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

Isokinetic knee muscular strength is associated with hematologic variables in female modern dancers

It is important to expose the risk factor in injury in the context of the health and the careers of dancers. Female are at greater risk of developing anemia than men, yet scarce data exist on anemia associated outcomes in female dancers. The aim of the present study was to investigate the relationships between bilateral isokinetic knee extensor and flexor muscles strength, and biochemical hematologic parameters in female modern dancers. Concentric isokinetic peak torque [(PT)-N.m], peak torque % body weight [(PT%BW)-N.m.kg-1], average peak torque [(AVGPT)-N.m] and total work [(TW)-J)] of the knee extensor and flexor muscles were measured at a velocity of 60º, 180º and 300ºs-1. To determine hematological parameters [red blood cell count (RBC), hematocrit (Hct), and Hb] were determined. The dancers of LHG and HHG had significant differences (p ≤ 0.05) for hematological parameters. HHG dancers’ strength production in extensors muscles of PT, TW and AVGPT in non-dominant left leg (p ≤ 0.05) were significantly higher than LHG dancers. There were significant (p ≤ 0.05) negative correlations between TW (300ºs-1) of left leg extensor muscles and RBC, Hct and Hb variables. Isokinetic knee muscular strength is associated with hematologic variables in female modern dancers. The current study provides evidence that the low-level hematologic parameters has decreased performance on torque production of extensors knee muscles in non-dominant leg during isokinetic muscle strength endurance in female modern dancers.This work was supported by the Marmara University Scientific Research Project Committee (project no: SAG-B- 060510-0116)

Establishment and practice of prerequisite programs on food businesses : a case study in dairy industries

Özellikle son yıllarda, canlıların sağlıklı bir yaşam sürdürebilmeleri için gerekli olan gıdaların güvenliğinin sağlanmasında gıda işletmelerinde HACCP'in temel ilkelerini esas alan birçok yönetim sistemleri uygulanmaktadır. Bu tür sistemlerin gıda işletmelerinde kurulması ve etkin olarak uygulanması amacıyla oluşturulması gereken ön gereksinim programlarının nasıl uygulanacağı bu araştırma ile süt sektörü örnek alınarak belirlenmiştir. Süt işletmesinde işletmenin yapısı, üretim çeşitliliği, bulunduğu ülke ve uygulanacak gıda güvenliği yönetim sistemine bağlı olarak ön gereksinim programları oluşturulmalıdır. Bu suretle Avrupa Birliği'ne girme sürecinde olan ülkemizdeki gıda işletmelerinde rekabet edebilir, mantığa dayanan, uygulanabilir ve bilimsel bazlı HACCPtemelli gıda güvenliği yönetim sistemlerinin oluşturularak sürekliliği sağlanabilecektir.In recent years, a number of management systems based on basic principles of HACCP in food plants for food safety. The establishment and effective implementation of such systems in dairy industry have been modeled, considering pre-requisite programs. The pre-requisite programs must be established in a dairy plant depending on the criteria including depending on the structure of the plant, diversity of production, country and food safety management system that will be applied. In this way, competitive, logic-based, and practical food safety management systems based on HACCP should be created and sustainability of these systems should be provided in the food plants in our country which is at the process of entering the European Union

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

Characteristics of food allergy in children: National multicenter study

Conference: Congress of the European-Academy-of-Allergy-and-Clinical-Immunology (EAACI) Location: Lisbon, PORTUGAL Date: JUN 01-05, 2019Background : Food allergies impose a significant burden on the life of the child and the family. In this study, to determine the demographic characteristics of food allergies, we investigated the characteristics of patients with food allergies in different regions of Pediatric Allergy- Immunology departments in Turkey. Method : Turkey ' s National Study of Allergy and Clinical Immunology Society has conducted a Study Group on Food Allergies. 25 centers participated in this multicenter, cross- sectional and descriptive study.European Academy of Allergy and Clinical Immunolog

Identifying Consensus Disease Pathways in Parkinson's Disease Using an Integrative Systems Biology Approach

Parkinson's disease (PD) has had six genome-wide association studies (GWAS) conducted as well as several gene expression studies. However, only variants in MAPT and SNCA have been consistently replicated. To improve the utility of these approaches, we applied pathway analyses integrating both GWAS and gene expression. The top 5000 SNPs (p<0.01) from a joint analysis of three existing PD GWAS were identified and each assigned to a gene. For gene expression, rather than the traditional comparison of one anatomical region between sets of patients and controls, we identified differentially expressed genes between adjacent Braak regions in each individual and adjusted using average control expression profiles. Over-represented pathways were calculated using a hyper-geometric statistical comparison. An integrated, systems meta-analysis of the over-represented pathways combined the expression and GWAS results using a Fisher's combined probability test. Four of the top seven pathways from each approach were identical. The top three pathways in the meta-analysis, with their corrected p-values, were axonal guidance (p = 2.8E-07), focal adhesion (p = 7.7E-06) and calcium signaling (p = 2.9E-05). These results support that a systems biology (pathway) approach will provide additional insight into the genetic etiology of PD and that these pathways have both biological and statistical support to be important in PD