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Item A radiologico-anatomical comparative study of the cochlear aqueduct(W.B. Saunders Ltd, 2000) Tekdemir I.; Aslan A.; Ersoy M.; Karahan S.T.; Tellioglu C.Aim: A comparative radiologico-anatomical study of the cochlear aqueduct (CA) was performed. Materials and Methods: Eight cadavers and 23 dry temporal bones were studied. High-resolution computed tomography (HRCT) was carried out on each cadaver before microdissection. Microdissection was carried out in a plane parallel to the HRCT sections. Results: The CA was found to be located an average of 7 mm inferior to the internal acoustic meatus and at the superior edge of the jugular foramen. The external aperture of the CA was triangular in shape in 18 bones (78.3%). The petrosal fossa was located just inferior to the external aperture and housed the glossopharyngeal nerve, which had an incomplete bony canal in four bones (17.4%) and a complete bony canal in three bones (13%). It was possible to demonstrate the petrosal portion of the CA on both coronal and axial HRCT. The otic capsule segment of the CA was impossible to demonstrate on coronal sections. Conclusion: The CA cannot be visualized in only one section of the plane in HRCT. Both the otic capsule and petrosal segments can be demonstrated on axial HRCT. © 2000 The Royal College of Radiologists.Item IL-5, IL-8 and MMP -9 levels in exhaled breath condensate of atopic and nonatopic asthmatic children(W.B. Saunders Ltd, 2015) Turkeli A.; Yilmaz O.; Taneli F.; Horasan G.D.; Kanik E.T.; Kizilkaya M.; Gozukara C.; Yuksel H.Rationale Asthma is a heterogeneous disease, and a great majority of pediatric patients with asthma demonstrate atopic characteristics and develop a Th2 type cytokine response. Nonatopic asthma, on the other hand, is seen more rarely. Methods In this study, levels of IL-5, IL-8 and MMP-9 were measured in exhaled breath condensate (EBC) of the subjects to demonstrate the extent of tissue damage as well as eosinophilic and neutrophilic inflammation in children with atopic and nonatopic asthma. A total of 37 children with atopic asthma and 37 children with nonatopic asthma were enrolled in the study. Patients who exhibited protease positive aeroallergen (House dust mite, mould mix, olea, grass mix) sensitivity in allergen skin prick test were included in the atopic asthma group. To evaluate the EBC, the fluid content of the breath was collected by having the patients exhale into an EBC device, after which the IL-5, IL-8 and MMP-9 levels were assayed using the ELISA method. Results The atopic asthmatics exhibited significantly higher IL-5 levels in their EBC samples than the nonatopic asthmatics (0.271 [0.198-0.489] pg/ml and 0.198 [0.125-0.344] pg/ml, respectively, p = 0.04), while no significant differences were observed in the levels of IL-8 and MMP-9 in the EBC samples of the atopic and nonatopic asthmatics. Conclusions IL-5 levels, as a marker of eosinophilic inflammation, were demonstrated to be higher in the children with atopic asthma when compared to those with nonatopic asthma in EBC. The fact that no significant difference was apparent in the IL-8 levels between the groups suggests that it is the severity of the disease rather than the atopic state that plays an important role in IL-8 levels. Since no difference was recorded between the groups in terms of MMP-9 levels, lung damage in asthma sufferers seems to develop independent of atopia. © 2015 Elsevier Ltd.Item Pediatric lung function testing during a pandemic: An international perspective(W.B. Saunders Ltd, 2020) Beydon N.; Gochicoa L.; Jones M.J.; Lands L.C.; Lombardi E.; Rosenfeld M.; Sly P.D.; Weiner D.J.; Yilmaz O.The COVID pandemic has passed its first peak for now in many countries while some are still on the rise, with some facing a second wave of cases. Precautions and infection control measures for both pediatric and adult pulmonary function testing (PFT) have been a topic of debate during the pandemic. Many centers had to close their PFT laboratories during the initial periods of the pandemic and are reopening as the numbers of new cases are decreasing. This review aims to summarize different practices of PFT laboratory management in different countries, including patient appointments, personal protective equipment, testing room requirements and telemedicine during and immediately following the COVID pandemic. © 2020Item The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients(W.B. Saunders Ltd, 2021) Kokturk N.; Babayigit C.; Kul S.; Duru Cetinkaya P.; Atis Nayci S.; Argun Baris S.; Karcioglu O.; Aysert P.; Irmak I.; Akbas Yuksel A.; Sekibag Y.; Baydar Toprak O.; Azak E.; Mulamahmutoglu S.; Cuhadaroglu C.; Demirel A.; Kerget B.; Baran Ketencioglu B.; Ozger H.S.; Ozkan G.; Ture Z.; Ergan B.; Avkan Oguz V.; Kilinc O.; Ercelik M.; Ulukavak Ciftci T.; Alici O.; Nurlu Temel E.; Ataoglu O.; Aydin A.; Cetiner Bahcetepe D.; Gullu Y.T.; Fakili F.; Deveci F.; Kose N.; Tor M.M.; Gunluoglu G.; Altin S.; Turgut T.; Tuna T.; Ozturk O.; Dikensoy O.; Yildiz Gulhan P.; Basyigit I.; Boyaci H.; Oguzulgen I.K.; Borekci S.; Gemicioglu B.; Bayraktar F.; Elbek O.; Hanta I.; Kuzu Okur H.; Sagcan G.; Uzun O.; Akgun M.; Altinisik G.; Dursun B.; Cakir Edis E.; Gulhan E.; Oner Eyuboglu F.; Gultekin O.; Havlucu Y.; Ozkan M.; Sakar Coskun A.; Sayiner A.; Kalyoncu A.F.; Itil O.; Bayram H.The COVID-19-related death rate varies between countries and is affected by various risk factors. This multicenter registry study was designed to evaluate the mortality rate and the related risk factors in Turkey. We retrospectively evaluated 1500 adults with COVID-19 from 26 centers who were hospitalized between March 11 and July 31, 2020. In the study group, 1041 and 459 cases were diagnosed as definite and highly probable cases, respectively. There were 993 PCR-positive cases (66.2%). Among all cases, 1144 (76.3%) were diagnosed with non-severe pneumonia, whereas 212 (14.1%) had severe pneumonia. Death occurred in 67 patients, corresponding to a mortality rate of 4.5% (95% CI:3.5–5.6). The univariate analysis demonstrated that various factors, including male sex, age ≥65 years and the presence of dyspnea or confusion, malignity, chronic obstructive lung disease, interstitial lung disease, immunosuppressive conditions, severe pneumonia, multiorgan dysfunction, and sepsis, were positively associated with mortality. Favipiravir, hydroxychloroquine and azithromycin were not associated with survival. Following multivariate analysis, male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were found to be independent risk factors for mortality. Among the biomarkers, procalcitonin levels on the 3rd-5th days of admission showed the strongest associations with mortality (OR: 6.18; 1.6–23.93). This study demonstrated that the mortality rate in hospitalized patients in the early phase of the COVID-19 pandemic was a serious threat and that those patients with male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were at increased risk of mortality; therefore, such patients should be closely monitored. © 2021 Elsevier LtdItem Re-examining the characteristics of pediatric multiple sclerosis in the era of antibody-associated demyelinating syndromes(W.B. Saunders Ltd, 2022) Yılmaz Ü.; Gücüyener K.; Yavuz M.; Öncel İ.; Canpolat M.; Saltık S.; Ünver O.; Çıtak Kurt A.N.; Tosun A.; Yılmaz S.; Özgör B.; Erol İ.; Öztoprak Ü.; Elitez D.A.; Direk M.Ç.; Bodur M.; Teber S.; Anlar B.; Aykol D.; Yıldız E.P.; Yarar C.; Kara B.; Haspolat; İncecik F.; Kutluk G.; Dilber C.; Dundar N.O.; Tan H.; Demir E.; Dursun B.D.; Dilek T.D.; Türkdoğan D.; Yalnızoğlu D.; Akbaş S.; Güleç A.; Yılmaz D.; Ayanoğlu M.; Kanmaz S.; Güngör S.; Öztürk G.; Besen; Haliloğlu G.; Karaca N.B.; Öztürk S.; Yüksel D.; Gürkaş E.; Oktay S.; Serin H.M.; Karadağ M.; Hakkı Akbeyaz İ.; Yiş U.; Polat B.G.; Okan M.S.; Bektaş Ö.; Orgun L.T.; Günbey C.; Per H.; Gültutan P.; Öztürk S.B.; Aksoy E.; Akyüz G.; Tekgül H.; Kürekçi F.; Kurul A.S.H.; Çarman K.B.; Alikılıç D.; Duman Ö.; Kömür M.; Yıldırım M.; Alıcı N.; Gümüş H.; Polat M.; Konuşkan B.; Güngör O.; Mert G.G.; Edizer S.; Mıhçı F.; Öztürk S.T.; Toker R.T.; Arslan M.; Şahin S.; Gencpinar P.; Yıldırım E.; Yüksel E.; Ekici A.; Deniz A.; Yayici Köken Ö.; Okuyaz Ç.; Süt N.Y.; Atasoy E.; Solmaz İ.; Yetkin M.F.; Bilgin N.; Atasever A.K.; Tekin H.G.; Dokurel İ.; Özçelik A.; Aksoy A.; Türköz A.N.; Cavusoglu D.; Özkan M.; Tekin E.; Şahin T.U.; Ünalp A.; Koç H.; Sarıgeçili E.; Sarıtaş S.; Ayça S.; Kayılıoğlu H.; Şenoğlu M.Ç.; Kamaşak T.; Asadova N.; Keskin F.; Karaoğlu P.; İpek R.; Acer H.Background: The discovery of anti-myelin oligodendrocyte glycoprotein (MOG)-IgG and anti-aquaporin 4 (AQP4)-IgG and the observation on certain patients previously diagnosed with multiple sclerosis (MS) actually have an antibody-mediated disease mandated re-evaluation of pediatric MS series. Aim: To describe the characteristics of recent pediatric MS cases by age groups and compare with the cohort established before 2015. Method: Data of pediatric MS patients diagnosed between 2015 and 2021 were collected from 44 pediatric neurology centers across Türkiye. Clinical and paraclinical features were compared between patients with disease onset before 12 years (earlier onset) and ≥12 years (later onset) as well as between our current (2015–2021) and previous (<2015) cohorts. Results: A total of 634 children (456 girls) were enrolled, 89 (14%) were of earlier onset. The earlier-onset group had lower female/male ratio, more frequent initial diagnosis of acute disseminated encephalomyelitis (ADEM), more frequent brainstem symptoms, longer interval between the first two attacks, less frequent spinal cord involvement on magnetic resonance imaging (MRI), and lower prevalence of cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCBs). The earlier-onset group was less likely to respond to initial disease-modifying treatments. Compared to our previous cohort, the current series had fewer patients with onset <12 years, initial presentation with ADEM-like features, brainstem or cerebellar symptoms, seizures, and spinal lesions on MRI. The female/male ratio, the frequency of sensorial symptoms, and CSF-restricted OCBs were higher than reported in our previous cohort. Conclusion: Pediatric MS starting before 12 years was less common than reported previously, likely due to exclusion of patients with antibody-mediated diseases. The results underline the importance of antibody testing and indicate pediatric MS may be a more homogeneous disorder and more similar to adult-onset MS than previously thought. © 2022 European Paediatric Neurology SocietyItem A network meta-analysis of the association between patient traits and response to regular dosing with ICS/long-acting β2-agonist plus short-acting β2 agonist reliever or maintenance and reliever therapy for asthma(W.B. Saunders Ltd, 2023) Yorgancıoğlu A.; Cruz A.A.; Garcia G.; Lavoie K.L.; Roche N.; Abhijith P.G.; Verma M.; Majumdar A.; Chatterjee S.Introduction: Current treatment for moderate–severe asthma with inhaled corticosteroid (ICS)-based therapy can follow two strategies: a single inhaler maintenance and reliever therapy (MART) regimen, or regular dosing with ICS/long-acting β2-agonist used as maintenance therapy plus a separate short acting β2-agonist reliever inhaler. It would be clinically useful to understand the potential of patient traits to influence regular dosing or MART treatment outcomes. Objectives: A systematic literature review (SLR) and meta-analysis was conducted to identify specific patient traits that may predict improved clinical outcomes with regular dosing or MART. Results: The SLR identified 28 studies in patients with moderate–severe asthma assessing regular dosing or MART treatments and reporting the traits and outcomes of interest. Network meta-regressions found no significant difference in the relative efficacy of regular dosing as compared with MART on any of the clinical outcomes (exacerbation rate, time to first exacerbation, FEV1, reliever use and adherence) for any of the patient traits (baseline lung function, baseline ACQ, age, BMI, and smoking history) evaluated. However, some trends towards traits influencing treatment efficacy were identified. Inconsistent reporting of traits and outcomes was observed between trials. Conclusions: The analysed patient traits evaluated in this study were associated with similar efficacy for the analysed outcomes to either regular dosing or MART; however, trends from the data observed encourage future analyses for possible identification of additional traits, or a combination of traits, that may be of interest. More comparable reporting of clinically important traits and outcomes would improve future analyses. © 2023 The AuthorsItem Therapeutic implications of etiology-specific diagnosis of early-onset developmental and epileptic encephalopathies (EO-DEEs): A nationwide Turkish cohort study(W.B. Saunders Ltd, 2024) Kanmaz S.; Tekgul H.; Kayilioglu H.; Atas Y.; Kart P.O.; Yildiz N.; Gumus H.; Aydin K.; Olculu C.B.; Dogan D.E.T.; Per H.; Canpolat M.; Gulec A.; Yildirim N.; Turk E.; Celik N.; Ozturk S.; Kumandas S.; Kilic B.; Topcu Y.; Ozpinar E.; Coskun A.; Arslan M.; Akkoyunlu D.S.; Cine N.; Uzan G.S.; Gunay C.; Akyol D.; Ersoy O.; Direk M.C.; Komur M.; Kirkgoz H.; Karaoğlu P.; Ibis I.B.P.; Cerci C.; Orak A.; Oktay S.; Ayanoglu M.; Yildirim M.; Bektas O.; Serdaroglu E.; Yilmaz S.B.; Cankurt I.; Hirfanoglu T.; Arhan E.; Gencpinar P.; Dundar N.O.; Teber S.; Serin H.M.; Yilmaz S.; Tosun A.; Polat M.; Yilmaz U.; Unalp A.; Kara B.; Okuyaz C.; Yis U.; Hiz S.; Aktan G.; Gokben S.; Unay B.; Serdaroglu A.; Cansu A.Objective: To evaluate the etiology-specific diagnosis of early-onset developmental epileptic encephalopathies (EO-DEEs) in a nationwide Turkish cohort to determine the implications for therapeutic management. Methods: The cohort comprised 1450 patients who underwent EO-DEE. The utility of genetic testing was assessed with respect to the initial phases of next generation sequencing (NGS) (2005–2013) and the current NGS era (2014–2022). A predefined four-stepwise diagnostic model was evaluated using cost-effectiveness analysis. The diagnostic and potential therapeutic yields of the genetic tests were subsequently determined. Results: Gene-related EO-DEEs were identified in 48.3 % (n = 701) of the cohort: non-structural genetic (62.6 %), metabolic genetic (15.1 %), and structural genetic (14.1 %). The most common nonstructural genetic variants were SCN1A (n = 132, 18.8 %), CDKL5 (n = 30, 4.2 %), STXBP1 (n = 21, 2.9 %), KCNQ2 (n = 21, 2.9 %), and PCDH19 (n = 17, 2.4 %). The rate of ultra-rare variants (< 0.5 %) was higher in the NGS era (52 %) than that in the initial phase (36 %). The potential therapeutic yields with precision therapy and antiseizure drug modification were defined in 34.5 % and 56.2 % in genetic-EO-DEEs, respectively. The diagnostic model provided an etiology-specific diagnosis at a rate of 78.7 %: structural (nongenetic) (31.4 %), genetic (38.5 %), metabolic (6.1 %), and immune-infectious (2.8 %). Based on a cost-effectiveness analysis, the presented diagnostic model indicated the early implementation of whole-exome sequencing for EO-DEEs. Significance: In the present cohort, the higher rate (48.3 %) of gene-related EO-DEE diagnoses in the NGS era provides a potential therapeutic management plan for more patients. © 2024 British Epilepsy AssociationItem Corrigendum to “Re-examining the characteristics of pediatric multiple sclerosis in the era of antibody-associated demyelinating syndromes” [Europ. J. Paediatr. Neurol. 41 (2022) 8–18 doi.org/10.1016/j.ejpn.2022.08.006, (S1090379822001246), (10.1016/j.ejpn.2022.08.006)](W.B. Saunders Ltd, 2024) Yılmaz Ü.; Gücüyener K.; Yavuz M.; Ibrahim Oncel; Canpolat M.; Saltık S.; Ünver O.; Çıtak Kurt A.N.; Tosun A.; Yılmaz S.; Özgör B.; Ilknur Erol; Öztoprak Ü.; Elitez D.A.; Çobanoğulları Direk M.; Bodur M.; Teber S.; Anlar B.; Erol İ.; Aykol D.; Direk M.Ç.; Yıldız E.P.; Yarar C.; Kara B.; Haspolat; İncecik F.; Kutluk G.; Dilber C.; Dundar N.O.; Tan H.; Öncel İ.; Demir E.; Dursun B.D.; Dilek T.D.; Türkdoğan D.; Yalnızoğlu D.; Akbaş S.; Güleç A.; Yılmaz D.; Ayanoğlu M.; Kanmaz S.; Güngör S.; Öztürk G.; Besen; Haliloğlu G.; Karaca N.B.; Öztürk S.; Yüksel D.; Gürkaş E.; Oktay S.; Serin H.M.; Karadağ M.; Akbeyaz İ.H.; Yiş U.; Polat B.G.; Okan M.S.; Bektaş Ö.; Orgun L.T.; Günbey C.; Per H.; Gültutan P.; Öztürk S.B.; Aksoy E.; Akyüz G.; Tekgül H.; Kürekçi F.; Hız Kurul A.S.; Çarman K.B.; Alikılıç D.; Duman Ö.; Kömür M.; Yıldırım M.; Alıcı N.; Gümüş H.; Polat M.; Konuşkan B.; Güngör O.; Mert G.G.; Edizer S.; Mıhçı F.; Öztürk S.T.; Toker R.T.; Arslan M.; Şahin S.; Gencpinar P.; Yıldırım E.; Yüksel E.; Ekici A.; Deniz A.; Köken Ö.Y.; Okuyaz Ç.; Süt N.Y.; Atasoy E.; Solmaz İ.; Yetkin M.F.; Bilgin N.; Atasever A.K.; Tekin H.G.; Dokurel İ.; Özçelik A.; Aksoy A.; Türköz A.N.; Cavusoglu D.; Özkan M.; Tekin E.; Şahin T.U.; Ünalp A.; Koç H.; Sarıgeçili E.; Sarıtaş S.; Ayça S.; Kayılıoğlu H.; Şenoğlu M.Ç.; Kamaşak T.; Asadova N.; Keskin F.; Karaoğlu P.; İpek R.; Acer H.The authors would like to apologise for any inconvenience caused. © 2024 European Paediatric Neurology SocietyItem A network meta-analysis of the association between patient traits and response to regular dosing with ICS plus short-acting β2-agonist reliever or ICS/formoterol reliever only in mild asthma(W.B. Saunders Ltd, 2024) Yorgancıoğlu A.; Cruz A.A.; Garcia G.; Lavoie K.L.; Roche N.; Verma M.; Majumdar A.; Chatterjee S.Introduction/background: Mild asthma treatment recommendations include intermittent inhaled corticosteroid (ICS)/formoterol dosing or regular ICS dosing with short-acting β2-agonist reliever. Due to the heterogeneity of asthma, identification of traits associated with improved outcomes to specific treatments would be clinically beneficial. Aims/objectives: To assess the impact of patient traits on treatment outcomes of regular ICS dosing compared with intermittent ICS/formoterol dosing, a systematic literature review (SLR) and network meta-analysis (NMA) was conducted. Searches identified randomised controlled trials (RCTs) of patients with asthma aged ≥12 years, containing ≥1 regular ICS dosing or intermittent ICS/formoterol dosing treatment arm, reporting traits and outcomes of interest. Results: The SLR identified 11 RCTs of mild asthma, of 14,516 patients. A total of 11 traits and 11 outcomes of interest were identified. Of these, a feasibility assessment indicated possible assessment of three traits (age, baseline lung function, smoking history) and two outcomes (exacerbation rate, change in lung function). The NMA found no significant association of any trait with any outcome with regular ICS dosing relative to intermittent ICS/formoterol dosing. Inconsistent reporting of traits and outcomes between RCTs limited analysis. Conclusions: This is the first systematic analysis of associations between patient traits and differential treatment outcomes in mild asthma. Although the traits analysed were not found to significantly interact with relative treatment response, inconsistent reporting from the RCTs prevented assessment of some of the most clinically relevant traits and outcomes, such as adherence. More consistent reporting of respiratory RCTs would provide more comparable data and aid future analyses. © 2024Item Systematic literature review of traits and outcomes reported in randomised controlled trials of asthma with regular dosing of inhaled corticosteroids with short-acting β2-agonist reliever, as-needed ICS/formoterol, or ICS/formoterol maintenance and reliever therapy(W.B. Saunders Ltd, 2024) Roche N.; Yorgancıoğlu A.; Cruz A.A.; Garcia G.; Lavoie K.L.; Abhijith P.G.; Verma M.; Majumdar A.; Chatterjee S.Introduction: Asthma treatments based solely on diagnostic label do not benefit patients equally. To identify patient traits that may be associated with improved treatment response to regular inhaled corticosteroid (ICSs) dosing with short-acting β2-agonist reliever or ICS/formoterol-containing therapy, a systematic literature review (SLR) was conducted. Methods: Searches of databases including MEDLINE and Embase identified randomised controlled trials (RCTs) of patients with asthma, aged ≥12 years, published 1998–2022, containing ≥1 regular ICS dosing or ICS/formoterol-containing treatment arm, and reporting patient traits and outcomes of interest. Relevant data was extracted and underwent a feasibility assessment to determine suitability for meta-analysis. Results: The SLR identified 39 RCTs of 72,740 patients and 90 treatment arms, reporting 11 traits and 11 outcomes. Five patient traits (age, body mass index, FEV1, smoking history, asthma control) and five outcomes (exacerbation rate, lung function, asthma control, adherence, time to first exacerbation) were deemed feasible for inclusion in meta-analyses due to sufficient comparable reporting. Subgroups of clinical outcomes stratified by levels of patient traits were reported in 16 RCTs. Conclusion: A systematic review of studies of regular ICS dosing with SABA or ICS/formoterol-containing treatment strategies in asthma identified consistent reporting of five traits and outcomes, allowing exploration of associations with treatment response. Conversely, many other traits and outcomes, although being potentially relevant, were inconsistently reported and limited subgroup reporting meant analyses of treatment response for subgroups of traits was not possible. We recommend more consistent measurement and reporting of clinically relevant patient traits and outcomes in respiratory RCTs. © 2023 GSKItem A retrospective cohort study of children diagnosed with Cystic Fibrosis after implementation of a newborn screening program in Turkey(W.B. Saunders Ltd, 2025) Kekeç H.; Eyüboğlu T.Ş.; Aslan A.T.; Hocoğlu Z.İ.; Yalçın E.; Sunman B.; Yavuz B.Ç.; Şen V.; Savaş S.; Kılınç A.A.; Başkan A.K.; Yazan H.; Ünal G.; Canıtez Y.; Sapan N.; Gülen F.; Öztürk G.K.; Keskin Ö.; Arık E.; Köse M.; Ersoy A.; Altıntaş D.U.; Serbes M.; Başaran A.E.; Bingöl A.; Özdemir A.; Barlık M.; Tuğcu G.D.; Bilgiç I.; Anıl H.; Özsezen B.; Tekin M.N.; Yüksel H.; Çaltepe G.; Hangül M.; Gayretli Aydın Z.G.; Kılıç M.; Hızal M.; İkizoğlu N.B.; Özcan G.; Emiralioğlu N.; Cinel G.; Pekcan S.; Çakır E.; Özçelik U.; Doğru D.Introduction: Newborn screening (NBS) for cystic fibrosis (CF) facilitates early diagnosis and has been shown to significantly improve long-term clinical outcomes. In this study, we aimed to evaluate the 7-year results of the immunoreactive trypsinogen (IRT)/IRT NBS of Turkey. Methods: The study included all CF patients who were born after NBS implementation, and who were enrolled in the CF Registry of Turkey (CFRT) in 2022. Patients were divided into three groups according to NBS results: Group 1 with positive NBS, Group 2 with negative NBS, and Group 3 with no screening or unknown screening results. All clinical and demographic data were compared between the three groups. Results: A total of 853 patients were included in the study, 668 (78.3%) patients were in Group 1, 90 (10.5%) in Group 2, and 95 (11.2%) in Group 3. The age at diagnosis was 0.17 (0.08-0.33) years in Group 1, 0.50 (0.25-1.0) in Group 2, and 0.33 (0.17-0.75) in Group 3 (p<0.001). The first and second sweat test results and frequency of pancreatic insufficiency were lowest in Group 2 (p<0.05). Median FEV1 (%) was 88 (77-103) in Group 1, 90 (71.5-104) in Group 2, 89.5 (81.75-97.5) in Group 3 (p>0.05). 49% of the patients had a severe genotype and it was detected most frequently in Group 1 (p=0.021). Conclusions: Patients with pancreatic sufficiency may be missed by IRT/IRT NBS and lower and negative sweat test results may contribute to delays in CF diagnosis. Approximately 22% of patients are not diagnosed through this screening method. © 2025 Elsevier LtdItem Comparing mesh and compressor nebulizers in pulmonary function test in pediatric asthma attacks: A double-blind randomized comparative clinical trial(W.B. Saunders Ltd, 2025) Okay B.; Hatipoglu H.U.; Okay Z.U.; Sahin K.; Yasar A.Objective: Asthma is a prevalent global health issue, especially affecting children in numerous countries. Our study aimed to determine the most effective nebulizer type by comparing the effects of mesh nebulizers (MNs) and compressor nebulizers (CNs) on spirometry tests in pediatric asthma attacks. Methods: The prospective, double-blind, randomized comparative study was conducted with patients aged 7–15 presenting with asthma attacks. The participating patients were divided into two groups by randomization: those using CNs and those using MNs. A pulmonary function test was performed before and after giving the patients three doses of salbutamol inhaler at 20-minute intervals, and changes in the test were recorded. Results: The increase in peripheral oxygen saturation was higher in the MN group, although this difference was not statistically significant (p = 0.391). However, statistically significant differences were observed in the decrease in respiratory rate (RR;/min; p = 0.002) and the increase in heart rate (/min; p = 0.022). The respiratory function test indicated a higher change in forced vital capacity (FVC) and peak expiratory flow in the MN group than the CN group, although this difference was not statistically significant (p = 0.258 and 0.256). However, statistically significant changes were observed in the forced expiratory volume in 1 second (FEV1) and forced expiratory flow at 25%–75% of FVC (FEF25–75; p = 0.001 and 0.043). Conclusion: MNs show superior improvement in vital signs and pulmonary function, particularly in RR, FEV1, and FEF25–75. MNs may be preferred for more effective treatment despite heart rate elevation. © 2025 Elsevier LtdItem Factors influencing the prescription of add-on long-acting muscarinic antagonists in real-world asthma management: Insights from a national registry(W.B. Saunders Ltd, 2025) Gemicioglu B.; Gokmen D.; Can A.; Sevinc C.; Oguzulgen I.K.; Soyyigit S.; Yakut T.; Havlucu Y.; Aydin O.; Buhari G.K.; Sozener Z.C.; Bulut I.; Beyaz S.; Orcen C.; Ozdemir S.K.; Keren M.; Damadoglu E.; Kalpaklioglu A.F.; Baccioglu A.; Yalim S.A.; Yilmaz I.; Kalkan I.K.; Uysal M.A.; Ozgun Niksarlioglu E.Y.; Kalyoncu A.F.; Karakaya G.; Erbay M.; Nayci S.; Tepetam F.M.; Gelincik A.; Dirol H.; Goksel O.; Karaoglanoglu S.; Erkekol F.O.; Isik S.R.; Yildiz F.; Yavuz Y.; Karadogan D.; Bozkurt N.; Seker U.; Basyigit I.; Baris S.A.; Ucar E.Y.; Erdogan T.; Polatli M.; Ediger D.; Gunaydin F.E.; Turk M.; Pur L.; Katran Z.Y.; Sekibag Y.; Aykac E.F.; Mungan D.; Gul O.; Cengiz A.; Akkurt B.; Ozden S.; Demir S.; Unal D.; Aslan A.F.; Gumusburun R.; Bogatekin G.; Akten H.S.; Inan S.; Erdinc M.; Ogus A.C.; Kavas M.; Yulug D.P.; Cakmak M.E.; Kaya S.B.; Alpagat G.; Ozgur E.S.; Uzun O.; Gulen S.T.; Pekbak G.; Kizilirmak D.; Donmez H.; Arslan B.; Cetin G.P.; Kara B.Y.; Dursun A.B.; Karakis G.P.; Kendirlinan R.; Ozturk A.B.; Simsek G.O.; Abadoglu O.; Cerci P.; Yucel T.; Yorulmaz I.; Tezcaner Z.C.; Tatar E.C.; Suslu A.E.; Ozer S.; Dursun E.; Yorgancioglu A.; Çelik G.E.Current guidelines recommend adding long-acting muscarinic antagonists (LAMAs) in patients with uncontrolled asthma, despite the use of moderate to high doses of inhaled steroid-long-acting beta agonists (ICS/LABA). This study aims to analyze the factors related to the prescription of add-on LAMA in clinical practice for asthma patients, shedding light on physicians’ preferences. This study included adult asthma patients on add-on LAMA and ICS/LABA monitored for at least one year in a national registry comprising 2053 asthmatics. Patients’ characteristics and disease profiles were analyzed to identify factors associated with the prescription of add-on LAMA across the entire cohort. A comparative analysis was performed among three groups: MART (ICS/formoterol as a maintenance and reliever therapy) plus LAMA, Conventional (ICS/LABA as a maintenance and short-acting beta agonist as reliever) plus LAMA and Triple (ICS/LABA/LAMA single inhaler). LAMAs were added to ICS/LABA in 11.7 % of patients in the national registry. Logistic regression analysis revealed that older age, low FEV1 (%), Asthma Control Test (ACT) scores less than 20, and severe exacerbation were the main factors influencing the initiation of LAMA in our registry. However, demographic characteristics of asthma, control status, pulmonary function test results were similar among the three groups of LAMA users (p > 0.05). Physicians used LAMAs without phenotyping based on allergic status or eosinophil levels (p > 0.05). Mepolizumab was added after LAMA in all patients, while omalizumab was initiated before LAMA in 16.9 % of the patients receiving LAMA along with biologics. Add-on LAMAs were predominantly prescribed for older, uncontrolled, and exacerbated asthma patients with low FEV1. © 2024 Elsevier LtdItem Nasal effects of environmental tobacco smoke exposure in children with allergic rhinitis(W.B. Saunders Ltd, 2025) Yigit E.; Yuksel H.; Ulman C.; Yilmaz O.Objectives: Tobacco smoke exposure is associated with inflammatory changes in the respiratory system including nasal mucosa. Our aim was to demonstrate nasal mucosal inflammation such as neutrophilic activation and epithelial permeability in patients with allergic rhinitis with exposure to environmental tobacco smoke (ETS) and reveal its effect on allergic rhinitis symptoms. Methods: We enrolled 204 subjects with allergic rhinitis to this cross-sectional study. Sociodemographic and AR clinical characteristics were recorded. Urinary cotinine levels >50 ng/ml were defined as exposure to secondhand tobacco smoke. Club cell 16 (CC16) and myeloperoxidase (MPO) levels were measured in the nasal lavage fluid. Levels of these biomarkers and clinical severity were compared between ETS exposed and non-exposed children with AR. Results: Among 204 children enrolled, 53 (26 %) had ETS exposure. Mean age of the ETS exposed group was significantly higher than the unexposed group (12.1 ± 3.5 and 10.7 ± 3.6 years respectively, (p = 0.02). Similarly, T5SS score was significantly higher in ETS exposure group (9.3 vs 8.3, p = 0.03) but this significance was lost when corrected for age. Age and T5SS were inversely correlated with MPO levels (r = −0,24, p < 0.001 and r = −0,14, p = 0.04). Nasal lavage CC-16 and MPO levels were not found to be significantly different among subjects with and without ETS exposure (p = 0.13 and p = 0.26 respectively). Conclusion: Our results demonstrated that ETS exposure is associated with more persistent AR in children. However, it is not related to severity or nasal lavage MPO or CC16 levels. Rhinitis symptoms beyond allergen period suggests isolated smoke exposure effect. © 2024