Atopy prevalance in children with cystic fibrosis

Purpose: It is known that genetic and geographic factors have significant roles in the expression of the clinical phenotype in cystic fibrosis. Another factor which may also be significant in determination of phenotype is coexistence of atopy. We aimed to investigate the frequency of atopy in children with cystic fibrosis who have been regularly followed up in our department. Methods: Total IgE, CAP-System FEIA (fluoroenzyme immunosorbent assay) and skin prick tests to common allergens were performed in children with cystic fibrosis who have symptoms of disease and whose sweat chloride level has been found greater than 60 mmol/L in two different times. FEV1 (forced expiratory volume in one second) values with spirometry and Shwachman-Kulczycki score were also recorded. Results: Forty patients aged between 1 and 20 years; mean 11 years were included to the study. Total IgE levels were between 17.6-2225 (median 376.7) IU/ml. CAP-System FEIA was found positive in five patients. One or more skin prick test results to common allergens were positive in four (10%) patients. All four patients with positive skin prick tests had also positive results for CAP-System FEIA. Only one patient with positive IgE-FEIA, did not show any positive reaction to skin prick tests. Mean Shwachman-Kulczycki score was 73.2 ± 11.0. There was no statistically significant difference between mean values of Shwachman-Kulczycki score of atopic and nonatopic patients. Conclusion: Atopy prevalance of Turkish children with cystic fibrosis as 10% is no more than the general population. Additionally, there is no correlation between the existence of atopy and Shwachman-Kulczycki score or FEV1 measurements. Further studies with larger series and follow up are needed to determine the role of atopy in the expression of the phenotype in cystic fibrosis

The prevalence of asthma and allergic diseases in children of school age in Adana in Southern Turkey

PubMedID: 15503474The aim of this study was to determine the prevalence of asthma and other allergic disorders as well as the factors affecting these disorders in school-children in Adana. This cross-sectional population-based study using the International Study of Asthma and Allergies in Childhood (ISAAC) protocol was carried out on 3164 school-children aged between 6-18 years during March to June 1997. There were 1521 (48.1%) boys and 1643 (51.9%) girls. The prevalence of asthma, allergic rhinitis and eczema in the 6-18 year-old children was found to be 12.6%, 13.6% and 8.3%, respectively. The prevalence of asthma was highest in 6-10 year-old school-children (14.7%), and lowest (6.0%) in 15-18 year-old children. The prevalence of asthma diagnosed by a doctor was 5.0%. The cumulative and current prevalences of wheezing were found to be 19.0% and 13.5%, respectively. The cumulative prevalence of allergic disorders was found to be 23.4%. The presence of domestic animals at home and dampness of the home were found to be important risk factors for asthma. Family histories of asthma, eczema, and diagnosis made by a doctor, and history of frequent sinusitis were found to be significantly higher in asthmatics. In conclusion, asthma is an important chronic disease of childhood in Adana in southern Turkey

Evaluation of efficacy of immunotherapy in children with asthma monosensitized to Alternaria

PubMedID: 21980810In this study, we aimed to evaluate the efficacy of specific immunotherapy (SIT) in children monosensitized to Alternaria. Sixteen children with bronchial asthma monosensitized to Alternaria were enrolled in the study. Patients were divided into two groups as the immunotherapy group (Group I; 9 patients) and control group (Group II; 7 patients). A significant reduction in bronchial responsiveness to methacholine and Alternaria was found in Group I after one year of SIT (p=0.03, p=0.006) in comparison to controls. Specific IgE levels were decreased in the immunotherapy group (p=0.001). Following allergen provocation, a rise in sputum eosinophil count was found to be lower in the SIT group compared to controls after one year (p=0.011), and sputum eosinophil cationic protein (ECP) levels did not change in the SIT group, while there was a statistically significant increase in controls. Our results demonstrated that SIT with Alternaria caused clear changes in airway responsiveness and serum-specific IgE levels. However, further long-term studies in large series should be carried out for clinical documentation of the efficacy of SIT in the treatment of children with Alternaria allergy

Evaluation of asthma and COPD awareness in primary care doctors in Turkey [Türkiye’de birinci basamak hekimlerinde astım ve KOAH farkındalığının değerlendirilmesi]

PubMedID: 27481082Introduction: Chronic pulmonary diseases cause significant morbidity and mortality. However awareness about the risk factors, symptoms, diagnosis and traetment of these disorders is low among patients and health care providers. Our aim was to evaluate the awareness of asthma and chronic obstructive pulmonary disease among primary care doctors. This study was performed by the national Global Alliance Against Chronic Respiratory Diseases programme. Material and Methods: Primary care doctors employed by the Ministry of Healthy were included to the study. Turkish Statistical Institute randomly selected 680 doctors. Questionnaires evaluating the awareness of asthma and COPD which were developed by the Turkish Thoracic Society COPD and asthma assemblies were completed online by these doctors. Results: 84% of the doctors described asthma as airway obstruction. Dyspnea was reported as the most common symptom of asthma (78.8%) and inspiratory rhonci was reported as the most common physical exam finding (42.3%). Around 50% of doctors thought impairment of pulmonary function tests (PFT) was important for diagnosis and evaluation of severity of asthma while 24.2% thought physical exam was more important. When treatment options were evaluated 87.6% chose inhaled treatment for asthma. COPD was described as bronchiectasis and chronic bronchitis by 9.1%, chronic bronchitis and emphysema by 61.6%, chronic bronchitis and asthma by 22.2% and asthma and emphysema by 7.1%. 1.2% of the doctors did not consider cigarette smoking as a risk factor for COPD. PFT was recommended for diagnosis by 83%. Most correctly differentiated asthma and COPD. Bronchodilators were the first choice for COPD by 72.5%. Conclusion: Awareness is low for asthma and COPD among primary care doctors. Awareness should be raised among health care professionals for these diseases with high economical burden to improve outcome. © 2016, Ankara University. All rights reserved

The effects of daily pulmonary rehabilitation program at home on childhood asthma

PubMedID: 10757852Objective: the aim of this study is to investigate the efficacy of pulmonary rehabilitation program in children with asthma. Patients and method: twenty eight children with mild persistent or moderate asthma were included into a double blind, randomised study. Sixteen children (9 girls , 7 boys) with the mean age of 10.8 ± 2.3 were assigned to receive pulmonary rehabilitation program with their parents for 30 days (group I). Control group included 12 children (6 girls, 6 boys ) with the mean age of 10.2 ± 2.4 (group II). Symptom and medication scores quality of life index and pulmonary function tests were evaluated in rehabilitation and control group in the beginning of the study and after the one month period. Results: the groups did not differ on all parameters before the study (p > 0.05). Statistically significant decrease were found in symptom and medication scores in rehabilitation group (p < 0.05) and quality of life index was increased significantly in the same group (p < 0.05). Pulmonary function measures also significantly improved including vital capacity, forced vital capacity, FEV1, PEF and FEF25-75 in the rehabilitation group (p < 0.05). The best improvement were seen in FEF25-75 (10.09% increase) and PEF (7.81% increase) values. In control group no statistically significant differences were found in all parameters. Conclusion: in this study it was shown that daily pulmonary rehabilitation at home could improve quality of life and pulmonary functions. So pulmonary rehabilitation should be placed as a component of management in childhood asthma

Exposure to house dust endotoxin and allergic sensitization in allergic and nonallergic children living in Adana, Turkey

PubMedID: 19817265It has been suggested that exposure to elevated levels of endotoxin decreases the risk of allergic sensitization. The objective of our study was to analyze associations between house dust endotoxin levels and allergic sensitization in children. One hundred children with self-reported allergic diseases and 100 healthy children were randomly selected from a list of a previous prevalence study in school children. These children attended the study center again to complete a detailed questionnaire and medical examination including skin prick test and pulmonary function test. Of these children, 65 had allergen sensitization. Parents of a total 100 children (50 allergic and 50 healthy) agreed to house dust sampling in their homes. Thirty-five allergic children had asthma and 25 had rhinitis. Thirteen allergic and 14 healthy children lived in rural areas. The endotoxin content was quantified using a chromogenic kinetic Limulus amoebocyte lysate test. Endotoxin was at a detectable level in all dust samples. Endotoxin levels ranged from 0.05 to 309 EU/ml, with a geometric mean of 61.8 (confidence interval [CI] %) (50-73) EU/ml. There were no differences in house dust endotoxin levels between allergic and nonallergic children (p=0.153). On the whole, the mean level of endotoxin in rural homes was higher than that of urban homes, but this was not statistically significant (p=0.354). The highest endotoxin level was found in the homes of nonallergic children living in the rural areas and the lowest level in the homes of allergic children living in an urban area; however, this was not important statistically (p=0.320). Exposure to endotoxin was not associated with a risk of allergic sensitization (odds ratio [OR]=0.98; 95% CI: 0.91-1.05, p=0.609). In conclusion, supposing that the current level of endotoxin may reflect that in the past, the levels of endotoxin in living room floor dust of homes of allergic and nonallergic children in our study population were not associated with allergic sensitization. Further studies are needed on this topic

Evaluation of asthma and COPD awareness in primary care doctors in Turkey

WOS: 000386264100008PubMed ID: 27481082Introduction: Chronic pulmonary diseases cause significant morbidity and mortality. However awareness about the risk factors, symptoms, diagnosis and traetment of these disorders is low among patients and health care providers. Our aim was to evaluate the awareness of asthma and chronic obstructive pulmonary disease among primary care doctors. This study was performed by the national Global Alliance Against Chronic Respiratory Diseases programme. Material and Methods: Primary care doctors employed by the Ministry of Healthy were included to the study. Turkish Statistical Institute randomly selected 680 doctors. Questionnaires evaluating the awareness of asthma and COPD which were developed by the Turkish Thoracic Society COPD and asthma assemblies were completed online by these doctors. Results: 84% of the doctors described asthma as airway obstruction. Dyspnea was reported as the most common symptom of asthma (78.8%) and inspiratory rhonci was reported as the most common physical exam finding (42.3%). Around 50% of doctors thought impairment of pulmonary function tests (PFT) was important for diagnosis and evaluation of severity of asthma while 24.2% thought physical exam was more important. When treatment options were evaluated 87.6% chose inhaled treatment for asthma. COPD was described as bronchiectasis and chronic bronchitis by 9.1%, chronic bronchitis and emphysema by 61.6%, chronic bronchitis and asthma by 22.2% and asthma and emphysema by 7.1%. 1.2% of the doctors did not consider cigarette smoking as a risk factor for COPD. PFT was recommended for diagnosis by 83%. Most correctly differentiated asthma and COPD. Bronchodilators were the first choice for COPD by 72.5%. Conclusion: Awareness is low for asthma and COPD among primary care doctors. Awareness should be raised among health care professionals for these diseases with high economical burden to improve outcome