How does the immunogenicity of hepatitis B vaccine change over the years in childhood?

Hepatitis B is the leading cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma worldwide. The incidence of HBV infection has significantly decreased with hepatitis B vaccination. Hepatitis B vaccine is administered to children at 0, 1 and 6 months of age according to the national schedule. There is a high rate of protective antibody (anti-HBs) development after hepatitis B vaccination. We conducted the study to investigate how the hepatitis B surface antibody (anti-HBs) positivity rates and the titers change over time in childhood following vaccination. Patients who presented at the general pediatric outpatient clinic of Yenimahalle Education and Training Hospital and the HBsAg and anti-HBs titers were tested for any reason between July 2011 and May 2018 were retrospectively evaluated. The cutoff level for protection by the anti-HBs titer was accepted as ≥10 mIU/mL with lower levels indicating no protection. Anti-HBs positivity was compared by age group. Anti-HBs levels were studied in 4326 children. The mean age of the included in the study was 127 ± 62 months. A protective anti-HBs level (≥10 mIU/mL) was present in 2292 children (69.2%). The highest anti-HBs antibody positivity rate was in the under 3 years’ age group. The positivity rate significantly decreased after age 7 years. The HBsAg level was determined in all children in the study and five had a positive result. In conclusion, our study found that the anti-HBs positivity rate and the anti-HBs level decreased with age. However, the anti-HBs antibody result remained positive in more than half of the children

Intracranial Hemorrhage Due To Vitamin K Deficiency in Infancy: Clinical and Radiological Findings

WOS: 000264808100004This retrospective study presents clinical and radiological findings and outcomes of 25 infants with intracranial hemorrhage due to vitamin K deficiency and evaluates the risk factors. Two of the infants (8%) were classical type and the others were late onset. Of the patients, 18 (72%) were male and 7 (28%) were female. Twenty four infants (96%) were being fed exclusively on breast milk. Eighteen of them (72%) had not received vitamin K prophylaxis at birth. The most disabling clinical symptoms were vomiting (44%) and convulsions (40%). The most common presentations were bulging fontanel (40%) and paleness (40%). Eleven patients (44%) showed intracranial hemorrhages at more than one site. Intraparenchymal hemorrhage was the commonest (68%) type of hemorrhage. Twelve of cases (57%) were developmentally normal. Mortality rate was 8%. Late type is frequently associated with intracranial hemorrhage particularly intraparenchymal. Lack of administration of vitamin K at birth to breastfeed babies is the most important risk factor for intracranial hemorrhage

İnfantlarda K vitamini eksikliğine bağlı intrakraniyal kanama: Klinik ve radyolojik bulgular

Bu çalışmada; K vitamini eksikliğine bağlı intrakraniyal kanaması olan 25 infantın klinik, radyolojik bulguları ve risk faktörleri geriye dönük olarak değerlendirildi. 25 olgunun 2 (%8)'si klasik tip ve 23'ü geç başlangıçlı tipte idi. 18 (%72)'i erkek ve 7 (%28)'si kız idi. Olguların 24 (%96)'ü sadece anne sütü ile beslenmekteydi. Olguların 18'ine doğumdan sonra K vitamini uygulanmıştı. En fazla görülen semptom kusma (%44) ve konvülsiyon (%40) idi. En fazla saptanan muayene bulgusu fontanel bombeliği (%40) ve solukluk (%40) idi. Onbir (%44) hastada intrakraniyal kanama birden fazla bölgede vardı ve kanama en fazla (%68) intraparankimal alana olmuştu. 12 olgu izleminde normal mental-motor gelişim gösterirken, mortalite oranı %8 bulundu. İntrakraniyal kanama özellikle geç tipin bulgusu olup en fazla intraparankimal alanda olmaktadır. Anne sütü ile beslenen bebeklerde doğumdan sonra K vitaminin yapılmamış olması en önemli risk faktörüdür.This retrospective study presents clinical and radiological findings and outcomes of 25 infants with intracranial hemorrhage due to vitamin K deficiency and evaluates the risk factors. Two of the infants (8%) were classical type and the others were late onset. Of the patients, 18 (72%) were male and 7 (28%) were female. Twenty four infants (96%) were being fed exclusively on breast milk. Eighteen of them (72%) had not received vitamin K prophylaxis at birth. The most disabling clinical symptoms were vomiting (44%) and convulsions (40%). The most common presentations were bulging fontanel (40%) and paleness (40%). Eleven patients (44%) showed intracranial hemorrhages at more than one site. Intraparenchymal hemorrhage was the commonest (68%) type of hemorrhage. Twelve of cases (57%) were developmentally normal. Mortality rate was 8%. Late type is frequently associated with intracranial hemorrhage particularly intraparenchymal. Lack of administration of vitamin K at birth to breastfeed babies is the most important risk factor for intracranial hemorrhage

Epidemiological, Clinical, and Laboratory Features of Children With COVID-19 in Turkey

Objectives: The aim of this study is to identify the epidemiological, clinical, and laboratory features of coronavirus disease 2019 (COVID-19) in children