Evaluation of hematologic parameters in children with Down syndrome

Objective: Congenital hematological disorders are frequently observed in Down syndrome (DS). In this study, we aimed to investigate peripheral blood-derived inflammation biomarkers such as neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and eosinophil/monocyte ratio in patients with Down syndrome. Material and Methods: Ninety-eight patients with karyotypically ascertained DS and 103 healthy controls were included. All subjects were divided into three age groups: 0-2 years (34 patients, 34 controls), 2-6 years (32 patients, 33 controls), and >6 years (32 patients, 36 controls). Demographic, clinical, and laboratory data between June 2010 and December 2021 were written from the file records from the pediatric allergy and immunology department. Results: Lymphocyte, eosinophil, and EMR were found to be significantly lower in children with DS compared to controls in group 2 (2-6 years) and group 3 (>6 years). PLR was found to be higher in children with DS in group 2 and group 3. There was no statistically significant difference between DS and controls in group 1 (6 years), there was a statistically significant difference between DS and controls in terms of lymphocyte, eosinophil, PLR, and EMR variables (P>0.05). Conclusion: We found significant differences among lymphocyte, eosinophil, PLR, and EMR in patients with DS. As a result, these parameters should be evaluated carefully for clinical outcomes

Increased fat graft survival with mesenchymal stem cell recruiting effect of PRP: in vitro and in vivo study of application techniques

Aim: Adding platelet-rich plasm (PRP) or mesenchymal stem cells are the most accepted methods to increase fat graft’s permanence. However, there is no consensus on timing and whether the effect of stem cells or PRP is observed more in the recipient area or in the donor area. It is aimed to present the application method and localization of PRP to be combined with fat graft to increase the survival. Material and Methods: in vitro part: Fat grafts were kept in a medium containing PRP. Cell output from the fat graft to the Petri dishes was examined every day. The time to recruit the maximum number of stem cells to the medium was determined (day 10). in vivo part: Eight group of rats were received PRP in different concentrations either to recipient or donor areas of fat grafts. After ten days, fat grafts were transferred to the recipient area. Ninety days after the transfer, histopathological examination and immunohistochemical staining were performed. Results: The group which had received the full-dose PRP to the recipient area showed the highest cellular integrity and vascularity (p< 0.05). Vascularity was superior in the half-dose PRP group compared to the control group (p< 0.05); cellular integrity did not increase. Donor site groups did not show increase in cellular integrity. Conclusion: Although PRP starts to increase fat graft permanence by increasing vascularity, it acts by preserving the cellular integrity of the fat cells as the concentrations increase. The PRP injection to the recipient area 10 days before fat grafting may provide higher survival rates

Suçiçeği ile ilişkili Stevens-Johnson sendromu

Stevens-Johnson Sendromu, deri ve mukozaları tutan, hedef lezyonlar ve büllerle seyreden, hayatı tehdit edebilen, akut bir aşırı duyarlılık reaksiyonudur. Klinik bulgular hafif deri ve müköz membran tutulumu ile ağır sistemik bozukluklar arasında değişkenlik gösterir. Stevens-johnson sendromunun bilinen en yaygın nedenleri; ilaçlar, aşılar ve viral enfeksiyonlardır. Bu makalede 9 yaşında, suçiçeği ile birlikte Stevens-Johnson sendromu gelişen bir olgu sunuluyor. Olgumuzda asiklovir ve intravenöz immünoglobulin teda- visi ile klinik bulguların düzeldiğini ve gelişebilecek komplikasyonların kontrol altına alındığını görüyoru

Foreign Body Aspiration Mimicking Congenital Lobar Emphysema

ÖZET Giriş: Konjenital lober amfizem (KLA), süt çocuğunda solunum yetmezliğine yol açan nadir akciğer gelişim malformasyonlarındandır. Hastalar, sıklıkla yaşamın ilk 6 ayında tekrarlayan solunum sıkıntısıyla başvururlar. Yabancı cisim aspirasyonu (YCA), çocukluk çağında morbidite ve mortalitenin önemli bir sebebidir. Tekrarlayan alt solunum yolu infeksiyonu hikayesi olan ve tedaviye cevap vermeyen hastalarda YCA akla gelmelidir. Olgu Sunumu: KLAi taklit eden uzun süreli solunum şikayeti olan ve radyolojik bulguları 11 aydır havalanma farkı şeklinde sebat eden 16 aylık YCA olgusu sunuldu. Tartışma: Yabancı cismin akut ve kronik dönemdeki radyolojik bulgusu her iki akciğer arasında havalanma farkı olabilir ve bu bulgu küçük çocuklarda bazen KLAi düşündürebilir. (Gün cel Pediatri 2012; 10: 70-3)SUM MARY Introduction: Congenital lobar emphysema (CLE) is a rare malformation of lung development which may be the cause of respiratory insufficiency of the suckling child. Patients often present within the first 6 months of life with recurrent respiratory distress. Foreign body aspiration (FBA) is an important cause of morbidity and mortality in childhood. Foreign body aspiration should be thought in patients who have a history of recurrent lower respiratory infections and resistance to treatment. Case Report: We report a case of 16 month old girl with FBA mimicking CLE. She was suffering for persistan respiratory symptoms and radiological finding was maintaned as the difference between two sides of the lungs aeration for 11 months. Conclusion: In the acute and chronic period of FBA, the radiological finding can be different between two sides of the lungs aeration and this finding sometimes might suggest CLE in infancy. (Jo urnal of Current Pediatrics 2012; 10: 70-3

Atopy and allergic diseases in immunoglobulin A deficiency

Giriş: İmmünglobulin (Ig) A eksikliği özellikle okul öncesi çocukluk çağında morbiditeye neden olan yaygın bir immün sistem bozukluğudur. Bu çalışmanın amacı, IgA eksikliği olan olguları atopi ve allerjik hastalık yönünden yaş gruplarına göre değerlendirmek, bu eksikliğin dört yaş altında ve üstündeki klinik sonuçlarını belirlemektir. Gereç ve Yöntem: Kasım 2001-2007 tarihleri arasında 272 parsiyel ve 23 selektif IgA eksikliği olan toplam 295 hasta retrospektif olarak incelendi. Bulgular: Hastaların tanı yaşları 64.3 43 (4-204) ay, infeksiyonların başlangıç yaşı 29.5 36 (1-168) ay idi. Tanı yaşı dört yaş altında 121 hasta mevcuttu. Başvuru sebepleri sırasıyla tekrarlayan bronşit (%40), tonsillofarenjit (%33), sinüzit (%6), pnömoni (%4), otit (%2), akut gastroenterit (%0.3) ve boyun apsesi (%0.3) olarak kaydedildi. Olguların %25’inde eozinofili ve %38’inde artmış IgE düzeyi ve aralarında ilişki belirlendi. Hastaların %31’inde spesifik IgE ve/veya deri testi pozitifliğiyle atopi saptandı. Allerjik hastalık sıklığı %78 oranında bulundu (%60 astım, %15 allerjik rinit, %8 atopik dermatit, %6 ürtiker, %0.7 allerjik konjunktivit). Klinik izlemde IgA düzeyinin normal sınırlara ulaşma zamanı 17 14 ay olup, 3-60 ay arasında değişmekteydi. Selektif IgA eksikliği olan üç hastada bronşektazi mevcuttu. Sonuç: Serum IgA düzeyi yalnızca tekrarlayan infeksiyon durumlarında değil, allerjik semptomlarla başvuran hastalarda da değerlendirilmelidir.Objective: Immunoglobulin (Ig) A deficiency is a common immune system disorder which causes morbidity especially in preschool children. The aim of this study is to evaluate atopy and allergic diseases of cases with IgA deficiency, determinate clinical results before and after four years of age. Materials and Methods: The data records of 295 children with IgA deficiency (272 partial, 23 selective IgA deficiency) between November 2001 and 2007 were examined retrospectively. Results: The mean age at the diagnosis was 64.3 ± 43 (4-204) months, the mean age at the beginning of infection was 29.5 ± 36 (1-168) months. There were 121 patients under the age of four years at the diagnosis time. The clinical presentations were recurrent bronchitis (40%), tonsillitis/ pharyngitis (33%), sinusitis (6%), pneumonia (4%), acute otitis media (2%), acute gastroenteritis (0.3%) and neck abscess (0.3%), respectively. Eosinophilia was present in 25% of patients, increased IgE levels was present in 38% of patients, and they were correlated with each other. Atopy was detected in 31% of patients by spesific IgE and/or skin prick test positivity. Allergic disease prevalance was found as %78 (60% asthma, 15% allergic rhinitis, 8% atopic dermatitis, 6% urticaria, 0.7% allergic conjunctivitis). During the clinical followup IgA levels reached to normal levels at 17 ± 14 months ranged between 3 and 60 months. Three patients with selective IgA deficiency had bronchiectasia. Conclusion: We found that allergic diseases were increased in these patients. Serum IgA level should be tested not only for recurrent infections but also for patients with allergic symptoms

Evaluation of Skin Prick Test Results Performed for the Diagnosis of Inhaled Allergens in Konya

Aims: We aimed to determine the distribution of inhaled allergens by evaluating the results of skin prick tests performed on patients with allergic complaints in Konya. Methods: The study included 2351 patients aged 2-18 years who underwent skin prick tests for the diagnosis of inhaled allergens at the Selçuk University Medical Faculty Pediatric Allergy and Immunology Outpatient Clinic between June 1, 2022 and May 31, 2023. Demographic characteristics and skin prick test results of 696 patients with sensitivity to at least one inhaled allergen were retrospectively evaluated. Results: Sensitivity to at least one inhaled allergen was detected in 696 (29.6%) of 2351 patients who underwent skin prick testing for allergic symptoms. The average age of patients with inhaled allergen sensitivity was 10.37 ± 4.14 years. 278 (39.9%) of the patients were girls and 418 (60.1%) were boys. Considering the distribution of inhaled allergens detected by skin prick test, the most frequent allergens were pollen allergens (78.2%), cat epithelium (38.8%) and dog epithelium (33.8%). The most common allergens detected in girls were pollen allergens (77.3%), cat epithelium (38.1%) and house dust mites (37.1%). The most common allergens detected in males were pollen allergens (78.7%), cat epithelium (39.2%) and dog epithelium (34.7%). When allergen sensitivities were evaluated according to gender, sensitivity to house dust mites was more common in girls than in boys. Sensitivity to pollen allergens was most frequently detected in all seasons. Statistically significant differences were detected between house dust mites, pollen allergens, rye, grass mix and cat epithelium sensitivities according to seasons. Conclusion: Our study shows the distribution of inhaled allergens in Konya province. Therefore, we assume that it can contribute to the implementation of environmental measures that can be taken to protect against allergens and thus to the treatment of patients

Clinical features and risk factors in children with acute asthma attack

Giriş: Çocukluk çağı kronik hastalıklarının en sık görüleni olan astım, morbiditesi, mortalitesi ve prevalansı artan bir hastalıktır. Akut astım atakları ise astımın mortalite ve morbiditesini belirleyen en önemli faktördür. Bu çalışmanın amacı; çocuklarda astım atağına neden olan risk faktörlerinin, astım ataklarının klinik özelliklerinin ve tedaviye yanıtın prospektif olarak belirlenmesidir. Hastalar ve Yöntem: Ocak 2008-Ocak 2009 tarihleri arasında kliniğimizde astım tanısıyla takipli ve astım atağı nedeniyle başvurmuş 40 çocuk hastanın klinik ve laboratuvar bulguları değerlendirildi. Bulgular: Çalışma grubunu oluşturan 40 çocuk hastanın 23ü erkek, 17si kız ve yaş ortalaması 7.8 1.9 yıl idi. Atağa neden olan en önemli risk faktörleri infeksiyon ve sigara dumanıyla temas; en sık yakınma ise öksürük olarak saptandı. Hastaların astım ataklarının şiddeti değerlendirildiğinde hafif atak 20 (%50) hastada, orta atak 18 (%45) hastada ve ağır atak 2 (%5) hastada mevcuttu. Astımlı hastalardan 24 (%60)ü oksijen tedavisi ve kısa etkili nebülize bronkodilatörle düzelirken, 16 (%40) hastaya sistemik steroid tedavisi uygulandı. Acil serviste uygulanan tedavi sonrası, 34 (%85) hasta evine gönderilirken, 4 (%10) hasta tedavi için yataklı çocuk servisine, 2 (%5) hasta ise yoğun bakım ünitesine yatırıldı. Sonuç: Akut astım atağına neden olabilecek risk faktörlerinin belirlenmesi, atak sıklığının ve şiddetinin azaltılmasında oldukça önemlidir. Bu nedenle, astımlı çocukların infeksiyonlardan korunmasının ve ev içi sigara dumanıyla temasın önlenmesi amacıyla aile eğitiminin çok önemli olduğu kanaatindeyiz.Objective: Asthma is one of the most common chronic diseases in childhood and has a high prevalence, morbidity and mortality. Acute asthma attacks are the most significant factor in the determination of the mortality and morbidity of asthma. The aim of this study was to evaluate the risk factors, clinical characteristics and the response of treatment of asthma attacks in children. Patients and Methods: Between January 2008 and January 2009, the clinical characteristics and laboratory findings of 40 children with asthma attack were evaluated. Results: Of 40 children consisting of the study group, 23 were boys and 17 were girls. Mean age was found to be 7.8 ± 1.9 years. While the most significant risk factors causing attacks were determi ned as infections and exposure to cigarette smoking, coughing was found as the most frequent symptom during attacks. The severity of the asthma attacks as follows: mild attacks in 20 (50%), moderate attacks in 18 (45%) and severe attacks in 2 (5%) of the patients, respectively. According to the severity of the attacks and response to the treatment, systemic steroid therapy was required in the treatment of 16 (40%) patients while 24 patients improved only with oxigen and short-acting bronchodilator. After the treatment in the emergency unit, 34 (85%) patients were discharged to home and 4 (10%) were hospitalized in the department of pediatrics and 2 (5%) into the intensive care unit. Conclusion: The determination of the risk factors of acute exacerbation is very important to reduce the frequency and the severity of the asthma attacks. We think that the education of the family is necessary to prevent the children with asthma from exposure to smoking and infections

Konya ili atmosferinde bulunan Alternaria ve Cladosporium sporları ve meteorolojik faktörlerle ilişkisi

Giriş: Bu çalışmanın amacı; Konya ili atmosferindeki Alternaria ve Cladosporium sporlarını etkileyen meteorolojik faktörleri (sıcaklık, nispi nem, rüzgar hızı, rüzgar yönü ve yağış miktarı) saptamaktır. Gereç ve Yöntem: Alternaria ve Cladosporium sporları 1 Ocak 2008-31 Aralık 2009 tarihleri arasında Burkard cihazıyla toplandı. Mikroskobik sayımlar atmos- ferik konsantrasyonlara çevrildi ve spor/m3 şeklinde ifade edildi. Bulgular: 2008-2009 yıllarında sırasıyla, 424 (%19.2) ve 3977 (%8.6) spor/m3 Alternaria sporu, 1784 (%80.8) ve 42.158 (%91.4) spor/m3 Cladosporium sporu tespit edildi. 2008 yılında Cladosporium konsantrasyonuyla günlük ortalama sıcaklık (r 0.181, p 0.045), maksimum sıcaklık (r 0.193, p 0.033) ve rüzgar hızı (r 0.242, p 0.007) arasında pozitif korelasyon; nispi nem (r -0.215, p 0.017) ile negatif korelasyon saptandı. 2009 yılında ise Alternaria ve Cladosporium spor konsantrasyonlarının, günlük ortalama sıcaklık (r 0.44, p 0.001; r 0.44, p 0.001), minimum sıcaklık (r 0.46, p 0.001; r 0.44, p 0.001) ve maksimum sıcaklık (r 0.40, p 0.001; r 0.43, p 0.001) ile pozitif ilişkili olduğu; nispi nem ile (r -0.29, p 0.001; r -0.37, p 0.001) negatif korelasyonu olduğu bulundu. Sonuç: Konya ili atmosferindeki Alternaria ve Cladosporium miktarı meteorolojik faktörlere göre değişiklik göstermektedir. Ayrıca, Cladosporiuma ait sporlar Alternaria sporlarından daha yoğun olarak tespit edilmiştir.Objective: The aim of this study was to determine the meteorological factors (temperature, relative humidity, wind speed, wind direction, rainfall) affecting Alternaria and Cladosporium spores in the atmosphere of Konya, Turkey. Materials and Methods: Measurement of Alternaria and Cladosporium spores were carried out between January 1st 2008 and December 31st 2009, with a Burkard Volumetric 7-Days Spore Trap. Microscope counts were converted into atmospheric concentrations and expressed as spore/m3. Results: While Alternaria spores were identified as 424 (19.2%) and 3977 (8.6%) spores/m3; Cladosporium spores were detected as 1784 (80.8%) and 42158 (91.4%) spores/m3 in 2008 and 2009 years, respectively. The daily concentrations of Cladosporium spore in 2008 were positively correlated with daily mean temperature (r 0.181, p 0.045), maximum temperature (r 0.193, p 0.033) and wind speed (r 0.242, p 0.007) and whereas they were negatively correlated with relative humidity (r -0.215, p 0.017). The daily concentra- tions of Alternaria and Cladosporium spore in 2009 were found to be positively correlated with the daily mean temperature (r 0.44, p> 0.001; r 0.44, p> 0.001), the minimum temperature (r 0.46, p> 0.001; r 0.44, p> 0.001) and the maximum temperature (r 0.40, p> 0.001; r 0.43, p> 0.001) whereas they were negatively correlated with the relative humidity (r -0.29, p> 0.001; r -0.37, p> 0.001), respectively. Conclusion: These findings showed that the concentrations of Alternaria and Cladosporium spores in Konya were affected from meteorological factors. Cladosporium spores were detected higher than Alternaria spores

Ischemia modified albumin levels in children with acute asthma attack

Giriş: Astımlı hastalar nonspesifik ajanlara maruz kaldıklarında akut astım atağı geçirebilmekte ve bu atağın şiddetine göre değişik oranlarda hipoksi gelişebilmektedir. İskemi modifiye albumin (IMA) özellikle miyokardiyal iskemi durumunda 6–10 dakika içerisinde hızla serumda yükselen bir belirteçtir. Diğer kardiyak iskemi belirteçlerinden (CK-MB, troponin-I, miyoglobin) en önemli farkı, henüz nekroz oluşmadan serumda yükselmesi, yani nekroz değil miyokardiyal iskemi göstergesi olmasıdır. Astım atağında IMA düzeylerinde değişiklik olup olmadığı ve atak şiddetinin belirlenmesinde IMA’nın bir belirteç olarak kullanılıp kullanılamayacağı bilinmemektedir. Gereç ve Yöntem: Bu çalışmaya astım atağı nedeniyle acil polikliniğimize başvuran 30 astımlı çocuk alındı. Bu hastalardan atak sırasında ve ataktan 14 gün sonra semptomsuz dönemde kan alınarak IMA düzeylerine bakıldı. Kontrol grubu olarak 20 sağlıklı çocuk çalışmaya dâhil edildi. Bulgular: Astımlı hastalarda astım atağı sırasında serum IMA düzeyi (0.510.16 Absorbans Ünitesi; ABSU) kontrol grubuna (0.390.12 ABSU) göre anlamlı derecede daha yüksekti (p0.03). Astımlı hastalarda serum IMA düzeylerine atak sonrasında semptomsuz dönemde bakıldığında ise (0.330.08 ABSU), kontrol grubu ile aralarında anlamlı bir fark olmadığı gözlendi (p0.076). Hastaların atakta ve atak sonrası semptomsuz dönemde IMA düzeyleri karşılaştırıldığında, atak sonrasında IMA düzeylerinde anlamlı olarak azalma olduğu tespit edildi (p0.001). IMA düzeyi ile atak şiddeti (p0.071), ve oksijen saturasyonu (p0.068) arasında herhangi bir ilişki olmadığı gözlendi. Sonuç: Bu çalışma akut astım atağı sırasında IMA düzeylerinin belirgin olarak yükseldiğini ve atak sonrasında normale döndüğünü göstermektedir.Introduction: When asthmatic patients are exposed to nonspecific agents, they may have acute asthma attacks and according to severity of this attack various levels of hypoxia may occur. Ischemia Modified Albumin (IMA) is a marker that increases fast in serum at 6-10 minutes especially in ischemia. The most important difference of IMA from the other cardiac markers (CK-MB, troponin-I, myoglobin) is that it increases early before necrosis, which means it is a marker of myocardial ischemia. It is not known whether IMA levels change during the asthma attack and also whether IMA can be used as a marker of asthma attacks severity or not. Material And Method: In this study 30 children admitted to emergency service with asthma attack were enrolled. The blood samples of these patients were taken at admission and symptom free period, 14 days after the asthma attack. The control group of 20 healthy children was included in the study. Results: IMA levels of the patients were found to be significantly higher (0.51±0.16 ABSU) than the control group (0.39±0.12 ABSU, p0.03). IMA levels after asthma attack (0.33±0.08 ABSU) were found to be similar with the control group (p0.076). We determined that the increased IMA levels during asthma attack decreased after the asthma attack (p0.001). There is no correlation between IMA levels and oxygen saturation and severity of attack. Conclusion: This study showed that IMA levels are significantly increase during asthma attack and return to normal levels after the attack in children with asthma