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Background: A limited number of studies have shown that fermented milk products (FMPs) regularly consumed by mothers during pregnancy may be beneficial for atopic dermatitis and food allergy in their children. In this study, we aimed to investigate the effect of regular maternal consumption of yogurt and cheese during pregnancy on the remission period of cow’s milk protein allergy (CMPA) in their children. Methods: In this retrospective cohort study, 59 consecutive children who presented to the pediatric allergy outpatient clinic between January 2020 and January 2023 and were evaluated for IgE-mediated CMPA were screened; 19 were excluded (incomplete data, non-IgE-mediated findings, or declined participation), leaving 40 children for analysis. The diagnosis of CMPA was made by skin prick test (SPT) and/or cow’s milk-specific IgE and oral food challenge (OFC). Demographic characteristics, laboratory data, duration of tolerance development and frequency of regular FMP consumption by mothers during pregnancy were recorded using a structured questionnaire. Results: Among cases, 42.5% were girls and 57.5% were boys. The median age of cases was 38.5 months (24-47.75). The median duration of breast milk intake was 20 months (14-24). Parental atopy was present in 45% of cases. The median age at symptom onset was 4.5 (2-6) months. Prediagnoses at presentation included atopic dermatitis in 57.5%, allergic proctocolitis in 5%, urticaria and angioedema in 32.5%, and anaphylaxis in 5%. The median cow’s milk SPT wheal diameter was 8 (5-13) mm, yogurt SPT wheal diameter was 5 (0-10) mm, and cow’s milk-specific IgE value was 0.66 (0.13-5.68) kU/L. Baked cow’s milk products were tolerated by 67.5% of subjects. Prevalence of daily FMP consumption during pregnancy was 55%, yogurt consumption was 62.5%, and cheese consumption was 70%. Although there was no significant difference between subgroups in age at onset of clinical symptoms, the age at first tolerance to cow’s milk, duration of tolerance development and yogurt SPT wheal diameter were significantly lower in children of mothers who consumed FMPs daily during pregnancy compared with those who did not (p<0.05); this lower yogurt wheal diameter may in part reflect a milder baseline sensitization profile in this subgroup. Age at symptom onset was correlated with serum total IgE and cow’s milk-specific IgE. Conclusion: The duration of remission of CMPA in offspring was found to be shorter if the mother used FMPs daily during pregnancy.

Allergic rhinitis (AR) is one of the most common chronic inflammatory diseases of childhood and adolescence, affecting a substantial proportion of children and imposing a considerable burden on qua...

Farklı Fenotiplerdeki Hışıltılı Çocuklarda Akciğer Fonksiyonlarındaki Etkilenmenin İmpuls Ossilometre Yöntemi ile Gösterilmesi - The Journal of Current Pediatrics

Wheezing is a common respiratory symptom affecting a substantial proportion of preschool children, with a prevalence ranging from 10% to 30% in this age group. Wheezing during the preschool years i...

Background: Maternal diabetes disrupts fetal lung development. This study aimed to compare cord blood adipokines and neonatal respiratory function tests (RFTs) in healthy neonates of diabetic mothers versus controls. Methods: This prospective cohort study involved term, healthy newborns born to diabetic mothers (NDM group, n = 37) and sex‐ and age‐matched healthy controls (NHC group, n = 40). RFTs were performed at 48 h of life using tidal breath analysis (TBA). The assessed parameters included time to peak tidal expiratory flow (TPTEF), the ratio of TPTEF to total expiratory time (TPTEF/TE), the ratio of volume to peak expiratory flow to total expiratory volume (VPTEF/VE), reflecting early airway mechanics. Low respiratory function was defined as TPTEF/TE below 35%. Cord blood adipokines including leptin, ghrelin, and adiponectin levels were measured by ELISA. Results: The NDM group exhibited lower TPTEF, TPTEF/TE, and VPTEF/VE ratio TBA parameters ( p < .001 for all). Cord blood leptin levels were higher in the NDM group, while ghrelin and adiponectin levels were lower ( p = .002, p < .001 and p < .001 respectively). Ghrelin levels were positively correlated with TPTEF ( ρ = 0.231, p = .043), TPTEF/TE ( ρ = 0.264, p = .020), and VPTEF/VE ( ρ = 0.236, p = .038). Decision tree analysis identified ghrelin as the primary discriminator of low RFTs, with an accuracy of 74%. Conclusion: Clinically healthy term infants born to diabetic mothers exhibit measurable impairments in RFTs at birth, accompanied by altered cord blood adipokine profiles, suggesting a potential role for adipokines as early biomarkers of respiratory vulnerability. image

Background: Prenatal smoke exposure impairs fetal lung development, but the interplay between cotinine, oxidative stress, and early respiratory dysfunction remains unclear. This study aimed to quantify the effects of prenatal smoke exposure on neonatal respiratory function and develop a validated predictive model to identify this dysfunction. Methods: This prospective cohort study included term newborns with prenatal tobacco smoke exposure ( n = 50) and healthy controls ( n = 41). Cord blood cotinine, oxidative stress markers, and tidal breathing parameters assessed at 48 h post‐delivery were compared. A decision tree model was developed and rigorously validated for performance, calibration, and temporal stability to predict decreased expiratory flow. Results: Smoke‐exposed newborns exhibited significantly impaired expiratory flow ( p < .001), elevated cord cotinine ( p < .001), and increased systemic oxidative stress ( p < .05). The decision tree model selected a cord blood cotinine level >26.1 ng/mL as the primary predictor, conferring a 94% probability of dysfunction. For those with lower cotinine, a total oxidant status >9.75 μmol/L was a secondary predictor (87.5% probability). The final model achieved 72.5% accuracy and demonstrated good calibration. Conclusion: Prenatal smoke exposure induces quantifiable neonatal respiratory dysfunction mediated by oxidative stress. Cord blood cotinine and total oxidant status are robust biomarkers for risk stratification. Our validated decision tree offers a practical framework for identifying respiratory dysfunction in newborns. image

Background: This study aimed to investigate the differences in cognitive distortions between patients with anxiety disorder (AD) and healthy controls, investigate the relationship between anxiety levels and cognitive distortions in AD, and investigate whether accompanying symptoms in AD had an impact on cognitive distortions Methods: Eighty-nine adolescents diagnosed with AD and 94 healthy adolescents were assessed using The Kiddie Schedule for Affective Disorders and Schizophrenia, Screen for Child Anxiety Related Emotional Disorders (SCARED), Beck Depression Inventory (BDI), Cognitive Distortions Scale (CDS), and the effects of major depressive disorder (MDD) were evaluated. Results: All cognitive distortions except catastrophizing were more problematic in AD. It also assessed the effects of comorbid MDD with AD on cognitive distortions. Another finding that was obtained in this study was that thought characteristics such as mindreading, catastrophizing, all-or-nothing thinking, emotional reasoning, personalization, minimizing the positive, and overgeneralization, CDS total scores were statistically significantly higher in the AD group with comorbid MDD. Conclusion: The study indicates that some cognitive distortions may be prevalent in AD or AD with comorbid depression. The importance of this study is the probability of laying the groundwork for future research in adolescents, the development of cognitive anxiety models, and guiding treatment practices.

Skin prick tests are a common method for diagnosing allergies in pediatric allergy clinics. Unfortunately, these tests can be distressing for children, causing pain and fear that can make them challenging to conduct. Virtual reality (VR) can be used to distract children during medical procedures. This study examines the effect of VR on skin prick test-related pain and fear in children. This parallel-group, single-blind, prospective, randomized controlled trial enrolled 233 children evaluated at the Pediatric Allergy Clinic and scheduled to undergo skin prick testing between March and June 2024. Among these children, 75 children aged 4–10 years who met the inclusion criteria were divided into two groups as VR group (n = 25) and control group (n = 25) by block randomization using gender and age group variables. The VR group wore VR goggles during the skin prick test, while the control group underwent the standard procedure. Pain and fear levels were assessed using the Wong-Baker FACES® Pain Scale and the Child Fear Scale. Children in the VR group exhibited a significant reduction in pain and fear levels associated with the skin prick test experience compared to the control group, as evaluated by children, parents, and researchers (p < 0.05). No side effects related to VR were reported. Conclusion: Virtual reality can be an effective tool in pediatric allergy clinics to reduce pain and fear during skin prick testing. By enhancing the child’s comfort, VR may also improve adherence to allergy follow-up and treatment, ultimately contributing to better clinical outcomes. What is Known: • Children often experience significant pain and fear during invasive procedures such as skin prick tests, and distraction methods have been shown to reduce pain and anxiety. What is New: • This study is the first randomized controlled trial to demonstrate that virtual reality (VR) significantly reduces pain and fear during skin prick tests in children. • This study supports the integration of new technologies such as VR as a standard practice for managing pain and fear during skin prick tests in pediatric allergy clinics. Trial registration: The clinical trial registration number is NCT06421779. Study start date: March 22, 2024. Study completion date: July 22, 2024. (https://clinicaltrials.gov/study/NCT06421779). Graphical Abstract

The aim of this study was to compare adolescents with disruptive mood dysregulation disorder (DMDD) and comorbid attention deficit hyperactivity disorder (ADHD) and healthy control adolescents in terms of emotional intelligence (EI), emotion regulation (ER) and theory of mind (ToM) abilities. Twenty-eight adolescents with DMDD and ADHD formed the DMDD group were compared to 31 healthy controls. We administered the Affective Reactivity Index (ARI), Difficulties in Emotion Regulation Scale (DERS), Kiddie-SADS, Bar-On Emotional Intelligence Test, Faux Pas, Comprehension Test, Unexpected Outcomes Test, Faces Test and Reading Mind in the Eyes Test (RMET) as ToM skills. ARI and DERS scores were significantly elevated in the DMDD-ADHD group. The DMDD-ADHD group had significantly lower ToM skills and emotional intelligence (p < .05). When RMET, Bar-On Emotional Intelligence Test -general mood, DERS- impulsivity scores were compared between the groups, their effect sizes were as follows: 0.52, 0.81, 0.79, respectively. DERS, emotional intelligence and ToM scores were correlated in the DMDD group. In the linear regression analysis, the sole significant predictors of self-reported irritability were EI and ED total scores. This study suggests that adolescents with DMDD and ADHD face difficulties in peer relationships, mentalizing, various domains of emotional intelligence andregulation. .