Psychiatric comorbidity in children with psychogenic and functional breathing disorders

Background The present study aims to assess psychiatric diagnoses in children with psychogenic and functional breathing disorders (PFBD), which consist of children with psychogenic cough, throat-clearing tics, and sighing dyspnea, and compare them to a control group without any diagnosis of chronic medical problems. Methods The participants consist of 52 children with PFBD and 42 children without any chronic medical problems. Psychiatric diagnoses were assessed via semistructured psychiatric interviews in both groups. Results The two groups did not differ on age (PFBD group 11.25 +/- 2.61, control group 11.17 +/- 2.58; t = 0.14, P = .88) or sex (48.1% of the PFBD group were female, 61.9% of the control group were female; chi(2) = 1.79, P = .18). 55.8% of the PFBD group and 28.6% of the control group had at least one psychiatric diagnosis according to the semistructured interviews (chi(2) = 6.99, P = .008). The most common psychiatric diagnoses in the PFBD group were attention deficit hyperactivity disorder (ADHD; 17.3%), tic disorders, (15.4%), and specific phobia (15.4%). 11.5% of the cases in the PFBD group were diagnosed with somatic symptom disorder and more than half of the patients (n = 27 (51.9%)) showed clinical characteristics of tic disorders. Conclusion Psychiatric diagnoses are common in children with PFBD, and teamwork involving child psychiatrists may be essential for the management of children with PFBD

Psychiatric comorbidity in children with psychogenic and functional breathing disorders

Background The present study aims to assess psychiatric diagnoses in children with psychogenic and functional breathing disorders (PFBD), which consist of children with psychogenic cough, throat-clearing tics, and sighing dyspnea, and compare them to a control group without any diagnosis of chronic medical problems. Methods The participants consist of 52 children with PFBD and 42 children without any chronic medical problems. Psychiatric diagnoses were assessed via semistructured psychiatric interviews in both groups. Results The two groups did not differ on age (PFBD group 11.25 +/- 2.61, control group 11.17 +/- 2.58; t = 0.14, P = .88) or sex (48.1% of the PFBD group were female, 61.9% of the control group were female; chi(2) = 1.79, P = .18). 55.8% of the PFBD group and 28.6% of the control group had at least one psychiatric diagnosis according to the semistructured interviews (chi(2) = 6.99, P = .008). The most common psychiatric diagnoses in the PFBD group were attention deficit hyperactivity disorder (ADHD; 17.3%), tic disorders, (15.4%), and specific phobia (15.4%). 11.5% of the cases in the PFBD group were diagnosed with somatic symptom disorder and more than half of the patients (n = 27 (51.9%)) showed clinical characteristics of tic disorders. Conclusion Psychiatric diagnoses are common in children with PFBD, and teamwork involving child psychiatrists may be essential for the management of children with PFBD

Human paraoxonase-1 activity in children with acute bronchiolitis

Human paraoksonaz-1 (PON1), oksidatif strese karşı çalışan endojen antioksidan moleküllerden biridir. Bu çalışmada akut bronşiolitli çocuklarda serum PON1 aktivitesini araştırmayı amaçladık. Akut bronşiyolitli 3-21 aylık 29 çocuk ile yaş uyumlu 35 sağlıklı kontrol çalışmaya dahil edildi. Bronşiolit hastaları hafif (% 65) ve orta (% 35) olarak sınıflandırıldı. Akut bronşiolitli hastalar ile kontrol grubu arasında PON1'in paraoksonaz ve arilesteraz aktiviteleri karşılaştırıldı. Akut bronşiyolitli çocukların paraoksonaz aktivitesi sağlıklı kontrollere göre daha düşüktü, ancak fark anlamlı değildi (127.53 ± 64.17 U / L'ye karşı 153.95 ± 74.40 U / L) (p = 0.13). Hafif ve orta derecede bronşiyolitli çocuklarda arilesteraz aktivitesi kontrol grubuna göre anlamlı olarak daha azdı (142.43 ± 56.60 kU / L ve 103.05 ± 26.03 kU / L'ye karşılık 201.09 ± 57.26 kU / L) (p <0.001). Akut bronşiolitli çocuklarda serum PON1 aktivitesi kontrol grubuna göre daha düşüktü. Antioksidan kapasitenin arttırılması, viral kaynaklı akciğer hastalığında etkili bir tedavi aracı olabilir.Human paraoxonase-1 (PON1) is one of the endogenous antioxidant molecules working against oxidative stress. We aimed to investigate serum PON1 activity in children with acute bronchiolitis. A total of 29 children aged between 3-21 months with acute bronchiolitis and 35 age-matched healthy controls were included in the study. Bronchiolitis patients were further classified as mild (65%) and moderate (35%). Paraoxonase and arylesterase activities of PON1 were compared between patients with acute bronchiolitis and the control group. Paraoxonase activity of children with acute bronchiolitis was lower than healthy controls but the difference was not significant (127.53 ± 64.17 U/L versus 153.95 ± 74.40 U/L) (p=0.13). Arylesterase activity was significantly decreased in children with mild and moderate bronchiolitis in comparison to the control group (142.43± 56.60 kU/L and 103.70± 26.03 kU/L versus 201.09± 57.26 kU/L) (p<0.001). Serum PON1 activity was lower in children with acute bronchiolitis compared to controls. Increasing antioxidant capacity may be an effective means of therapy in viral induced lung disease

Hematological Indices for Differential Diagnosis of Beta Thalassemia Trait and Iron Deficiency Anemia

Background. The two most frequent types of microcytic anemia are beta thalassemia trait (β-TT) and iron deficiency anemia (IDA). We retrospectively evaluated the reliability of various indices for differential diagnosis of microcytosis and β-TT in the same patient groups. Methods. A total of 290 carefully selected children aged 1.1–16 years were evaluated. We calculated 12 discrimination indices in all patients with hemoglobin (Hb) values of 8.7–11.4 g/dL. None of the subjects had a combined case of IDA and β-TT. All children with IDA received oral iron for 16 weeks, and HbA2 screening was performed after iron therapy. The patient groups were evaluated according to red blood cell (RBC) count; red blood distribution width index; the Mentzer, Shine and Lal, England and Fraser, Srivastava and Bevington, Green and King, Ricerca, Sirdah, and Ehsani indices; mean density of hemoglobin/liter of blood; and mean cell density of hemoglobin. Results. The Mentzer index was the most reliable index, as it had the highest sensitivity (98.7%), specificity (82.3%), and Youden’s index (81%) for detecting β-TT; this was followed by the Ehsani index (94.8%, 73.5%, and 68.3%, resp.) and RBC count (94.8%, 70.5%, and 65.3%). Conclusion. The Mentzer index provided the highest reliabilities for differentiating β-TT from IDA

Relationships between bronchoscopy, microbiology, and radiology in noncystic fibrosis bronchiectasis

Background: Published data on the correlations of bronchoscopy findings with microbiological, radiological, and pulmonary function test results in children with noncystic fibrosis (CF) bronchiectasis (BE) are unavailable. The aims of this study were to evaluate relationships between Bronchoscopic appearance and secretion scoring, microbiological growth, radiological severity level, and pulmonary function tests in patients with non-CF BE. Methods: Children with non-CF BE were identified and collected over a 6-year period. Their medical charts and radiologic and bronchoscopic notes were retrospectively reviewed. Results: The study population consisted of 54 female and 49 male patients with a mean age of 11.7 ± 3.4 years. In the classification according to the bronchoscopic secretion score, Grade I was found in 2, Grade II in 4, Grade III in 9, Grade IV in 17, Grade V in 25, and Grade VI in 46 patients. When evaluated according to the Bhalla scoring system, 45 patients had mild BE, 37 had moderate BE, and 21 had severe BE. Microbial growth was detected in bronchoalveolar lavage fluid from 50 of the patients. Forced expiratory volume in 1 s (FEV1) and functional vital capacity decreased with increasing bronchoscopic secretion grade (P = 0.048 and P = 0.04), respectively. The degree of radiological severity increased in parallel with the bronchoscopic secretion score (P = 0.007). However, no relationship was detected between microbiological growth rate and radiological findings (P = 0.403). Conclusions: This study showed that bronchoscopic evaluation and especially scoring of secretions correlate with severe clinical condition, decrease in pulmonary function test, worsening in radiology scores, and increase in microbiological bacterial load in patients. Flexible endoscopic bronchoscopy should be kept in mind in the initial evaluation of non-CF BE patients

Audiological findings in pediatric perineal allergic rhinitis (house dust mite allergy) patients

Allergic rhinitis is the type 1 hypersensitivity reaction of the nasal mucosa and its primary mediator is Ig E. It is most frequently observed in children and adolescents. Our purpose in this study is to investigate the impact of allergy on hearing functions in children with perineal allergic rhinitis (house dust mite allergy). 50 perineal allergic rhinitis (house dust mite allergy) patients (33 male, 17 female patients, aged between 6 and 15, average age 10.4) and 20 control patients (12 male, 8 female, aged between 6 and 15, average age 11.2) underwent high frequency pure tone audiometry, acoustic reflex, otacoustic emission (OAE) and auditory brainstem potentials to assess their auditory functions. No statistically significant difference was detected between the study group and the control group with respect to their hearing thresholds (250–16,000 Hz). No statistically significant difference was detected as a result of the comparison between the study group and control group in terms of their signal– noise ratios at Distortion Product OAE in all frequencies (996–8,004 Hz). No statistically significant difference was detected between the study group and the control group in terms of the 1st, 3rd and 5th wave latencies and 1–3, 3–5 and 1–5 inter-peak values. This study is the first study where the audiological functions of the pediatric perineal allergic rhinitis (house dust mite allergy) patients were assessed. No significant difference was detected between the group of pediatric perineal allergic rhinitis (house dust mite allergy) patients and th