Vaccination Practices in Pediatric Dialysis Patients Across Europe. A European Pediatric Dialysis Working Group and European Society for Pediatric Nephrology Dialysis Working Group Study

Background: Data on the immunization practices in pediatric chronic kidney disease (CKD) patients are scarce. The purpose of this study was to evaluate current vaccination practices for children on dialysis across European pediatric nephrology centers. Methods: A total of 18 tertiary pediatric nephrology centers from 12 European countries were included in the study. The data on universal national immunization programs and immunization practices for children with chronic disease or risk were recorded from European Center for Disease Prevention and Control and the World Health Organization. The immunization practices and center protocols for monitoring antibody titers after vaccination in dialysis patients were obtained through a questionnaire. Results: All centers included in the study recommended immunization against hepatitis B virus (HBV), diphtheria, tetanus, pertussis, Hemophilus influenzae type b (Hib), poliomyelitis, measles, mumps, rubella (MMR), and streptococcus pneumonia in dialysis patients. In 16 centers, dialysis patients were vaccinated against influenza virus annually. HBV protective antibody titers were measured in 17 centers (during dialysis period in 14 centers, during pre-renal transplantation preparations in 14 centers or in both times in 11 centers). Hepatitis A virus (HAV) was reported to be followed in 13 centers, in 8 centers during dialysis period, and in 11 centers during pre-RTx preparations. MMR and varicella-zoster virus (VZV) protective antibody titers were measured during the dialysis period or before renal transplantation (RTx) in 12 and 15 centers, respectively, and in 6 centers both titers were checked both times. Conclusion: There are variations in vaccination practice across Europe. Children with CKD, those undergoing dialysis, and transplant candidates should receive age-appropriate vaccinations before RTx as well as before the transition to adult nephrology clinics and antibody levels should be monitored to evaluate the immunization status before and after RTx. (C) 2017 S. Karger AG, Basel.Peer reviewe

Behavioral Correlates of Television Viewing in Young Adolescents in Turkey

We evaluated the behavioral effects of television (TV) viewing in 860 young adolescents as reported by parents (n=581) on Child Behavior Checklist (CBCL). The mean duration of TV viewing was 2.32 +/- 1.77 hours/day according to parents and 2.08 +/- 1.41 hours/day according to self report (r=0.37, P < 0.0001). The linear regression analysis revealed a statistically significant relation between socioeconomic status (P=0.019) and aggressive behavior score of CBCL (P=0.016) and parent reported TV viewing hours. Self reported TV viewing for more than 2 hours was significantly associated with social problem score (OR 1.17; 95% CI: 1.016-1.349; P=0.030) and having a TV in bedroom (OR:1.706; 95% CI: 1.065-2.731, P=0.026)

EFFECTS OF CLIMATE CHANGE ON CHILD HEALTH

Global climate change is now recognized as one of the threats of the 21st century and human activities are very likely (90% probability) the main cause of this problem. Global climate change has multiple adverse effects on human health, and vulnerable populations especially (children, the elderly and poor people) have been disproportionately affected. Children are particularly vulnerable to these adverse health effects because of their physical, physiologic and cognitive immaturity and their dependence on caregivers. Pediatricians and health care professionals have a critical leadership role in implementing programs that mitigate and adapt the climate change at local, national and international levels

The modified checklist for autism in Turkish toddlers: A different cultural adaptation sample

This study aimed to investigate adaptation of the modified checklist for autism in toddlers (M-CHAT) in a large community sample in Kayseri, a central Anatolian city in Turkey. The M-CHAT was administered to 2021 parents of healthy toddlers aged 18-30 months by a trained team by face-to-face interview at family health centers. Screen positive children and randomly selected screen negative children were evaluated by a child psychiatrist according to diagnostic and statistical manual of mental disorders, text revision (DSM-IV-TR) criteria and childhood autism rating scale (CARS). Screen positive children were re-evaluated at 3 years of age. The M-CHAT detected both cases of autism spectrum disorders that were diagnosed. Cronbach's alpha was found to be 0.84 for the 23 items and 0.79 for the 6 critical items. Although the M-CHAT originally was designed to be filled by the parents, this study showed that, in Turkey, the M-CHAT can be used as a screening tool by face-to-face interview method at well child visits. (C) 2015 Elsevier Ltd. All rights reserved

The modified checklist for autism in Turkish toddlers: A different cultural adaptation sample

This study aimed to investigate adaptation of the modified checklist for autism in toddlers (M-CHAT) in a large community sample in Kayseri, a central Anatolian city in Turkey. The M-CHAT was administered to 2021 parents of healthy toddlers aged 18-30 months by a trained team by face-to-face interview at family health centers. Screen positive children and randomly selected screen negative children were evaluated by a child psychiatrist according to diagnostic and statistical manual of mental disorders, text revision (DSM-IV-TR) criteria and childhood autism rating scale (CARS). Screen positive children were re-evaluated at 3 years of age. The M-CHAT detected both cases of autism spectrum disorders that were diagnosed. Cronbach's alpha was found to be 0.84 for the 23 items and 0.79 for the 6 critical items. Although the M-CHAT originally was designed to be filled by the parents, this study showed that, in Turkey, the M-CHAT can be used as a screening tool by face-to-face interview method at well child visits. (C) 2015 Elsevier Ltd. All rights reserved

Salmonella gastroenteritis in children (clinical characteristics and antibiotic susceptibility): comparison of the years 1995-2001 and 2002-2008

We document herein the prevalence and serotype distribution among Salmonella enterica strains isolated from children treated for diarrhea over two seven-year periods spanning 14 years. Four hundred and eight (1.38%) S. enterica cases were isolated among 29,601 diarrheal admissions. Among the Salmonella isolates, 63.7% were serogroup D and 29.9% were serogroup B. Overall, 21.7% of cases were under one year of age, with 2.1% being younger than three months. Bloody diarrhea was found in 18.8% of the cases. The resistance rates were 25.8%, 18.2%, 7.0%, 4.7%, and 0.3%, to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, ceftriaxone, and ciprofloxacin, respectively. In conclusion, our study has revealed that the predominance of Salmonella serogroup D continues. The clinical features of our patients were mostly mild, with no deaths or severe complications. While resistance to antimicrobial agents changes constantly, it is important to keep these strains under surveillance in order to formulate policies for the rational use of antimicrobial agents

PLASMA PHTALATE AND BISPHENOL A LEVELS AND OXIDANT ANTIOXIDANT STATUS IN AUTISTIC CHILDREN

Phthalates and bisphenol A (BPA) are endocrine disruting chemicals (EDCs) that are suggested to exert neurotoxic effects. This study aimed to determine plasma phthalates and BPA levels along with oxidant/antioxidant status in autistic children [n = 51; including 12 children were diagnosed with "Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)]. Plasma levels of BPA, di (2-ethylhexyl)-phthalate (DEHP) and its main metabolite mono (2-ethylhexyl)-phthalate (MEHP); thiobarbituric acid reactive substance (TBARS) and carbonyl groups; erythrocyte glutathione peroxidase (GPx1), thioredoxin reductase (TrxR), catalase (CAT), superoxide dismutase (SOD) and glutathione reductase (GR) activities and glutathione (GSH) and selenium levels were measured. Plasma BPA levels of children with PDD-NOS were significantly higher than both classic autistic children and controls (n=50). Carbonyl, selenium concentrations and GPx1, SOD and GR activities were higher (p < 0.05); CAT activity was markedly lower in study group. BPA exposure might be associated with PDD-NOS. Intracellular imbalance between oxidant and antioxidant status might facilitate its neurotoxicity. (C) 2016 Elsevier B.V. All rights reserved

Plasma phthalate and bisphenol a levels and oxidant-antioxidant status in autistic children

Phthalates and bisphenol A (BPA) are endocrine disruting chemicals (EDCs) that are suggested to exert neurotoxic effects. This study aimed to determine plasma phthalates and BPA levels along with oxidant/antioxidant status in autistic children [n = 51; including 12 children were diagnosed with "Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)]. Plasma levels of BPA, di (2-ethylhexyl)-phthalate (DEHP) and its main metabolite mono (2-ethylhexyl)-phthalate (MEHP); thiobarbituric acid reactive substance (TBARS) and carbonyl groups; erythrocyte glutathione peroxidase (GPx1), thioredoxin reductase (TrxR), catalase (CAT), superoxide dismutase (SOD) and glutathione reductase (GR) activities and glutathione (GSH) and selenium levels were measured. Plasma BPA levels of children with PDD-NOS were significantly higher than both classic autistic children and controls (n=50). Carbonyl, selenium concentrations and GPx1, SOD and GR activities were higher (p < 0.05); CAT activity was markedly lower in study group. BPA exposure might be associated with PDD-NOS. Intracellular imbalance between oxidant and antioxidant status might facilitate its neurotoxicity. (C) 2016 Elsevier B.V. All rights reserved