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Biomedical subjects

S Cağlayan

Publications and source records attributed to S Cağlayan.

13 recordsLinked to original sources

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.

Antibody Formation↗

Carob bean juice: a powerful adjunct to oral rehydration solution treatment in diarrhoea.

In children, the treatment of acute diarrhoea with the World Health Organization (WHO) standard oral rehydration solution (ORS) provides effective rehydration but does not reduce the severity of diarrhoea. In community practice, carob bean has been used to treat diarrhoeal diseases in Anatolia since ancient times. In order to test clinical antidiarrhoeal effects of carob bean juice (CBJ), 80 children, aged 4-48 months, who were admitted to SSK Tepecik Teaching Hospital with acute diarrhoea and mild or moderate dehydration, were randomly assigned to receive treatment with either standard WHO ORS alone or a combination of standard WHO ORS and CBJ. Three patients were excluded from the study because of excessive vomiting. In the children receiving ORS + CBJ the duration of diarrhoea was shortened by 45%, stool output was reduced by 44% and ORS requirement was decreased by 38% compared with children receiving ORS alone. Weight gain was similar in the two groups at 24 h after the initiation of the study. Hypernatraemia was detected in three patients in the ORS group but in none of those in the ORS + CBJ group. The use of CBJ in combination with ORS did not lead to any clinical metabolic problem. We therefore conclude that CBJ may have a role in the treatment of children's diarrhoea after it has been technologically processed, and that further studies would be justified.

Acute Disease↗

Magnetic resonance imaging of posterior pituitary for evaluation of the neurohypophyseal function in idiopathic and autosomal dominant neurohypophyseal diabetes insipidus.

We investigated the role of MR imaging for evaluation of the functional status of the neurohypophyseal system in both idiopathic central diabetes insipidus (DI) and familial autosomal dominant neurohypophyseal DI. The patients and family with DI were analyzed retrospectively for the presence or absence of posterior pituitary gland hyperintense signal on MR images. A total of 19 adult patients with idiopathic central DI, 7 members of a family with autosomal dominant DI and 20 control subjects were included in the study. Diagnosis of idiopathic DI was based on the presence of central DI in the absence of any alteration that is known to be responsible for DI. The patients were studied retrospectively and the morphology and intensity of the posterior lobe by MR imaging was assessed by blinded reading. In all patients with idiopathic central DI and the affected members of the family, the posterior bright signal was absent while the stalk was normal on MR images. In contrast, normal posterior pituitary bright signal and stalk were found in unaffected members of the family and all control subjects. We conclude that MR imaging of the posterior pituitary lobe can be used to evaluate the functional status of the neurohypophyseal system in idiopathic central DI and familial autosomal dominant DI.

Adolescent↗

Evaluation of sponging and antipyretic medication to reduce body temperature in febrile children.

Two hundred and twenty-four children aged 6 months to 5 years, with rectal temperatures greater than or equal to 30 degrees (104 degrees F), were randomly treated with sponging alone or with medication including a single oral dose of aspirin 15 mg/kg, or paracetamol 15 mg/kg, or ibuprofen 8 mg/kg. Twenty-three children were excluded from the final analysis because they did not complete the study. Demographic characteristics of the patients were found to be comparable in all groups. Rectal temperatures were recorded every 30 min for a 3 h period. During the first 30 min of intervention, sponging was found to be more effective than all of the three medications. After 60 min, the effects of each medication became superior to sponging with tepid water in reducing body temperature. Twenty-three children were excluded from the final analysis because they did not complete the study. Comparing the effect of the three different medications, it was seen that the antipyretic efficacy of aspirin and ibuprofen were significantly more than paracetamol 3 h after intervention (P < 0.05). For the management of fever over 39 degrees C, it is therefore recommended to give children an antipyretic drug, preferably ibuprofen, and at the same time to begin sponging to provide a rapid and sustained antipyresis

Acetaminophen↗

Effectiveness of an active method in teaching physiology.

A three-year study was conducted in search of a better method of teaching physiology that would enhance the critical thinking skills of first-year nursing students in Istanbul University, Florence Nightingale College of Nursing. Three different methods of teaching were used: 1) a straight lecture method, 2) an active method with no previous preparation of students, 3) an active method with previous preparation. Each method was evaluated by end-of-term marks, student feedback in that year, and a follow-up the next year by questionnaires distributed to both students and nursing teachers. The results of end-of-term examinations and Student Acceptance Indexes, as well as comments of nursing teachers, show that the active method of teaching is better than straight lecture and that the active method is most effective when students are familiarized with it beforehand.

Curriculum↗

In vitro effects of thyroxine on the mechanical properties of erythrocytes.

In vitro effects of thyroxine on erythrocyte deformability and mechanical fragility were observed. Deformability of erythrocytes was improved in a dose dependent manner by thyroxine. Mechanical hemolysis was found to be lower if thyroxine was included in erythrocyte suspensions at concentrations close to the physiological levels (10(-9)M). These changes might be related to the alterations of intracellular calcium concentration, as in the erythrocyte suspensions containing 10(-9)M thyroxine, intracellular calcium concentration was found to be 30 times lower than the control suspensions which did not contain thyroxine. Thyroxine also reduced the mechanical hemolysis ratio in calcium loaded cells. These observations suggest that thyroxine might play some role in the regulation of the mechanical properties of erythrocytes which might be mediated via the effects on calcium metabolism.

Adult↗

A different approach to sleep problems of infancy: swaddling above the waist.

Daytime sleep and wake periods of ten swaddled infants were periodically recorded by their mothers. The babies were swaddled above the waist for the first four days of the second, third and fourth months of life. During the next four days of the same months, the same infants were monitored with no swaddling. Comparison of the two sleep situations (swaddled and unswaddled) demonstrated that the increase in the total daytime sleep was statistically significant when the baby was loosely swaddled above the waist.

Circadian Rhythm↗

Ectopic thoracic kidney.

A five-month-old female infant was hospitalized for bronchopneumonia. Ultrasonography and other studies demonstrated the presence of an ectopic thoracic kidney with normal anatomical structures.

Female↗

Diluted yogurt (ayran) versus water in dissolving oral rehydration salts.

Seventy-six children with gastroenteritis were treated with oral rehydration salts dissolved in ayran (diluted yogurt), and eighty patients were treated with oral rehydration salts dissolved in water. The patients whose ages ranged between three and twelve months accepted both solutions equally. However, the acceptance of the ayran-based solution was significantly greater than WHO's salt solution in the patients whose ages ranged between one and four years. It is proposed that ayran be used to dissolve oral rehydration salts in the treatment of diarrhea since it is more palatable and easily acceptable by children.

Child, Preschool↗

Long-term use of anti-D in chronic idiopathic thrombocytopenic purpura.

Chronic idiopathic thrombocytopenic purpura is an autoimmune disease characterized by antibody-mediated destruction of platelets. To maintain the platelets above the symptomatic level, we administered anti-D (100 micrograms for 5 consecutive days) in 19 children with idiopathic thrombocytopenic purpura (ITP). Four patients did not respond to treatment. Fifteen responded with an increase in the average platelet number to 76,000/microL on the 7th postinjection day. Within 45 days, however, platelets dropped to 27,000/microL. Three months after this study, two patients from the study group were re-administered anti-D in daily injections for 5 consecutive days, as was done previously. Monthly administration of anti-D in two patients maintained platelets above 30,000/microL for periods of five and six months. We concluded that monthly administration of anti-D after five consecutive daily injections can maintain platelet levels above the symptomatic level and may provide a corticosteroid-free safe interval of nearly five months.

Adolescent↗

Recombinant human granulocyte-macrophage colony-stimulating factor therapy and endogenous plasma GM-CSF, IL-3, IL-4 concentrations in pediatric patients with solid tumors.

Ten pediatric patients with solid tumors and chemotherapy-induced neutropenia were given recombinant human granulocyte-macrophage colony-stimulating factor (rHuGM CSF). The duration of the neutropenic phase was then compared with the results obtained from eight patients also with solid tumors, but not treated with rHuGM-CSF. It was found that rHuGM-CSF treatment significantly decreased the duration of the neutropenic phase. Endogenous plasma GM-CSF, IL-3, and IL-4 levels were also measured in the study group and in healthy children. No significant correlation has been found between plasma GM-CSF concentrations and absolute neutrophil counts. However, IL-3 levels of the neutropenic patients positively correlated with platelet counts. Furthermore, IL-4 concentrations were positively correlated with the GM-CSF level in the same individual. Plasma GM-CSF, IL-3, and IL-4 levels in the neutropenic solid tumor group were found to be significantly higher than those in healthy children. Plasma IL-4 levels were significantly elevated in patients with osteosarcoma as compared to patients with other solid tumors. Although rHuGM-CSF has a half-life of only two to three hours, one day after rHuGM-CSF therapy, plasma GM-CSF levels were found to be higher than initial values. In contrast, plasma IL-4 values decreased significantly after administration of rHuGM-CSF. The probable mechanisms for the changes in cytokine levels are discussed.

Adolescent↗

A comparison of different filters for white cell reduction.

Removal of white blood cells (WBCs) from blood components before transfusion by filters with at least 3 log10 depletion may prevent or delay leukocyte-associated transfusion reactions such as HLA alloimmunization, non-hemolytic febrile reactions, transmitted infections (e.g., CMV, HTLV-1), and immunomodulation. The aim of this study was to compare the leukocyte removal efficiency (LRE) of six commercial bedside filters that are said to achieve 3 log10 (Bio R-01), Leucostop 4LT-1, Pall RC 50) and 4 log10 (Bio R-01 Plus, Pall RC 400, Pall RC XL-1) WBC depletion. A total of 430 units of whole blood ranging from 32 to 92 for each filter type were analyzed by an automated counter before and after filtration. Postfiltration blood samples were also evaluated for WBCs by Nageotte chamber. All the filters demonstrated leukocyte removal about 1 log10 less than the manufacturer's claim. The fourth generation filters showed a better performance than the third generation filters. Of them, Pall RC XL-1 showed the best efficacy with 99.93 percent leukocyte removal and a median residual WBCs of 1.6 x 10(6) per unit. These results indicate that the fourth generation filters, which are designed for the filtration of packed red cells, in particular Pall RC XL-1, are also able to reduce WBCs from whole blood below the critical antigenic leukocyte load (5 x 10(6)), and can be efficiently used for polytransfused patients to prevent alloimmunization.

Blood Group Incompatibility↗

Pro-inflammatory cytokines, lymphocyte subsets and intravenous immunoglobulin therapy in Guillain-Barré syndrome.

Both cell-mediated immunity and humoral factors are involved in the pathogenesis of Guillain-Barré syndrome (GBS). Intravenous immunoglobulin (IVIG) has been reported to be a practical, effective and safe treatment in childhood GBS, although the mode of action of IVIG remains uncertain. We studied pro-inflammatory cytokines (interleukin-2, interleukin-1 alpha and tumor necrosis factor-alpha) in plasma and cerebrospinal fluid (CSF) and lymphocyte subsets in peripheral blood both in the acute phase and in the recovery period in six children with GBS treated with IVIG. Flow cytometry was used to determine the subsets of lymphocytes in peripheral blood, and cytokines analyses were performed by using ELISA technique. Results were compared with a control group of 20 healthy children. A standard protocol of IVIG (400 mg/kg/day for 5 days) was administered to all the patients. Plasma interleukin-2 concentrations and the number of HLA DR+ active T cells in peripheral blood were significantly higher in the acute phase of the disease than in the recovery period and in healthy controls. There was no significant difference in the other cytokine concentrations in plasma and CSF or in the other lymphocyte subsets in peripheral blood. Our data indicate that IVIG may provide its possible therapeutic effect by acting in the cell-mediated immunity in GBS patients.

Adolescent↗