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    Importance of flexible bronchoscopy in the diagnosis of childhood respiratory diseases
    (2020) Ayzit Kilinc, Ayse; Cokugras, Haluk
    Aim: One of the methods used for the diagnosis of childhood respiratory diseases is flexible fiber optic bronchoscopy (FFB). This diagnostic method allows examination of the nose, pharynx, larynx, and tracheobronchial tree. In this study, we present 2 years of FFB experience and highlight its diagnostic advantages in pediatric medicine. Material and Methods: We retrospectively evaluated 213 FFB procedures that were performed between March 2017 and April 2019. Age, sex, FFB indication, bacterial growth in bronchoalveolar lavage (BAL) analysis, the presence of pathological bronchoscopy findings and complications after bronchoscopy were assessed.Results: Of the 213 patients included in the study, 116 (54%) were female and 97 (46%) were male. The mean age was 4.7 ± 6.32 months. The most common indications for bronchoscopy were abnormal radiological findings (30.5%), stridor (13.6%), and chronic cough (11.3%). In 152 patients (71%), diagnostic and therapeutic findings were obtained after bronchoscopy. Transbronchial biopsy was performed in eight patients for whom the etiology could not be determined; a diagnosis was obtained in five of these patients. Bacterial growth in BAL was detected in 68 patients (32%). Temporary complications developed in 17 patients (7.9%) with the most common complication being coughing during the procedure in 8 patients (3.8%).Conclusion: FFB is an important method that allows visualization of the upper and lower airways. The widespread use of pediatric FFB will enable early and non-invasive diagnosis of many respiratory diseases.
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    Non-cystic fibrosis bronchiectasis: Etiologic approach and effects of long-term azithromycin in children
    (2021) Ayzit Kilinc, Ayse; Cokugras, Haluk
    Aim: Non-cystic fibrosis bronchiectasis (NCFB) is a chronic pulmonary problem that includes a group of heterogeneous diseases. Macrolide antibiotics are increasingly prescribed for patients with NCFB, but there are very few studies on their use in children. This study aimed to search the clinical features of children with NCFB and the effect of long-term use of azithromycin on the frequency of aggravation, microbiological reproduction, and pulmonary function tests.Materials and Methods: A total of 79 cases diagnosed with NCFB were recorded. Clinical, laboratory, and radiological evaluations were also recorded. Exacerbation frequency, sputum cultures, and pulmonary function tests of 27 children who received azithromycin before and during prophylaxis were also analyzed.Results: The median age of children was 7.6 years old (1 to 16 years), when the children were diagnosed with NCFB. Bronchiectasis etiology was detected in 62 patients. Primary ciliary dyskinesia (PCD) was the most common cause of bronchiectasis, which 24 (30%) children were diagnosed with PCD. Azithromycin treatment was given to 27 bronchiectasis patients for six months. A statistically significant decrease was detected in pulmonary aggravation frequency and sputum microbiology during azithromycin treatment (p 0.05)Conclusion: The use of azithromycin in children with NCFB improves aggravation frequency but has no significant effect on the pulmonary function test.
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    Respiratory syncytial virus and effect of palivizumab prophylaxis in patients with congenital heart disease
    (2020) Ayzit Kilinc, Ayse; Aygun, Canan; Sungur, Metin; Baysal, Kemal
    Aim: We evaluated the prevalence of Respiratory syncytial virus (RSV), the rates of hospitalization and intensive care unit (ICU) admission due to RSV infection, the need for mechanical ventilation, and the efficacy of palivizumab prophylaxis in children with congenital heart disease (CHD).Material and Methods: A total of 419 patients under 2 years old who were hospitalized with lower respiratory tract infection (LRTI) were included in this study. Patients were divided into two groups according to the presence of CHD. 241 patients had unstable CHD and 178 patients had no underlying conditions. Palivizumab prophylaxis was administered to 29 of the patients with CHD and RSV infection; 22 of these patients were followed for 1 year.Results: RSV infection was detected in 19.5% of the patients with CHD and in 20% of those without CHD. Among the 241 patients with CHD and LRTIs, the rate and duration of hospitalization for RSV were 14% and 9.9 days, respectively. The rate of admittance to the ICU was 32% and that of mechanical ventilation was 19% in the CHD patients with RSV infection. Of the patients without CHD, 12% were admitted to the ICU and 8% received mechanical ventilation. These rates were significantly higher among the RSV-infected patients with CHD. The rates of hospitalization for RSV before and after palivizumab prophylaxis were 59% and 14%, respectively; the difference was significant. Conclusion: RSV infection is a common cause of mortality and morbidity in patients with CHD; palivizumab prophylaxis is effective in these patients.