Pediatric Allergy Research Articles

Pediatric allergy: a common occurrence with multifarious implications

Pediatric professionals treat nature’s most benevolent creation i.e., the child.It is important to focus not only on oral health but also on the overall health of the pediatric patient because oral health is an integral part of total development.There are various dental materials ranging from diagnosis to rehabilitation for the management of oral diseases that are not devoid of posing a potential risk of inducing allergic reactions to Pediatric patients in the dental setting.Most importantly, a dental practitioner must be trained in medical emergencies and be capable of resuscitating a patient. Not only the dentist but also the assistants present in the clinic should be trained on how to manage any allergic emergency conditions in children in dental settings.As some of these diseases have higher rates of morbidity and mortality, management of such conditions requires a multidisciplinary medical team approach consisting of physicians, dermatologists, Pediatric dentists, and ophthalmologists.So, this review involves in-detail information regarding what is an allergy, history of allergy, allergic and immunological responses of the oral mucosa, dental materials prone to allergies, its diagnosis, and treatment modalities in child hoping that it will be helpful to every practicing pediatric professional. Â

Effects of COVID-19 lockdown on weight in a cohort of allergic children and adolescents

BackgroundCOVID-19 lockdown caused sudden changes in people’s lifestyle, as a consequence of the forced lockdown imposed by governments all over the world. We aimed to evaluate the impact of lockdown on body mass index (BMI) in a cohort of allergic children and adolescents.MethodsFrom the first of June until the end of October 2020, we submitted a written questionnaire to all the patients who, after lockdown, carried out a visit at the Pediatric Allergy Unit of the Department of Mother-Child, Urological Science, Sapienza University of Rome. The questionnaire was composed by 10 questions, referring to the changes in their daily activities. Data were extrapolated from the questionnaire and then analyzed considering six variables: BMI before and BMI after lockdown, sugar intake, sport, screens, sleep, and anxiety.ResultsOne hundred fifty-three patients agreed to answer our questionnaire. Results showed a statistically significant increase in the BMI after lockdown (20.97 kg/m2 ± 2.63) with respect to the BMI before lockdown (19.18 kg/m2 ± 2.70). A multivariate regression analysis showed that the two variables that mostly influenced the increase in BMI were sleep and anxiety.ConclusionsFor the analyzed cohort of allergic children and adolescents we obtained significant gain in BMI as consequences of lockdown, which can be explained by many factors: high consumption of consolatory food, less sport activities, more time spent in front of screens, sleep alteration associated with increased anxiety. All these factors acted together, although sleep alteration and increased anxiety were the most influential factors that led to the worsening or the onset of weight gain, creating the basis for future health problems.

Evaluation of the Clinical Characteristics of Patients with Food Protein-Induced Enterocolitis Syndrome: A Multicenter Study

Introduction: Food protein-induced enterocolitis syndrome (FPIES) is a rare non-IgE, cell-mediated food allergy disorder. We aimed to report the demographic characteristics, clinical features, and management of pediatric patients with FPIES. Methods: This retrospective study included all children diagnosed with FPIES at the pediatric allergy departments of the participating twelve study centers from January 2015 to November 2020. Results: A total of 73 patients (39 males, 53.4%) with a male/female ratio of 1.1 were included in the study. The median (interquartile ranges) age at symptom onset was 6 months (0.5–168, 4–9.5). The most frequent offending foods were cow’s milk, egg’s yolk, fish, and egg’s white, identified in 38.4% (n = 28), 32.9% (n = 24), 21.9% (n = 16) and 20.5% (n = 15) of the patients, respectively. The total number of reported FPIES episodes was 290 (3.9 episodes per child). Oral food challenge (OFC) was performed in 54.8% (n = 40) of the patients, and tolerance was detected in 17 OFCs (42.5%) at a median age of 15 months (range 8–132 months). Conclusion: FPIES is a non-IgE-mediated food hypersensitivity that commonly affects infants and is often misdiagnosed. The pathophysiology of the disease remains unclear and the low awareness of FPIES among physicians and parents highlights the need for more education.

Editorial introductions.

Editorial introductions.

Etiological Evaluation of Acute Urticaria in Children

Objective: Acute urticaria is one of the most common causes of admission to hospitals in children. The aim of the study is to evaluate the etiology of acute urticaria in patients who admitted to pediatric allergy outpatient clinics. Material and Methods: The patients who were diagnosed as acute urticaria in pediatric allergy outpatient clinics between January 1, 2016 and December 31, 2016 were included in the study. Patient information was recorded retrospectively from medical files. Results: In this study, 469 patients with acute urticaria were evaluated. The median (min-max) age of the patients was 7 years (2 months-18 years), and 48.8 % of them were male. Angioedema was accompanying in 20 % of the patients. Recurrent acute urticaria was seen in 33.5 % (n = 157) of the patients. In the history, infections were the triggers in 37.5 % (n=176) of the patients, drugs in 17.9 % (n=84), food in 10.9 % (n=51), insect bites in 3.2 % (n=15), and 0.2 % (n=1) of them had the vaccine. When the patients were evaluated with the medical histories, physical examination and laboratory findings; triggers could not be detected in 59 % (n=276) and these patients were diagnosed as idiopathic acute urticaria. Infections (37.5 %; n=176) were in the first place in patients with triggers. Food and drug allergies were confirmed in only one patient each. Considering the etiological distribution according to age groups, it was seen that idiopathic acute urticaria was more common in the 12-18 age group and infection-associated acute urticaria in the group under 2 years old (p=0.009). Conclusion: Mostly, triggers cannot be found in children who apply to the allergy clinic due to acute urticaria. In patients who can be identified triggers, infections are in the first place. However, patients’ clinical histories may also include food or drug(s) as a suspected trigger, and it is important to evaluate these patients with diagnostic allergy tests. Thus, misdiagnosis of patients and unnecessary food or drug restrictions would be prevented.

Evaluation of Frequency and Characteristics of Drug Allergy in Pediatric Patients with Cystic Fibrosis.

Background: Previous studies reported that the prevalence of drug allergy is higher in patients with cystic fibrosis (CF) than in the general population. It is important to exclude or confirm the drug allergy diagnosis with detailed allergic evaluation for preventing drug allergy overdiagnosis. Our study aims to determine the actual frequency of drug allergy proven by diagnostic tests in children with CF and to compare it with the control group. Methods: Patients diagnosed with CF who were followed up in the Pediatric Pulmonology Clinic were included in the study group. Children with similar gender and age characteristics who did not have any chronic diseases and who applied to the Pediatric Polyclinics were included in the control group. We reviewed the medical data of patients with CF. Also, we evaluated the parents of the patients via phone conversation and/or during the control of the outpatient clinic and questioned them in terms of drug allergy. In addition, we assessed those with suspected drug allergies in the pediatric allergy clinic for diagnostic tests and compared it to the control group. Results: CF patients (n = 44) and control group (n = 100) were included in the study. Only 1 patient (2.2%) out of the 44 patients in the study group had a suspicion of drug-related hypersensitivity history. In the control group, 1 patient had a history of rash, provocation test was performed to rule out drug hypersensitivity reaction, and it was evaluated as a negative result. Conclusions: The result of our study showed that the frequency of drug allergy in children diagnosed with CF was not different from the control group. However, it will be useful to confirm the data of pediatric patients with CF in larger groups. In the presence of suspicion of drug allergy, a diagnostic evaluation can prevent unnecessary drug allergy diagnoses.

The perceived impact of pediatric food allergy on mental health care needs and supports: Apilot study.

Evidence suggests a mental health impact of food allergy on affected children and their families; however, little is known about health care professionals' understanding of these impacts and the resources available to patients and their families. Our aim was to conduct a pilot study examining health care professionals' perceptions of the psychosocial and financial burden of food allergy to identify gaps in education and resources and thus better support families with food allergy moving forward. Between February 20 and November 19, 2020, we conducted audiorecorded interviews (n= 6) and profession-specific focus groups (n= 2 [representing 7 individuals]). The participants included pediatric allergists, allergy nurse educators, and clinical dietitians who were directly involved in pediatric food allergy care. The interviews were recorded and transcribed verbatim. Thematic analysis was subsequently applied to identify the main themes. Our study consisted of an interdisciplinary group of Manitoban health care providers (N= 13) who were directly involved with pediatric food allergy care. We identified 3 main themes from these interviews: anxiety among families with food allergy, which is a common comorbidity; limited resources available within current public infrastructure; and empowerment through education. These themes describe issues surrounding access to information and resources and how this can affect anxiety and parenting styles among families with food allergy. Health care professionals perceive that many families experience anxiety as a result of their child's food allergy. They further advocate that access to information and suitability of public resources be considered when planning forrelated programs.

The Effectiveness and Student Perceptions of Peer-Conducted Team-Based Learning Compared to Faculty-Led Teaching in Undergraduate Teaching.

BackgroundToday’s professionals need to be capable of independent information retrieval, teamwork, and lifelong learning. To meet these demands, more active learning methods are needed in university teaching. Team-based learning (TBL) is a learner-centered method which enables activation of students in large classes.ObjectiveThe aim of this study was to compare a method combining peer teaching and TBL (peer-conducted TBL; pTBL) with faculty-led seminar teaching. More precisely, students’ opinions about teaching methods and immediate and long-term learning outcomes were aimed to compare.MethodsA faculty-led design was compared to a pTBL design when teaching pediatric and dermatological allergy in a seminar setting for 5th year medical students. For that purpose, students were randomly split into two learning groups. In a faculty-led seminar (n = 44 students) the instructor first lectured on each subject; then, named students from each group were asked to present clinical cases given to them beforehand and them raising questions were answered. In a pTBL group (n = 50) student’s prior knowledge was first tested. Then, randomly selected, pre-prepared students took a tutors role in a seminar and presented clinical case to be solved in groups by all students. Students’ performance was equally tested after both sessions and 5–6 months afterwards. Students’ opinions were asked by an electronic survey.ResultsIn this study, pTBL was significantly preferred over faculty-led learning (mean grade 8.5 vs 6.5). Those participating in pTBL group studied pre-learning material more actively than those in faculty-led group. However, there was no difference in learning outcomes (immediate or long term) between the groups.ConclusionStudents prefer teaching method in which they are self in active role. Combining TBL and peer teaching may further increase the accumulation of non-academic skills like expertise and proficiency.

P155 Implementing change in treatment delivery for children and young people during a pandemic

Abstract Background/Aims The Paediatric Rheumatology Team at the Great North Children’s Hospital (GNCH) provides care to children and young people (CYP) across the northern region. On average 70 new CYP are diagnosed annually with rheumatic conditions. Approximately 1/3 will require long-term treatments and long-term rheumatology follow-up. The team support over 300 patients receiving treatments for at home, with 75 CYP requiring regular treatments administered in hospital. Tocilizumab targets IL-6 and is used to treat rheumatic conditions. Tocilizumab, approved for use in children with certain subtypes of JIA in 2011, is normally administered via an intravenous infusion on the Paediatric Day Unit, at GNCH. The procedure takes approximately 3 hours and involves a cannula for administration. Part of Continuity and Emergency Planning for the COVID- 19 pandemic the Medicines & Healthcare Products Regulatory Agency (MHRA) compiled a list in April 2020 of medications including tocilizumab, not to be exported from the UK or hoarded. Tocilizumab was a proposed treatment for hyper-inflammatory response for COVID-19 and concern that supplies would be affected. NHS hospitals were advised to reduce routine activity and footfall through the hospital. The team agreed the need to consider alternative treatment delivery. Methods A patient cohort were identified attending GNCH for intravenous infusions. 38/65 (58%) patients were receiving tocilizumab. The pharmacist agreed to switch CYP from intravenous to subcutaneous tocilizumab. A total of 34 eligible patients were identified (32/38 current patients and two new patients) Using a multi-disciplinary approach, the pharmacist established agreement, arranged supply and delivery of medication to the families. The CNS contacted all families via nurse-led telephone clinic and invited eligible CYP to a face-to-face clinic, to received counselling and training to administer. The rheumatology consultants supported the change with prescription management. Over a 6-week period all eligible CYP transferred to subcutaneous form of tocilizumab administered at home. Medication was transported to families via home care delivery company. Results 34 patients switched, 9/34(26%) reported localised injection-site reactions, varying in severity but could lead to discontinuation of treatment. An inconsistent approach to managing these reactions was recognised by the pharmacist and CNS. Collaboration with the paediatric allergy teams, devised a standardised approach to manage injection-site reactions using an algorithm. Conclusion • Reduce pressure on precious hospital resources • More convenient for families - minimise long distance travel for treatment and time off school/ work • True collaboration and recognition of multidisciplinary team working swiftly to find a solution to a problem impacting upon patients, their family and the Trust • Algorithm devised by the paediatric pharmacist using easily accessible oral and topical treatments for families to use at home to manage site reactions. • Tocilizumab has proven to be useful in treatment of critically unwell patients infected with COVID-19. Disclosure R. Wyllie: None.

Environmentdependent microcirculatory and autonomic neurovascular changes in the children with allergic rhinitis

Recently, the studies of environmental effects upon public health of children become quite relevant [1, 12, 20]. Over last decades, there is a rapid increase in allergic diseases, including allergic rhinitis, among the child population. A large number of studies connect this increment in pediatric allergies with influence of environment, technogenic development and urbanization [4]. Allergic rhinitis (AR) is one of the most pressing problems in allergology and immunology [2], being among the most common chronic disorders in children [6, 21]. Thus, it was found that the pathogenesis of AR is a complex mechanism that is not limited to a purely allergic reaction and inflammation in the nasal region. It includes complex mechanisms of neurogenic inflammation under participation of the main neuropeptides and neurotransmitters, which are closely related to the individual condition of endocrine and immune systems, being largely determined by the state of mucous membranes of the nasal cavity and respiratory tract in general. The pathogenesis of AR is primarily influenced by the state of microvasculature of the mucous membrane, as well as dictinct qualitative and quantitative characteristics of microbiocenosis of the nasal cavity, nasopharynx and oropharynx, upper and lower respiratory tract. All these parameters are directly determined by neurovegetative mechanisms [5, 7, 9, 16]. An important place in the pathogenesis of the development of allergic diseases belongs to changes of the microcirculation system which is involved into all the clinical manifestations observed. The microcirculation disorders play an important initial triggering role in pathogenesis of allergic rhinitis. Likewise, the autonomic nervous system is responsible for setting links between the body, ambient and internal environment via regulation of metabolism, functioning of organs and tissues based on changes in this environment; it also provides integration of all organs into a single entity, acting as one of the main adaptive systems in human body [13]. Therefore, the autonomic nervous system regulates the body and homeostasis by unifying the separate pathogenetic links of disease progression and setting basis for structural and functional unity [3, 19]. This regulatory mechanism is implemented via nerves and reflexes by different neurohumoral factors. Their nature has been established under experimental conditions and is beyond doubt to date [8].

157 Evaluating Interest in Clinical Trial Participation for the Treatment of Pediatric Food Allergy

OBJECTIVES/GOALS: Roughly 8% of children in the United States have a diagnosed food allergy (FA). The ubiquity of most food allergens increases the potential for accidental exposures. Clinical trials (CT) are used to test novel treatments for FA. This project will evaluate the influence of biopsychosocial factors on interest in CT participation for pediatric FA. METHODS/STUDY POPULATION: This project is subsumed under the FORWARD study (5R01AI130348-04), a multisite study currently underway at four pediatric FA clinics across the United States. Eligible participants include patients and families who meet the following criteria: 1) New clinic visit presenting for a possible FA complaint and/or has a physician diagnosis in a follow-up clinic visit; 2) child is between the age of 6-months and 12 years at intake visit; 3) are English speaking, and 4) no history of developmental disorders. Parents are asked to complete an intake survey, followed by a series of quarterly surveys administered via REDCap. A single variable from the intake survey queries interest in CT participation; quarterly surveys assess FA knowledge, attitudes, health beliefs, and management practices. RESULTS/ANTICIPATED RESULTS: To date, 890 families have completed the intake survey. Working hypotheses include: 1) parents of older children and children with a higher condition severity rating will report greater levels of interest in CT participation; 2) parents with greater FA knowledge, more health management beliefs that support action, and less FA-related anxiety, will report greater levels of interest in CT participation; 3) relative to White families, African American families will be less interested in participating; 4) families with >1 child with FA will report greater levels of interest in CT participation; 5) families who are uninsured, low-SES, and are unemployed will report lower levels of interest in CT participation; and 6) families with higher educational attainment will report lower levels of interest in CT participation. DISCUSSION/SIGNIFICANCE: This study will advance decision science, address existing disparities, and have far-reaching clinical implications. This novel approach will enhance our ability to predict who is at the greatest risk of anaphylaxis and help healthcare providers identify families who could benefit from experimental treatment options for pediatric FA.

Needs assessment for an infant and toddler food allergy curriculum for pediatric residents.

The prevalence of pediatric food allergies is increasing. Although pediatric residents are frontline providers for children with food allergies, little is known about pediatric residents' educational experiences and comfort with infant and toddler food allergy. An anonymous online needs assessment survey was created and distributed to 64 residents in one residency program. The survey explored residents' knowledge sources, experience, and comfort in diagnosing, treating, and counseling patients with regard to food allergy and anaphylaxis. Fifty-one pediatric residents (79.7%) completed the survey. Pediatric residents who had formal engagement with allergy-trained clinicians had 8.27 times the odds (odds ratio 8.27 [95% confidence interval, 1.16-59.01]; p = 0.035) of feeling comfortable in treating infant and toddler anaphylaxis compared with those who did not feel comfortable. These findings suggest that a standardized pediatric residency curriculum, in partnership with pediatric allergists, may present enhanced educational opportunities for pediatric residents.

Evaluation of the basophil activation test as diagnostic method in pediatric peanut allergy

Peanut allergy diagnosis relies on various tests including the oral food challenge (OFC), which is potentially associated with severe symptoms such as anaphylaxis. An alternative has emerged, the basophil activation test (BAT), which allows to determine the basophil allergen threshold sensitivity in vitro. We aimed to determine the discriminative ability of BAT between, first, OFC reactive and non-reactive patient, and secondly low or high cumulative dose-reactive patients in comparison with other diagnostic tools for peanut allergy. The ability of BAT to discriminate patient with mild or severe OFC clinical reactions was also evaluated. We performed a prospective study, from February 2018 to October 2020, evaluating in 79 peanut allergic children the basophils allergen reactivity (CDmax) and the basophils allergen sensitivity [CDsens or area under the curve (AUC)] in BAT (CD63+ or CD203c+) as well as specific IgE level and skin prick-test in relation to OFC performed the same day. Based on ROC curve analyses, optimal cutoff of CDmax, CDsens and AUC to peanut and Ara h 2 were defined by the Youden index. Among the 79 children included, ROC curve analysis showed that f13- or Ara h 2-CDmax and AUC appeared to be the best markers associated with reactivity on OFC. We defined positive cutoff [i.e. Closet to 100% positive predictive value (PPV)] and demonstrated that 21% of the OFC could have been avoided. Also, by discriminating peanut-reactive patients according to low (< 200 mg) or high (> 200 mg) cumulative dose of peanut proteins in OFC [corresponding to effective dose 50 (ED50)], basophils allergen sensitivity monitored with AUC to f13 and Ara h 2 were the best biomarkers predicting cumulative dose with 92% and 88% specificity and 88% and 91% sensitivity, respectively. BAT to f13 and Ara h 2 may be a useful diagnostic tool to predict the allergic status and could reduce dangerous OFC. Then, BAT may be useful for risk assessment of clinical reactions during OFC and could significantly improve management by integrating a personalized approach.

Psychometric Properties of a Measure Assessing Anxiogenic Parenting Practices in Food Allergy.

Pediatric food allergy represents a significant public health burden. In order to avoid allergen consumption, adequate management requires daily vigilance and involvement from parents, frequently leading to increased parental anxiety. While specific anxiogenic parenting practices (i.e., parenting behaviors which may aid in the development and/or exacerbation of childhood anxiety) have been documented within this population, to this point, these behaviors have not been systematically measured. The current study aimed to develop and examine a parent-report scale designed to measure anxiogenic parenting behaviors related to food allergy. Participants included 177 parents of children with food allergy recruited online using Amazon Mechanical Turk (mTurk). An exploratory factor analysis was conducted to determine the factor structure of the newly developed scale. Subsequently, psychometric properties (e.g., construct validity) were examined via correlational analyses. Results indicated a 24-item, 3 factor (Factor 1: Involvement in Food Allergy; Factor 2: Worry about Food Allergy; Factor 3: Autonomy Promotion) scale, which accounted for 53.11% of the total variance. The Kaiser-Meyer-Olkin measure was acceptable, KMO = 0.872 and Bartlett's test of sphericity indicated sufficient correlations between items (χ2(378)=2568.95). All subscales demonstrated strong internal consistency (Involvement in Food Allergy: α = .880; Worry about Food Allergy: α = .892; Autonomy Promotion α = .796) as well as convergent and discriminant validity. Results support the overall psychometric properties of the scale. Interpretations, limitations, and future directions are discussed.

Development of the Pediatric food allergy disease-specific quality of life Questionnaire

Development of the Pediatric food allergy disease-specific quality of life Questionnaire

Technologies for Type 1 Diabetes and Contact Dermatitis: Therapeutic Tools and Clinical Outcomes in a Cohort of Pediatric Patients.

The increasing use of technological devices for the management of diabetes is related to the prolonged exposure of patients’ skin to chemical and mechanical agents and, consequently, to the increased risk of developing dermatological complications. Among these, contact dermatitis is the most insidious skin disorder. Despite the magnitude of the issue, no universally accepted recommendations on the management of this common complication are currently available. Our observational study aimed to describe all the solutions adopted by patients and their caregivers to treat and prevent the appearance of contact dermatitis and to describe the clinical impact of this cutaneous complication. Twenty-one pediatric patients (mean age 12.1 ± 3.7 years) with type 1 diabetes were recruited in the study. The most common treatment used to treat acute skin lesions was the application of topical corticosteroids, sometimes associated with topical antibiotics (9.5%). In order to prevent the further appearance of dermatitis, the most frequently adopted measure was the use of hydrocolloid and/or silicone-based adhesives, followed by the application of protective barrier films. One patient reported benefit from the off-label use of fluticasone propionate nasal spray. However, only 52.4% of the study participants achieved a definitive resolution of the skin issue, and 38.1% of patients were forced to discontinue insulin pump therapy and/or continuous glucose monitoring. No differences were observed in glycated hemoglobin values between the period before and after the onset of contact dermatitis. Our study confirms the severity of this dermatological complication that may hinder the spread of new technologies for the management of diabetes. Finally, our findings highlight the importance of establishing close collaboration both with pediatric allergy specialists to prescribe the most suitable treatment and with manufacturing companies to ensure that adhesives of technological devices are free of harmful well-known sensitizers.

Barriers and challenges affecting parents' use of adrenaline auto-injector in children with anaphylaxis.

BACKGROUNDAnaphylaxis is a life-threatening condition that develops as a reaction to exposure to an allergen which can be found in common foods such as cow's milk, egg, fish, and nuts in children. The use of an intramuscular adrenaline auto-injector (AAI) is considered the most essential treatment in these situations and parents and caregivers are always encouraged to carry this device for use in an emergency which commonly takes place in public places such as restaurants, schools, and parks, where medical staff are not guaranteed to be available. However, previous studies, in different settings, have reported underuse of the AAI by parents. AIMTo explore the reasons for underutilisation of the AAI in our community. METHODSA cohort of parents attending the paediatric allergy clinic at Al Ain Hospital in the United Arab Emirates completed a questionnaire survey aimed at assessing their understanding and knowledge of their child's allergy management, including their aptitude with the use of the AAI, as well as their competence and comfort in providing this treatment in an emergency.RESULTSOf 47 parents participating in the study, 39 were Emirati parents (83% and most parents who completed the survey were mothers (66%). As expected, food was the main cause of allergic reactions requiring prescription of the auto-injector device. Tree nuts and peanuts were noted to be the most common offending food in these children (62% and 38%, respectively). A doctor provided demonstrations and training on using the auto-injector device to 94% of the parents. More than two-thirds of the parents and caregivers (79%) were deemed knowledgeable on the indication for use of the device. Reluctance to administer the device was expressed by many of the parents, despite their satisfaction with the coaching they received on using the device in the study. CONCLUSIONOngoing coaching and teaching of parents on use of the AAI is paramount. However, this should be carried out together with psychological support to aid the parents to eliminate their hesitancy and acquire sufficient confidence in using the device when needed. Group teaching and sharing experiences is an excellent educational technique in a non-formal setting. Paediatric clinic play therapists can also have a role in needle phobia desensitisation for parents and children. More research is needed to explore the lack of empowerment and other reasons behind their fear and anxiety in using the device to plan effective interventions.

Evaluation of the Impact of Environmental Changes on Asthma Control in Children, Access to Health Care, and Treatment Adherence in Early COVID-19 Lockdown.

Objective : During the coronavirus disease 2019 pandemic, lockdown measures and difficulties in accessing healthcare have impacted asthma management in children. This study aimed to determine the evaluation of the impact of environmental changes on asthma control in children, access to health care, and treatment adherence in early coronavirus disease 2019 lockdown.Materials and Methods: The study included children with asthma aged 6-11 years. A survey form was administered to the patients who visited the pediatric allergy outpatient clinic between June 1 and 30, 2020. The survey acquired demographic information about the children and their families as well as information about their asthma symptoms, how they reached healthcare services, and adherence. The childhood asthma control test was administered. The P values <.05 were considered significant. Results: The study included a total of 123 children (female/male : 48/75) with a mean age of 8.4 ± 1.9 years. According to the mothers’ self-report, it was found that 78% of the patients were not able to follow-up routinely, 19.5% were non-adherence to treatment, and 16.2% were poorly controlled asthma. It was found that, based on childhood asthma control test scores, asthma control was better during the pandemic lockdown period (P = .001). Asthma symptoms were better in 41.5% of the patients compared to the previous months and in 53.7% compared to the same period last year. Conclusion: Our study found that the children’s asthma was controlled although most of them did not have their follow-up visits, and poorly controlled asthma was higher in older children in early coronavirus disease 2019 lockdown.

Social well-being among children with vs without food allergy before and during coronavirus disease 2019

Social well-being among children with vs without food allergy before and during coronavirus disease 2019

The burden of food allergy on children and teens: A systematic review.

Over the last two decades, researchers have placed increasing attention on understanding how food allergy affects the health-related quality of life (HRQL) and psychosocial well-being of children and teens. In response, a number of reviews have been published that aim at synthesizing the literature. However, many of these papers focus narrowly on HRQL or suffer from methodological limitations. The current review aims to fill this gap by providing a comprehensive overview of the burden of pediatric food allergy by synthesizing the quantitative and qualitative literature. Findings from the present review provide evidence of reduced HRQL among children and teens with food allergy, particularly older children and those with more severe manifestations of the condition. In comparison to HRQL, the link between food allergy and psychosocial functioning is less clear; however, some evidence can be cited linking food allergy to greater levels of psychological distress. Qualitative evidence suggests that the burden of pediatric food allergy largely stems from worries surrounding exposures outside of the home and the social consequences of the condition. The current review also highlights several gaps in the literature, including a paucity of longitudinal research, research focused on predictors of psychological distress among children and teens with food allergy as well as a dearth of studies comparing rates of bullying in food-allergic and non-food-allergic samples. More emphasis should be placed on not only alleviating the social and psychological consequences of food allergy, but also on identifying and assisting those most acutely burdened by the condition.