Breastfeeding Duration Reduces the Risk of Childhood Leukemia and Modifies the Risk of Developing Functional Gastrointestinal Disorders.

Objective: The aim of this study was to test the hypothesis that the duration of breastfeeding in infancy reduces the risk of childhood leukemia or lymphoma, and modifies the risk of developing functional gastrointestinal disorders (FGIDs). Subjects and Methods: This case-control study involved the recruitment of children with lymphoid malignancy and functional gastrointestinal symptoms with healthy children as controls. Focused questionnaires were used to collect data on breastfeeding history and other key risk factors. Univariate and multivariate analyses were undertaken. Results: Of the 334 children with lymphoid malignancy, 65% were male. The control group included 334 age- and sex-matched participants. Most (n = 189; 56.6%) of the children with leukemia were <10 years of age. Differences between cases and controls included the duration of breastfeeding (p < 0.0001), mean birthweight (p < 0.001), maternal age (p < 0.001), paternal age (p < 0.001), birth order (p < 0.001), mean number of children (p < 0.001), BMI percentile (p = 0.042), and maternal smoking (p = 0.012). Breastfeeding duration of up to 6 months' duration, when compared with feeding of longer than 6 months, was associated with increased odds ratios (OR) for acute lymphoblastic leukemia (OR = 3.43, 95% confidence interval [CI] 2.37-4.98; p < 0.001), Hodgkin's lymphoma (OR = 1.58, 95% CI: 0.88-2.84, p = 0.120), Non-Hodgkin's lymphoma (OR = 2.14, 95% CI: 1.25-3.65, p = 0.005), and overall (OR = 1.95, 95% CI: 1.40-2.71, p < 0.001). Cases also differed from controls with regard to FGIDs, such as stomach ache (p < 0.001), dyspepsia (p < 0.001), early satiety (p = 0.017), bowel satisfaction (p < 0.001), bloating (p < 0.001), nausea (p = 0.005), vomiting (p = 0.039), constipation (p = 0.003), diarrhea (p = 0.010), gastrointestinal canal congestion (p =0.039), muscle aches pains (p = 0.008), fecal incontinence (p = 0.021), and indigestion (p = 0.003). A multivariate stepwise regression analysis revealed that maternal smoking (p < 0.001), formula feeding (p < 0.001), duration of breastfeeding (p < 0.001), birth order (p = 0.002), mother's age (p = 0.004) and the child's birthweight (p = 0.009) were predictors for leukemia. Further analysis showed that dyspepsia (p < 0.001), gastrointestinal tract canal congestion (p < 0.001), constipation (p = 0.009), diarrhea (p = 0.013), bowel satisfaction (p = 0.021), bloating (p = 0.022), duration of breastfeeding (p < 0.001), and stomach ache (p = 0.025) were significant predictors for developing FGID symptoms after adjusting for age, gender, and other confounding variables. Conclusion: This study confirmed that breastfeeding has some effect on reducing possible risk of childhood lymphoma and leukemia and FGID symptoms compared with healthy control children.

Sleep quality, quality of life, fatigue, and mental health in COVID-19 post-pandemic Türkiye: a cross-sectional study.

Aim: This study explores the predictors and associated risk factors of sleep quality, quality of life, fatigue, and mental health among the Turkish population during the COVID-19 post-pandemic period. Materials and methods: A cross-sectional survey using multi-stage, stratified random sampling was employed. In total, 3,200 persons were approached. Of these, 2,624 (82%) completed the questionnaire package consisting of socio-demographic information, Pittsburgh Sleep Quality Index (PSQI), the WHO Quality of Life Brief Version (WHOQOL-BREF), Fatigue Assessment Scale (FAS), Patients Health Questionnaire (PHQ-15), GAD-7 anxiety scale, and the 21-item Depression, Anxiety, Stress Scale (DASS-21). Results: Significant differences between genders were found regarding socio-demographic characteristics (p < 0.01). Using PHQ-15 for depressive disorders, significant differences were found between normal and high severity scores (≥ 10), regarding age group (p < 0.001), gender (p = 0.049), educational level (p < 0.001), occupational status (p = 0.019), cigarette smoking (p = 0.002), waterpipe-narghile smoking (p = 0.039), and co-morbidity (p = 0.003). The WHOQOL-BREF indicated strong correlations between public health, physical health, psychological status, social relationships, environmental conditions, and sleep disorders (p < 0.01). Furthermore, comparisons of the prevalence of mental health symptoms and sleeping with PHQ-15 scores ≥ 10 (p = 0.039), fatigue (p = 0.012), depression (p = 0.009), anxiety (p = 0.032), stress (p = 0.045), and GAD-7 (p < 0.001), were significantly higher among the mental health condition according to sleeping disorder status. Multiple regression analysis revealed that DASS21 stress (p < 0.001), DASS21 depression (p < 0.001), DASS21 anxiety (p = 0.002), physical health (WHOQOL-BREF) (p = 0.007), patient health depression-PHQ-15 (p = 0.011), psychological health (WHOQOL-BREF) (p = 0.012), fatigue (p = 0.017), and environmental factors (WHOQOL-BREF) (p = 0.041) were the main predictor risk factors associated with sleep when adjusted for gender and age. Conclusion: The current study has shown that sleep quality was associated with the mental health symptoms of depression, anxiety, stress, and fatigue. In addition, insufficient sleep duration and unsatisfactory sleep quality seemed to affect physical and mental health functioning.

The Etiology and Clinical Features of Anaphylaxis in a developing country: A nationwide survey in Turkey.

BACKGROUND: Despite the increasing frequency of anaphylaxis, there is inadequate information on the etiology and clinical features in various countries, regions and age groups, especially in developing countries. OBJECTIVE: Our aim is to assess the etiology and clinical findings of anaphylaxis in Turkey. Gathering reliable data about the etiology and clinical findings of anaphylaxis in the general population will decrease the related morbidity and mortality. METHOD: We obtained the names and phone numbers of individuals who had been prescribed an epinephrine auto-injector with a diagnosis of anaphylaxis from ministry of health. Demographic data, clinical history of the first episode of anaphylaxis including the triggering agent, clinical findings, course of hospitalization, and the management of anaphylaxis were obtained by phone survey. RESULTS: A total of 843 patients with a mean age of 21.4±17.3 years were evaluated. There was a significant male predominance among children younger than 10 years of age but a female predominance in older subjects. The most common causes of anaphylaxis were foods(40.1%) in children and bee venom(60.8%) in adults. The biphasic reaction rate was 4.3% and the median length of stay at an emergency department was 4.0 hours. Almost 60% of the patients had recurrent anaphylaxis episodes. Only 10.7% of the cases were prescribed an epinephrine auto-injector at their first anaphylaxis episode and only 59.2% of the patients were referred to an allergist during discharge from the emergency department. CONCLUSIONS: In Turkey, bee venom was the most common cause of anaphylaxis, followed by food and drug. While more than a half of patients reported recurrent attacks; only 10% had been prescribed epinephrine auto-injector kit after their first episode. Strategies to improve the anaphyalxis management are therefore urgently required.