Turkish version of C-ACT is an accurate and reliable tool to evaluate asthma control in children aged 4-11 years. Its widespread use may facilitate appropriate assessment of asthma control and may lead to decrease the number of uncontrolled patients.

Asthma is a disease where there is an accumulation of collagen in the reticular basal membrane of the airway leading to chronic inflammation. The enzyme prolidase plays an important role in the breakdown of collagen and the breakdown of intracellular protein especially in the final stage when peptides and dipeptides contain a high level of proline. To evaluate the relationship between prolidase activity and oxidative status in asthma patients. Comparison was made between 42 patients diagnosed with bronchial asthma and 32 healthy children of similar age and gender. Serum prolidase activity was measured spectrophotometrically. Oxidative status was determined using total antioxidant capacity (TAC) and total oxidant status (TOS) measurement. The prolidase activity of the asthma patient group was statistically significant compared with the control group (P< or =0.001). TAC and TOS levels in the asthma patient group were higher than the control group (P< or =0.001, P< or =0.002, respectively). No correlation was found between the prolidase and oxidative levels of the two groups. A positive correlation was determined between the prolidase activity and TAC in the asthma patient group (P< or =0.001, r=0.501). The prolidase enzyme activity, which plays a role in the collagen turnover, was low in the asthma patients; therefore, their collagen metabolism had undergone a change and this indicates that there may be an effect on the accumulation of collagen in the reticular basal membrane. Moreover, the high level of TOS indicates that these patients were exposed to severe oxidative stress with an increased TAC response.

The combination of oral restriction and surgical procedures may be a causal factor in ceftriaxone-associated biliary pseudolithiasis. It is emphasized that when gallstone and/or sludge are detected in the gallbladder in children by ultrasonographic examination, the administration of ceftriaxone must be sought beyond other causative factors.

We aimed to investigate the relationship between quantitative Plasmodium vivax parasitaemia and serum cytokine levels in a highly endemic region of Turkey, where such a relation has not been investigated before. Active screening was done in a total of 1316 people residing in 33 villages of Sanliurfa province, Turkey. The study population consisted of 79 consecutive patients with P. vivax malaria, and a control group included 89 healthy subjects. Thick blood smears were examined for malaria parasite and parasite count. Serum samples were analysed for IL-1beta, IL-2, IL-4, IL-6, IL-8, IL-10 and IL-12 by the ELISA method. Compared to controls, levels of pro-inflammatory cytokines, i.e. IL-1beta, IL-6 and IL-12, were significantly higher in patients with parasitaemia. There was a significant positive correlation between serum IL-10 and IL-12 levels and the parasite burden (r = 0.264, P = 0.024 and r = 0.264, P = 0.024, respectively). Serum IL-8 levels showed a significant negative correlation with parasite burden (r =-0.356, P = 0.002). There was a positive correlation between IL-8 levels and age, while the opposite was observed for IL-12. High fever was correlated with IL-6 and IL-10 levels. Compared to controls, patients with a parasite count greater than 5000/microL had a significantly higher IL-1beta and IL-10 levels (P < 0.05), while the difference was not significant for patients with a parasite count less than 1000/microL. Thus, we can conclude that pro-inflammatory response against P. vivax gains more importance during periods of increased parasite burden.

Objective: To compare paraoxonase activity and changes in oxidative status in asthmatic children and healthy children by determining serum paraoxonase activity and total oxidative status, total antioxidant capacity and lipid hydroperoxidation. Methods: Forty two asthmatic children were compared with 32 healthy children of similar age and sex. To evaluate the paraoxonase and oxidative status, total antioxidant capacity and lipid hydroperoxidation were examined. Serum paraoxonase activity was evaluated by measuring the rate of paraoxon hydrolosis. Oxidative status was evaluated by the method developed by Erel. Lipid hydroperoxide was measured by an iodometric method. Results: In comparison with the healthy control group, the paraoxonase activity of the asthmatic children was found to be low (163.7 ± 73.0 (U/L) and 349.2 ± 153.9 (U/L), P = 0.002) and total oxidant status (9.0 ± 3.5 µmol H2O2 Eq/L and 13.4 ± 7.0 µmol H2O2 Eq/L, P =0.002), total antioxidant capacity (5.5 ± 2.5 µmol Trolox Eq/L and 1.0 ± 0.6 µmol Trolox Eq/L, P < 0.001), and lipid hydroperoxidation values (9.9 ± 3.4 µmol H2O2 Eq/L and 4.4 ± 1.5 µmol H2O2 Eq/L, P < 0.001) were found to be high. The high density lipoprotein (HDL) concentration of the asthmatic children was lower than that in the control group (40.1 ± 9.2 mg/dl and 54.5 ± 15.9 mg/dl, P < 0.001) Conclusion: In asthmatic children, when total oxidant status, total antioxidant capacity and lipid hydroperoxidation levels increase, paraoxonase activity decreased.Coronary heart disease (CHD) is a major killer and the most common cause of mortality and morbidity in the world. 1 It usually involves middle and older age groups but, recently, the incidence of CHD in younger individuals has been increasing. 2 Atherosclerosis is a process that starts in childhood and has a long preclinical phase before leading to clinical manifestations which usually appear in middle age. 3 Changes in the peripheral vascular endothelium are the earliest signs of atherosclerosis and CHD. 4 This has been demonstrated in asymptomatic children and young adults who are healthy but carry risk factors for atherosclerosis (e.g., high cholesterol, smoking, diabetes). 5 HDL retards the accumulation of lipid peroxides on LDL cholesterol 6 apparently due to paraoxonase which is an enzyme located on HDL particles. 7 Paraoxonase has two functions. First, it contributes to detoxification of organophosphorous compounds, including the pesticide paraoxon. Secondly, it hydrolyzes lipid peroxides and prevents LDL oxidation. 8 In both asthma and atherosclerosis, leukotrienes, which are potential inflammation mediators, play a role. 9,10 Some studies have suggested that asthma itself could be a risk factor for stroke and heart ORIGINAL RESEARCH

The purpose of this study was to investigate serum prolidase activity and its relationship with collagen metabolism and joint hypermobility, and to determine the prevalence and characteristics of joint hypermobility in prepubertal children. Serum prolidase activity was measured spectrophotometrically. Joint hypermobility was defined using Beighton criteria. The children underwent complete history and physical examination. Serum levels of prolidase were lower in the hypermobile group compared with controls and no statistical difference (1,598.61 +/- 54.99, 1,741.89 +/- 57.54; P > 0.05). However, there was significant negative correlation between prolidase level and Beighton score (r = -0.295, P = 0.002). The prevalence of hypermobility was distributed as follows: >or=4, 39.3%; >or=5, 22.7%; >or=6, 13.3%. There was correlation between joint hypermobility and pes planus (P = 0.006), arthralgia (P = 0.042), and musculoskeletal disorders in mother and/or father (P < 0.001). The decrease in prolidase activity may be related with collagen metabolism in joint hypermobility Therefore, joint hypermobility appeared to warrant further investigation due to concomitant signs and symptoms.

Increased production of reactive oxygen species leading to an imbalance between the oxidative forces and the antioxidant defense systems favoring an oxidative injury has been implicated in the pathogenesis of asthma. The aim of the study was to investigate the peripheral DNA damage, and its association with oxidative and antioxidative measurements in children with asthma bronchiale. The study population contained 42 children with asthma bronchiale and 32 healthy controls. DNA damage was assessed by alkaline comet assay in peripheral lymphocytes. Plasma levels of total antioxidant status (TAS), total peroxide concentration (LOOHs), and total oxidant status (TOS) were determined. In asthma bronchiale patients, DNA damage was significantly higher than in controls (17.9 +/- 11.8 AU vs. 1.2 +/- 2.0 AU, p < 0.001). Plasma TOS and LOOHs were higher in patients than in healthy controls (13.4 +/- 7.0 vs. 9.0 +/- 3.5, p = 0.002; 9.9 +/- 3.4 vs. 4.4 +/- 1.5, p < 0.001, respectively). Plasma TAS level in patients was higher than in healthy controls (5.5 +/- 2.5 vs. 1.0 +/- 0.6, p < 0.001). DNA damage was correlated with TOS (r = 0,616, p < 0.001). The findings indicated that lymphocyte DNA damage level increases in children with asthma bronchiale. Elevated DNA damage may be related to increased oxidative stress. However, the mechanism of this association, and whether it is direct or indirect, remains to be explored.

Regular physical activity may play a protective role against cardiovascular disease in adults, and paraoxonase activity may serve to mediate this effect. This study compared paraoxonase activity and that of other antioxidative agents in adolescent athletes compared with inactive youth. Paraoxonase level was 177.32 +/- 100.10 (U/L) in children with regular physical activity and 98.11 +/- 40.92 (U/L) in the control group (P < 0.0001). The levels of total antioxidative capacity, total oxidative status, oxidative stress index, and lipid hydroperoxide were significantly higher in the athlete group compared with controls (P < 0.0001). Paraoxonase activity was found to be greater in adolescent athletes, suggesting that regular exercise might provide a cardio-protective effect by this means.