Risk Factors for Exacerbations in School-Age Children with Asthma.

INTRODUCTION: Awareness of risk factors for asthma exacerbation can reduce the morbidity and mortality of the disease. The current study aimed to investigate the risk factors associated with current asthma exacerbations in school-age children. METHODS: This study enrolled children who were admitted to a tertiary outpatient paediatric allergy and asthma department and were diagnosed with asthma. Patients and their caregivers underwent an interviewer-administered questionnaire, which obtained information regarding the demographic features and parameters to determine environmental exposures along with previous disease history. Laboratory examinations, including complete blood count with differential, total IgE levels, skin prick tests, and pulmonary function tests, were also performed. RESULTS: A total of 431 children (288 male, 66.8%) with a median age (interquartile range) of 8.1 (6.3-11.2) years were included, among whom 265 (61.5%) had aeroallergen sensitization. Asthma was controlled, partially controlled, and uncontrolled in 154 (35.7%), 53 (12.3%), and 143 (33.2%) patients, respectively. A total of 81 patients (18.8%) experienced asthma exacerbation. Multivariate logistic regression analysis revealed that a history of asthma exacerbation within the last year (odds ratio [confidence interval]) (20.73 [9.95-43.20]; p < 0.001), a shorter asthma duration (<2.5 years) (2.58 [1.44-4.61]; p = 0.001), and a lack of regular controller therapy (4.12 [1.54-10.98]; p = 0.005) were associated with current asthma exacerbation. DISCUSSION/CONCLUSION: Awareness of risk factors for asthma exacerbation may help physicians treat school-age children with asthma by providing prompt and rational interventions in order to prevent asthma exacerbations.

Mosquito hypersensitivity may be associated with atopic background in children.

BACKGROUND: Many children encounter unusual or "exaggerated" reactions such as large local, atypical or systemic reactions after mosquito bites. OBJECTIVE: The aim of this study was to document the clinical features of children with mosquito allergy and investigate the possible associations between demographic features and type of reactions in this population. METHODS: Children with large local or unusual reactions after mosquito bites who attended to our outpatient pediatric allergy department were enrolled in the study along with control subjects. RESULTS: A total of 180 children (94 with mosquito allergy and 86 age and sex-matched control subjects) with a median age of 6.8 years (IQR 5.5-9.3) were enrolled. Atopy (35.1% vs. 11.6%, p < 0.001) and grass pollen sensitization (28.7% vs. 8.1%, p < 0.001) were significantly more frequent in children with mosquito allergy. Skin prick test with mosquito allergen was positive in only 6 children (6,4%). Grass pollen sensitization was most common in children (28.7%) followed by sensitization to house dust mite (9.6%). 30 children (31.9%) had an accompanying atopic disease such as allergic rhinitis, asthma or atopic dermatitis. Bullae were significantly more frequent in children with asthma (41.7% vs.15.9, p = 0.034). The median duration of symptoms after onset were significantly longer in patients with ecchymosis, with immediate wheals and in children whose symptoms start in 20 min to 4 hours after mosquito bites. CONCLUSION: There is an association between unusual, large local or exaggerated reactions after mosquito bites and allergic diseases in children. The severity of reactions increases with age and particularly in children with atopic background.

Mosquito hypersensitivity may be associated with atopic background in children

Background Many children encounter unusual or “exaggerated” reactions such as large local, atypical or systemic reactions after mosquito bites. Objective The aim of this study was to document the clinical features of children with mosquito allergy and investigate the possible associations between demographic features and type of reactions in this population. Methods Children with large local or unusual reactions after mosquito bites who attended to our outpatient pediatric allergy department were enrolled in the study along with control subjects. Results A total of 180 children (94 with mosquito allergy and 86 age and sex-matched control subjects) with a median age of 6.8 years (IQR 5.5–9.3) were enrolled. Atopy (35.1% vs. 11.6%, p < 0.001) and grass pollen sensitization (28.7% vs. 8.1%, p < 0.001) were significantly more frequent in children with mosquito allergy. Skin prick test with mosquito allergen was positive in only 6 children (6,4%). Grass pollen sensitization was most common in children (28.7%) followed by sensitization to house dust mite (9.6%). 30 children (31.9%) had an accompanying atopic disease such as allergic rhinitis, asthma or atopic dermatitis. Bullae were significantly more frequent in children with asthma (41.7% vs.15.9, p = 0.034). The median duration of symptoms after onset were significantly longer in patients with ecchymosis, with immediate wheals and in children whose symptoms start in 20 min to 4 hours after mosquito bites. Conclusion There is an association between unusual, large local or exaggerated reactions after mosquito bites and allergic diseases in children. The severity of reactions increases with age and particularly in children with atopic background (AU)

Clinical features and treatment results in children with hemangioma.

Atas E, Koç O, Artik HA. Clinical features and treatment results in children with hemangioma. Turk J Pediatr 2017; 59: 254-260. Hemangioma is a frequent disease which has a proliferative and involution phase. In this single center retrospective study, we evaluated clinical and therapeutic features of hemangiomas in children (n: 49). The median (range) age at onset and at admission were 21 days (10 days-156 months) and 7 months (0.25-192 months), respectively. The localization of lesions was: head region (n: 28; 57.2%), trunk (n: 8; 16.3%) trunk, limb (n: 8; 16.3%), and neck region (n: 5; 10.2%) neck region. Seventeen patients (34.7%) were treated. Following treatments were used: propranolol alone in 12 (24.5%) patients, steroid alone in 2 (4.1%) patients, prednisone plus propranolol in 2 (4.1%) patients, and propranolol plus surgery in 1 (2.0%) patient. The number of hemangioma (n > 1) (p = 0.026, OR = 9.5, 95% CI 1.3-69.2) and treatment other than observation (p = 0.008, OR = 10.5, 95% CI 1.8-59.1) were significant predictors in the univariate analysis; treatment other than observation was an independent predictor for clinical response (p = 0.014, OR = 9.8, 95% CI 1.5-90.9).