PPD was positive. Among the PPD (-) patients skin prick test was positive in 64 % (n = 89). Among the PPD (+) patients skin prick test was positive in 71 % (n = 80). As the two groups were compared for having positive skin prick test reactions no statistically significant difference was detected between them (p = 0.283). Conclusions: Tuberculin reactivity is not inversely associated with atopy in asthmatic children (AU)

Información básica: Se ha propuesto que existe una asociación inversa entre la infección por Mycobacterium tuberculosis y la atopia. Nuestro objetivo era investigar si había una relación semejante en nuestro grupo de estudio, constituido por 252 niños asmáticos. Método: Se aceptaron como positivas induraciones superiores o iguales a 5 mm en la prueba de tuberculina. Se utilizaron los aeroalergenos más comunes en las pruebas cutáneas (prick-test) y se consideraron positivas las reacciones 3 mm. Resultados: En 139 pacientes la PPD fue negativa y en 113, positiva. Entre los pacientes (-) la prueba cutánea fue positiva en el 64 per cent (n = 89). Entre los pacientes ( +) la prueba cutánea fue positiva en el 71 per cent (n = 80). Como los dos grupos se compararon con respecto a su reacción positiva en las pruebas cutáneas, no se detectaron diferencias estadísticas entre ellos (p = 0,283).Conclusiones: La reactividad a la tuberculina no se asocia de manera inversa a la atopia en niños asmáticos (AU)