Browsing by Author "Yüksel H."
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Item The use of intermittant dose azithromycin in children with sinusitis; [Çocukluk çaǧinda akut si̇nüzi̇t tedavi̇si̇nde i̇ntermi̇ttant doz azi̇tromi̇si̇n kullanimi](2001) Yüksel H.; Coşkun Ş.; Demir E.; Ikizoǧlu T.; Yilmaz D.; Onaǧ A.; Tanaç R.Aim: Antibiotic selection and the duration of its use are two of the most important factors that affect the prognosis of children with sinusitis. New effective antibiotherapy strategies with higher dose and short usage interval in children with sinusitis are needed because compliance to drug usage is difficult in childhood. In this study we aimed to compare 'single dose intermittent usage' of azithromycin (AZT) therapy and 'two doses per day for 15 days usage' of amoxisilin-clavunate (AMK) in the treatment of children with acute maxillary sinusitis. Material and Method: Sixty-one children diagnosed as having maxillary sinusitis (between 5 and 14 years old) were enrolled into study. Twenty-nine children were treated using single daily dose of AZT for five days. After a treatment- free period for 5 days, the drug was readministered for five days. Thirty-two children were treated using two doses of AMK for fifteen days. Clinical signs, symptom scores of sinusitis and compliance to the therapy were followed up for two weeks. Results: At the end of the first week, the mean symptom score of the AZT group was significantly lower than that of the AMK group (p<0.05). Although it was lower in AZT group, the symptom scores at the end of the second week were not significantly different between the two groups. Recovery rate from sinusitis was 93% in the AZT and 91% in the AMK group. Seven percent of the AZT group patients failed to use the total recommended dose and also 3% stopped the therapy earlier. In the AMK group, these were 24% and 15% respectively, and the difference between two groups was statistically significant (p<0.05). Satisfaction from using the drug was significantly higher in the AZT group than the AMK group. Conclusion: The therapy regimen with a single dose - intermittant usage of AZT for five days is as effective as two doses of AMK therapy for fifteen days. Furthermore, it was shown that intermittant dose AZT reduced symptom scores of sinusitis earlier. Thus, an intermittant dose of AZT recommendation may be a new, more compliant and effective therapy regiment in the treatment of children with sinusitis.Item Is attempting suicide an adverse effect of oxybutynin in a child with enuresis nocturna? [1](Lippincott Williams and Wilkins, 2001) Coskun S.; Yüksel H.; Onag A.[No abstract available]Item Non-invasive evaluation of the adaptations of cardiac function in the neonatal period: A comparison of healthy infants delivered by vaginal route and caesarean section(2001) Coskun S.; Yüksel H.; Bilgi Y.; Lacin S.; Tansug N.; Onag A.Postnatal adaptations of cardiac hemodynamics in infants born vaginally or by caesarean section may be different. These cardiac functions were evaluated by Doppler echocardiography to assess adaptation differences. Cardiac output, heart rate, stroke volume, mean arterial pressure, total systemic vascular resistance, ejection fraction, and ductus arteriosus diameter were determined and compared at 1, 24 and 72 h of life in 22 infants born vaginally (group 1) and 23 born by caesarean section (group 2). One hour after delivery, heart rate, mean blood pressure, and total systemic resistance were found to be higher in group 1 infants (P < 0.01, P < 0.05, P < 0.05 respectively). Stroke-volume measurements were significantly higher in group 2 (P < 0.05). The ejection fraction and cardiac output values were similar in both groups. At 24 and 72 h, no significant differences were observed in measurements of infants born vaginally or by caesarean section. We did not find a parameter negatively affecting healthy newborns in either mode of delivery. However, under pathological conditions affecting the cardiovascular system at 1 h of life, including perinatal infections and hypoxemia, a lower stroke volume, higher heart rate, higher mean blood pressure, and higher peripheral resistance may cause additional work load to the cardiovascular system in infants born vaginally.Item Pumpkin seed aspiration into the middle of the trachea in a wheezy infant unresponsive to bronchodilators [1](2001) Yüksel H.; Coskun S.; Onag A.[No abstract available]Item Diagnosis of asymptomatic atrial septal aneurysms using two-dimensional color Doppler and contrast transthoracic echocardiography(2003) Coşkun S.; Sekuri C.; Bayturan Ö.; Yüksel H.; Saribülbül O.; Bilge A.Objective. To evaluate the dimensions of atrial septal aneurysm (ASA), the presence and characteristics of interatrial shunt, the movement of the wall of the aneurysm, and correlation between these findings and sign and/or symptoms suggesting embolism in Manisa, a district of a western Anatolian city of Turkey. Methods. Two thousand five hundred cases were examined by routine transthoracic echocardiography (TTE) in both pediatric and adult cardiology outpatient clinics. ASA was detected in 20 cases and evaluated by two-dimensional color Doppler echocardiography (CDE). The length of the base, the maximum radius and the maximum displacement of ASA were measured. The shunt between the atria was examined by CDE. In cases where a shunt could not be found, galactose and palmitic acid was injected. Standard 12-lead electrocardiogram (ECG) and exercise stress test were also performed. Results. No clinical signs or symptoms were found, suggesting a systemic or cerebral embolism. The maximum displacement of ASA was between 2 and 5 mm. All of the aneurysms were localized in the right atrium, and the walls of the aneurysm did not move beyond the base of the left atrium during the maximum displacement. Interatrial shunt was detected in 14 of 20 patients (70%) by CDE and in the remaining six cases by contrast TTE. Frequent ventricular ectopic beats were observed in one patient. Conclusion. During routine TTE we observed 0.8% asymptomatic ASA in our population. The use of a contrast agent was found to be a valuable additional method in patients with ASA when the shunt could not be detected by CDE. The risk for embolism is not high when the maximum displacement of the wall of ASA was 5 mm or less and no bulge into the left atrium was observed. Based on our experience with this method, TTE is easy to perform, well-tolerated and acceptable.Item Protective Effect of Leukotriene Receptor Antagonist Montelukast on Smoking-Induced Lung Injury in Wistar Rats(2003) Yüksel H.; Ozbilgin K.; Coskun S.; Tuglu I.Increased activation of alveolar macrophage, neutrophil and mast cell has been proven in cigarette smoking (CS)-related lung disorders (CSLD). An increased production of cysteinyl-leukotrienes (LTs), which are mediators secreted from the mentioned cells, in response to CS has been shown in humans. The protective effect of LT1 receptor-1 antagonist (LTR-1AT) on CSLD is, however, not known. In this study we aimed to determine whether there is any protective effect of a LTR-1AT, montelukast (MK), on CSLD in Wistar rats. Nine controls and twenty-three smoke-exposed rats were enrolled into this study. Controls were exposed to non-filtered air, and the smoke-exposed rats were exposed to CS for 6 h/day, 6 days/week for three weeks. The CS-exposed rats were also treated with 0.1 mg/kg/day of MK or saline. Morphometric criteria for lung injury were determined as the mean linear intercept of alveolar septa (Lm), the volume density of alveolar septa (Vvspt) and the density of the alveolar surface area per unit volume of lung parenchyma (Sva.pa). Lung mast cells (LMC), which are a major source of LTs, were also counted. Results showed that Lm of the control group was significantly lower and Vvspt, Sva.pa of the controls were significantly higher compared to those of the CS-exposed groups. Animals treated with MK had significant protection against CSLD. Lm was significantly higher and Vvspt, Sva.pa were lower in the saline group than in the MK-treated group. The number of LMC in the CS-exposed groups was also significantly higher than that in the control group. Based on these results, one can suggest that some part of the pathogenesis of CSLD may be related to an enhanced LTs synthesis and LTR-1AT. Therefore, montelukast may protect against active or passive smoking-induced lung injury and related disorders.Item Biochemical markers of bone metabolism and calciuria with inhaled budesonide therapy(2004) Akil I.; Yüksel H.; Ürk V.; Var A.; Onur E.We investigated the changes in renal excretion of calcium, sodium, and potassium in asthmatic children treated with inhaled budesonide, an inhaled glucocorticoid. Twenty-two asthmatic patients (7 female, 15 male, mean age 10.1±4.3 years) treated with 400-600 μg/day inhaled budesonide and 23 healthy children (6 female, 17 male, mean age 10.2±2.8 years) were enrolled in the study. The parameters recorded were serum sodium, potassium, calcium, phosphorus, alkaline phosphatase (ALP), type I collagen carboxyterminal telopeptide (ICTP), osteocalcin, intact parathyroid hormone (PTH) levels, first spot morning urine calcium/creatinine ratio, sodium/potassium ratio, and daily renal calcium excretion rate (UCa-ER). These parameters were measured in the control group and pre- and post-budesonide treatment in asthmatic children. Serum electrolytes, ALP, PTH, ICTP, and UCa-ER were in the normal ranges and were not significantly different between controls and asthmatic children. Serum levels of ICTP increased, while levels of osteocalcin decreased after budesonide therapy in the asthmatic group (P=0.001, P=0.005). UCa-ER was decreased after budesonide therapy in asthmatics (P=0.000). In conclusion, moderate doses of inhaled budesonide cause hypocalciuria and decreased bone turnover. These results may be attributed to a mechanism compensating for decreased absorption of calcium in the gut due to the topical effect of swallowed budesonide rather than the systemic effects of the drug. Increased bone metabolism and decreased turnover may have an important role in this compensatory mechanism. © IPNA 2004.Item Fulminant meningococcemia and acute renal failure in a 3-year-old boy(2004) Akil I.; Yüksel H.; Coskun S.; Yilmaz D.; Onag A.Acute renal failure is a common occurrence in sepsis, but is rarely reported in meningococcemia. We present a young child diagnosed with fulminant meningococcemia who had several poor prognostic factors, including hypotension, thrombocytopenia, purpura fulminans, seizures, the absence of meningitis with meningococcemia, and acute renal failure, which was successfully treated with peritoneal dialysis. Peritoneal dialysis was started on the 5th day because the patient had been anuric for 48 h. At that time, analysis showed that the child was both hypokalemic and hypophosphatemic. His serum blood urea nitrogen was 61 mg/dl, creatinine 2.75 mg/dl, potassium 2.8 mEq/l, and phosphorus 0.7 mg/dl. Urine output began on the 12th day post admission and normalization of serum creatinine was achieved on the 26th day. In conclusion, renal failure is an important complication of meningococcemia and, to be effective, sometimes long-term peritoneal dialysis is required. Profound metabolic abnormalities, such as hypokalemia and hypophosphatemia, may occur paradoxically in the presence of oliguria.Item Hypernatremic dehydration and renal vein thrombosis in a case with Cornelia de Lange syndrome associated with holoprosencephaly; [Corneli̇a de Lange sendromuna eşli̇k eden holoprosensefali̇li̇ olguda hi̇pernatremi̇k dehi̇dratasyon ve renal ven trombozu](2004) Akil I.; Yüksel H.; Gözmen S.; Tarhan S.Cornelia de Lange syndrome (CDL) has characteristic features such as microcephaly, synophrys, long philtrum and intrauterine growth retardation, and mental and motor retardation. The syndrome is usually sporadic, although autosomal dominant and recessive inheritance might be a factor in some cases. Although midline malformations of the brain are common in CDL, holoprosencephaly is not usual. In this paper, we discussed hypernatremic dehydration and renal vein thrombosis complications in a case with CDL associated with holoprosencephaly.Item Septic pulmonary emboli presenting with deep venous thrombosis secondary to acute osteomyelitis(2004) Yüksel H.; Özgüven A.A.; Akil I.; Ergüder I.; Yilmaz D.; Çabuk M.[No abstract available]Item Calcitonin expression of high endothelial venules during lymphocyte migration in human pharyngeal tonsil(2006) Ozbilgin M.K.; Kirmaz C.; Yüksel H.; Kurtman C.; Kaya M.The migration routes of lymphocytes through high endothelial venules (HEVs) of control and hypertrophic pharyngeal tonsil (HPT) tissue sections were investigated by immunohistochemistry using the expression of a hormone [calcitonin (CT)] and two calcium-dependent endothelial adhesion molecules (E-selectin and P-selectin), as well as electron microscopy. A marked increase in CT-specific staining was observed in the endothelial cells of HEV in the HPT group compared to the control group. Expressions of E-selectin and P-selectin on HEVs of control group were faint, when compared to the strong expression of these selectins on HEVs of HPT. Electron microscopically, we demonstrated that lymphocytes transmigrated through HEV and observed the close membranous contact between endothelial cells and lymphocytes during this process. We speculate that increasing CT during inflammation may be important for lymphocyte migration through the HEVs via controlling the expression of E-selectin and P-selectin.Item Frequency of gastroesophageal reflux disease in nonatopic children with asthma-like airway disease(2006) Yüksel H.; Yilmaz O.; Kirmaz C.; Aydogdu S.; Kasirga E.Gastroesophageal 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 24 h 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. © 2005 Elsevier Ltd. All rights reserved.Item Improved efficacy of aerosol delivery to distal airways in pediatric subjects using a new spacer mouth-mask(Meditions Carline, 2007) Yüksel H.; Berardino L.; Yüksel D.; Yilmaz Ö.; Burak Z.Aerosol nebulization is one of the safest and most effective ways of treating airway diseases especially in children. Failure of inhaled asthma treatment is mainly due to inadequate deposition of drugs in the peripheral area of the lungs. The aim of this study was to compare the efficacy of a traditional mask and that of a new spacer mouth-mask (Nebula, Markos Mefar, Italy) when used with a jet nebulizer, by measuring aerosol deposition in the lungs, oropharynx, upper airways, and gastrointestinal tract. Twelve children without respiratory disease aged between 8 and 13 years were included in the study. Aerosol inhalation was performed using a jet nebulizer with 2 mL of saline solution containing 20 Mci of Tc99m-DTPA. The first group initially performed aerosol inhalation using a traditional facemask and then, one week later, using the new spacer mouth-mask. The second group performed aerosol inhalation using the new spacer mouth-mask first and then, one week later, using a traditional mask. Scintigraphic ventilation images ware then obtained, and aerosol deposition in the trachea, oropharynx, lungs and stomach was measured. In the first group, the radioaerosol deposition in the peripheral lung area using the new spacer mouth-mask was greater 97.8±7.0 vs 68.5*7.9 (p=0.04). On the other hand, the oropharyngeal radioaerosol deposition was greater using the traditional mask: 50.2±5.2 vs 20.3±11.8 (p = 0.028). Similarly, in the second group the peripheral lung deposition was greater and the oropharyngeal deposition was less using the new spacer mouth-mask: 97.3±9.4 vs 70.2*11.2 and 20.7 ± 8.9 vs 46.3±16.8 (p=0.028 and 0.046 respectively). In conclusion, the new design of the spacer mouth-mask allows greater aerosol deposition in the peripheral lung area and less in other parts such as the oropharyngeal area, the central airways and the stomach.Item A province-based study using sampling method to investigate the prevalence of cystic echinococcosis among primary school children in Manisa, Turkey(2007) Ok U.Z.; Özkol M.; Kilimcioǧlu A.A.; Dinç G.; Bayindir P.; Östan I.; Pabuşçu Y.; Özcan C.; Korkmaz M.; Coşkun S.; Yüksel H.; Girginkardeşler N.A 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. © 2007 Elsevier B.V. All rights reserved.Item A case of primary pulmonary tuberculosis presenting as foreign body aspiration(IOS Press, 2007) Ikizoǧlu T.; Yilmaz O.; Özkol M.; Söǧüt A.; Yüksel H.An 18-month-old child was hospitalized with presumptive diagnosis of foreign body aspiration. Chest radiography revealed atelectasis in the right lower lobe. Foreign body was not seen at rigid bronchoscopy. Tuberculin skin test was 11 mm with one scar of Bacillus Calmette-Guerin vaccine. Computerized tomography of thorax revealed conglomerating lymphadenopathy in the right hilus and calcified lymphadenopathy as well as pneumonic consolidation of the right lower lobe. Tuberculosis was diagnosed based on his tuberculin skin test and thorax computerized tomography. This case is presented to emphasize that tuberculosis should be included to the differential diagnosis of children that present with signs and symptoms of foreign body aspiration and atelectasis. © 2007 IOS Press. All rights reserved.Item A rare cause of persistent atelectasis in childhood: Mucoepidermoid carcinoma(2008) Söǧüt A.; Yilmaz Ö.; Yüksel H.A 12-year-old boy presented to our clinic with recurrent lower respiratory tract symptoms that are wheezing, cough, bronchopneumonia, and fever and with a diagnosis of bacterial endocarditis. Physical examination revealed that breath sounds diminished in the left lower lobe. Because cardiac sounds and echocardiography were normal bacterial endocarditis was excluded. Chest radiograph and computerized tomography scan showed a left lower lobe atelectasis and consolidation. Despite medical therapy including antibiotics, bronchodilator etc, atelectasis persisted. Fiberoptic flexible bronchoscopy (FFB) revealed a tumor that totally obstructed the left lower lobe bronchus. Open lung biopsy revealed a low-grade mucoepidermoid carcinoma. Left lower lung lobectomy was performed. The patient is in good condition 12 months after the operation. We proposed that FFB should be performed earlier in patients with recurrent lower respiratory symptoms who have persistent atelectasis or unifocal infiltration.Item Common viral etiologies of community acquired lower respiratory tract infections in young children and their relationship with long term complications; [Küçük çocuklarda toplum kökenli viral alt solunum yolu enfeksiyonu etkenlerinin sιklιǧι ve uzun dönem komplikasyonu ile ilişkileri](2008) Yüksel H.; Yilmaz Ö.; Akçali S.; Söǧüt A.; Yilmaz Çiftdoǧan D.; Urk V.; Ertan P.; Şanlidaǧ T.Viral lower respiratory tract infections (LRTIs) and their late complications are important causes of morbidity and mortality in childhood. The aims of this study were the detection of viral agents that cause community-acquired LRTIs in young children and investigation of the relationship between viral etiology and bronchiolitis obliterans (BO) which is one of the late complications of LRTIs. A total of 151 children (86 male, 65 female; mean age: 2.9 ± 1.9 years) who were diagnosed to have LRTIs between the period of 2002-2004, at Pediatric Allergy and Pulmonology Department of a University Hospital in Manisa (located in the Aegean region of Turkey) were included to the study. The presence of respiratory viruses [respiratory syncytial virus (RSV), influenza virus type A and B, parainfluenza virus types 1, 2 and 3, adenovirus] in the nasopharyngeal aspirate specimens collected from children have been searched by direct fluorescence antibody test (Biotrin, Ireland). Respiratory viruses were detected in 25.2% (38/151) of the patients with LRTIs, while this rate was 46.8% (22/47) for 2002 period, 13.3% (8/60) for 2003 period and 18.2% (8/44) for 2004 period. RSV and adenoviruses both detected with a frequency of 31.5% (n= 12/38); were the most common agents encountered, and followed by parainfluenza (10/38, 26.3%) and influenza (9/38, 23.6%) viruses. Postinfectious BO have been diagnosed in 7.3% (11/151) of the patients; seven in 2002, one in 2003 and three in 2004 periods. Viral etiology were present in all of the patients who developed BO in 2002, while viral infection was detected in one of the patients who developed BO in 2003-2004 periods. Adenoviruses were the most frequently detected agents (n= 5) in BO cases with viral etology (n= 8). Viral agents were found positive in 72.7% (8/ 11) and 21.4% (30/140) of the patients with and without BO development, respectively, and this difference was found statistically significant (p= 0.02). Besides, BO development was detected in 21.1% (8/38) and 2.6% (3/113) of LRTI patients with and without viral etiology, respectively, and this difference was also significant (p< 0.05). In conclusion, the long term follow-up is important in young children with viral LRTIS for the early diagnosis of complications. Thus the identification of viruses might aid in estimation of prognosis.Item Evaluation of sleep quality in mothers of children with bronchiolitis obliterans; [Bronşiyolitis obliteransli çocuklarin annelerinde uyku niteliǧinin deǧerlendirilmesi](Kare Publishing, 2009) Yüksel H.; Çiftdoǧan D.Y.; Yilmaz Ö.; Söǧüt A.Aim: The aim of this study was to evaluate the quality of sleep in mothers of children with bronchiolitis obliterans. Material and Method: The study group consisted of 36 mothers with a child who had bronchiolitis obliterans and 62 mothers with healthy children. All mothers enrolled in the study filled in the Pittsburgh Sleep Quality Index (PSQI). Results: The mean ages of the children of the mothers enrolled in the study were statistically similar (3.57±2.58 vs 3.85±1.46 years, p>0.05). Total Pittsburgh Sleep Quality Index scores and subjective sleep quality scores in the mothers of children with bronchiolitis obliterans were significantly higher than those in the mothers of healthy children (both p=0.015). Conclusions: In this study, it was found that mothers of children with bronchiolitis obliterans have poor sleep quality. Therefore, assessment may be needed for the requirement of support regarding sleep quality in them.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 A multi-center survey of childhood asthma in Turkey - I: The cost and its determinants(2009) Beyhun N.E.; Soyer O.U.; Kuyucu S.; Sapan N.; Altintaş D.U.; Yüksel H.; Anlar F.Y.; Orhan F.; Cevit O.; Çokùras H.; Boz A.B.; Yaziciòlu M.; Tanaç R.; Şekerel B.E.Successful management of childhood asthma requires a thorough idea of the economic impact of asthma and its determinants, as policy makers and physicians inevitably influence the outcome. The aim of this study was to define the cost of childhood asthma in Turkey and its determinants. In April 2006, a multi-center, national study was performed where data regarding cost and control levels were collected. Asthmatic children (6-18 yr) with at least a 1-yr follow-up seen during a 1-month period with scheduled or unscheduled visits were included. The survey included a questionnaire-guided interview and retrospective evaluation of files. Cost and its determinants during the last year were analyzed. A total of 618 children from 12 asthma centers were surveyed. The total annual cost of childhood asthma was US$1597.4 ± 236.2 and there was a significant variation in costs between study centers (p < 0.05). Frequent physician visits [odds ratio (95% confidence intervals)] [2.3 (1.6-3.4)], hospitalization [1.9 (1.1-3.3)], asthma severity [1.6 (1.1-2.8)], and school absenteeism due to asthma [1.5 (1.1-2.1)] were major predictors of total annual costs (p < 0.05 for each). The comparable cost of asthma among Turkish children with that reported in developed countries suggests that interventions to decrease the economic burden of pediatric asthma should focus on the cost-effectiveness of anti-allergic household measures and on improving the control levels of asthma. © 2008 Blackwell Munksgaard.