The present study was designed to evaluate the significance of echocardiography versus cardiac troponin I levels in early detection of anthracycline dependent cardiotoxicity in acute lymphoblastic leukemia (ALL) patients. A total of 276 pediatric ALL patients were included in the study prospectively along 3 phases of data collection lasted from 2002 to 2009; including phase I (March 2002 to February 2003; n = 25; 53.3% females), phase II (September 2003 to April 2004; n = 35; 57.1% females), and phase III (January 2005 to June 2009; n = 216; 52.7% females) with respect to cumulative anthracycline doses applied. Anthracycline was administered in accordance with berlin-Franfurt-Munich (BFM)-2000 protocol in doses of 30 to 350 mg/m(2) (in the first phase) and 30 to 240 mg/m(2) (in the following phases). Evaluation of cardiotoxicity was performed via echocardiography and measurement of cardiac troponin I levels. Patients in each phase were homogenous in terms of gender and age. Diastolic dysfunction determined via reduction E/A ratio below the cutoff value was demonstrated to deteriorate earlier than systolic functions and alteration in cardiac enzymes. Being similar between dose groups, cTnI levels were shown to rise in the presence of congestive heart failure. In conclusion, anthracycline cardiotoxicity appears to be detected in an earlier stage by using diastolic parameters compared to systolic parameters and cardiac enzymes.

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Aim:The aim of this study is to determine the effect of age at the time of diagnosis on development of additional allergic diseases and aeroallergen sensitivity in pediatric patients with a diagnosis of AD. Material and Method: The study includes 114 pediatric patients who were diagnosed as atopic dermatitis according to Hanifin and Rajka criteria. After all patients were divided into two groups according to age at the time of diagnosis as less than 24 months and more than 24 months, total serum IgE, inhalant spesific IgE, ECP levels were measrued and skin prick tests were performed. The additional allergic diseases developed during the followup were recorded. Results: 90 patients (%78.9) were under 24 months of age, 24 (%21.1) patients were over 24 months of age, when the patients were gouped according to age at the time of diagnosis. In our study group, mean age at the time of diagnosis was 14.0±21.4 months, the duration for development of an additional allergic disease was 23.8±22.3 months and mean follow-up period was 58.7±41.2 months (min.8 monthsmax.180 months ; median 50.5 months). In the group who were under 24 months of age at the time of diagnosis, a significant difference was determined for development of asthma in the future (p=0.042). Conclusions:To prevent the allergic process in cases in whom atopic dermatitis findings start at an early age, the families should be warned about the allergic diseases associated with the repiratory system and should protect their children from inhalant allergens. (Turk Arch Ped 2011; 46: 299-303)