Measles and absence of Koplik spots in vaccinated children.
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Child↗
Biomedical subjects
S Caglayan
Publications and source records attributed to S Caglayan.
Fatal hypernatremia in an infant due to salting of the skin.
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Administration, Topical↗
The decline of BCG immunity after neonatal vaccination: what about revaccination at one year?
Two hundred and nineteen healthy newborns were vaccinated with the BCG vaccine, and their immunity was checked thereafter at 3, 6 and 12 months of age. We determined that 87% of tuberculin reactivity at 3 months declined to 61% at 12 months. Revaccination of nonreactive infants provided a 100% rate of reactivity. In the light of this information we propose a revision in the BCG vaccination programme in developing countries. We also found a close relationship between the tuberculin reactivity and scar formation after BCG vaccination, suggesting that a simple check of the left deltoid region for a BCG scar may give enough information about the child's immunity to tuberculosis.
BCG Vaccine↗
Steroid-free interval with anti-D in chronic idiopathic thrombocytopenic purpura.
Chronic idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease characterized by the antibody-mediated destruction of platelets. To maintain the platelets above the symptomatic level we administered 100 micrograms of anti-D for 5 consecutive days to 19 children with ITP. Four patients did not respond to the treatment. Fifteen responded with an increase in the average platelet number to 76,000/microL 7 days postinjection. However, the platelet count dropped within 45 days to 27,000/microL. Three months after this study, two patients from the study group were then administered monthly anti-D after reinjecting anti-D daily for 5 consecutive days, as previously performed. Platelet levels in these two patients were maintained above 30,000/microL for 5 and 6 months respectively. We concluded that anti-D administration for 5 consecutive days can induce an increase in platelets followed by a decrease below 30,000/microL after 30-45 days. However, monthly administration of anti-D after daily injections for 5 consecutive days can keep platelets above the symptomatic level and may provide a corticosteroid-free safe interval for nearly 5 months.
Adolescent↗
Disappearing intracardiac thrombi in both atria after mumps in a patient with Turner syndrome.
A girl with Turner syndrome was admitted with an acute cerebrovascular occlusive disease 15 days after mumps infection. Imaging techniques such as Doppler echocardiography, computed tomography and angiography of the heart revealed the existence of masses in both atria. Eight days after the last radiologic study the patient had an operation, but no masses were found in either atrium. It was thought that atrial thrombi, probably formed after viral infection, had broken down to form emboli and disappeared. It is proposed that the patients with congenital cardiopathy should be regularly examined after viral infections for possible intracardiac thrombus formation. If such a mass is found and the decision is to operate, the existence of the mass must be confirmed even in the operating room just before intervention.
Child↗
Superiority of oral agar and phototherapy combination in the treatment of neonatal hyperbilirubinemia.
OBJECTIVE: To determine the value of oral agar in the treatment of neonatal hyperbilirubinemia and to compare it with two other treatment modalities: phototherapy alone and phototherapy plus oral agar. METHODS: Two hundred eight jaundiced full-term newborns were divided into four groups. They were given either phototherapy alone, phototherapy plus oral agar, oral agar alone, or no treatment (control group). The changes in the serum bilirubin values were determined and the results were compared statistically, mainly using analysis of variance. RESULTS: In all three therapy groups, the time required to reduce the bilirubin level to either 15 mg/dL or to 10 mg/dL was significantly shorter than that required by the control group. Although oral agar was found to be as effective as phototherapy, the most significant decrease in bilirubin level was in the combination group. CONCLUSIONS: The efficacy of phototherapy in decreasing the serum bilirubin level in neonatal hyperbilirubinemia can be augmented with the use of oral agar. Oral agar can also be used as a single agent for the treatment of neonatal hyperbilirubinemia, since it is as effective as phototherapy.
Administration, Oral↗
Sigtuna score versus Apgar score: simple and practical evaluation of the newborn.
In this prospective study, we investigated the relation between the Apgar and Sigtuna scores in 1605 newborns. In 169 of them, umbilical arterial blood specimens were analysed for blood gases. There were significant correlations between the Sigtuna and Apgar scores at 1, 5 and 10 minutes after birth (P less than 0.001). Umbilical arterial blood pH (pHua) values were shown to be correlated with both the Sigtuna and Apgar scores. The Sigtuna score was similar to the Apgar score in respect of sensitivity, specificity, positive predictive value and negative predictive value in relation to pH level. We conclude that because of the simplicity of the Sigtuna score, it may be used in place of the Apgar score to establish a rapid diagnosis of asphyxia.
Apgar Score↗
Vancomycin-induced hypertension with transient blindness and generalized seizure.
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Blindness↗
Effect of erythrocyte deformability on renal hemodynamics and plasma renin activity.
Increased blood viscosity has been previously noted in a subgroup of patients with essential hypertension with concomitant high plasma renin activity (PRA). It has been suggested that the cause of hyperviscosity in hypertensives is the presence of circulating red blood cells (RBCs) that were rendered less deformable by significant alterations in their cationic milieu, namely an increase in intracellular concentration of calcium and sodium. The relation between RBC deformability and PRA however is not clear. Our study was conducted to examine this issue. RBC deformability was reduced experimentally, and its effects on renal blood flow, renal artery resistance, glomerular filtration rate and PRA were investigated in experimental (n = 8) and control (n = 4) groups of dogs. Blood was collected from the animals before the experiments and incubated with 0.025% glutaraldehyde. These hardened RBCs were administered to the animals through exchange transfusions. Following the exchange transfusion with the hardened RBCs, there were no changes in renal blood flow, renal artery resistance, and the creatinine clearance. The only change observed was an increase in PRA. In the control group, all parameters that were determined remained unchanged. The data are consistent with the notion that the presence of circulating hardened RBCs may by itself increase PRA, and this effect can be important in some types of hypertension and some other disorders in which impaired deformability of RBCs have been reported.
Animals↗
Management of suppuration in regional lymph nodes secondary to BCG vaccination.
We describe 50 patients with suppurative regional lymphadenitis following intradermal BCG vaccination. For non-drained suppurations we performed needle aspiration in twenty-three patients (aspiration group). Of the remaining 27 patients (drainage group) 16 had spontaneous drainage and 11 incisional drainage. In the drainage group, 17 patients were followed up conservatively. Ten patients from the drainage group and 3 patients from the aspiration group (drained after needle aspiration) accepted total surgical excision to terminate the drainage. Twenty of twenty-three patients in the aspiration group recovered after needle aspiration. Average period of cessation of drainage and healing of wound was 7.5 weeks in patients with drainage (spontaneous and incisional). Healing was complete after total surgical excision of draining suppurations in all of 11 patients. We concluded that simple needle aspiration was sufficient for the treatment of suppurating but non-drained BCG lymphadenitis. For suppurating lymph nodes that were surgically (not recommended) or spontaneously drained, a more invasive procedure, total surgical excision, was proposed to terminate the long and disturbing drainage period.
BCG Vaccine↗
Changing incidence of neural tube defects in Aegean Turkey.
The incidence of neural tube defects was monitored among all live- and still-births delivered between June 1986 and July 1988. In all there were 19,115 total births. The incidence of neural tube defects (NTD) was 1.9 per 1000 among those whose conception time was prior to May 1986. However, in conceptions occurring in May, June and July 1986, the NTD rate increased to a level of 8.9 per 1000, subsequently gradually declining to previous levels within 9 months. This dramatic change in incidence, which parallels a previous finding from Turkey, suggests that this finding may be associated with the Chernobyl disaster of May 1986.
Accidents↗
Endobronchial tuberculosis simulating foreign body aspiration.
A case of sudden onset of severe respiratory distress is reported. Appropriate clinical and roentgenologic findings suggested foreign body aspiration. The foreign body was removed by fiberoptic rigid bronchoscope. Bronchoscopic, histopathologic, and microbiologic findings revealed that the foreign body was a granulomatous mass originating from endobronchial tuberculosis.
Bronchi↗
Bronchial foreign body vs asthma.
Between January 1983 and June 1988, 30 unsuspected foreign bodies were extracted from the respiratory tracts of children. Twelve of them showed no roentgenologic findings and their histories revealed repeated hospitalization due to reactive airways disease (RAD) or croup syndrome. As a test-therapy, theophylline, corticosteroids and epinephrine were administered simultaneously to these patients in appropriate doses. No response was obtained in two patients with subglottic foreign bodies (SFB). In seven of the ten patients with bronchial foreign bodies (BFB), wheezing was either decreased or disappeared in the uninvolved lung, but no change was observed in the lung with a foreign body in its main bronchus.
Aminophylline↗
Is medical therapy effective for regional lymphadenitis following BCG vaccination?
We describe 120 patients with regional lymphadenitis following intradermal BCG vaccination. Seventy-eight of the patients were given medical therapy to prevent drainage and suppuration, and 42 patients were followed up without such treatment. The medical therapy group is divided into three subgroups: 36 were given erythromycin stearate, 21 isoniazid, and 21 isoniazid plus rifampin. No statistical difference in the incidence of spontaneous drainage and suppuration was found between the "no therapy" and the "medical therapy" groups. No significant superiority of any specific therapy was shown. If lymphadenitis develops rapidly (in two months), the incidence of spontaneous drainage and suppuration is significantly higher than in patients with slowly developing lesions. Total surgical excision is recommended to prevent spontaneous drainage and chronic suppuration in these rapidly evolving instances.
BCG Vaccine↗
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.
Adolescent↗
Event-related brain potentials in male hypogonadism.
Several studies based on psychometric tests have determined an impairment of cognitive functions in patients with androgen deficiency. However, little is known about event-related potentials (ERPs) alterations in male hypogonadism. We investigated alterations of ERP in male hypogonadism before and 3 months after gonadotropin treatment. ERPs were elicited in 20 untreated male patients with idiopathic hypogonadotropic hypogonadism (IHH) (mean age: 21.1+/-1.4 years) and in a group of 30 male controls with comparable mean age and educational level. ERP recordings were repeated 3 months after hCG/hMG treatment. Untreated hypogonadal patients had longer mean P300 latencies and increased P300 amplitudes when compared to those in controls (321.6+/-18.5 vs 299.3+/-20.1 msec, p=0.0002; 12.15+/-4.47 vs 9.38+/-3.02 microV, p=0.011, respectively). The mean P300 latencies did not change significantly 3 months after gonadotropin treatment, while P300 amplitudes were decreased significantly. P300 latencies did not correlate with serum testosterone and other hormone levels. We conclude that prolongation of P300 latencies and increased P300 amplitudes are associated with male hypogonadism, but P300 prolongation is not reversed 3 months after gonadotropin treatment. These findings confirm the occurrence of cognitive defects in hypogonadal patients and would support the hypothesis that perinatal androgen deficiency contributes to an insufficient cognitive development.
Adult↗
Hematological and hemorheological effects of air pollution.
Selected hematological parameters and erythrocyte deformability indexes for 16 young male military students were compared before and after a period of exposure to heavy pollution. These students lived in Ankara, which has a serious air pollution problem. The mean sulfur dioxide levels measured at a station proximal to the campus where the students lived were 188 micrograms/m3 and 201 micrograms/m3 during first and second measurements, respectively. During the period between the two measurements, the mean sulfur dioxide level was 292 micrograms/m3. Significant erythropoiesis was indicated by increased erythrocyte counts and hemoglobin and hematocrit levels. Methemoglobin percentage was increased to 2.37 +/- 0.49% (mean +/- standard error) from 0.51 +/- 0.23%. Sulfhemoglobinemia was present in six subjects after the period of pollution, but it was not present in any student prior to this period. Significant increases in erythrocyte deformability indexes were observed after the period of pollution, i.e., from 1.13 +/- 0.01 to 1.21 +/0 0.02, implying that erythrocytes were less flexible, which might impair tissue perfusion.
Adult↗
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.
Blood Transfusion↗