Measles seroprevalence of an adolescent population vaccinated with a single dose of measles vaccine before their first birthday

This study determined the age-specific measles seroprevalence of an adolescent population in Ankara vaccinated with a single dose of measles vaccine before their first birthday. The study sample included 440 adolescents (227 female, 213 male) aged 9-16 years admitted to the Adolescent Outpatient Clinic of Hacettepe University Faculty of Medicine. For each participant, a questionnaire was completed and measles specific IgG antibodies screened quantitatively by the enzyme linked immunosorbent assay. Of the 440 subjects screened for measles antibodies, 114 (25.9 %) were seronegative. Measles seronegativity according to sex and age groups were, 32.6, 24.7, 13.3% in females and 29.5, 30.1, 6.3% in males in the age groups of 9-11, 12-14, 15-16 years, respectively. In countries where the two dose vaccination schedule against measles has not been incorporated to the national immunization program, the adolescent health maintenance visit at age 11-12 years should serve as an opportunity to evaluate vaccination status and administer MMR vaccine to all adolescents who have not received two doses at the recommended ages.     

Psychiatric symptoms of adolescents with physical complaints admitted to an adolescence unit

SUMMARY: The aim of this study was to evaluate the psychiatric symptoms among adolescents who were seen in the outpatient clinic for their physical complaints. Two hundred and ninety adolescent outpatients (154 males and 136 females) between 13 and 17 years of age (mean 14.3+/-1.2) are included in this study. Patients with known psychiatric disorders, mental retardation, organic brain diseases, or chronic organic problems were excluded. The Brief Symptom Inventory, which measures the psychiatric symptoms under the categories of anxiety, depression, negative self, somatization, and hostility, was given to all subjects. Symptoms of urinary and cardiovascular systems were related to hostility. Patients with obesity, hirsutism, problems of external genitalia, enuresis nocturna, abdominal pain, chest pain, and lack of weight gain showed psychiatric symptoms at pathological levels. Hostility symptom was found to be high in all groups.     

Feasibility of kangaroo mother care in Mumbai

Objective: The purpose of this study was to determine the feasibility and acceptability of kangaroo care in a tertiary care hospital in India.Methods: A randomized controlled trial was performed over one year period in which 89 neonates were randomized into two groups kangaroo mother care (KMC) and conventional method of care (CMC).Results: Forty-four babies were randomized into KMC group and 45 to CMC. There was significant reduction in KMCvs CMC group of hypothermia (10/44vs 21/45, p-value<0.01). There were no statistically significant differences in the incidence of hyperthernia, sepsis, apnea, onset of breastfeeding and hospital stay in two groups. 79% of mothers felt comfortable during the KMC and 73% felt they would be able to give KMC at home. KMC is feasible, as mothers are already admitted in hospitals and are involved in the care of newborn.Conclusion: KMC is a simple and feasible intervention; acceptable to most mothers admitted in hospitals. There may be benefits in terms of reducing the incidence of hypothermia with no adverse effects of KMC demonstrated in the study. The present study has important implications in the care of LBW infants in the developing countries, where expensive facilities for conventional care may not be available at all place.     

Do sexual maturation stages affect flexibility in adolescent boys aged 14 years?

AIM: Pubertal changes constitute a background for development of motor abilities and flexibility as an important component of physical fitness. The aim of the present study was to investigate whether the flexibility is actually related to sexual maturation stages in adolescent boys. METHODS: This cross-sectional study was conducted on 69 healthy boys aged 14 years. Before testing, all participants performed a 3 min warm up and static stretch routine, emphasizing the lower body. The flexibility tests were performed in a counterbalanced design. Sit-and-reach test and goniometric measurement of hamstring flexibility was administered. The results of flexibility tests and body measures were analysed for cross-sectional comparison. Groups were formed according to Tanner's classification and consisted of boys in Stage II, III, IV, V, respectively. RESULTS: The results of sit and reach test scores and goniometric measurements did not correlate with age in months, height, weight and BMI; and furthermore they did not correlate with the sexual maturation stages (p>0.05). The sit and reach test scores were significantly correlated with goniometric measurements (right: r=0.653, p=0.00; left: r=0.638, p=0.00). CONCLUSIONS: The results suggest that sexual maturation stages in pubertal period would not be effective in determining the flexibility. Besides, sexual maturation is not a cause of decreased flexibility in adolescent boys aged 14 years.     

The effect of tamoxifen on sex hormone binding globulin in adolescents with pubertal gynecomastia

We investigated the relationship between sex hormone binding globulin (SHBG) and pubertal gynecomastia in 21 adolescents evaluated longitudinally. Thirteen patients were given tamoxifen treatment after grading according to the Nydick classification (group 1). Group 2 consisted of eight patients followed without treatment. Gynecomastia existed bilaterally in 15 patients. There was a statistically significant breast size reduction in both groups. There was a significant decrease in serum SHBG only in group 2. These findings suggest that serum SHBG is increased by tamoxifen treatment in male adolescents. There was a decrease in SHBG levels through the duration of follow up in patients who recovered with or without treatment. However, this decrease was statistically significant in the untreated group, but not in the tamoxifen treated group. In conclusion, we suggest that the pubertal fall in SHBG levels is attenuated by tamoxifen treatment given for pubertal gynecomastia since tamoxifen increases SHBG levels in male adolescents.     

Uncertainties about the use of inhaled nitric oxide in preterm infants

Respiratory failure in the premature neonate is frequently complicated by pulmonary hypertension. When conventional therapies including administration of exogenous surfactant, conventional mechanical ventilation or high-frequency oscillatory ventilation using an appropriate high-volume strategy have failed, one should assess the pulmonary circulation status with colour-coded Doppler echocardiography. There is now considerable evidence that the regulation of foetal and postnatal pulmonary circulation occurs via nitric oxide (NO), and that persistent pulmonary hypertension of the neonate may be related to a relative deficiency in NO release. Low-dose (10-20 ppm), short-duration (1-2 d) inhaled NO has generally been shown to improve the oxygenation and relieve pulmonary hypertension in premature neonates with severely hypoxaemic respiratory failure. Whether this therapy (eventually prolonged >1-3 wk?) would improve survival and lessen morbidity (e.g. intracranial haemorrhage and chronic lung disease) remains to be proven by appropriately designed controlled trials. Until these issues can be clarified, NO therapy for premature neonates should be still considered as an experimental drug, and its use restricted to clinical studies.     

Effects of tactile-kinesthetic stimulation in preterms: a controlled trial.

BACKGROUND: To determine the effects of tactile-kinesthetic stimulation to preterms on physiologic parameters, physical growth and behavioral development. DESIGN: Controlled trial. SETTING: The premature unit (growing nursery) of a large, teaching hospital. SUBJECTS: 48 well preterms with birth weights between 1000-2000 grams. INTERVENTION: The neonates were systematically allocated into test and control groups. Test babies received tactile-kinesthetic stimulation in the form of a structured baby massage from day 3 to term corrected age. They were observed for changes in vital parameters (heart rate, respiration, temperature and oxygen saturation) during the first few days of stimulation in hospital. Thereafter, massage was continued at home. Changes in weight, length and head circumference and neuro-behavior (Brazelton Neuro-Behavioral Assessment Scale) were assessed in both groups before, during and after the study period. RESULTS: An increase in heart rate (within physiologic range) was seen in the test group during stimulation. This group also showed a weight gain of 4.24 g/day more than controls, which was statistically significant. On the Brazelton Scale the test group showed statistically significant improved scores on the "orientation", "range of state", "regulation of state" and "autonomic stability" clusters at follow-up. No significant complications were noted. A positive correlation was found between the duration of stimulation in days and the weight gain in grams but this did not reach statistical significance. CONCLUSIONS: Tactile-kinesthetic stimulation when administered to well, preterm infants has a beneficial effect on growth and behavioral development with no adverse effects on physiologic parameters.