Characteristics of children with cat sensitivity: a prospective cross-sectional study.

BACKGROUND: Animal dander is one of the most common respiratory allergens in children, and there is evidence that cat sensitivity is a risk factor for asthma and allergic rhinitis. In this study, it was aimed to evaluate children with cat sensitivity and to identify their demographic and clinical characteristics. METHODS: Patients who were found to be sensitive to cats following skin prick tests performed in our allergy clinic over a period of one year (and two control groups), were included in the study. Patients in the study and control groups filled in a questionnaire including demographic and clinical characteristics. RESULTS: The prevalence of cat sensitivity in our allergy clinic was 6% (182/3033). The most common diagnoses in patients were 41.8% allergic rhinitis, 25.8% asthma, and 13.2% allergic rhinitis + asthma. Allergic rhinitis symptoms were the most prevalent symptom associated with cat contact (29.4%), whereas 28% of the patients were asymptomatic. Only 17.3% had a cat at home and 13.4% had cat exposure apart from home but having a cat at home was significantly higher than the control groups (p < 0.05). Eosinophilia was present in 54.6% of the patients, and 17.3% had blood tIgE levels of >1000 IU/mL. Eosinophilia and tIgE levels were significantly higher than both control groups (p < 0.05). DISCUSSION: Cat ownership can affect the development of cat sensitivity but the majority of patients with cat sensitivity are not cat owners. Elevated tIgE levels (> 1000 IU/mL) may be associated with cat sensitivity, these patients should be evaluated for cat sensitivity, even if they do not report symptoms with cat contact.

Iron deficiency anemia in infants: does it really affect the myocardial functions?

The aim was to assess the myocardial functions in infants with iron deficiency anemia (IDA). The findings of 22 infants with IDA and 16 healthy infants were compared. Complete blood count in all infants, serum iron level, total iron binding capacity (TIBC), and serum ferritin level in patients were evaluated. Echocardiography with tissue Doppler imaging (TDI) was performed in all infants. The mean hemoglobin was 8.5 versus 11 g/dL, hematocrit was 26.7 versus 33.1% and the mean corpuscular volume (MCV) was 59.8 versus 72.2 fL in patients and controls, respectively. The median serum iron level was 14.5 µg/dL, TIBC was 444 µg/dL, and serum ferritin level was 4.9 ng/mL in patients. There were significant differences between patients and controls for the myocardial performance indexes of the left ventricle (LV) (0.57 vs. 0.45, P < .05), interventricular septum (IVS) (0.56 vs. 0.48, P < .05), and the right ventricle (RV) (0.56 vs. 0.41, P < .05). The similar significances were also present for the ejection times (ET) of the LV (173.1 vs. 212.1 ms, P < .05), IVS (173.7 vs. 195.6 ms, P < .05), and RV (169.9 vs. 213.3 ms, P < .05). In spite of negatively significant correlations between hemoglobin, hematocrit, MCV and MPI, the correlations between these parameters and ET were positively significant. However, there were no correlations between serum iron level, TIBC, serum ferritin level, and the TDI parameters of patients. According to these findings, we could say that, the IDA affects the myocardial functions in a negative manner.

Evaluation of nocturnal blood pressure changes and urinary electrolyte excretion in children with enuresis.

BACKGROUND: Monosymptomatic nocturnal enuresis (MNE) is defined as involuntary nighttime urination of children over five years of age without any congenital or acquired defect in the central nervous system. Many factors, mainly nocturnal polyuria, sleep disorders, decreased bladder capacity, and bladder dysfunctions play a role in the etiology of MNE. METHODS: Eighty-three children diagnosed with MNE were included in the study. Complete blood cell count, blood biochemistry, renin, and aldosterone levels of all children were obtained. Twenty-four-hour urine samples were collected separately daytime and nighttime and urinary electrolytes were evaluated. Also, 24-hour ambulatory blood pressure monitoring (ABPM) was performed for each patient. The results were evaluated by comparing both enuretic children vs. control group and enuretic children with polyuria vs. without polyuria. RESULTS: When we compared the enuretic children and the control group in terms of urinary electrolytes, the fractional excretion of sodium (FENa) and fractional excretion of potassium (FEK) values of the enuretic group were higher than the control. The evaluation of the 24-hour ABPM findings revealed no significant difference in terms of the mean arterial pressure (MAP) and diastolic blood pressure (DBP) during the daytime and nighttime measurements. The daytime systolic blood pressure (SBP), however, was significantly lower in the enuretic group. When enuretic children with and without polyuria and the control group were compared, the nighttime, FENa, FEK, as well as nighttime urinary excretion of calcium and protein were significantly higher in enuretic children with polyuria. No difference was detected on the MAP, SBP, or DBP values. CONCLUSIONS: In conclusion, the nighttime urinary solute excretion of enuretic children was found to be higher and this condition may especially be associated with pathogenesis of nighttime polyuria. In enuretic children, nighttime blood pressure changes were not influential in the etiopathogenesis in all patient groups and multiple mechanisms may play a role in the pathogenesis of enuresis.

Complementary and alternative treatment methods practiced by parents in pediatric cases diagnosed with atopic dermatitis.

INTRODUCTION: Atopic dermatitis (AD) is a chronic, recurrent, and inflammatory skin disease experienced mostly in childhood. Chronicity of the disease, relapses, constant need of regular skin care causes seeking for alternative treatments. AIM: The aim of this study is to evaluate the complementary and alternative treatments (CAT) used by parents' caregivers in pediatric patients diagnosed with AD, and the association between CAT use and patient characteristics. MATERIALS AND METHODS: A questionnaire questioning the sociocultural and demographic characteristics of the family, the clinical findings of the patients, their treatments and CAT applications was recorded. RESULTS: Eighty-three patients were included in the study. 68.7% of the patients used at least one type of CAT. Vitamins and oils were the most commonly used CAT (48.8% and 47%, respectively) and 73.3% of the patients using CAT continued normal AD treatment while using CAT. The biggest factor affecting CAT choice was the advice of the immediate circle (75%), and 40.6% of the patients stated that they benefited from the complementary therapy. CONCLUSIONS: CAT are widely used in AD. Physicians should know the socio-cultural structure of the region they are in, the CAT used and their side effects, and inform the families.

Eczema herpeticum emerging during atopic dermatitis in infancy.

BACKGROUND: Eczema herpeticum (EH) is an acute disseminated viral infection that develops in the presence of an existing skin lesion, often on the ground of atopic dermatitis (AD). Morbidity and mortality of EH can be minimized by starting antiviral therapy at the earliest time in diagnosis. CASE: Herein we report five infants diagnosed with EH in the course of AD treatment. All patients had early onset, moderate to severe AD and needed intermittent topical corticosteroid (TCS) therapy. In physical examination, newly formed, TCS-resistant vesiculo-papular skin lesions were recognised on the present dermatitis. The presence of AD with food allergy and moderate to severe eosinophilia were other prominent findings. CONCLUSION: All patients were misdiagnosed as AD exacerbation. Therefore, EH should be considered in the differential diagnosis of AD exacerbation especially in the infants with moderate to severe AD.