Experiences and attitudes of parents of children with cow’s milk and other food-allergy

Introduction and objective: The attitude and behaviors of parents are important in the man-agement of children with food allergy (FA). The aim of this study is to evaluate th e experi-ences and attitudes of parents of children with allergy to cow’s milk and other FA.Materials and methods: The parents of children with FA were asked to complete an 18-item questionnaire to evaluate the FA history and experiences during diagnosis, treatment, and follow up.Results:Th e dat a fro m 55 8 (91.2%) surve y questionnaire tha t wer e fille d completely wer e ana-lyzed. The mean age of the parents was 33.4+4.9. It was found that most common food aller-gen was cow’s milk (85.3%). The mean time to diagnosis from the onset of symptoms was 10.9±18.4 months. Around 22 9 parents (41.6%) admitted to at leas t fou r different physicians and 68 (12.3%) parents admitted to at leas t fiv e different physicians before diagnosis. Th e median time to d iagnosis from the o nset of s ymptoms was five ( 1-108) months in t he p atients admitted to four or more physicians, but it was one (1-48) month in the patients that admitted to less physicians (p<0.001). The most common symptoms were dermatitis and mucus-bloody stool, the least common ones were cardiovascular symptoms. Only 21.1% of the patients were able to use hypoallergenic formulas (HAF) in accordance with the recommendation of the physician.Conclusions: Delayed diagnosis of FA is a major concern, and during this period the patients admi t man y physicians. A majority of th e patients wit h CMP A experience difficulties while using HAFs, and only one-fifth of them is able to use formula regularly (AU)

Determining anatomical localisations of cervical oesophagus, hiatal clamp and oesophagogastric junction with oesophagogastroduodenoscopy.

BACKGROUND: In this study, the purpose was to determine the anatomical localisations of the cervical oesophagus length, hiatal clamp, and oesophagogastric junction depending on age and gender in patients who undergo oesophagogastroduodenoscopy (EGD). MATERIALS AND METHODS: The images of the patients who underwent EGD between 2018 and 2020 were analysed retrospectively in this study. The distance of the anatomical localisations of the cervical oesophagus length, hiatal clamp, and oesophagogastric junction to the anterior incisors, and the relations of this distance with the demographic characteristics and clinical manifestations of the patients were investigated on the EGD data. RESULTS: A total of 298 patients (174 women, 124 men) were included in the study. The cervical oesophagus length and the distance of the oesophagogastric junction and hiatal clamp localisation of the patients were found to be 15.06 ± 0.57 cm, 37.51 ± 2.23 cm and 38.62 ± 2.23 cm, respectively. It was also found that the mean values of all lengths in males were higher at a statistically significant level than in females (p < 0.001; p < 0.01). CONCLUSIONS: Knowing these anatomical localisations may be important in predicting complications that may occur in this region in EGD and planning the precautions to be taken. We also believe that it will guide clinicians in determining hiatal hernia and related deficiencies.

Evaluation of the Ocular Surface, Conjunctival Impression Cytology and Meibomian Gland Dropout in Patients with Familial Mediterranean Fever.

PURPOSE: Familial Mediterranean fever (FMF) is an idiopathic disease with chronic inflammation. We aimed to determine the changes caused by the chronic inflammatory nature of FMF on the ocular surface, meibomian glands (MG), and conjunctiva via conjunctival impression cytology (CIC). MATERIAL-METHOD: Forty-two FMF patients with a mean age of 11.93±3.92 years and 36 control patients with a mean age of 11.83±3.38 years were included in the study. Ocular surface anomalies of the patients were evaluated using Schirmer II, TBUT and OSDI. MG function (meibum quality), morphology (meiboography), and CIC were evaluated. RESULTS: Although there was a significant difference between the groups in terms of Schirmer II and TBUT, OSDI scores did not significantly differ (P=0.022, 0.010, and 0.099 respectively), and no significant dry eye sign was observed in either group. There was significant difference between the groups in terms of the percent area of MG dropout, MG density, meiboscore (P=0.020, 0.023, and 0.031 respectively), but no significant difference was observed in relation to MG quality (P=0.650). Although conjunctival impression cytology was of a higher grade in the patients with FMF according to Nelson's classification, no significant difference was observed between the groups (P=0.109). CONCLUSION: Although there was a decrease in the number of MGs in FMF patients, no significant deterioration was observed in conjunctival cytology. In these patients, tear film stability may deteriorate in particular. Clinicians should be aware of the possibility of ocular surface disease secondary to MG dropout in patients with FMF.

Coexistence of phylloides tumour and invasive ductal cancer in the breast.

Phylloides tumor in the breast is a rare fibroepithelial tumor, which is often seen in young adult women. Phylloides tumor of the breast accounts for about 1% of all breast tumors and approximately 3% of all fibroepithelial tumors. Pre-operative diagnosis is difficult. Since there aren't any specific mammography and ultrasound findings, they cannot be distinguished from fibroadenomas through these imaging methods and are mostly followed up as if they are fibroadenomas. Patients often present with the complaint of a mass that has been present for a long time and had started to grow suddenly. The primary preferred approach for treatment is wide local excision with negative surgical margins. Coexistence of invasive ductal carcinoma with phylloides tumor in the same breast is a very rare occurrence. We present in this article, a 42-year-old female patient with an invasive ductal carcinoma inside a phylloides tumor in the same breast.

Internet use patterns and Internet addiction in children and adolescents with obesity.

BACKGROUND: There are no data regarding the Internet addiction (IA) rates and patterns in youth with obesity. OBJECTIVE: This study aimed to explore the prevalence and patterns of IA in children and adolescents with obesity. The relationship between IA and body mass index (BMI) was also investigated. METHODS: Study includes 437 children and adolescents with age ranging from 8 to 17 years: 268 with obesity and 169 with healthy controls. The Internet addiction scale (IAS) form was administered to all participants. The obesity group also completed a personal information form including Internet usage habits and goals. Linear regression analysis was utilized to assess the contributions of Internet use habits and goals to BMI in the obesity group and IAS scores to BMI in both groups. RESULTS: A total of 24.6% of the obese children and adolescents were diagnosed with IA according to IAS, while 11.2% of healthy peers had IA (p < 0.05). The mean IAS scores for the obesity group and the control group were 53.71 ± 25.04 and 43.42 ± 17.36, respectively (p < 0.05). The IAS scores (t = 3.105) and spending time more than 21 h week-1 on the Internet (t = 3.262) were significantly associated with increased BMI in the obesity group (p < 0.05). Other Internet habits and goals were not associated with BMI (p > 0.05). The IAS scores (t = 8.719) were also found to be associated with increased BMI in the control group (p < 0.05). CONCLUSIONS: The present study suggests that obese children and adolescents were found to have higher IA rates than their healthy peers, and the results indicate an association between IA and BMI.

Thermal inactivation kinetics of hepatitis A virus in homogenized clam meat (Mercenaria mercenaria).

AIMS: Epidemiological evidence suggests that hepatitis A virus (HAV) is the most common pathogen transmitted by bivalve molluscs such as clams, cockles, mussels and oysters. This study aimed to generate thermal inactivation kinetics for HAV as a first step to design adequate thermal processes to control clam-associated HAV outbreaks. METHODS AND RESULTS: Survivor curves and thermal death curves were generated for different treatment times (0-6 min) at different temperatures (50-72°C) and Weibull and first-order models were compared. D-values for HAV ranged from 47·37 ± 1·23 to 1·55 ± 0·12 min for the first-order model and 64·43 ± 3·47 to 1·25 ± 0·45 min for the Weibull model at temperatures from 50 to 72°C. z-Values for HAV in clams were 12·97 ± 0·59°C and 14·83 ± 0·0·28°C using the Weibull and first-order model respectively. The calculated activation energies for the first-order and Weibull model were 145 and 170 kJ mole(-1) respectively. CONCLUSION: The Weibull model described the thermal inactivation behaviour of HAV better than the first-order model. SIGNIFICANCE AND IMPACT OF THE STUDY: This study provides novel and precise information on thermal inactivation kinetics of HAV in homogenized clams. This will enable reliable thermal process calculations for HAV inactivation in clams and closely related seafood.

Increased serum levels of GDF-15 associated with mortality and subclinical atherosclerosis in patients on maintenance hemodialysis.

BACKGROUND/AIMS: Increased carotid intima-media thickness (CIMT) was shown to be an independent predictor of cardiovascular (CV) mortality in dialysis patients and the general population. Growth differentiation factor 15 (GDF-15), a member of the transforming growth factor superfamily, is produced by cardiomyocytes and atherosclerotic lesions under stress conditions such as inflammation. We assessed associations between serum concentrations of GDF-15, mortality, and CIMT for subclinical atherosclerosis in hemodialysis (HD) patients. METHODS: A total of 87 patients on maintenance hemodialysis and 45 sex- and age-matched healthy controls were included in this prospective study. Serum GDF-15 levels were measured by ELISA. CIMT was assessed by Doppler ultrasonography. The association between serum GDF-15 levels and mortality was assessed using Cox regression analysis with serum levels categorized into two groups according to the median value (328.18 pg/ml). Patients were followed for 2 years and cause-specific and all-cause mortality were determined. RESULTS: The median level of serum GDF-15 was significantly higher in HD patients than controls [328 (198-522) vs. 176 (101-289) pg/ml, p < 0.01, respectively]. Serum GDF-15 levels were correlated to CIMT (r = 0.607, p < 0.001), C-reactive protein (CRP; r = 0.250, p = 0.010), HD duration (r = 0.376, p = 0.004), and serum albumin (r = - 0.156, p = 0.030). The multivariate analysis revealed that GDF-15 was found to be an independent variable of CIMT in HD patients. In the study, the serum GDF-15 level was an independent marker of all-cause of mortality when adjusted for age, CRP, and history of diabetes mellitus. CONCLUSION: The relationship between serum GDF-15, mortality, and carotid artery thickening suggests that GDF-15 may be a novel marker of atherosclerosis, inflammation, and malnutrition in HD patients.

Cervical lymphadenitis: tuberculosis or tularaemia?

Both tuberculosis cervical lymphadenitis (TCL) and oropharyngeal tularaemia (OT) have similar signs, symptoms and pathological findings. We aimed to investigate the frequency of tularaemia antibodies in patients diagnosed with TCL. Using data from the Tuberculosis Control Dispensaries between the years of 2008 and 2011 in Turkey, all patients diagnosed with TCL were informed about and included in the study. Control group subjects were selected from healthy blood donors who lived in the same region. After informed consent was obtained, the sera obtained from volunteer TCL patients and the control group were tested with a microagglutination technique for Francisella tularensis. Antibodies to Brucella were also investigated with a tube agglutination test for cross-reactivity in sera that were seropositive for tularaemia. Sera were obtained from a total of 1170 individuals in the TCL group and 596 in the control group from 67 of 81 provinces in Turkey. Francisella tularensis-positive antibodies were found in 79 (6.75%) cases in the TCL group and two (0.33%) cases in the control group with a titre of ≥1:80 (p < 0.01). When the presence of antibody of any titre was considered, the ratio became 8.2% (96/1170) in the TCL group and 0.67% (4/596) in the control group (p < 0.001). For the first time, with this study, tularaemia serology was found to be positive in a significant portion (6.75%) of diagnosed cases of TCL. In tularaemia endemic regions, it was concluded that tularaemia serology should be investigated in patients suspected of having TCL.

Short- and long-term effects of diethylstilboesterol administration during and after the cessation of Sertoli cell proliferation on the testis of domestic fowl.

1. This study examined the effects of diethylstilboesterol (DES), administered during and after Sertoli cell proliferation, on the testes of hatched cockerel up to the age of 20 weeks. 2. DES was injected into White Leghorn male chicks (200 ng/g body weight) over 10 d periods. The groups were first injected at 6, 8 and 10 weeks after hatching because Sertoli cell proliferation ceases at no later than 9 weeks. The birds first injected at 6 weeks and at 8 weeks were examined at 10 weeks, those first injected at 10 weeks were examined at 12 weeks and others, first injected at weeks 6, 8 and 10, were examined at 20 weeks. 3. In the birds killed at up to 12 weeks, the DES did not affect the Sertoli cell number of those first injected at week 6 and killed at week 10, although it did reduce the numerical density of seminiferous tubule containing late spermatids and increased seminiferous tubule not containing primary spermatocytes of the birds injected during weeks 6, 8 and 10. 4. In those killed at 20 weeks however, the DES did not cause any alteration in testis weight, gonado-somato index, seminiferous tubule volume, seminiferous lumen volume or comb height.

Correlation of slime production investigated via three different methods in coagulase-negative staphylococci with crystal violet reaction and antimicrobial resistance.

This study investigated slime production by coagulase-negative staphylococci (CNS) using the standard tube (ST), Congo red agar (CRA) plate and Christensen's tube (CT) methods, and compared the results with those of the crystal violet reaction (CVR) test. The potential correlation between slime production and antimicrobial resistance was also evaluated. In total, 205 CNS strains were isolated from biological samples: 92 (44.9%) were shown to produce slime by the ST method; 96 (46.8%) by the CRA plate method; 90 (43.9%) by the CT method; and 89 (43.4%) strains were CVR positive. Eighty-three (40.5%) CNS strains were positive for slime production by the ST, CRA and CT methods. The findings of the ST, CRA and CT test methods were consistent with each other but were not related to CVR positivity. Based on the ST method, rates of antibiotic resistance to several antimicrobial agents were higher in slime-positive strains than in slime-negative strains and, in some cases, this was statistically significant.

Platelet gel does not improve peripheral nerve regeneration: an electrophysiological, stereological, and electron microscopic study.

Although use of platelet gel (PG) for promoting tissue regeneration is a popular approach because of its capacity to accelerate tissue regeneration, to our knowledge, its effects on peripheral nerve have still not been elucidated. Therefore, the aim of this study was to investigate effects of PG on sciatic nerve regeneration using electrophysiology, stereology, and electron microscopy. The study was performed using five groups of rats: sham operated (Sham), collagen tube conduit (CT), collagen tube conduit plus platelet gel (CT + PG), autogenous nerve graft (ANG), and primary repair (PR) groups. Gap length for CT and CT + PG groups is 1 cm. Electrophysiology showed that nerve conduction velocity was not different among experimental groups; the amplitude of compound action potential of PR group was significantly higher than other groups. Examination of the nerves showed that Sham group not only had a larger axon diameter but also a thicker myelin sheath. A higher number of myelinated axon was found in both ANG and PR groups in comparison to Sham, CT, and CT+PG groups. There is no significant difference between morphological quantities of CT+PG and CT group. It was expected that regeneration degree of the nerve fibers of CT+PG group would be better than CT group, which was the control group permitting to disclose the presence of a positive effect of PG on nerve regeneration, but this was not the case. Therefore, our results suggest that PG does not improve axon regeneration after microsurgical reconstruction of a nerve gap by collagen tubes.

Distribution, optimum detection time and antimicrobial susceptibility rates of the microorganisms isolated from blood cultures over a 4-year time period in a Turkish university hospital and a review of the international literature.

This study retrospectively examined 8986 blood cultures from patients over a 4-year time period in an eastern Turkish university hospital to determine the detection times and distribution of isolated microorganisms using the automated BACTEC 9050 and BACTEC 9120 systems. A total of 1914 (21.3%) blood cultures contained pathogenic microorganisms and 252 (2.8%) positive cultures were considered contaminated. Of all the cultures, 18 (0.2%) were false positives and 224 (2.5%) were false negatives. In cultures containing pathogenic microorganisms, Gram-positive and Gram-negative bacterial isolation rates were 436 (22.8%) and 1440 (75.2%), respectively, and yeasts (all Candida sp.) were found in 38 (2.0%) cultures. Coagulase-negative staphylococci occurred in 936 (48.9%) cultures and Staphylococcus aureus occurred in 302 (15.8%) cultures. The mean detection time for all of the pathogens was 21 h and Brucella spp were isolated within 10 days. This study helps in understanding the epidemiology of the region and in providing positive therapeutic approaches. A review of the international literature helps to place this understanding into a global context.

An efficient stereological sampling approach for quantitative assessment of nerve regeneration.

AIMS: The aim of the present study was to find the most efficient sampling strategy for stereological analysis of peripheral nerve, including the number of myelinated nerve fibres, axon cross-sectional area and myelin sheet thicknesses of nerve fibres. METHODS: Two groups of rats underwent experimental resection of the tibial and peroneal nerves. The first group received tibial-peroneal end to end autograft repair (n = 6). Tibial and peroneal nerves were isolated, transected, and separated 1 cm distal to the trifurcation, where they lay adjacent to each other by a 1-cm gap, then repaired with an autologous nerve graft taken from the tibial nerve. The proximal stump of the tibial nerve and distal stump of the peroneal nerve were connected to each other by means of the nerve graft. The second group received tibial-peroneal repair with a flexible collagen tube (n = 6). After 90 days of recovery, animals were sacrificed and nerve segments were removed and sectioned for microscopy. Three different sampling strategies, that is, small, medium and large step sizes were applied to obtain each quantitative parameter. RESULTS: There are no significant differences between these sampling strategies with respect to total number of myelinated nerve fibres, axon cross-sectional area and myelin sheet thicknesses of nerve fibres. CONCLUSION: Findings show that one can achieve the desired estimate precisely with a rather large and less time-consuming sampling approach. In addition, it was observed that the size discrepancy of nerve regeneration can be improved by collagen tube conduit even with a 1-cm gap.

Sertoli cell proliferation during the post hatching period in domestic fowl.

There has been no study aimed at directly determining of the periods of Sertoli cell proliferation in birds even domestic fowl. The aims of this study were to observe the cessation of post-hatching mitotic proliferation of Sertoli cells in domestic fowl, and to determine the volume density of Sertoli and germ cells during this period. A total of 50 Leghorn chicks were used in this study. The testes sections of the animals were immunostained with BrdU to observe the proliferation of cells from one to 10 weeks of age. The volume density of the Sertoli and germ cells were determined using the standard point counting method. The volume density of the germ cell nuclei was initially less than that of the Sertoli cells but the volume density converged by week 6, and remained relatively constant until the commencement of meiosis. Clear labeling of Sertoli and germ cells was observed from week 1 to week 7. The only those cells still labeled after 8 weeks were germ cells, indicating that Sertoli cell proliferation had ceased. Therefore, it is recommended that any research into the testes of domestic fowl should consider the cessation of Sertoli cell proliferation by approximately 8 weeks.

An abattoir survey on bovine spongiform encephalopathy (BSE) in Turkey.

The aim of this study was to investigate Bovine Spongiform Encephalopathy (BSE) in Turkish cattle in the Marmara region which borders the European Union (EU). For this, cattle brought to abattoirs in Istanbul were analysed. The high risk group were selected and therefore 384 cattle above 2 years old were included in the study. They were primarily examined for the presence of any clinical signs of nervous system and also other clinical disorders. The whole brains were taken and analysed for the presence of vacuolar degeneration and prion protein by PLATELIA BSE test kit. Only 5 cattle were found to be nervous and showed aggressive behaviour. There were no cattle showing incoordination or other neurological disorders. Cysts were observed in 3 brains. Histopathologically, no vacuolar degeneration indicative of BSE was found in any cattle examined. However, in 8 brains, few vacuoles were observed in neurons in sections taken from the brain, cerebellum, medulla oblongata and medulla spinalis. Slight mononuclear cell infiltration in 9 brain, intensed mononuclear cell infiltration in 1 brain, haemorrhages in 5 brains and gliosis in 11 brains were also found. No infective prion was detected by ELISA in samples taken from 384 cattle brain.

Change in serum concentrations of interleukin-2 and interferon-gamma during treatment of tuberculosis.

We aimed to investigate changes in serum concentrations of the cytokines interleukin (IL)-2 and interferon (IFN)-gamma during the clinical course of active tuberculosis, to establish the presence of cellular immunity before and after treatment. Blood samples were taken from 18 patients with active tuberculosis before and 2 months after therapy; IL-2 and IFN-gamma concentrations were evaluated. The mean serum IL-2 concentration before therapy was 164.5 pg/ml (range 12-980 pg/ml) and the concentration 2 months after therapy was 92.11 pg/ml (range 1-490 pg/ml). The mean serum IFN-gamma concentrations were 10.83 pg/ml (range 1-22.2 pg/ml) and 4.64 pg/ml (range 1-28.5 pg/ml), respectively. The decrease in concentrations of both cytokines after therapy was statistically significant. Further studies investigating the benefits of adding cytokines to drug treatment for tuberculosis are needed.

Tinea capitis in Van, Turkey.

Forty patients with an average age of 6.5 +/- 3.2 years (28 male 12 female) who applied to the YYU Medical Faculty Dermatology Department outpatient clinic were investigated. Tinea capitis profunda was determined as the most frequent clinical type. The isolated dermatophytic flora of the patients consisted of Trichophyton verrucosum (43%), T. violaceum (30%), T. rubrum (23%) and T. mentagrophytes (3%). The patients with tinea capitis profunda were mostly from rural areas.

Epidemiological analysis of Staphylococcus aureus strains from nasal carriers in a teaching hospital.

The present study was conducted to assess the epidemiological relation of Staphylococcus aureus isolates from nasal carriers of hospital staff. Nasal swabs were taken from each of 327 personnel. After culturing on blood agar for overnight, probable staphylococcal isolates were identified and subjected to tube coagulase test. After a two-week interval, second nasal swabs were taken from the subjects whose first cultures were positive for S. aureus. Nasal carriage was defined in 58 (17.7%) personnel with positive culture for both sampling time. Antibiogram typing and arbitrarily-primed polymerase chain reaction (AP-PCR) with M13 primer were used for typing of the strains. Antibiotyping distinguished seven types and three subtypes, and 85% of the isolates were clustered in one group. AP-PCR, in contrast, identified 12 distinct patterns with 13 variants. A specific profile was not found among the isolates obtained from the personnel in a particular clinic. These results indicate that antibiotyping has poor discrimination power and heterogeneity among the nasal S. aureus strains in the hospital personnel screened is high.

Antioxidant vitamin levels in term and preterm infants and their relation to maternal vitamin status.

BACKGROUND: Lipid peroxidation plays a vital role in the pathogenesis of many neonatal complications. Preterm babies are especially predisposed to lung diseases and retinopathy, probably due to a deficiency in their antioxidant systems. Vitamins E, A, and C are part of the natural antioxidant defense systems. We aimed to determine the levels of vitamins E, A, and C in maternal and cord blood plasma of term and preterm infants and to investigate the relationships between these levels. METHODS: In the present study we determined vitamin E, A, and C levels in the umbilical cord blood of term (n = 30) and preterm (n = 22) infants and their mothers by HPLC. Blood samples were taken during delivery. RESULTS: Levels of lipid soluble antioxidant vitamin E and A in cord blood were lower than maternal values (p <0.01, p <0.05, respectively). Conversely, the level of water-soluble vitamin C was higher in cord blood than in maternal level (p <0.05). Significantly higher levels of vitamins E, A, and C were found in term babies as compared with those born preterm (p <0.05). CONCLUSIONS: There was a positive correlation between maternal and cord blood levels of vitamins E and A (r = 0.775, r = 0.725, respectively). In conclusion, preterm babies have fewer lipid-soluble antioxidant vitamins in their serum compared to term infants. Therefore, it is possible to postulate that preterm infants are more susceptible to oxidative stress.