Browsing by Author "Yüksel, H"
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Item A province-based study using sampling method to investigate the prevalence of cystic echinococcosis among primary school children in Manisa, TurkeyOk, UZ; Özkol, M; Kilimcioglu, AA; Dinç, G; Bayindir, P; Östan, I; Pabusçu, Y; Özcan, C; Korkmaz, M; Coskun, S; Yüksel, H; Girginkardesler, NA province-based field study using a portable ultrasound scanner (US) was performed for the first time using sampling method to investigate the prevalence of cystic echinococcosis (CE) in primary school children in Manisa, Turkey. A total of 6093 children from 37 primary schools was selected as the representative sample of the total number of 166,766 primary school children, and examined by the US. Prevalence was found to be 0.15%, as nine children were diagnosed with CE, seven new and two previously operated. A questionnaire applied to the children revealed no significant relationship between the risk factors and the infection (P > 0.05). In conclusion, it would be advisable to repeat the study at the same schools in eight years' time, in order to evaluate the efficacy of the control programs, since nearly all students involved in this study will have graduated by then. Besides, it is recommended to choose a sampling group to find the prevalence of an infection in a defined region. (c) 2007 Elsevier B.V. All rights reserved.Item The Effect of Flexible Bronchoscopy on Anxiety in ChildrenTürkeli, A; Yilmaz, Ö; Topçu, I; Yüksel, HOBJECTIVES: Flexible bronchoscopy (FB) is a semi-invasive diagnostic tool that allows direct visualization of the airways. The use for diagnostic and therapeutic purposes in children is incrasing with the developments in modern anesthesia. Irrespective of the type of the invasive diagnostic procedure, these interventions are known to cause anxiety in patients. The aim of our study was to evaluate the anxiety and depression status in children hospitalized for bronchoscopy and to investigate the effects of FB. MATERIAL AND METHODS: Thirty children hospitalized for FB and 30 controls, aged 7 to 16 years, were enrolled in this study. Anxiety was evaluated with the Hospital anxiety and depression scale (HADS) besides other parameters recorded. RESULTS: The mean HADS anxiety scores in the patient and control groups were respectively 10.1 (3.5) and 2.7 (1.3) (p=0.001). The mean HADS depression scores were respectively 8.8 (3.7) and 2.2 (1.1) (p=0.001). Among the patients, 50% had anxiety and 53.3% had findings while none in the control group showed signs of anxiety and depression. A positive correlation was found between the age and, anxiety and depression scores in patients' groups (respectively r(1) = 0.257; p=0.05 and r(2) = 0.288; p=0.02). CONCLUSION: Anxiety was demonstrated in nearly half of the children hospitalized for bronchoscopy. It has been observed that behavioral and physical problems may be encountered in approximately 40-60% of children who feel generalized anxiety before anesthesia, during the preoperative, postoperative period, and subsequent periods. These results suggest that the detection of children with increased anxiety and indicate the individual requirements can be assisted pharmacological and psychological supports.Item Improvement in sleep quality with allergen-spesific immunotherapy in patients with allergic rhinitisBayrak Degirmenci, P; Kirmaz, C; Deveci, A; Yüksel, H; Yilmaz, ÖObjective: In the medical literature, it has been shown that quality of life and sleep quality are impaired due to allergic rhinitis and are improved with treatment. In this study, we aimed to determine the change in sleep quality of patients with allergic rhinitis using allergen-specific immunotherapy. Materials and Methods: Seventy-four patients diagnosed with allergic rhinitis according to the clinical evaluation and skin prick test findings in Celal Bayar University Allergy-Immunology Outpatient Department were enrolled in our study. Sleep quality was evaluated with Pittsburgh Sleep Quality Index (PSQI) just before specific immunotherapy was initiated and at the end of the first year of treatment with specific immunotherapy. Results: Frequency of having healthy sleep increased significantly after specific immunotherapy in the patients (p<0.001). A significant correlation was detected between the changes in symptom score and PSQI when evaluated with Spearman correlation analysis (p= 0.01). Improvement was demonstrated in subjective sleep quality, sleep latency, sleep duration, sleep efficacy, factors influencing sleep, use of hypnotics, and daytime somnolence parameters of the PSQI with a decrease in symptom score. Conclusion: In our study, chronic sleep disorder disappeared and improvement in sleep quality was detected in most patients during the second evaluation one year after initiation of specific immunotherapy. Sleep quality increased as the symptom score decreased. These findings demonstrated improvement in the patients' sleep quality with improvement in symptoms following specific immunotherapy treatment. These data should be supported with longer specific immunotherapy therapy in patients with allergic rhinitis.Item The Key Cell of the Mucosal Immunity: M CellSimsek, Y; Yilmaz, Ö; Yüksel, HM cells are immune cells located in the mucosal epithelium. They constitute the initial step of mucosal as well as systemic immune response by presenting antigens to the mucosa-associated lymphoid tissue located under the mucosa. Structural and functional characteristics of M cells which are different from their neighboring epithelial cells show that their primary function is antigen presentation. Furthermore, they are used as an entrance gate to the host tissue by many pathogens. These characteristics make M cells the target for oral, nasal vaccine and intestinal drug applications. The role of M cells in the antigen sampling makes these cells important for oral immunotherapy applications, too. With the advancement in M cell cultures and increasing understanding of M cells would make M cell-mediated differences in the treatment and applications.Item Effectiveness of magnetic resonance angiography in the evaluation of lung perfusion in constrictive bronchiolitis obliteransYilmaz, Ö; Savas, R; Sogut, A; Özkol, M; Yüksel, HChildhood 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.Item Validity and reliability of asthma quality of life questionnaire in a sample of Turkish adult asthmatic patientsAlpaydin, AO; Yorgancioglu, A; Yilmaz, O; Bora, M; Göktalay, T; Çelik, P; Yüksel, HWe aimed to investigate the validity and reliability and of Asthma Quality of Life Questionnaire (AQLQ) in Turkish adult asthmatic patients. New or previously diagnosed [according to Global Initative for Asthma (GINA) 2008] symptomatic 118 consecutive stable asthmatic patients between 18 and 55 years old were included. Asthma severity was determined and Turkish adaptation of the AQLQ was administered. Lara asthma symptom scales (LASS), pulmonary function tests, Turkish adaptation of Medical Outcomes Survey Short Form-36 (SF-36) were evaluated. All assessments were done twice at recruitment and after 10 weeks. During this period patients were allowed to make modifications on their medication when necessary. Among the recruited 118 patients 95 were female and 14 were lost in the follow-up. Sixty-two percentages of the patients had mild and 38% moderate asthma. The internal consistency of AQLQ was high (Cronbach's alpha 0.81-0.87) and item-total score correlations were ranging from 0.75-0.89. The cross-sectional and longitudinal correlations between AQLQ total and domain scores and SF36 domain scores were in a range of little or fair degree (r= 0.241-0.626, p<0.005). Total AQLQ scores were observed significantly different according to disease severity and LASS both in the first (p<0.001, both) and 10 weeks follow-up visits (p=0.006, p<0.001 respectively). A statistical significant change was observed in AQLQ symptom score as in total LASS changed ( p<0.001, both) in the follow-up. Our results demonstrated that Turkish version of AQLQ is feasible, reliable, valid and sensitive to changes in adult asthmatics.Item Frequency of gastroesophageal reflux disease in nonatopic children with asthma-like airway diseaseYüksel, H; Yilmaz, O; Kirmaz, C; Aydogdu, S; Kasirga, EGastroesophageal reflux disease (GERD) is commonly associated with asthma; however, frequency in nonatopic children with asthmatic symptoms is unknown. The aim of this study was to determine the frequency of gastroesophageal reflux (GER) in nonatopic children with asthma-like airway disease that recur despite conventional asthma treatment and to evaluate the clinical response to lansoprazole treatment. Twent-five nonatopic children aged between 1 and 16 years who have asthma-like airway disease and 25 healthy children were included in the study. All cases underwent 24h pH monitoring with dual. sensor catheters. Additionally, acid suppressor treatment was administered to patients diagnosed as having GERD and clinical response was evaluated. Major symptoms encountered in the patient group included wheezing and cough (88%, and 32%, respectively). Reflux episodes were more common in distal esophagus during the prone position (reflux index (RI) of 11.5 +/- 10.3 vs. 16.2 +/- 9.4 during supine vs. prone). ALL distal esophageal parameters were significantly higher in the patient group except number of reflux episodes lasting longer than 5 min (RI of 13.3 +/- 13.1 vs. 3.9 +/- 2.9 in the patient vs. control groups, respectively). There was a significant improvement in symptoms and requirement for medication with treatment (number of systems decreased from 2.3 +/- 0.6 to 0.4 +/- 0.6, P = 0.00). In conclusion, GERD is significantly more common in nonatopic children with asthma-Like airway disease compared to the controls and clinical improvement is significant after acid suppressor treatment. Thus, we suggest that children followed-up with the diagnosis of nonatopic asthma with recurrent exacerbations despite adequate asthma treatment have a high frequency of GER and that Lansoprazole treatment may be considered early in management. (c) 2005 Elsevier Ltd. All rights reserved.Item The Psychometric Properties of the New Turkish Generic Health-Related Quality of Life Questionnaire for Children (Kid-KINDL)Eser, E; Yüksel, H; Baydur, H; Erhart, M; Saatli, G; Özyurt, BC; Özcan, C; Ravens-Sieberer, UObjective: There are few health-related quality of life (HRQOL) instruments available that have been validated for use with Turkish children, The Kid-KINDL is a generic measure of children's (8-12 years) HRQOL, which contains 24 categorical items that assess 6 dimensions (physical well-being, emotional well-being, self-esteem, family, friends, and school). The Kid-KINDL is available in many languages. Following on elaborate translation procedure and cognitive focus group interviews, the Kid-KINDL was adopted into Turkish. This paper describes the psychometric properties of the new Turkish Kid-KINDL. Methods: In total, 1918 children aged 8-12 years at a school in Manisa completed the Kid-KINDL. A confirmatory approach was used for validity and reliability analysis. Using the Multi-trait/Multi-item analysis program (MAP) item-internal consistency and item-discriminant validity were calculated to confirm the instrument's structure. Likert scaling assumptions were tested and confirmatory factor analysis (CIA) was applied as well. After modification of 2 unsatisfactory items the Kid-KINDL was administered to a different group of 84 randomly selected children and the analyses were repeated. Results: Cronbach's alpha was 0.35-0.78 before and 0.54-0.78 after the scales was modified. MAP-scaling success was 60%-100% before and 90%-100% after the modification. CIA confirmed the Kid-KINDL structure for the original version (RMSEA = 0.077) was less than the modified version (RMSEA = 0.059), although for the latter the sample was rather small, Floor effects were negligible, and ceiling effects reached 19%. Conclusion: The results indicate that the Turkish Kid-KINDL was a reliable and factorially valid assessment of the children's HRQOL. The modifications mode to the 2 unsatisfactory items increased the psychometric quality of the scale.Item Attention deficit and hyperactivity symptoms in children with monosymptomatic nocturnal enuresisErtan, P; Gönülal, D; Sögüt, A; Yilmaz, Ö; Bozgül, A; Dinç, G; Aydemir, Ö; Yüksel, HAim: Monosymptomatic nocturnal enuresis in children may cause psychological and behavioral problems. The aim of this study was to assess symptoms of attention deficit and hyperactivity in children with monosymptomatic nocturnal enuresis. Material and Method Fifty-seven children (23 male, 34 female) with monosymptomatic nocturnal enuresis and 57 healthy controls (25 male, 32 female) aged 6 to 12 years participated in the study. Conners' Parent Rating Scale-48 (CPRS), a 48-item multiple-choice questionnaire, was completed by the mothers to identify the attention deficit and hyperactivity symptoms in children. Results: Mean age of the children with enuresis was 8.54 +/- 2.18 years and that of the control group 9.12 +/- 2.13 years. Attention deficit score in the enuretic group was significantly higher than that in the control group (p=0.02). Hyperactivity scores were not significantly different between the groups (p=0.36). Bedwetting frequencies were not different between enuretic children with and without attention deficit or hyperactivity symptoms (p=0.06). Conclusions: Psychological and behavioral assessment may be indicated in children with monosymptomatic nocturnal enuresis since the results of this study demonstrate increased attention deficit symptomatology. (Turk Arch Ped 2010; 45: 37-40)Item DIFFERENCE OF SURFACE DERMATOFAGOID ALLERGEN CONCENTRATION ON 0-2 YEARS AGE GROUP AND BABY AND CHILDREN CLOTHES MANUFACTURED FROM VARIOUS FABRICSÜnal, ZB; Öndogan, Z; Yüksel, HAllergic illness based on home dust affects not only the life style of the adults as well as the life quality of the children. Mites are found in all kinds of home textile products and clothing. The main reason that triggers the asthma illness in babies and children is these bugs called mites which cannot be seen with naked eye. In this study, the factors that cause allergic effects due to textile clothing are aimed to be investigated in the most used baby underwear. With this purpose, underwears produced from six different kinds of knitted fabrics worn to each child for three days were investigated. Under the light of this study, the most appropriate fabric types were determined in order to prevent asthma in children based on mites.Item Significant Changes in Trans-Epithelial Barrier Proteins of Adenoid Tissue with Atopic Status in ChildrenYilmaz, Ö; Simsek, Y; Inan, S; Buga, Ö; Eskiizmir, G; Pinar, E; Kanik, E; Yüksel, HOBJECTIVES: Adenoid tissue is important in local immune response and epithelial barrier dysfunction of this tissue may contribute to allergies. The aim of this study was to evaluate the relationship between the status of cross-epithelial barrier elements in adenoid tissue lymphoepithelium and inhalant allergen sensitization. MATERIALS AND METHODS: Children aged 5-15 years, who underwent adenotonsillectomy, participated in this study. All subjects underwent skin prick testing with environmental inhalant allergens. Occludin, ZO1, e-cadherin, beta-catenin, desmoglein, desmoplakin, and connexon-43 were stained immunohistodiemically in the adenoid tissues obtained and scored by H-score. RESULTS: We enrolled 76 children, 14 among whom were sensitized to environmental allergens. Among the zonula occludens proteins, median H-scores for occludin, claudin, and ZO-1 were significantly lower in the atopic compared to the nonatopic group respectively (p<0.001). Similarly, median H-scores for e-cadherin and beta catenin proteins of the zonula adherens were significantly lower in the atopic group (p<0.001). Both desmoglein and desmoplakin H-scores were significantly lower in the atopic group [60 (50-100) vs 280 (260-300), p<0.001 and 105 (87.5-120) vs 280 (67.25-300), p<0.001 respectively]. Moreover, connexin-43 protein of the gap junction was significantly lower in the atopic group (p<0.001). CONCLUSION: Adenoid tissue, which is the initial point of contact of inhalant allergens demonstrates epithelial barrier junctional protein, changes in children with inhalant allergen sensitization without clinical allergic disease symptoms. Therefore, it may be concluded that epithelial barrier function plays an important role in the development of allergen sensitization versus tolerance.Item Does having an asthmatic sibling affect the quality of life in children?Yilmaz, Ö; Türkeli, A; Karaca, Ö; Yüksel, HChronic illness in a family member leads to deterioration of quality of life in other members of that family. We aimed to investigate the influence of having an asthmatic sibling on a child's quality of life (QoL). We enrolled 2-12 year aged healthy children with an asthmatic sibling in the study group and healthy children with a healthy sibling in the control group of this cross-sectional study. Sociodemographic characteristics of children and disease severity characteristics of asthmatic siblings were recorded. All parents filled in Turkish generic PedsQLTM short form appropriate for the child's age group. Study and control groups had 114 children each. Total PedsQLTM scores were not significantly different in any of the age groups (p=0.23, p=0.13, p=0.11 respectively). Emotional PedsQLTM sub-scores in children with an asthmatic sibling were significantly worse (83.0 +/- 16.5 vs 91.6 +/- 10.9 in the 2-4 year age group, 72.0 +/- 17.8 vs 92.2 +/- 11.6 in the 5-7 year age group, 73.7 +/- 24.1 vs 88.7 +/- 14.8 in the 8-12 year age group respectively, p=0.002 for all). Similarly, psychosocial sub-score was significantly lower in the 2-4 and 5-7-year-olds but not the 8-12 year old groups (p=0.01, p=0.01, p=0.08 respectively). In conclusion, healthy children with asthmatic siblings have significantly lower emotional QoL and this needs to investigated for other chronic diseases in further research.Item Change in quality of life, anxiety and depressive symptoms with asthma severity in childrenYilmaz, Ö; Sögüt, A; Kader, S; Taskin, O; Yüksel, HObjective: The aim of this study was to evaluate the change in anxiety-depression symptoms with the change in asthma related symptom score and quality of life in children. Materials and Methods: Thirty five children with asthma aged 6 to 16 years were enrolled in this cohort. Symptom scores were recorded and all children filled in Pediatric Asthma Quality of Life Questionnaire (PAQLQ), Hospital Anxiety Depression Scale (HADS) and Center for Epidemiologic Studies Depression Scale (CES-D). They were called in again four months later to evaluate for change in all parameters. Results: When initial presentation and follow-up values were compared, significant decrease in symptom score, number of exacerbations and number of emergency visits was detected (p< 0.001, p= 0.001 and p= 0.004 respectively). Similarly, HADS anxiety and depression scores as well as CES-D score improved significantly at follow-up when compared to the initial presentation (p< 0.001, p= 0.001 and p< 0.001 respectively). Change in symptom score was significantly correlated with changes in CES-D score as well as PAQLQ symptom, emotion and total scores (r= 0.39 p= 0.04, r= -0.57 p< 0.001, r= -0.66 p< 0.001, r= -0.66 p< 0.001 respectively). Change in PAQLQ total score demonstrated significant negative correlation with the change in HADS anxiety score (r= -0.42, p= 0.02). Conclusion: Improvement in asthma symptoms and QoL is associated with improvement in depression-anxiety symptoms.Item Anti-VEGF treatment suppresses remodeling factors and restores epithelial barrier function through the E-cadherin/β-catenin signaling axis in experimental asthma modelsTürkeli, A; Yilmaz, Ö; Karaman, M; Kanik, ET; Firinci, F; Inan, S; Yüksel, HBesides maintaining a physical barrier with adherens junctional (AJ) and tight junctional proteins, airway epithelial cells have important roles in modulating the inflammatory processes of allergic asthma. E-cadherin and beta-catenin are the key AJ proteins that are involved in airway remodeling. Various mediators such as transforming growth factor-beta (TGF-beta), epidermal growth factor (EGF), fibroblast growth factor (FGF), platelet derived growth factor (PDGF), insulin-like growth factor (IGF), tumor necrosis factor-alpha (TNF-alpha) and angiogenic factors, such as vascular endothelial growth factor (VEGF), are released by the airway epithelium in allergic asthma. The signaling pathways activated by these growth factors trigger epithelial-mesenchymal transition (EMT), which contributes to fibrosis and subsequent downregulation of E-cadherin. The present study used a mouse asthma model to investigate the effects of anti-VEGF, anti-TNF and corticosteroid therapies on growth factor and E-cadherin/beta-catenin expression. The study used 38 male BALB/c mice, divided into 5 groups. A chronic mouse asthma model was created by treating 4 of the groups with inhaled and intraperitoneal ovalbumin (n= 8 per group). Saline, anti-TNF-alpha (etanercept), anti-VEGF (bevacizumab) or a corticosteroid (dexamethasone) were applied to each group by intraperitoneal injection. No medication was administered to the control group (n=6). Immunohistochemistry for E-cadherin, beta-catenin and growth factors was performed on lung tissues and protein expression levels assessed using H-scores. Statistically significant differences were observed in E-cadherin, beta-catenin, EGF, FG, and PFGF (P<0.001 for all) as well as the IGF H-scores between the five groups (P<0.005). Only anti-VEGF treatment caused E-cadherin and beta-catenin levels to increase to the level of non-asthmatic control groups (P>0.005). All treatment groups had reduced TGF-beta, PDGF and FGF H-scores in comparison with the untreated asthma group (P=0.001). The EGF and IGF levels were not significantly different between the untreated asthmatic and non-asthmatic controls. The results suggested that anti-VEGF and TNF-alpha inhibition treatments are effective in decreasing growth factors, in a similar manner to conventional corticosteroid treatments. Anti-VEGF and TNF inhibition therapy may be an effective treatment for remodeling in asthma while offering an alternative therapeutic option to steroid protective agents. The data suggested that anti-VEGF treatment offered greater restoration of the epithelial barrier than both anti-TNF-alpha and corticosteroid treatment.Item IgE mediated food allergy in Turkish primary school childrenMustafayev, R; Civelek, E; Orhan, F; Yüksel, H; Boz, AB; Sekerel, BItem Prevalence of and factors related to tobacco smoking in children with asthmaYüksel, H; Yasar, A; Türkeli, A; Kalkiner, CS; Yilmaz, OItem Cord blood Interleukin-13 and IFN-Gamma levels As Biomarkers of Ever-Wheezing in the First Year of LifeYilmaz, Ö; Yasar, A; Ay, P; Polat, AC; Cingöz, FO; Alkin, T; Taneli, F; Hasdemir, S; Basbay, YS; Yüksel, HItem Awareness and intervention approaches related to smoking addiction among child and adolescent psychiatristsErten, T; Sapmaz, SY; Güleç, AG; Hesapçioglu, ST; Kandemir, H; Yilmaz, Ö; Yüksel, HAim: To determine the attitudes of child and adolescent psychiatrists working in different institutions throughout Turkey towards smoking addiction and intervention steps. Material and Methods: An information form assessing physicians' 5As approach was established considering the studies included in the literature, and this form was applied to physicians working in the area of child psychiatry by way of e-mail and phone. Results: Although most physicians (52.5%) asked about smoking status, which is included in the first step in the 5As approach used in smoking cessation, it was observed that they implemented further steps of the 5As with gradually decreasing rates in our study. Only 15% of the physicians performed follow-up in smoking cessation treatment. Conclusion: Physicians who work with pediatric and adolescent patients in Turkey have low levels of awareness about smoking addiction and they do not feel competent. Considering that tobacco and related addictions are gradually increasing in children and adolescents, physicians must receive training in the area of smoking cessation methods and start practicing these methods. It was thought that organizing smoking cessation training for physicians would contribute positively to the treatment of patients.Item Effects of Vitamin D Levels on Asthma Control and Severity in ChildrenTurkeli, A; Ayaz, O; Uncu, A; Özhan, B; Kavaz Tufan, A; Bas, VN; Yilmaz, Ö; Yüksel, HObjective: The prevalence rates of asthma and vitamin D deficiency have been increasing in parallel, leading to significant morbidity. This study aimed to compare the vitamin D levels in the children with asthma and in healthy controls and to assess the relationship between vitamin D levels and asthma clinical parameters and control. Materials and Methods: 115 children with asthma and 115 controls who presented to the Pediatric Immunology and Allergy outpatient clinic between December 2014 and February 2015 were enrolled in the study. Vitamin D levels were measured. Levels = 20 ng/ml were considered adequate and those lower than 20 ng/ml as deficient. Asthma control was classified according to the Global Initiative for Asthma guidelines (GINA) and Childhood asthma control test (C-ACT). Results: Serum vitamin D levels were 17.27 (5.77) ng/ml in the asthma group and 22.78 (10.64) ng/ml in the control group, indicating statistical significance (p= 0.001). When the asthma patients were divided into groups according to vitamin D level, 72.2% were deficient while 27.8% had adequate levels. The number of asthma exacerbations, number of emergency service visits and the number of hospitalizations within the last year were higher in the deficient group, compared to the adequate group (p < 0.001, p 0.001 and p < 0.002, respectively). Uncontrolled asthma rates were higher in the deficient group, compared to the adequate group (p < 0.01). Serum vitamin D levels were correlated with the ACT score (r= 0.204, p= 0.03). Conclusion: The rate of vitamin D deficiency was higher in asthmatic children compared to the controls. We also showed that increased asthma severity and reduced asthma control were associated with vitamin D deficiency. There was a positive correlation between serum vitamin D levels and asthma control.Item Clinical significance of lung perfusion defects in children with post-infectious bronchiolitis obliteransYüksel, H; Yilmaz, Ö; Ürk, V; Yüksel, D; Göktan, C; Savas, R; Sayit, EClinical significance of segmental lung perfusion defects in children with bronchiolitis obliterans (BO), have not been reported before. The aim of this study was to evaluate clinical significance of lung perfusion defects in children with BO and to reveal its impact on follow up. The study included 38 children aged 9 to 60 months (17.8 +/- 13.4 months) with BO. Diagnosis was based on persistent respiratory findings beyond six weeks and oligemic-mosaic pattern in lung high resolution computerized tomography. Chest X-ray, 24 hour esophageal pH monitoring, sweat chloride test, immunoglobulin levels and respiratory viral screening were carried out in all. Lung perfusion scintigraphy was carried out at least three months after the first clinical sign of BO. Perfusion defects were scored. Scintigraphy demonstrated perfusion defects in 24 (63.2%) patients but was normal in 14 (36.8%). Number of segments having perfusion defects was 2.9 +/- 2.6. Mean number of exacerbations and days of hospitalization during the first year of follow up were 4.7 +/- 4.4 and 26.9 +/- 29.8 respectively. It was detected that number of perfusion defects correlated significantly with the number of exacerbations and duration of hospitalization (r= 0.66 and p= 0.00). In conclusion, number and extent of segments with perfusion defects in lungs of children with BO are correlated with clinical severity. Therefore, evaluation of lung perfusion status may aid in clinical determination of disease severity and its follow-up.