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    Which has an Influence on Mean Platelet Volume: Allergic Rhinitis or Asthma?
    (2022) Senol, Handan Duman; Ozdogru, Emine Ece; Sancakli, Ozlem; Dogru, Mahmut; Tuncel, Tuba
    Aim: 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.
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    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; 35383020
    Objective: 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.
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    The effects of maternal anxiety and attitudes on the adherence to inhaled corticosteroids in children with asthma
    (2021) Sancakli, Ozlem; Aslan, Asli Akin; 33938199
    Objective: 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.
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    Effect of Inhaled Corticosteroid Treatment on Body Composition Parameters in Children with Asthma
    (2021) Koksal, Burcu Tahire; Yilmaz Ozbek, Ozlem
    Objective: 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.
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    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; 32049442
    Objectives 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.