Dysfunction In Young People Research Articles

Associations of Adipocytokines and Early Renal Dysfunction in Young People on the Background of Dyslipidemia.

There are data supporting the idea that atherogenic dyslipidemia is a risk factor for CKD and reduced GFR. The aim was to evaluate the associations between adipocytokines and early renal dysfunction in young people with dyslipidemia. A population study was conducted in IIPM-Branch of IC&G SB RAS, in 2013-2017. Furthermore, 1033 people were included in the study (469 men (45.4%) and 564 women (54.6%)). The study included blood sampling, anthropometric data, and adipokines by multiplex analysis. Among people with reduced kidney function and DLP, men were 3.1 times more common than without DLP, women smoked 2 times less often, arterial hypertension was 7.8 times more common, and abdominal obesity was 2.7 times more common (and women with DLP were 3 times more likely than those without DLP). An increase in the level of resistin by 1 mcg/mL was associated with an increased chance of having renal dysfunction by 0.2%. An increase in the level of GIP was associated with an increased chance of having renal dysfunction by 1.1%. In young people with dyslipidemia, regardless of the presence of abdominal obesity, resistin and GIP are associated with the presence of renal dysfunction.

The social domains organization of mentalizing processes in adolescents: a contribution to the conceptualization of personality function and dysfunction in young people.

We propose and evaluate a contribution to the conceptualization and assessment of personality functioning based on social domains and mentalizing hypotheses. Social domains are distinct social contexts, such as with acquaintances and friends, with differentiated expectations regarding participants' behaviours and social attributions. The capacity to organize social participation according to these expectations requires the ability, we suggest, to modulate mentalizing processes domain by domain. Drawing on evidence that social domain organization is impaired in borderline personality disorder (BPD) and that hypermentalizing, a heightened interpretation of others' motives, thoughts or emotions, is elevated in adolescent BPD, we hypothesized that hypermentalizing levels in adolescents will vary by social domain and that elevated BPD features will be associated with impairment of this domain organization of hypermentalizing. Measures including the borderline personality features scale for children (BPFSC) and the movie for the assessment of social cognition (MASC) were administered to 171 adolescents aged 12-17 recruited from public schools and community organizations in a large metropolitan area in southwestern United States. Mean hypermentalizing scores were computed for adolescent interpretations of sequences in the MASC focusing on the social domains of acquaintance, friends and romantic interactions. There was a progressive increase in hypermentalizing scores across the acquaintance, friends and romantic interactions (repeated measures ANOVA, p < .001, all pairwise comparisons, p ≤ .02), which was markedly reduced in the presence of elevated BPD features (interaction term, p = .007). Hypermentalizing is organized according to social domain and this organization is impaired in the presence of elevated BPD features. The findings are consistent with the proposal that personality functioning entails a social domains organization of hypermentalizing, which is impaired in personality dysfunction. Identifying mentalizing processes domain by domain has the potential to create a personalized focus for the treatment of adolescents with personality difficulties.

P02 - Erectile dysfunction in young people with type I diabetes: Prevalence, comorbidities and therapeutic response

P02 - Erectile dysfunction in young people with type I diabetes: Prevalence, comorbidities and therapeutic response

Normal ranges of non-invasive left ventricular myocardial work indices in healthy young people.

ObjectivesEchocardiographic global myocardial work (GMW) indices recently emerged to non-invasively evaluate left ventricular (LV) myocardial performance with less load-dependence than LV ejection fraction (LVEF) or global longitudinal strain (GLS). Yet, few data exist on the descriptions of LV GMW indices in young people. We therefore aimed to provide normal reference values of LV GMW in a healthy young cohort, and simultaneously to investigate factors associated with non-invasive GMW indices.Materials and methodsA total of 155 healthy young people (age 10–24 years, 59% male) underwent transthoracic echocardiography were recruited and further stratified for age groups and divided by gender. Two-dimensional speckle-tracking echocardiography (2D-STE) were performed to determine LV GLS, peak strain dispersion (PSD) and GMW indices, which include global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE). LV peak systolic pressure was assumed to be equal to the systolic brachial artery cuff blood pressure.ResultsAge and gender specific normal ranges for LV GMW indices were presented. On multivariable analysis, GWI and GCW correlated more closely with systolic blood pressure (SBP) than LV GLS, while both GWW and GWE independently correlated with PSD (P < 0.05 for all). There were no associations between any of the GMW indices with age, sex, body mass index, heart rate, left ventricular mass index as well as LV sizes or LVEF. Of noted, LV GMW indices had good intra-observer and inter-observer reproducibility.ConclusionWe reported echocardiographic reference ranges for non-invasive LV GMW indices in a large group of healthy young subjects, which are reproducible and reliable, and thus can be further used when assessing subclinical dysfunction in young people with myocardial diseases.

Distribution of vegetative dysfunctions and depressive positions among sexually active students and students without sexual debut of National Pirogov Memorial Medical University, Vinnytsya

Annotation. Autonomic dysfunction syndrome is one of the most common disorders, which has a wide range of interpretations among specialists of different profiles. The autonomic nervous system (ANS) occupies a significant place in the development of somatic pathology. The course and manifestation of all pathological conditions is associated with autonomic dysfunction. Together with vegetative disorders, depressive disorders are also widespread among students. The aim of the study: to identify the clinical psychopathological features of somatized depressive disorders and autonomic dysfunction among sexually active students in comparison with students without a sexual debut of 4th year of study at Vinnytsya National Pirogov Memorial Medical University. A survey of 308 medical students was carried out. Obtained data were analyzed using the program “Statistica 6.1” using nonparametric methods of estimation of the obtained results. It was found that among medical students is a very high percentage of depressive disorders (96.1%) and disorders of autonomic function (69.8%). However, the manifestations of vascular dysfunction in young people are not related to their sexual activity. Mild and minimal manifestations of depressive disorders are also not associated with sexual activity. Symptoms of very severe depression are more prevalent in virgin girls than in sexually active girls and boys.

Identifying pathways to early-onset metabolic dysfunction, insulin resistance and inflammation in young adult inpatients with emerging affective and major mood disorders.

Young people with common mood disorders face the prospect of shortened life expectancy largely due to premature cardiovascular disease. Metabolic dysfunction is a risk factor for premature cardiovascular disease. There is an ongoing debate whether metabolic dysfunction can be simply explained by weight gain secondary to psychotropic medications or whether shared genetic vulnerability, intrinsic immune-metabolic disturbances or other system perturbations (e.g. dysregulated sympathetic nervous system, circadian dysfunction) are more relevant determinants of premature cardiovascular disease. Thus, we aimed to investigate underlying drivers of metabolic dysfunction and premature cardiovascular disease in young people in the early phases of common mood disorders. We evaluated the relationships between insulin resistance (assessed by HOMA2-IR) and body mass index (BMI), sex, diagnosis, medication, inflammatory markers and hormonal factors in 327 inpatients with emerging affective and major mood disorders admitted to the Young Adult Mental Health Unit, St Vincent's Private Hospital, Sydney. While HOMA2-IR scores were positively associated with BMI (rs =0.465, p < .001), they were also higher in those prescribed mood stabilizers (p=.044) but were not associated with specific diagnoses, other medication types or the number of prescribed medications. Further, high-sensitivity C-reactive protein levels (but not thyroid-stimulating hormone and ferritin levels) were positively associated with HOMA2-IR (rs =0. 272, p < .001) and BMI (rs =. 409, p < .001). In addition to BMI, other non-specific markers of inflammation are associated with early metabolic dysfunction in young people with emerging affective and major mood disorders.

Risk factors for dementia are not associated with cognitive dysfunction in young people with major depressive disorder

Background: Hippocampal thinning and carrying the ε4 allele of the apolipoprotein E (APOE) are associated with reduced cognitive performance in older people. Although cognitive impairment is also frequent during and after depressive episodes, it may occur irrespective of age, which makes it difficult to determine, whether this symptom indicates a risk for or shared mechanisms with neurodegeneration. We therefore investigated the influence of genetic and brain imaging risk factors for dementia on cognitive impairment in young people with major depressive disorder. MethodsWe used magnetic resonance imaging, APOE genotyping and neurocognitive assessments to examine young adults (mean age: 29.1 ± 6.3 years) with major depressive disorder and a current depressive episode, presenting with or without cognitive deficits. ResultsNeither hippocampal thickness nor APOE genotype predicted cognitive impairment. Patients with objective cognitive deficits reported a greater number of previous depressive episodes. LimitationsOur results have to be interpreted with caution. The small sample size could have prevented the detection of effects. Complementing research methods and investigations across the life span would be necessary to reveal possible interactions between risk factors for dementia, neurodegeneration, depression, and age. ConclusionsIn young adults, recurrent depressive episodes may increase the likelihood for cognitive deficits, while common risk factors for dementia do not.

Foci of chronic infection and vascular rigidity in persons of military age

The role of focal infection as a possible risk factor for development of atherosclerotic cardiovascular diseases is discussed quite intensively now. Estimated some parameters of vascular stiffness in young men of military age with the features of their infectious-inflammatory medical history by the type of foci of chronic infection. It is established that in young men with foci of chronic infection such indicators of vascular stiffness, as peripheral augmentation index, augmentation index, normalized to heart rate, and augmentation index of the aorta were significantly higher than in their peers with a positive history. The differences in the first two indicators have reached a reliable level. It should be emphasized the presence of more low blood pressure in the presence of foci of chronic infection , which eliminates the distortion parameters of vascular status, influenced by the tensile effect from the blood pressure in the time of the study. The obtained data clearly indicate the higher rigidity of the walls of the aorta and large arteries in young men under the influence of their foci of chronic infection. Some tendency to development of left ventricular dysfunction in young people with presence of chronic tonsillitis and other infectious and inflammatory diseases was also revealed. This dysfunction is expressed in reducing the maximum rate of growth of blood pressure and increasing the period of expulsion of the left ventricle. The presented results confirm the concept of lifelong formation of «infectious-inflammatory load» in terms of increasing vascular rigidity and subclinical changes in the functioning of the myocardium at young age, subject to the presence of a focal chronic infection. These data allow us to regard foci of chronic infection as another risk factor of atherosclerosis, which in turn requires consideration when carrying out the relevant preventive measures among young population in the process of health checkups.

Accuracy of cystatin C for the detection of abnormal renal function in children undergoing chemotherapy for malignancy: a systematic review using individual patient data.

We conducted a systematic review and individual patient data (IPD) meta-analysis to examine the utility of cystatin C for evaluation of glomerular function in children with cancer. Eligible studies evaluated the accuracy of cystatin C for detecting poor renal function in children undergoing chemotherapy. Study quality was assessed using QUADAS-2. Authors of four studies shared IPD. We calculated the correlation between log cystatin C and GFR stratified by study and measure of cystatin C. We dichotomized the reference standard at GFR 80ml/min/1.73m2 and stratified cystatin C at 1mg/l, to calculate sensitivity and specificity in each study and according to age group (0-4, 5-12, and ≥ 13years). In sensitivity analyses, we investigated different GFR and cystatin C cut points. We used logistic regression to estimate the association of impaired renal function with log cystatin C and quantified diagnostic accuracy using the area under the ROC curve (AUC). Six studies, which used different test and reference standard thresholds, suggested that cystatin C has the potential to monitor renal function in children undergoing chemotherapy for malignancy. IPD data (504 samples, 209 children) showed that cystatin C has poor sensitivity (63%) and moderate specificity (89%), although use of a GFR cut point of < 60ml/min/1.73m2 (data only available from two of the studies) estimated sensitivity to be 92% and specificity 81.3%. The AUC for the combined data set was 0.890 (95% CI 0.826, 0.951). Diagnostic accuracy appeared to decrease with age. Cystatin C has better diagnostic accuracy than creatinine as a test for glomerular dysfunction in young people undergoing treatment for cancer. Diagnostic accuracy is not sufficient for it to replace current reference standards for predicting clinically relevant impairments that may alter dosing of important nephrotoxic agents.

Sexual functioning and experiences in young people affected by mental health disorders

The majority of mental disorders have their onset in late adolescence and early adulthood and this coincides with important stages of sexual development. Although sexual dysfunction is highly prevalent among people with mental health disorders, little is known about this topic among youth. This study aimed to evaluate the sexual functioning and subjective experience of sex in young people aged between 15 and 26 years attending a youth mental health service. One hundred and three participants were assessed with the Sexual Health Questionnaire, Sexual Functioning Questionnaire, Brief Psychiatric Rating Scale, Scale for the Assessment of Negative Symptoms and the Medication Adherence Rating Scale. There were 43 males, 52 females, and 8 transgender and gender diverse participants with a range of mental health disorders. Eighty (77.7%) had experienced consensual sexual intercourse. Ninety-nine (95.8%) endorsed at least one item of sexual dysfunction and clinical sexual dysfunction was present in 37 (38.9%) cases. Sexual dysfunction was associated with greater severity of general psychopathology, negative symptoms, antipsychotic use, lower antipsychotic medication adherence, and negative subjective experiences around sex. Addressing this sexual dysfunction in young people could lead to both an improvement in subjective experiences of sexual relationships and potentially improvement in adherence to treatment.

Prevalence of external respiratory dysfunction in young people

To investigate the prevalence of impaired external respiration function (ERF) in young Novosibirsk dwellers. A cross-sectional population-based survey in one of the typical districts of Novosibirsk was conducted at the Research Institute of Internal and Preventive Medicine in 2013-2015. ERF was examined by spirometry in accordance with the guidelines. The best indicators of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio were selected and three reproducible attempts were made to evaluate ERF. Spirometry was carried out in 787 respondents (358 males and 429 females) for the entire period. The results were interpreted according to the guidelines of the European Respiratory Society, the American Thoracic Society, and the Russian Respiratory Society. The prevalence of a FEV1/FVC of <70% in the total sample was 10.3% (13.4% for men and 7.7% for women; p=0.009); a FEV1 of <80% was 13.9% (14.5% for men and 13.3% for women; p=0.617); a FVC of <80% was 7% (6.1% for men and 7.7% for women; p=0.397). The obstructive type of ventilation disorders (FEV1/FVC <70%, FVC ≥80%) was recorded in 9.4% of the people, the restrictive type (FVC <80%, FEV1/FVC ≥70%) in 6.1%, and the mixed one (FEV1/FVC <70%, FVC <80%) in 0.9%; normal values (FEV1/FVC ≥70% and FVC ≥80%) were seen in 83.6%. Spirometric screening of a young Novosibirsk population demonstrated the incidence of impaired ERF, which is comparable with Russian and foreign data.

Abnormalities of vascular structure and function in pediatric hypertension.

Hypertension is associated with adverse cardiovascular (CV) events in adults. Measures of vascular structure and function, including increased carotid intima-media thickness (cIMT) and elevated arterial stiffness predict hard CV events in adulthood. Newer data suggest that abnormalities in target organ damage are occurring in adolescents and young adults with high blood pressure. In this review, we discuss the techniques for measuring vascular dysfunction in young people and the evidence linking blood pressure levels to this type of target organ damage.

Reducing Sedentary Time or Increasing Moderate and Vigorous Intensity Physical Activity in Youth? Associations with Health Outcomes

Current recommendations for physical activity in young people state that those between 5 and 18 years of age should accumulate at least 60 minutes of moderate and vigorous intensity physical activity per day. Emerging evidence suggest that the majority of young people do not achieve the recommended levels of activity which may influence on their health. On the opposite end of the energy expenditure spectrum, sedentar y time has been recognised as a potential risk factor for chronic disease in adults. Recent systematic reviews have suggested there is little evidence for a prospective association between baseline time spent sedentary and later health outcomes. There is a paucity of data examining the prospective associations between objectively measures physical activity and health outcomes. However, the cross-sectional evidence linking time in moderate and vigorous intensity physical activity with cardio-metabolic health outcomes is consistent with potentially greater magnitude of association for more vigorous intensity activity. Further, time spent sedentary appears unrelated to these outcomes following appropriate adjustments for time in moderate and vigorous intensity physical activity. The appropriate amount of time in moderate and vigorous intensity physical activity needed to prevent cardiovascular dysfunction in young people needs to be determined and the potential benefits of more vigorous intensity physical activity established. Additional large scale, well-designed prospective studies and randomised controlled trials are warranted to address these uncertainties.

Retinal Vascular Geometry Predicts Incident Renal Dysfunction in Young People With Type 1 Diabetes

OBJECTIVETo examine the relationship between retinal vascular geometry parameters and development of incident renal dysfunction in young people with type 1 diabetes.RESEARCH DESIGN AND METHODSThis was a prospective cohort study of 511 adolescents with type 1 diabetes of at least 2 years duration, with normal albumin excretion rate (AER) and no retinopathy at baseline while attending an Australian tertiary-care hospital. AER was quantified using three overnight, timed urine specimen collections and early renal dysfunction was defined as AER >7.5 μg/min. Retinal vascular geometry (including length-to-diameter ratio [LDR] and simple tortuosity [ST]) was quantified from baseline retinal photographs. Generalized estimating equations were used to examine the relationship between incident renal dysfunction and baseline venular LDR and ST, adjusting for age, diabetes duration, glycated hemoglobin (A1C), blood pressure (BP), BMI, and cholesterol.RESULTSDiabetes duration at baseline was 4.8 (IQR 3.3–7.5) years. After a median 3.7 (2.3–5.7) years follow-up, 34% of participants developed incident renal dysfunction. In multivariate analysis, higher retinal venular LDR (odds ratio 1.7, 95% CI 1.2–2.4; quartile 4 vs. 1–3) and lower venular ST (1.6, 1.1–2.2; quartile 1 vs. 2–4) predicted incident renal dysfunction.CONCLUSIONSRetinal venular geometry independently predicted incident renal dysfunction in young people with type 1 diabetes. These noninvasive retinal measures may help to elucidate early mechanistic pathways for microvascular complications. Retinal venular geometry may be a useful tool to identify individuals at high risk of renal disease early in the course of diabetes.

P.3.c.001 Quality of life: sexual dysfunction in young people with schizophrenia treated with ziprasidone

P.3.c.001 Quality of life: sexual dysfunction in young people with schizophrenia treated with ziprasidone

Evidence for executive dysfunction in young people at high genetic risk for schizophrenia? Results of the Hayling sentence completion test

Evidence for executive dysfunction in young people at high genetic risk for schizophrenia? Results of the Hayling sentence completion test