Higher COVID-19 pneumonia risk associated with anti-IFN-α than with anti-IFN-ω auto-Abs in children

We found that 19 (10.4%) of 183 unvaccinated children hospitalized for COVID-19 pneumonia had autoantibodies (auto-Abs) neutralizing type I IFNs (IFN-alpha 2 in 10 patients: IFN-alpha 2 only in three, IFN-alpha 2 plus IFN-omega in five, and IFN-alpha 2, IFN-omega plus IFN-beta in two; IFN-omega only in nine patients). Seven children (3.8%) had Abs neutralizing at least 10 ng/ml of one IFN, whereas the other 12 (6.6%) had Abs neutralizing only 100 pg/ml. The auto-Abs neutralized both unglycosylated and glycosylated IFNs. We also detected auto-Abs neutralizing 100 pg/ml IFN-alpha 2 in 4 of 2,267 uninfected children (0.2%) and auto-Abs neutralizing IFN-omega in 45 children (2%). The odds ratios (ORs) for life-threatening COVID-19 pneumonia were, therefore, higher for auto-Abs neutralizing IFN-alpha 2 only (OR [95% CI] = 67.6 [5.7-9,196.6]) than for auto-Abs neutralizing IFN-. only (OR [95% CI] = 2.6 [1.2-5.3]). ORs were also higher for auto-Abs neutralizing high concentrations (OR [95% CI] = 12.9 [4.6-35.9]) than for those neutralizing low concentrations (OR [95% CI] = 5.5 [3.1-9.6]) of IFN-omega and/or IFN-alpha 2

Pediatricians' attitudes in management of acute otitis media and ear pain in Turkey

Ciftci, Ergin/0000-0002-4955-160X; Dinleyici, Ener Cagri/0000-0002-0339-0134; Sutcu, Murat/0000-0002-2078-9796; Ozdemir, Halil/0000-0002-7318-1688; Buyukcam, Ayse/0000-0002-4015-4210WOS: 000428492100004PubMed: 29501295Objectives: Acute otitis media (AOM) is predominantly a disease of childhood and one of the common reasons for prescribing antibiotics. Ear pain is the main symptom of AOM, with the result that parents frequently seek immediate medical assistance for their children. Antibiotic therapy for AOM does not provide symptomatic relief in the first 24 hours, and analgesics are commonly recommended for relieving the pain associated with AOM. the aims of the present study were to assess pediatricians' attitudes toward AOM and ear pain management in Turkey. Methods: This multicenter descriptive questionnaire study was conducted in 20 centers from different geographic locations in Turkey, with 977 pediatricians, between June 2015 and December 2016. the questionnaire comprised 20 questions focusing on the pediatricians' sociodemographic variables, experiences, and treatment related to AOM and ear pain. Results: of the pediatricians, 58.2% were residents, 36.5% were specialists, and 4.3% were lecturers. Most participants were working in a university hospital (54.8%) or education and research hospital (32.2%). in general daily practice, the AOM diagnosis rates were between 6% and 20% in outpatient clinics, and 52.3% of the participants stated the patients complained about ear pain in pediatric clinics. the watchful waiting (WW) rate, as opposed to immediate antibiotic treatment, was 39.8% for all the pediatricians. the pediatric residents used the WW strategy less than the specialists and lecturers did (p = 0.004). the rates of the WW strategy were higher in outpatient clinics where AOM was commonly diagnosed (p < 0.001). the most common antibiotic prescribed for AOM was amoxicillin clavulanate (76.7%). the mean recommended treatment period for AOM was 9.3 +/- 2.2 days. the choices for systemic ear pain treatment were acetaminophen (26.8%), ibuprofen (29.4%), and alternating between ibuprofen and acetaminophen (43.9%). Moreover, 34.6% of the participants recommended topical agents for otalgia. Topical agents were more commonly recommended by the pediatric residents than specialists or lecturers (p < 0.001). Finally, 58.3% of pediatricians had experiences of the parents' usage of a variety of herbal and folk remedies, such as breast milk or olive oil, for their children's ear pain. Conclusion: Amoxicillin clavulanate was the most frequently prescribed antibiotic for AOM. WW was approved by the pediatricians, and having more AOM patients was a significant factor in the physicians' choice of WW; nevertheless, the WW rate was poor. Implementation of educational intervention strategies will help pediatricians in improving their compliance with evidence-based guidelines for AOM treatment. Otalgia is taken seriously by parents and pediatricians, and otalgia treatment seems to be well accepted in Turkey for providing symptomatic relief and enhancing the patients' quality of life

Evaluatıon of adverse events following immunization reported during national immunization programs (Between 2017-2019 in Ankara Province)

Vaccination services are important in primary health-care service. The Expanded Programme on Immunization (EPI) began in 1981 in Turkey. Vaccines are generally safe products; although rare, undesirable effects may be observed after vaccination. In order to increase vaccination rates, vaccine acceptability and service quality; the Vaccine Adverse Event Reporting System (VAERS) and performing necessary interventions are indispensable parts of vaccination programs. This study aimed to evaluate Adverse Events Following Immunization (AEFI) cases during 2017–2019 in Ankara. A total of ~1.7 million doses of vaccine were administered, and only 71 adverse events following immunization (AEFI) were reported (0.41 cases/million doses of risk). AEFI forms were examined, and of these 71 cases, 17 (24%) were hospitalized and 54 (76%) were followed-up

A Syrian refugee with meningococcal empyema

Meningococcal infections are an important cause of mortality and morbidity in childhood. Herein we report a 2-year-old Syrian refugee boy living in Turkey diagnosed with Neisseria meningitidis serotype B infection complicated with intracranial empyema. Refugees are a sensitive population in all aspects especially infectious diseases. Endemic diseases in the refugees’ own countries constitute a major health problem. Vaccination in sensitive populations and in the country would be important precaution to decrease disease burden

Using mobile phone text messages to improve insulin injection technique and glycaemic control in patients with diabetes mellitus: a multi-centre study in Turkey

Aim and objectivesTo improve the knowledge and skills of diabetic patients on insulin injections using mobile phone short message services and to evaluate the association of this intervention with metabolic outcomes