Suat Caglayan

Rubella seroprevalence in an unvaccinated population in Izmir: recommendations for rubella vaccination in Turkey.

BACKGROUND The European Advisory Group on the Expanded Program on Immunization of WHO has recommended that by 2010 or earlier congenital rubella should be well-controlled or eliminated in all countries in Europe. Debate on the introduction of rubella vaccine into national immunization schedules continues to occur, and data on rubella and congenital rubella syndrome in Turkey are insufficient. OBJECTIVE To determine age-specific rubella seroprevalence in the 1- to 29-year-old unvaccinated population in Izmir, Turkey. METHODS A total of 600 unvaccinated persons 1 to 29 years old were selected for the study with cluster sampling in Izmir, Turkey. The information on sociodemographic characteristics and disease history was gathered for each participant, and in 580 of them rubella-specific IgG antibodies were assayed quantitatively by the micro-enzyme immunoassay. RESULTS Of the 580 participants tested for rubella antibodies, 135 (23.3%) were seronegative. The proportions of susceptible individuals were 61.7, 29.5, 12.4, 10.3 and 8.4% in the age groups of 1 to 4, 5 to 9, 10 to 14, 15 to 19 and 20 to 29 years, respectively. Of the young women 15 to 19 years of age, 13.5% were susceptible to rubella infection. CONCLUSIONS Because a substantial proportion of women in their childbearing years are susceptible to rubella, immunization efforts should be directed at infants or prepubertal children.

Plasma concentrations of granulocyte-macrophage colony-stimulating factor and interleukin-6 in septic and healthy preterms.

Abstract Plasma granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-6 (IL-6) concentrations were determined in 21 preterm infants with sepsis and nine healthy preterm neonates of the same postnatal age at sampling. Plasma GM-CSF levels were elevated at diagnosis in the septic preterms as compared to the healthy preterms (P = 0.01), but did not differ significantly on recovery. IL-6 levels were also elevated markedly at diagnosis (P = 0.0003), but decreased to normal on recovery as compared to the healthy preterm infants. GM-CSF levels were more prominent in septic preterms with neutropenia than those of non-neutropenic infants (P = 0.03). Conclusion Preterm infants can produce high levels of granulocyte-macrophage colony-stimulating factor and interleukin-6 in response to bacterial sepsis.

Adequate immune response to tetanus toxoid and failure of vitamin A and E supplementation to enhance antibody response in healthy children

The effects of vitamin A and vitamin E supplementation on the IgG response to tetanus toxoid after primary immunization were evaluated in a prospective, randomized controlled clinical trial involving 89 healthy infants with normal serum vitamin A and E levels at 2 months of age. Before the first dose of DPT vaccine, the infants were randomly enrolled into four different study groups [Group I (n=24): 30,000 IU vitamin A for 3 days just after each three doses of primary vaccination, Group II (n=21): 150 mg oral vitamin E for only 1 day after the injections for primary immunization, Group III (n=21): vitamins A and E together in the same order, Group IV (n=23) no vitamin after DPT vaccines]. Serum tetanus antitoxin (IgG) titres were measured three times; initially at 2 months of age before the first dose of DPT, secondly at 5 months of age 1 month after primary immunization and thirdly at 16-18 months of age before the booster dose of DPT. Before the first dose of the DPT vaccine, 1 month after the third DPT injection and at 16-18 months before the booster dose of DPT, there was no significant difference in serum tetanus antitoxin levels between these four groups. A significant increase was observed in all the groups when serum tetanus antitoxin levels before (2 months) and after (5 months) primary immunization were compared. In addition, serum antibody levels against tetanus significantly decreased in the four groups before booster vaccination. Before the beginning of primary immunization, 15 infants (16.8%) had serum tetanus antitoxins (IgG) below protective level. After three doses of DPT, all the infants had protective antitoxin levels. At 16-18 months of age before booster dose, four infants (10%) also had serum tetanus antitoxins (IgG) below the protective level. No side-effects were observed except bulging fontanelle in two infants in Group I.

Increased Gastric Production of Platelet-Activating Factor, Leukotriene-B4, and Tumor Necrosis Factor-α in Children with Helicobacter pylori Infection

The concentrations of platelet-activating factor(PAF), leukotriene-B4 (LTB4), andtumour necrosis factor-α (TNF-α) inhomogenate supernatants of gastric mucosal biopsyspecimens and in gastric juice from Helicobacter pylori-positive (N =21) and-negative children (N = 14) were investigated inorder to determine whether these lipid mediators and thecytokine are involved in the inflammatory reaction of H. pylori-associated gastritis. PAF andLTB4 concentrations were measured afterhigh-performance liquid chromatography (HPLC)purification by specific radioimmunoassay, andTNF-α concentrations were determined by using an enzyme-linkedimmunosorbent assay. The concentrations of PAF, LTB, andTNF-α measured in gastric juice and biopsyhomogenate supernatants of children with H. pyloripositive gastritis were found to be statisticallyelevated and in positive correlation with each other.This study suggested that increased local mucosalproduction of potent proinflammatory agents such as PAF, LTB4, and TNF-α may beimplicated in the pathogenesis of H. pylori-associatedgastritis in childhood.

Increased mucosal inflammatory cytokines in children with Helicobacter pylori-associated gastritis

The concentrations of tumour necrosis factor‐alpha (TNF‐α), interleukin‐6 (IL‐6) and IL‐1‐β in tissue homogenates of gastric mucosal biopsy specimens, and in gastric juice samples from Helicobacter pylori‐positive and ‐negative children, were determined. The study population comprised 30 children with recurrent abdominal pain attending upper gastrointestinal endoscopy. Of these patients 18 were infected with H. pylori. Cytokine concentrations in gastric biopsy homogenate supernatants and in gastric juice were measured by enzyme‐linked immunosorbent assay (ELISA). TNF‐α levels in gastric juice and in gastric biopsy homogenate supernatants in patients with H. pylori‐positive gastritis were found to be significantly higher than those in children without H. pylori infection. IL‐6 levels were also higher in H. pylori‐infected subjects, but the difference in IL‐6 concentrations measured in gastric juice and biopsy homogenate supernatants did not reach statistical significance. IL‐1‐β concentrations in both specimens showed no significant difference between the two groups of children. It was suggested that increased levels of inflammatory cytokines, especially TNF‐α and IL‐6 generated locally within the gastric mucosa might be implicated in the pathogenesis of H. pylori‐associated gastritis in childhood.

Assessment of Neutrophil Chemotaxis and Random Migration in Children with Thalassemia Major

Neutrophil chemotaxis and random migration were evaluated in 21 patients with thalassemia major and 21 healthy controls by a filter technique (Boyden chamber). Chemotactic and random migrations in patient group were found to be defective, which may partially account for the increased susceptibility to infection occasionally observed in these patients. The effects of serum ferritin levels, transferrin saturations that show iron overload, total count of blood transfusions for chronic immunostimulation, desferrioxamine therapy, and splenectomy on these neutrophil functions were examined in thalassemic patients in order to determine whether they are responsible for these defective functions because the mechanism of abnormal neutrophil chemotaxis and random mobility in thalassemic patients is not still clear.

Aflatoxin: Is it a neglected threat for formula-fed infants?

In the present study, the risk of exposure to aflatoxin in infants fed breast milk and formula was investigated. For this purpose, aflatoxin B1 (AFB1) was determined in the serum of both breast‐fed and formula‐fed infants. Serum AFB1 positivity was significantly higher in the formula‐feeding (F) group than the breast‐feeding (B) group (42.8 vs 8.5%, P <0.01). The AFB, concentration in different commercial formulas was also determined. Aflatoxin B1 was found in seven of the eight newly opened packages of different brands of formula. The concentrations showed a statistically significant increase at the 30th day after opening the packages (P <0.01). Although AFB1 concentrations in the formulas were found to be within acceptable limits for most countries, still, its existence must be carefully evaluated because future influences of very small amounts of aflatoxin on the growing organism have not been fully elucidated. Therefore, it was again concluded that for infants, human milk is safer than commercial formulas because of the lower contamination risk of aflatoxin. Also, commercial formulas must be regularly examined by authorities for the possible risk of aflatoxin contamination.

Serum immunoglobulins, IgG subclasses, isohemagglutinins and complement-3 levels in patients with thalassemia major

Serum IgG, IgM, IgA, IgG subclasses (IgG1, G2, G3, G4), isohemagglutinins and complement-3 concentrations were measured in 23 beta-thalassemic patients suffering from recurrent infections. No significant abnormalities were found in these humoral immunity investigations, both in splenectomized and non-splenectomized patients. On the other hand, iron overload or repeated blood transfusions were not found to down-regulate the humoral immune system of thalassemic patients.

Seasonal benzathine penicillin G prophylaxis for recurrent streptococcal pharyngitis in children

Abstract Background. To assess the efficacy of benzathine penicillin G (BPG) prophylaxis in recurrent streptococcal pharyngitis in children.

Plasma and Synovial Fluid Soluble CD23 Concentrations in Children with Juvenile Chronic Arthritis

Since increased levels of sCD23 were demonstrated in patients with autoimmune diseases, plasma and synovial fluid sCD23 levels were examined in 22 patients with juvenile chronic arthritis (JCA) and in 10 children undergoing arthrocentesis for orthopedic disorders. There was no significant difference in plasma sCD23 concentrations between patients with pauciarticular and polyarticular onset. Plasma and synovial fluid sCD23 concentrations were found to be significantly increased in JCA patients as compared to controls. However, plasma sCD23 levels were not positively correlated with laboratory parameters showing disease activity such as erythrocyte sedimentation rate, C-reactive protein, serum IgG and IgA. It was concluded that increased production of sCD23 in peripheral blood and synovial fluid might be important in the pathogenesis of JCA. However, determination of this immunological parameter provides no useful clinical information about disease activity and management.