Erdem Topal

Metabolic disorders in Turkish children with urolithiasis.

OBJECTIVEnTo review metabolic disorders in Turkish children with urinary tract stone disease.nnnMATERIALS AND METHODSnThe medical records of 308 pediatric patients with the diagnosis of urolithiasis between 1996 and 2008, whose disease progression was followed in a single tertiary-care center, were reviewed retrospectively. Two hundred forty-eight patients whose metabolic analyses were performed were included in the study.nnnRESULTSnOf the 248 patients participating in the study, 142 (57%) were men and 106 (43%) were women. The median age of the patients was 48xa0months (minimum-maximum, 2-180 months). Seventy-six percent of the patients had metabolic disorders. Of all patients, 44% had 1, 23% had 2, and 7% had 3 metabolic disorders. Hypercalciuria, hypocitraturia, hyperoxaluria, hyperuricosuria, and cystinuria were detected in 41%, 39%, 22%, 9%, and 4% of the patients, respectively. The rate of multiple stone formation, infection, and recurrence was significantly higher in the 0-2 years age group (Pxa0= .030, Pxa0= .001, Pxa0= .019, respectively). The median age of patients was greater (Pxa0= .001) in patients with hyperoxaluria in comparison with other metabolic disorders. Compared with other metabolic disorders, multiple stones and recurrence were more frequent in patients with cystinuria (Pxa0= .022 and Pxa0= .008, respectively). The size of the stones was greater in patients with hyperuricosuria in comparison with other metabolic disorders (Pxa0= .009).nnnCONCLUSIONnThe majority of children with urinary tract stone disease exhibitedxa0≥1 metabolic risk factors. Metabolic risk factors should be evaluated in all children with urinary stone disease to provide appropriate treatment.

Psychiatric disorders and symptoms severity in pre-school children with cow's milk allergy.

BACKGROUNDnPsychiatric disorders are seen frequently in atopic diseases. The present study aims to evaluate the frequency of psychiatric disorders and the severity of psychiatric symptoms in pre-school children with cows milk allergy.nnnMETHODSnThe parents of the pre-school children with cows milk allergy were interviewed in person and asked to fill out the Early Childhood Inventory-4 form.nnnRESULTSnThe cows milk allergy group included 40 children (27 male, 13 female) with mean age, 44.5±14.7 months, and the control group included 41 children (25 male, 16 female) with mean age, 47.6±15.2 months. It was established that 65% of the group with cows milk allergy received at least one psychiatric diagnosis, while 36.6% of the control group received at least one psychiatric diagnosis, with a statistically significant difference (p=0.02). Within the psychiatric disorders, attention deficit hyperactivity disorders (odds ratio: 4.9, 95% CI: 1.472-16.856, p=0.006), oppositional defiant disorder (odds ratio: 5.6, 95% CI: 1.139-28.128, p=0.026), and attachment disorder (odds ratio: 4.8, 95% CI: 1.747-13.506, p=0.004) were found significantly higher compared with the healthy control group. When the groups were compared in terms of psychiatric symptom severity scores, calculated by using the Early Childhood Inventory-4 form, attention deficit hyperactivity disorders severity (p=0.006) and oppositional defiant disorder severity (p=0.037) were found to be higher in the cows milk allergy group.nnnCONCLUSIONnPsychiatric disorders are frequent and severe in pre-school children with cows milk allergy.

Relationship between hypogammaglobulinemia and severity of atopic dermatitis

BACKGROUNDnAtopic dermatitis is an itchy, inflammatory, chronic, or chronically relapsing skin disease. The disease occurs in people who have an atopic tendency or may appear as a clinical sign of primary immunodeficiency.nnnOBJECTIVESnTo determine the relation between severity of atopic dermatitis and hypogammaglobulinemia.nnnMETHODSnOne hundred sixty pediatric patients with atopic dermatitis (98 boys and 62 girls, 1-60 months old, median age 14.5 months) and 95 healthy children (57 boys and 38 girls, median age 16 months; control group) were included in the study. In patients with atopic dermatitis, the severity of disease was determined by the SCORing Atopic Dermatitis index. Serum immunoglobulin levels of all patients and children in the control group were measured by nephelometry on admission.nnnRESULTSnThe incidence of hypogammaglobulinemia was higher in patients with atopic dermatitis than in the control group (Pxa0= .009). The main reason for this difference was the low level of IgG in the atopic dermatitis group (Pxa0= .024). Analysis of the relation between hypogammaglobulinemia and the severity ofxa0atopic dermatitis showed no statistically significant difference between the group with mild to moderate atopic dermatitis and the group with severe atopic dermatitis with respect to hypogammaglobulinemia (Pxa0=xa0.859), IgG (Pxa0= .068), IgA (Pxa0= .410), and IgM (Pxa0= .776) values.nnnCONCLUSIONnHypogammaglobulinemia was more frequent in patients with atopic dermatitis compared with the control group, mostly owing to the low IgG level. Hypogammaglobulinemia is not associated with the severity of atopic dermatitis.

Assessment of skills using a spacer device for a metered-dose inhaler and related independent predictive factors in caregivers of asthmatic preschool children

The correct use of inhalation devices is essential for successful therapy. We aimed to evaluate the skills in the use of a spacer device with an metered‐dose inhaler (MDI) and factors that influence this skill in asthmatic preschool childrens caregivers.