Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Spontaneos Pneumomediastinum After Persistent Cough in Asthmatic Patient: Case Report(2014) Kocak, Nagihan Durmus; Eyuboglu, Fusun Oner; 0000-0003-4028-2797; 0000-0002-5525-8207; AFM-4219-2022; AAR-4338-2020Spontaneous pneumomediastinum (SPM) is a clinical condition that is characterized by the presence of free air in the mediastinal space that is unrelated to trauma or medical procedure. Although SPM is a rare and generally benign condition, during the period of the status, life threatening complications can result such as tension pneumothorax, tension pneumomediastinum, pneumopericardium or acute upper airway obstruction. The patient who had persistent cough for a week and known asthma disease referred to the hospital with complaints of chest pain, dyspnea, and neck pain. Subcutaneous crepitation on the neck was the only pathological finding on physical examination. SPM and subcutaneous emphysema was detected on computed tomography of the chest. The patient was hospitalized with diagnosis of asthma, SPM and subcutaneous emphysema and discharged after 72 hours of hospital admission with successfully treated conservatively. We report this case because of this clinic condition is rare and serious complications may occur. In patients who have chest or neck pain, SPM must be in differential diagnosis when there are precipitating factors such as asthma attack or severe cough.Item Oxygen Saturation/Minute Heart Rate Index: Simple Lung Function Test for Children(2017) Ozdemir, Ali; Dogruel, Dilek; Yilmaz, Ozlem; 27377817BackgroundThe severity of airway obstruction can be accurately determined on spirometry in children with asthma. Other assessments may include peak expiratory flow and pulse oximetry. In the present study, we evaluated the validity and reliability of oxygen saturation/minute heart rate (SpO(2)/MHR) index in the prediction of degree of severe airway obstruction in children with asthma. MethodsThis was a retrospective study of children aged 7-17 followed for asthma at Mersin Women and Children's Hospital. The study compared SpO(2)/MHR ratio with forced expiratory volume in 1 s (FEV1) measured on spirometry, an important indicator of small airway obstruction. A total of 296 patients were included in the study, and classified either as having normal FEV1 (FEV1 > 80% of predicted, n = 178) or severely reduced FEV1 (FEV1 < 60% of predicted, n = 118). Positive and negative predictive values (PPV and NPV), sensitivity and specificity of SpO(2)/MHR index in predicting low FEV1 were calculated on receiver operating characteristics analysis. ResultsAn SpO(2)/MHR ratio cut-off <0.90 was associated with a PPV of 83.14%, NPV of 71.77%, sensitivity of 80.34% and specificity of 75.42% in predicting low FEV1. ConclusionsSpO(2)/MHR ratio appears to be a highly useful index to assess airway obstruction in older children with asthma. Thus, it can be used as a marker of airway obstruction severity when spirometry is not available.Item Which has an Influence on Mean Platelet Volume: Allergic Rhinitis or Asthma?(2022) Senol, Handan Duman; Ozdogru, Emine Ece; Sancakli, Ozlem; Dogru, Mahmut; Tuncel, TubaAim: Bronchial asthma and allergic rhinitis are mediated by similar allergic inflammatory mechanisms. Platelets play a role in allergic reactions which are inflammatory processes. The mean platelet volume (MPV) is a marker of platelet activation. This study aimed to investigate MPV value differences between children with allergic rhinitis during symptomatic or asymptomatic periods to determine whether MPV is a useful indicator of inflammation in allergic rhinitis. Materials and Methods: The records of those patients with allergic rhinitis were analyzed retrospectively. Patients over two years of age who had complete blood count results from both their asymptomatic and the symptomatic periods were included in this study. Clinical characteristics (age, age at diagnosis, symptoms, and comorbid allergic diseases) and laboratory data (thrombocyte count, MPV, white blood cell count, eosinophil count, and percentage, immunoglobulin E level, and skin prick test results) were recorded from the patient files and the hospital registry system. Results: MPV values during the symptomatic periods were statistically significantly higher than those from the asymptomatic period (p<0.001) in all patients. When the patients were grouped according to having asthma or not, MPV was found to be higher in the symptomatic period compared to the asymptomatic period in the group with asthma, but there was no difference between these two periods in the group without asthma (p=0.017, p=0.102 respectively). Additionally, MPV levels were significantly higher in the asthma group during both the symptomatic and the asymptomatic periods (p=0.04, p=0.013, respectively). Conclusion: This study suggests that MPV cannot be used as an inflammation indicator in the symptomatic period for patients with allergic rhinitis. Asthma influences MPV values. It is recommended to conduct more detailed and prospective studies to show MPV inflammation in AR.Item Anxiety Levels and Changes in Health and Hygiene Behaviors in Mothers of Children with Asthma in Early COVID-19 Lockdown in Turkey(2022) Sancakli, Ozlem; Tuncel, Tuba; Eren Akarcan, Sanem; Kanik, Ali; Ozyurt, Gonca; Ozdogru, Emine Ece; 35290751Objective: The restrictions imposed by the coronavirus disease 2019 (COVID-19) pandemic have caused significant changes in people's lives. This study aimed to investigate anxiety levels and changes in health and hygiene behaviors in mothers of children with asthma in early COVID-19 lockdown in Turkey.Materials and Methods: This study was a cross-sectional survey conducted on children with asthma, 6 to 11 years of age, between June 1 and 30, 2020, in Turkey. A sociodemographic data form, health and hygiene behavior form, childhood asthma control test, and state-trait anxiety inventory were administered to the mothers of the children.Results: The asthma group included 123 children (Female: 39.0%) and median age, interquartile range (IQR) [minimum-maximum]: 8.0 (6) [6-12] years; the control group included 88 children (Female: 47.7%) median age, IQR [minimum-maximum]: 8.0 (7) [5-12] years. Increased hygiene behaviors and high compliance with social isolation measures were recorded in the early lockdown, with no difference between the groups. Before the pandemic, the most frequently used cleaning products were general-purpose cleaners. During the early lockdown, however, the most frequently used product was disinfectants and was similar in both groups.In both groups, the rate of using nutritional supplements increased during the pandemic period, but the rate was higher in children with asthma both before and during the early lockdown (P < 0.001). The anxiety levels of the mothers in asthma and control groups were similar.Conclusion: This study is the first in Turkey demonstrating that, in mothers of children with asthma, lifestyle changes related to health and hygiene and anxiety levels are similar to those of other children and their mothers during the early lockdown period of COVID-19 pandemic.Item Evaluation of the Impact of Environmental Changes on Asthma Control in Children, Access to Health Care, and Treatment Adherence in Early COVID-19 Lockdown(2022) Sancakli, Ozlem; Tuncel, Tuba; Akarcan, Sanem Eren; Kanik, Ali; Ozyurt, Gonca; 35383020Objective: During the coronavirus disease 2019 pandemic, lockdown measures and difficulties in accessing healthcare have impacted asthma management in children. This study aimed to determine the evaluation of the impact of environmental changes on asthma control in children, access to health care, and treatment adherence in early coronavirus disease 2019 lockdown. Materials and Methods: The study included children with asthma aged 6-11 years. A survey form was administered to the patients who visited the pediatric allergy outpatient clinic between June 1 and 30, 2020. The survey acquired demographic information about the children and their families as well as information about their asthma symptoms, how they reached healthcare services, and adherence. The childhood asthma control test was administered. The P values < .05 were considered significant. Results: The study included a total of 123 children (female/male : 48/75) with a mean age of 8.4 +/- 1.9 years. According to the mothers' self-report, it was found that 78% of the patients were not able to follow-up routinely, 19.5% were non-adherence to treatment, and 16.2% were poorly controlled asthma. It was found that, based on childhood asthma control test scores, asthma control was better during the pandemic lockdown period (P = .001). Asthma symptoms were better in 41.5% of the patients compared to the previous months and in 53.7% compared to the same period last year. Conclusion: Our study found that the children's asthma was controlled although most of them did not have their follow-up visits, and poorly controlled asthma was higher in older children in early coronavirus disease 2019 lockdown.Item The effects of maternal anxiety and attitudes on the adherence to inhaled corticosteroids in children with asthma(2021) Sancakli, Ozlem; Aslan, Asli Akin; 33938199Objective: Long-term inhaled corticosteroid (ICS) use in children with asthma causes serious concerns in parents, leading to treatment non-adherence. This study aimed to investigate the effect of maternal anxiety and attitudes on adherence to ICS therapy in children with asthma. Method: The patient group included the children with mild to moderate persistent asthma, aged 6-11 years. Healthy children in a similar age range were included as a control group. The patient group was divided into two categories (treatment adherent and non-adherent) according to the regularity of ICS use. All patients were assessed with Childhood-Asthma Control Test (C-ACT), and their mothers were assessed using Parent Attitude Research Instrument (PARI) and Beck's Anxiety Inventory (BAI). Results: A total of 156 children (age: 7.4 +/- 1.4 years, F/M: 71/85) with persistent asthma and 60 healthy children (age: 7.5 +/- 1.3 years, F/M:25/35) were included in the study. The rate of adherence in children with asthma was 52.6%. Mothers of non-adherent patients had significantly higher BAI scores than those of the adherent patients and controls (p < 0.001 and p < 0.001, respectively). The number of mothers who indicated that they did not have enough information about asthma and treatment was also higher in the non-adherent group. PARI subtest scores were not different between the adherent and non-adherent groups. Conclusions: In our study, it was found that mothers' anxiety levels and their knowledge about asthma and medications were associated with treatment adherence in children with asthma. Psychological and educational support to the families of children with asthma would improve their treatment adherence and efficacy. (C) 2021 Codon Publications. Published by Codon Publications.Item Evaluation of choroidal thickness in children with acute asthma attack by optical coherence tomography(2021) Kurultay, Isil; Sancakli, Ozlem; 34482738Objective: To evaluate the change in central choroidal thickness in children with asthma attack before and after treatment with beta(2) agonists. Materials and methods: About 100 eyes of 50 patients (5-17 years old) with visual acuity of 20/20 who had no retinal, choroidal, and systemic comorbidity were examined by enhanced depth optical coherence tomography (EDI-OCT) before and after asthma attack treatment. Sixty eyes of 30 healthy children of similar age and gender were evaluated as the control group. The central choroidal thickness, peak expiratory flow (PEF), forced expiratory volume 1(FEV1), oxygen saturation, and heart rate were evaluated. Results: The mean age of the patients was 9.2 +/- 3.1 years, and the mean saturation values of patients was 97.2 +/- 1.3 before treatment, and it increased to 98.3 +/- 0.9 after treatment with a statistically significant difference. The mean FEV1 values were 80.8 +/- 15.2 before, and 92.7 +/- 12.9 after the treatment and PEF values were 75.9 +/- 18.6 before and 89.3 +/- 18.9 after treatment. This differences were statistically significant (p < 0.001). The average choroidal thickness before the treatment were 310.4 +/- 34.2 mu m and decreased to 302.7 +/- 34.4 mu m after the treatment, this decrease was statistically significant (p < 0.001). The mean choroidal thickness of the control group was 303.0 +/- 7.3 mu m and compared to the pre-treatment and post-treatment values, it was more similar to the post-treatment values, although there was no statistically difference. Conclusion: In our study, it was shown that choroidal thickness was significantly reduced in children with asthma who received attack treatment with beta(2) agonists, and it was similar to the control group after the treatment.Item Effect of Inhaled Corticosteroid Treatment on Body Composition Parameters in Children with Asthma(2021) Koksal, Burcu Tahire; Yilmaz Ozbek, OzlemObjective: Prolonged treatment with low doses of inhaled corticosteroids may affect the growth rate; however, limited data are currently available for body composition parameters in children with asthma. We examined whether treatment with inhaled corticosteroids has an effect on body mass index, basal metabolic rate, percentage body fat, obesity degree, fat mass, and muscle mass in children with mild asthma. Materials and Methods: The study was performed in 45 children with mild persistent asthma being treated with inhaled corticosteroids and 45 healthy controls. Body composition parameters; body mass index, percentage body fat, obesity degree, basal metabolic rate, body fat mass, muscle mass, and waist-hip circumferences were measured. Written questionnaires including duration of television/computer viewing, frequency of fast food consumption, and weekly physical activity were completed. Results: There was no difference in body composition parameters and waist-hip circumference measurements between the groups. A positive correlation was demonstrated between the duration of inhaled corticosteroid treatment and the percentage of body fat, muscle mass, fat mass, and hip circumference. When compared with healthy controls, a significant increase in the duration of television/ computer viewing and frequency of fast food consumption and a significant decrease in weekly physical activity were observed in children with asthma. Conclusion: Body composition parameters seem not to be affected in the inhaled steroid-using children with asthma. However, as the duration of inhaled corticosteroid treatment increased, the percentage of body fat, body fat mass, and hip circumference also increased. Children with asthma should be encouraged to increase physical activity and be recommended to decrease the duration of television/computer viewing.Item Postinfectious bronchiolitis obliterans masked by misdiagnosis as asthma(2020) Onay, Zeynep R.; Gursoy, Tugba Ramasli; Aslan, Ayse T.; Eyuboglu, Tugba Sismanlar; Kibar, Busra S.; Pekcan, Sevgi; Hangul, Melih; Kose, Mehmet; Budakoglu, Isil I.; Gokturk, Bahar; 32049442Objectives Asthma and postinfectious bronchiolitis obliterans (PIBO) have similar clinical findings, and PIBO may be misdiagnosed with asthma. This study aimed to determine the clinical features of PIBO in children and the causes of delay in its diagnosis. Methods We retrospectively evaluated all patients diagnosed with PIBO in four pediatric pulmonology centers between 2007 and 2018. In total, 64 PIBO patients were retrospectively reviewed. We compared the clinical and laboratory differences between PIBO patients who had initially been misdiagnosed with asthma and correctly diagnosed with PIBO. Results Of the 64 patients, 22 (34.4%) had initially been misdiagnosed with asthma. Adenovirus was the most common infectious agent in children. The age upon diagnosis was older, and the symptom duration was significantly longer in patients misdiagnosed with asthma (P < .05). There were no statistical differences in terms of sex, history of prematurity, duration of hospitalization, treatment, history of oxygen or mechanical ventilation support, pulmonary function test (PFT) results and asthma-predisposing findings between the two groups (P > .05). Conclusions Patients with PIBO who had initially been misdiagnosed with asthma were correctly diagnosed at older ages and had longer symptom duration. Asthma may mask PIBO diagnosis by the similarity of symptoms and the clinical response to inhaled beta 2-agonist or steroid treatment. PFTs may not help clinicians because of the age of children. The delay in the diagnosis of PIBO is probably attributable to the fact that some clinicians fail to include PIBO in the differential diagnosis when there is no clinical response to asthma medication.