Open-label, randomized study of Amoxicillin, Azithromycin, and Cefprozil in Childhood Sinusitis

Aim: There are many antibiotics used in acute sinusitis in paediatric practice. We planned this study to contribute rational antibacterial treatment considering the clinical efficiency, side effects and cost of the treatment. Materials and methods: Our study was a prospective, randomized and open label study in children. Patients diagnosed as having acute sinusitis based on the major and minor clinical diagnostic criteria were randomized to receive 14 days of amoxicillin (40 mg/kg/day, in 3 doses), 5 days of azithromycin (10 mg/kg/day, single dose for first 3 days and 5 mg/kg/day-single dose for 2 days) and 14 days of cefprozil (30 mg/kg/day, 2 doses). Results: Of a total of 151 patients who were between the ages of5 and 14 years (mean: 8.33±2.82 standard error), 50 patients received amoxicillin, 52 azitromycin and 49 cefprozil. At the end of the treatment improvement rates were 72 %,80.7 %, and 69.3 % respectively (p>0.05). The occurrence rates of adverse effects were 8 %, 7 %, and 10 % in these groups respectively (p > 0.05). Conclusion: We emphasize that clinicians should prefer appropriate antibiotics for acute sinusitis in children, in regard to the parameters of low cost, high compliance and minimum adverse effects.peer-reviewe

Growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula in infants with cow’s milk protein allergy

ObjectiveTo evaluate growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula (eHCF) in infants with cow’s milk protein allergy (CMPA).MethodsA total of 226 infants (mean ± SD age: 106.5 ± 39.5 days, 52.7% were girls) with CMPA who received eHCF comprising at least half of the daily dietary intake were included. Data on anthropometrics [weight for age (WFA), length for age (LFA) and weight for length (WFL) z-scores] were recorded at baseline (visit 1), while data on infant feeding and stool records, anthropometrics and Infant Feeding and Stool Patterns and Formula Satisfaction Questionnaires were recorded at visit 2 (on Days 15 ± 5) and visit 3 (on Days 30 ± 5).ResultsFrom baseline to visit 2 and visit 3, WFA z-scores (from −0.60 ± 1.13 to −0.54 ± 1.09 at visit 2, and to −0.44 ± 1.05 at visit 3, p < 0.001) and WFL z-scores (from −0.80 ± 1.30 to −0.71 ± 1.22 at visit 2, and to −0.64 ± 1.13 at visit 3, p = 0.002) were significantly increased. At least half of infants never experienced irritability or feeding refusal (55.7%) and spit-up after feeding (50.2%). The majority of mothers were satisfied with the study formula (93.2%), and wished to continue using it (92.2%).ConclusionsIn conclusion, eHCF was well-accepted and tolerated by an intended use population of infants  ≤ 6 months of age with CMPA and enabled adequate volume consumption and improved growth indices within 30 days of utilization alongside a favorable gastrointestinal tolerance and a high level of parental satisfaction

The peripheral blood inflammatory patterns in the control levels of asthma in children

Objective: Asthma is the most common chronic inflammatory disease of childhood, but there are no useful and easily accessible laboratory tests routinely used in the diagnosis and follow-up of this disease in children. Therefore, this study aimed to investigate the roles of white blood cell (WBC) count, platelet count, mean platelet volume (MPV), and eosinophil percentage as full blood count inflammatory markers in evaluating the control level and follow-up of asthma in the pediatric age group. Methods: A retrospective review of patient records and files of 3,580 patients diagnosed with asthma at the University of Health Sciences in Ankara, Turkey was performed. Patients who met inclusion/exclusion criteria were divided into two groups based on the asthma control level: controlled and uncontrolled. Laboratory data were compared according to the asthma control levels, drug use status, and atopy status of the patients. Results: A total of 348 patients between 4 and 18 years of age, who were followed-up with the diagnosis of asthma, were included in this study. A significant difference was found between the controlled and uncontrolled groups of asthma patients in terms of the eosinophil percentage (mean +/- SD, respectively; 3.493 +/- 2.24; 4.992 +/- 3.43; p = .003). When patients were grouped according to their asthma control levels and atopy status, only the eosinophil percentages were different in the logistic regression analysis (odds ratio = 1.276, 95% confidence interval = 1.113-1.462). Conclusion: Our study showed that the percentage of eosinophils can be used as an asthma control parameter, but additional prospective studies would be desirable to confirm our results

Is There a Need for Repetition of Skin Test in Childhood Allergic Diseases? Repetition of Skin Test and Allergic Diseases

Background: Skin prick tests are widely used to determine sensitivity in allergic diseases. There is limited information about the natural history of skin sensitization tests and factors that affect them. It was aimed to determine the changes in skin test results and the factors affecting the reactivity of skin tests after a period of approximately four years in children with allergic disease. Methods: SPT of 170 patients among 2485 children with asthma and/or allergic rhinitis and/or atopic dermatitis, who underwent SPT between 2005 and 2007, were repeated after an interval of at least 3 years. Results: The mean age was 10.7±3.1 (5-18) years and 70% of the patients were male. In total 66 (39.0% of the study population) had a different skin tests result in follow-up. Alterations: loss of sensitivity in 18 (11%) patients, the formation of a new sensitivity in 37 (22%) patients, and 11 (6%) both gained and lost sensitization. The presence of atopy in the family, the presence of allergic rhinitis and IgE elevation significantly predicted the incidence of new sensitization. The presence of sensitization to multiple allergens significantly predicted the incidence of loss of sensitization. Conclusions: It is found that there was an alteration of sensitization in 4/10 children at the end of the average 4-year period. The presence of family atopy, the presence of allergic rhinitis and serum total IgE elevation were risk factors for the development of new sensitization. On the other hand sensitization to multiple allergens was risk factors for the loss of sensitization

Insulin sensitivity obtained from the oral glucose tolerance test and its relationship with birthweight

Background: Glucose intolerance and insulin sensitivity in preadolescent children might predict the risk of developing type 2 diabetes mellitus in adult life in small for gestational age (SGA) children. We aimed to investi-gate whether reduced birthweight is related to low insulin sensitivity in preadolescence. Subjects and Methods: Twenty-five SGA children and 29 appropriate for gestational age children (AGA) children born between 1993 and 1994 were evaluated for insulin sensitivity in preadolescence. At the beginning of the study, body mass index (BMI) was calculated and an oral glucose tolerance test (OGTT) was performed. Blood samples to measure glucose and insulin were taken every 30 minutes during OGTT. Homeostasis of model assessment-insulin resistance (HOMA-IR) and composite index (CI) values were measured to assess insulin sen-sitivity. Results: On the OGTT, 120-minute glucose and insulin levels were higher in SGA than AGA children ( P =0.02 and P =0.001, respectively). Although there was no difference between HOMA-IR values, the mean CI value was lower in SGA than AGA children ( P =0.001). There was an inverse correlation between birthweight and 120-min-ute glucose concentrations (r=-0.30, P =0.02). This correlation was stronger between birthweight and 120-min-ute insulin concentrations (r=-0.50, P =0.001). BMI was positively correlated with 120-minute insulin (r=0.50, P =0.001). There was no relationship between HOMA-IR values and birth size, but the CI index was positively correlated with birthweight (r=0.40, P =0.002). Conclusions: Birthweight may be a predictive factor for insulin sensitivity and CI is more reliable than HOMA-IR to assess this sensitivity in preadolescence

Does activity held on World Asthma Day have an impact on the asthma knowledge and awareness of family physicians?

OBJECTIVE: Annually, certain activities are performed on World Asthma Day (WAD) for the awareness of both patients and physicians about asthma. The study aimed to observe the effects of asthma education on the skills and knowledge of family physicians on WAD, which basically includes updated information of the international asthma guideline. MATERIALS AND METHODS: Our quasi-experimental study was started on May 3, 2016, WAD. Education was provided by the Global Initiative for Asthma, 2016. A questionnaire including 25 questions was applied for family physicians before and 6 months after the education. RESULTS: In the investigation of 32 family physicians, 62.5% were women, with 32.6 ± 26.0 months in family physician practice. 59.4% of the family physicians had received education about asthma in their postgraduate period. Twenty-five percent of the participants were using asthma guidelines in their daily practice. In pre- and posteducation, the percentage of accuracy in the tests was 58.4%–77.6% among specialists and 62.3%–75.9% among trainees of family physicians. The percentage levels of accuracy developed in the questions of focusing asthma treatment and correct inhaler medication use after the education program were 62.5%–93.8% (P = 0.002) and 56.2%–90.6% (P = 0.007), respectively. CONCLUSIONS: Our study revealed that family physicians did not have a tendency to use guidelines for asthma diagnosis and treatment. With the aid of the education program, their attitude changed positively. We believe that family asthma physicians should also be trained in “WAD” activities