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Biomedical subjects

G Kanra

Publications and source records attributed to G Kanra.

At least 91 records · Page 5Linked to original sources

Clinical trial to evaluate immunogenicity and safety of inactivated hepatitis A vaccination starting at 2-month-old children.

Active immunization with hepatitis A vaccine has been shown to provide long-term protection against hepatitis A virus (HAV) infection. However, few data are available regarding use of the hepatitis A vaccine in children under two years of age. The present study was conducted to test the safety and immunogenicity of inactivated hepatitis A vaccine administered to infants, and to evaluate the correlation between mother and infant anti-HAV antibodies. A total of sixty healthy children, two months of age, were enrolled in this study and immunized with 360 EU of inactivated hepatitis A vaccine (Havrix) according to the two, four and six months of age schedule. Blood sampling was performed prior to the first vaccination and one month after the third vaccination at seven months. Venipuncture was also done on mother on admission. The reactogenicity was expressed as the percentage of reported local and systemic reactions. The most common side effects were erythema on the injection site and fever. Infants with passively transferred maternal anti-HAV antibodies had a reduced anti-HAV GMT after vaccination. On admission, only one infant and his mother were seronegative and seroconversion was only detected in this infant. One month after the third dose seven infants (12.3%) were found to be seronegative. The infant without passively acquired maternal anti-HAV had the protective levels with a GMT of 3176 mIU/ml one month following the third dose. There was a significant positive correlation between the titers of mother and infant anti-HAV antibodies (n = 0.96, p < 0.001) on admission. Hepatitis A vaccine showed no immunogenicity in infants with presence of maternal antibodies. Hepatitis A vaccine is safe but it should be used after the disappearance of maternal antibodies.

Age Factors↗

Salmonella septic arthritis in a patient with acute idiopathic thrombocytopenic purpura treated with steroid.

Salmonella has three clinical presentations: self-limiting gastroenteritis, a systemic syndrome (enteric or typhoid fever), and bacteremia with focal infection. Hematogenous infections can cause focal lesions, but unusual manifestations occur more often when predisposing factors such as T cell defect, hemolytic disorders (sickle cell disease, malaria) or trauma are present. Salmonella tend to invade bones and joints. There is no mention of acute idiopathic (immune) thrombocytopenic purpura as a predisposing factor for salmonella septic arthritis; however there are reports about the importance of platelets for the immune response. Here we present a case of Salmonella enteritidis septic arthritis following acute idiopathic (immune) thrombocytopenic purpura in a 15-year-old female patient who has been on steroid therapy for the last two weeks.

Adolescent↗

Reactogenicity and immunogenicity of a new measles-mumps-rubella vaccine containing RIT 4385 mumps virus strain in healthy Turkish children.

A total of 44 children aged between 15-18 months were randomly vaccinated either with a new measles-mumps-rubella (MMR) vaccine (Priorix, SmithKline Beecham) or a commercially available MMR vaccine (MMR-II, Merck) to compare the reactogenicity and immunogenicity. No local symptoms or fever was reported. Seroconversion rates of the study vaccine were 100, 95 and 100 percent for measles, mumps and rubella, respectively. The seroconversion rates for the control vaccine were 100, 94.7 and 95.5 percent, respectively. The geometric mean titers (GMT's) for the study and control groups were 1695, 95, 58; and 2198, 1183 and 47; respectively. In conclusion, the new MMR vaccine containing RIT 4385 mumps strain derived from the Jeryl Lynn strain was shown to be immunogenic and safe in healthy Turkish children. Further post-marketing surveillance should be conducted.

Antibody Formation↗

Monotherapy with meropenem versus combination therapy with piperacillin plus amikacin as empiric therapy for neutropenic fever in children with lymphoma and solid tumors.

The purpose of this study was to compare meropenem monotherapy with combination therapy for empirical treatment of neutropenic fever in children with lymphoma and solid tumors. Ninety episodes of neutropenic fever in children (0.7-16.0; mean age 7.7 years) with solid tumors in a single center were randomized to receive either meropenem (50 mg/kg/dose-maximum 1 g, every 8 hours) or piperacillin (200 mg/kg/dose, every 6 hours) plus amikacin (15 mg/kg daily). Failure was defined as treatment modification. Non-Hodgkin's lymphoma (NHL) accounted for 62.2 percent of all episodes, and solid tumors (37.8%) for the rest. Blood cultures were positive in 23 percent of all episodes. Sixty-seven percent of all isolated microorganisms stained Gram-positive. Overall success was 70.0 percent (63/90). The success with meropenem was comparable to that seen with piperacillin plus amikacin: 76.6 versus 64.6 percent (p = 0.25). The failure rate was 33 percent with Gram-positive culture and 78 percent with Gram-negative or mixed cultures. The solid tumor group had significantly less bacteremia (4/34 versus 17/56; p < 0.05) and treatment failure (3/34 versus 24/56; p < 0.001) than the NHL group. No serious drug-related adverse event was noticed. Meropenem monotherapy was as effective as piperacillin plus amikacin combination in the empirical treatment of neutropenic fever in children with lymphoma and solid tumors.

Adolescent↗

Screening for tuberculosis in a primary school in Ankara.

Tuberculosis is still an important health problem in developing countries. A screening program was conducted upon learning that one of the teachers of a primary school in Ankara was diagnosed to have active pulmonary tuberculosis. A total of 341 students in the same building with the index case were screened for tuberculosis. There were 109 students with positive tuberculin test reaction. A higher ratio of tuberculin test positivity among the students of the teacher with active tuberculosis versus students vaccinated with BCG one year previously according to the routine vaccination program was determined. Isoniazid prophylaxis was given to the students with positive tuberculin test. The study shows the importance of an urgent work-up of index cases and their environment to prevent the spread of tuberculosis.

Child↗

Giant cell pneumonia in a leukemic child in remission: a case report.

Giant cell pneumonia is a rare and uncommon type of lung infection developing as a complication of measles, especially in immunocompromised patients, whether their immune systems are affected primarily or whether they have acquired immune defects. As well as being uncommon, it is also atypical because of absence of the characteristic rash and of absent or low antibody titers against measles in most of the cases. It is known that cellular immunity is more important than humoral immunity in the host response to measles, so hypogammaglobulinemic patients with normal cellular immunity usually recover uneventfully from measles and also have the characteristic rash. We report a case with giant cell pneumonia that was confirmed by postmortem histopathological examination. We especially want to point out that even in the absence of rash, with the clinical and radiological features of pneumonia, measles should be considered in a patient, whether in remission or not, receiving immunosuppressive treatment.

Antineoplastic Combined Chemotherapy Protocols↗

The evaluation of vaccination against measles at nine months of age (report of an epidemic).

Sixteen measles cases were studied during an epidemic that broke out in Etimesgut district of Ankara. Eight of these children had never been vaccinated against measles while the remainder had been vaccinated at nine months of age. In the sera obtained during the course of the illness, anti-measles antibody was not detectable in six vaccinated children and in four unvaccinated children. Upon observing the siblings of the subjects, it was determined that one out of three who had not been vaccinated against measles and three out of seven who had been vaccinated at nine months of age contracted the disease within a month. However none of the siblings who had been vaccinated against measles at 15 months contracted the disease. In our cases, although vaccination at nine months of age could not prevent measles, it resulted in a milder form of the disease. It seems that measles vaccine administered to infants at around nine months of age does not prevent the occurrence of the disease in many children.

Age Factors↗

Elimination of maternal antibodies against measles (is the policy of vaccinating children younger than nine months of age suitable for Turkey?).

Maternal antibodies against measles in 223 healthy children aged 22 to 31 weeks were studied. The ratio of children with detectable antibodies declined from 61.4 percent at 22-23 weeks of age to 20 percent at 26-27 weeks of age. Since the minimum proportion of antibody-positive children (15.6% at 26-27 weeks of age) is still higher than the optimum proportion (5%), the Schwarz vaccine which is used mostly in measles immunization seems not to be effective to obtain a high seroconversion rate in our infants. We suggest that the Edmonston-Zagreb strain of measles vaccine be used for infants under 9 months of age in Turkey.

Age Factors↗

Serological evaluation of 52 children immunized with the combined measles, mumps and rubella vaccine.

Fifty-two of 298 children vaccinated with the measles-mumps-rubella (MMR) vaccine at around the age of 16 months were evaluated for antibody titres against measles, mumps, and rubella. The seropositivity rates for measles, mumps, and rubella were 86%, 92%, and 98%, respectively. While the most prominent side effects were irritability (6.04%) and fever (4.69%), 83.55% of the vaccinated children showed no undesirable reaction to the vaccine. The MMR vaccine appeared to be immunogenic and nonreactogenic for the children in the study.

Antibodies, Viral↗