Over restrictive elimination of foods in children with foodallergy

Background. Previous studies demonstrated critical deficits in diagnosis and management of childhood foodallergy (FA), and recent developments in FA research support adopting a proactive approach in FA management.Our objective was to describe FA knowledge and management patterns of pediatricians.Method. We applied a 24-item survey to 170 general pediatricians, pediatric allergists and pediatricgastroenterologists practicing in Turkey.Results. Some IgE-mediated symptoms of FA such as cough, urticaria, wheezing and anaphylaxis were falselyrecognized as symptoms of non-IgE-mediated FA by 30%, 29%, 25% and 19% of the participants, respectively.By contrast, 50% of the participants falsely recognized bloody stool, a finding of IgE-mediated FA. Mostfrequently and least frequently used diagnostic tools were specific IgE (30.5%) and oral food challenge test(1.7%), respectively. Maternal diet restrictions and infant diet restrictions were advised by 82% and 82%,respectively. Percentages of physicians eliminating only 1 food were 21%, 19%; 2 foods were 15%, 11%; 3 foodswere 7%, 8%; 4-5 foods were 8%, 11%; 5 to 10 foods were 21%, 26%; and >10 foods were 28%, 25% from thematernal and infant diet, respectively. Cow’s milk, cheese, butter, yoghurt, baked milk products and hen’s eggwere the most commonly restricted items.Conclusion. Overall, FA knowledge of pediatricians was fair. Pediatricians utilize an overly restrictive approachwhen advising diet eliminations in FA. Recent developments favor a more proactive approach to induce immunetolerance and need to be encouraged in pediatric clinical practice. Future educational efforts should focus onemphasizing the deleterious effects of injudicious and extensive eliminations

A genomic snapshot of demographic and cultural dynamism in Upper Mesopotamia during the Neolithic Transition

Upper Mesopotamia played a key role in the Neolithic Transition in Southwest Asia through marked innovations in symbolism, technology, and foodways. We present thirteen ancient genomes (c.8500-7500 calBCE) from Pre-Pottery Neolithic Çayönü in the Tigris basin together with bioarchaeological and material culture data. Our findings reveal that Çayönü was a genetically diverse population, carrying a mixed ancestry from western and eastern Fertile Crescent, and that the community received immigrants. Our results further suggest that the community was organised along biological family lines. We document bodily interventions such as head-shaping and cauterization among the individuals examined, reflecting Çayönü's cultural ingenuity. Finally, we identify Upper Mesopotamia as the likely source of eastern gene flow into Neolithic Anatolia, in line with material culture evidence. We hypothesise that Upper Mesopotamia's cultural dynamism during the Neolithic Transition was the product not only of its fertile lands but also of its interregional demographic connections

The genetic history of the Southern Arc: a bridge between West Asia and Europe

By sequencing 727 ancient individuals from the Southern Arc (Anatolia and its neighbors in Southeastern Europe and West Asia) over 10,000 years, we contextualize its Chalcolithic period and Bronze Age (about 5000 to 1000 BCE), when extensive gene flow entangled it with the Eurasian steppe. Two streams of migration transmitted Caucasus and Anatolian/Levantine ancestry northward, and the Yamnaya pastoralists, formed on the steppe, then spread southward into the Balkans and across the Caucasus into Armenia, where they left numerous patrilineal descendants. Anatolia was transformed by intra–West Asian gene flow, with negligible impact of the later Yamnaya migrations. This contrasts with all other regions where Indo-European languages were spoken, suggesting that the homeland of the Indo-Anatolian language family was in West Asia, with only secondary dispersals of non-Anatolian Indo-Europeans from the steppe

Karaciğer fibrokistik hastalıklarının değerlendirilmesi tek merkez deneyimi

Amaç: Karaciğerin fibrokistik hastalığı (KFKH), intrauterin dönemden adölesan yaşa kadar geniş bir yaş aralığındagörülebilen, multisistemik bir hastalıktır. Çalışmadaki amacımız kliniğimizde KHFK olan hastaların, başvuru semptomları,klinik-laboratuvar bulguları, tedavi yaklaşımı ve takip sonuçlarını değerlendirmektir.Gereç ve Yöntemler: Ocak 2008-Aralık 2019 yılları arasında, Çocuk Gastroenteroloji, Hepatoloji ve Beslenmepolikliniğinde KFKH nedeniyle takipli olan hastaların demografik özellikleri, klinik-laboratuar bulguları, tedavi yaklaşımlarıve son durumları geriye dönük olarak incelendi.Bulgular: Otuz dokuz hastanın (56.4 erkek, ortanca yaş 5 yıl 3 ay, yaş aralığı: 10 gün-6.8 yıl) sekizinde (20.5) Carolihastalığı (CH), 16’sında (41) konjenital hepatik fibrozis (KHF), 15’inde koledok kisti tespit edildi. En sık başvuru şikayetisarılık (n=8, 20.5), kronik karın ağrısı (n=6, 15.4) ve splenomegali (n=4, 10.3)’dü. Hastaların sekizi (20.5) böbrektekist tespit edildikten sonra yapılan incelemelerde, yedisi (17.9) intrauterin dönemde, ikisi (5.1) insidental olarak tespitedilmişti. Otozomal resesif polikistik böbrek hastalığı (ORPBH) olan altı hastada PKHD1 gen mutasyonu saptandı. On sekizhasta (46.2) opere edildi (karaciğer nakli, sol lob segmental hepatektomi, mezokavalşant, böbrek nakli, kistektomi).Yirmi beş hastada (64.1) ekstrahepatik tutulum mevcuttu [ORPBH (n=18), mental motor retardasyon (n=2, birindemetokromatik lökodistrofi, diğerinde Arnold Chiari malformasyonu), nefrokalsinozis (n=1), juvenil nefronofitizis (n=1),akut pankreatit (n=1), pulmoner hipoplazimetakarpal distal falanks hipoplazisi (n=1) ve medüler sünger böbrekpinealkist (n=1)]. Takip edilen 39 hastanın altısında portal hipertansiyon, beşinde kronik böbrek yetmezliği (12.8), dördündekompanse kronik karaciğer hastalığı (10.3) gelişmiş olup iki hastaya dekompanse siroz nedeniyle karaciğer nakli, birhastaya son dönem böbrek yetmezliği nedeniyle böbrek nakli yapıldı.Sonuç: Karaciğerin fibrokistik hastalıklarında, morbidite ve komplikasyon riskinin yüksek olması nedeniyle erken tanı,düzenli takip ve tedavi önemlidi

Simultaneous determination of phorate and oxyfluorfen in well water samples with high accuracy by gc-ms after binary dispersive liquid-liquid microextraction.

The potential risk of pesticides to cause harm to humans and other organisms even at trace levels calls for sensitive and accurate analytical techniques for their simultaneous qualitative and quantitative determinations. In this study, a sensitive binary dispersive liquid-liquid microextraction (B-DLLME) strategy was developed for the simultaneous determination of phorate and oxyfluorfen by gas chromatography mass spectrometry after extraction/preconcentration from aqueous solution. An experimental design was used to optimize parameters of the B-DLLME method to obtain maximum outcome. Under the optimum conditions of B-DLLME, the limit of detection (LOD) for phorate and oxyfluorfen were found to be 0.41 µg L-1 and 0.54 µg L-1, respectively. The detection limits correlate to about 37 and 73 folds enhancement in detection powers when compared to direct GC-MS determination of phorate and oxyfluorfen, respectively. In order to find out the applicability of developed method to real samples, recovery tests were performed for 20 µg L-1 of phorate and oxyfluorfen spiked in well water samples. Percent recovery values were found to be 94.5% for phorate and 101.9% for oxyfluorfen. © 2018, Springer Nature Switzerland AG

Over restrictive elimination of foods in children with food allergy

Background. Previous studies demonstrated critical deficits in diagnosis and management of childhood food allergy (FA), and recent developments in FA research support adopting a proactive approach in FA management. Our objective was to describe FA knowledge and management patterns of pediatricians. Method. We applied a 24-item survey to 170 general pediatricians, pediatric allergists and pediatric gastroenterologists practicing in Turkey. Results. Some IgE-mediated symptoms of FA such as cough, urticaria, wheezing and anaphylaxis were falsely recognized as symptoms of non-IgE-mediated FA by 30%, 29%, 25% and 19% of the participants, respectively. By contrast, 50% of the participants falsely recognized bloody stool, a finding of IgE-mediated FA. Most frequently and least frequently used diagnostic tools were specific IgE (30.5%) and oral food challenge test (1.7%), respectively. Maternal diet restrictions and infant diet restrictions were advised by 82% and 82%, respectively. Percentages of physicians eliminating only 1 food were 21%, 19%; 2 foods were 15%, 11%; 3 foods were 7%, 8%; 4-5 foods were 8%, 11%; 5 to 10 foods were 21%, 26%; and >10 foods were 28%, 25% from the maternal and infant diet, respectively. Cow’s milk, cheese, butter, yoghurt, baked milk products and hen’s egg were the most commonly restricted items. Conclusion. Overall, FA knowledge of pediatricians was fair. Pediatricians utilize an overly restrictive approach when advising diet eliminations in FA. Recent developments favor a more proactive approach to induce immune tolerance and need to be encouraged in pediatric clinical practice. Future educational efforts should focus on emphasizing the deleterious effects of injudicious and extensive eliminations

Could Pyelonephritic Scarring Be Prevented by Anti-Inflammatory Treatment? An Experimental Model of Acute Pyelonephritis

Objectives. This study aimed to demonstrate if the addition of anti-inflammatory treatment to antibiotic therapy shows any superiority to the treatment with antibiotic only. Methods. Forty-nine Wistar rats were divided into 7 groups. Pyelonephritis was performed by E. coli injection to upper pole of kidneys except control group. Group 2 was not treated. Ceftriaxone, ketoprofen, “ceftriaxone + ketoprofen,” methylprednisolone, and “ceftriaxone + methylprednisolone” were given in the groups. The technetium-99m-dimercaptosuccinic acid scintigraphies were performed in 3rd day to detect pyelonephritis and 10th week to detect renal scarring. All kidneys were also histopathologically evaluated. Results. When 3rd day and 10th week scintigraphies were compared, initial 2.00 ± 0.30 point pyelonephritis score resulted in 0.71 ± 0.36 renal scar score in “ceftriaxone + ketoprofen” group (P=0.039). Initial 2.00 ± 0.43 point pyelonephritis score resulted in 0.86 ± 0.26 renal scar score in “ceftriaxone + methylprednisolone” group (P=0.041). Renal scar score was declined in “ceftriaxone + ketoprofen” group and “ceftriaxone + methylprednisolone” group compared with no-treatment group on 10th week of the study (P=0.026, P=0.044). On histopathological evaluation, it was seen that renal scar prevalence and expansion declined significantly in “ceftriaxone + ketoprofen and ceftriaxone + methylprednisolone” (P=0.011, P=0.023). Conclusion. It was evidenced that ceftriaxone treatment in combination with ketoprofen or methylprednisolone declined scar formation in scintigraphic and histopathologic examinations of the kidneys