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Background: Systemic inflammation, attacks, deterioration of thoracic region mechanics, medications used, and decreased physical activity level (PAL) and fitness negatively may affect respiratory muscle strength. The primary aim of this study was to evaluate dynamic inspiratory muscle strength (S-index), PAL, and physical fitness in children with asthma compared to healthy peers. The secondary aim of this study was to investigate the relationships between S-index and peak inspiratory flow (PIF) values and functional parameters in childhood asthma. Methods: This cross-sectional prospective study consisted of participants of 6–11 years of age, specifically, 20 children with asthma and 20 healthy peers. The device (POWERbreathe K5) evaluated PIF and S-index variables. PAL was determined with the Physical Activity Questionnaire-Child (PAQ-C) and fitness was evaluated with the FITNESSGRAM test battery. Results: The PIF Average (Avg): 1.8 ± 0.6, Best: 2.6 ± 0.6 (asthmatic children) vs. Avg: 2.4 ± 0.7, Best: 3.1 ± 0.9 (healthy children); p = 0.017, p = 0.027, respectively) and S-index (Avg: 34.1 ± 10.3, Best: 45.6 ± 9.9 (asthmatic children) vs. Avg: 43.2 ± 12.1, Best: 56.6 ± 14.7 (healthy children); p = 0.015, p = 0.008 respectively) values of children with asthma were significantly lower compared to healthy peers. The PAL and physical fitness of asthmatic and healthy peers were similar (p > 0.05). There were significant relationships between S-indexavg and S-indexbest with the PAQ-C score (r = 0.498, p < 0.025 r = 0.547, p < 0.013, respectively) and PIFavg and PIFbest with the PAQ-C score (r = 0.490, p < 0.028 r = 0.602, p < 0.005) in children with asthma. Conclusions: Dynamic respiratory muscle strength is negatively affected in children with asthma whereas their physical activity and fitness levels are comparable to their peers. However, it was found that children with a higher S-index and PIF rate had higher PALs. These findings suggest that pulmonary rehabilitation interventions to improve respiratory muscle function should be considered an important strategy to maintain and increase physical activity levels in children with asthma. [ABSTRACT FROM AUTHOR]

Background: Legumes are nutritionally valuable as an inexpensive protein source, but may cause severe allergic reactions. This study aimed to identify the characteristics of legume allergies (LAs) in Turkish children. Methods: A total of 87 children (4.9 (3.1–7.0) years) with LAs confirmed by either oral food challenge (OFC) or consistent history were reviewed. Results: The median age of onset was 19 (12–38) months. The most frequent LA was lentil (n = 57, 66%), followed by peanut (n = 53, 61%), chickpea (n = 24, 28%), pea (n = 21, 24%), bean (n = 7, 8%), and soybean (n = 1, 1%). From these, it was observed that 60% had multilegume (≥2) allergies and the age of onset occurred earlier compared with the single LA subgroup (18 (11–30) vs. 28 (17–42) months, p =.042). Single LA was present in peanut (51%) and lentil (16%) allergies, but not chickpea, pea, and bean. Fifteen patients had tolerated lentils before their first allergic reaction. The majority of children with LA (91.9%) were allergic to multiple foods including tree nuts (71%), hen's egg (66%), and cow's milk (49%). Seventy‐eight patients (89.7%) also presented with atopic comorbidities concerning atopic dermatitis (70%), asthma (40%), and allergic rhinitis (30%). Patients with anaphylactic type of reaction (20%) had higher frequency of aeroallergen sensitization (p =.001). Lip dose challenge with legume paste predicted the result of OFC with a diagnostic accuracy of 81.82% and a positive likelihood ratio of 10.8. Conclusion: In Turkey, LA is a reflection of multiple food allergies and the presence of allergy to a least frequently encountered legume is a sign of multiple LA. [ABSTRACT FROM AUTHOR]

Introduction/objectives: The characteristics of tree nuts (TNs) and peanut (PN) allergies vary in different regions of the world. We aim to identify the characteristics of TNs/PN allergies in Turkish children., Patients and Methods: A total of 227 children [4.8 (3.2-6.8) years] with TN and/or PN allergies were included. The phenotypical features of TNs/PN allergic children and the risk factors for multiple TNs/PN allergies were evaluated., Results: Allergy to TNs/PN developed at a median age of 12.0 (10.0-18.0) months. The most common TNs/PN responsible for food allergies were the hazelnut (63.9%) and the pistachio (54.6%). Of TNs/PN allergic children, 54.2% experienced reactions with at least two types of . Current ages 6-10 years [OR:2.455, 95% CI:1.255-4.852, p=0.009] and family history of atopy [OR:2.156, 95% CI:1.182-3.932, p=0.012] were the risk factors for multiple TNs/PN allergies. Most of the patients with cashew nut and pistachio allergies exhibited co-sensitization and co-allergy to both of these TNs/PN. Although the rarest TNs/PN allergy was seen with almond, the possibility of allergy to other TNs or PN was highly increased in the patients with almond allergy compared to other TNs/PN., Conclusions: Children with TNs/PN allergy living in an East Mediterranean region differ from the counterparts living in Western countries by an earlier age of onset of the TNs/PN allergy symptoms, increasing possibility to have multiple TNs/PN allergy at older ages, and different spectrum of TN/PN allergies (hazelnut followed by pistachio/cashew) that all indicate the consumption habits which are important determinants of TN/PN allergy development., (Copyright © 2019 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.)

Background: International guidelines highlight the importance of assessing asthma control status in children with asthma, and research on practical and objective instruments for assessing asthma control is ongoing., Objective: To determine the role of the Childhood Asthma Control Test (C-ACT) and fractional concentration of exhaled nitric oxide (FeNO) in identifying children with not well-controlled asthma., Methods: Children 6 to 11 years of age with asthma were enrolled in the study. They completed C-ACT and underwent FeNO and spirometric measurements during the monthly clinic visits. An asthma specialist assessed asthma control according to the gold standard Global Initiative for Asthma guideline and decided the treatment of the patients., Results: Seventy-six children with a mean (SD) age of 8.7 (1.4) years were evaluated in the first visit, whereas 64 and 51 children were admitted for second and third visits, respectively. A C-ACT score of 22 or less had 69% sensitivity and 77% specificity in determining not well-controlled asthma, whereas an FeNO value of 19 ppb or higher had 61% sensitivity and 59% specificity in patients who completed 3 visits. Receiver operating characteristic curve analysis revealed that the C-ACT was better than FeNO for identifying patients with not well-controlled asthma (area under the curve, 0.79; P < .001 [C-ACT] vs .58, P = .10 [FeNO]) Results of multivariate generalized estimating equation analysis revealed that a C-ACT score of 22 or less (odds ratio, 8.75; 95% confidence interval, 4.35-17.59; P < .001) and an FeNO of 19 ppb or greater (odds ratio, 2.60; 95% confidence interval, 1.07-6.29; P = .03) were significant indicators for the presence of not well-controlled asthma., Conclusion: The C-ACT is superior to FeNO in determining the control status of children with asthma and may be used as a complementary tool in clinical practice to detect children with not well-controlled asthma., (Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)