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For allergic diseases to develop, three components must be present: heredity, allergen contact and environmental factors. Allergic diseases are the most common chronic diseases in children and adolescents. This paper aims to present the latest findings on prenatal and perinatal risk factors for the development of atopic disease. The analysis was conducted by researching papers from the MEDLINE and PubMed databases published before September 2021. It has been determined that a mother's immune system during pregnancy plays a key role in the development of the fetus and affects the overall well-being of her offspring later in life. Immune dysregulation during the gestation period is proven to be associated with adverse maternal, fetal and neonatal outcomes. Contrary to the long-established belief that amniotic fluid is a sterile medium, it is now known that the fetus receives its first dose of probiotics by swallowing amniotic fluid. In connection with that, the microbiota of the mother greatly affects the microbiome of the newborn. Premature birth, cesarean delivery, intrapartum administration of antibiotics and other drugs can all harm the formation of the baby's microbiome. Understanding the importance of environmental factors in the pathogenesis of allergic diseases as well as the old hygiene hypothesis concept in the light of microbial disorders, it is clear that all previously mentioned parameters can have a very important impact on the development of allergic diseases in children.

Allergic diseases are the most common chronic diseases in children and no complete agreement on effective measures for primary prevention is available. Atopic family history is one of the most important risk factors for the development of asthma. A decline in microbial diversity due to modern lifestyle particularly in urban areas was proposed to have an important role in allergic epidemic. Recent studies are more focused on the specific mode of prevention such as probiotic usage in early pregnancy and infants period. It is well known that the composition of the gastrointestinal microbiota has been postulated to play a role in the development of allergies because it promotes potentially antiallergenic processes: TH1-type immunity, generation of TGF (which has an essential role in suppression of TH2-induced allergic inflammation and induction of oral tolerance), and IgA production, an essential component of mucosal immune defenses. Probiotic interventions administered during pregnancy and breastfeeding offer a unique opportunity to influence a range of important maternal and infant outcomes.

Introduction/Objective Insect stings are the second most common cause of allergic reactions and anaphylaxis. Allergic reactions after insect stings (bee, wasp, hornet) can vary from local skin changes to fatal anaphylactic reactions. The objective of the article is to present prehospital treatment of an anaphylactic reaction after an insect sting in the Infirmary of the Municipal Institution for Emergency Medical Aid. Case study Half an hour before coming to the Infirmary, the 22 year old patient felt sharp pain and a burning sensation in the neck area. The pain occurred as a result of being stung by an insect, probably a hornet. The physical examination found him to be mildly disoriented, dyspneic, afebrile, sweaty and tachycardic, with pale skin and mucous membranes. His eyelids, lips, tongue and uvula were swollen. At the site of the sting (the back side of the neck) a nodus had developed measuring 3x3cm surrounded with a skin edema measuring 10x10cm and erythema. The skin of both upper and lower extremities, as well as the torso, was covered with generalized urticaria. Based on patient's history and physical findings, the diagnosis of anaphylactic reaction was made. As the first line of therapy, the patient received an intramuscular injection of Adrenalin 500μg (0,5ml diluted to the ratio of 1:1000) in the anteromedial region of his thigh. He was given oxygen by mask (6l/min) and 1000ml of Ringer's solution. After initial stabilization, the patient received the second line of therapy: antihistamines (H1 and H2 antagonists) and a slow i.v. injection of Methylprednisolone. The patient's vital signs had stabilized after the initial treatment and he was transferred by ambulance, while being constantly monitored, to the Emergency Center where he was kept under close observation for the next six hours. He was then discharged in good health, with the advice to submit to additional allergology testing. Conclusion: This case study of an all too common situation in prehospital settings accentuates the need to be familiar with protocols for anaphylactic reaction treatment and their implementation in every day work.

The incidence of asthma and allergic rhinitis (AR) is significantly increased, especially in younger children. Current treatment for children with asthma and allergic rhinitis include allergen avoidance, standard pharmacotherapy, and immunotherapy. Since standard pharmacotherapy is prescribed for symptoms, immunotherapy at present plays an important role in the treatment of allergic diseases. This article presents insights into the up-to-date understanding of immunotherapy in the treatment of children with allergic rhinitis and asthma. PubMed articles published from 1990 to 2014 were reviewed using the MeSH terms "asthma", "allergic rhinitis", "children", and "immune therapy". Additional articles were identified by hand searching of the references in the initial search. Numerous studies have shown that sublingual application of allergen specific immunotherapy (SLIT) is an adequate, safe and efficient substitution to subcutaneous route of allergens administration (SCIT) in the treatment of IgE-mediated respiratory tract allergies in children. According to the literature, better clinical efficacy is connected with the duration of treatment and mono sensitized patients. At least 3 years of treatment and stable asthma before the immunotherapy are positive predictors of good clinical efficacy and tolerability of SLIT. SLIT reduces the symptoms of allergic diseases and the use of medicaments, and improves the quality of life of children with the diseases.