血清Eotaxin、IL-13及总IgE在支气管哮喘患儿中的表达及意义

目的 探讨支气管哮喘(哮喘)患儿Eotaxin、IL-13及总IgE在哮喘发病中的作用及其相互关系.方法 选择30例哮喘儿童及22例健康儿童为研究对象,酶联免疫吸附法检测血清Eotaxin、IL-13,荧光酶联免疫法检测总IgE水平.哮喘息儿同时做肺功能检测.结果 (1)哮喘患儿急性发作期与临床缓解期肺功能各项指标比较...     

Magnesium Concentration in Acute Asthmatic Children

Objective

Magnesium (Mg) is thought to be an important element in the pathogenesis of acute asthma attacks. We hypothesized that erythrocytic Mg would be decreased during an acute asthma exacerbation. We aimed at investigating plasma and erythrocytic Mg in acute asthmatic children.

Methods

This case-control study included 30 Egyptian outpatients with acute asthma. Thirty healthy matched children were included as controls. All candidates had measurements of plasma and erythrocytic Mg levels before and after treatment.

Findings

No significant differences were detected in plasma Mg levels between cases and controls (1.53±0.33 mmol/L versus 1.67±0.50 mmol/L respectively, P =0.2). However, erythrocytic Mg levels were significantly reduced in cases when compared to controls (1.06±0.43 mmol/L versus 2.57±0.59 mmol/L respectively, P<0.001). Plasma Mg levels did not significantly change in acute asthmatics before and after their rescue treatment (1.53±0.33 mmol/L versus 1.68±0.31mmol/L respectively, P=0.07). In contrast, the study detected a significant increase in erythrocytic Mg levels in cases after their treatment from acute attacks (1.06±0.43 mmol/L versus 1.56±0.23 mmol/L respectively, P<0.001), with significant negative correlation with severity of attack (Spearman''s rho = -0.647, P<0.001).

Conclusion

Erythrocytic Mg levels were significantly lower during the acute asthma, and were negatively correlated with severity of exacerbation, while plasma Mg did not significantly change. Only erythrocytic Mg levels were significantly elevated after receiving rescue treatment.     

支气管哮喘患儿血清瘦素、白细胞介素-13、嗜酸性粒细胞趋化因子及总免疫球蛋白E的动态变化

目的探讨血清瘦素、IL-13、嗜酸粒细胞趋化因子(Eotaxin)及总IgE(TIgE)在支气管哮喘(哮喘)发病中的作用及其关系。方法选择30例哮喘儿童(哮喘组)及22例健康儿童(健康对照组)为研究对象。二组年龄、性别、BMI比较差异均无统计学意义。ELISA法检测各组儿童血清IL-13、Eotaxin,放射免疫法检测各组儿童血清瘦素,荧光酶联免疫法检测其血清TIgE水平。哮喘患儿同时行肺功能检测。结果1.哮喘患儿急性期血清瘦素水平与健康对照组比较差异有统计学意义(P<0.05);哮喘患儿急性期血清瘦素水平与体质量指数(BMI)无明显相关性(r=0.330,P=0.075),哮喘患儿缓解期血清瘦素水平与BMI有明显相关性(r=0.565,P=0.001),健康对照组血清瘦素水平与BMI有明显相关性(r=0.732,P=0.000)。2.哮喘急性期与缓解期、哮喘缓解期与健康对照组之间血清Eotaxin、IL-13、TIgE水平差异均有统计学意义(Pa<0.001)。3.在哮喘急性期、缓解期血清Eotaxin与IL-13、Eotaxin与TIgE及IL-13与TIgE之间均呈正相关;血清瘦素与Eotaxin、IL...     

Association of Serum Soluble Triggering Receptor Expressed on Myeloid Cells Levels in Malignant Febrile Neutropenic Patients with Bacteremia and Fungemia

Objective

Infections are the major cause of morbidity and mortality in febrile neutropenic patients with malignancy. Rapid diagnostic tests are needed for prompt diagnosis and early treatment which is crucial for optimal management. We assessed the utility of soluble triggering receptor expressed on myeloid cells (sTREM-1) in the diagnosis of bacteremia and fungemia in febrile neutropenic patients.

Methods

Sixty-five febrile neutropenic children with malignancy hospitalized in Mofid Children''s Hospital during a period of one year from January 2007 were recruited for this cross sectional study (mean age 66.2± 37 months; 35 females and 30 males). Thirty patients (46.2%) had acute lymphoblastic leukemia, 2 (3.1%) acute myeloid leukemia, one (1.5%) lymphoma and 32 (49.2%) were under treatment for solid tumors. Simultaneous blood samples were collected for measurement of serum sTREM-1 levels and for blood cultures which were grown in BACTEC media. Gold standard for the presence of infection was a positive BACTEC culture as a more sensitive method compared to current blood culture techniques.

Findings

Blood cultures with BACTEC system were positive in 13(20%) patients (12 bacterial and one fungal culture). The mean serum sTREM-1 level in BACTEC positive patients was 948.2±592.9 pg/ml but in BACTEC negative cases it was 76.3±118.8 pg/ml (P<0.001). The optimal cut-off point of sTREM-1 for detecting patients with positive result of BACTEC was 525 pg/ml with sensitivity and specificity of 84.6% and 100%, respectively.

Conclusion

Our study revealed a significant association between serum sTREM-1 level and bacteremia and fungemia in febrile neutropenic patients suffering malignancy with acceptable sensitivity and specificity.     

Serum Interleukin 8 Level as a Diagnostic Marker in Late Neonatal Sepsis

Objective

Late-onset sepsis is responsible for high morbidity and mortality in newborn infants in the world and in particular in developing countries. In this study, we evaluated whether clinical characteristics, laboratory parameters and measurements of serum interleukin-8 (IL-8) are able to discriminate between late neonatal sepsis and normal baby.

Methods

This was a prospective (case-control) study conducted between March 2007 and April 2008, at the neonatal intensive care unit, Ghaem Hospital, Mashhad, Iran. The study comprised 93 neonates ≥72 hours of life. The infants were categorized in two groups based on the clinical presentation, and biochemical markers including complete blood count, C-reactive protein (CRP) and blood culture: 1) Control group including 42 infants with routine screening and 2) Case group consisting of 38 infants with definitive infection (positive blood and/or cerebrospinal fluid culture) or clinical sepsis (clinical and laboratory signs of infection without positive blood or CSF culture). Receiver-operating characteristic curves were used for the determination of thresholds for the infection group versus healthy neonate group.

Findings

Eighty infants were enrolled in this study. IL-8 and CRP decreased in order of definitive infection, clinical sepsis and healthy subjects respectively (P<0.001). Sensitivity, specificity, positive predictive value, negative predictive value for serum levels were 0.95, 0.1, 0.97, 0.1 for IL-8 and 0.83, 0.86, 0.83, 0.69 for CRP respectively (cut-off point for IL-8 >60pg/ml and for CRP>6mg/dl).

Conclusion

IL-8 may be a valid and early predictive marker of neonatal infection. Also, IL-8 is associated with severity of infection.     

血清Clara 细胞分泌蛋白、总IgE与嗜酸性粒细胞阳离子蛋白在儿童哮喘检测中的临床意义

目的探讨血清Clara细胞分泌蛋白（CC16）、总IgE和嗜酸性粒细胞阳离子蛋白（ECP）检测在哮喘儿童中的意义。方法采用酶联免疫吸附法（ELISA）测定59例哮喘患儿急性发作期血清CC16水平,同时应用UniCAP100变态反应检测仪检测血清总IgE、ECP;另设30例健康儿童作为健康对照组。结果与健康对照组比较,哮喘组血清CC16水平显著降低、血清总IgE、ECP水平显著增高（t=2.93,2.72,4.52Pa〈0.01）;中重度哮喘发作患儿血清CC16水平显著低于轻度发作患儿（t=5.26P〈0.05）,中重度哮喘发作患儿血清总IgE显著高于轻度发作患儿（t=3.89P〈0.05）,血清ECP水平在哮喘轻度发作组与中重度发作组比较无统计学差异（t=1.57P〉0.05）;哮喘组血清CC16与总IgE呈显著负相关（r=-0.602P〈0.05）,血清CC16与ECP（r=0.153P〉0.05）及总IgE与ECP（r=0.290P〉0.05）无相关。结论血清CC16降低与总IgE、ECP水平增高在儿童哮喘发病过程中发挥重要作用;血清总IgE、CC16可反映哮喘发作严重程度;血清ECP水平高低并不能反映呼吸道炎症严重程度。     

Prevalence of Asthma in Children of Chemical Warfare Victims

Objective

Exposure of DNA to sulfur mustard gas may increase the inheritance of asthma in chemical warfare victims'' (CWV) offspring. The objective of this study was to determine the prevalence of asthma in children of CWV and compare it to asthmatic children in the general population.

Methods

Four hundred and nine children from 130 CWV fathers and 440 children from 145 asthmatic parents from two cities in Iran participated in this study. The prevalence of asthma was determined by standard questionnaire released for epidemiological survey of asthma in children and compared between two groups.

Findings

The prevalence of asthma in the CWV group was 15%; this was not significantly different from the control group (12.5%). The children of the CWV group reported a significantly greater incidence of wheezing (1.2±3.1 attacks) per year, but the control group reported more severe attacks leading to speech difficulties (3%) and coughing (7%). Regression analysis showed that with increasing family size in the control group, the number of subjects suffering from asthmatic symptoms decreases significantly (r=0.86, P=0.001).

Conclusion

Chemical agents may increase the prevalence of asthma in the offspring of CWV.     

Evaluation of Oxidative Stress and Erythrocyte Properties in Children with Henoch-Shoenlein Purpura

Objective

Pathogenesis of Henoch-Schönlein purpura (HSP) is not clearly defined. The present study was conducted to investigate the alterations in erythrocyte deformability and oxidative stress in HSP and to examine the possible relationship between erythrocyte deformability and organ involvement in this disease.

Methods

Plasma malondialdehyde (MDA) levels, total antioxidant status (TAS), erythrocyte deformability and aggregation were measured in 21 children with HSP at the disease onset and during the remission period in comparison with healthy subjects.

Findings

HSP patients at the active stage had significantly higher MDA and lower TAS levels (P<0.05). Erythrocyte deformability was decreased at the active-stage and increased again at the remission period of HSP (P<0.05). Erythrocyte deformability was significantly decreased at four different shear stresses in patients with gastrointestinal system or renal involvement; and decreased at six different shear stresses in patients with gastrointestinal system, and renal involvement compared to the patients without organ involvement (P<0.05). No significant difference was observed in aggregation parameters (P>0.05).

Conclusion

The present findings emphasize the association between impaired erythrocyte deformability and organ involvement in HSP.     

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目的探讨诱导痰细胞和白细胞介素8(IL8)、白细胞介素9(IL9)、嗜酸性粒细胞趋化因子(eotaxin)在儿童哮喘发病中的作用及相互关系。方法以2004年9月至2005年3月重庆医科大学附属儿童医院确诊哮喘的44例患儿为研究对象,其中急性发作期25例、缓解期19例,同时选10例因骨骼畸形入院的患儿作对照组,进行诱导痰的细胞分类检查和ELISA方法检测IL8、IL9、eotaxin。结果哮喘患儿诱导痰细胞总数明显升高,急性发作期诱导痰中性粒细胞数明显高于缓解期和对照组,缓解期淋巴细胞数明显高于急性发作期和对照组,嗜酸性粒细胞各组间比较差异无显著性意义;哮喘患儿诱导痰IL8、IL9质量浓度与对照组比较有明显升高,且IL8、IL9质量浓度与中性粒细胞百分数呈正相关,eotaxin在各组间比较差异无显著性意义。结论与成人过敏性哮喘不同,中性粒细胞在儿童哮喘的发病中扮演重要角色,IL8趋化中性粒细胞聚集于气道,中性粒细胞在IL9的作用下产生和释放IL8,三者相互影响,共同参与哮喘的发病。     

哮喘儿童 PBMC培养上清中 IL-13变化及其与嗜酸细胞计数、IgE关系探讨

目的 探讨白介素13（IL-13）在儿童支气管哮喘发病中的作用及其与嗜酸细胞（EOS）、IgE之间的关系。方法 测定32例哮喘儿童急性发作期外周血单个核细胞（PBMC）培养上清中IL-13水平,其中20例测定了恢复期PBMC培养上清中IL-13水平,20例正常儿童PBMC培养上清IL-13作对照,同时检测外周血EOS及血清IgE。结果 哮喘儿童在急性期和恢复期PBMC培养上清中IL-13均高于正常对照组,差异有统计学意义（P均〈0．05）,IL-13水平变化与EOS、IgE呈显著正相关（r=0.7498,0．9218,P均〈0.001）。结论 IL-13参与了儿童支气管哮喘的发病,在嗜酸细胞激活、活化及炎性介质的释放以及IgE分泌、合成方面可能具有一定的作用;减少IL-13生成的治疗对控制儿童支气管哮喘发作可能有重要意义。     

Infection Rate of Cryptosporidium parvum among Diarrheic Children in Isfahan

Objective

Cryptosporidiosis is an important enteric parasitic infection among infants and children in developing countries with significant morbidity and mortality especially among immuno-suppressed individuals. The aim of the present study was to estimate the prevalence of enteric cryptosporidiosis in children presenting with diarrhea in Isfahan.

Methods

This cross-sectional study was conducted from August 2007 to June 2008 in three university hospitals in Isfahan. Children aged 1 month to 10 years presenting with acute or persistent diarrhea were selected consecutively. The oocyst of C. parvum was investigated in stool specimens using a modified acid-fast staining method.

Findings

During the study period, 606 children (mean age 42.4±30.0 months, 58.1% female) were recruited. Acute and persistent diarrhea was present in 422 (69.6%) and 184 (30.4%) of the children, respectively. Twenty eight (4.6%) specimens were oocyst positive. The prevalence of Cryptosporidium infection was significantly higher in children with persistent diarrhea compared to children with acute diarrhea (12.5% vs 1.2%; P<0.001). Most of the infected children were under 5 years of age (89.2%), however, the age difference between infected and non-infected children was not statistically significant. Also, there was no significant difference between infected and non-infected children in gender.

Conclusion

The prevalence of Cryptosporidiosis in children presenting with persistent diarrhea is considerable and we suggest routine stool examination for Cryptosporidium in this group of children.     

Evaluation of Serum Lead Levels in Children with Constipation and Normal Controls in Northern Iran

Objective

Constipation is a major debilitating problem in children. We aimed to assess the serum lead levels of 2-13 year-old children complaining from constipation who referred to our center in Guilan province, Northern Iran.

Methods

This cross-sectional study was done on ninety 2-13 year-old children referring to 17^th Shahrivar Hospital, complaining from constipation (case group) and 90 healthy children The demographic data as well as the children''s serum lead levels were evaluated and recorded. Data were analyzed using SPSS software. Chi-square test was used as applicable.

Findings

Lead poisoning was significantly more frequent in the case group (37.8%) compared with the control group (8.9%). The frequency of lead poisoning in the case group compared with the control group, was significantly higher in children <7 years old (40.2% vs. 10%), boys (40.9% vs. 9.3%), girls (34.8% vs 8.3%), residents of old houses (43.1% vs. 9.7%), residents of new houses (28.1% vs. 8.5%), residents of low-traffic areas (26.8% vs. 5.3%), urban residents (40.5% vs. 9.9%), children whose fathers had low risk (33.3% vs. 10.9%) and high risk jobs (40.7% vs. 3.8%).

Conclusion

The frequency of lead poisoning was higher in children suffering from constipation.No significant difference was found between the two groups with respect to their sex, age, father''s job, and living in urban or rural areas.     

Prevalence of hypothalamic-pituitary-adrenal axis suppression in children treated for asthma with inhaled corticosteroid

OBJECTIVE:

To determine the prevalence of hypothalamic-pituitary-adrenal (HPA) axis suppression in asthmatic children on inhaled corticosteroids (ICS).

METHODS:

Clinical and demographic variables were recorded on preconstructed, standardized forms. HPA axis suppression was measured by morning serum cortisol levels and confirmed by low-dose adrenocorticotropic hormone stimulation testing.

RESULTS:

In total, 214 children participated. Twenty children (9.3%, 95% CI 5.3% to 13.4%) had HPA axis suppression. Odds of HPA axis suppression increased with ICS dose (OR 1.005, 95% CI 1.003 to 1.009, P<0.001). All children with HPA axis suppression were on a medium or lower dose of ICS for their age (200 μg/day to 500 μg/day). HPA axis suppression was not predicted by drug type, dose duration, concomitant use of long-acting beta-agonist or nasal steroid, or clinical features.

CONCLUSION:

Laboratory evidence of HPA axis suppression exists in children taking ICS for asthma. Children should be regularly screened for the presence of HPA axis suppression when treated with high-dose ICS (>500 μg/day). Consideration should be given to screening children on medium-dose ICS.     

Evaluation of Serum and Pleural Levels of Angiopoietin-1 and Angiopoietin-2 in Children with Transudative and Exudative Pleural Effusions

Objective

Angiopoietins are involved in the pathogenesis of a variety of human diseases. We tried to evaluate the application of pleural and serum Angiopoietin-1 and 2 in categorizing pleural effusions (PEs) into exudates and transudates in children.

Methods

Pleural fluid (PF) and serum Angiopoietin (Ang)-1 and Ang-2 were measured in 80 children with PEs (40 transudative and 40 exudative) by using enzyme-linked immunosorbent assay.

Findings

PF Ang-2 levels were significantly higher in pleural exudates than in transudates (P 0.012). PF Ang-2 levels were significantly higher than serum Ang-2 levels in patients with pleural exudates and transudates (P<0.001). PF Ang-2 levels were higher in tuberculous than in non-tuberculous pneumonic PEs and empyema (P=0.01). PF Ang-2 levels correlate with serum Ang-2 levels (P<0.003). PF Ang-1 levels were significantly lower than serum Ang-1 levels both in patients with exudates and those with transudates (P<0.001). Cutoff points of serum and PF Ang-2, differentiating between transudative and exudative effusions were 3ng/ml and 8ng/ml respectively. Predictive potentials of serum and PF Ang-2 cutoff points were: Sensitivity 90% and 95% respectively, specificity 92.50% and 97.50% respectively, positive predictive value 92.30% and 97.40% respectively and negative predictive value 90.20% and 95.10% respectively.

Conclusion

Ang-2 levels were elevated in exudative PEs and correlated with levels of markers of pleural inflammation and pleural vascular hyperpermeability. It could categorize PE to exudates and transudates with valuable discriminative properties. That was detected more obviously in pleural fluids than in serum.     

Growth Impairment and Nutritional Status in Children with Chronic Kidney Disease

Objective

Malnutrition is closely linked to chronic kidney disease (CKD) in adult patients with poor outcome. But data on pediatric patients is inadequate. The aim of this study was to describe the prevalence of growth failure and malnutrition in pediatric CKD patients and explore the relationship of these parameters to each other and to other clinical parameters.

Methods

This study included 42 patients and 29 healthy children matched for age and gender. Patients were classified firstly in age group and secondly in therapy modalities. Nutritional evaluations were performed according to the Kidney Disease Outcomes Quality Initiative guidelines, and we performed adjustments using values from children with the same chronological age as reference.

Findings

In pubertal group, the mean height SDS was lower than in pre-pubertal period while it was higher than in early childhood (P=0.4 and P=0.03 respectively). In all groups, 45% of patients had malnutrition: 20 patients on predialysis, 22 patients with end stage renal disease (14 on hemodialysis, and 8 on peritoneal dialysis). The mean weight SDS was lower in end stage renal disease groups (P<0.001). The height SDS was lower in end stage renal disease groups (P<0.001).

Conclusion

Growth failure and malnutrition remain a significant clinical problem as age and therapy modalities are dependent in children with CKD.     

Th1/Th2 Cytokine Profile and Its Diagnostic Value in Mycoplasma pneumoniae Pneumonia

Background:

The levels of Th₁/Th₂ cytokine can alter in pathogenic infection in children with pneumonia.

Objectives:

To evaluate Th₁/Th₂ cytokine profile and its diagnostic value in M. pneumoniae pneumonia in children.

Patients and Methods:

Children with M. pneumoniae mono-infection and 30 healthy children were tested with cytokines assay. We used real time PCR to detect M. pneumoniae in children with pneumonia.

Results:

M. pneumoniae test was positive in 2188 (16.62%) out of 13161 pneumonia children. Children aged 5 - 9 years had the highest rate and summer was a season with high rate of M. pneumoniae incidence in Zhejiang province. During the course of study, in 526 pneumonia children with M. pneumoniae mono-infection and 30 healthy children cytokines assay was performed. IL-2 level of M. pneumoniae pneumonia children was lower than that of healthy children (median levels, pg/mL: IL-2: 3.2 vs. 5.7, P = 0.00), while IL-4, IL-10 and IFN-γ were higher than in healthy children (median levels, pg/mL: IL-4: 3.2 vs. 1.5, P = 0.00; IL-10: 5.6 vs. 2.5, P = 0.001; IFN-γ: 20.4 vs. 4.8, P = 0.001).

Conclusions:

IL-2 decreases and IL-4, IL-10 and IFN-γ increase in children with M. pneumoniae pneumonia, which has a promising prospect in diagnosis of this disease in clinical practice.     

The Levels of Calcium and Magnesium,and of Selected Trace Elements,in Whole Blood and Scalp Hair of Children with Growth Retardation

Objective

Metals such as copper (Cu), zinc (Zn), iron (Fe) are essential for human beings. Chronic metabolic disturbances may result from an excess or deficiency of these metals. Ca and Mg are also nutrient elements and play an important role in biological systems. Thus, it is very important to check regularly trace elements concentration in the body. The purpose of this study was to measure the content of Fe, Cu, Zn, Ca and Mg in whole blood and hair of children with growth retardation compared to that of controls.

Methods

A quantitative elemental analysis of whole blood and scalp hair of children with constitutional growth retardation (n = 27) and matched controls (n = 21) was used to find out correlation and possible changes, between growth retardation and healthy controls. Atomic absorption spectrophotometric (AAS) analysis of quantitative method was used to determine iron, zinc, copper, calcium and magnesium levels of whole blood and scalp hair.

Findings

The whole blood levels of Fe and Zn were significantly lower in children with growth retardation (P<0.05), but there were no differences in Cu, Ca and Mg concentrations in whole blood between children with growth retardation and healthy controls. The hair levels of Fe, Zn, Ca and Mg were significantly lower in children with growth retardation when compared to that of controls (P<0.05). The Cu concentrations in the hair of children with growth retardation and healthy controls showed no significant differences (P>0.05).

Conclusion

The usefulness and significance of these elements in growth retardation should be discussed more detailed in the light of the most recent data.     

哮喘患儿血清IL 12 TGFβ1 与IgE 水平变化的研究

目的：检测哮喘患儿不同病期的白细胞介素12 ( IL-12) 、转化生长因子β1 ( TGFβ1 ) 与免疫球蛋白E( IgE) 水平变化的规律,并探讨不同病期IL-12,TGFβ1水平与IgE水平的相关性,据此阐述它们在哮喘中的临床意义。方法：采用ELISA 方法检测85例哮喘患儿及30例正常儿童的血清IL-12,TGFβ1与总IgE 水平。结果：哮喘组血清IL-12,TGFβ1水平明显低于对照组,而IgE 水平则哮喘组明显高于对照组,且发作期IL-12,TGFβ1 水平（28.42±10.73 ng/L,40.25±11.73 pg/mL）明显低于缓解期（40.42±15.26 ng/L,65.41±22.38 pg/mL）,差异有显著性 (P< 0. 01),缓解期血清IL-12,TGFβ1 水平明显低于对照组（67.42±20.58 ng/L,178.54±90.56 pg/mL）,差异有显著性(P<0.01),发作期血清IgE 水平（280.35±80.54 IU/mL）明显高于缓解期（145.67±51.25 IU/mL）, 差异有显著性(P< 0.01), 缓解期血清IgE 水平明显高于对照组（53.61±13.32 IU/mL）, 差异有显著性(P<0.01),哮喘患儿血清IL-12,TGFβ1水平与IgE呈负相关(P< 0.01)。结论：哮喘患儿存在IL-12,TGFβ1及IgE 水平失衡,提示IL-12,TGFβ1 在哮喘的发病中起着重要作用,检测它们的水平可为哮喘的诊断及判断病情提供依据。     

Relationship between Vitamin D and Childhood Asthma: A Case–Control Study

Objective:

Studies determining the relationship between serum vitamin D status and childhood asthma have yielded controversial results. Findings indicated that vitamin D deficiency is associated with asthma and airway hyper responsiveness. The aim of this study was to assess the relationship between serum vitamin D status and childhood asthma.

Methods:

Data were obtained from 200 asthmatic children (age 3–12 years) and 200 healthy controls. Serum levels of 25(OH) vitamin D, total IgE, calcium, phosphorus, parathormone (PTH) and eosinophil count were measured in both asthmatic children and healthy controls. Also, the mean values of 25(OH) vitamin D were compared with asthma symptom severities.

Findings:

There was a significant decrease in the concentration of serum 25(OH) vitamin D in the asthmatic patients as compared with the controls (20.34±2.8 vs 25.39±4.1 ng/mL, 95%CI: 1.46–3.86, P=0.01). Out of total asthmatic subjects, 40 (20%) were vitamin D sufficient, 48 (24%) were insufficient, and 112 (56%) were deficient. Total IgE concentration was also significantly higher in asthmatic patients having vitamin D deficiency (132.4±20.1 IU/ml, 95%CI: 1.38–3.75, P=0.03). Comparing asthmatic patients with healthy controls, odds of having vitamin D level less than 20ng/mL was 2.47.

Conclusion:

Our findings suggest that vitamin D deficiency or insufficiency may be positively related to the prevalence of asthma in children.     

Lactose-Free Compared with Lactose-Containing Formula in Dietary Management of Acute Childhood Diarrhea

Objective

Few reports are available on some benefits, such as shortened duration of diarrhea and better weight gain, for lactose-free over lactose-containing formula in acute childhood diarrhea. We evaluated the effects of lactose-free formula in dietary management of acute diarrhea in formula-fed children.

Methods

This controlled-clinical trial was conducted on formula-fed children, aged 1 to 24 months, referring with acute non-bloody diarrhea (≤2 weeks). Those who had major systemic illness, severe malnutrition, severe dehydration, severe vomiting, or history of antibiotic therapy were not included. Children were allocated to receive lactose-free formula (intervention, n=37) or lactose-containing formula (control, n=34). Time to diarrhea relief and weight change were compared between the two groups after one week.

Findings

During the study, 32 male and 39 female children (7.1±3.7 months) were included. Those who received lactose-free formula had a significantly shorter time to diarrhea relief compared with the controls (1.7±0.7 vs. 2.6±0.7 days, P<0.001). Weight significantly increased in both groups, but there was no difference between the two groups in weight change (37±100 vs. 38±77 gr, P=0.673). Multivariate analysis showed that receiving lactose-free formula significantly predicted time to diarrhea relief (95% CI: 1.5 to 3.9, P<0.001) controlling for baseline characteristics.

Conclusion

Early administration of lactose-free formula for formula-fed children presenting with acute diarrhea can result in a more rapid relief of acute diarrhea and thus perhaps less mortality and morbidity. Trials with longer follow-ups are warranted to better evaluate long-term results such as weight change and feeding problems in this regard.