The association between stressful life events and respiratory infections during the first 4 years of life: The Environmental Determinants of Diabetes in the Young study

The aim of this study was to conduct a prospective analysis of the association between negative life events (NLEs) and respiratory infections in children genetically at risk for islet autoimmunity (IA) and type 1 diabetes (T1D). Long- and short-term temporal associations between NLEs and rate of respiratory infection episodes (RIEs) in 5,618 children in The Environmental Determinants of Diabetes in the Young study for at least 1 up to 4 years were analysed. All models were adjusted for demographic, day care, season of infection, and psychosocial factors associated with the rate of child RIEs between study visits. The rate of child RIEs was 26% higher in Europe (Sweden, Finland, Germany) than in the United States (rate ratio [RR] = 1.26, p < 0.001). However, the percentage of child NLEs (odds ratio [OR] = 1.18, p < 0.001) and mother NLEs (OR = 1.83, p < 0.001) was higher in the United States compared with Europe. In both continents (Europe, RR = 1.12, p < 0.001; United States, RR = 1.07, p = 0.006), high child cumulative NLEs (>1 NLE per year since study inception) was significantly associated with an increased rate of child RIEs. This large-scale prospective study confirms observations that stress may increase the susceptibility for infections in paediatric populations and suggests at least one mechanism by which stress could increase risk for IA and T1D in genetically at risk children.

Diseases of the Upper Respiratory Tract in Preschool and School Age Children in Ambulatory Ear Nose Throat Practice

The most common diseases of the upper respiratory tract in children treated by ear-nose-throat (ENT) specialists in ambulatory practice are infections, such as colds, rhinitis, sinusitis and pharyngitis, very frequently accompanied and promoted by chronic nasal obstructions of various etiology. These diseases, when treated incorrectly or for too long, cause frequent school absenteeism and may also lead to hearing disorders linked with acute or suppurative otitis. They may also habitually perpetuate abnormal breathing and result in occlusal disorders. The aim of this study was to assess the incidence and type of upper respiratory tract diseases in children, depending on age and sex of patients and on the seasons. We also discussed the role of the ENT specialist in the diagnosis and treatment of certain diseases. In the study we analyzed the medical records of patients of preschool and school age treated in the ENT outpatient clinic over one calendar year. It was found that the largest group of patients comprised children of 3-7 years of age, and most children visited the outpatient clinic in the period March-May. The most common main disorder, according to ICD-10, was acute nasopharyngitis (J00) and vasomotor and allergic rhinitis (J30). Among the comorbid disorders H65 and H66 were the most frequent. No significant gender differences were noted in the frequency of particular types of disease.