The relationship between ABO and rh blood types and cow’s milk protein allergy

Objective: Cow’s milk protein allergy (CMPA) is the most common type of food allergy among infants. Several studies have found an association between ABO blood types and allergies such as allergic rhinitis, asthma, and atopic dermatitis, but the role of blood type differences in cases of IgE-mediated CMPA and food protein-induced-allergic proctocolitis (FPIAP) is not known yet. Methods: A total of 100 patients born in our hospital approximately 2017-2021 and followed up in our Paediatric Allergy Clinic with the diagnosis of IgE-mediated CMPA and FPIAP, and as the control group, 259 children born in our hospital who had no family history of atopy and no signs of allergic disease in the follow-up were included in the study. Blood types of healthy children, and those with IgE-mediated CMPA and FPIAP diagnosis were compared. Results: One hundred patients with CMPA were included in the study. The mean age of these patients was 10.8 months, and 49% (n=176) were male. 57% of the patients were followed up with a diagnosis of IgE-mediated CMPA and 43% with FPIAP. Familial atopy accompanied 23% (n=23) of the cases with CMPA. There was no statistically significant difference between the distribution of ABO and Rh blood types between the cases with CMPA and the control group (p>0.05). Additionally, there was no significant difference in blood type comparisons of the cases followed up with the diagnosis of IgE-mediated CMPA and FPIAP (p>0.05). Conclusion: As far as we know, this is the first study of investigating the relationship between the blood type distribution of patients with CMPA and healthy subjects. To comprehend the role of blood type in the pathogenesis of CMPA and investigate the effect of blood types on tolerance development in CMPA cases, we think prospective studies with wider groups are necessary

Çocuklarda influenza A ve B enfeksiyonlarının klinik ve laboratuvar özelliklerinin karşılaştırılması

Aim: In this study, we aimed to compare the clinical and laboratory findings of Influenza A and Influenza B infections in children. Methods: The study included 1826 pediatric patients (aged <16 years) who were di¬agnosed with Influenza A (n=1400) and B (n=426) infections between 1 October 2019 and 30 April 2020. The patients were also divided into age groups: the age groups of 0–2 years, 3–9 years, and 10–16 years. The characteristic clinical and laboratory findings were compared. Results: Influenza A infection was significantly more common in patients aged <2 years and was significantly less common in patients aged 3–9 years. Body temperature was significantly higher in all age groups with Influenza A infection than in children with Influenza B infection. While leukocy¬tosis and lymphopenia were significantly more common in the Influenza A group, leukopenia and neutropenia were significantly more common in the Influenza B group. While acute otitis media was more common in Influenza A infection, myositis was more common in Influenza B infection. No significant difference was found between the Influenza A and B groups in terms of hospitalization rates. Of all patients, 98.3% were treated with oseltamivir. Conclusion: Our findings indicate that Influenza A and B infections are, in general, very similar in terms of symptoms. However, Influenza A infection is more common in very young children. It progresses with higher fever and is more frequently associated with pharyngeal hy¬peremia and acute otitis media, while leukopenia, neutropenia, conjunctivitis, nasal discharge, and myositis were found to be more common in Influenza B infection.Amaç: Bu çalışmada, çocuklarda İnfluenza A ve İnfluenza B enfeksiyonlarının klinik ve laboratuvar bulgularını karşılaştırmak amaçlanmıştır. Yöntem: Çalışma 1 Ekim 2019 ile 30 Nisan 2020 tarihleri arasında İnfluenza A (n=1400) ve B (n=426) enfeksiyonu tanısı almış 16 yaş altı 1826 çocuk hasta içerdi. Hastalar aynı zamanda yaş gruplarına ayrıldı: 0–2 (yıl) yaş grubu, 3–9 yaş grubu, ve 10–16 yaş grubu. Karakteristik klinik bulgu¬lar ve laboratuvar bulguları karşılaştırıldı. Bulgular: İnfluenza A enfeksiyonu <2 yaşındaki hastalarda anlamlı biçimde daha yaygın, 3–9 ya¬şındaki hastalarda anlamlı biçimde daha enderdi. Vücut sıcaklığı İnfluenza A enfeksiyonlu tüm yaş gruplarında İnfluenza B enfeksiyonlu çocuklara göre anlamlı biçimde daha yüksekti. İnfluenza A grubunda lökositoz ve lenfopeni anlamlı biçimde daha yaygınken, İnfluenza B grubunda lökopeni ve nötropeni anlamlı biçimde daha yaygındı. Akut orta kulak iltihabı İnfluenza A enfeksiyonunda daha yaygınken, miyozit İnfluenza B enfeksiyonunda daha yaygındı. Hastaneye yatış oranı açısından ise İnfluenza A ve B grupları arasında anlamlı fark bulunmadı. Tüm hastaların %98,3’ü oseltamivir ile tedavi edildi. Sonuç: Bulgularımız İnfluenza A ve B enfeksiyonlarının semptomlar açısından genel olarak çok benzer olduğuna işaret etmektedir. Bununla birlikte, İnfluenza A enfeksiyonu çok küçük çocuklarda daha yaygındır. Daha yüksek ateşle ilerler ve farengeal hiperemi ve akut orta kulak ilti¬habı daha sık görülür. Lökopeni, nötropeni, konjonktivit, burun akıntısı ve miyozitin ise İnfluenza B enfeksiyonunda daha yaygın olduğu tespit edilmiştir

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

Reference intervals for complete blood count from umbilical cord blood in newborns and comparison with venous blood values

Background and Objective: Umbilical cord blood which can be obtained by a non-invasive method can be informative about the clinical status of the newborn. It was aimed to establish reference intervals for umbilical cord blood parameters, and to compare complete blood count results between umbilical cord and venous blood samples in this study. Methods: This study was conducted at Medipol University Sefaköy Hospital, Department of Pediatrics, Istanbul, Turkey. A total of 1898 newborns who were born in a two-year period between January 2018 and December 2019 were included in the study. Venous blood samples were taken from 184 of them, and umbilical cord blood samples were taken from 1714 newborns. Results: The percentiles were determined according to gender and delivery method for the hematological parameters of umbilical cord blood. While mean platelet, eosinophil and mean corpuscular volume values were similar between the groups (p>0.05 for each), and significant differences were found between the groups in terms of all other mean hematological parameters (p<0.05 for each). Conclusion: The results of the complete blood count of umbilical cord blood samples can provide reliable information about the newborn. There are significant differences between umbilical cord and venous blood samples in terms of hematological parameters. For these reasons, it is necessary to determine reliable value ranges for umbilical cord blood hematological parameters in newborns. Data of our study can be a guide for further studies and clinicians

Enfeksiyöz mononükleoz tanısı alan çocuk hastaların klinik ve laboratuvar verilerinin değerlendirilmesi

Aim: In childhood, infectious mononucleosis cases caused by Epstein-Barr virus (EBV) are seen with high frequency. The signs and symptoms of acute EBV infection can manifest with different clinical pictures. Care should be taken in differential diagnosis for correct treatment. In our study, it was aimed to examine the clinical presentation of acute EBV infections by age and high-risk age groups among children. Patients and Methods: A total of 337 pediatric patients with infectious mononucleosis who applied to our tertiary hospital in 2013-2020 were included in the study. EBV VCA IgM and IgG antibodies were studied by ELISA method (quantitative microplate ELISA, Euroimmun®, Germany) in accordance with company recommendations. Patient information and results were evaluated retrospectively. Results: The mean age of the patients was 5.1 ± 3.4 years. 22.8% of the patients were in the group of 0-2, 43.0% of them were 3-5, 29.7% of them were 6-12, and 4.5% of them were 12 years old and above. The most common signs or symptoms in children diagnosed with acute EBV infection were lymphadenopathy (59.6%), lymphocytosis (45.1%), fever (40.9%), swelling in the throat (39.2%) and pharyngitis (30.0%). Fever complaints were significantly higher between the ages of 3-5 compared to other age groups. The seasonal distribution of the cases was similar. It was determined that the cases increased over the years and the most cases were seen in 2019 (23.4%). It was observed that the time between the start of complaints and the application to the hospital increased directly proportional to age groups. Conclusion: In our study, it was concluded that there was no difference in acute EBV infection in childhood age groups in terms of signs and symptoms, and the number of cases increased slightly over the years, especially in children with lymphadenopathy, splenomegaly and hepatomegaly.Amaç: Çocukluk döneminde Epstein-Barr virüsü (EBV) nedenli enfeksiyöz mononükleoz olguları yüksek sıklıkta görülmektedir. Akut EBV enfeksiyonu belirti ve bulguları farklı klinik tablolarla kendini gösterebilmektedir. Çalışmamızda çocuklar arasında yaş ve yüksek riskli yaş gruplarına göre akut EBV enfeksiyonlarının klinik sunumunun incelenmesi amaçlandı. Hastalar ve Yöntem: Çalışmaya 2013-2020 yıllarında üçüncü basamak hastanemize başvuran ve enfeksiyöz mononükleoz tanılı toplam 337 çocuk hasta dahil edildi. EBV VCA IgM ve IgG antikorları ELISA yöntemiyle (quantitative microplate ELISA, Euroimmun®, Almanya) firma önerileri doğrultusunda çalışıldı. Hasta bilgileri ve sonuçları retrospektif olarak değerlendirildi. Bulgular: Hastaların ortalama yaşı 5.1±3.4 yıl idi. Hastaların %22.8’si 0-2, %43.0’i 3-5, %29.7’si 6-12, %4.5’i ise 12 yaş ve üzeri gruptaydı. Akut EBV enfeksiyonu tanısı konulan çocuklarda en sık görülen belirti veya bulgular lenfadenopati (%59.6), lenfositoz (%45.1), ateş (%40.9), boğazda şişlik (%39.2) ve farenjit (%30.0) idi. Ateş şikayeti, 3-5 yaş arasında diğer yaş gruplarına göre anlamlı yüksekti (p=0.003). Olguların mevsimsel dağılımı benzerdi. Olguların yıllara göre artış içinde olduğu, en çok olgunun 2019 yılında görüldüğü (%23.4) belirlendi. Şikayetlerin başlamasından hastaneye başvuru yapılana kadar geçen sürenin yaş grupları ile doğru orantılı olarak arttığı görüldü. Sonuç: Çalışmamızda akut EBV enfeksiyonunda çocukluk dönemi yaş grupları arasında belirti ve bulgular açısından farklılık olmadığı, yıllara göre olgu sayılarının hafif bir artış içinde olduğu, özellikle lenfadenopati, splenomegali ve hepatomegali görülen çocuklarda EBV enfeksiyonundan şüphe etmek gerektiği sonucna varıldı

The relationship between IgA vasculitis and antioxidant activity in children

Objective: Immunoglobulin A vasculitis (IgAV) is the most common systemic vasculitis seen in children. The aim of this study is to investigate the relationship between malondialdehyde-induced oxidative stress, antioxidant system and organ involvement in IgAV patients. Method: 32 patients and 28 healthy children were included in the study. Serum malondialdehyde, reduced glutathione, vitamin E, vitamin C, retinol, and beta-carotene levels were measured in patients (separately in both the active and remission phases) and healthy children. Results: MDA levels were significantly higher in patients with active phase while reduced glutathione and vitamin C levels were markedly lower in both the active and the remission phases. Retinol and beta-carotene levels were lower in the active phase. It was found that retinol levels were significantly lower in patients with gastrointestinal system involvement compared to those without. Vitamin C levels were significantly lower in those with kidney involvement compared to those without. Also, a negative correlation was observed between retinol levels and the number of organs involved. Conclusion: We consider that especially vitamin C and vitamin A may be used in the treatment of IgAV. However, whether the derangements of the oxidant/antioxidant balance in the direction of increased oxidative stress are consequences or causes of the events occurring in the active phase of IgAV are open to further investigation.Amaç: İmmünoglobulin A vaskülit (IgAV) çocuklarda en sık görülen sistemik vaskülittir. Bu çalışmanın amacı, IgAV hastalarında malondialdehit kaynaklı oksidatif stres, antioksidan sistem ve organ tutulumu arasındaki ilişkiyi araştırmaktır. Yöntemler: Çalışmaya 32 hasta ve 28 sağlıklı çocuk dahil edildi. Hastalarda (hem aktif hem de remisyon fazlarında ayrı ayrı) ve sağlıklı çocuklarda serum malondialdehit, redükte glutatyon, E vitamini, C vitamini, retinol ve beta-karoten seviyeleri ölçüldü. Bulgular: Aktif fazı olan hastalarda MDA seviyeleri önemli ölçüde daha yüksekken, redükte glutatyon ve C vitamini seviyeleri hem aktif hem de remisyon fazlarında belirgin şekilde daha düşüktü. Retinol ve beta-karoten seviyeleri aktif fazda daha düşüktü. Gastrointestinal sistem tutulumu olan hastalarda retinol düzeylerinin olmayanlara göre anlamlı derecede düşük olduğu bulundu. Böbrek tutulumu olanlarda, olmayanlara göre C vitamini seviyeleri önemli ölçüde daha düşüktü. Ayrıca, retinol seviyeleri ile ilgili tutulan organ sayısı arasında negatif bir korelasyon gözlendi. Sonuç: IgAV tedavisinde özellikle C vitamini ve A vitamininin kullanılabileceğini düşünüyoruz. Bununla birlikte, oksidan / antioksidan dengesindeki artmış oksidatif stres yönündeki düzensizliklerin, IgAV'nin aktif fazında meydana gelen olayların sonuçları mı yoksa nedenleri mi olduğu daha fazla araştırmaya açıktır

A comparison of upper respiratory tract infections caused by Group A Streptococci and İnfluenza A/B

Amaç: İnfluenza koenfeksiyonu şeklinde olan bakteriyel enfeksiyonlar özellikle yaşlılar ve küçük çocuklar gibi yüksek riskli gruplar arasında ciddi bir morbidite ve mortalite nedenidir. Çalışmamızda olgularımızda saptanan grup A streptokok ile influenza virüs tip A ve tip B nedenli üst solunum yolu enfeksiyonlarının klinik ve laboratuvar bulgularının karşılaştırılması ile her iki etkenin koenfeksiyon sıklığının irdelenmesi amaçlanmıştır. Yöntem: Çalışmaya üçüncü basamak hastanemiz pediatri kliniğine üst solunum yolu enfeksiyonları şikayetiyle 2019 Ocak - 2020 Ocak tarihleri arasında başvuran ve streptokok hızlı antijen testi ile influenza A ve B hızlı testleri uygulanan toplam 1884 çocuk hasta dahil edildi. Eş zamanlı olarak çocukların tam kan sayımı ve C-reaktif protein testleri de çalışılmış olup sonuçlar influenza virüsü ve grup A steptokok enfeksiyonları için karşılaştırıldı. Sonuçların istatistiksel analizi yapıldı ve p0.005). Ancak influenza A grubunda öksürük düzeyi (%61.8) diğer gruplardan anlamlı yüksek bulundu (p0.005). The cough levels in the influenza A group (61.8%) were significantly higher compared to the other groups (p<0.001). Conclusion: Whether the agent of the cause of the upper respiratory tract infections is viral or bacterial should be determined rapidly and accurately in children. It was concluded that our study provided data that could be a guide for clinicians and researchers by rapid antigen tests of both group A streptococci and influenza viruses and by comparing clinical and laboratory findings

COVID-19'lu çocuklarda ABO ve Rh kan gruplarının dağılımı ile klinik seyir arasındaki ilişki

Amaç: Bu çalışma, ABO ve Rh kan gruplarının çocuklarda COVID-19 sıklığını ve semptom gelişimini etkileyip etkilemediğini araştırmayı amaçlamaktadır.Gereç ve Yöntem: Çalışmaya SARS-CoV-2 PCR testi pozitif 337 çocuk ve kontrol grubu olarak 1286 sağlıklı çocuk dahil edildi.Bulgular: Rh (+) çocuklarda hasta oranı, Rh (-) çocuklara göre anlamlı derecede yüksekti (p=0,006). Kan grubu A'nın, COVID-19 vakalarında semptom geliştirme için bir risk faktörü olduğu ve riski artırdığı bulunmuştur. Rh (+) kan grubunun COVID-19 için bağımsız bir risk faktörü olduğu ve COVID-19 vakalarının semptomatik olma oranını artırdığı bulunmuştur.Sonuç: Çalışmamızdan elde edilen veriler, Rh pozitifliğinin çocukları hem COVID-19'a hem de COVID-19 durumunda semptomların gelişimine duyarlı hale getirdiğini ve kan grubu A'nın COVID-19 pozitif çocuklarda semptom geliştirme riskini artırdığını göstermektedir.Aim: This study aims to investigate whether ABO and Rh blood groups affect the prevalence and symptom development of COVID-19 in children.Materials and Methods: The study included 337 children with positive SARS-CoV-2 PCR test and 1286 healthy children as control group.Results: The rate of patients in Rh (+) children was significantly higher than in Rh (-) children (p=0.006). Blood type A has been found to be a risk factor for developing symptoms in COVID-19 cases and increases the risk. It has been found that the Rh (+) blood group is an independent risk factor for COVID-19 and increases the rate of being symptomatic of COVID-19 cases.Conclusion: The findings of our study show that Rh positivity renders children sensitive to the development of clinical symptoms both against COVID-19 and in the case of COVID-19, and blood type A increases the risk of developing symptoms in children with COVID-19

Can hematological parameters be used for differential diagnosis in rotavirus infection at any age of children? A 6-year outcomes from a tertiary referral center

Aim: Routine blood parameters are widely used to detect of infectious diseases. Our study aimed to investigate the hematological parameters changes in rotavirus (RV) acute gastroenteritis and to evaluate the value of these parameters in children. Methods: In our study, the hematological data of patients diagnosed with RV-positive acute gastroenteritis (RPAGE) and RV-negative acute gastroenteritis (RNAGE) were analyzed between 2015-2020. In addition to the data automatically measured by complete blood count, lymphocyte/monocyte ratio (LMR), neutrophil/lymphocyte ratio (NLR), mean platelet volume/platelet ratio (MPVPR) were calculated. All cases were evaluated in three different age groups (5-year-old). Results: The present study included 2,144 patients (340 children with RPAGE, 1,804 children with RNAGE). Red blood cell count, hemoglobin, and hematocrit were higher in cases over 1 year of age with RPAGE. The MPVPR was lower in all age groups with RPAGE. The cut-off values of MPVPR for predicting Rotavirus infection (RI) were 0.023 (5-year-old group). The LMR was lower and NLR was higher in cases over 1 year of age with RPAGE. The cut-off value of LMR for predicting RI were 1.99 (1-to 5-year-old group) and 0.96 (>5-year-old group). The cut-off value of NLR for predicting RI were 1.41 (1-to 5-year-old group), and 3.79 (>5-year-old group). Conclusion: The low MPVPR can be used as a hematological biomarker for the identification of RPAGE cases in all age groups. Low LMR and high NLR can indicate RPAGE cases in over 1 year of age

Body weight changes of preterms in the postnatal period

Aim: Survival and complications are very sensitive in preterm infants. Any negative situation in the preterms can lead to unintended consequences. In this study, it was aimed to analyze the data on demographic characteristics, complications, morbidity, mortality, and weight monitoring information of a high number of preterm neonates.Material and Methods: A total of 1091 preterm newborns born before the 37th gestational week in our tertiary care hospital were included in the study. All data were analyzed from hospital records. The weights of the newborns at birth, on the 7th, 15th, and 30th days were recorded..Results: Of the newborns, 39 (3.6%) died within 30 days after delivery. The cesarean section rate was 91.7%. While 7.9% of the preterms had birth weight below 1000 grams, the preterm rate in normal birth weight (>2500 g) was 15.6%. The mean birth weight was 1909.76 g, the first day mean weight loss was 0.6%, the first 3-day mean weight loss was 3.8% and the first 7-day mean weight loss was 2.5%.The mean birth weight in late preterm infants was significantly lower than in those who were born in the following weeks, while the mean birth weight in late preterm births was significantly higher than in those born before (p<0.001).Discussion: We found that preterm infants and those with lower birth weight had a worse prognosis, and that weight gain after birth was associated with prognosis. We believe that data obtained from our study may be a guide for clinicians and researchers