Between September 2004 and December 2005 a prospective study was conducted to understand the epidemiology of rotavirus infection among children with diarrhea attending two hospitals in Ankara, Turkey. Rotavirus was detected in 39.7% of the 322 stool samples and affected mainly children in the age group of 6-23 months. More than 70% and 39% of these cases occurred in children <2 and <1 year of age, respectively. In the temperate climate of Ankara rotavirus infection was prevalent throughout the year. Serotype G1P[8] was dominant followed by G9P[8]. In 38 samples a total of 5 electropherotypes were detected. All G9P[8] were of long electropherotype except one of short electropherotype. A proportion of G1 and G9 strains were in combination with P[6], P[4] or P nontypable. Mixed serotypes were responsible for 2.4% of the infections. A phylogenetic tree constructed with the deduced amino acid sequences of the VP7 gene showed that 16 Turkish G9 strains clustered with rotaviruses of lineage III. One G9 strain formed a new lineage, lineage IV with the Sri Lankan G9 rotaviruses. In the phylogenetic tree of the VP8* gene, the Turkish G9P[6] rotaviruses clustered with human strains of lineage Ia. Increased diversity of the G/P type combination and the presence of infection throughout the year in Turkey was a situation similar to developing countries. The occurrence of rotavirus infection at later age and low level of mixed infections in Turkey represented the situation of developed countries. This study suggests that diverse G9 rotaviruses are emerging in Turkey.

Chronic low-dose exogenous steroid therapy in children can result in hypothalamic-pituitary-adrenal axis dysfunction. However, the development of Cushing syndrome from topical steroid therapy is unusual. A 9-month-old girl with a diagnosis of Cushing syndrome caused by long-term topical clobetasol propionate application was evaluated. The patient was found to have severe adrenal suppression. Limiting the use of steroid-containing drugs, prescription of less potent agents, especially during infancy, and warning of parents about potential side effects are very important.

Background: It is important to understand that allergic rhinitis, whether seasonal or perennial, may be difficult to distinguish clinically from the nonallergic forms of rhinitis. Objective: This study aimed to investigate the presence of local allergic rhinitis (LAR) in children who have allergic rhinitis symptoms in the absence of skin test positivity and specific IgE by performing a nasal provocation test (NPT). Methods: Our study followed a case-controlled, prospective design. Twenty-eight patients and 30 healthy children were included in the study in a pollen-free season. The NPTs with a grass mix, Dermatophagoides pteronyssinus (DP) and D. farinae (DF) allergens were performed with an interval of 1 week. The total symptom score and visual analog scale, nasal eosinophilia and pulmonary function tests were evaluated before and after each NPT. The change to nasal flow and resistance was recorded by anterior rhinomanometry. Results: The symptom frequencies before the NPTs were as follows: nasal congestion 100%; itching 82.1%; rhinorrhea 75% and sneezing 71.4%. The NPT was positive in 7 (25%) patients. In the NPT-positive group there was a statistically significant decrease in nasal flow at the concentrations of 10 and 100 IR/ml for DF (p = 0.026, p = 0.031, respectively). In the NPT-positive group total nasal resistance for DP was increased at the concentrations of 0.1 and 10 IR/ml, and for DF at 10 and 100 IR/ml (p = 0.049, p = 0.041, p = 0.022, p = 0.035, respectively). Conclusions: We emphasize that the diagnosis of LAR should be taken into consideration by pediatricians and pediatric allergy specialists.

The World Health Organization (WHO) reports that pertussis remains one of the least well-controlled vaccine-preventable diseases. It is supposed that the incidence of reported pertussis among adolescents, adults, and young infants has increased over the past decade. The aim of this study is to evaluate recent epidemiological data on pertussis in Turkey by regions. Data on vaccination coverage and pertussis incidence between 1986 and 2005 obtained from the Expanded Programme on Immunization national surveillance database of the Ministry of Health of Turkey were analyzed. Age and geographical distribution of the reported cases between 2000 and 2005 were evaluated. It was found that third-dose vaccination coverage increased from 1986 (45%) to 2005 (90%). In 2005, pertussis incidence tended to decrease (0.38 per 100,000) compared to 1986 (2.03 per 100,000). Even though only up to 6.5% of the cases were > or =15 years of age until 2005, 16.9% of them were included in this age group in 2005. It was observed that vaccination coverage rates steadily increased and pertussis incidence decreased by years despite some regional differences. In Turkey, pertussis incidence appears to be reaching the WHO targets, except East Anatolia. It is possible that waning immunity is responsible for the change of the age distribution of pertussis cases. However, priority should be given to strengthening available vaccination efforts throughout the country. A booster dose of pertussis vaccine in adolescence might be required in the future.

Zinc deficiency may be suspected to play a role in the pathogenesis, control, and severity of asthma because of its antioxidant, antiapoptotic, and anti-inflammatory effects. We aimed to investigate whether there was any relationship between erythrocyte zinc levels and childhood asthma. The erythrocyte zinc levels of 67 asthmatic and 45 healthy children were analyzed in this case-control study. The mean concentrations of erythrocyte zinc were 1215.8 ± 145.1 µg/dl in asthma patients and 1206.9 ± 119.5 µg/dl in controls with no significant difference (P = 0.472). The erythrocyte zinc level was below 1,000 µg/dl in 6 asthmatic patients (8.9%) and 2 control group patients (4.4%). There was no relationship between erythrocyte zinc levels and duration of follow-up, severity, and control of the asthma (P > 0.05). On the other hand, patients hospitalized for an asthma attack had significantly lower erythrocyte zinc levels compared with nonhospitalized patients and the control group (P = 0.000 and P = 0.004 respectively). This study's findings indicate that asthmatic children are not a risk group for zinc deficiency. We emphasize that checking zinc levels in children who are hospitalized for an asthma attack may be useful.