Death In Adolescents Research Articles

Cardiac channelopathies in the context of hereditary arrhythmia syndromes

Genetic arrhythmia disorders are rare diseases; however, they are acommon cause of sudden cardiac death in children, adolescents, and young adults. In principle, adistinction can be made between channelopathies and cardiomyopathies in the context of genetic diseases. This paper focuses on the channelopathies long and short QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia (CPVT). Early diagnosis of these diseases is essential, as drug therapy, behavioral measures, and if necessary, implantation of acardioverter defibrillator can significantly improve the prognosis and quality of life of patients. This paper highlights the pathophysiological and genetic basis of these channelopathies, describes their clinical manifestations, and comments on the principles of diagnosis, risk stratification and therapy.

Prevalence and Predictors of Suicidal Ideation among Adolescents

Suicides among young people continue to be a serious problem. Suicide is the second leading cause of death for children, adolescents, and young adults. The objectives of the present study were to assess the prevalence and predictors of suicidal ideation among adolescents; associate suicidal ideation among adolescents with selected socio-demographic variables and predictors. Quantitative research approach and descriptive research design was adopted for the study. The study was conducted among 250 adolescents selected through purposive sampling technique from selected Colleges, Thrissur. The tool consisted of a semi structured questionnaire to assess the socio-demographic data, Columbia Suicidal Severity Rating Scale (C-SSRS) screen version to assess the prevalence of suicidal ideation and a structured questionnaire to assess the predictors of suicidal ideation among adolescents. Reliability and validity of the tools were established. Data were collected, tabulated and analyzed using descriptive and inferential statistics. The findings of the study revealed that the prevalence rate of suicidal ideation among adolescents is 28%. The predictors such as lack of teachers support (91.4%), social media abuse (74.3%), loneliness and hopeless (72.9%) are found in most of the adolescents. A statistically significant association was found between education of father (p=0.04) and education of mother (p=0.04) with suicidal ideation among adolescents at p<0.05. The predictors such as family history of suicide (p=0.00), helplessness (p=0.04) and lack of parental support (p=0.01) have a statistically significant association with suicidal ideation among adolescents. The study concluded that the prevalence rate of suicidal ideation among adolescents is significant. The early identification of the predictors can prevent the actual occurrence of suicide among adolescents.

Suicidal Ideation, Suicide Attempts, and Suicide Deaths in Adolescents and Young Adults With Type 1 Diabetes: A Systematic Review and Meta-analysis.

Evidence is lacking on the risk of suicide-related behaviors (suicidal ideation, suicide attempt, suicide death) in youth with type 1 diabetes (T1D). We aimed to 1) determine the prevalence of suicidal ideation, suicide attempts, and suicide deaths in adolescents and young adults (AYA) with T1D aged 10-24 years; 2) compare suicide-related behavior prevalence in youth with and without T1D; and 3) identify factors associated with suicide-related behaviors. A systematic search was conducted in MEDLINE, Embase, and PsycInfo up to 3 September 2023. We included observational studies where investigators reported the prevalence of suicide-related behaviors among AYA aged 10-24 years with T1D. We collected data on study characteristics, data on prevalence of suicide-related behaviors, and data on associated factors. We included 31 studies. In AYA with versus without T1D, pooled prevalence of suicidal ideation was 15.4% (95% CI 10.0-21.7; n = 18 studies) vs. 11.5% (0.4-33.3; n = 4), respectively, and suicide attempts 3.5% (1.3-6.7; n = 8) vs. 2.0% (0.0-6.4; n = 5). Prevalence of suicide deaths ranged from 0.04% to 4.4% among youth with T1D. Difficulties with T1D self-management were frequently reported to be associated with higher rates of suicide-related behaviors. However, findings on the association of glycemic levels and suicide-related behaviors were inconsistent. There was a considerable level of heterogeneity in meta-analysis of both suicidal ideation and suicide attempts. Suicidal ideation and suicide attempts are prevalent in AYA with T1D. Current evidence does not suggest that these rates are higher among AYA with T1D than rates among those without.

OTHR-21. DEVELOPING A NEURO-ONCOLOGY PROGRAM FOR ADOLESCENTS AND YOUNG ADULTS IN CANADA – THE CANON EXPERIENCE

Abstract BACKGROUND Brain tumors are the leading cause of cancer-related death in adolescents and young adults (AYA). These tumors possess both pediatric-type and adult-type qualities, with up to 30% of gliomas harboring pediatric-type alterations. Specialized expertise and significant collaboration between pediatric and adult providers is needed to guide therapy for AYAs. To address this, we have developed the Canadian Adolescent and Young Adult Neuro-Oncology Network (CANON). METHODS In April 2021, we established a national virtual AYA tumor board integrating comprehensive molecular analysis of available tumors. Rounds included representatives from both pediatric and adult neuro-oncology, radiation oncology, neurosurgery, neuropathology and neuroradiology. We collected clinical data and recommendations from rounds. RESULTS In the first 2 years of rounds through CANON, 156 cases have been reviewed. Gliomas (108) accounted for most cases followed by medulloblastoma (18) and ependymoma (7). Sequencing was available in 47% of cases. Of those with molecular data available, the majority (36) had a pediatric-type alteration, followed by IDH mutation (10). Additional molecular analysis was recommended in 29% of cases presented. Of those with sequencing data available, 35% had a potentially targetable alteration identified. Despite this, only 8% were eligible for a clinical trial based on their diagnosis and age. Recurrent clinical questions included access to molecular analysis, use of “off-label” targeted agents, lack of clinical trial options for AYA patients and the practice variation in treatment of AYA tumors typically seen in childhood such as medulloblastoma and germ cell tumor. DISCUSSION Dedicated AYA rounds have highlighted many inequities in care of these patients, highlighting a need for inclusion of AYAs in clinical trials and further study of tumor biology and clinical outcomes of this cohort. AYAs with pediatric-type tumors would also benefit from management by dedicated physicians with expertise in these complex tumors.

სოციალიზაციის გამოწვევები, ფსიქიკური ჯანმრთელობა და ემოციური კეთილდღეობა დასწავლის სირთულის მქონე მოსწავლეებში

The emotional well-being of a child with a learning disability can alter when there is no emotional support available. This can lead one to become depressed and/or consider suicide. In North America, adolescent suicide has become a major public health problem. Currently, suicide is the third primary cause of adolescent death in both Canada and the United States. Suicide rates in the United States increased 142% between 1960 and 1981 for both boys and girls in the 15 to 19-year old age group. There are a number of factors that put a person's life in jeopardy, such as life events, trauma, and learning disabilities. Adolescents with learning disabilities are uncertain about their future and their personal goals. Depression may manifest when opportunities seem limited while trying to reach their personal and educational goals. They are often haunted by the stigma of having a learning disability. Youths are inclined to develop emotional difficulties and are likely to inflict self-harm. Emotional disorders are common among people with learning disabilities than those who are non-learning disabled. Individuals with learning disabilities are more likely to develop self- harming disorders as a result to being labeled with a learning disability. The definition of self-harm is defined as a non-accidental injury, which produces bleeding of momentary or permanent tissue damage over a repeated amount of time. Self-harming is found to be a physical and emotional outlet to relieve the stressors of school and home life. Another part of self-harm is head banging, cutting, biting, scratching, and hair pulling.

Examining putamen resting-state connectivity markers of suicide attempt history in depressed adolescents.

Suicide is a current leading cause of death in adolescents and young adults. The neurobiological underpinnings of suicide risk in youth, however, remain unclear and a brain-based model is lacking. In adult samples, current models highlight deficient serotonin release as a potential suicide biomarker, and in particular, involvement of serotonergic dysfunction in relation to the putamen and suicidal behavior. Less is known about associations among striatal regions and relative suicidal risk across development. The current study examined putamen connectivity in depressed adolescents with (AT) and without history of a suicide attempt (NAT), specifically using resting-state functional magnetic resonance imaging (fMRI) to evaluate patterns in resting-state functional connectivity (RSFC). We hypothesized the AT group would exhibit lower striatal RSFC compared to the NAT group, and lower striatal RSFC would associate with greater suicidal ideation severity and/or lethality of attempt. We examined whole-brain RSFC of six putamen regions in 17 adolescents with depression and NAT (MAge [SD] = 16.4[0.3], 41% male) and 13 with AT (MAge [SD] = 16.2[0.3], 31% male). Only the dorsal rostral striatum showed a statistically significant bilateral between-group difference in RSFC with the superior frontal gyrus and supplementary motor area, with higher RSFC in the group without a suicide attempt compared to those with attempt history (voxel-wise p<.001, cluster-wise p<.01). No significant associations were found between any putamen RSFC patterns and suicidal ideation severity or lethality of attempts among those who had attempted. The results align with recent adult literature and have interesting theoretical and clinical implications. A possible interpretation of the results is a mismatch of the serotonin transport to putamen and to the supplementary motor area and the resulting reduced functional connectivity between the two areas in adolescents with attempt history. The obtained results can be used to enhance the diathesis-stress model and the Emotional paiN and social Disconnect (END) model of adolescent suicidality by adding the putamen. We also speculate that connectivity between putamen and the supplementary motor area may in the future be used as a valuable biomarker of treatment efficacy and possibly prediction of treatment outcome.

Global epidemiology of alcohol-associated liver disease in adolescents and young adults.

The objective of the study was to analyse the prevalence, incidence, and death of alcohol-associated liver disease (ALD) among adolescents and young adults globally, continentally, and nationally, focusing on trends over time. The study analysed data from the Global Burden of Disease (GBD) study between 2000 and 2019. It examined ALD's prevalence, incidence, and death in adolescents and young adults aged 15-29, segmented by region, nation, and sociodemographic index. The analysis utilised Joinpoint regression modelling to calculate the annual per cent change (APC) in the rate of these parameters over time. In 2019, there were 281,450 ALD prevalences, 18,930 incidences, and 3190 deaths among adolescents and young adults globally. From 2000 to 2019, the age-adjusted prevalence rate per 100,000 increased in the 25-29 age group (APC: +0.6%, p = 0.003), remained stable among ages 20-24 (p = 0.302) and ages 15-19 (p = 0.160). Prevalence increased significantly from age 15-19 to 20-24 (19-fold increase) and from age 20-24 to 25-29 (2.5-fold increase). ALD prevalence rates increased in all age groups in adolescents and young adults in Africa and the Eastern Mediterranean region. Around three-quarters of countries and territories experienced an increase in ALD incidence rates in young adults. Over two decades, the burden of ALD among adolescents and young adults has increased globally. The study emphasises the importance of public health policies aimed at reducing alcohol consumption and preventing ALD among younger populations.

Access for adolescents and young adults with hard-to-cure cancer to PROFYLE: The pan-Canadian precision oncology pipeline.

10012 Background: Cancer is the most common cause of disease-related death in children, adolescents and young adults (CAYA). Approximately, 1.5% of patients with cancer in Canada are adolescents and young adults (AYAs) (age 15-29). AYAs often present with advanced disease and limited access to clinical trials including genomic testing. The PRecision Oncology For Young peopLE (PROFYLE) national, collaborative program, was created to provide equitable access to molecular profiling to identify novel targeted treatment options for CAYA with hard-to-cure cancers. The AYA node of PROFYLE aims to enhance the inclusion of AYAs across Canada at pediatric and adult centers while raising awareness of improving cancer outcomes of this underserved population. Methods: Building upon 3 pre-existing regional precision oncology programs, PROFYLE was implemented as the first pan-Canadian precision oncology pipeline. The PROFYLE study is multi-centred, non-randomized, interventional, and qualitative. Inclusion criteria: ≤29y; treatment at a Canadian center; diagnosis of a hard-to-cure cancer. It includes genomic and transcriptomic sequencing of paired germline and cancer fresh/frozen samples. Actionable findings, potential targeted therapy options including available clinical trials, clarification of diagnosis, and genetic counseling recommendations are provided to the clinical care team. Results: To date, &gt; 1,200 CAYA are included from all provinces. Of these, 33% were AYAs. Cancer diagnoses included: 47% sarcoma, 15% leukemia/lymphoma, 13% CNS tumor, 25% other. Of the AYAs enrolled, 53% had ≥1 significant tumour profiling finding (48% specific mutations/fusions; 6% DNA repair defect signature, hypermutation, microsatellite instability, chromosomal instability; 3% predictors of therapeutic resistance; 5% outliers in gene expression). 71% had potentially useful findings (15% diagnostic; 9% prognostic; 59% therapeutic; 2% etiologic; 15% cancer predisposition; 2% secondary germline; 0.5% pharmacogenetic). 23% had a pathogenic/likely pathogenic germline variant. 60% had ≥1 potentially actionable somatic alteration. 64% of clinicians indicated that molecular findings impacted clinical management (12% diagnostic; 6% prognostic, 60% therapeutic; 16% germline genetic). 24% indicated a change in treatment planning in response to these findings. Conclusions: The goal of developing a national precision oncology pipeline that provides equitable access to molecular profiling in a clinically relevant timeframe has been realized through the establishment of PROFYLE. Findings demonstrate that the sequencing platform provided medically informative results in the majority of enrolled AYAs. The success of PROFYLE underscores the importance of the continuing efforts to increase the access to this precision oncology initiative for all AYAs with cancer in Canada.

Trends in location of death for individuals with pediatric cancer in the United States.

1591 Background: Children and adolescents with cancer face unique symptomatic, psychosocial, and existential challenges at the end of life (EOL). Premature death alongside severe pain and complex symptoms is distressing for the patients and families. Location of death is an important clinical and psychosocial decision for many patients. Therefore, we explored differences in location of death amongst pediatric patients with cancer using a large, national US database. Methods: We performed multinomial logistic regressions and analyzed trends in place of death for children and adolescents (ages 0 to 19) diagnosed with cancer from 2003-2019 using the Centers for Disease Control and Prevention Wide-Range Online Data for Epidemiologic Research database (CDC WONDER). We studied associations in place of death with essential decedent characteristics (age, sex, and race) for ICD10 codes C00-C96 and D00-D49, which encompass the most common causes of cancer death in children and adolescents. Results: Of 1,910 pediatric oncology decedents, 910 died in a hospital, 794 died at home, 12 died in nursing facilities, 59 in hospice, and 135 in outpatient facilities. Over time, death at home decreased by 50%. Death in the hospital increased by 64% and death in hospice increased by 200%. Children 10-19 years-of-age were more likely to die in hospice than children younger than 4 and children between 5-9 years-of-age. Additionally, they were less likely to die in outpatient medical facilities and ED. 1,388 decedents were White, 411 were Black, 18 were American Indian, and 93 were Asian. Children of racial and ethnic minorities were significantly more likely to die in hospitals than White children with cancer (Black: 1.81 [1.44-2.28], Asian: 1.57 [1.03-2.41], and Hispanic: 1.60 [1.26-2.04]). Black children with cancer were also more likely (1.67 [1.11-2.53]) to die in outpatient facilities compared to White children. Asian children &amp; Black children were less likely to die at home (0.48[0.38-0.61] and 0.55 [0.35-0.86] respectively). Conclusions: In contrast to the adult population that has demonstrated steady increases in deaths at home, for children with cancer, relative rates of death at home decreased while death in the hospital increased, with distinct differences among race/ethnic groups. Adequate education and support are needed to facilitate both autonomy and symptom palliation at EOL. Future work must explore underlying reasons for differences in place of death across time and demographic groups, so as to identify and alleviate any potential barriers, and to promote equitable access to a good death for each individual.

Trends in youth risk behaviours and firearm injury in the USA over 20 years

BackgroundFirearm injuries are the leading cause of death in children and adolescents in the USA. We hypothesised that high rates of risky behaviour in high school students are associated with...

An Examination of the Mortality Rate Associated With Teenage Pregnancy in South Africa

This study investigates factors contributing to teenage pregnancy in South Africa and their impact on maternal mortality. Twenty participants were purposively sampled for one-on-one interviews using a mixed-methods and descriptive study design. SPSS software analysed the data, revealing reduced risk factors through educational policies. Teenage mortality rates from pregnancy and maternal health issues are lower than the rates in adults, with high blood pressure, abortion and injuries being the leading causes of adolescent death. The study emphasises a significant public health concern in South Africa, influencing women’s life expectancy due to socioeconomic barriers and insufficient awareness of danger signs, urging prioritised policies and programmes.

Predictive Validity of the K-CAT-SS in High-Risk Adolescents and Young Adults

Suicide is a leading cause of death in adolescents and young adults and has increased substantially in the past 15 years. Accurate suicide risk stratification based on rapid screening can help reverse these trends. This study aimed to assess the ability of the Kiddie Computerized Adaptive Test Suicide Scale (K-CAT-SS), a brief computerized adaptive test of suicidality, to predict suicide attempts (SAs) in high-risk youth. A total of 652 participants (age range, 12-24 years), 78% of whom presented with suicidal ideation or behavior, were recruited within 1 month of mental health care contact. The K-CAT-SS, scaled from 0 to 100, was administered at baseline, and participants were assessed at about 1, 3, and 6 months after intake. Weekly incidence of SAs was assessed using the Adolescent Longitudinal Interval Follow-up Evaluation and Columbia-Suicide Severity Rating Scale. A secondary outcome was suicidal behavior, including aborted, interrupted, and actual SAs. The K-CAT-SS showed a 4.91-fold increase in SAs for every 25-point increase in the baseline score (95% CI 2.83-8.52) and a 3.51-fold increase in suicidal behaviors (95% CI 2.32-5.30). These relations persisted following adjustment for prior attempts; demographic variables including age, sex, gender identity, sexual orientation, and race/ethnicity; and other measures of psychopathology. No moderating effects were identified. At 3 months, area under the receiver operating characteristic curve was 0.83 (95% CI 0.72-0.93) for 1 or more SAs. The K-CAT-SS is an excellent tool for suicide risk stratification, particularly in higher-risk populations where other measures have shown lower predictive validity.

Perceptions Related to Death in Adolescents and Their Parents During the Management of Type 1 Diabetes: A Thematic Analysis

Type 1 diabetes (T1D) is associated with an increased risk of premature death compared to those without T1D, yet perceptions of dying have not been well studied. The purpose of this secondary analysis of existing data was to explore the fears of adolescents with T1D and their parents related to the possibility of death due to T1D. A reflexive thematic analysis was used to examine data from interviews conducted with adolescents with T1D and their parents who participated in a primary grounded theory study of interdependence in T1D management. Three themes were generated from the data including: (1) Facing the Reality of Death, (2) Fearing Highs and Lows, and (3) Finding a Way through Fears. Participants indicated they see death as a consequence of failing to optimally manage T1D. Additional investigation is needed to explore the fear of death in adolescents with T1D and any fear their parents may have of their adolescents' mortality.

Suicide planning type interventions as an evidence based alternative for no-suicide contracts

Introduction Suicidality is a common concern in psychiatric patients and one of the leading causes of death in adolescents and young adults. (Adolescent health. (2019, November 26) WHO). Some mental health professionals engage in a no-suicide contract with their patients. In this type of intervention, the patient usually agrees to not harm or kill himself/herself. There is an increasing body of evidence to support brief interventions, such as group of safety planning-type interventions (SPTIs) (McCabe et al. MC Psychiatry, 2018, May 3; 18(1)). Safety planning is derived from cognitive therapy and cognitive behavioral therapy used for suicide prevention.ObjectivesOur objective was to summarize and critically analyze current evidence of effectiveness of SPTIs and no-suicide contracts in suicide prevention.MethodsWe conducted a literature review to compare no-suicide contract to safety-planning interventions in suicide prevention.ResultsAlthough no-suicide contracts may work for some individuals, there is not enough quantitative evidence to support such contracts as clinically effective tools. A recent meta-analysis has shown that SPTIs were associated with reductions in suicidal behaviors although no effect was identified with frequency of suicidal thoughts (Nuij et al. (2021, April 30). The British Journal of Psychiatry, 219 (2), 419–426).ConclusionsBased on the evidence and straightforward implementation of SPTIs in different clinical settings it may to be a more effective alternative to no-suicide contracts.Disclosure of InterestNone Declared

Suicide prevention project with young people in the Rocinha slum in Rio de Janeiro

IntroductionThe 2019 WHO report on suicide warned of a serious public health problem. It was found that suicide is a serious problem for global public health, causing approximately 703 thousand deaths every year. Self-extermination is among the leading causes of death worldwide, with more deaths than from malaria, HIV/AIDS, breast cancer, war and homicide. More than one in every 100 deaths (1.3%) in 2019 were the result of suicide.Suicide is the fourth leading cause of death in older adolescents (15–19 years). Risk factors are multifaceted and include harmful use of alcohol, which includes abuse during childhood, stigma against seeking help, barriers to accessing care and means of suicide.The total number of deaths due to self-extermination registered in the adolescent population in the period from 2016 to 2021 was 6,588. According to the WHO director-general, “attention to suicide prevention is even more important now, after many months of living with the pandemic and many of the risk factors, such as loss of employment, financial stress and social isolation, still very present.” Therefore, suicide prevention work with young adolescents in Rocinha, one of the largest slums in Rio de Janeiro, is extremely important, given the increase in suicide rates and mental health problems in this age group. This approach must be thoughtful, culturally sensitive, and involve a range of strategies to address the complex issues affecting adolescents in the community. The Community of Rocinha was chosen to host this prevention project.ObjectivesCreate a preventive event by surveying participants’ opinions, integrating, welcoming and deconstructing stigmas about suicide.MethodsThis study investigated, in a population of 140 young adolescents with cultural differences in a theater class, their level of knowledge regarding relevant information about suicide. A structured questionnaire was presented and answered before and after a lecture, resulting in a class at the end, carried out by the young participants themselves. The scenes were filmed and a film produced. This dynamic process also included the distribution of a shirt alluding to the fact, making the participants multiplier references.ResultsThe results of the lecture showed a significant improvement in mental health awareness and willingness to seek help among young people, totaling a 20% increase in knowledge.ConclusionsStudents attended the event in significant numbers, taking into account that the slum had a curfew due to armed conflict. The results of the lecture showed a significant improvement in mental health awareness and willingness to seek help among young people, totaling a 20% increase in knowledge. The young people reported a feeling of support and belonging to the community, highlighting the importance of the debate in a final lecture given by them.Disclosure of InterestNone Declared

Zebrafish-A Suitable Model for Rapid Translation of Effective Therapies for Pediatric Cancers.

Pediatric cancers are the leading cause of disease-related deaths in children and adolescents. Most of these tumors are difficult to treat and have poor overall survival. Concerns have also been raised about drug toxicity and long-term detrimental side effects of therapies. In this review, we discuss the advantages and unique attributes of zebrafish as pediatric cancer models and their importance in targeted drug discovery and toxicity assays. We have also placed a special focus on zebrafish models of pediatric brain cancers-the most common and difficult solid tumor to treat.

Investigation of Childhood Traumas of Individuals Who Experienced Parental Death in Childhood or Adolescence in Turkey

This study investigates the childhood traumas of individuals who experienced parental death in childhood or adolescence in Turkey. Participants (n = 382; 63.1% female and 36.9% male; MAGE=29.41, SD = 9.6) are composed of individuals who lost either or both of their parents before the age of 18. The findings indicated that there is a significant difference between the subdimensions of Childhood Trauma Questionaire and the study variables including gender, marital status, educational status, number of siblings, gender of the deceased parent, the caregiver after the parental death, relationship with the surviving parent and the age at the time of parental death (p < .05). The results further show that individuals who lost their parents before the age of 10, who lost their mothers, and who received care from other relatives instead of parents are exposed to more neglect and abuse. By identifying childhood traumas in individuals and examining related variables, the findings contribute trauma-informed social work practices. Based on the results, it is recommended that school social work programs focus on monitoring the relationship between caregivers and children, as well as enhancing the psychosocial well-being of students. These programs can also serve as a means to raise awareness among professionals and students.

The global burden of childhood and adolescent leukaemia and attributable risk factors: An analysis of the Global Burden of Disease Study 2019.

Aim of this study is to estimate the burden of leukaemia in children and adolescents, as well as the socio-demographic index (SDI), for 21 regions around the world from 1990 to 2019. We also conducted an analysis of the Joinpoint model to estimate the time trend of childhood and adolescent leukaemia incidence, death, and disability-adjusted life years (DALYs) rate and age-standardised rates (ASR) of leukaemia. According to our analysis, the middle SDI experienced the highest decrease in incidence rate between 1990 and 2019, with an average annual percent change (AAPC) of -2.8 (95% confidence interval (CI) = -3.0, -2.6, P < 0.05). We showed that DALYs of children leukaemia is 155.98 (95% uncertainty interval (UI) = 127.18, 182.64) for global male, however, global female leukaemia DALYs is 117.65 (95% UI = 102.07, 132.70). Despite the observed decline in the incidence, mortality, and DALYs of leukaemia over the last three decades, the burden of childhood and adolescent leukaemia remains high, particularly in areas with lower SDI.

Myocarditis in children.Etiology. Pathogenesis. Epidemiology. Clinical presentation

Readers will be presented with a series of articles on myocarditis in children, which are based on clinical guidelines developed by a group of authors on this topic. Myocarditis is an inflammatory myocardial disease characterized by a wide range of clinical manifestations — from minor to sudden cardiac death. Given the absence of pathognomonic symptoms, as well as the similarity of manifestations in the onset with common childhood diseases such as respiratory distress, gastrointestinal diseases, infectious pathology, specialists often overlook the likelihood of a diagnosis of “myocarditis”, which causes a late start of therapy and an adverse outcome. Considering that myocarditis accounts for 12% of cases of sudden cardiac death in adolescents and young adults, suspicion of this disease in differential diagnosis in children with nonspecific symptoms and disease progression may be the key to the formation of a proper treatment strategy. Despite significant advances in the study of myocarditis in both adults and children, there are still many unresolved issues. The purpose of this article is to highlight the current view of the etiology, pathogenesis, epidemiology and clinical features in children with various types of myocarditis in order to increase the knowledge of practitioners for better clinical management of patients with myocarditis.

Neural correlates of automatic emotion regulation and their association with suicidal ideation in adolescents during the first 90-days of residential care

Background: Suicide is the second leading cause of death for adolescents in the United States. However, relatively little is known about the forms of atypical neuro-cognitive function that are correlates of suicidal ideation (SI). One form of cognitive/affective function that, when dysfunctional, is associated with SI is emotion regulation. However, very little work has investigated the neural correlates of emotion dysregulation in adolescents with SI. Methods: Participants (N = 111 aged 12-18, 32 females, 31 [27.9%] reporting SI) were recruited shortly after their arrival at a residential care facility where they had been referred for behavioral and mental health problems. Daily reports of SI were collected during the participants’ first 90-days in residential care. Participants were presented with a task-fMRI measure of emotion regulation – the Affective Number Stroop task shortly after recruitment. Participants were divided into two groups matched for age, sex and IQ based on whether they demonstrated SI. Results: Participants who demonstrated SI showed increased recruitment of regions including dorsomedial prefrontal cortex/supplemental motor area and parietal cortex during task (congruent and incongruent) relative to view trials in the context of emotional relative to neutral distracters. Conclusions: Participants with SI showed increased recruitment of regions implicated in executive control during the performance of a task indexing automatic emotion regulation. Such data might suggest a relative inefficiency in the recruitment of these regions in individuals with SI.