Children Of Patients Research Articles

Modifiable risk factors and risk of myocardial infarction in offspring with parental disease.

Children of patients with early-onset myocardial infarction (MI) are at increased risk, but the importance of concordant versus discordant parent-offspring risk factor profiles on MI risk is largely unknown. We quantified the long-term absolute risk of MI according to shared risk factors in adulthood. We sampled data on familial predisposed offspring and their parents from the Framingham Heart Study. Early MI was defined as a history of parental MI onset before age 55 in men or 65 in women. Individuals were matched 3:1 with non-predisposed offspring. Cardiovascular risk factors included obesity, smoking, hypertension, high cholesterol, and diabetes. We estimated the absolute 20-year incidence of MI using the Aalen-Johansen estimator. At age 40, the 20-year risk of MI varied by cholesterol level (high cholesterol 25.7% [95% confidence interval 11.2%; 40.2%] vs. non-high cholesterol 3.4% [0.5; 6.4]) among predisposed individuals and this difference was greater than in controls (high cholesterol 9.3% [1.5; 17.0] vs. non-high cholesterol 2.5% [1.1; 3.8]). Similar results were observed for prevalent hypertension (26.7% [10.8; 42.5] vs. 4.0% [0.9; 7.1] in predisposed vs. 10.8% [3.2; 18.3] and 2.1% [0.8; 3.4] in controls). Among offspring without risk factors, parental risk factors carried a residual impact on 20-year MI risk in offspring (0% [0; 11.6] for 0-1 parental risk factors versus 3.3% [0; 9.8] for ≥2 parent risk factors at age 40, versus 2.9% [0; 8.4] and 8.5% [0; 19.8] at age 50 years). Children of patients with early-onset MI have low absolute risks of MI in the absence of midlife cardiovascular risk factors, especially if the parent also had a low risk factor burden prior to MI.

Оценка клинико-анамнестических характеристик тяжести течения ковидной пневмонии в разные сроки беременности и развития риска досрочного родоразрешения

Aim: To evaluate the influence of clinical and anamnestic factors on the severity of the course and early delivery in pregnant women with covid pneumonia. Study design: Retrospective cohort single-center study. Materials and methods. The study included 81 pregnant women with covid pneumonia at a gestational age of 22.0–41.3 weeks. Depending on the severity of the condition, the women were divided into three groups: the 1st group included 13 patients who did not require respiratory support, the 2nd group included 52 pregnant women who received non-invasive respiratory support, the 3rd group included 16 patients who required invasive respiratory support. On the first day after hospitalization, clinical and anamnestic indicators, clinical manifestations of viral pneumonia, data from laboratory and instrumental studies of patients were analyzed. Computed tomography (CT) of the chest organs was prescribed to pregnant women after a consultation on the need for this study. An assessment of anthropometric data and the condition of children at birth was performed. Results. Women of all groups were comparable in clinical and anamnestic characteristics. A higher risk of invasive respiratory support was determined in patients with the onset of the disease at gestational age ≤ 207 (187–233) days (p < 0.001), with an increase in body temperature during illness ≥ 38.6 (38.0–39.0) °C (p = 0.009), saturation in atmospheric air ≤ 90.0 (87.0–93.0)% (p < 0.001). With this combination of parameters, a higher probability of changes in the structure of the lungs according to chest CT data was revealed: ≥ 77.5 (68.2–90.0)% (p < 0.001). Pregnant women with ferritin levels ≥ 125.0 (84.4–268.9) ng/ml had a higher risk of severe viral pneumonia and preterm delivery (p = 0.001). Compared with women in other groups, patients with invasive respiratory support had a shorter delivery time (≤ 210.0 (203.5–238.5) days) (p < 0.001) and a higher chance of preterm birth (odds ratio = 7.07 (95% confidence interval — 1.44; 69.02)). Children of patients with severe viral pneumonia received a statistically significantly worse Apgar score at 1 and 5 minutes of life (p < 0.001), and also had lower weight and body length at birth compared to newborns at 1 and 2 groups (p < 0.001). Conclusion. The study revealed the most informative factors of severity and early delivery in pregnant patients with viral pneumonia caused by a new coronavirus infection. These predictors are important to consider during outpatient monitoring of pregnant patients with coronavirus pneumonia in order to make a timely decision on hospitalization. Keywords: pregnancy, coronavirus infection, covid pneumonia, early delivery.

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Background:Children of patients with Alcohol use disorder (AUD) are at risk of several behavioral and psychological problems, like behavioural addiction.Aims:To study the association between mobile-phone addiction in the children of patients with Alcohol Use Disorder (AUD).Methods:A cross-sectional, observational, age and gender-matched case-control study was designed. The study was conducted at Subharti Medical College & Hospital, Meerut, from December 2019 to September 2021. Participants were recruited from Psychiatry OPD/Inpatient using the purposive sampling technique. Patients with AUD were defined as ‘cases’ while their healthy first-degree relative (FDR) without substance use disorder as ‘control’. One child of every case and control participated. Socio-demographic characteristics and clinical features were recorded in a semi-structured proforma. Cases were assessed on Alcohol Use Disorders Identification Test (AUDIT). The outcome of mobile-phone addiction in the children of AUD and their FDR was evaluated on Mobile Phone Addiction Scale (MPAS).Results:40 pairs of age and gender-matched cases and controls; and 80 children were recruited. A cut-off score of 80 or more on MPAS was marked for mobile-phone addiction. A statistically significant association was found between mobile-phone addiction among the children of patients with AUD X2(p-value)=6.054(0.014). A greater association of mobile-phone addiction among the children of patients with AUDIT severity score [adjusted Odd’s Ratio (AOR)(95%CI)=6.818(2.281-20.383), unadjusted OR(95%CI)=1.759(1.115-2.776) surfaced. Regarding socio-demographic variables, a higher association of stage of adolescence and mobile-phone addiction [AOR(95%CI)=0.014(0.001-0.146), unadjusted OR(95%CI)=0.061(0.015-0.240) emerged.Conclusion:The children of patients with AUD are at higher risk of mobile-phone addiction.

Do Children of Patients with Bipolar Disorder have a Worse Perception of Sleep Quality?

IntroductionThe offspring of bipolar parents (BO) is a high-risk population for inheriting the bipolar disorder (BD) and other early clinical manifestations, such as sleep disturbances. ObjectiveTo compare the presence of psychiatric disorders and sleep disturbances of BO versus offspring of control parents (OCP). MethodsA cross-sectional analytical study was conducted that compared BO versus OCP. The participants were assessed using valid tools to determine the presence of psychiatric symptoms or disorders. The “Sleep Evaluation Questionnaire” and “School Sleep Habits Survey” were used to determine sleep characteristics and associated factors. Sleep records (7-21 days) were also obtained by using an actigraphy watch. ResultsA sample of 42 participants (18 BO and 24 OCP) was recruited. Differences were found in the presentation of the psychiatric disorder. The BO group showed a higher frequency of major depression disorder (MDD; P = .04) and Disruptive Mood Dysregulation Disorder (DMDD; P = .04). The OCP group showed a higher frequency of Attention Deficit and Hyperactivity Disorder (ADHD; P = .65), and Separation Anxiety Disorder (SAD; P = .46). Differences were also found in sleep by using subjective measurements. Compared to the OCP group, BO had a worse perception of quality of sleep (P = .02), a higher frequency of nightmares (P = .01), a shorter total sleep time, and a higher sleep latency. Nevertheless, no differences were found between groups in the actigraphy measurements. ConclusionsThe BO group had a higher frequency of Mood Disorders, and at the same time a higher number of sleep disturbances in the subjective measurements. It is possible that there is an association between mood symptoms, sleep disturbances, and coffee intake. No differences were found in the sleep profile by using actigraphy.

22.2 Early Signs of Bipolar Disorder in Adolescent Offspring With Bipolar Disorder: Clinical Assessment Versus Self-Report: A Prospective Study

Early recognition of bipolar disorder (BD) remains challenging for clinicians. Children of patients with BD (bipolar offspring) have an increased risk to develop mood disorders in general and BD specifically. Longitudinal bipolar offspring studies provide the opportunity to study the early trajectories of BD. In previous work on the Dutch Bipolar Offspring Study, we reported that BD typically debuts with a (mild) depressive episode. Here, we present findings of the Dutch Bipolar Offspring Study on early (sub)threshold dimensional psychopathology using self-report and clinical assessment.

"I Did Not Tell it to Anyone": Please Pay Attention to the Children of Patients Suffering From Psychosis.

"I Did Not Tell it to Anyone": Please Pay Attention to the Children of Patients Suffering From Psychosis.

Health features of newborns depending on vitamin D level of their mothers during pregnancy

Aim. Evaluation of health state in newborns whose mothers were at risk of pre-eclampsia, depending on vitamin D level. 
 Methods. Study materials included peripheral blood from pregnant women and umbilical cord blood of newborns. Vitamin D level was measured by enzyme-linked immunoassay kits of BIOMEDICAGRUPPE company (Germany). Intrauterine fetal state was studied with the use of ultrasonography. 
 Results. Analysis of the study proved that vitamin D level in the umbilical cord blood correlates with its concentration in the mother’s blood. In women at pre-eclampsia risk decreased calcium level and vitamin D deficiency in the blood were detected. Administration of 2,000 IU of vitamin D and 1.5 g of calcium from the beginning of 2nd trimester of pregnancy resulted in reduction of frequency and severity of pre-eclampsia and its complications, including intrauterine growth retardation. Use of vitamin D in combination with calcium supplementation was shown to significantly improve unfavorable perinatal outcomes in women at high risk of pre-eclampsia, reducing by 3 times hypoxia and cerebral fetal lesions frequency that proves the vitamin D importance for functioning of mother-placenta-fetus system. 
 Conclusion. Children of patients at risk of pre-eclampsia not taking vitamin D and calcium supplementation have lower birth weight and Apgar score, they have more frequent perinatal complications.

Study of the Factors Leading to Fetal and Neonatal Dysthyroidism in Children of Patients With Graves Disease.

Context:Neonatal hyperthyroidism was first described in 1912 and in 1964 was shown to be linked to transplacental passage of maternal antibodies. Few multicenter studies have described the perinatal factors leading to fetal and neonatal dysthyroidism.Objective:To show how fetal dysthyroidism (FD) and neonatal dysthyroidism (ND) can be predicted from perinatal variables, in particular, the levels of anti-thyrotropin receptor antibodies (TRAbs) circulating in the mother and child.Design and Patients:This was a retrospective multicenter study of data from the medical records of all patients monitored for pregnancy from 2007 to 2014.Setting:Among 280,000 births, the medical records of 2288 women with thyroid dysfunction were selected and screened, and 417 women with Graves disease and positive for TRAbs during pregnancy were included.Results:Using the maternal TRAb levels, the cutoff value of 2.5 IU/L best predicted for FD, with a sensitivity of 100% and specificity of 64%. Using the newborn TRAb levels, the cutoff value of 6.8 IU/L best predicted for ND, with a sensitivity of 100% and a specificity of 94%. In our study, 65% of women with a history of Graves disease did not receive antithyroid drugs during pregnancy but still had infants at risk of ND.Conclusions:In pregnant women with TRAb levels ≥2.5 IU/L, fetal ultrasound monitoring is essential until delivery. All newborns with TRAb levels ≥6.8 IU/L should be examined by a pediatrician with special attention for thyroid dysfunction and treated, if necessary.

Personality Traits in the Siblings and Children of Patients with Frontotemporal Dementia: A Questionnaire-based Study.

Introduction:Frontotemporal dementias (FLD) form a group of relatively young onset, male dominant dementias with significant behavioral abnormalities early in the course of the disease. Routine assessment suggested preexisting traits such as lack of empathy, self-directedness, and persistence in most of these persons even before the onset of disease. Hence, we decided the study, the siblings and children of patients for any specific traits and correlation with hexanucleotide expansion repeats if any traits were identified.Patients and Methods:A total of 35 age- and gender-matched cases and controls were included for the study as per criteria. They were screened for mental illness and cognitive dysfunction using Hindi Mental State Examination and Mini-mental State Examination. Eligible persons were given temperament and character inventory (TCI) scores for the recommended parameters. Hexanucleotide expansion was also studied in the patients, cases and controls.Results:No specific personality trait was found to have an increased correlation with siblings and children of patients with FLD in this small group using TCI scores.Conclusions:7% of cases showed Hexanucleotide expansion suggesting a possible risk. The role of self reporting bias resulting in normal personality trait needs to be addressed in future studies.

Risk of Pregnancy in Moderate and Severe Aortic Stenosis: From the Multinational ROPAC Registry

BackgroundControversial results on maternal risk and fetal outcome have been reported in women with aortic stenosis (AS). ObjectivesThe authors sought to investigate maternal and fetal outcomes in patients with AS in a large cohort. MethodsThe Registry on Pregnancy and Cardiac Disease (ROPAC) is a global, prospective observational registry of women with structural heart disease, providing a uniquely large study population. Data of women with moderate (peak gradient 36 to 63 mm Hg) and severe AS (peak gradient ≥64 mm Hg) were analyzed. ResultsOf 2,966 pregnancies in ROPAC, the authors identified 96 women who had at least moderate AS (34 with severe AS). No deaths were observed during pregnancy and in the first week after delivery. However, 20.8% of women were hospitalized for cardiac reasons during pregnancy. This was significantly more common in severe AS compared with moderate AS (35.3% vs. 12.9%; p = 0.02), and reached the highest rate (42.1%) in severe, symptomatic AS. Pregnancy was complicated by heart failure in 6.7% of asymptomatic and 26.3% of symptomatic patients, but could be managed medically, except for 1 patient who was symptomatic before pregnancy and underwent balloon valvotomy. Children of patients with severe AS had a significantly higher percentage of low birth weight (35.0% vs. 6.0%; p = 0.006). ConclusionsMortality in pregnant women with AS, including those with severe AS, appears to be close to zero in the current era. Symptomatic and severe AS does, however, carry a substantial risk of heart failure and is associated with high rates of hospitalization for cardiac reasons, although heart failure can nearly always be managed medically. The results highlight the importance of appropriate pre-conceptional patient evaluation and counseling.

Comparison of Carotid Intima Media Thickness in Children of Patients with and without Premature Coronary Artery Disease.

Increased Carotid Intima Medial Thickness (CIMT) is associated with cardiovascular risk factors and vascular events like Coronary Artery Disease (CAD) and stroke. This study was designed to identify whether CIMT is increased in the children of parents with premature coronary artery disease and compare it with age and sex matched controls who are children of normal individuals. We also tried to compare and correlate the changes in CIMT if any, among the study group with relation to family history of diabetes and hypertension. It was an observational prospective case control study. Twenty five cases (children of parents with premature coronary artery disease) were recruited as per the inclusion and exclusion criteria. Age and sex matched controls were recruited from the paediatric Outpatient Department (OPD). The CIMT was measured using ultrasound Doppler as per the protocol by the Mannheim intima media thickness consensus statement. Ten children out of 25 controls had CIMT of 0.05 cm and 5 out of 25 cases had CIMT of 0.07 cm. The association between cases and controls was not statistically significant. Even though the CIMT increases after 10 years, there is no statistically significant association between cases and controls in the different age groups. Out of the total 48% of the children among the case group had family history of hypertension whereas 28% in the control group. A 33% of children in the case group with family history of hypertension had CIMT of 0.07 cm; 46% of children in case group without family history of hypertension had CIMT of 0.05 cm. This difference was statistically significant (p=0.005). There was no significant association between family history of diabetes mellitus and CIMT in both groups. There was significant association between CIMT in children with family history of premature CAD and family history of hypertension when compared with no family history of hypertension with premature CAD. There was no significant association between CIMT of children with and without family history of premature CAD.

A Study on Hs-CRP, Carotid Intima Media Thickness, and Lipid Profile in Children of Patients with Premature CAD

Background: This study aimed to evaluate the risk markers of Coronary Artery Disease (CAD), so that appropriate lifestyle changes can be instituted early to prevent or delay development of the disease. Objectives: This study aimed to evaluate the risk markers of CAD based on inflammation and arterial morphology; i.e., high sensitivity C-Reactive Protein (hs-CRP) and carotid artery Intima Media Thickness (IMT), in children of patients with premature CAD. Patients and Methods: This was a case-control study with predetermined end points. It was conducted on 40 subjects randomly selected from the children of premature CAD patients and 40 age- and sex-matched healthy controls. Blood levels of hs-CRP, lipid profile, and carotid IMT were assessed for all the subjects. The relationship among these parameters was evaluated by univariate and multivariate analyses using the SPSS statistical software, version 22.0 and P < 0.05 was considered as statistically significant. Results: The mean values of Total Cholesterol (TC, 139.8 ± 24 vs. 111.3 ± 14.7, P < 0.05), Triglycerides (TG, 81.8 ± 15.3 vs. 63.4 ± 10.8, P < 0.05), Low Density Lipoprotein (LDL, 85.2 ± 22.2 vs. 57.5 ± 14.1, P < 0.05), hs-CRP (1.2 ± 0.77 vs. 0.79 ± 0.27, P < 0.05) and carotid artery IMT (0.49 ± 0.09 vs. 0.422 ± 0.03, P < 0.05) were significantly higher in the cases compared to the controls. Also, both LDL/High Density Lipoprotein (HDL) and TC/HDL ratios were significantly higher in the cases compared to the controls. Moreover, a significant positive correlation was found between carotid IMT and hs-CRP. Conclusions: Children of patients with premature CAD showed a significantly higher incidence of dyslipidemia as well as significantly increased levels of the inflammation marker, hs- CRP, compared to the age- and sex-matched controls. This indicates that atherosclerosis is not only a disease of lipid deposition, but also an inflammatory process. This was further confirmed by demonstration of a significantly raised IMT.

A Study on Hs-CRP, Carotid Intima Media Thickness, and Lipid Profile in Children of Patients with Premature CAD

A Study on Hs-CRP, Carotid Intima Media Thickness, and Lipid Profile in Children of Patients with Premature CAD

A Study on Hs-CRP, Carotid Intima Media Thickness, and Lipid Profile in Children of Patients with Premature CAD

A Study on Hs-CRP, Carotid Intima Media Thickness, and Lipid Profile in Children of Patients with Premature CAD

Predictors of Benefit Finding in the Adult Children of Patients with Cancer

This study aimed to investigate the predictors of benefit finding in 311 adult children of patients with cancer. Participants completed a comprehensive online/pen-and-paper survey measuring benefit finding, gender of parent, outcome and duration of illness, caregiving experience, and emotional experiences including reaction to diagnosis and grief and loss. Greater benefit finding was positively associated with stronger emotional experiences, satisfaction with the caregiving role, and outcome of parental cancer, explaining 15.3% of the variance in benefit finding. Higher emotional reactions and outcome of parental cancer as significant predictors of parental cancer provide some support for the applicability of theories of post-traumatic growth to this cohort.

Children of cancer patients: prevalence and predictors of emotional and behavioral problems.

Children of patients with cancer are at increased risk for developing emotional and behavioral problems. This study explored the prevalence and predictors of emotional and behavioral problems in Children of cancer patients in a multisite research project. A cross-sectional sample of N = 235 families was recruited simultaneously in 5 university medical centers. The participants, including parents (N = 402) and children (N = 324; ages 11-21 years) completed standardized questionnaires. Emotional and behavioral problems in children were measured by the Strengths and Difficulties Questionnaire (SDQ). On the basis of previous research and using a mixed-model approach, child-, parent-, family- and cancer-related variables were examined in addition to socioeconomic status as potential predictors. Descriptive statistics and a multiple random coefficient model were used in the analyses. Compared to norms, Children of cancer patients show increased mean levels of emotional and behavioral symptoms. The best predictor of emotional and behavioral problems from the perspectives of the child, the healthy parent, and the ill parent was general family dysfunction. Although family dysfunction was identified as the main predictor, the analysis revealed that the main part of variance was related to the individual child's level. The results indicate that screening for child mental health problems and family dysfunction in oncological and psychosocial treatment units can identify the families most in need of psychosocial support. Psychological services need to be both family-oriented and child-centered and focus on family dysfunction to prevent mental health problems in children.

The societal impact of herpes zoster and postherpetic neuralgia on patients, life partners, and children of patients in Germany.

The aim of this study was to assess the impact of herpes zoster (HZ) and postherpetic neuralgia (PHN) on the daily activities of patients and family members who care for them. Some former patients and family members participated in face-to-face interviews or in a T-group meeting (qualitative phase) and some participated in telephone interviews (quantitative phase). They all expressed feelings of helplessness and frustration mixed with depression, sadness, or rage. Many of the former patients said their lives stopped, in contrast to family members who said that their lives were busy and stressful. Family members caring for patients with PHN were more psychologically stressed than those caring for patients with HZ. Although former patients appreciated the psychological and emotional support given by their family members, they underestimated the impact that their disease had on them. Former patients and their family never forgot this illness and its considerable impact on their lives, particularly when PHN occurred. We need to raise the awareness of the general public about the real life impact of HZ and PHN and their often severe, debilitating consequences and the potential benefits from vaccination.

The experiences and needs of children living with a parent with young onset dementia: results from the NeedYD study

Children of patients with young onset dementia (YOD) who are confronted with a parent who has a progressive disease, often assist in caregiving tasks, which may have a great impact on their lives. The objective of the present study is to explore the experiences of children living with a young parent with dementia with a specific focus on the children's needs. Semi-structured interviews with 14 adolescent children between the ages of 15 and 27 years of patients with YOD were analyzed using inductive content analysis. Themes were identified based on the established codes. The emerging categories were divided into three themes that demonstrated the impact of dementia on daily life, different ways of coping with the disease, and children's need for care and support. The children had difficulties managing all of the responsibilities and showed concerns about their future. To deal with these problems, they demonstrated various coping styles, such as avoidant or adaptive coping. Although most children were initially reluctant to seek professional care, several of them expressed the need for practical guidance to address the changing behavior of their parent. The children felt more comfortable talking to someone who was familiar with their situation and who had specific knowledge of YOD and the available services. In addition to practical information, more accessible and specific information about the diagnosis and the course of YOD is needed to provide a better understanding of the disease for the children. These findings underline the need for a personal, family-centered approach.

Temperament, Character and Anxiety Sensitivity in Panic Disorder: A High-Risk Study

Background: Adult patients with panic disorder (PD) show high levels of harm avoidance and anxiety sensitivity. Peculiar temperament profiles and high anxiety sensitivity have been proposed as developmental risk factors for PD in adult age. Since familial-genetic influences play a role both in PD and in anxiety sensitivity and temperament profiles, this study aims to investigate the possible association between family history of PD and peculiar temperament-character profiles or high anxiety sensitivity in offspring of patients with PD. Sampling and Methods: Thirty-four children of patients with PD with/without agoraphobia and 30 children of healthy subjects were compared. Temperament and character dimensions and anxiety sensitivity levels of children were obtained by the Junior Temperament and Character Inventory and the Childhood Anxiety Sensitivity Index. Results: Children of patients with PD and children of healthy subjects differed neither in temperament and character dimensions nor in anxiety sensitivity levels. Conclusions: Our results show that family history of PD is not associated with peculiar temperament and character profiles or high anxiety sensitivity in children, suggesting that these factors may not be early expressions of familial vulnerability to PD. Since the sample is small and the study has a cross-sectional design, longitudinal studies in larger samples are warranted to confirm these findings and to clarify the role of anxiety sensitivity and temperament-character dimensions in the development of PD.

P-106 - Risk of mental disorders in children of parents with alcohol or heroin dependence: a controlled high risk study

Children of patients with substance use disorders (SUD) are at high risk for mental disorders. The effects of specific SUD in both parents on the risk of psychopathology in offspring have hardly been studied. To gain a better understanding of the morbid risk of these children. To assess, 1) the associations between alcohol dependence (AD) or heroin dependence (HD) in patients and psychopathology in their children; 2) the morbid risk conferred by having a second parent with SUD. The sample included 276 children aged from 6 to 17.9 years (mean age = 11.5): 23 children of 15 patients with HD, 101 offspring of 50 patients with AD, 152 children of 81 orthopedic patients (controls) and 158 biological co-parents of the children. Subjects were interviewed by psychologists blind to patient diagnoses, using a semi-structured diagnostic interview. 1) Children of HD or AD patients had largely elevated rates of recurrent major depressive disorder and children of HD patients were also at an increased risk for ADHD and SUD; 2) There were interactions between drug disorders and alcohol disorders in both parents to increase the risk of early SUD in offspring. The early manifestations of mental disorders in children of SUD patients emphasize the need for prompt identification and treatment of these disorders. The involvement of co-parental disorders in the development of offspring psychopathology highlights the need to pay clinical attention not only to the patient, but also to the co-parent in order to optimize prevention in offspring.