Muhammet Furkan Korkmaz

Objective: Asthma is the most common chronic disease of childhood. The goal of asthma treatment is to achieve complete control of the damage. This study aimed to investigate the control status of children diagnosed with asthma aged 4-18 years, using asthma control tests, and the factors affecting this control.Methods: 500 asthmatic children aged 4-18 years were included in the study. Patients were assessed using the C-ACT in the 4-11 age group and the ACT in the 12-18 age group. Patients with asthma aged 4-11 years were classified as under-controlled based on the C-ACT results between 20 and 27 points, and as uncontrolled if they scored 19 or below. Patients with asthma aged 12-18 years were classified as well-controlled based on the ACT results between 20 and 25 points and poorly controlled if they scored 19 or below. To compare the vitamin D levels of the patients, the vitamin D levels of 100 children aged 4-18 years without any chronic disease were recorded retrospectively. Results: Of the cases, 55.6% (n=278) were male and 44.4% (n=222) were female. When evaluated in general, the median age at diagnosis was 7.2 years (minimum=1, maximum=16). According to the results of C-ACT, 51.7% (n=151) of the cases with asthma in the 4-11 age group were under control, and according to the results of ACT, 58.7% (n=122) of the cases between the ages of 12-18 were well controlled. Number of emergency visits; median=2 in the 4-11 age group (minimum=1, maximum=30), median=2 in the 12-18 age group (minimum=1, maximum=20) (p>0.05). Use of antibiotics at least once in the past year was significantly higher in the 4-11 age group (n=259, 88.70%) than in the 12-18 age group (n=156, 75%) (p<0.001). Asthma-related school absences (median=3, min=0, max=30) were significantly higher in the 12-18 age group than in the 4-11 age group (median, min=0, max=40) (p = 0.007). There was no significant difference in serum 25-OH-vitamin D levels between asthma and controls in either age group.Conclusion: In our study, a significant portion of the cases were uncontrolled despite regular follow-up and treatment. The low rate of influenza vaccination in asthmatic children and the higher-than-expected rate of smoking at home suggest a lack of education on this topic. No significant difference was found between asthmatic patients’ and controls’ vitamin D levels.

Obstructive Sleep Apnoea Syndrome (OSAS) is increasingly recognised in the paediatric population. It is important to consider that certain pulmonary and endocrinological disorders may be influenced by OSAS or exhibit a more severe clinical course due to the presence of OSAS. This study aims to highlight the application of polysomnography in the paediatric population, particularly in the diagnosis and treatment of sleep disorders associated with chronic comorbidities—most notably endocrinological and respiratory conditions—and to emphasise the importance of improving quality of life measures to support healthy development in affected children. Polysomnography (PSG) recordings obtained between January 2020 and April 2025 at the Sleep Disorders Unit of the Department of Neurology, Faculty of Medicine, Bursa Uludag University, were retrospectively reviewed. Among these PSG records, patients referred from the Departments of Paediatric Endocrinology and Metabolism, Paediatric Pulmonology, and Paediatric Immunology and Allergy were identified. Demographic data, medical history, and PSG findings of the included patients were analysed. The results of polysomnography (PSG) performed in our center showed that the incidence of obstructive sleep apnea syndrome (OSAS) in children with endocrinologic or respiratory diseases was higher (25.7% vs. 3%) and the mean age was older (7 years vs. 4 years) compared to the normal pediatric population. The prevalence of sleep disorders was similar in these patients and normal children (54.4% vs. >50%), as was the prevalence of central apnea (2.9%). There were no gender differences among patients with sleep disorders.

Congenital corrected transposition of the great arteries (ccTGA) is a rare disorder with variable cardiac malformations that can result in a wide range of clinical outcomes, from asymptomatic to mortality. In ccTGA cases, the right atrium is connected to the left ventricle by the mitral valve, and this structure is supported by the pulmonary artery. After opening into the left atrium, the pulmonary veins are connected to the right ventricle by the tricuspid valve, and this structure continues with the aorta. As a result, systemic venous blood with low oxygenity goes to the lungs through the pulmonary artery and blood with high oxygenity from the pulmonary veins goes to the systemic circulation through the aorta and cyanosis is not seen. Although most cases are clinically asymptomatic in childhood, findings are more common in late adolescence and adulthood in the presence of additional lesions, such as ventricular septal defect or Ebstein anomaly. Bradycardia (with or without heart failure), complete AV block, tachyarrhythmia and congestive heart failure may be present. In addition, in later years, heart failure may develop and patients may die because the structure that functions as a pump to the systemic circulation is in the right ventricular musculature.

Introduction: We aimed to present the changes that may occur in pulmonary functions in children who experienced more severe coronavirus disease 2019 (COVID-19) during long-term follow-up. Methodology: A prospective longitudinal observational cohort study was conducted with 34 pediatric patients (7–18 years) who were hospitalized with COVID-19 infection (moderate n = 25, severe n = 9), and followed up at our Pediatric Infection Outpatient Clinic for approximately two years. Pulmonary function tests (PFTs) were performed using spirometry. Results: Data from the hospitalization period revealed no significant differences between the severity groups in terms of demographic, clinical, laboratory, radiological, treatment, and outcome (p > 0.05). The median time interval between COVID-19 infection and PFTs was 15 months (range 11–29 months), and there was no significant difference between severity groups (p = 0.878). Eight patients (24%) had abnormal pulmonary functions; among them, seven had an obstructive pattern (21%) and one had a restrictive pattern (3%). The severity groups had no statistical difference in pulmonary functions (p = 0.105). While forced expiratory volume in 1 second (FEV1) %, FEV1/forced vital capacity (FVC)%, and forced expiratory flow during the middle half of FVC (FEF25–75%) ratios were lower in the severe patient group, Z-scores were similar. Among the patients continuing polyclinic follow-up, 41% had persistent respiratory symptoms before PFTs. No differences were observed in PFTs when compared based on the presence of symptoms (p > 0.05). Conclusions: We observed no significant long-term differences in pulmonary function between moderate and severe COVID-19 cases in children.

Background: Immature granulocytes can be measured easily in a complete blood count by new automated hemolytic analyzers and have recently been studied as bio‐markers in many infectious/inflammatory diseases. This study aims to investigate whether immature granulocyte percentage (IG%) would enable greater discrimination than conventionally utilized laboratory values in terms of early clinical prediction in instances with respiratory syncytial virus (RSV) bronchiolitis. Methods: A prospective observational cohort study involved 149 individuals with RSV bronchiolitis. Complete blood count (including IG%), C‐reactive protein, and procalcitonin (PCT) assays were performed. Results: Sixty‐two (42%) RSV bronchiolitis patients responded well to outpatient therapy; 60 (40%) were admitted to the hospital, and 27 (18%) required pediatric intensive care unit (PICU) follow up. Inpatients had a higher platelet count than outpatients, and PICU patients had a higher platelet lymphocyte ratio (PLR). Pediatric intensive care unit patients had greater PCT levels than outpatients, and their IG% was higher than that of both inpatient and outpatient groups. In the receiver operating characteristic analysis examining the usefulness of parameters in predicting PICU hospitalization, PLR, PCT, and IG% produced statistically significant findings, with IG% having the highest area under the curve (0.730). Conclusions: Immature granulocyte percentage was the biomarker that best differentiated PICU patients from other patient groups when compared with traditional acute phase reactants. Immature granulocytes may help to determine the severity of infection/inflammation at an early stage of the disease.

Purpose: This study was carried out to compare the demographic, laboratory, neurodiagnostic, and clinical characteristics of children with seizures infected with coronavirus disease 2019 (COVID-19) during the period when the Omicron variant of concern (VOC) was the dominant VOC with those of the children infected with seizures infected with COVID-19 during the period prior to the emergence of the Omicron variant. Methods: The population of this retrospective observational cohort study consisted of totally 58 pediatric patients who had seizures and were diagnosed with COVID-19 between March 15th, 2020, and August 31st, 2022. Results: The median frequency of seizures during the follow-up period was 2 (min. 1, max. 7). Focal seizures were observed in four (7%) patients. There was no significant difference between the Omicron and pre-Omicron VOC groups in the demographic and clinical characteristics at admission and seizure findings (p>0.05). Excluding the patients with known neurological disease, the majority of the patients were under the age of six, and 84% were diagnosed with febrile convulsions. There was no significant difference between the groups in treatment protocols, diagnosis types, and clinical outcomes (p>0.05). Conclusion: The increase in seizures observed in children infected with COVID-19 during the last stages of the pandemic was associated with the Omicron VOC, which was the dominant VOC in this period. Nevertheless, the study findings indicated that the impact of the Omicron VOC was not more severe in children with seizures than in those infected with other COVID-19 variants.

Acute bronchiolitis (AB) is one of the most common respiratory diseases in early childhood and is still an important health problem worldwide. The systemic immune-inflammatory index (SII) is thought to have potential to be a new-generation inflammatory biomarker. We sought to investigate the value of SII for severity assessment in children with AB. A total of 74 AB patients were included in a prospective observational study. Patients were classified into 3 AB groups according to this classification: mild (1-5 points), moderate (6-10 points), and severe (11-12 points). Complete blood count, C-reactive protein, and procalcitonin tests were carried out. Modified Tal score was evaluated to determine severity. The performance of parameters to predict the severity of AB was assessed using the receiver operating characteristic (ROC). Whereas neutrophil count (P = .037), neutrophil-to-lymphocyte ratio (P = .030), and SII (P = .030) values increased significantly with disease severity, red cell distribution width (P = .048) values were higher in the moderate AB group. The SII was found to have the highest area under the curve in the comparison of the mild-moderate groups combination and the high group on ROC analysis (P = .009). The SII values of pediatric patients hospitalized with the diagnosis of AB were significantly higher in the high-severity group. The SII may offer additional severity stratification in children with AB.

Objective The havoc caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic could not have been predicted, with children being affected worldwide. Testing for SARS-CoV-2 infection helped to define the interventions against the spread of the disease. A polymerase chain reaction (PCR) test has been the mainstay of diagnostic testing. Cycle threshold (Ct) is a semiquantitative value that indicates approximately how much viral genetic material was in the sample. The aim of this study was to evaluate the impact of Ct values among children with SARS-CoV-2 infection. Methods Between May 3, 2020 and August 3, 2020, clinical laboratory input and the data of patients with positive SARS-CoV-2 PCR tests were retrospectively studied. Results There was no statistical significance between Ct values and the patient's status, symptoms other than fever, or other laboratory findings. However, the Ct value of patients who had symptoms at the time of admission to the hospital was significantly lower. Conclusion In this study, symptomatic patients had lower Ct than asymptomatic patients that reflected higher viral loads. In evidence-based medicine applications, it might be useful to correlate the clinical history with laboratory test results. Even symptomatic patients with high Ct value coinfections, or an alternative acute infection, should be considered.

β-thalassemia major (β-TM) is a hemoglobinopathy characterized by reduced or absent β-globin production. A balance remains between the production of free radicals and suppression of increased levels of reactive oxygen species by the antioxidant system. This study aimed to examine thiol/disulfide homeostasis (TDH) and serum ischemia-modified albumin (IMA) levels to evaluate the oxidant/antioxidant balance in healthy children and persons with β-TM receiving and not receiving chelation therapy. This prospective study was carried out from January to June 2021 among 46 individuals with β-TM and 35 healthy controls. A spectrophotometric method was used to analyze TDH and IMA concentrations. We found that, compared to controls, native thiol (NT) (P = .048) and total thiol (TT) (P = .027) values were lower in the patient group, whereas disulfide (P < .001), disulfide/native thiol (D/NT) (P = .004), disulfide/total thiol (D/TT) (P = .005), native thiol/total thiol (NT/TT) (P = .004) and IMA (P = .045) values were higher. NT and TT levels were significantly lower in the chelation− group compared to the chelation+ and control groups (P = .002, P = .001). D/NT, D/TT, and NT/TT levels were higher in the chelation+ group than the control group (P = .007), and IMA levels were significantly higher in the chelation+ and chelation− groups compared to the control group (P = .002). The receiver operating characteristic analysis demonstrated that IMA levels were significantly higher in the children with β-TM not taking regular chelation therapy. Thiol/disulfide homeostasis was observed to be weakened in children with β-TM in our study. Our findings show that when children with β-TM do not receive regular chelation therapy, their oxidant imbalance worsens.