Adverse drug reactions affecting treatment adherence in first-line treatment of asthma: An observational study

BACKGROUND: Asthma is the most common chronic lung disease among children. International guidelines recommend inhaled corticosteroids (ICS) as the first-line daily controller therapy for children with asthma and leukotriene receptor antagonists (LTRA) as the second alternative therapy. Adherence to treatment is the most significant component to optimize the benefits of therapy in asthma. OBJECTIVE: This study aims to investigate the frequency of drug discontinuation due to adverse drug reactions (ADRs) that affect adherence to treatment in children with asthma or asthma and allergic rhinitis using LTRA or ICS as monotherapy. METHODS: The subjects aged 4-18 years with asthma or asthma and allergic rhinitis and using montelukast or ICS as monotherapy were included in the study. They were evaluated in terms of ADRs affecting adherence to treatment in the first and third months of treatment. RESULTS: A total of 468 cases, 356 of whom received montelukast monotherapy and 112 of whom received ICS treatment, with a mean age of 9.10 ± 3.08 (4-17) years, were included in the study. Males constituted 65.6% of the total cases (n = 307). In the first month of follow-up of the cases, it was observed that 4.8% (n = 17) of the patients in the montelukast group could not continue the treatment due to ADR. It was determined that the drug discontinuation rate in the montelukast group in the first month was significantly higher than in the ICS group (P = 0.016), and the risk of drug discontinuation due to ADR in the montelukast group was 1.333 (95% CI, 1.26-1.40) times higher. CONCLUSIONS: As a result, it was observed that the drug was discontinued due to ADR at a higher rate in children with asthma who received montelukast monotherapy compared to those who received ICS monotherapy

The {-gA/Iç} and {-(I/A)ç} Morphemes in Turkish: A Synchronic Approach to Derivation

Derivation processes show a high degree of variation from one language to another and in terms of the range of derivation and frequency of use. This variation indicates that derivation is a productive process, which seems to form a continuum rather than a dichotomy between productivity and unproductivity (Uzun, 2006, p. 90). This study started as a result of our observation that a certain base cannot be clearly identified in the following lexemes: BİLGİÇ, ÇALGIÇ and YARGIÇ. In order to eliminate this uncertainty, it is necessary to determine the range and the frequency of the derivations obtained by the {-gA/Iç} and {-(I/A)ç} morphemes. To this end, we examined the range of the derivations based on these morphemes and investigated their degree of productivity with respect to one another. We also aimed to answer the question whether one of the morphemes can be treated as the other's allomorph and discussed the ways in which the base of the problematic lexemes in question can be determined. Our data were the list of lexemes derived by {-gA/Iç} and {-(I/A)ç} listed in the Turkish Dictionary by Dil Derneği (2002). We discussed the data, compared the findings in the literature with the new data we presented, and thus aimed to contribute to the existing literature

CD4+CD25+CD127loFOXP3+ cell in food allergy: Does it predict anaphylaxis?

Background: Food allergy (FA), hence the incidence of food anaphylaxis, is a public health problem that has increased in recent years. There are still no biomarkers for patients with FA to predict severe allergic reactions such as anaphylaxis. Objective: There is limited information on whether regulatory T (Treg) cell levels are a biomarker that predicts clinical severity in cases presenting with FA, and which patients are at a greater risk for anaphylaxis. Methods: A total of 70 children were included in the study: 25 who had IgE-mediated cow’s milk protein allergy (CMPA) and presented with non-anaphylactic symptoms (FA/A−), 16 who had IgE-mediated CMPA and presented with anaphylaxis (FA/A+) (a total of 41 FA cases), and a control group consisting of 29 children without FA. The study was conducted by performing CD4+CD25+CD127loFOXP3+ cell flow cytometric analysis during resting at least 2 weeks after the elimination diet to FA subjects. Results: When the FA group was compared with healthy control subjects, CD4+CD25+CD127loFOXP3+ cell rates were found to be significantly lower in the FA group (p < 0.001). When the FA/A− and FA/A+ groups and the control group were compared in terms of CD4+CD25+CD127loFOXP3+ cell ratios, they were significantly lower in the FA/A− and FA/A+ groups compared to the control group (p < 0.001). Conclusions: Although there was no significant difference between the FA/A+ group and the FA/ A− group in terms of CD4+CD25+CD127loFOXP3+ cells, our study is important, as it is the first pediatric study we know to investigate whether CD4+CD25+CD127loFOXP3+cells in FA p redict anaphylaxis

Baby with neonatal systemic juvenile xanthogranuloma born within a cross-cousin marriage

AbstractJuvenile xanthogranuloma is a non-Langerhans cell histiocytosis seen most commonly in childhood and adolescence. Extracutaneous involvement is rare. We report an interesting and extremely rare case of systemic (skin, lung, spleen, and colon) “juvenile xanthogranuloma” in the neonatal period. Our case was the first ever reported case born to a cross-cousin marriage

Prevalence of allergic rhinitis and risk factors in school children

Objective: To evaluate the prevalence and the risk factors of allergic rhinitis in a particular area. Methods: The main study group consisted of all school children in Kemalpasa district aged 13-14 years. Children with current rhinitis based on responses given in ISAAC questionnaire survey were further evaluated for confirmation. Parents responded to a more detailed questionnaire about allergic diseases and risk factors. Then peak nasal inspiratory flow (PNIF) was evaluated to objectively assess nasal patency. Skin-prick test was performed for ten common allergens. Results: The questionnaire was answered by 90.8% (1373) of children. The prevalence of physician-diagnosed AR was 11.1%. Current rhinitis was found to be 31.3%. Of this group, 55.0% were admitted for the parent questionnaire and tests. Precisely, 90.3% of children accepted PNIF evaluation, and %10.1 of them had a nasal obstruction. Skin-prick tests revealed allergy for at least 1 allergen in 16.6% of children. The present study showed that the children with maternal allergic rhinitis history had 2,18 fold, and the children with seasonal allergic rhinitis had 2,11 fold higher possibility of sensitization to an allergen. The probability of perennial allergic rhinitis was 3,1 fold higher in the children who had siblings with allergic rhinitis. Conclusion: We included all children in a specific age group living in an area in our survey. As well as we found the prevalence of current rhinitis with the ISAAC questionnaire; we also evaluated peak nasal inspiratory flow and used skin-prick tests that yielded objective results

Can mean platelet volume be used as a biomarker for asthma?

Introduction : Platelets play important roles in airway inflammation and are activated in inflammatory lung diseases, including asthma. Aim :We evaluated the mean platelet volume (MPV), used as a marker of platelet activation, in asthmatic patients during asymptomatic periods and exacerbations compared to healthy controls to determine whether MPV can be used as an indicator of inflammation. Material and methods :Our patient group consisted of95 children with exacerbation of asthma who were admitted to our allergy clinic. The control group consisted of 100 healthy children matched for age, gender, and ethnicity. Mean platelet volume values of the patient group obtained during exacerbation of asthma were compared to those of the same group during the asymptomatic period and with the control group. We investigated factors that can affect the MPV values of asthma patients, including infection, atopy, immunotherapy treatment, and severity of asthma exacerbation. Results :The patient group consisted of 50 (52.6%) boys and 45 (47.4%) girls with a mean age of 125 ±38 months old. Mean MPV values in the exacerbation period, the healthy period, and in the control group were 8.1 ±0.8 fl, 8.1 ±1.06 fl, and 8.2 ±0.9 fl, respectively; there were no significant differences between groups (p > 0.05). The severity of asthma, severity of asthma exacerbation, immunotherapy, coinfection, eosinophil count, and IgE level also had no effect on MPV (p > 0.05). Conclusions : Although platelets play a rolein the pathophysiology of asthma, MPV measurement is insufficient to detect inflammation through platelet

Evoluation of childhood poisoning at our hospital

Amaç: Acil servislere başvurular içerisinde sayıları giderek artan zehirlenmelere dikkat çekmek ve hastanemize zehirlenme ile başvuran olguları değerlendirmek için bu çalışma planlanmıştır. Gereç ve Yöntem: Dr Behçet Uz Çocuk Hastanesine 1994 yılı Ocak-Mayıs ayları arasında zehirlenme nedeni ile başvuran 123 olgu geriye dönük olarak yaş, cins, alınan toksik maddenin türü, başvuru süreleri, başvuru şikayetleri, tedavi yöntemleri hastanede kalış süreleri açısından değerlendirilmişlerdir. Bulgular: Olguların %80'inin 5 yaşından küçük, erkek/kız oranının 1.2 olduğu saptanmıştır. Zehirlenmelerin sırasıyla ilaçlarla (%61), petrol türevi hidrokarbonlu bileşiklerle(%17), besinlerle (%7.2), organik fosforla (%6.5), fare zehiriyle (%4), CO gazıyla (2.4) ve kimyasal ajanlarla (1.7) olduğu tespit edilmiştir. Zehirlenme olgularının %95.2'si kaza sonucunda meydana gelmiş, %4.8'i istemli ilaç alımı şeklinde olmuştur. Sonuç: Zehirlenmeler daha çok 5 yaş altındaki çocuklarda görülmektedir. ılaçlar ve hidrokarbonlu bileşikler en sık çocukluk çağı zehirlenmelerine yol açan ajanlardır. Çocukların bu ajanlardan uzak tutulması bu tip zehirlenmeleri önleyecektir.Objective: The aim of this study is to evaluate childhood poisoning at our hospital and to draw the attention to the increasing incidence of childhood poisoning. Material and Method: In this retrospective study, the records of 123 cases who were hospitalized due to poisoning between January 1standMay 1stin 1994 were evaluated. Their age, sex, the type of material ingested, initial complaints, hospitalization time, the duration of hospitalization, treatment protocols were investigated. Results: Eighty percent of cases studied were younger than five years old with a male/female ratio of 1.2. The toxic agents ingested orexposedwere as follows: Drugs 61%, hydrocarbon compound 17%, food7.2%, organic phosphorus 6.5%, ratpoison4%, CO 2.4% and other chemicals 1.7%. Ninety five percent of cases wereexposed to the toxic agents accidentally whereas 4.8 % had ingested onpurpose. Conclusion: Poisoning is observed more commonly in children younger than five years old. Drugs and hydrocarbon compounds are the most common agents causing childhood poisoning. Keeping children away from these agents canprevent these types of poisoning

The Analysis of Fractures of Forearms, Wrists and Hands due to Traffic Accidents

INTRODUCTION: Limb injuries have an important place in traffic accidents. Although it has been identified among the most frequently injured areas in hand, wrist and forearm in traffic accidents; often neglected due to more severe injuries. In our study, it was aimed to evaluate the cases with hand, wrist and forearm fractures after traffic accidents, to define the age and gender distribution of the injured people, to compare the location and types of fractures in and out of the vehicle. METHODS: In this study, the medical files of patients who applied to the Emergency Department of the Medical Faculty and the Forensic Medicine Outpatient Clinic after a traffic accident in the 7-year period between 01.01.2013 and 31.12.2019 were included in the study. RESULTS: In our study, ulna-radius diaphysis fractures, which usually occur as a result of a direct blow to the forearm, were seen in more than 70% of all cases in the presented series with forearm, wrist and hand bone fractures due to traffic accidents. Direct mechanisms were effective in 65.9% of the fractures, and direct fractures were prominent especially in pedestrians and passengers. DISCUSSION AND CONCLUSION: In our study, the founding of radius-ulna fractures, which usually occur as a result of a direct blow to the forearm in more than 70% of the cases in the presented series, the detection of effect of direct mechanisms in 65.9% of the fractures, and the seeing of in the foreground of direct fractures in pedestrians and passengers have been accepted as important indicators revealing that primary injuries are at the forefront rather than secondary injuries in traffic accidents