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.
This study was conducted to understand the pathogenetic mechanisms that are involved in the development of bone loss in children with severe haemophilia A (HA). Fourty-four children with severe HA and 40 age- and gender-matched healthy control subjects were enrolled in this study. Markers of bone remodelling and osteoclast regulation including serum bone specific alkaline phosphatase, parathormone, 25-hydroxy-vitamin D(3) (25HOvitD(3)), osteocalcin and calcitonin levels were studied. Bone mineral density (BMD) was also studied in all children. The measurement of markers of bone remodelling and osteoclast regulation suggested increased osteoclast-mediated resorption activity in children with severe HA. Although serum parathormone levels were significantly increased, serum 25HOvitD(3) and osteocalcin levels were significantly reduced. BMD was significantly reduced in severe haemophilics compared with healthy controls. There was also significant inverse correlation between BMD z-score and total joint scores, and insignificant inverse correlation between BMD z-score and single joint scores. There were also significant inverse correlation between 25HOvitD(3) and osteocalcin levels and total joint scores. Children with severe HA could have significantly reduced BMD, compared with gender- and age-matched healthy control subjects. Our results of the markers of bone remodelling and osteoclast regulation suggested that increased osteoclast-mediated resorption and decreased osteoblastic activity in children with severe HA. All children with severe HA should be routinely screened in terms of BMD.
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.
The aim of the study was to evaluate the antioxidative Cu/Zn-SOD (superoxide dismutase) response to obesity-related stress in obese children compared to a similar-aged control group. Forty-eight exogenic obese children and 11 healthy children were compared for red cell Cu/Zn-SOD, glucose, and lipid profiles and the relations between them were investigated. Antioxidant response as Cu/Zn-SOD was significantly higher in the obese group (p<0.05). Although glucose and lipid levels were statistically higher in the obese group, a certain relation with the SOD level was not established in childhood. This is the first study showing the oxidative stress caused by obesity and related antioxidative response even in the childhood period. Interventions, including diet modifications, should be kept in mind to diminish the obesity-related oxidative stress from the childhood period.
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