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Study objective: The lockdown imposed on children due to the COVID-19 pandemic and their inability to attend school increased their exposure to indoor allergens by causing them to spend more time indoors. In this study, the aim was to reveal the effect of the pandemic and increased exposure to indoor aeroallergens on the symptom severity of school-age children with house dust mite-sensitized allergic rhinitis (AR). Patients and methods: Patients between the ages of 6-18-years old, who were followed-up with the diagnosis of perennial AR sensitized to only mites were questioned about their sinonasal symptoms. The Total Nasal Symptom Score (TNSS) questionnaire was performed. The clinical findings, drug usage, frequency of infections and attacks were evaluated and compared during COVID-19 lockdown and the same time frame in 2019. Results: Sixty-five patients had AR, and 33 patients (50.8%) had AR with asthma. TNSS of the patients improved during the pandemic (P < 0.001) and their medication scores decreased significantly (P < 0.001). The frequency of respiratory tract infections and asthma attacks decreased significantly (P < 0.001). In multivariate analysis, risk factors were evaluated for the 'group with worsening TNSS' and coal/wood burning was detected to be an independent risk factor (P = 0.006; OR = 10.09 (95% CI: 1.97-51.87)). Conclusion: Although the increased stay at home, it is surprising that nasal symptoms improved in our patients. This result suggests that whereas allergen sensitivity is responsible for the pathogenesis of AR, exposure to pollution and viral infections which are reduced by masking and social distance may also play an important role in the pathogenesis.
Introduction: Le confinement imposé aux enfants en raison de la pandémie de COVID-19, l'impossibilité pour les enfants d'aller à l'école; ont augmenté leur exposition aux allergènes intérieurs en les obligeant à passer plus de temps à l'intérieur. Dans cette étude, il visait à révéler l'effet de la période pandémique et de l'exposition accrue aux aéroallergènes intérieurs sur la sévérité des symptômes des enfants d'âge scolaire atteints de rhinite allergique (RA) sensibilisée aux acariens. Méthode: Patients âgés de 6 à 18 ans, qui ont été suivis avec le diagnostic de RA perannuelle avec seulement des acariens sensibilisés; ont été interrogés sur leurs symptômes naso-sinusiens. Le questionnaire Total Nasal Symptom Score (TNSS) a été réalisé. Leurs résultats cliniques, l'utilisation de médicaments, la fréquence des infections et des attaques ont été évalués et comparés pendant le verrouillage de COVID-19 et la même période de 2019. Résultats: Soixante-cinq patients avaient une RA et 33 patients (50,8 %) avaient une RA avec asthme. Le TNSS des patients pendant la période pandémique s'est amélioré (p < 0,001) et leurs scores de médication ont diminué de manière significative (p < 0,001). La fréquence des infections des voies respiratoires et des crises d'asthme a diminué significativement (p < 0,001). En analyse multivariée, les facteurs de risque ont été évalués pour le « groupe d'aggravation du TNSS ¼, la combustion de charbon/bois a été détectée comme étant un facteur de risque indépendant (p = 0,006 ; OR = 10,09 (IC95 % : 1,9751,87)). Conclusion: Malgré l'augmentation du séjour à domicile, il est surprenant que les symptômes nasaux de nos patients se soient améliorés. Ce résultat suggère que si la sensibilité aux allergènes est responsable de la pathogenèse de la RA, l'exposition à la pollution et aux infections virales qui sont réduites par le masque et la distance sociale peuvent également jouer un rôle important dans la pathogenèse.
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INTRODUCTION: The risk of kidney stone formation increases with urinary stasis, which is associated with decreased peristaltism. The relationship between nonobstructive kidney stone formation and ureteral jet dynamics, which can be measured with Doppler ultrasonography (US) and provide information about ureteral peristaltism, has been demonstrated in adults. OBJECTIVE: To investigate the relationship between ureteral jet dynamics, which provide information about ureteral peristaltism, and stone formation in children. STUDY DESIGN: Children admitted to Dokuz Eylul University Hospital with flank pain, and asymptomatic age-matched children for the control group, were prospectively enrolled and underwent Doppler US for diagnostic reasons and bilateral ureteral jet flow measurements. Children diagnosed with unilateral nonobstructive lower pole kidney stones formed Group 1, and the control group, without any evidence of stone disease, formed Group 2. Ureteral jet dynamics were compared between the affected renal units in Group 1, and healthy renal units in Group 1 and Group 2. RESULTS: A total of 32 children were included for each group. The mean average jet flow-rate (JETave (cm/second)) in affected renal units in Group 1 was found to be significantly lower than in the healthy renal units in Group 1 and left and right healthy renal units in Group 2 (P < 0.05). The continuous JETpattern rate in affected renal units in Group 1 was found to be significantly higher compared with healthy renal units in Groups 1 and 2 (P = 0.012) (Table). The odds ratio for kidney stone formation was 5.6 for renal units with JETave <9.5 cm/s when compared with renal units with JETave ≥9.5 cm/s. DISCUSSION: In a recent study, it was demonstrated in adults that low ureteral jet flow-rate and continuous JETpattern were significantly higher in affected renal units. The findings in children were also similar to adults: the mean JETave was significantly lower and determination rate of continuous flow pattern was significantly higher in affected renal units. CONCLUSIONS: Children with low JETave and continuous JETpattern as a sign of decreased ureteral peristaltism are at an increased risk of kidney stone formation. However, it is vital that further studies are conducted to elaborate on this topic.
