Childhood interstitial lung diseases are rare disorders of largely unknown etiology characterized by variable types and degrees of parenchymal inflammation. Disease spectrum and prognosis considerably from those in adults. Respiratory bronchiolitis–associated interstitial lung disease (RB-ILD) is a well-described entity occurring almost exclusively in adults who are current heavy cigarette smokers. We describe an 11-year-old boy with failure to thrive, dry cough, and exertional dyspnea for 1 year who was diagnosed with RB-ILD due to heavy passive smoking exposure. Although RB-ILD is well defined in smoking adults, there are no reports in the English literature in nonactive smokers, especially in childhood.
Childhood acute lower respiratory infection (ALRI) is one of the most common reason for morbidity and mortality especially in developing countries. Predisposing factors include season, nutrition, suboptimal immunization, lower socioeconomic status, prematurity, underlying disease, tobacco exposure and vitamin D deficiency. Vitamin D deficiency is the 25(OH)D levels below In this study we aimed to describe vit D status in children with lower respiratory infection. Between November 2010 and February 2011 63 children with acute lower respiratory infection between 0.5-5 years of age and 59 age matched children without respiratory symptoms were enrolled in the study. Both study and control groups received vitamin D prophylaxis for one year and they have no predisposing factors for ALRI. Vitamin D status of children with acute lower infection (mean 34,9 ng/ml) were compared with children without ALRI (mean 37,2 ng/ml). No difference was found between the patient and the control group (p=0,38). In the patient group 17 patients diagnosed to have ALRI again after February 2011 – after one year period. In terms of ALRI recurrence, statistically significant difference was found between vitamin D status normal and insufficient patients (p= 0,003). In conclusion although there was no association between vitamin D status and childhood ALRI, significant association was found between vitamin D status and ALRI recurrence. Larger serial studies are needed for precise results.
Introduction: Primary ciliary dyskinesia (PCD) negatively affects quality of life because of various symptoms. However, no study evaluated quality of life, exercise capacity, pulmonary functions, respiratory muscle strength and endurance in patients with PCD. Aims and objectives: To compare aforementioned outcomes in patients with PCD and healthy controls. Methods: Twenty-seven patients (10.74±4.01years,16F,11M) and 28 controls (12.07±3.64years,15F,13M) were included. Quality of life (6-12years child/parents', 13-17years adolescent (QOL-PCD)), pulmonary functions (spirometer), exercise capacity (6-minute walk test (6MWT)), respiratory muscle strength (MIP, MEP) (mouth pressure device) and endurance (incremental threshold loading test) were evaluated. Results: Children with PCD (6-12years) and parents' physical functioning, upper and lower respiratory symptoms, hearing functioning, parents' treatment burden scores, 6MWT distance, FEV1(L), FVC(L), FEV1/FVC, PEF(L), FEF%25-75(L), FEF%25-75(%), MIP, respiratory muscle endurance were significantly lower (p<0.05), MEP (p=0.076) and parents' health perception (p=0.061) score were close to significantly significance in patients with PCD compared with controls. 13-17 years adolescent QOL-PCD scores were similar in groups (p>0.05). Conclusions: The quality of life is adversely effected in PCD patients during childhood. Pulmonary function, functional exercise capacity, respiratory muscle strength and endurance are impaired in patients with PCD. Patients should be included in appropriate pulmonary rehabilitation program at an early age.
Aim In this study, we aimed to determine the psychosocial status of primary care givers of children with cystic fibrosis ( CF ) and its relationship with the clinical scores of children with CF. Methods Thirty‐six patients with CF and their primary care givers were assessed. A personal information form, as well as the Parent Attitude Research Instrument, Maslach Burnout Inventory, Beck Depression Scale and modified Shwachman‐Kulczycki Score, were used for data collection. Results All the CF children's primary care givers were their mothers. The mothers' occupation and educational level affected their child‐rearing attitudes ( P < 0.05). Furthermore, the frequency of hospital visits and hospitalizations was associated with increased emotional exhaustion, depression and negative attitudes towards child‐rearing ( P < 0.05). Higher levels of emotional exhaustion in mothers were associated with increased depersonalization and depression, while personal accomplishment was associated with lower levels of depression ( P < 0.05). Depression was present in 69.4% of mothers, and its severity was correlated with their children having a poor clinical status. Moreover, increased depression was associated with increased negative attitudes towards child‐rearing ( P < 0.05). Conclusion The rate of depression is high in mothers of children with CF. These mothers displayed a negative attitude towards child‐rearing, along with the disease, which was more severe in their children. These mothers should undergo routine psychosocial screening, and support should be given to those in need.
We reviewed our experience on tracheomalacia (TM) and bronchomalacia (BM) in children who presented with chronic respiratory problems and evaluated their clinical and radiologic characteristics and their associations with other disorders. There were 26 males and 8 females with a median age of 9 months. The main symptoms were wheezing, persistent or recurrent pneumonia, and chronic cough. Atelectasis on chest radiograph was the most common sign. Of 23 children with TM, 1 had a double aortic arch, 1 had tracheoesophageal fistula, and 1 other had associated laryngomalacia. BM was found in 27 children and was predominantly seen on the right side. TBM was found in 16 cases (in an infant TBM was accompanied by pharyngeal dyskinesia and in another by laryngomalacia). Malacia disorders were associated with gastroesophageal reflux, cardiovascular anomalies, and tracheoeosophageal fistula. TM and BM should be considered in the differential diagnosis of children with chronic and recurrent respiratory symptoms. Early diagnosis of malacia disorders will prevent unnecessary use of antibiotics or antiasthmatic drugs, which are often abused to treat these children. In these patients, treatment for associated diseases should also be considered.
Objectives: Primary ciliary dyskinesia (PCD) is characterized inflammation and oxidative stress (OS). Thiol disulfide homeostasis (TDH) is a marker of OS. We aimed to evaluate TDH for the clarification of etiopathogenesis in clinically stable PCD patients. Methods: Fourteen PCD patients without acute exacerbation and age-matched 14 healthy controls were enrolled the study in a pediatric pulmonology department. Native thiol (NT), total thiol (TT) and disulfide levels (DL) were assessed by Erel&Neselioglu automated measurement method. Age, radiological findings and presence of situs anomalies of the patients were noted. Results: The mean age of the patients was 10.8±3.7 and 10.3±4.1 years of the control group. TT level was 431.1±85.1 μmol/L in the PCD group and 435.9±56.0 μmol/L in the control group and there was no significant difference between two groups (p=0.864). DL was 37.4±12.2 μmol/L in the PCD group and 19.3±6.8 μmol/L in the control group. Disulphide/NT and disulphide/TT ratio were 10.5±2.7 %, 8.6±1.8 % in the PCD group and 4.8±1.2 %, 4.3±0.9 % in the control group. DL, disulphide/NT, disulphide/TT ratios were significantly higher in PCD patients (p=0.001). There were no statistically significant differences in terms of chest x-ray findings, presence of situs anomalies of the patients and TDH between two groups (p>0.05). Conclusions: This is the first study demonstrating that TDH in children with PCD in stable period. We found that TDH was disrupted in favor of DL in patients without acute exacerbation. TDH can play a role in the elucidation of the pathophysiology and the development of new therapeutic approaches in children with PCD.
