Browsing by Author "Sogut A."
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Item Evaluation of sleep quality and anxiety-depression parameters in asthmatic children and their mothers(2007) Yuksel H.; Sogut A.; Yilmaz O.; Demet M.; Ergin D.; Kirmaz C.Background: Having a child with a chronic disease may cause anxiety and depression and impair the sleep quality in the mothers. The aim of this study was to evaluate sleep quality in asthmatic children and their mothers as well as the status of anxiety-depression in the mothers. Methods: Study group consisted of 75 asthmatic children aged between 7 and 16 years (mean±SD 8.4±2.9) and the control group consisted of 46 healthy children aged between 7 and 15 years (mean±SD 9.1±3.6). Pittsburgh Sleep Quality Index (PSQI) was administered to both the children and their mothers while Hospital Anxiety and Depression Scale (HADS) was administered only to the mothers. Results: Total PSQI score of the mothers in the asthmatic group was significantly correlated with asthma severity of the children (r=0.49, p=0.00). There was a significant correlation between asthma symptom score and sleep disturbing factors subscore in children with asthma (r=0.34, p=0.01). Moreover, anxiety and depression subscores of the mothers in the asthma group were significantly higher (p=0.02). Conclusion: Asthma may be associated with altered sleep quality in children and their mothers. Similarly, mothers of children with asthma may have disorder of anxiety and depression. Therefore, children with and their mothers need to be assessed for the requirement of support regarding sleep quality and anxiety-depression status. © 2007 Elsevier Ltd. All rights reserved.Item Pulmonary hemosiderosis with normocomplementemic urticarial vasculitis in a child(PI-ME Tipografia Editrice S.r.l., 2007) Yuksel H.; Yilmaz O.; Savas R.; Kirmaz C.; Sogut A.; Özalp S.Pulmonary hemosiderosis is rarely associated with urticarial vaculitis especially if normocomplementemic. An eigth year old girl presented with relapsing and remitting chronic and persistent urticarial lesions, conjunctival injection, recurrent cough and hemoptysis. Respiratory findings started at seven years of age. Physical examination revealed diffuse skin lesions mainly settled on the extremites, nonpurulent conjunctival injection, rare ronchi and fine crackles in bilateral lower zones of the lungs. Biopsy of the urticaria like skin lesions demonstrated leukocytoclastic vasculitis. Rheumatological markers were negative. Levels of complement fractions 3 and 4 were normal. Chest x-ray demonstrated diffuse alveolar infiltrative images. High Resolution Computed Tomography of the chest revealed diffuse ground-glass appearance, increased interstitial density. Diagnostic flexible fiberoptic bronchoscopy was performed and bronchoalveolar lavage fluid revealed hemosiderin laden alveolar macrophages. She was started on systemic corticosteroid treatment. During follow up, pulmonary symptoms disappeared, however skin lesions and conjunctival symptoms persisted and exacerbated four times in two years. CT of lungs after two years of treatment revealed rare patchy areas of ground glass appearance in bilateral lower lobes and right upper lobe as well as a few of milimetric pleural nodules. This patient is still followed up under low dose steroids and pulmonary findings regressed but low grade inflammation due to vasculitis is thought to continue as supported by the persistence of tomographic findings in the lungs despite the absence of any symptoms. This case demonstrates association of urticarial vasculitis and pulmonary hemosiderosis in the setting of normocomplementemia.Item Improvement in symptoms of psoriasis in a child after treatment with grass pollen specific allergen immunotherapy(Dermatologia Pediatrica, 2007) Sogut A.; Yilmaz O.; Yuksel H.Psoriasis is a chronic inflammatory disease of skin in which Th1 lymphocytes have a central role. Similar to all inflammatory diseases, additional inflammation may lead to the exacerbation of manifestations. Allergic asthma is the chronic eosinophilic inflammatory disease of the bronchial mucosa in which Th2 lymphocyte activity predominates. A nine year old boy who had been under conventional topical treatment for psoriasis without improvement for three months, presented to the outpatient department with recurrent cough, dyspnea and wheezing of one year duration. The physical examination revealed white plaques on extensor surfaces of elbows and knees as well as prolonged expirium and wheezing. Positive allergen skin prick test against "olea europea" and "fraxinus excelsior" pollens were observed. Inhaled steroids and allergen specific immunotherapy were initiated with the diagnosis of allergic asthma. Psoriatic findings regressed without requirement for an additional topical treatment during follow up along with asthma findings. As a conclusion, inflammatory stress of allergic asthma may aggravate psoriasis and treatment with allergen specific immunotherapy may help decrease findings of psoriasis.Item Correlation of quality of life with clinical parameters and eosinophilic cation protein levels in children with allergic rhinoconjunctivitis(2008) Yuksel H.; Yilmaz O.; Sogut A.; Ertan P.; Onur E.Background: Systemic and mucosal roles of eosinophils in the pathogenesis of allergic rhinoconjunctivitis (AR) are known. The aim of this study was to investigate the relationship of clinical parameters and quality of life with eosinophilic cationic protein (ECP) in grass pollen-sensitive children with seasonal AR. Methods: This study included 31 children with AR and 18 healthy controls aged between 5 and 15 years. ECP levels in nasal lavage fluid and serum were measured. AR symptom scores were calculated and the pediatric rhinoconjunctivitis quality of life questionnaire (PRQLQ) was filled in for all patients. Results: Mean serum and nasal ECP levels (ng/ml) were significantly higher in the patient group (p < 0.05 for both). In the AR group, the mean clinical symptom score was 7.3 ± 2.2, while the total PRQLQ score, activity limitation, symptoms and emotional function domains were 2.5 ± 0.9, 3.0 ± 1.1, 2.5 ± 1.2 and 2.6 ± 1.1, respectively. The total clinical symptom score and disease duration showed a significant correlation with the total PRQLQ score (p = 0.00 and 0.003, respectively). However, neither nasal lavage nor serum ECP levels were significantly correlated with symptom score, duration of disease, PRQLQ total score or domains (p > 0.05 for all). Conclusion: These results may indicate the absence of a correlation between clinical status and quality of life and levels of ECP in tissues with allergic inflammation. Copyright © 2008 S. Karger AG.Item Sleep quality and depression-anxiety in mothers of children with two chronic respiratory diseases: Asthma and cystic fibrosis(2008) Yilmaz O.; Sogut A.; Gulle S.; Can D.; Ertan P.; Yuksel H.Background: Sleep quality and psychological well being of parents are expected to be influenced by the child's health and disease status. The aim of this study was to compare sleep quality and depression-anxiety parameters in mothers of children with cystic fibrosis (CF) asthma and healthy controls. Methods: The study included mothers of 62 children with asthma, 21 children with CF and 35 healthy children. All mothers filled in the Pittsburgh Sleep Quality Index (PSQI) questionnaire and hospital anxiety depression scale (HADS). Results: Comparison of the three groups with Kruskall Wallis analysis demonstrated that subjective sleep, sleep efficiency and total PSQI scores were significantly different between the groups (p = 0.02, p = 0.01 and p = 0.04 respectively). Comparisons of the groups in pairs with Mann Whitney U test with Bonferroni correction revealed that subjective sleep quality scores in mothers of children with asthma were significantly higher than the ones in the control group (1.0 ± 0.9 vs 0.6 ± 0.7, p = 0.015). The other PSQI scores as well as the anxiety and depression scores were higher in CF and asthma groups when compared to the control group but did not reach statistical significance. Anxiety and depression scores were significantly correlated with PSQI total score in CF (rho = 0.54 and 0.49 respectively) and asthma groups (rho = 0.45 and 0.60 respectively) but not in the control group. Conclusion: In conclusion, presence of a chronic respiratory disease in a child may be associated with disturbed sleep quality and increased depression and anxiety in mothers. © 2008 European Cystic Fibrosis Society.Item Attention deficit and hyperactivity symptoms in children with asthma(2008) Yuksel H.; Sogut A.; Yilmaz O.Background. Asthma that is chronic may influence children's behavioral health and quality of life (QoL) negatively. Objective. To evaluate the frequency of attention deficit and hyperactivity symptoms in children with asthma and to determine if these symptoms are associated with a deterioration of QoL. Methods. Mothers of 62 children with moderate asthma and those of 38 healthy children aged between 7-12 years were included in the study. Conners' Parent Rating Scale-48 (CPRS), a 48-item multiple-choice questionnaire, was completed by the mothers to identify attention deficit and hyperactivity symptoms in children. The Pediatric Asthma Quality of Life Questionnaire (PAQLQ) was filled in by children to measure QoL. Results. Mean age was 9.2 ± 1.5 years for asthmatic children (37 male, 25 female) and 10.1 ± 1.3 years for control group (20 male, 18 female). The two groups were similar regarding age and sex. Attention deficit score in the asthma group was significantly higher than that in the control group (p = 0.01). The frequency of hyperactivity was higher in the asthmatic group but the difference between the groups was not significant (p = 0.36). Attention deficit and hyperactivity scores of Conners-P were not correlated with PAQLQ scores (regarding total, activity, emotional and symptom domains). Conclusion. Increased rates of attention deficit symptoms in children with asthma, as reported by mothers, might reflect the negative impact of asthma on neurobehavioral health. Asthmatic children, especially the ones who display attention deficit symptoms, must be considered for further evaluation regarding attention deficit hyperactivity disorder. Copyright © 2008 Informa Healthcare USA, Inc.Item Influence of ambulatory inhaled treatment with different devices on the duration of acute asthma findings in children(2009) Yilmaz O.; Sogut A.; Kose U.; Sakinci O.; Yuksel H.Background. Efficacy of bronchodilator treatment in children with asthma depends on the proper use of inhalation devices. The aim of this study was to compare the efficacy of inhaled bronchodilator treatment with a spacer and a nebulizer in children with acute asthma findings. Methods. Fifty-eight children with acute asthma findings who received ambulatory inhaled bronchodilator treatment with a nebulizer and 39 with a spacer were enrolled in the study. Duration of asthma, inhaled steroid treatment and the number of exacerbations during the previous year were recorded. Duration of current acute symptoms, exacerbation severity score and duration of respiratory findings after initiation of treatment were also recorded. Results. Children in both groups were similar in age (76.5 > 30.3 months using a nebulizer vs 83.1 > 25.1 in spacer group, p = 0.26). Duration after diagnosis of asthma, initiation of inhaled steroid treatment and exacerbation symptoms were similar between groups (p = 0.15, 0.76 and 0.93, respectively). Exacerbation severity score in the nebulizer group was not significantly different from the spacer group (2.6 > 0.7 vs 2.8 > 0.7 respectively, p = 0.19). Number of exacerbations in the previous year was not different (2.0 > 1.2 in the nebulizer group vs 1.6 > 0.9 in the spacer group, p = 0.08). Duration of acute asthma findings after initiation of inhaled bronchodilator treatment was similar between the two groups (6.5 > 2.9 vs 7.2 > 4.6 p = 0.34). Conclusion. Nebulizers and spacers have similar influence on the duration of acute asthma findings in children when used in ambulatory home bronchodilator treatment.Item Sleep actigraphy evidence of improved sleep after treatment of allergic rhinitis(American College of Allergy, Asthma and Immunology, 2009) Yuksel H.; Sogut A.; Yilmaz H.; Yilmaz O.; Dinc G.Background: Children with allergic rhinitis (AR) are reported to have disturbed sleep and daytime fatigue due to nasal obstruction. Objective: To evaluate sleep impairment in children with AR using actigraphic evaluation. Methods: Fourteen children aged 7 to 16 years with grass pollen-sensitized seasonal AR were enrolled. They completed the Total 4-Symptom Score (T4SS) scoring system for AR symptom score and the Pittsburgh Sleep Quality Index (PSQI) questionnaire for sleep quality, and they underwent actigraphy for 3 days in the pretreatment period. After topical corticosteroid and antihistaminic treatment for 8 weeks, actigraphy, the T4SS, and the PSQI were repeated. Fourteen healthy children aged 8 to 16 years underwent actigraphy and completed the PSQI questionnaire as controls. Results: There were no significant age or sex differences between the AR and control groups. Pretreatment PSQI and actigraphy scores were worse in the AR group vs the control group. After treatment, sleep quality improved, and there were no differences in actigraphy and PSQI scores between the 2 groups. Before treatment, the T4SS was significantly correlated with the sleep efficiency, daytime napping episodes, and total nap duration variables of actigraphy (r = -0.53, P = .004; r = 0.43, P = .02; and r = 0.39, P = .04, respectively). The T4SS was correlated with the total PSQI score (r = 0.67, P < .001). Conclusions: Sleep can be compromised in children with AR. There is a significant correlation of clinical symptom score with the actigraphic and PSQI variables. Therefore, actigraphy may be used as an objective tool to evaluate sleep disturbance in children with AR.Item Effectiveness of magnetic resonance angiography in the evaluation of lung perfusion in constrictive bronchiolitis obliterans(2009) Yilmaz Ö.; Savaş R.; Sogut A.; Özkol M.; Yüksel H.Childhood constrictive bronchiolitis obliterans (CBO) is characterized clinically by the persistence of obstructive respiratory symptoms following a prolonged episode of lower respiratory viral infection. The diagnosis depends on the clinical, radiological and laboratory findings. Perfusion defects on scintigraphy may predict the severity. This report describes a 2-year-old girl who presented with a 15-day history of respiratory distress despite treatment. Auscultation of the lungs revealed prolonged expiration and bilateral crepitant rales. CXR revealed bilateral paracardiac infiltration. She improved with a treatment regimen of bronchodilators, systemic steroids and antibiotherapy; however, rales were detected again 10 days after discharge. HRCT of the lung revealed an oligaemic-mosaic pattern, more prominent in the left lung. The diagnosis of CBO was made on the basis of these clinical and radiological findings. Perfusion was normal in the right lung but diffusely decreased in the left lung on perfusion scintigraphy by Tc99m-MAA. Magnetic resonance (MR) angiography source images of the lungs revealed significant but not diffuse perfusion defects in the left lung, in contrast to radionuclide scintigraphy. There were areas of low perfusion in the right lung, which were not evident in radionuclide scintigraphy. The use of source images of MRI angiography of the lungs may be more sensitive and specific for the detection of perfusion defects in patients with CBO and may assist in determining the prognosis. © 2008 Asian Pacific Society of Respirology.Item Relationship of sleep quality and quality of life in children with monosymptomatic enuresis(2009) Ertan P.; Yilmaz O.; Caglayan M.; Sogut A.; Aslan S.; Yuksel H.Background: Health-related quality of life (QoL) in children with monosymptomatic nocturnal enuresis might be influenced by impaired quality of sleep. The aim of this study was to evaluate possible deteriorations in QoL and sleep quality and the association between these parameters in children with monosymptomatic nocturnal enuresis. Methods: The study consisted of 44 children with monosymptomatic nocturnal enuresis and 27 healthy controls aged 6-15 years. KINDL QoL and Pittsburgh Sleep Quality Index (PSQI) were applied to all children. Results: Mean total KINDL scores in enuresis and control groups were 65.1 ± 11.0 vs. 67.4 ± 13.7, respectively (P = 0.44). PSQI scores were not significantly different between the groups (P > 0.05l). In the enuresis group, age showed significant negative correlation with self-esteem domain of KINDL (r = -0.39, P = 0.01) and positive correlation with sleep duration sub-score of the PSQI (r = 0.37, P = 0.03). Duration of enuresis showed significantly negative correlation with total KINDL score and self-esteem domain (r = -0.32 and r = -0.39, P = 0.04 and P = 0.01, respectively). There was significant correlation between physical well-being sub-score of KINDL with daytime dysfunction and total scores of PSQI (r = -0.53, P = 0.001 and r = -0.41, P = 0.02, respectively). Daytime dysfunction sub-score of PSQI was significantly correlated with friends sub-score of KINDL (r = -0.33, P = 0.04). Conclusions: As age of the child and duration of enuresis increase, self-esteem domain of QoL worsens. Moreover, there is a significant correlation of physical well-being and friends domains of QoL score and total and daytime dysfunction scores of PSQI. These findings necessitate global evaluation of QoL and sleep quality in children with monosymptomatic nocturnal enuresis to increase efficacy of health care. © 2009 Blackwell Publishing Ltd.Item Prevalence of habitual snoring and symptoms of sleep-disordered breathing in adolescents(2009) Sogut A.; Yilmaz O.; Dinc G.; Yuksel H.Objective: Sleep-disordered breathing is an important public health problem in adolescents. The aim of this study was to investigate the prevalence and risk factors of habitual snoring and symptoms of sleep-disordered breathing in adolescents. Methods: A cross-sectional study was conducted with children from primary schools and high schools that the ages ranged from 12 to 17 years. Data were collected by physical examination and questionnaires filled in by parents regarding sleep habits and possible risk factors of snoring. According to answers, children were classified into three groups: non-snorers, occasional snorers, and habitual snorers. Results: The response rate was 79.2%; 1030 of 1300 questionnaires were fully completed and analyzed. The prevalence of habitual snoring was 4.0%. Habitual snorers had significantly more nighttime symptoms including observed apneas, difficulty breathing, restless sleep and mouth breathing during sleep compared to occasional and non-snorers. Prevalence of habitual snoring was increased in children who had had tonsillar hypertrophy, allergic rhinitis, and maternal smoking. Conclusion: We found the prevalence of habitual snoring to be 4.0% in adolescents from the province of Manisa, Turkey which is low compared to previous studies. Habitual snoring is an important problem in adolescents and habitual snorers had significantly more nighttime symptoms of sleep-disordered breathing compared to non-snorers. © 2009 Elsevier Ireland Ltd. All rights reserved.Item Effects of allergen-specific immunotherapy on functions of helper and regulatory t cells in patients with seasonal allergic rhinitis(2011) Kirmaz C.; Kirgiz O.O.; Bayrak P.; Yilmaz O.; Vatansever S.; Ozbilgin K.; Onur E.; Celik O.; Sogut A.; Ay G.; Yuksel H.Background. Seasonal allergic rhinitis (SAR) is characterized by a helper T (Th)2 cell-mediated immune response at the target site. There is a relative Th1 and/or regulatory T (Treg) cell insufficiency in patients with SAR. It has been demonstrated that there is a change in the balance between these cells after allergen-specific immunotherapy (SIT), which is a curative treatment modality for this disease. However, there are few studies that evaluate the number and function of these cells in the inflammatory area after SIT treatment. Objective.We aimed to investigate the distribution of Th1, Th2 and Treg cells in nasal biopsies and lavage fluid (NLF) specimens from patients with SAR, before and after SIT. Methods. Twenty-four, symptomatic SAR patients sensitized to Olea europeae, were enrolled in the study prior to treatment. Fifteen, non-allergic subjects with nasal septum deviation, who needed surgical treatment, served as the control group. NLF and inferior turbinate biopsies were obtained from both groups during the pollen season. Conventional, subcutaneous SIT with Olea europeae extract was initiated in patients with SAR. One year after the first biopsy, biopsies and NLF specimens were again obtained for reevaluation. All biopsies were evaluated for Th1, Th2 and Treg cell counts by means of their transcription factors (T-bet, GATA-3 and FoxP3) using an immunohistochemical analysis method. Additionally, all NLF specimens were evaluated for the functions of these cells, by means of their specific cytokines, using an ELISA method. Results. When the basal status of those patients with SAR was evaluated based on transcription factors, prior to treatment, Th1 and Treg cells were found to be fewer than in non-allergic controls (p=0.001 for both T-bet and FoxP3). It was demonstrated that numbers of GATA-3-carrying cells, which are a marker for Th2, were not significantly different between the groups (p=0.276), but evaluation of the Th1/Th2 ratio revealed a relative Th2 dominance in patients with SAR prior to treatment. When evaluated on the basis of cytokine levels, it was observed that Th1-originated IFN- was lower in patients with SAR compared to the control group, both before and after treatment (p=0.012 for both comparisons), Th2-originated IL-4 levels were not significantly different between the groups either before or after treatment (p=0.649, p=0.855; respectively). Th2- and Treg cell-originated IL-10 levels were higher in patients with SAR before treatment (p=0.033), but this difference was not statistically signifact following treatment compared with controls (p=0.174). Treg cell-originated TGF-β levels were slightly lower in patients with SAR compared to the controls, although the difference was not statistically significant (p=0.178, p=0.296; respectively). None of the above mentioned cytokine levels changed significantly as a result of SIT. Conclusion. The results of our study indicate that although clinical findings improve after one year of SIT, this duration may not be sufficient to detect changes in cytokine patterns and transcription factors. Further studies that evaluate outcome over a longer duration of treatment would provide valuable information.Item Regulatory-T, T-helper 1, and T-helper 2 cell differentiation in nasal mucosa of allergic rhinitis with olive pollen sensitivity(2012) Sogut A.; Yilmaz O.; Kirmaz C.; Ozbilgin K.; Onur E.; Celik O.; Pinar E.; Vatansever S.; Dinc G.; Yuksel H.Background: Allergic rhinitis (AR) is a disease in which T-helper (Th)2 response is predominant and its pathogenic mechanism is still poorly understood. Aim: To evaluate the possible role of Th1, Th2 and regulatory-T (Treg) cells in the pathogenesis of AR. Methods: This case-control study enrolled 41 patients with seasonal AR (10-62 years old), sensitive to olive pollens, and 15 healthy controls (18-60 years old). Nasal biopsy was performed and specimens of nasal lavage fluid were obtained from all participants. The levels of interleukin (IL)-4, IL-10, interferon (IFN)-γ and transforming growth factor-β (TGF-β) were measured in nasal lavage fluid specimens. The expression of FOXP3, GATA-3 and T-bet was measured by immunohistochemical methods in the nasal biopsy specimens. Results: The levels of IFN-γ in the group with AR were significantly lower than those in the control group (p = 0.008). The levels of IL-4, IL-10 and TGF-β did not differ between the two groups. The expression of FOXP3 and T-bet in patients with AR was significantly lower than that in the control group (both p = 0.001). Expression of GATA-3 in the nasal mucosa was similar between the groups (p = 0.2). The ratios of T-bet/GATA-3 and FOXP3/GATA-3 in the AR group were significantly lower than those in the control group (p = 0.001). Conclusion: Insufficient Treg and Th1 cells may be associated with the allergic inflammation that may be attributed to the Th2 immune response in patients suffering from AR who are sensitive to olive pollen. Copyright © 2011 S. Karger AG, Basel.Item Role of adipokines and hormones of obesity in childhood asthma(2012) Yuksel H.; Sogut A.; Yilmaz O.; Onur E.; Dinc G.Purpose: The aim of this study was to evaluate serum levels of leptin, ghrelin, and adiponectin in obese and non-obese children with asthma and in healthy non-asthmatic children, and analyze their relationships with clinical outcomes. Methods: This study enrolled 40 obese and 51 non-obese children with asthma and 20 healthy children. Body mass index and serum leptin, ghrelin, and adiponectin levels were determined in all children. Asthma symptom scores and lung function test results were recorded for subjects with asthma. Results: Serum leptin levels (11.8±7.9, 5.3±6.8, and 2.1±2.4 ng/mL in the obese asthmatic, non-obese asthmatic, and control groups, respectively) and adiponectin levels (12,586.2±3,724.1; 18,089.3± 6,452.3; and 20,297.5±3,680.7 ng/mL, respectively) differed significantly among the groups (P<0.001 for all). Mean ghrelin levels were 196.1±96.8 and 311.9±352.8 pg/mL in the obese and non-obese asthmatic groups, respectively, and 348.8±146.4 pg/mL in the control group (P=0.001). The asthma symptom score was significantly higher in the obese children with asthma than in the non-obese children with asthma (P<0.001). Leptin and adiponectin levels were correlated with the asthma symptom score in non-obese children with asthma (r=0.34 and r=-0.62, respectively). Conclusions: Obesity leads to more severe asthma symptoms in children. Moreover, leptin, adiponectin, and ghrelin may play important roles in the inflammatory pathogenesis of asthma and obesity co-morbidity. © The Korean Academy of Asthma, Allergy and Clinical Immunology.Item Interrupter resistance changes in children with bronchiolitis(2012) Yilmaz O.; Sogut A.; Alkan S.; Yuksel H.Introduction: Determination of lung function in children younger than three years with bronchiolitis may aid in treatment; however, technical difficulties such as requirement of sedation and lack in standardization limit clinical use. Objectives: Aim of this study was to evaluate lung function changes using the interrupter technique in unsedated wheezing children younger than 3 years during and after acute bronchiolitis. Methods: Children with acute bronchiolitis younger than three years age were enrolled in this cohort study. Number of previous bronchiolitis episodes, severity of pulmonary findings, duration of acute bronchiolitis findings before presentation, requirement for hospitalization were recorded during initial enrollment. Duration of the current bronchiolitis was recorded. Interrupter resistance (Rint) measurements were performed on all children during and after bronchiolitis, using a face mask. Results: Mean (±SD) age of the children enrolled was 9.4 ±2.9 months. Mean bronchiolitis score was 5.6 ±1.4 at presentation. Mean duration of acute bronchiolitis before and after presentation were 10.1 ±13.0 and 5.1 ±2.3 days, respectively. There was a significant decrease in expiratory Rint values after clinical bronchiolitis findings terminated [1.08 (0.45) vs 0.80 (0.33) kPa.L-1.s, p=0.009]. Flow had not changed significantly while mouth pressure had decreased (p=0.96 and p=0.01, respectively). Conclusion: Interrupter technique measurements showed higher resistance during acute bronchiolitis in children, which decreased after acute findings, disappeared. Rint may be used as a method to detect the change in airway function in unsedated children younger than three years in ambulatory conditions, despite some limitations of standardization in this age group.Item Sensitization pattern of inhalant allergens in children with asthma who are living different altitudes in Turkey(Springer New York LLC, 2015) Ozkaya E.; Sogut A.; Küçükkoç M.; Eres M.; Acemoglu H.; Yuksel H.; Murat N.Variability in children’s allergic sensitization has been detected not only among different countries but also among cities within the same nation but yet different climatic areas. The aim of this study was to investigate the sensitization pattern of asthmatic children who lived in different altitude areas: the two largest Turkish cities, Istanbul (sea level) and Erzurum (high altitude). Five hundred and twelve asthmatic children (6–15 years old) from Istanbul (western Turkey, at sea level) and 609 from Erzurum (eastern Turkey, at an altitude of 1800 m) were included in the study. All participants underwent skin testing with common inhalant allergens, spirometry, total IgE level, and clinical examination. The positive sensitization ratio to aeroallergens in children with asthma living at sea level was statistically higher than that in children living in the high altitude group [p = 0.001, OR (odds ratio) 4.9 (confidence interval (CI) 3.67–6.459)]. However, pollen sensitization in asthmatic children living in high altitudes was significantly higher than that in children living at sea level [p = 0.00, OR 2.6 (CI 1.79–3.87)]. Children with asthma who live at high altitudes are characterized by higher pollen but lower mite sensitization rates than those living at sea level in Turkey. Different climatic conditions and altitudes may affect aeroallergen sensitization in children with asthma. © 2015, ISB.