Patient-reported outcomes are critical to multidisciplinary, patient-centred approaches in diseases requiring lifelong management. Among inborn errors of immunity (IEIs), reports on this subject are typically limited to specific diagnostic subgroups or focus narrowly on the route of immunoglobulin replacement therapy (IgRT), offering a restricted perspective. We aimed to evaluate the health-related quality of life (HRQoL) and IgRT-related treatment satisfaction (TS) of a heterogeneous cohort of IEI patients and identify factors influencing these outcomes to guide improving the health and well-being of IEI patients. We conducted a cross-sectional survey targeting IEI patients on IgRT, assessing TS (TSQM-9) and HRQoL (KINDL/SF-36). Patient/caregiver-reported data were integrated with clinical data to identify outcomes and influencing factors. The survey included 500 IEI patients (356 children, 144 adults) diagnosed 54% Primary Antibody Deficiency (PAD), 36% combined immunodeficiency, 7% immune-dysregulation, and 3% other IEIs. Non-PAD diagnoses, comorbidities, absence of school/work attendance, and IgRT-related systemic adverse reactions negatively impacted HRQoL. Severe infections and related hospitalizations adversely influenced both HRQoL and TS. The subcutaneous route of IgRT, particularly at home, was associated with higher TS due to its convenience and reduced school/work absenteeism. However, the IgRT route did not influence adult HRQoL. Patient-reported well-being and satisfaction in IEIs are multifactorial and cannot be solely attributed to the route of IgRT. Minimizing negative experiences related to the disease or its treatment and, where possible, encouraging patients to maintain school/work attendance or engage in activities that promote societal participation can enhance self-esteem, coping abilities, and overall well-being.

BACKGROUND:Cold-induced urticaria (ColdU) is a rare chronic inducible urticaria that can cause systemic reactions, including cold-induced anaphylaxis (ColdA), but pediatric data are limited. The aim of this study was to evaluate the clinical characteristics, comorbidities, management approaches, risk of anaphylaxis, and long-term course of ColdU in a pediatric cohort, and to identify risk factors for ColdA, determinants of disease resolution, and predictors of persistence into adulthood. METHODS:This retrospective multicenter study included 203 pediatric patients with ColdU across 30 centers in Türkiye. Clinical characteristics and management of patients were analyzed. Logistic regression was used to identify factors associated with ColdA and disease resolution. RESULTS:The median age at diagnosis was 14.3 years, and the median age at onset was 10 years; 56.1% of patients were female. ColdA occurred in 17.2%, with increased risk associated with male sex, autoimmune comorbidities, older age, and triggering by cold food/beverage ingestion. Most patients (82.2%) received second-generation H1-antihistamines; omalizumab achieved >90% symptom control in 12 refractory cases. Over a median 3.5-year follow-up, 30.5% achieved disease resolution (median duration: 18 months). The history of anaphylaxis and comorbid atopy significantly reduced the likelihood of remission. Some patients showed adult persistence, without clear predictors. DISCUSSION:ColdA may occur even without classic high-risk features; pediatric ColdU management should be guided by individualized risk assessment, prioritizing clinical risk factors-such as older age, high-risk cold triggers, angioedema, and autoimmune comorbidities-over isolated diagnostic parameters. In refractory cases, omalizumab is an effective and well-tolerated option. Prior anaphylaxis and comorbid allergic disease predicted poorer remission.

Childhood interstitial lung diseases (chILD) include a diverse range of rare disorders, complex clinical progressions, and high rates of morbidity and mortality. This study aims to assess the clinical and psychosocial impacts of chILD in children registered in the National chILD-Turkiye database. Data from 17 centers were analyzed as of January 2024. Patients aged 1 month to 18 years were included in the study. Through face-to-face interviews, patients and their families completed the Pediatric Quality of Life Inventory (PedsQL™ 4.0 Generic Core Scales) and PedsQL™ 2.0 Family Impact Module. Higher scores suggest better performance and higher health-related quality of life (HRQoL). Patient clinic data, demographic information, pulmonary function tests, Fan scores, and household income were recorded. Patients were categorized into two groups according to their use of O2 therapy and diffuse progressive lung disease (DPLD) groups A and B. The study included 175 patients (90 girls), with a median age of 7.7 (1.0–17.8) years. A strong positive correlation was found between the FEV1

BACKGROUND:Severe asthma (SA) in children is a complex condition with high morbidity and healthcare costs. Mepolizumab, an anti-interleukin-5 biologic, is approved for severe eosinophilic asthma (SEA) in patients ≥ 6 years, yet long-term real-world pediatric data remain limited. AIM:To assess the long-term safety and effectiveness of mepolizumab in pediatric SEA, focusing on lung function, oral corticosteroid (OCS) use, and exacerbation rates. METHODS:This retrospective, multicenter study examined the medical records of 33 patients with SEA (aged 6-17 years) who received mepolizumab treatment at three tertiary centers in Turkiye. Inclusion criteria included GINA-defined SA, ≥ 2 severe exacerbations in the previous year requiring OCS, high-dose ICS plus a second controller, and elevated eosinophil counts. Data on exacerbations, pulmonary function tests (PFTs), OCS use, ACT scores, eosinophils, and adverse events were collected over 24 months. RESULTS:At baseline, patients showed poor asthma control (median ACT: 13), impaired lung function (FEV1%: 62%), and frequent exacerbations (median: 7/year). Mepolizumab significantly reduced exacerbation rates (median: 7 to 0-0.05 at 12/24 months, p = 0.005) and OCS use (87.9% OCS-free by 3 months). ACT scores improved (median: 13-25, p < 0.001), as did FEV1% (62% to 89%, p < 0.001) at 24 months. Eosinophil counts decreased markedly (460 to 50 cells/µL, p < 0.001). The treatment was well-tolerated; one patient discontinued due to anaphylaxis and four due to lack of efficacy. CONCLUSION:Mepolizumab showed sustained effectiveness and good tolerability in pediatric SEA, significantly reducing exacerbations and OCS use while improving asthma control and lung function. These findings support its real-world utility and underscore the need for careful patient selection and monitoring.

BACKGROUND:Food allergies affect 4%-6% of the pediatric population and are often present within the first 2 years of life. Cord blood cells and cytokines in high-risk infants can predict allergic problems; however, their predictive value remains unclear. PURPOSE:This study aimed to determine whether a cow's milk allergy in infants can be predicted using a basophil activation test (BAT) of cord blood samples by stimulating basophils with milk protein antigens (cow's milk and casein). METHODS:We collected cord blood during the birth of 30 mother-child pairs and immediately analyzed BAT stimulated with milk protein antigens. One year later, we compared the results of those infants who developed an allergy to those who did not. RESULTS:We found that infants with a casein-BAT value ≥2.6 were 33.2 times more likely than those with a casein- BAT value <2.6 to develop food allergy symptoms within the first year of life (P=0.03). CONCLUSION:High casein-BAT values in cord blood may predict the development of food allergies during the first year of life. Although no association with cow's milk sensitivity has been found, casein sensitivity may indicate food allergy risk. However, further studies are required to confirm this association.

Background. Respiratory colonization with Pseudomonas aeruginosa is associated with increased morbidity and mortality in cystic fibrosis (CF) patients. This study aims to assess the clinical characteristics and associated factors of CF infants under two years of age with P. aeruginosa colonization in Türkiye. Method. Of the 1637 patients registered in the Cystic Fibrosis Registry of Türkiye in 2019, 284 patients under two years of age were included in this retrospective cross-sectional study. Patients were classified into two groups: those with P. aeruginosa colonization (Group 1) and those without (Group 2). Cystic fibrosis transmembrane conductance regulator (CFTR) gene functions were categorized according to CFTR mutation functional class. Results. Twenty-three patients (8.1%) were categorized as Group 1 and 262 participants (91.9%) were classified as Group 2. Infants with P. aeruginosa colonization (Group 1) were more likely to have minimal CFTR function compared with those without colonization (87% vs. 39.8%, p = 0.017). In addition, both Staphylococcus aureus colonization (47.8% vs. 7.3%, p < 0.001) and methicillin-resistant S. aureus positivity (17.4% vs. 6.1%, p = 0.042) were observed more commonly in Group 1. There were no statistical differences between the groups in terms of age at diagnosis, gender, mean z-scores of weight and height, newborn screening test positivity, sweat chloride test results, and pancreatic insufficiency (p > 0.05). Univariate logistic regression analysis did not identify significant associated factors for P. aeruginosa colonization. Conclusions. Our findings suggest that minimal CFTR function and S. aureus colonization are associated with P. aeruginosa colonization in CF patients under two years of age. Further studies are needed to investigate associated factors for early P. aeruginosa colonization, eradication treatment effectiveness, and longitudinal outcomes of in CF patients under two years of age.

Background: Cow's milk protein allergy (CMPA) imposes a significant burden on the lives of infants and families and can cause various complications, but there are limited data on the clinical burden associated with infection. Objective: This study aimed to compare infection frequency, antibiotic use, and hospitalization rates between children with CMPA and healthy controls. Methods: Patients diagnosed with CMPA (IgE-mediated or non-IgE-mediated) in the pediatric allergy-immunology outpatient clinic and healthy infants admitted to the social pediatrics outpatient clinic were evaluated prospectively at initial visit, 6 months, and 12 months. Clinical characteristics, history of respiratory, skin, gastrointestinal, and urinary tract infections, antibiotic use, and hospitalization rates were analyzed. Results: Compared to controls, the CMPA group had significantly lower prevalence and duration of exclusive breastfeeding (p < 0.001 for both) and significantly higher income (p = 0.035), presence of siblings (p < 0.001), household size (p < 0.001), rate of suburban dwelling (p = 0.008), and rate of atopic dermatitis (p = 0.003). Rates of infection (all systems), antibiotic use, and hospitalization were higher in the CMPA group compared to controls (p < 0.001 for all) and among patients with IgE-mediated CMPA compared to those with non-IgE-mediated CMPA (p < 0.05 for all). Respiratory and skin infections were more common and gastrointestinal infections were less common in IgE-mediated CMPA compared to non-IgE-mediated CMPA (p < 0.001 for all). Conclusion: CMPA (especially the IgE phenotype) was associated with increased infection frequency and severity in infants. These findings suggest the need for a more careful approach to infection risk in patients with CMPA and the importance of disease control.

BACKGROUND:Pulmonary exacerbations (PEs) are associated with a subsequent decline in lung function. We aim to evaluate lung function in cystic fibrosis (CF) patients with frequent PEs in their first 2 years of age using spirometry at age 6. METHODS:This retrospective cohort study included CF patients who were 6 years old from the CF registry of Turkey in 2019. According to the number of PEs, patients were classified: those who had two or fewer PEs in the first 2 years of age were defined as Group 1 and those who had more than two PEs were defined as Group 2. The patients' demographics and clinical characteristics were compared between Group 1 and Group 2. RESULTS:The study included 88 patients who had data on PE from their first 2 years and completed their sixth year by 2019. Fifty-nine patients were included in Group 1 and 29 in Group 2. The mean percent-predictive FEV1 (ppFEV1), percent-predictive FVC (ppFVC) values, and the mean age at first PE were lower in Group 2 than in Group 1 (p = 0.019, p = 0.017, p < 0.001). The patients with chronic Pseudomonas aeruginosa (PA) colonization had lower mean ppFEV1 and ppFVC values than those without (p = 0.001, p = 0.001). Patients with PA in respiratory-sample culture during their first PE had lower ppFEV1 and ppFVC values than those with SA (p = 0.046; 0.018). CONCLUSIONS:This study showed that more frequent PEs in the first 2 years of age and chronic PA colonization were associated with poorer FEV1, FVC, and BMI values in CF patients.

INTRODUCTION:Cystic fibrosis (CF) is a complex genetic disorder characterized by significant clinical heterogeneity. We aimed to investigate the genotype-phenotype relationship of nasal polyps (NP) in CF Registry of Turkey (CFRT). METHODS:The study included all children registered in the CFRT in 2023, divided into two groups based on NP presentation. Clinical and demographic data were compared. The Sinus-Nasal Quality of Life (QoL) Survey-5(SN-5) evaluated patients with NP history. RESULTS:A total of 2258 patients were registered, with 115 (5.1%) having NP and 2143 without NP. Age was higher in the NP group (p < 0.001). The first and second sweat tests were higher in the NP group (p < 0.05). Median FEV1% was 89 (31-133) for the NP group and 85 (15-142) for those without NP (p = 0.015). Chronic colonization of MSSA and MRSA, CF-related liver disease, and CF-related diabetes were also more common in NP (p < 0.05). No differences were detected in pulmonary exacerbations (p > 0.05). In the NP group, severe genotype and F508del were more frequent (p < 0.05). Elexacaftor/tezacaftor/ivacaftor use was more common in NP (p = 0.003). A weak negative correlation was found between age and the SN-5 score (p = 0.020, r = -0.231), as well as a weak positive correlation between age and the Visual Analog Scale (VAS) (p = 0.001, r = 0.322). CONCLUSION:Although uncommon, NP is associated with more severe clinical and genetic characteristics in CF. These findings underscore the importance of integrating upper airway evaluation into CF management and highlight the potential for age-related adaptation or improved symptom perception in older patients.

BACKGROUND:Childhood interstitial lung diseases (chILDs) encompass a wide range of rare, chronic respiratory disorders, with pulmonary fibrosis (PF) being the clinical entity closely associated with mortality and morbidity. RESEARCH QUESTION:What is the prevalence and radiologic spectrum of PF in children with chILD, and how is it associated with pulmonary function and clinical characteristics? STUDY DESIGN AND METHODS:This multicenter, retrospective observational cohort study used data from the Turkish Childhood Interstitial Lung Disease Registry as of January 2024. An experienced radiologist reviewed the chest CT scans for PF findings. Patients were divided into 2 groups based on the presence or absence of PF findings, and their clinical and demographic data were analyzed. RESULTS:A total of 404 patients (47.5% female) from 25 centers were included. The median age was 137 months (interquartile range [IQR], 24-376 months). The median z score for weight was -1.02 (IQR, -8.8 to 6.88), and the median z score for height was -0.59 (IQR, -7 to 6.45). The median FEV1 was 68% (IQR, 16%-127%), and the median diffusion capacity of the lungs for carbon monoxide (Dlco) was 66% (IQR, 21%-132%). The PF findings were as follows: reticular abnormalities, 34.9% of patients; cystic abnormalities, 21% of patients; traction bronchiectasis, 19.8% of patients; architectural distortion, 14.4% of patients; and honeycombing, 2.5% of patients. Two groups were compared based on the presence (n = 183) or absence (n = 221) of PF findings; the group with fibrotic findings showed a higher age and lower z score for weight (P < .05). Although no differences were found in PFT parameters between groups (P > .05), Dlco was lower in the fibrotic group (P = .015). The prevalence of PF was higher in patients with diffuse parenchymal lung disease (DPLD) group A disorders than in those with DPLD group B (P = .014). INTERPRETATION:Our results show that PF is a common complication in chILD and becomes more pronounced with age, underscoring the importance of early detection. The higher rate of PF findings in patients with DPLD-A disorders suggests that children with surfactant dysfunction or alveolar developmental abnormalities may be at an increased risk of PF developing. PF may be more common in children with a lower Dlco score, with a DPLD-A disorder, or of an older age.

Background Allergic bronchopulmonary aspergillosis (ABPA), is a hypersensitivity reaction in the lung against the antigens of Aspergillus fumigatus. The aim of this study is to determine the incidence of ABPA, and to determine the risk factors leading to the development of ABPA.Methods The study was designed as a retrospective cohort study. Using the CF Registry System of Turkey data, the incidence of ABPA was determined and the clinical and demographic characteristics of 44 patients newly diagnosed with ABPA in 2022 and 132 patients with similar mutation weight and age range without ABPA diagnosis in that year were examined and compared. Also risk factors affecting the development of ABPA were determined.Results Low pulmonary function test values, having had at least one pulmonary exacerbation in that year, receiving intravenous antibiotic treatment, using inhaled antibiotics, having high number of pulmonary exacerbations, having Pseudomonas aeruginosa colonization, having low body mass index (BMI), having cystic fibrosis related diabetes mellitus were found to be among the risk factors for the development of ABPA.Conclusions Early recognition and treatment of ABPA is essential to prevent further damage to the lungs. Patients with frequent pulmonary exacerbations, low BMI and low pulmonary function test values, chronic colonization should definitely be considered for ABPA.

OBJECTIVES:Cystic fibrosis-related diabetes (CFRD) is the most common comorbidity in patients with cystic fibrosis (CF). This study aimed to determine the prevalence and risk factors of CFRD using data from the CF Registry of Türkiye (CFRT). METHODS:All patients with CF who underwent diabetes screening in 2022 or earlier were included in the study. The clinical and demographic characteristics of patients with CFRD, pre-diabetes (impaired glucose tolerance, impaired fasting glucose, indeterminate glucose tolerance), and those with normal screening results (NSR) were compared. RESULTS:Of the 1,702 patients registered in the data system in 2022, 916 patients from 21 centers who underwent diabetes screening were included in the study. CFRD was diagnosed in 102 patients (11.2 %), there were 56 patients (6.1 %) with pre-diabetes, and NSR were found in 757 patients (82.7 %). The youngest patient diagnosed with diabetes was 6 years old. In patients with CFRD, the median age of patients was found to be higher (p<0.001), body mass index (BMI) was found to be lower (p 0.017); chronic Pseudomonas aeruginosa (P. aeruginosa) colonization (p<0.001), severe mutations (60.8 %, p<0.001), and pancreatic insufficiency (56.1 %, p<0.001) were more frequent; median FEV1% and FVC% values were significantly lower (p<0.001 and p<0.002, respectively) compared to non-diabetic patients. CONCLUSIONS:CFRD is associated with impaired pulmonary function, poor nutritional status, and increased chronic bacterial colonization of the airways. Advanced age, decreased respiratory function, severe genotype, and pancreatic insufficiency are risk factors for CFRD.

The main drawback of hypoallergenic formulas for cow's milk protein allergy (CMPA) is their low palatability. This study aims to examine the decisions made by mothers of infants diagnosed with CMPA and physicians regarding the taste of extensively hydrolyzed formulas (eHFs), amino acid-based formulas (AAFs), and rice-based formulas. This single-blind, multicenter study was conducted in nine pediatric allergy centers across Türkiye and included 181 pediatricians and 137 mothers of children with CMPA. Seven substitution formulas without added sweeteners or additional flavorings available on the market were tested: Two AAFs (Neocate-Numil®, Alfamino-Nestlé®), one AAF with synbiotics (Pregomin Syneo-Numil®), one AAF specifically designed to meet the nutritional and lifestyle needs of children over 1 year of age (Neocate Junior-Numil®), one synbiotic eHF (Aptamil Pepti Syneo-Numil®), and two rice protein-based formulas (Evolvia RP1-Montero® and Evolvia RP2-Montero®). A sensory evaluation was conducted using a single-blind protocol, following the methodology previously applied in the CONTEST-1 study. Neocate Junior-Numil® was the most preferred product in terms of taste, smell, and appearance, as rated by both mothers and physicians. It was the most preferred formula by both mothers (49.6%) and physicians (62.4%) in terms of taste. Aptamil Pepti Syneo-Numil® ranked second (32.8% for mothers, 42.0% for physicians), followed by Evolvia RP2-Montero® (23.4%) for mothers and Alfamino-Nestle® (22.1%) for physicians. The fact that both mothers and physicians most frequently preferred Neocate Junior-Numil® suggests that sensory characteristics of formulas used in CMPA management-such as taste, smell, and appearance-may play a decisive role in treatment adherence. This finding highlights the importance of considering not only nutritional adequacy but also acceptability when selecting a formula.

OBJECTIVE:The Cystic Fibrosis Registry of Türkiye (CFRT) was established by the Turkish Pediatric Respiratory Diseases and Cystic Fibrosis Society and has provided detailed information on demographic, clinical, genetic, and treatment-related aspects of cystic fibrosis (CF) patients since 2017. We aimed to describe the current status of CF in Türkiye using CFRT's 2023 annual data. MATERIAL AND METHODS:Demographic, clinical, and treatment data were taken from CFRT's 2023 record. RESULTS:In 2023, 2,258 patients from 34 centers were recorded. The median age of patients was 9.1 years, and 46.9% were female, with a median age at diagnosis of 0.3 years. Only 14.9% of the patients were older than 18 years. Genetic analyses were completed in 97.3% of patients. The most common variant, F508del, had a total variant frequency of 22.1%. The median percent predicted FEV1 and FVC were 88.0 and 94.0 in those aged 6-17 years 71.0 and 84.0 in those aged ≥18 years, respectively. The median values of body mass index z-scores were -0.5, and -0.5 for patients 2-18 and older than 18 years, respectively. Chronic colonization with Pseudomonas aeruginosa was present in 17.2% of the patients. Most patients used inhaled recombinant human DNase (87.1%) and oral pancreatic enzyme replacement treatment (83.0%). CF transmembrane conductance regulator (CFTR) modulators were used by 15.9% of patients. Over the year, 24 patients died, with a median age at death of 13.3 years. CONCLUSION:The CFRT report provides a valuable resource showing the clinical and laboratory data of patients with CF in the country.

[This corrects the article DOI: 10.3389/falgy.2024.1516774.].

Background. Although flexible bronchoscopy (FB) is frequently performed in children, there is limited information on the potential complications and risk factors. In this study we aimed to evaluate the complications associated with pediatric FB and identify predictors of these complications. Methods. Patients aged 0-18 years who underwent FB at the Akdeniz University Pediatric Pulmonology Department between February 1, 2015 and June 30, 2023 were included in the study. We retrospectively recorded the patients’ demographic data, known diseases, pulmonary function test results, chest computed tomography findings, bronchoscopy time/indication/route/findings, vital signs, minor and major complications associated with the FB procedure, post-procedure intensive care unit admission, procedure and sedation durations, and American Society of Anesthesiologists physical status (ASA-PS) classification, Mallampati score and anticipated need for post-procedural intensive care as evaluated in the pre-procedure anesthesiology consultation. Results. The study included a total of 292 patients; 157 (53.8%) girls and 135 boys, with a mean age of 9.9±4.8 years. There were a total of 55 FB-related complications (18.8%), 19 major (6.5%) and 36 minor (12.3%), and 10 patients (3.4%) required intensive care unit admission due to the procedure. The most common complication was hypoxia (11.3%). Patient age, height, anticipated need for intensive care, and baseline oxygen saturation values were significant predictors of the development of bronchoscopy-related complications, while patient age, baseline diastolic blood pressure, anticipated need for intensive care, and route of insertion were predictors of major complications after bronchoscopy. ASA-PS score, pulmonary function test values, and procedure/sedation durations had no effect on the development of complications. Conclusion. Although FB is a fairly safe diagnostic method in children, extra caution regarding possible complications is warranted in young children, when using the nasal route of insertion, or if the patient is evaluated as high-risk in the pre-procedure assessment performed by the anesthesiologist.

BACKGROUND:Montelukast is a leukotriene receptor antagonist commonly used in allergic diseases. In this study, we investigated the frequency, severity and risk factors for neuropsychiatric side effects and sleep disorders associated with montelukast in children. METHOD:Children aged 6 months to 17 years prescribed montelukast for allergic rhinitis or asthma at 31 Paediatric Allergy and Immunology centres were enrolled in this cohort study. At enrollment, sociodemographic characteristics, prior diagnoses of neuropsychiatric diseases or sleep disorders, and indications for montelukast treatment were recorded, and the primary caregivers completed a baseline questionnaire about neuropsychiatric symptoms (insomnia, nightmares and depressed mood) of their children. All participants were followed up for 1 month, and a post-treatment follow-up questionnaire on neuropsychiatric symptoms was completed at the end of this period. Moreover, caregivers were instructed to contact the clinic if neuropsychiatric side effects or sleep disorders were observed during this period. RESULTS:Total of 1163 children were enrolled. There was a significant increase in the frequency of insomnia, nightmares, night terrors, drowsiness, behavioural problems, irritability, depressive mood, agitation, anxiety, hyperactivity, learning difficulties and headache during the 1 month period after montelukast treatment compared to the previous 1 month (p < 0.001 for all). Overall, caregiver reports of neuropsychiatric symptoms in children increased from 172 (14.8%) to 399 (34.3%) after 1 month of montelukast treatment (p < 0.001). CONCLUSIONS:Montelukast treatment increases the risk of neuropsychiatric symptoms and sleep disorders in children with allergic diseases, especially if there is concomitant use of antihistamines.

AIMS AND OBJECTIVES:To evaluate the efficacy of YoungAsthma, a nurse-led, web-based mHealth intervention on asthma control and self-efficacy among adolescents with asthma utilizing decision tree analysis. BACKGROUND:Asthma is a prevalent chronic condition in pediatric populations, necessitating sustained management for optimal disease control. DESIGN:A randomized controlled clinical trial. METHODS:Fifty-four eligible adolescents were randomly assigned to either the intervention group (YoungAsthma + Usual care, n = 27) or the control group (Usual care, n = 27) for 4 weeks. Primary outcomes-asthma control and self-efficacy-were assessed using the Information Form, Asthma Control Test, Self-Efficacy Scale for Children and Adolescents with Asthma. Statistical analyses included Fisher's exact test, chi-square test, Wilcoxon signed-rank test, Mann-Whitney U test, and Intention-to-Treat (ITT) analysis. RESULTS:Forty-eight participants completed the study (11% dropout per group). The intervention group exhibited a greater improvement in asthma control than the control group. While both groups showed increased self-efficacy, the intervention group's improvement was significantly higher. Decision tree analysis identified key predictors, indicating that lower scores were associated with a higher likelihood of remaining in the control group. CONCLUSIONS:Nurse-led, technology-supported interventions significantly enhance asthma control and self-efficacy in adolescents. Decision tree analysis provided valuable insights into key factors influencing asthma control and self-efficacy improvements, identifying subgroups that benefited most from the intervention. Interdisciplinary collaboration facilitated a user-centered approach grounded in Bandura's Self-Efficacy Theory, offering a data-driven framework for personalized asthma management. RELEVANCE TO CLINICAL PRACTICE:Decision tree analysis aids in identifying patients who would benefit most, enabling precision-targeted interventions. REPORTING METHOD:This study was conducted in accordance with Consolidated Standards of Reporting Trials and with the Mobile Health Evidence Reporting and Assessment guidelines. CLINICAL TRIAL REGISTRATION NUMBER:Clinicaltrials. gov, ID: NCT04691557 & Date of first recruitment: December, 2020. https://register. CLINICALTRIALS:gov/prs/beta/studies/S000AJ5B00000102/recordSummary.

Primary pulmonary tumors are rare in pediatric patients, and benign types are more frequently observed than malignant ones. Granular cell tumors (GCTs), of neuroectodermal origin, are uncommon in the lungs and especially rare in children. We report a case of a 16-year-old female with persistent respiratory symptoms initially diagnosed as asthma, who was ultimately found to have a bronchial granular cell tumor. The diagnosis was confirmed histopathologically, and the lesion was removed via rigid bronchoscopy. We also provide a review of the literature focusing on pediatric pulmonary GCTs. Granular cell tumors should be considered in the differential diagnosis of adolescents with persistent respiratory symptoms unresponsive to medical therapy. Early imaging and bronchoscopy can assist in timely diagnosis and lung-sparing treatment.