BackgroundThe objective of this study is to assess the index of decayed, missing and filled teeth (DMF-T), habit of brushing teeth, and the microbiological agents accumulating on the children’s toothbrushes for 4 weeks and response of these agents to disinfection via a chlorhexidine solution, then compare those results with the education and income levels of the children’s parents.MethodIncluded in the study were 187 children (96 in the control group and 91 in the experiment group – chlorhexidine) chosen randomly from 600 kindergarten children whose ages ranged from 24 months to 72 months. The children selected had not taken any antibiotics, antimicotics for three months and dental treatments during this trial. The distribution of these children to the groups was also done randomly. After performing a survey for the education, occupation, and income status of the parents, the children were examined and the number of decayed teeth was recorded. The children were given toothbrushes, toothpaste (with fluroide), and the solutions (including distilled water and chlorhexidine) for four weeks under the condition that toothbrushes were returned at the end of each week. The 14 different microbiological agents observed as a result of the assessment of the samples taken in the first week were also included in the assessments of the samples taken over the four-week period.ResultsThe decrease in the DMF-T index was found to be meaningful according to the differences in education, income, and occupation status of the parents. Of all the samples taken from the toothbrushes, the bacteria with the greatest rate of reproduction included Streptococcus mutans, Escherichia Coli, Pseudomonas aeuroginosa, Enterococcus spp, Staphylococcus epidermidis and Candida albicans. Except for Candida albicans, the other microorganisms taken as samples from the toothbrushes reproduced less overall. In the group using the solution with chlorhexidine, a meaningful decrease in bacterial reproduction was discovered compared to the control group.ConclusionThe findings of this study show that the education, occupation, and socioeconomic situations of the parents should be considered when discussing children’s oral and dental health. Moreover, the study shows that disinfection of toothbrushes in order to prevent reinfection and contamination oral flora with the bacteria again is important in terms of preventive medicine and family-children health.
Objective: Nowadays nearly, Acinetobacter baumanniihas become an incurable nosocomial infections’ pathogendue to its ability developing multiple resistance againstantibiotics strains In our study, it was aimed to determinerates of resistance of A. baumannii strains isolated fromvarious samples in the Dicle University Hospital.Methods: A. baumannii culture results of 270 patientsthat were followed in the Dicle University Medical FacultyHospital between June 2010 and June 2011 wereevaluated. Resistance rates of A. baumannii strains werecultured by conventional methods and BD Phoenix (BDDiagnostic Systems, Sparks, MD) automated system.Results: Our study included 82 (30.4%) female and 188(69.6%) male. Resistance rates of A. baumannii strainswere as follows: amikacin (76%), ampicillin / sulbactam(94%), aztreonam (96%), cefepime (95%), cefotaxime(98%), ceftazidime (95%), ciprofloxacin (93%), colistin(6%), gentamicin (94%), imipenem (87%), levofloxacin(87%), meropenem (87%), piperacillin / tazobactam(92%), tetracycline (84%), trimethoprim / sulfamethoxazole(82%).Conclusions: A. baumannii strains isolated from ourcultures have very high rate of resistance against antimicrobialagents except colistin. It should not be forgottenthat antibiotic susceptibility may change from year to yearin the regions, hospitals and even clinics, and resistancerates should be continuously monitored. When selectingempiric treatment, resistance rates of A. baumannii of thatlocation should be considered until having culture results.In the infections caused by A. baumannii cultures and antibiogramsshould be repeated during treatment becausethat A. baumannii strains may change resistance ratio. JClin Exp Invest 2013; 4 (3): 318-321Key words: A. baumannii, antibiotic, resistance
The incidence of sleep-disordered breathing (SDB) increases in chronic lung diseases. Our aim was to evaluate SDB and sleep quality in children with postinfectious bronchiolitis obliterans (BO) and assess associated risk factors. We hypothesized that children with BO are at increased risk for SDB and have impaired sleep quality. We also hypothesized that severity of SDB and impairment of sleep quality is related to the severity of lung disease. Sleep Related Breathing Disorder (SRBD) subscale of the Pediatric Sleep Questionnaire (PSQ) and Pittsburgh Sleep Quality Index (PSQI) questionnaires; spirometry, impulse oscillometry (IOS), and overnight polysomnography (PSG) were performed. Twenty-one patients (14 male, median age: 8.3 years) were enrolled. Five patients (25%) had a PSQ score of >0.33, predictive of a SDB. Ten patients (48%) had poor sleep quality. Four patients (19%) had an OAHI of >1/hr. Nineteen patients (90%) had a high desaturation index. Four patients (19%) had a mean oxygen saturation of <93%. Median central apnea time was 7.5 (IQR: 6.9-9.1) seconds. Central apnea index of the patients correlated positively with R5, R10, R15, R20, Z5, and negatively with X10 and X15 at IOS. There was a positive correlation between the lowest oxygen saturation and FVC, FEV1 , X5, X10, X15, X20 while there was a negative correlation between lowest saturation and the central apnea index at PSG, R5, R10, and Z5 at IOS. Mean oxygen saturation during PSG correlated positively with FVC, FEV1, FEF(25-75), X5, X10, X15, X20 results. The risk of nocturnal hypoxia is increased in patients with BO and correlated to the severity of lung disease determined by pulmonary function tests. Although BO patients have a shorter duration of central apneas, they are more prone to desaturate.
In these case series, we report on six children (3 girls, 3 boys) aged 5-13 years with Henoch-Schönlein purpura (HSP) who developed severe gastrointestinal (GI) bleeding resistant to both 2 mg/kg or pulse (10-30 mg/kg) i.v. methylprednisolone. All patients responded to single-dose (500 mg/m(2) ) i.v. cyclophosphamide (CPA) and none of them developed new GI bleeding after CPA treatment. No patients required surgical intervention. Single high-dose CPA may be beneficial in HSP with severe GI involvement, in which bleeding is non-responsive to high-dose steroids.
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