The effect of tetanus toxoid immunization pregnant women who had a full primary course of immunization in early childhood on antibody titration [Cocukluk caginda asilanmis gebelerde tetanoz asisinin antikor duzeylerine etkisi]

OBJECTIVE: To evaluate the protective effect of a single dose and two doses of tetanus vaccine in pregnant women who were vaccinated with tetanus and toxoid in childhood. STUDY DESIGN: Eighty-six mothers and newborn babies were included into the study. They were grouped into three classes according to the doses of vaccination during recent pregnancy. Group 0= No vaccination, Group 1= A single dose of vaccination, Group 2= Two doses of vaccination. Maternal and cord blood specimens were collected at delivery and tetanus specific IgG were measured by enzyme immunoassay. RESULTS: Mean tetanus specific IgG (mg/L) were 0.0620 and 0.0849 in group 0, 0.2795 and 0.2376 in group 1, 0.2302 and 0.1736 in group 2 in cord and mother blood, respectively. The mean concentration of tetanus specific IgG in group 0 was significantly lower than group 1 and 2 (p<0.005). There were no significant difference between group 1 and 2 (p<0.05). In group 0, 84% of tetanus specific IgG concentration was above in the protective level (0.151 mg/L) against tetanus while in the other two groups nearly 100 % of values were above this level. CONCLUSION: Single dose tetanus vaccination during pregnancy is enough for tetanus prophylaxis in women immunized in their childhood. The protective effect of tetanus vaccine in women who were vaccinated at childhood continues in 84.6 % at the time of delivery

Neutrophil chemotaxis in children with extrinsic bronchial asthma.

PubMedID: 8055555Chemotactic activities of neutrophils were studied in 20 patients with bronchial asthma and 20 healthy matched controls. Chemotaxis studies were performed by the millipore filter technique using modified Boyden chambers. Mean neutrophil chemotactic activities of asthma and control groups were 17.82 +/- 7.87 microns and 14.09 +/- 6.07 microns; mean chemotactic indexes were 2.04 +/- 0.44 and 1.84 +/- 0.60 and mean random migrations were 9.53 +/- 4.61 microns and 7.93 +/- 3.33 microns, respectively. No significant difference was found between the two groups (p > 0.05)

Uterus didelphys with unilateral imperforate hemivagina and ipsilateral renal agenesis

Five patients with a double uterus, unilateral vaginal obstruction, and ipsilateral renal agenesis are described The most common clinical presentation was that of the onset of pelvic pain and dysmenorrhea, in association with the finding of a pelvic mass. In three of our cases the patient was initially managed by another physician who failed to recognize the true nature of the syndrome. A greater awareness of this syndrome should lead to accurate diagnosis and excision of the obstructing vaginal septum offers a complete relief of symptoms while preserving reproductive capacity

Respiratory function tests of healthy Turkish children in Southern Turkey and their relationships with anthropometric measurements

Purpose: The purpose of this study was determine the respiratory function tests (RFT's) for Turkish children in Southern Turkey. Methods: This study was conducted on 1359 healthy nonsmoking children (727 boys, 632 girls) with a mean age of 11.7 ± 3.4 years (6-17 years). Their RFT's were measured with a spirometer. Results: RFT values were regressed with age and height. The relative increase of RFT's in boys was found to be significantly higher in puberty (p < 0.01). The normal values of Turkish children were found to be similar to those of Europeans. It is concluded that; although found to be similar to those of Europeans in this study; the 'normal ranges' for RFT values should be determined for Turkish children. Conclusions: We conclude with the suggestion that; parallel to carrying out other studies to establish standarts for the RFT of the Turkish children; our curves may be used as guidelines for the normal values of our 6-17 years old

Bronchiectasis: Still a problem

PubMedID: 11477735Summary. The prevalence of bronchiectasis (BR) has decreased significantly in industrialized countries, but is still commonplace in developing countries. We evaluated the causes and clinical features of BR in 23 children (13 boys (57%) and 10 girls (43%), with a mean age of 8.45±4.02 years). Infection was the major cause of BR in our region. In 8 patients, BR developed after tuberculosis or pneumonia, was associated with immune deficiency syndromes in 4 children, and with asthma in 4. Cystic fibrosis was diagnosed in 4 cases and ciliary dyskinesia in 3. In 10 patients, only one lobe was involved. Bronchiectatic lesions were most commonly found in the left lower lobe and were observed in 7 patients. Multilobar involvement was found in 13 patients. The initial treatment was primarily medical, but in 2 patients whose medical therapy failed, pulmonary resection was carried out. Three patients died from severe pulmonary infection and respiratory failure. © 2001 Wiley-Liss, Inc

Exhaled breath condensate MMP-9 levels in children with bronchiectasis

PubMedID: 19725099Bronchiectasis (BE) is still an important cause of chronic supurative respiratory diseases in developing countries. Neutrophil-derived proteases such as neutrophil elastase and matrix metalloproteases (MMPs) are implicated in causing airway damage in chronic pulmonary disease. In this study, we aimed to evaluate the MMP-9 and its natural tissue inhibitors of metalloproteinases (TIMP-1) levels utilizing the exhaled breath condensate (EBC) method and their relationship with radiological findings and pulmonary functions in children with BE. Thirty-eight children with BE and 12 healthy children were included: Group 1 (cystic fibrosis [CF] BE), Group 2 (non-CF BE), Group 3 (control group). High-resolution computerized tomography (HRCT) scores were calculated according to the anatomic extent of BE. Pulmonary function tests were performed, and MMP-9 and TIMP-1 levels in EBC were analyzed by ELISA. Exhaled breath condensate MMP-9 level was 48.9±26.8 ng/ml for Group 1, and for Group 2, 42.8±18.1 ng/ml; and for Group 3, 30±3.7 ng/ml. Although no statistically significant difference was found between the Groups 1 and 2, a significant difference was detected between these groups and controls. No statistically significant difference was found in TIMP-1 levels regarding all groups. EBC MMP-9 levelswere inversely correlated with pulmonary functions test, and positively with HRCTscores and annual number of pulmonary infections. In conclusion, this study showed that EBC of children with both CF BE and non-CF BE contained higher levels of MMP-9 in comparison to controls. We suggest that EBC MMP-9 level may be a useful marker of airway injury in patients with BE however prospective studies are needed. © 2009 Wiley-Liss, Inc

The clinical and genetical features of 124 children with Familial Mediterranean fever: Experience of a single tertiary center

PubMedID: 19115056The aim of the present study was to evaluate the clinical features of childhood-onset Familial Mediterranean fever (FMF) patients and to assess the phenotype-genotype correlation. The study included patients with childhood-onset FMF that followed up over a period of 18 years in the Division of Pediatric Allergy and Immunology clinic. Twelve MEFV mutations were investigated in all patients. The patients were classified into four groups according to mutations: 1, M694V homozygote; 2, M694V heterozygote; 3, compound heterozygote for M694V; and 4, other-other gene mutation group. The following parameters were evaluated: gender, age of onset, age at diagnosis, time interval between disease onset and diagnosis, fever, abdominal pain, chest pain, arthralgia, arthritis, myalgia, vomiting, diarrhea, constipation, headache, erysipela-like erythema, protracted febrile myalgia, splenomegaly, hepatomegaly, consanguinity, number of attacks before and after treatment, severity score, response to colchicine treatment. Of the 124 patients included in the study, 105 had at least one MEFV gene mutation. M694V homozygosity was the most common mutation, followed by M694V heterozygotes and M694V-M680I compound heterozygotes. Severity score was found significantly higher in patients with M694V homozygote and compound heterozygote for M694V compared with other groups. The data supported the findings in literature that FMF patients with M694V homozygote and compound heterozygote for M694V gene mutations experience a more severe clinical course. © 2008 Springer-Verlag

Specific allergen immunotherapy: Effect on immunologic markers and clinical parameters in asthmatic children

PubMedID: 17982919Background: Specific allergen immunotherapy (SIT) is the main treatment modality for achieving long-term symptom relief in perennial allergic diseases. Objective: The aim of this study was to evaluate the effect of 1 year of house dust mite immunotherapy on the concentrations of 3 immunologic markers: eosinophil cationic protein (ECP), nitric oxide (NO), and monocyte chemoattractant protein 1 (MCP-1). We also compared the effect on asthma symptoms and medication scores, allergen-specific bronchial challenge test, and the skin prick test. Methods: A total of 31 mite-allergic, asthmatic children (age range, 6-16 years) were enrolled; 19 were treated with SIT and 12 controls who had refused SIT received only drug treatment. Efficacy was evaluated using serum NO, ECP, and MCP-1 levels, and asthma symptom and medication scores, allergen-specific bronchial challenge test, and skin-prick test. The results of the tests were compared at baseline and after 1 year of treatment. Results: Serum NO and ECP levels decreased significantly in the SIT group (P = .01 and P = .018) compared to baseline, whereas control group values remained similar. The serum MCP-1 level decreased significantly in both the SIT and control groups (P = .009 and P = .041, respectively). The SIT group experienced significant improvement in asthma symptoms (P = .001) and medication scores (P = .001) and skin reactivity to Dermatophagoides pteronyssinus (P = .020), whereas the control group did not. The results of bronchial challenge to D pteronyssinus showed a similar pattern at baseline and after 1 year of treatment in both groups. The tolerated allergen concentration increased in both groups (P < .05). Lung function tests, total immunoglobulin (Ig) E and specific IgE to D pteronyssinus and Dermatophagoides farinae did not change after a year of treatment in either group. Conclusion: SIT with D pteronyssinus improves immunological and clinical parameters in mite-allergic asthmatic children after 1 year of treatment. The skin prick test may be used as a marker of efficacy of therapy. © 2007 Esmon Publicidad

Correlation between nasal eosinophils and nasal airflows in children with asthma and/or rhinitis monosensitised to house dust mites

PubMedID: 23122003Background: Allergic rhinitis and asthma due to mite sensitisation are diseases which are frequently associated and characterised by persistent inflammation. In the present study, we aimed to investigate the relationship between nasal airflows and nasal eosinophils in patients with asthma and/or rhinitis due to house dust mite sensitisation. Methods: Twenty-four children with both rhinitis and asthma (R. +. A), 13 children with rhinitis and no asthma (R) and 10 non-allergic healthy children were evaluated prospectively. The patients belonging to the first two groups had moderate-severe grade of nasal obstruction. Total nasal symptom scores, peak nasal inspiratory flows (PNIFs) obtained by anterior rhinomanometry, skin prick tests, nasal eosinophils and FEV1 values were all assessed. Results: Percentages of nasal eosinophils and PNIFs in patients with R. +. A and R (r= -0.415, p= 0.04) were found to be statistically significant and to have an inverse correlation. Skin prick tests were also significantly correlated with nasal eosinophils and PNIFs (r= 0.372, p= 0.01 and r= -0.306, p= 0.04, respectively). Both PNIFs and nasal eosinophils of patients with R. +. A were significantly correlated with FEV1 values (r= -0.641, p= 0.001 and r= 0.548, p= 0.007, respectively). Conclusion: In this study, a close relationship was demonstrated between eosinophil infiltration and nasal airflows in children having asthma and/or rhinitis monosensitised to mites. Additionally, the significant association found between FEV1 values and nasal eosinophils or PNIFs supported the close link of upper and lower airways. © 2012 SEICAP

Effect of one-year subcutaneous and sublingual immunotherapy on clinical and laboratory parameters in children with rhinitis and asthma: A randomized, placebo-controlled, double-blind, double-dummy study

PubMedID: 22041501Background: It has been reported that both sublingual (SLIT) and subcutaneous (SCIT) allergen-specific immunotherapy have clinical efficacy, yet there are rather few comparative placebo studies of children. We aimed to investigate the clinical and immunological efficacy of mite-specific SLIT and SCIT versus a placebo in rhinitis and asthma in children. Methods: The outcomes of this 1-year, randomized, placebo- controlled, double-blind, double-dummy study were symptom and medication scores, visual analog scores (VAS), titrated skin prick tests, nasal and bronchial allergen provocation doses, serum house dust mite-specific immunglobulin E (HDM-sIgE), sIgG4, IL-10 and IFN- ß levels. Results: Clinical and laboratory parameters were evaluated in 30 patients. SCIT significantly diminished symptom and medication scores for rhinitis and asthma (p = 0.03 and p = 0.05 for rhinitis; p = 0.01 and p = 0.05 for asthma) and VAS. SLIT also reduced VAS, symptoms associated with rhinitis and asthma as well as medication usage for rhinitis, but this reduction was not significant when compared with the placebo. Skin reactivitiy to HDM and HDM-sIgE levels was reduced significantly in both immunotherapy groups. Serum IL-10 levels and nasal provocative doses increased significantly with both SCIT and SLIT. Nasal eosinophil increments after nasal challenge decreased with two treatment modes, but bronchial provocative doses and sputum eosinophil increments after bronchial challenge were reduced only with SCIT. In both treatment arms, there was no change in IFN- ? levels. Serum sIgG4 levels increased significantly only in the SCIT group. Conclusion: Based on the limited number of patients at the end of the 1-year immunotherapy, the clinical efficacy of SCIT on rhinitis and asthma symptoms was more evident when compared with the placebo. Copyright © 2011 S. Karger AG, Basel