[Detection of human bocavirus DNA by polymerase chain reaction in children and adults with acute respiratory tract infections]. / Akut solunum yolu enfeksiyonlu çocuk ve eriskinlerde insan bokavirus DNA'sinin polimeraz zincir reaksiyonu ile saptanmasi

Human bocavirus (HBoV) which was described in 2005 by molecular techniques, is a member of Parvoviridae. The role of HBoV is being questioned in acute respiratory diseases (ARD) in many recent studies. The aim of this study was to determine the presence of HBoV DNA in the respiratory specimens of patients with ARD. A total of 155 throat swab and/or washing specimens from 76 children and 79 adults with ARD were examined. HBoV DNA was investigated by single step in-house polymerase chain reaction (PCR) using NS1 primers (5-'TATGGCCAAGGCAATCGTCCAAG-3', 5'-GCC GCGTGAACATGAGAAA-CAG-3') which amplify the 290 base pair region of NS1 gene located between nucleotides 1545-1835 of prototype HBoV st1 strain. HBoV DNA was detected in 5 (6.5%) of 76 children and 2 (2.5%) of 79 adults. Three sequenced samples showed 100% homology with the reference sequences. This study in which HBoV DNA was detected in children and adults with ARD, is the first HBoV prevalence study in Turkey. Larger scale prospective clinical and molecular studies are required to explain the association between HBoV and respiratory disease.

Purified protein derivative response in juvenile idiopathic arthritis.

OBJECTIVE: To examine the purified protein derivative (PPD) response that develops depending upon Th1 immune response in children with juvenile idiopathic arthritis (JIA). METHODS: PPD skin test was performed in 115 children with JIA who were vaccinated with bacillus Calmette-Guerin (BCG), and then they were compared to the PPD response of 45 healthy children of the same age who were vaccinated with BCG. Children with a PPD induration > or = 5 mm were accepted as PPD-positive. PPD induration > or = 10 mm was accepted as a limit for suspecting tuberculosis. RESULTS: PPD induration size and PPD positivity rates (PPD > or = 5 mm) of children with JIA were significantly lower than those of healthy children. The mean of PPD induration size was significantly lower (p < 0.0001) in patients with either 1 BCG vaccine (3.7 +/- 3.6) or more than 1 BCG vaccine than controls with either 1 BCG vaccine (7.10 +/- 3.2) or more than 1 BCG vaccine (10.05 +/- 4.1). PPD was positive in 35.9% of patients with JIA vaccinated once (n = 32), in 50% of patients with JIA vaccinated more than once (n = 13), in 82.1% of controls vaccinated once (n = 23), and in 88.2% of controls vaccinated more than once. This result was statistically significant (patients, p = 0.03; controls, p = 0.039). It was determined that neither the activity of the disease nor the use of corticosteroid and methotrexate affected the PPD response. CONCLUSION: The response to PPD, which is one of the Th1 cell-type responses, was significantly lower in BCG-vaccinated children with JIA compared to healthy children.

Nicolau syndrome after intramuscular benzathine penicillin treatment.

Nicolau syndrome (livedoid dermatitis) is a very rare complication of intramuscular injections and manifests as excruciating pain immediately after injection. We describe a 3-year-old boy with diagnosis of Nicolau syndrome after intramuscular benzathine penicillin injection to the midanterior part of the left thigh. He was treated with hyberbaric oxygen and pentoxyphilline in addition to supportive treatment and recovered with no sequelae.

Vestibular neuritis caused by enteroviral infection.

Vestibular neuritis is characterized by the sudden onset of nausea, vomiting, and spontaneous horizontal or horizonto-rotatory nystagmus. The etiology of the disease is multifactorial. Mumps, rubella, herpes simplex virus type 1, cytomegalovirus, and Epstein-Barr virus may have a role in the disease. Enteroviruses are among the other rare causes. This report presents a 7-year-old male admitted with nausea, vomiting, rotatory vertigo, horizonto-rotatory nystagmus with positive Romberg's sign and positive head-thrust test. Cranial magnetic resonance imaging and audiometry of the patient were normal. He was diagnosed with vestibular neuritis, and steroid therapy was initiated. At the second month of follow-up, all symptoms had regressed. To the best of our knowledge, this case report describes the first pediatric patient in whom enteroviral ribonucleic acid is documented both in cerebrospinal fluid and in nasopharyngeal material in active disease. This finding supports the possible role of enteroviruses in the etiology of vestibular neuritis.

Is the mycobacteria-derived purified protein response in atopic asthmatic children different?

BACKGROUND: The response to mycobacteria-derived purified protein (PPD) is mediated primarily by T-helper-1 response and is expected to be inhibited in atopic diseases. The aim of this study was to investigate whether the PPD response is different in atopic asthmatic children. METHODS: 40 atopic asthmatic children (mean age 8.3 +/- 4.9 years) and 40 healthy age- and sex-matched children who had received bacillus Calmette-Guerin (BCG) vaccination were included in the study. Five PPD units were administered intradermally to all children and were interpreted after 48 h. RESULTS: There was no correlation between serum total IgE level and PPD induration (p=0.054). The PPD induration was not statistically different between the children who used inhaled corticosteroid and those who did not. Although the PPD positivity (induration > or =5 mm) rate was higher in atopic asthmatic children (50%) than in healthy children (32.5%), the difference was not found to be statistically significant. The PPD induration in atopic asthmatic children (7.41 +/- 5.58 mm) was found to be greater than the one in healthy children (5.21 +/- 3.39) (p < 0.039). The induration in atopic asthmatic children (5.21 +/- 3.77) and healthy children (4.43 +/- 2.32) did not show a difference in children who where vaccinated only once with BCG, but it was found to be statistically significantly greater in atopic asthmatic children (12.50 +/- 5.90) than healthy children (7.08 +/- 4.70) who were vaccinated with BCG twice (p <0.012). The proportion of having a PPD induration of > or =10 mm was found to be higher in atopic asthmatic children than in the healthy ones (32.5 vs. 12.5%) (p <0.032). CONCLUSION: Our data showed that the PPD response was stronger in BCG-vaccinated atopic asthmatic children than in healthy BCG-vaccinated ones.

Clinical spectrum of acute abdominal pain in Turkish pediatric patients: a prospective study.

BACKGROUND: The aim of the present study was to determine the prevalence, associated symptoms, and clinical outcomes of children with acute abdominal pain who had been admitted to an emergency department. METHODS: Children aged between 2 and 16 years who presented to the emergency department of Cerrahpasa Medical School, Istanbul University between July 2001 and August 2002 with acute abdominal pain were enrolled in this study. A questionnaire was completed each patient admitted to our pediatric emergency unit for acute abdominal pain. Data collected included presenting signs and symptoms, the hospital follow up for all children who returned within 10 days, test results, and telephone follow up. RESULTS: The number of children referred to the emergency department was 7442, with 399 (5.4%) of these having acute abdominal pain. The mean age of the study population was 6.9 +/- 3.5 years, and 201 of the patients were male. The five most prevalent diagnoses were: (i) upper respiratory tract infection and/or complicated with otitis media or sinusitis (23.7%); (ii) abdominal pain with uncertain etiology (15.4%); (iii) gastroenteritis (15.4%); (iv) constipation (9.4%); and (v) urinary tract infection (8%). The most common associated symptoms were decreased appetite, fever and emesis. Because of follow-up deficiency the progress of 28 patients was not obtained. Eighty-two children were referred to the department of pediatric surgery, but only 17 of 82 (20.7%) required surgical intervention (15 of these 17 for appendicitis). Eleven patients returned within 10 days for re-evaluation, but the initial diagnosis was not changed. The complaints of 57 patients with uncertain etiology were resolved within 2 days. CONCLUSIONS: An acute complaint of abdominal pain was usually attributed to a self-limited disease. However, the percentage of surgical etiology is not negligible.