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N Uzel

Publications and source records attributed to N Uzel.

25 records · Page 2Linked to original sources

The current value of tuberculin testing and BCG vaccination in school children.

We have examined the value of routine tuberculin testing and BCG vaccination in Edinburgh school children from 1970 to 1983. Over 89,000 children were observed for a mean period of 7 years, during which 77 new cases of tuberculosis were notified in Caucasians. The average annual incidence of tuberculosis in the 65,692 children receiving BCG vaccination at school was 7/10(5), significantly less than the 19/10(5) estimated in 12,987 Heaf negative children who missed BCG vaccination, and the 41/10(5) in 5,308 tuberculin positive children (P less than 0.001). The efficacy of BCG vaccination in this study exceeded 60%. The 5,308 tuberculin positive children were offered chest radiographs with an initial yield (new cases of tuberculosis detected/radiographs taken) of 1/555 for Heaf grade II children, 1/75 for grade III, and 1/25 for grade IV (P less than 0.001). During the period of this study approximately 700 BCG vaccinations were necessary to prevent one new case of tuberculosis and this represents considerably greater benefit than in England and Wales during the same period. There may be a case for continuing the schools' BCG programme in Scotland for a number of years longer than in England and Wales. A national BCG survey for Scotland would be valuable.

Adolescent↗

Thyroid function in critically ill infants with infections.

To investigate thyroid function in critical illness in infancy, serum thyroxine (T4), triiodothyronine (T3), reverse triiodothyronine (rT3) and thyroid-stimulating hormone (TSH) concentrations were measured in serum in 13 such patients. T4 and TSH values were found to be comparable to control values, while T3 values were significantly low and rT3 values were high. When the patients were evaluated according to prognosis, significantly lower initial and subsequent T4 values were found in the fatal group as compared with the control group. Initial T3 concentrations both in fatal cases and in patients who recovered were significantly lower than those in the controls. Subsequent T3 values in the group who recovered showed a relative increase, but in the fatal cases a further decrease, in T3 levels, accompanied by a decrease in rT3 levels to values comparable to those of the controls, was observed in the terminal stage.

Bacterial Infections↗

Bacterial nosocomial infections in mechanically ventilated children.

Of 480 patients admitted to the Pediatric Intensive Care Unit of the Institute of Child Health Children's Hospital in Istanbul, 97 required mechanical ventilation (MV). Sixty of these children were included in a retrospective analysis aiming to determine the frequency of and factors contributing to the development of nosocomial infections (NI). NI rate was 45 percent, ventilator-associated pneumonia (VAP) accounted for the greater part (66.7%) of the NI, followed by urinary tract infections (16.7%), septicemia (13.3%), and meningitis (3.3). Pseudomonas aeruginosa was the most frequent cause of VAP. The duration of the MV and invasive interventions were important risk factors for the development of VAP.

Bacterial Infections↗

Experience with diarrheal disease in a university pediatric hospital.

In 1987, 3227 diarrhea cases, half of which were infants, presented at the Out-patient Department of the Istanbul University Children's Hospital. An examination of these cases showed that in 1,066 cases diarrheal disease (DD) was accompanied by a coexisting infection or other disease. The cases with severe dehydration, shock or severe systemic disease were immediately hospitalized. All the remaining cases were administered oral rehydration therapy (ORT) in the Diarrhea Unit, and 94.7 percent of them were successfully rehydrated with ORT. Severe dehydration, shock, severe systemic infection, abdominal distention, failure of rehydration by the enteral route, severe protein energy malnutrition (PEM), and the presence of convulsions were the indications for i.v. therapy. The overall mortality rate was 11 percent. Our experience with DD indicates that widespread implementation of ORT in diarrheal disease and the establishment of Diarrhea Units in large hospitals will contribute not only to saving more lives but will also have an economic impact by reducing the number of admissions.

Child↗

Analysis of patients admitted to the emergency unit of a university children's hospital in Turkey.

A retrospective analysis of the computerized data of patients admitted to our Emergency Unit Inpatient Service in 1991 was conducted to obtain data about age, sex, referred sources, admission period, monthly admission rates, diagnoses and eventual outcome. More than 47% of patients were younger than one year of age. The most common causes for hospital admission were infectious, respiratory and neurological diseases. The mean hospitalization period was 3.26 days. More than 60% of patients were treated by the Emergency Unit staff. The net mortality rate was 2.9%, infectious diseases being the most common cause of mortality. We conclude that demographic and diagnostic data regarding admissions to the Emergency Unit can be utilized to develop new strategies for patient care and to reorganize education programs for pediatric residents.

Adolescent↗

Analysis of measles cases in a university pediatric hospital during 1988 and 1993 outbreaks.

In Turkey, a mass measles immunization campaign was initiated in 1985, and the decision was made to administer the first of the measles vaccinations at nine months of age instead of 12-15 months. Following the campaign there was a decrease in the number of measles cases seen in the Outpatient Department of Istanbul University Children's Hospital in 1986 and 1987; however, after 1987 an increase was observed in measles cases, which continued until 1993. In order to investigate the current measles epidemics, we reevaluated the measles cases seen in our Outpatient Department from 1986 to 1993. We also investigated the vaccination status and the hospitalization and mortality rates of measles cases in the epidemics of 1988 and 1993. Since 1988 (except 1989) a significant increase (412-1375 percent) has been observed in measles cases, and between 1986 and 1993 more than half of all measles cases were in children older than four years of age. In 1988 and 1993 we found that most vaccinated measles cases were also in this age group, but the rate of complications and hospitalization among the vaccinated cases was lower compared to those who were not vaccinated.

Child, Preschool↗