Asthma knowledge level of child daycare center teachers' in Istanbul, Turkey.

AIM: Teachers are primarily responsible for supervising schoolchildren with asthma during school hours. The purpose of this study was to elucidate the level of knowledge of child daycare center teachers about asthma and factors affecting their knowledge. METHODS: This study was performed on 297 teachers from 20 randomly selected child daycare centers in Istanbul. The teachers' level of knowledge about asthma was assessed by a questionnaire with 32 questions about asthma. The teachers were asked thirteen additional questions about demographic data and other characteristics of the child daycare centers and about themselves. One-way ANOVA and the independent samples t-test were used to determine differences in the level of asthma knowledge. RESULTS: A total of 297 teachers (287 females/10 males) filled in the questionnaire. The mean age of the teachers was 26.4 ± 8.1 years (range, 20-53 year). The teachers' "response score rate for each question" ranged from 38% to 94%. The teachers' "completely true response rate for each question" was lower and ranged from 1.6% to 83.9%. "The mean of asthma knowledge score" for the 32 questions was 113.64 ± 20.26 (71% ± 12.7%) from a maximum of 160 marks. "Asthma knowledge score for all questions" was related to teachers' gender, age, location and property of child daycare center and number of children in child daycare center. CONCLUSION: Although teachers of child daycare centers have some knowledge about asthma, their "completely true response rate for each question" was insufficient. Much more efficient educational programs are needed for these teachers.

Bone mineral metabolism changes in epileptic children receiving valproic acid.

OBJECTIVE: The aim of this study was to evaluate bone mineral density (BMD) in epileptic children receiving valproic acid (VPA) and to determine differences between osteopenic and non-osteopenic children. METHODS: Thirty-three epileptic children, receiving VPA for at least 6 months, were compared with 33 healthy children for BMD. BMD was measured by dual-energy X-ray absorptiometry at lumbar vertebrae, femoral neck and greater trochanter. Serum calcium, phosphorus, alkaline phosphates, osteocalcin and VPA levels were also determined. RESULTS: Patient's osteocalcin levels were significantly higher (P = 0.02) and femur and trochanter BMD values were significantly lower (P = 0.04 and P = 0.03, respectively). Duration of VPA therapy was significantly longer and doses of VPA were significantly higher in seven osteopenic patients compared with 26 non-osteopenic patients. Osteopenic patients (4.6 +/- 2.4 years) were younger than non-osteopenic patients (7.8 +/- 3.2 years) (P = 0.01). CONCLUSION: Long-term and high dose VPA therapy may cause osteopenia, primarily in younger epileptic children. These patients should be followed closely by BMD measurements.

Thrombocytopenia: an important indicator for the application of partial exchange transfusion in polycythemic newborn infants?

BACKGROUND: The conventional therapeutic approach in polycythemic newborn infants is to apply partial exchange transfusion (PET) when hematocrit value exceeds 70% or when the infant develops symptoms with the exception of plethora. METHODS: In order to investigate the possibility of using platelet count as a simple criterion implying the PET requirement, we retrospectively reviewed polycythemic newborn infants with respect to the relationship between thrombocytopenia and severity of symptoms, and the association of platelet count and the PET performance. Thrombocytopenia has been defined as a platelet count < 150,000/microL. RESULTS: We studied 18 polycythemic infants with thrombocytopenia (group 1, 35%) and 34 without it (group 2, 65%). Perinatal asphyxia, gestational toxemia and intrauterine growth retardation, which are the three common causative factors leading to polycythemia, were not significantly different in the two groups. No correlation existed between platelet counts and hematocrit values within each group, but there was a very significant difference between the two groups in terms of severity of clinical findings (P < 0001); no difference in terms of moderate findings and moderately significant difference with respect to mild symptoms and asymptomatic situation (P < 0.05). Partial exchange transfusion was performed in all patients in group 1, while only 12 infants in group 2 (32%) received transfusion and the difference was statistically significant (P < 0.05). A significant rise in platelet counts has been achieved only in group 1, while hematocrit values decreased significantly in both groups following PET. CONCLUSIONS: This study emphasizes the relationship between thrombocytopenia and the severity of clinical findings and PET performance rate in polycythaemic newborn infants, implying that thrombocytopenia is a possible marker of hyperviscosity, the results of which warrant further investigation.