Ferhat Çatal

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

BACKGROUND Psychiatric 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. METHODS The 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. RESULTS The 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. CONCLUSION Psychiatric disorders are frequent and severe in pre-school children with cows milk allergy.

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.

Does atopy affect the course of viral pneumonia

Abstract Background The presence of atopy is considered as a risk factor for severe respiratory symptoms in children. The objective of this study was to examine the effect of atopy on the course of disease in children hospitalised with viral pneumonia. Methods Children between the ages of 1 and 6 years hospitalised due to viral pneumonia between the years of 2013 and 2016 were included to this multicentre study. Patients were classified into two groups as mild–moderate and severe according to the course of pneumonia. Presence of atopy was evaluated with skin prick tests. Groups were compared to evaluate the risk factors associated with severe viral pneumonia. Results A total of 280 patients from nine centres were included in the study. Of these patients, 163 (58.2%) were male. Respiratory syncytial virus (29.7%), Influenza A (20.5%), rhinovirus (18.9%), adenovirus (10%), human metapneumovirus (8%), parainfluenza (5.2%), coronavirus (6%), and bocavirus (1.6%) were isolated from respiratory samples. Eighty-five (30.4%) children had severe pneumonia. Atopic sensitisation was found in 21.4% of the patients. Ever wheezing (RR: 1.6, 95% CI: 1.1–2.4), parental asthma (RR: 1.5, 95% CI: 1.1–2.2), other allergic diseases in the family (RR: 1.8, 95% CI: 1.2–2.9) and environmental tobacco smoke (RR: 1.6, 95% CI: 1.1–3.5) were more common in the severe pneumonia group. Conclusions When patients with mild–moderate pneumonia were compared to patients with severe pneumonia, frequency of atopy was not different between the two groups. However, parental asthma, ever wheezing and environmental tobacco smoke exposure are risk factors for severe viral pneumonia in children.

Nasal saline as a placebo in chronic rhinosinusitis

I read with interest Mainz et al’s article in the July issue of your journal [1]. The authors concluded that; vibrating sinonasal inhalation of dornase alfa reduces rhinosinusitis symptoms in cystic fibrosis. We question the interpretation of the results. It is well known that nasal washing with isotonic saline solution facilitates nasal drainage and cleans the airway of any postnasal discharge (including allergens); furthermore, it can be effective when applied appropriately [2–6]. Isotonic saline solution is applied (five dropperfuls in each nostril) at least four times a day until the symptomatology subsides [2]. In addition, isotonic saline solution irrigation has been found to reduce inflammatory mediators (histamine, prostaglandin D2, and leukotriene C4) and allergens in nasal secretions. As a consequence, “nasal washing with saline” is effective against common cold, acute/chronic sinusitis and particularly rhinitis [7]. As a result, nasal saline with the correct technique can be as effective as nasal drugs; therefore it cannot be used as a placebo in a chronic rhinosinusitis study.