Anxiety Levels and Changes in Health and Hygiene Behaviors in Mothers of Children with Asthma in Early COVID-19 Lockdown in Turkey.

Objective: The restrictions imposed by the coronavirus disease 2019 (COVID-19) pandemic have caused significant changes in people's lives. This study aimed to investigate anxiety levels and changes in health and hygiene behaviors in mothers of children with asthma in early COVID-19 lockdown in Turkey. Materials and Methods: This study was a cross-sectional survey conducted on children with asthma, 6 to 11 years of age, between June 1 and 30, 2020, in Turkey. A sociodemographic data form, health and hygiene behavior form, childhood asthma control test, and state-trait anxiety inventory were administered to the mothers of the children. Results: The asthma group included 123 children (Female: 39.0%) and median age, interquartile range (IQR) [minimum-maximum]: 8.0 (6) [6-12] years; the control group included 88 children (Female: 47.7%) median age, IQR [minimum-maximum]: 8.0 (7) [5-12] years. Increased hygiene behaviors and high compliance with social isolation measures were recorded in the early lockdown, with no difference between the groups. Before the pandemic, the most frequently used cleaning products were general-purpose cleaners. During the early lockdown, however, the most frequently used product was disinfectants and was similar in both groups. In both groups, the rate of using nutritional supplements increased during the pandemic period, but the rate was higher in children with asthma both before and during the early lockdown (P < 0.001). The anxiety levels of the mothers in asthma and control groups were similar. Conclusion: This study is the first in Turkey demonstrating that, in mothers of children with asthma, lifestyle changes related to health and hygiene and anxiety levels are similar to those of other children and their mothers during the early lockdown period of COVID-19 pandemic.

An evaluation of the factors affecting the clinical and laboratory findings, prognosis, and treatment response in children with chronic urticaria.

Chronic urticaria (CU) is a rare disease in childhood, and studies in children are limited. In this study, the aim was to investigate the clinical and laboratory findings and demographic characteristics of children with CU and to determine the factors affecting prognosis. The study included 141 patients aged 0-18 years who were diagnosed with CU in the pediatric allergy outpatient clinic between January 1, 2013, and December 31, 2018. Risk factors related to prognosis were investigated by comparing the duration of CU and treatment response with clinical and etiological features. IBM SPSS version 24 was used for statistical analyses. In the study group, the female/male ratio was 69/55, and the median age at first visit was 9.5 years (min:1, max:17). Among patients, 63 (44.5%) had an accompanying atopic disease, and 23 (16.3%) had chronic disease. Of the patients, 124 (88%) had chronic spontaneous urticaria, and 17 patients (12%) had chronic inducible urticaria (CIU). Of those with CIU, 72.2% had symptomatic dermographism, 16.7% had cholinergic urticaria, and 11.1% had cold urticaria. After the evaluations, the most common pathological findings in our patients were intestinal parasitosis (n = 14), anemia (n = 10), and urinary tract infection (n = 8). The median total duration of urticaria was 47 weeks (min:8, max:284). The duration of urticaria was longer in patients with atopy (p < 0.05), and the group that went into remission with standard-dose antihistamine was the group with highest eosinophil count (p = 0.022). In most children with CU, the underlying cause/disease cannot be determined. In our study, treatable triggers were found in some of the patients. Therefore, it is appropriate for each patient to be evaluated with selected laboratory tests after detailed history and physical examination.

Adolescents with asthma reported more peer victimization, more anger repression, and less anger expression.

OBJECTIVE: The aim of this study was to investigate the peer victimization and anger expression in adolescents with asthma. The relationship between asthma control and psychological features was also examined. METHODS: The study was a cross-sectional study with a healthy control group. The sample of the study was composed of 61 adolescents who were previously diagnosed by a physician with asthma of various intensities. Sixty adolescents with no chronic disorders were enrolled as the control group. Peer victimization was examined using the Multidimensional Peer Victimization Scale (MPVS). The State-Trait Anger Expression Inventory (STAXI) was used to assess anger expression styles. Emotional and behavioral symptoms of the adolescents were measured using the Strengths and Difficulties Questionnaire (SDQ). RESULTS: Adolescents with asthma reported more peer victimization in the subscales of physical, social, verbal, attacks on property, and frightening in the MPVS; and having more problems in emotional, social, and peer relations areas in the SDQ (p < .001 for all subscales) compared to the control group. The results were similar between the groups regarding the conduct problems and hyperactive behaviors. The adolescents with asthma reported more anger repression and less anger expression than the control group (p < .001 for both subscales). CONCLUSIONS: The results indicated that the adolescents with asthma were subjected to more peer victimization and experienced more difficulties in anger expression than the controls. Based on the findings of this study, we suggest that these psychological factors should be kept in mind during the management of asthma in adolescents.

Physicians' Approach to Anaphylaxis in Childhood.

METHODS: A questionnaire form consisting of a total of 18 questions was prepared. Six questions concerned demographic data; 7 questions inquired about physician's knowledge level about treatment of anaphylaxis. In the last part, 5 different case scenarios were given, and their diagnoses and treatments were asked. RESULTS: A total of 120 physicians participated in the study. Of the participants, 66.7% were residents. The rate of correct answer about dose of epinephrine was 57.5%. The rates of making correct diagnoses in anaphylaxis case scenarios 1, 2, and 3 were 60%, 73.3%, and 91.7%, respectively, whereas epinephrine administration rates were 54%, 67.5%, and 92.5%, respectively. When the answers of all these questions given by the residents and specialists and among physicians who updated and did not update were compared, there were no statistically significant differences except epinephrine administration rate and its route (P < 0.05). CONCLUSIONS: The results of the current study suggest that physicians' knowledge levels were inadequate in making the diagnosis of anaphylaxis, and physicians use epinephrine in conditions without hypotension or an undefined possible/known allergen contact. Information about epinephrine administration was partially correct. It is currently considered to be the simplest measure to have a written anaphylaxis action plan including diagnostic criteria for anaphylaxis.

Atopic dermatitis, inhalant allergy and food allergy: A paediatric approach.

Food and inhalant allergens have also been identified as potential trigger factors of atopic dermatitis symptoms. Here we aimed to investigate relationships between atopic dermatitis and inhalant-food allergen sensitization in Turkish children with atopic dermatitis. We included 70 patients (42 male, 28 female) with atopic dermatitis and 45 controls (30 male, 15 female) with no atopy, no atopy familial history, no atopy clinical findings no atopic dermatitis. We noted patients' and controls' age, gender, passive smoking exposure, atopy, xerosis, bath water temperature, shower gel type, clothes detergent type, blood hemoglobin, blood eosinophil count, blood eosinophil percent, values of serum immunoglobulin E, serum immunoglobulin A, serum immunoglobulin G, serum immunoglobulin M, results of inhalant allergen, and food allergen testing. We found that nine cases had inhalant allergen sensitization and 21 cases had food allergen sensitization. There were significant relationships between cases and controls in terms of count of eosinophil and percent of eosinophil (P = .008, P = .009, respectively). Humoral and cellular allergen-specific immune responses to food and inhalant allergens can be detected in patients with atopic dermatitis. Accordingly, we believe that blood eosinophil count and percent are more valuable laboratory parameters than serum total IgE for following patients with atopic dermatitis.