Cetirizine use in childhood: an update of a friendly 30-year drug

Prevalence and Regional Factors in the Development and Course of Allergic Diseases in Children in Southern Kyrgyzstan

Background: The prevalence of allergic diseases in children worldwide has increased rapidly over the past 30 years. This study aimed to identify regional factors influencing the development and course of allergic diseases for further prevention, control, and reduction of the risk and frequency of complications. Methods: To investigate the issue, 104 studies by different authors and countries, as well as topics related to allergy in children, air pollution, and regional factors of detection and prevalence of this disease in Kyrgyzstan, were selected. Of these, 52 studies were noted and analysed, which met the selection criteria and were of direct importance in this topic. Results: This study of allergic diseases in children found that more than 35% of children worldwide suffer from allergic diseases. Of these, allergic rhinitis occurs in 12% of children, atopic dermatitis is less common, but its incidence is 10-20%, and bronchial asthma, according to statistics, covers more than 14% of children. Conclusion: The results of the study helped to investigate the prevalence of allergic diseases relative to the region of residence, the impact of environmental pollution, geographical significance, and the effect of smoking on the development of allergies in children.

Practical experience of allergy to egg proteins clinical manifestation

Food allergy occupies a significant place among disorders that impair the quality of patients’ lives, bringing a large number of restrictions to their diet and lifestyle. Therefore, the purpose of this study is to examine the clinical features of allergy to chicken eggs with the determination of key trends in diagnosis and treatment. A descriptive and comparative analysis of three cases was carried out with a large-scale assessment of specific Immunoglobulins E (IgE), determined by the enzyme-linked immunosorbent assay. It becomes clear, that due to the high prevalence of allergy to white and yolk of chicken eggs in the general population (among the Polish population including), chicken eggs have severe allergenic characteristics and may display various symptoms that may be problematic to differentiate. The patients from the presented cases were characterized by a severe course of the disease – minimal consumption of chicken eggs led to the development of urticaria, swelling of the eyelids, and bronchospasm, which required urgent administration of adrenaline and hospitalization. For the purpose of diagnosis, patients with anaphylactic reactions are highly restricted, because methods of skin prick testing, and provocation tests (oral and nasal) are contraindicated. In this regard, molecular diagnostics and the determination of specific immunoglobulins E for ovalbumin, ovomucoid, and other glycoproteins are recommended. This research can lead to the creation of purified recombinant allergens for use in the process of diagnosis and treatment, as well as in the food industry, also, it emphasizes the introduction of preventive measures for the development of anaphylaxis.

Side effects and hypersensitivity reactions to corticosteroids

The relevance of the topic under study is due to the fact that patients receiving large or repeated doses of corticosteroids often suffer from hypersensitivity reactions or side effects from taking this category of drugs. As a result, this poses a serious problem for healthcare authorities, as the scientific understanding of this phenomenon is still at an early stage. The purpose of study is to comprehensively disclose the various types of mechanisms underlying corticosteroid hypersensitivity, as well as to develop recom­mendations for more accurate methods of diagnosis, treatment, and prevention of this reaction. To achieve this goal, this theoretical study used various methods, including analysis, deduction, abstraction and generalization, and the method of synthesis. The results of the study underscore the broad spectrum of applications for corticosteroid drugs in medicine, highlighting their systemic effects and potential for side effects and hypersensitivity reactions across various bodily systems. These adverse reactions encompass hyperglycemia, hypertension, respiratory issues, visual impairments, skin conditions like contact dermatitis, bone tissue complications, and behavioral disorders, notably in children. Administering cortico­steroids in COVID-19 treatment necessitates caution due to the potential for life-threatening immediate hypersensitivity reactions, which may be mistaken for disease progression. The results and conclusions of this study, which were formed using the above methods, may lead to a more accurate diagnosis of hypersensitivity to drugs such as corticosteroids, and may also contribute to the development of effective preventive measures. This study is of practical importance for dermatologists, allergists and immunologists, as well as researchers working in the field of rheumatology, allergology and immunology.

Impact of gibberellin-regulated protein allergy on quality of life

The purpose of this study was to investigate possible allergens that cause gibberellin-regulated protein allergy. For this purpose, a thorough search of relevant information in the databases Embase, PubMed, Scopus, and Web of Science, presented for 2018-2023, was carried out. The study showed that about 4% of the world’s population suffers from food allergies. The main manifestations of allergic reactions and the degree of resistance to allergens depend on the age group of patients. The study identified the following food allergens in gibberellin-regulated protein allergy: Pru p7 (peach), Pru m7 (Japanese apricot), Cit s7 (orange), Pun g7 (pomegranate), Pru av7 (sweet cherry), Cap a7 (bell pepper), Fra a3 (strawberry), Cup s7 (cypress pollen). Gibberellin-regulated protein allergy is characterised by a predominantly adolescent and young adult population. The symptoms of this allergy usually manifest themselves in the form of oral syndrome, facial swelling (including eyelids), anaphylactic reactions and are aggravated by the action of cofactors. Such manifestations substantially impair the quality of life of patients, causing a social, psychological, and economic burden.

Research Advances in the Treatment of Allergic Rhinitis by Probiotics

Allergic rhinitis (AR) impairs the quality of life of patients and reduces the efficiency of social work, it is an increasingly serious public medical and economic problem in the world. Conventional anti-allergic drugs for the treatment of allergic rhinitis (AR) can cause certain side effects, which limit the quality of life of patients. Therefore, it makes sense to look for other forms of treatment. Several studies in recent years have shown that probiotics have shown anti-allergic effects in various mouse and human studies. For example, the application of certain probiotic strains can effectively relieve the typical nasal and ocular symptoms of allergic rhinitis in children and adults, thereby improving the quality of life and work efficiency. At the same time, previous studies in humans and mice have found that probiotics can produce multiple effects, such as reduction of Th2 cell inflammatory factors and/or increase of Th1 cell inflammatory factors, changes in allergy-related immunoglobulins and cell migration, regulate Th1/Th2 balance or restore intestinal microbiota disturbance. For patients with limited activity or allergic rhinitis with more attacks and longer attack duration, oral probiotics have positive effects. The efficacy of probiotics in the prevention and treatment of allergic rhinitis is remarkable, but its specific mechanism needs further study. This review summarizes the research progress of probiotics in the treatment of allergic rhinitis in recent years.

Pediatric chronic spontaneous urticaria: a brief clinician's guide

INTRODUCTION

Chronic urticaria (CU) appears with daily or intermittent/recurrent wheals with/without angioedema for more than six weeks. When no specific eliciting factors are found, chronic urticaria is defined as spontaneous (CSU). Up to 50% of patients with CSU do not respond to therapy, leading to a prolonged disease course and the need for expensive therapies, impacting the quality of life (QoL) and healthcare resources.

AREAS COVERED

: Diagnosis of CSU is made when other potential causes of chronic urticaria are excluded. CSU therapy aims to achieve complete control of symptoms and normalization of QoL. Current treatment options for urticaria aim to target mast cell mediators such as histamine, or activators, such as autoantibodies. Guidelines recommend starting with second generation antihistamines (sgAHs) and adding omalizumab therapy if symptoms are not controlled. This review aims to provide a practical guide for CSU in the pediatric population.

EXPERT OPINION

: Treatment options for pediatric CSU are primarily based on adult data that have been extrapolated for children. Current guidelines should be re-evaluated based on pediatric data, new biological treatments, and the COVID-19 pandemic. Future research is needed to investigate strategies to personalize current treatments and identify potential predictive biomarkers.

Comparing available treatments for pollen-induced allergic rhinitis in children

INTRODUCTION

Pollen-induced allergic rhinitis (PIAR) is a widespread disease in children, and its prevalence is rapidly evolving. In addition, it may be associated with other atopic diseases, in particular asthma. In most cases, PIAR can be treated effectively by avoiding exposure to responsible allergens and using symptomatic treatments, including intranasal/oral antihistamines or/and nasal corticosteroids, according to ARIA guidelines. In recent decades, new medicines have been studied and developed: allergen-specific immunotherapy (AIT), anti-IgE antibodies, and probiotics. In addition, nutraceuticals have also been used as add-on treatments. This review aims to discuss and compare the old and new therapeutic strategies for PIAR in children.

AREAS COVERED

Allergic rhinitis is a type 2 inflammatory disease. The management of patients with PIAR entails medications, AIT, and ancillary therapies. In addition, children with PIAR and associated severe asthma may be inclusively treated with biologics. Namely, subjects with allergic comorbidities could benefit from biological agents. However, AIT presently remains the unique causal treatment for PIAR.

EXPERT OPINION

New strategies may include combined treatments, mainly concerning fixed associations with antihistamines and corticosteroids, nutraceutical products, and new AIT formulations.

Cetirizine for the treatment of allergic diseases in children: A systematic review and meta-analysis

OBJECTIVE

The global prevalence of allergic diseases has led to a negative and extensive impact on the health and lives of a large population of children. This study investigates the efficacy, acceptability, and safety of cetirizine (CTZ) for treating allergic diseases in children and provides evidence-based assertions for decision-making.

METHODS

PubMed, Embase, the Cochrane Library, World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov, and the European Union Clinical Trials Register were systematically searched from inception to April 21, 2022. Randomized controlled trials (RCTs) or quasi-RCTs of children with allergic diseases receiving CTZ compared with those receiving placebo or other drugs were included without language limitations. Two investigators independently identified articles, extracted data, conducted meta-analyses, assessed the Cochrane risk of bias of individual studies, and evaluated the evidence certainty using the Grading of Recommendations Assessment, Development, and Evaluation approach; any discrepancies were resolved by consulting with a third investigator. Primary outcomes included scales that evaluated the recovery of allergic conditions in AR, such as the total symptom score (TSS). Secondary outcomes included laboratory test changes, safety (adverse events, AEs), and quality of life (QOL). Data were pooled using the Cochrane Review Manager 5.4, and a fixed-effects model was used if heterogeneity was evaluated as low (I ² < 50%); otherwise, a random-effects model was adopted.

RESULTS

A total of 22 studies (5,867 patients) were ultimately included [eight with perennial AR, six with seasonal AR, four with atopic dermatitis (AD), and four with other allergic diseases], most of which had a low or unclear risk of bias. Moderate certainty evidence showed that CTZ was found to benefit allergic symptom control [mean difference (MD) of TSS at 1 week: MD, -0.32 (-0.52, -0.12); at 2 weeks: MD, -0.25 (-0.35, -0.14); at 4 weeks: MD, -4.07 (-4.71, -3.43); at 8 weeks: MD, -4.22 (-4.73, -3.72); at 12 weeks: MD, -5.63 (-6.14, -5.13); all P-values were less than 0.05] and QOL [at 12 weeks: MD, -23.16 (-26.92, -19.39); P < 0.00001] in children with AR. It had similar efficacy compared with other antihistamines (AHs) or montelukast, without showing better control of AD severity in children. Moderate-to-low certainty evidence demonstrated that CTZ was well tolerated and did not increase the risk of severe and overall AEs, cardiotoxicity, damage to the central nervous and digestive systems, or other systems in children, except for the risk of somnolence [risk ratio, 1.62 (1.02, 2.57); P = 0.04, compared with placebo].

CONCLUSION

Moderate-to-low certainty evidence revealed that CTZ could improve clinical improvement and QOL in children with AR and have comparable efficacy with other AHs. CTZ is well tolerated in the pediatric population, except for an increased risk of somnolence.

SYSTEMATIC REVIEW REGISTRATION

[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021262767].

Nasal Nitric Oxide and Nasal Cytology as Predictive Markers of Short-Term Sublingual Allergen-Specific Immunotherapy Efficacy in Children with Allergic Rhinitis

BACKGROUND

Few studies have been conducted on the short-term response to sublingual immunotherapy (SLIT).

OBJECTIVE

The purpose of our experimental trial was to evaluate if two markers such as nasal nitric oxide (nNO) and nasal cytology could be useful to identify a precocious clinical efficacy of SLIT treatment.

METHODS

We enrolled 34 children aged 6 to 14 years old with diagnosis of allergic rhinitis (AR) and documented sensitization towards house dust mites. We started allergoid-monomeric tablets immunotherapy along with any conventional therapy for AR and we evaluated at baseline (T0), after one (T1), two (T2), three (T3), and six months (T6) the effects of the treatment through the study of: i) a visual analogue scale (VAS 1-10); ii) measurement of nNO; iii) measurement of FeNO; iv) nasal cytology; v) spirometry; and vi) evaluation of any conventional therapy.

RESULTS

We observed an improvement in symptoms evaluated by global VAS (T0 vs. T6: 47.13 vs. 17.57; p < .05) and a statistically significant reduction of nNO (1035.2 ± 956.08 vs. 139.2 ± 59.01; p < .05). In this case, significance was reached when the patients completed the 6 months of treatment. Cytological evaluation revealed significant reduction in nasal eosinophils (T0 vs. T6: 87% vs. 16%; p < .01). Moreover, at T0, 56% of patients had also neutrophils that were reduced up to the 8% at T6 (p < .05).

CONCLUSIONS

Our data confirm the effectiveness of SLIT treatment from a clinical perspective and identifies two biomarkers, such as nNO and nasal cytology, as predictive of treatment efficacy in the short term.

Single Vibroacoustic Impact Effect of Singing Bowls over the Psycho-Emotional State and Cardiovascular System Work

This article presents a two-stage study result of the author's method of vibroacoustic massage using singing bowls application. At the first stage, the effect of vibroacoustic massage single application over psycho-emotional characteristics was studied. 19 studied volunteers took part in our study. The testing results before and after exposures were compared according to the WAM (Weighted average mark), Zung, and Spielberg-Khanin tests. The study of the psycho-emotional sphere showed that after the vibroacoustic massage procedure, the indicators of "well-being" and "activity" of the WAM test significantly improved (p = 0.002). In addition, the depression level determined by the Zung test, personal anxiety indicators (p = 0.004), and situational anxiety ones (p = 0.028) decreased. At the second stage, 62 volunteers were divided into two groups. The first group underwent a vibroacoustic massage session according to the patented author's method. The second group received only acoustic exposure using only singing bowls. Differences in the Kerdo index were revealed in the dynamics, and in the first group, the changes were less significant than in the second one. Changes in heart rate variability characteristics for both groups were similar: there was an increase in parasympathetic influences at rest and during the orthostatic test (increased levels of RMSSD (Root Mean Square of Successive Differences), NN50, pNN50) and a decrease in sympathetic effects at rest and their slight increase with orthostatic loading (TINN, RR triangular index). The dynamics were more significant in the first group that received a vibroacoustic massage session. When assessing changes in the neurovegetative regulation levels activity of the heart rhythm, the main difference was associated with very low-frequency waves power dynamics during the orthostatic test. Thus, vibroacoustic massage using singing bowls improves the psycho-emotional state, reduces depression and anxiety, and increases Parasympaticus (autonomic nervous system) activity.

Study of the Characteristic Mental Development Features of Primary School Students with Visçion Impairments

Severe vision impairments are an obstacle to the adequate cognitive and social development of the child. The educational response to priority problems that occur with vision disorders requires appropriate training of vision impairment specialists. For this purpose, they need basic knowledge related to the classification of vision impairments and the main aspects of the development and education of this category of children. This study aimed to analyse the main features of educational activities of children with vision impairments using special diagnostic methods and to search for effective methods for correcting the cognitive activity of children with vision impairments. During the study, an experiment was conducted with children with vision impairments (15 children). To conduct the experiment, the study used methods proposed by V.V. Tarasun and adapted them to the contingent of children with vision impairments. In particular, the following methods: the method of motivational preferences "Three wishes", the method of "Memorising 10 words", and the method of "What, why, how". The depth and time of vision impairment are considered as a primary defect, which has corresponding secondary consequences and requires corrective action under the guidance of an experienced vision impairment specialist.

Emotional Intelligence and Burnout of Teachers of Higher Education Institutions

Emotional intelligence is an important resource for overcoming professional stress in members of socionomic professions. The research objective is to determine the role of its components in the development of emotional burnout. A natural experiment was conducted, which determined the manifestations of emotional burnout of 56 university teachers at the end of the academic year. The author used the questionnaire. Two experimental groups were identified in the general sample: teachers with burnout and those resistant to burnout (16 and 30 people, respectively). At the end of the academic year, signs of burnout were detected in one-third of university teachers. The leading symptoms are emotional exhaustion and depersonalisation, with no reduction in professional achievement. The dynamics of emotional life during the annual professional cycle are shown. The integrated indicator of emotional intelligence (EI) remains at the same level, but there are structural changes in the components of intrapersonal intelligence. At the end of the year, teachers' attention to their emotional states, work roles, and communication increase significantly. At the same time, there is a decrease in the ability to manage their own emotions. Resistance to burnout is accompanied by a high ability to realise and control their own emotions with a relatively vague focus on the emotional states of others. It was concluded that individual components of EI (intrapersonal and interpersonal, understanding and management) have different effects on burnout symptoms.

Cooperation with Parents on Environmental Education of Preschool Children with Speech Disorders

This article presents a comprehensive pedagogical technology for correctional and developmental work with parents and their preschool children with speech disorders. The purpose of this article is also to consider the change in parents' attitude to the environmental education of a child with speech disorders. The project is designed to involve parents and increase their interest in the environmental education of preschoolers with speech disorders. It is investigated to what extent the involvement of parents and teachers in joint research projects increases competencies in terms of knowledge, abilities, and attitudes to educational processes. The article uses several methods of synthesis and analysis in research. The descriptive method and the experimental method were also used. The hypothesis is that using a comprehensive program involving parents for research and experimental activities in environmental education of preschool children with speech disorders promotes the more successful acquisition of knowledge about nature, improves therapy, and strengthens family relationships. In technology, attention is paid to the actual educational activities and the reflection of teachers' and parents' internal structures of competencies. The presented technology systematizes the instrumental-methodical, expressive (behavioral) aspects of teaching and raising a child with speech disorders and provides a universal basis for any intervention program to change attitudes and involve parents in educational work.

Fundamentals and Main Provisions of the Functional-Procedural Concept of Mental Deprivation

Science still does not have a single scientifically sound concept of mental deprivation, which would explain its psychological essence, this mental phenomenon cannot be adequately assessed, or measures to prevent or eliminate negative mental phenomena it provoked cannot be developed. The article aims to reveal the basic principles and substantiate the main provisions of the functional-procedural concept of mental deprivation. Psycho-energetic and energy-psycho-functional approaches were used, as well as methods of analysis, synthesis, abstraction, specification, comparison, generalisation, and grouping of knowledge about the human psyche. The functional-procedural concept of mental deprivation of humans covers an interconnected system of provisions. According to them, mental deprivation is a course of more or less powerful destructive processes in the functioning of his psyche. Such processes arose from the destruction of mental parameters in various areas due to long-term unfulfilling necessary for normal functioning and development. The development of a functional-procedural concept of mental deprivation of a human will make it possible, first, to adequately define its essence and content in the scientific dimension as a phenomenon of the psyche; secondly, to assess its impact on the functioning of the whole psyche; third, to disclose the impact on development or its delay, actions, behaviour, and activities of an individual; fourth, to develop psychotherapeutic measures to prevent the occurrence of mental deprivation and eliminate its negative consequences.

Formation Mechanisms of Emotional Intelligence of a Future Psychologist in the Context of Vocational Education

Objective: Emotional intelligence is an indicator of a person's ability to communicate, the ability to be aware of their emotions and understand the feelings of others. Background: The development of the emotional intelligence of junior university students occurs through various activities, especially in the process of specially organised training and education. This work aims to study the mechanisms of formation of emotional intelligence and stages of formation of emotional intelligence in psychology  students. Method: Data analysis, synthesis and pedagogical modelling were used. Scientific works on the formation of emotional intelligence were studied. Results: This paper presents a model of the formation of emotional intelligence in students of psychology and practical recommendations for the formation of emotional intelligence in students. Conclusion: The results obtained in this work can be used in practice during the training of psychological and pedagogical faculties students. Also, the materials presented in this paper can be used by teachers of psychology and pedagogy.

Cough Remedies for Children and Adolescents: Current and Future Perspectives

Cough is a widespread symptom in children and adolescents. Despite advances in scientific knowledge about the neurophysiological mechanisms underlying the cough reflex, the best therapeutic approaches for children and adolescents who cough remain unclear, and many needs are still unmet. Many remedies for cough are self-prescribed, reflecting strong demand, but significant evidence of their efficacy and safety is missing in pediatric populations. Moreover, as most coughs are part of self-limited illnesses, treatment could be considered unnecessary in some patients. Drug therapy to relieve cough and other symptoms is an essential part of treating a child with cough. However, unfortunately, the number of studies in each category of cough medications is minimal, and dosing and treatment duration varies significantly among studies. Some treatments have been shown to be no more effective than placebo. Lack of clear indications for dosing and treatment duration, the number of available drugs, the numerous active ingredients in products, and multiple caregivers administering medication to children have been considered contributors to an increased risk of inappropriate prescribing, accidental overdosing, and adverse events. This review presents the most recent evidence on the safety and efficacy of available cough remedies, focusing on the pediatric age group, and includes H₁ receptor antagonists, mucolytics and expectorants, drugs acting peripherally on the cough reflex, drugs acting centrally on the cough reflex, drugs acting both peripherally and centrally on the cough reflex, and other compounds, including menthol, glycerol, honey, and medical devices composed of complex natural substances. Future perspectives on new therapeutic targets are also discussed.

Current and emerging pharmacotherapy for pediatric allergic rhinitis

INTRODUCTION

Allergic rhinitis (AR) is a global health problem in adults as well as the younger population, continuously increasing and posing a significant problem for patients, health care systems and economies. For the younger population, some aspects differ from treatment of adults, namely, prevention, compliance and adherence.

AREAS COVERED

This narrative review summarizes all the pharmacotherapeutic options with special focus on the pediatric population. Moreover, it elucidates prevention strategies as well as future developments of AR treatment. Currently, symptomatic therapy in the form of steroids and antihistamines is applied topically and systemically where steroids need to be administered with caution and for a very short term. The only disease-modifying and causal treatment is allergen immunotherapy administered sublingually and subcutaneously. Future and current novel therapeutic options are human monoclonal antibodies.

EXPERT OPINION

The greatest potential for future developments currently lie in allergen immunotherapy and here in different routes of administration and modification of (recombinant) allergens as well as immune-modulating adjuvants and nanoparticles. Secondly, monoclonal antibodies are promising molecules blocking and/or interfering with up- and downstream immune mechanisms. Another important aspect lies in prevention of allergic sensitization and disease progression through both AIT and biologics which is particularly true for the pediatric population.