Oxidative stress in the developing brain: effects of postnatal glucocorticoid therapy and antioxidants in the rat.

In premature infants, glucocorticoids ameliorate chronic lung disease, but have adverse effects on long-term neurological function. Glucocorticoid excess promotes free radical overproduction. We hypothesised that the adverse effects of postnatal glucocorticoid therapy on the developing brain are secondary to oxidative stress and that antioxidant treatment would diminish unwanted effects. Male rat pups received a clinically-relevant tapering course of dexamethasone (DEX; 0.5, 0.3, and 0.1 mg x kg(-1) x day(-1)), with or without antioxidant vitamins C and E (DEXCE; 200 mg x kg(-1) x day(-1) and 100 mg x kg(-1) x day(-1), respectively), on postnatal days 1-6 (P1-6). Controls received saline or saline with vitamins. At weaning, relative to controls, DEX decreased total brain volume (704.4±34.7 mm(3) vs. 564.0±20.0 mm(3)), the soma volume of neurons in the CA1 (1172.6±30.4 µm(3) vs. 1002.4±11.8 µm(3)) and in the dentate gyrus (525.9±27.2 µm(3) vs. 421.5±24.6 µm(3)) of the hippocampus, and induced oxidative stress in the cortex (protein expression: heat shock protein 70 [Hsp70]: +68%; 4-hydroxynonenal [4-HNE]: +118% and nitrotyrosine [NT]: +20%). Dexamethasone in combination with vitamins resulted in improvements in total brain volume (637.5±43.1 mm(3)), and soma volume of neurons in the CA1 (1157.5±42.4 µm(3)) and the dentate gyrus (536.1±27.2 µm(3)). Hsp70 protein expression was unaltered in the cortex (+9%), however, 4-HNE (+95%) and NT (+24%) protein expression remained upregulated. Treatment of neonates with vitamins alone induced oxidative stress in the cortex (Hsp70: +67%; 4-HNE: +73%; NT: +22%) and in the hippocampus (NT: +35%). Combined glucocorticoid and antioxidant therapy in premature infants may be safer for the developing brain than glucocorticoids alone in the treatment of chronic lung disease. However, antioxidant therapy in healthy offspring is not recommended

Effects of different corticosteroids on the brain weight and hippocampal neuronal loss in rats.

Equivalent antiinflammatory doses of steroids including betamethasone, methylprednisolone and dexamethasone were administered in the neonatal period in a rat model. In situ cell death in hippocampus quantified by Terminal Deoxynucleated Transferase Nick-End Labeling and on ratio of brain to body weight was investigated. Apoptotic index (AI) was significantly higher in methylprednisolone, and high dose dexamethasone groups than the other groups. AI in "Cornu ammonis 1" (CA1) and "Cornu ammonis 3" (CA3) subregions of high dose dexamethasone group was the highest among the five groups tested. AI in CA3 subregions of methylprednisolone group was also significantly higher than the control, betamethasone and low dose dexamethasone groups. AI in CA1 subregion were not different among control, betamethasone, methylprednisolone and low dose dexamethasone groups. In addition, high dose dexamethasone resulted significant decrease in the ratio of brain weight to body weight in comparison to all other groups tested. In conclusion, betamethasone and low dose dexamethasone may be better alternative treatments among agents tested in this study for chronic lung disease (CLD)

The prevalence of atopic dermatitis in adolescents living in Denizli, Turkey (ISAAC Phase III): Is a parent working in textile industry a risk factor?

Objective: To evaluate trends in the prevalence of symptoms and risk factors of atopic eczema in 13-14 years old school children in Denizli. Material and Methods: This survey was first conducted in 2002 and repeated in 2008 using the same ISAAC questionnaire in the same age group. Possible risk factors were also asked. Results: A total of 3004 children (response rate, 93.8%) in 2002 and 4078 children (response rate, 75%) in 2008 were included into the studies. Doctor diagnosed eczema ever increased from 2.1% to 3% (POR =0.7, 95% CI = 0.52-0.95, p= 0.015). The prevalence of itch rash ever and itch rash in last 12 month decreased respectively from 20.8% to 14.7% (POR =1.52, 95% CI =1.39-1.72, p<0.001) and from 15.4% to 9.5% (POR=1.72, 95% CI=1.49-1.99, p<0.001). The prevalence of itch rash with typical distribution, itch rash cleared completely in last 12 month and kept awake at night by this itchy rash in last 12 month were significantly decreased in 2008. Atopic family history, tumble drying at home, working father or mother in textile industry were found as significant risk factors for atopic eczema in 2008. Conclusion: Although the prevalence of doctor diagnosed atopic eczema in 13-14 years age group was found to be increasing in Denizli, this study showed a decrease in the prevalence of typical clinical symptoms and signs of atopic eczema. Atopic family history, tumble drying at home, a working parent in textile industry were important risk factors for doctor diagnosed atopic eczema in 2008. Copyright © 2016 by Türkiye Klinikleri

The prevalence of asthma diagnosis and symptoms is still increasing in early adolescents in Turkey.

BACKGROUND: This study was performed to evaluate the time trends in prevalence of asthma and related factors in Denizli, Turkey. METHODS: Two cross-sectional surveys were performed, 6 years apart (2002 and 2008) using the ISAAC protocol, in the 13-14 age groups and comparisons were made between the results. RESULTS: Lifetime prevalence of wheeze, 12 month prevalence of wheeze, and the prevalence of wheeze after exercise in the previous 12 months were significantly increased respectively from 10.2% to 13.4% (POR = 1.37, 95%CI = 1.18-1.58, p < 0.001), from 5.0% to 6.2% (POR = 1.26, 95%CI = 1.02-1.55, p = 0.016) and from 9% to 10.2% (POR = 1.15, 95%CI = 0.98-1.35, p = 0.046) in 2008 study. Doctor diagnosed asthma prevalence also increased significantly from 2.1% to 12.9 (POR = 6.80, 95%CI = 5.22-8.85, p < 0.001). Prevalence of sleep disturbed by wheeze in the last 12 months; but, never woken with wheezing (POR = 1.62, 95%CI = 1.26-2.09, p = < 0.001) and less than one night per week (POR = 1.58, 95%CI = 1.06-2.36, p = 0.013) were significantly increased in 2008 study. Severe attacks of wheeze limiting speech in the last year was increased from 1.3% to 2.2% (POR = 1.67, 95%CI = 1.14-2.43, p = 0.004). The number of wheeze attacks in the previous 12 months was increased significantly for 4-to-12 attacks (POR = 1.54, 95%CI = 1.03-2.32, p = 0.02) in 2008 study. However, prevalence of waking with cough in the last 12 months did not change. While history of family atopy and domestic animal at home were found as significant risk factors for asthma in 2002 study, male gender, history of family atopy and stuffed toys were found significant in 2008. CONCLUSIONS: The prevalence of asthma symptoms were increased in Denizli. History of family atopy, male gender and stuffed toys were important risk factors for asthma in 2008

Transfusion: Case Report

The principal indications for exchange transfusion are hemolytic diseases of the newborn with hyperbilirubinemia. However, there are some potential complications of exchange transfusion such as infection, coagulopathies (i.e., thrombocytopenia), electrolyte abnormalities (i.e., hypocalcemia), metabolic acidosis, hypoglycemia, and necrotizing enterocolitis. Stored blood develops some platelet-white cell microaggregates. These microaggregates or blood debris have been found to produce changes in pulmonary hemodynamics in animals and have been implicated in post-traumatic pulmonary insufficiency in man. Authors suggested that pulmonary gas exchange alterations following blood transfusion were primarily due to increased dead-space ventilation secondary to vasoconstriction and occlusion of the pulmonary microvasculature because of microaggregates. In this article, a newborn with transient pulmonary perfusion abnormality who had massive exchange transfusion for Rh isoimmunization and hyperbilirubinemia was reported

Factors Affecting Duration of Hospital Stay in Deceased COVID-19 Patients

Ercan Kurtipek,1 Mehmet Mermer,1 Bilgenur Y&inodot;ld&inodot;r&inodot;m,1 Mehmet Akif Yazar,2 Mustafa Duran,3 Faysal Duksal4 1Department of Chest Diseases, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey; 2Department of Anesthesiology and Reanimation, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey; 3Department of Cardiology, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey; 4Department of Chest Diseases, University of Health Sciences, Konya Beyhekim Training and Research Hospital, Selcuklu, Konya, TurkeyCorrespondence: Ercan Kurtipek, Department of Chest Diseases, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey, Email [email protected]: Extensive research has been conducted to identify the predictive criteria for COVID-19 disease. White blood cell, C-reactive protein, CRP/albumin ratio, neutrophil-to-lymphocyte ratio and ferritin are among the indicators of increased inflammatory response; hence, they could be used to determine the prognosis of COVID-19 cases. Within the scope of this study, we aimed to elucidate the predictivity of NLR, CAR and other laboratory parameters on the duration of hospital stay and mortality in patients with COVID-19.Materials and Method: The data of 1516 COVID-19 patients who were hospitalized in our institution have been analyzed retrospectively. Patients were divided into two groups those who deceased within the first 10 days of hospitalization (Group I, ≤ 10 days) and those who deceased in the later period (Group II, > 10 days). Age, gender, time to mortality after hospitalization, neutrophil count, CRP, neutrophil-to-lymphocyte ratio (NLR), CRP/albumin ratio (CAR), and d-dimer values were obtained from blood samples taken during hospitalization.Results: NLR and CAR values were significantly higher in those who died in the first 10 days compared to the other group (p< 0.02 and p< 0.001, respectively). In addition, WBC, neutrophil, CRP and d-dimer levels were statistically significantly higher than the other group (p< 0.05). Logistic regression analysis results for NLR and CAR were significant. The cut-off values were calculated (5.74 and 4.27, respectively) for both parameters. Among the most common comorbid diseases were hypertension (HT) in 41%, coronary artery disease (CAD) in 41.7%, asthma-chronic obstructive pulmonary disease (COPD) in 36.7%, diabetes mellitus (DM) in 36.1%.Conclusion: NLR and CAR may have a decisive influence in determining the length of stay in hospital for patients who die in hospital due to COVID-19. In addition, it is recommended that COVID-19 cases with diabetes be followed closely.Keywords: COVID-19, neutrophil-to-lymphocyte ratio, CRP/albumin ratio, hospital mortality, predictive valu

Prevalence of asthma, local risk factors and agreement between written and video questionnaires among Turkish adolescents.

BACKGROUND: There is currently no standard tool for the measurement of asthma in epidemiological studies. The objectives of this study were to determine the prevalence of asthma, to describe the potential local risk factors, and to assess the agreement between written and video questionnaires in 13- to 14-year-old schoolchildren. METHODS: We performed a cross-sectional study involving 5427 adolescents in 26 schools. Prevalence of asthma symptoms were evaluated using the International Study of Asthma and Allergies in Childhood (ISAAC) written and video questionnaire. The adolescents were asked additional questions for risk factors of asthma. RESULTS: The prevalence of lifetime wheeze, wheeze in the last 12 months and doctor-diagnosed asthma with written questionnaire were found as 13.5%, 6.3% and 11.2% respectively. Prevalence of lifetime wheeze, wheeze in the last 12 months, wheeze after exercise in the last 12 months, with video questionnaire were found as 9.6%, 5.5%, 11.9% and 1.9% respectively. The proportion of total agreement between the two questionnaires was high (0.77-0.81) with poor kappa value (0.25-0.50). In multivariate analysis, family history of atopy, stuffed toys and accompaniment of children to their parents after school hours in textile industry were found as risk factors for asthma. In addition kind of bird, such as canary was found as a risk factor. CONCLUSION: Prevalence of asthma is moderate in Turkey. Agreement between the two questionnaires was high. Accompaniment of children to their parents in textile industry is a newly-described risk factor for asthma

schoolchildren

Objectives: To assess the time trends and possible risk factors associated with allergic rhinitis symptoms in schoolchildren from Denizli, Turkey.Method: Two identical cross-sectional surveys were performed in the 13- to 14-yr age group at intervals of six years using ISAAC questionnaire. Possible risk factors were also asked and the children completed questionnaires by self.Results: A total of 4078 children (response rate 75%) in the 2008 and 3004 children (response rate, 93.8%) in 2002 were included. The lifetime prevalence of rhinitis, 12-month prevalence of rhinitis, prevalence of associated itchy eye in the previous 12 months and doctor diagnosed allergic rhinitis prevalence were increased from 34.2% to 49.4% (POR = 1.87, 95% CI = 47.8-50.9 and p <= 0.001), from 23.5.0% to 32.9% (POR = 1.59, 95% CI = 31.4-34.3 and p <= 0.001), from 9.6% to 14.9% (POR = 1.64,95% CI = 13.8-16.0 and p <= 0.001), and from 4.3% to 7% (POR = 1.67, 95% CI = 6.2-7.8 and p <= 0.001) respectively. Severe interference with daily activity in the previous 12 months did not change. In multivariate analysis, history of family atopy, stuffed toys, high annual family income, presence of allergy in mother, father and accompaniment of children to their parents after school hours in textile industry were found as risk factors in 2008 study.Conclusion: The prevalence of allergic rhinitis increased significantly in 2008. Family history of atopy, stuffed toys, high annual family income and accompaniment of children to their parents in textile industry were found as risk factors for doctor diagnosed allergic rhinitis. (C) 2013 Elsevier Ireland Ltd. All rights reserved

Turkey

Aim. Teachers are primarily responsible for supervising schoolchildren with asthma during school hours. The purpose of this study was to elucidate the level of knowledge of child daycare center teachers about asthma and factors affecting their knowledge.Methods. This study was performed on 297 teachers from 20 randomly selected child daycare centers in Istanbul. The teachers' level of knowledge about asthma was assessed by a questionnaire with 32 questions about asthma. The teachers were asked thirteen additional questions about demographic data and other characteristics of the child daycare centers and about themselves. One-way ANOVA and the independent samples t-test were used to determine differences in the level of asthma knowledge.Results. A total of 297 teachers (287 females/10 males) filled in the questionnaire. The mean age of the teachers was 26.4 +/- 8.1 years (range, 20-53 year). The teachers' "response score rate for each question" ranged from 38% to 94%. The teachers' "completely true response rate for each question" was lower and ranged from 1.6% to 83.9%. "The mean of asthma knowledge score" for the 32 questions was 113.64 +/- 20.26 (71%+/- 12.7%) from a maximum of 160 marks. "Asthma knowledge score for all questions" was related to teachers' gender, age, location and property of child daycare center and number of children in child daycare center.Conclusion. Although teachers of child daycare centers have some knowledge about asthma, their "completely true response rate for each question" was insufficient. Much more efficient educational programs are needed for these teachers

Asthma knowledge level of child daycare center teachers' in Istanbul, Turkey

Aim. Teachers are primarily responsible for supervising schoolchildren with asthma during school hours. The purpose of this study was to elucidate the level of knowledge of child daycare center teachers about asthma and factors affecting their knowledge