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    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-4338-2020
    Spontaneous 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.
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    Effect of Inspiratory Muscle Training in the Management of Patients With Asthma A Randomized Controlled Trial
    (2018) Duruturk, Neslihan; Acar, Manolya; Dogrul, Mustafa Ilgaz; 29652761; ACK-5152-2022; AAD-3908-2020
    Purpose: The aim of this study was to investigate the effects of inspiratory muscle training (IMT) on respiratory muscle strength, exercise capacity, dyspnea, fatigue, quality of life, and daily living activities of asthmatic patients. Methods: Thirty-eight asthmatic patients, between 18 and 65 years of age, were enrolled in the study and randomly divided into 2 groups; IMT (n = 20) or control (n = 18). Participants in the IMT group performed 30 breaths using a patient-specific threshold pressure device, twice daily for 6 wk at 50% maximal inspiratory pressure (MIP), in addition to "breathing training" during this period. Participants in the control group performed only the "breathing training" (sham or no threshold pressure device). Outcome measurements, performed before and after the intervention, included pulmonary function test, respiratory muscle strength, 6-min walk test, modified Medical Research Council dyspnea scale, St George's Respiratory Questionnaire, Fatigue Severity Scale, and London Chest Activity of Daily Living scale. Results: Among the outcomes in the study, changes to key variables including MIP (P < .01); MIP, percent predicted (P < .01); maximal expiratory pressure (MEP), percent predicted (P < .01); 6-min walk test walking distance (P = .001); modified Medical Research Council scale (P = < .001); Fatigue Severity Scale (P = .03); St George's Respiratory Questionnaire symptoms (P = .03); London Chest Activity of Daily Living domestic (P = .03); and London Chest Activity of Daily Living leisure (P = .01) were significantly different in favor of IMT versus control. Conclusion: These findings suggest that IMT may be an effective modality to enhance respiratory muscle strength, exercise capacity, quality of life, daily living activities, reduced perception of dyspnea, and fatigue in asthmatic patients.
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    Oxygen Saturation/Minute Heart Rate Index: Simple Lung Function Test for Children
    (2017) Ozdemir, Ali; Dogruel, Dilek; Yilmaz, Ozlem; 27377817
    BackgroundThe 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.
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    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; 35290751
    Objective: 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.
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    Evaluation of choroidal thickness in children with acute asthma attack by optical coherence tomography
    (2021) Kurultay, Isil; Sancakli, Ozlem; 34482738
    Objective: 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.
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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.