Background : We aimed to investigate food allergen sensitization as a prognostic factor of new onset wheezing episodes as well as of wheezing severity during follow up in young children with recurrent wheezing. Our secondary aim was to compare serum levels of Club Cell-16 (CC-16) and surfactant protein D (SP-D) among wheezing children with and without food allergen sensitization as potential pathogenetic indicators of the association between food allergen sensitivity and wheezing. Methods : This was a prospective cohort study among children with recurrent wheezing; specific-IgE to five common foods allergens was assessed at baseline and children were followed-up for one year for new onset wheezing episodes. Baseline wheezing severity score, CC-16 and SP-D levels were measured. Results : We enrolled 295 children among which 44 were food specific IgE (Fx5) (+). Poisson regression analysis with food allergen sensitivity, age and wheezing score at presentation revealed that Fx5 positivity changed yearly frequency of wheeze by a factor of 1.66 (p=0.05, 95%CI: (0.99-2.75)). Age changed the yearly frequency of wheeze by a factor of 0.95 (p=0.005, 95%CI: (0.92-0.99)). One-point change in wheezing score at presentation changed the wheezing frequency in the following year by a factor of 1.11 (p=0.005, 95%CI: (0.67-1.99)). Levels of CC-16 and SP-D were not significantly different between the two groups (p=0.679 and p=0.988). Conclusion : Food allergen sensitization defined as serum specific IgE positivity irrespective of food associated clinical allergy findings is associated with worse prognosis of wheezing in children.

Background: Change in airway resistance and inflammation are the two most commonly accused pathogenetic processes in the coexistence of asthma and obesity. The aim of this study was to compare airway resistance between normal weight and overweight/obese children using impulse oscillometry (IOS). Methods: We consecutively enrolled 3 to 10-year-old children with asthma who presented to our department between May and August 2018. Ones with a body mass index percentile at or above 85th percentile were grouped as overweight/obese. Sociodemographic characteristics such as age, sex and family history of allergy were recorded and Test for Respiratory and Asthma Control in Kids (TRACK) was filled in for all. Finally, impulse oscillometric (IOS) measurements were taken. Results: We enrolled 170 subjects; among which 114 (67.1%) were normal weight while 56 (33%) were overweight/obese. Sociodemographic characteristics were not significantly different between the two groups, but asthma control was significantly worse in the overweight/obese group (75.9±21.1 vs 85.9±17.8, p=0.001). Impulse oscillometric measurements of resistance and reactance were nor significantly different between the two groups. Conclusion: Asthma control in children who are overweight or obese are worse compared to the normal weight ones but, airway resistance and reactance measured by IOS at different frequencies are not significantly different between these two groups. This implies that airway resistance change may not the main pathogenetic mechanism underlying the uncontrolled asthma and obesity coexistence.

Background: Change in airway resistance and inflammation are the two most commonly accused pathogenetic processes in the coexistence of asthma and obesity. The aim of this study was to compare airway resistance between normal weight and overweight/obese children using impulse oscillometry (IOS). Methods: We consecutively enrolled 3 to 10-year-old children with asthma who presented to our department between May and August 2018. Ones with a body mass index percentile at or above 85th percentile were grouped as overweight/obese. Sociodemographic characteristics such as age, sex and family history of allergy were recorded and Test for Respiratory and Asthma Control in Kids (TRACK) was filled in for all. Finally, impulse oscillometric (IOS) measurements were taken. Results: We enrolled 170 subjects; among which 114 (67.1%) were normal weight while 56 (33%) were overweight/obese. Sociodemographic characteristics were not significantly different between the two groups, but asthma control was significantly worse in the overweight/obese group (75.9±21.1 vs 85.9±17.8, p=0.001). Impulse oscillometric measurements of resistance and reactance were nor significantly different between the two groups. Conclusion: Asthma control in children who are overweight or obese are worse compared to the normal weight ones but, airway resistance and reactance measured by IOS at different frequencies are not significantly different between these two groups. This implies that airway resistance change may not the main pathogenetic mechanism underlying the uncontrolled asthma and obesity coexistence.

Background: Environmental tobacco smoke (ETS) exposure and sleep associated problems can lead to serious health problems in children. We aimed to evaluate association between ETS and sleep disturbance in children. Methods: We enrolled 209 children without chronic health problems or acute infections aged 4 to 12 years between June 2019 and March 2020 to this cross-sectional study. Parents’ smoking habits and ETS exposure of children were questioned and Children’s Sleep Habits Questionnaire (CSHQ) was administered to screen for the most common sleep problems in children. “Sleep disturbance” was defined as a score ≥41 in CSHQ. Plasma cotinine levels were measured in all subjects enrolled and levels ≥ 3 ng/mL were defined as ETS exposure. Results: Total 115 children (55 %) were in the “sleep disturbance” group according to CSHQ, and 66 (57.3%) of them were exposed to ETS according to parental report. The children with parent reported ETS exposure had increased risk of sleep disturbance (adjusted OR: 1.3). All 209 children had plasma cotinine levels ≥3 ng/ml, with a mean (SD) 50.55 (13.78) ng/ml, revealing that all of them were exposed to ETS although only 105 of them were parent reported. Multivariable analysis of risk factors for sleep disturbance revealed that parent reported ETS exposure was associated with increased risks of sleep disturbance (p=0.023, adjusted OR: 1.9 and 95%CI: 1.09-3.3) Conclusions: Parent reported ETS exposure is associated with sleep disturbance in their children however parental reports about smoking habits may not be compatible with plasma cotinine levels of the children.