Aim We aimed to assess the impact of COVID‐19 on asthma exacerbations and to compare the severity of symptoms of SARS‐CoV‐2 infection of asthmatic children with those of healthy children. Methods The clinical course of COVID‐19 was compared among 89 children with asthma and 84 healthy children with age‐ and gender‐matched. Demographic factors, severity of asthma, duration of asthma, presence of atopy, type of treatment, and compliance to treatment in asthmatic children on clinical course of infection and to determine the risk factors for severe course for asthma exacerbation during COVID‐19 were evaluated retrospectively. Demographic characteristics, clinical symptoms, duration of complaints, and hospitalization rates were statistically compared between the two groups. Results Both groups had similar rates of symptomatic disease, hospitalization, and duration of fever. Among children with asthma mean age was 10.3 years, 59.6% were male, and 84.3% had mild asthma. Dyspnea was more prevalent in asthmatic children ( p :0.012), but other clinical findings were not different from those of healthy controls. 12.4% ( n :11) of asthmatic children had asthma exacerbation, 2.2% ( n :2) of them were hospitalized; one (1.1%) of which was due to asthma exacerbation. Conclusion The course of COVID‐19 in patients with mild to moderate asthma, who were followed up regularly and who were compliant with their treatment, was similar to their healthy peers. Since there was no severe asthma case in our study, the results could not have been generalized to all asthmatic patients. Further comprehensive and multicenter studies are required in pediatric population.

Asthmatic patients are not immunised regularly with influenza vaccine due to misperceptions about vaccine effectiveness and fear of adverse effects. Another important reason of this is that most the physicians caring for these patients neither immunise themselves nor recommend the vaccine to their patients.

Many surveys worldwide have consistently demonstrated a low level of asthma control and under-utilization of preventive asthma drugs. However, these studies have been frequently criticized for using population-based samples, which include many patients with no or irregular follow-ups. Our aim, in this study, was to define the extent of asthma drug utilization, control levels, and their determinants among children with asthma attending to pediatric asthma centers in Turkey. Asthmatic children (age range: 6-18 yr) with at least 1-yr follow-up seen at 12 asthma outpatient clinics during a 1-month period with scheduled or unscheduled visits were included and were surveyed with a questionnaire-guided interview. Files from the previous year were evaluated retrospectively to document control levels and their determinants. From 618 children allocated, most were mild asthmatics (85.6%). Almost 30% and 15% of children reported current use of emergency service and hospitalization, respectively; and 51.4% and 53.1% of children with persistent and intermittent disease, respectively, were on daily preventive therapy, including inhaled corticosteroids. Disease severity [odds ratio: 12.6 (95% confidence intervals: 5.3-29.8)], hospitalization within the last year [3.4 (1.4-8.2)], no use of inhaled steroids [2.9 (1.1- 7.3)], and female gender [2.3 (1.1-5.4)] were major predictors of poor asthma control as defined by their physicians. In this national pediatric asthma study, we found a low level of disease control and discrepancies between preventive drug usage and disease severity, which shows that the expectations of guidelines have not been met even in facilitated centers, thus indicating the need to revise the severity-based approach of asthma guidelines. Efforts to implement the control-based approach of new guidelines (Global Initiative for Asthma 2006) would be worthwhile.

A ny reaction that occurs after the intake of food is an adverse food reaction and an adverse food reaction mediated by the immune system is defined as food allergy. [1,2] Food allergy is most commonly seen with intake of milk, egg, wheat, soy, peanuts, nuts, fish and shellfish. [3] Food al-lergies are classified as immunoglobulin E (IgE) mediated, non-IgE mediated (non-IgE) and mixed type. In IgE-mediated food allergy, symptoms are seen after a short time (within minutes-2 hours). [4] Skin (urticaria, angioedema), gastrointestinal system (oral allergy syndrome, gastroin-Objectives: This study aimed to examine the clinical and laboratory features of the patients diagnosed with food allergy who applied to the pediatric allergy outpatient clinic. Methods: This study was performed between March 2016 and December 2017 as a cross-sectional observational study. The files of 90 patients with food allergy were evaluated retrospectively. Results: Ninety patients were included in the study. Sixty three (70%) of the cases were male and 27 (30%) were female. The median age of the patients was 12 months (range 3-156), and the age at onset of symptoms was 4 months (1-156). At the time of the diagnosis, the total number of eosinophils was 410/mm 3 (0-4600), and the total IgE value was 83.1 IU/ml (3.17-2500). When the cases were divided into two groups according to their gender, no significant difference was found between the groups regarding the median age, onset age of the symptoms, total IgE, eosinophil and specific IgE levels. Fifty (55.6%) cases had atopic dermatitis, 31 (34.4%) had urticaria, 6 (6.7%) had proctocolitis, 2 (2.2%) had angioedema and 1 (1.1%) had anaphylaxis. Thirty-four (37.8%) of the cases had IgE-mediated, six (6.7%) cases had non-IgE mediated, and 50 (55.5%) cases had mixed type food allergy. The most common food allergens were egg 29 (32.2%), cow's milk and egg 27 (30%) and cow's milk 22 (24.4%). In the skin prick test, sensitivity was found in 52 (57.7%) patients. The most common sensitization was against egg (22.2%). Specific IgE values were found as F1: 0.87 kU/L (0.10-100), F2: 0.30 kU/L (0.10-96.90) and F5: 0.48 kU/L (0.10-53). Conclusion: Egg and cow's milk allergy were the most common food allergens in our study. However; more than half of the patients were diagnosed with atopic dermatitis. Evaluation of the patients with atopic dermatitis in terms of food allergy may be appropriate.

Evaluation of the Knowledge of Cow's Milk Allergy among Pediatricians C ow's milk allergy (CMA) is one of the most common food allergies to occur in infants and children under 3 years of age. The incidence in early childhood varies between 2% and 7.5%. [1] Studies carried out in different regions in Turkey have recorded an incidence of between 0.55% and 1.55%. [2-4] Clinical symptoms of CMA manifest in infants fed with breast milk generally within the first months of life, and in infants fed with formula containing cow's milk, it may be seen in just days or weeks following formula intake. [5] Clinically, skin findings reflecting an allergic reaction are observed in 50% to 60%, gastrointestinal system symptoms are seen in 50% to 60%, and respiratory system symptoms appear in 20% to 30% of CMA patients. [6, 7] Immunoglobulin E (IgE)-mediated reactions typically occur within 1 to 2 hours after ingestion of cow's milk, and non-IgE-mediated reactions may be seen some 2 hours after intake. Due to the role of cellular and humoral mechanisms in mixed-type reactions, the symptoms may be acute or chronic. [5] There are at least 20 protein compo-Objectives: The aim of this study was to determine the level of knowledge of pediatric residents and practicing pediatricians about cow's milk allergy (CMA) and to evaluate the effect of occupational education. Methods: Pediatric residents and pediatricians were included in the study. A survey about CMA was administered to the participants before and after occupational training. Results: A total of 45 doctors were included in the study. Of the group, 31 were pediatric residents and 14 were practicing pediatricians. The pediatric resident group had a mean of 2.3 years professional experience, and the mean was 8.9 years in the pediatrician group. The mean number of correct answers of a possible score of 10 before the training was 8.32±1.37 in the resident group and 7.5±1.69 in the pediatrician group. There was no significant difference between the groups (p=0.09). The mean number of correct answers after training was 10 in the pediatric resident group, and 9.71±0.6 in the pediatrician group. The difference between the groups was statistically significant (p=0.01). Intragroup evaluation post training revealed significantly higher scores (p=0.001). Conclusion: The results of this study indicate that occupational education significantly increased the level of knowledge about CMA in both pediatric residents and practicing pediatricians.