Dysfunction In Adolescents Research Articles

THE ROLE OF GENETIC FACTORS IN REPRODUCTIVE DYSFUNCTION IN ADOLESCENTS WITH VARICOCELE

In the pathogenesis of male infertility, up to 30% of cases can be attributed to the role of genetic factors and cause both minor changes in spermatogenesis and absolute dysfunction of the gonads. With varicocele under conditions of testicular ischemia and hypoxia, the expression of various genes responsible for spermatogenesis can be modified. Target. To assess the contribution of genetic factors to the risk of reproductive dysfunction in adolescents with varicocele. Materials and methods. Adolescents with varicocele underwent karyotype analysis, study of deletions of the AZF and CFTR gene loci, and spermogram evaluation. Results. When evaluating the karyotype in adolescents with varicocele, shortening of the long arm of the Y chromosome was detected in 1 case (1%), a study of the AZF locus in three people from the main group (3%) revealed a deletion of sY1291, one person (1%) was diagnosed with a deletion in CFTR gene — Nmdel F508. In the study of spermogram, normozoospermia (52%) was most often diagnosed in adolescents with varicocele, and asthenozoospermia (24%) was diagnosed as pathological changes. Conclusions. 1. The frequency of detection of genetic factors of infertility in adolescents with varicocele does not exceed 5%. 2. The identified genetic variants in the groups of adolescents examined did not lead to impaired spermatogenesis, which allows us to consider the contribution of genetic causes to reproductive dysfunction in varicocele as insignificant.

Роль факторов ангиогенеза в патогенезе овариальной дисфункции у подростков

Роль факторов ангиогенеза в патогенезе овариальной дисфункции у подростков

Immune characterization of suicidal behavior in female adolescents

BackgroundTo address the need to identify potential markers of suicide behavior for adolescents (ages 12–18 years), mass cytometry was used to explore the cellular mechanisms that may underpin immune dysregulation in adolescents with recent suicidal behavior. MethodsPeripheral blood mononuclear cell (PBMC) samples from 10 female adolescents with a recent suicide attempt and 4 healthy female adolescents were used. A panel of 30 antibodies was analyzed using mass cytometry. We used two complementary approaches to 1) identify the cell types that significantly differed between the two groups, and 2) explore differences in the expression profile of markers on the surface of these cells. Mass cytometry data were investigated using (Center for Disease Control, 2021) Opt-SNE for dimension reduced (Curtin and Heron, 2019), FlowSOM for clustering, and (Bridge et al., 2006) EgdeR and SAM for statistical analyses. ResultsOpt-SNE (a data driven clustering analysis) identified 15 clusters of distinct cell types. From these 15 clusters, cluster 5 (classical monocytes) had statistically lower abundance in suicidal adolescents as compared to healthy controls, whereas cluster 7 (gamma-delta T cells) had statistically higher abundance in suicidal adolescents compared to healthy control. Furthermore, across the 15 cell types, chemokine receptors, CXCR3 (cluster 5) and CXCR5 (clusters 4, 5, 7, and 9), had an elevated expression profile in those with a recent suicide attempt versus healthy controls. ConclusionThis report demonstrates the utility of high dimensional cell phenotyping in psychiatric disorders and provides preliminary evidence for distinct immune dysfunctions in adolescents with recent suicide attempts as compared to healthy controls.

Cardiac Autonomic Nerve Dysfunction Predicts Incident Retinopathy and Early Kidney Dysfunction in Adolescents With Type 1 Diabetes.

Cardiac autonomic neuropathy (CAN) may contribute to vascular complications in diabetes. We hypothesized that adolescents with CAN are at greater risk of diabetic retinopathy and early kidney dysfunction. In this prospective longitudinal study of 725 adolescents with type 1 diabetes without retinopathy and albuminuria at baseline, early CAN was defined as one or more abnormalities in seven heart rate tests derived from a 10-min electrocardiogram. Retinopathy was defined as the presence of one or more microaneurysms, early kidney dysfunction as an albumin excretion rate (AER) >7.5 μg/min, and albuminuria as an AER >20 μg/min. Multivariable generalized estimating equations were used to examine the association between CAN and retinopathy or early kidney dysfunction. Cox proportional hazards regression analysis was used to assess cumulative risks of incident retinopathy and albuminuria. At baseline, the mean age of the sample was 13.6 ± 2.6 years, 52% were male, and mean diabetes duration was 6.1 ± 3.3 years. Over a median follow-up of 3.8 (interquartile range 2.2-7.5) years, the complication rate 27% for retinopathy, 16% for early kidney dysfunction, and 3% for albuminuria. The mean study HbA1c was 72.3 ± 16 mmol/mmol (8.6 ± 1.4%). CAN predicted incident retinopathy (odds ratio 2.0 [95% CI 1.4, 2.9]) and early kidney dysfunction (1.4 [1.0, 2.0]) after adjusting for HbA1c and diabetes duration. CAN also predicted retinopathy (hazard ratio 1.57 [95% CI 1.09, 2.26]) and albuminuria (2.30 [1.05, 5.04]) independently of HbA1c. CAN predicted incident retinopathy and kidney dysfunction in adolescents with type 1 diabetes, likely reflecting autonomic microvascular dysregulation contributing to complications. Therefore, screening and interventions to reduce CAN may influence the risk of complications.

Sleep Dysfunction in Adolescents With Prolonged Postconcussion Symptoms: A Reciprocal Coupling of Traumatic Brain Injury and Sleep-Related Problems.

Concussions are often neglected injuries that affect children and adolescents. Two physiological responses to a concussion are an ionic flux and an increased indiscriminate release of glutamate, which leads to an increase of intracellular calcium and extracellular potassium. This can ultimately result in sleep dysfunction, which often occurs after concussion and has long been thought of as simply another concussion symptom. Does the likelihood of prolonged postconcussion symptoms increase with reported sleep-related problems (SRPs) in young athletes (8-18y) compared to concussed young athletes without SRPs and healthy controls? Four cohort studies with level 2/3 evidence measured subjective and objective sleep dysregulations in concussed and healthy populations. Overall, there was a difference in subjective SRPs between concussed and healthy patients. This correlated with other studies where worse sleep scores during the acute phase of concussion and increased SRPs led to worse ImPACT scores in patients 3 to 12 months postconcussion and longer overall recovery. Objective sleep dysfunction measures were significantly worse in concussed patients than in healthy controls, but no significant difference existed in melatonin measures. There is strong evidence that sleep dysfunction is both a symptom of concussion as well as a causal factor of prolonged postconcussion symptoms. These studies show that sleep dysregulation is not always evident in objective measurements, leading to the strong possibility of a functional dysregulation of the sleep-wake cycle that is evident solely from subjective reports. While there are strong cohort studies researching the role of sleep in those with postconcussion symptoms, the nature of sleep studies prevents the production of strong, high-level evidence studies such as randomized control trials. Thus, there is level B evidence that the likelihood of prolonged postconcussion symptoms is increased by a higher amount of SRPs.

Early Signs of Microvascular Endothelial Dysfunction in Adolescents with Newly Diagnosed Essential Hypertension.

Endothelial dysfunction represents one of the key pathomechanisms in many diseases, including hypertension. Peripheral arterial tonometry (PAT) evaluates the functional status of microvascular endothelium and offers a biomarker of early, potentially reversible, vascular damage. This study aimed to assess endothelial function using conventional and novel indices of PAT in pediatric hypertensives. As such, 100 adolescents with normal blood pressure, and essential and white-coat hypertension were examined using EndoPAT 2000. Conventional reactive hyperemia index (RHI) and novel indices of hyperemic response, including the area under the curve of hyperemic response (AUC), were evaluated. AUC was the only parameter sensitive to the effect of hypertension, with significantly lower values in essential hypertensives compared to normotensives and white-coat hypertensives (p = 0.024, p = 0.032, respectively). AUC was the only parameter significantly correlating with mean ambulatory monitored blood pressure (r = −0.231, p = 0.021). AUC showed a significant negative association with age (p = 0.039), but a significant positive association with pubertal status indexed by plasma levels of dehydroepiandrosterone (p = 0.027). This is the first study reporting early signs of microvascular endothelial dysfunction evaluated using PAT in adolescents with newly diagnosed essential hypertension. Detailed analysis of hyperemic response using overall magnitude indexed by AUC provided a more robust method compared to the conventional evaluation of RHI.

Menstrual dysfunction in adolescent girls who are overweight: a literature review

This study aimed to review the modern literature on the problems of adolescent obesity and the pathogenesis of menstrual dysfunction in overweight adolescents and women of reproductive age. In recent years, a large number of works have been published on the relationship of hyperinsulinemia with ovarian hyperandrogenism. Most authors recognize that insulin resistance and hyperinsulinemia contribute to polycystic ovary syndrome formation. The formation of menstrual disorders in overweight girls is based on the violation of gonadotropin secretion, insulin resistance, and hyperinsulinemia, which over time lead to hyperandrogenism. A decreased level of somatotropic hormone and insulin-like growth factor and an increased level of leptin leads to malfunctions in the correct functioning of the hypothalamic-pituitary system. These changes disturb the ovulatory function and, consequently, adolescent reproductive health. The relationship between obesity and depression is actively discussed by foreign authors, and the obtained results often contradict each other. Most studies suggest that excessive weight gain during adolescence can lead to depression, negative mood, and low self-esteem.
 This study analyzes the results of research by domestic and foreign authors on the issues of diagnosis and treatment. Menstrual disorder therapy against the background of overweight adolescent girls is a matter of dispute among clinicians. With weight loss in adolescents, a significant improvement is found in carbohydrate and lipid metabolism, decreased levels of hepatic transaminases, and a decreased severity of obstructive sleep apnea syndrome.

Cytokine network analysis in a community-based pediatric sample of patients with myalgic encephalomyelitis/chronic fatigue syndrome.

Studies have demonstrated immune dysfunction in adolescents with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS); however, evidence is varied. The current study used network analysis to examine relationships between cytokines among a sample of pediatric participants with ME/CFS. 10,119 youth aged 5-17 in the Chicagoland area were screened for ME/CFS; 111 subjects and controls were brought in for a physician examination and completed a blood draw. Youth were classified as controls (Cs, N = 43), ME/CFS (N = 23) or severe (S-ME/CFS, N = 45). Patterns of plasma cytokine networks were analyzed. All participant groups displayed a primary network of interconnected cytokines. In the ME/CFS group, inflammatory cytokines IL-12p70, IL-17A, and IFN-γ were connected and included in the primary membership, suggesting activation of inflammatory mechanisms. The S-ME/CFS group demonstrated a strong relationship between IL-17A and IL-23, a connection associated with chronic inflammation. The relationships of IL-6 and IL-8 in ME/CFS and S-ME/CFS participants also differed from Cs. Together, these results indicate pro-inflammatory responses in our illness populations. Our data imply biological differences between our three participant groups, with ME/CFS and S-ME/CFS participants demonstrating an inflammatory profile. Examining co-expression of cytokines may aid in the identification of a biomarker for pediatric ME/CFS.

Characterization and assessment of endothelial dysfunction in adolescents with obesity and vitamin D deficiency

Background. Obesity and vitamin D deficiency in children are widespread in economically developed countries. Among children with obesity and components of the metabolic syndrome, vitamin D deficiency is more common than in children with a normal body mass index (BMI). The growth of metabolic disorders, atherosclerosis, early onset of type 2 diabetes mellitus lead to fatal vascular accidents in young people, and therefore the search for new ways of early diagnosis of these processes is relevant.
 Aim. To study of the relationship of endothelial dysfunction with vitamin D deficiency, obesity and associated metabolic disorders among adolescents in Saint Petersburg.
 Materials and methods. 5 adolescents aged 1416 years (150.76 years) with primary obesity were examined. Anthropometric parameters were studied: waist circumference, weight, height, calculation of BMI, stage of puberty according to Tanner. Laboratory examination included the following parameters: serum glucose, cholesterol, triglycerides, high density lipoproteins, low density lipoproteins, insulin, 25(OH)D. Atherogenicity index (AI), insulin resistance index (HOMA-IR), vitamin D sufficiency were calculated. Endothelial function was assessed by the value of the reactive hyperemia index (RHI), automatically calculated by the EndoPAT 2000 device (Itamar Medical, Israel).
 Results. All examined patients had abdominal obesity (median BMI 33.5 kg/m2 [30.9; 34.2]) and reduced vitamin D supply (median 25(OH)D 17.2 ng/ml). Hypercholesterolemia and dyslipidemia due to an increase in low density lipoproteins were diagnosed in 1 (20%) case. Dyslipidemia due to a decrease in high density lipoproteins was detected in 3 (60%) patients. An increase in IA was found in 4 (80%) people. Insulin resistance was present in 60% of the examined, the median value of HOMA-IR was 5.6. The median RHI was 1.74 [1.72; 2.13]. Optimum RHI values were observed in 2 (40%) patients; in most (60%) adolescents, the RHI values corresponded to subnormal values and were close to the lower limit of this zone. A significant inverse correlation of RHI with AI was obtained (R=-0.63, p0.05).
 Conclusion. Taking into account the risk factors previously identified in the examined patients (dyslipidemia, insulin resistance, reduced vitamin D supply), endothelial dysfunction in these patients was regarded as a cardiovascular risk factor. A manageable risk factor is a reduced supply of vitamin D, which can be corrected by an additional donation of cholecalciferol.

W217 Postprandial inflammation and metabolic dysfunction in adolescents with obesity and insulin resistance

W217 Postprandial inflammation and metabolic dysfunction in adolescents with obesity and insulin resistance

Prospectively Predicting Adult Depressive Symptoms from Adolescent Peer Dysfunction: a Sibling Comparison Study.

Previous studies have shown that peer dysfunction in adolescence predicts depression in adulthood, even when controlling for certain individual- and/or family-level characteristics. However, these studies have not controlled for numerous potential familial confounders, precluding causal inferences. The present study therefore used a sibling comparison design (i.e., comparing siblings within families) to test whether peer dysfunction (e.g., lack of friendships, victimization) in adolescence continues to predict depression in adulthood after accounting for unmeasured familial confounds and individual characteristics in adolescence. Participants’ (N = 85) dysfunction with peers was assessed in adolescence (Mage = 13.21, SD = 3.47) by self- and parent-report, and adult depressive symptoms were assessed up to five times, up to 38 years later. Multilevel modeling was used to examine the effect of adolescent peer dysfunction on adult depressive symptoms after adjusting for familial confounds and/or individual characteristics in adolescence (e.g., baseline depressive symptoms, dysfunctional relations with siblings/parents). Both self-reported (b = 1.28, p < 0.001) and parent-reported (b = 0.56, p = 0.032) adolescent peer dysfunction were associated with greater depressive symptom severity in adulthood in unadjusted models. Self-reported (but not parent-reported) adolescent peer dysfunction continued to predict adult depressive symptoms after controlling for familial confounding and measured covariates such as adolescent depressive symptoms and relations with siblings and parents (b = 1.06, p = 0.035). Although confidence intervals were wide and the potentially confounding effects of numerous individual-level factors were not ruled out, these findings provide preliminary evidence that perceived peer dysfunction in adolescence may be an unconfounded risk factor for depressive symptoms in adulthood.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10802-022-00906-4.

Arsenic exposure from drinking water and endothelial dysfunction in Bangladeshi adolescents

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide, with ∼80% of CVD-related deaths occurring in low- and middle-income countries. Growing evidence suggests that chronic arsenic exposure may contribute to CVD through its effect on endothelial function in adults. However, few studies have examined the influence of arsenic exposure on cardiovascular health in children and adolescents. To examine arsenic's relation to preclinical markers of endothelial dysfunction, we enrolled 200 adolescent children (ages 15–19 years; median 17) of adult participants in the Health Effects of Arsenic Longitudinal Study (HEALS), in Araihazar, Bangladesh. Participants' arsenic exposure was determined by recall of lifetime well usage for drinking water. As part of HEALS, wells were color-coded to indicate arsenic level (<10 μg/L, 10–50 μg/L, >50 μg/L). Endothelial function was measured by recording fingertip arterial pulsatile volume change and reactive hyperemia index (RHI) score, an independent CVD risk factor, was calculated from these measurements. In linear regression models adjusted for participant's sex, age, education, maternal education, land ownership and body weight, individuals who reported always drinking water from wells with >50 μg/L arsenic had a 11.75% lower level of RHI (95% CI: −21.26, −1.09, p = 0.03), as compared to participants who drank exclusively from wells with ≤50 μg/L arsenic. Sex-stratified analyses suggest that these associations were stronger in female participants. As compared to individuals who drank exclusively from wells with ≤50 μg/L arsenic, the use of wells with >50 μg/L arsenic was associated with 14.36% lower RHI (95% CI: −25.69, −1.29, p = 0.03) in females, as compared to 5.35% lower RHI (95% CI: −22.28, 15.37, p = 0.58) in males for the same comparison. Our results suggest that chronic arsenic exposure may be related to endothelial dysfunction in adolescents, especially among females. Further work is needed to confirm these findings and examine whether these changes may increase risk of later adverse cardiovascular health events.

A graph theory-based whole brain approach to assess mood state differences in adolescents and young adults with bipolar disorder.

Identifying hubs of brain dysfunction in adolescents and young adults with Bipolar I Disorder (BDAYA ) could provide targets for early detection, prevention, and treatment. Previous neuroimaging studies across mood states of BDAYA are scarce and often examined limited brain regions potentially prohibiting detection of other important regions. We used a data-driven whole-brain Intrinsic Connectivity Distribution (ICD) approach to investigate dysconnectivity hubs across mood states in BDAYA . Functional magnetic resonance imaging whole-brain ICD data were investigated for differences across four groups: BDAYA -depressed (n=22), BDAYA -euthymic (n=45), BDAYA -elevated (n=24), and healthy controls (HC, n=111). Clusters of ICD differences were assessed for regional dysconnectivity and mood symptom relationships. Analyses were also performed for BDAYA overall (vs. HC) ICD differences persisting across mood states. ICD was higher in the BDAYA- depressed group than other groups in bilateral ventral/rostral/dorsal prefrontal cortex (PFC) and right lenticular nucleus (LN) (pcorrected <0.05). In BDAYA -depressed, functional connectivity (FC) was increased between these regions with their contralateral homologues and PFC-medial temporal FC was more negative (p<0.005). PFC-related findings correlated with depression scores (p<0.05). The overall BDAYA group showed ICD increases in more ventral left PFC and right cerebellum, present across euthymia and acute mood states. This ICD approach supports a PFC hub of inter- and intra-hemispheric frontotemporal dysconnectivity in BDAYA with potential trait features and disturbances of higher magnitude during depression. Hubs were also revealed in LN and cerebellum, less common foci of BD research. The hubs are potential targets for early interventions to detect, prevent, and treat BD.

Postprandial inflammation and metabolic dysfunction in adolescents with obesity and insulin resistance

BackgroundPostprandial dyslipidemia is an independent risk factor for cardiovascular disease, and inflammatory and metabolic markers are implicated in its pathogenesis. We hypothesize that the postprandial inflammatory and metabolic profiles of adolescents with obesity and insulin resistance (IR) is dysregulated and more informative to the pathogenesis of postprandial dyslipidemia than at fasting. MethodsAdolescents with normal weight (N=15) and with obesity (N=30) were recruited in Toronto, ON, and underwent a six-hour oral fat tolerance test. Eight cytokines were assessed using an automated sandwich immunoassay, and a metabolomics profile (>133 metabolites) was quantified using liquid chromatography tandem mass spectrometry and nuclear magnetic resonance spectroscopy. A lipid/lipoprotein, bile acid, and anthropometric profile were previously quantified in this cohort. ResultsAmong the studied cytokines, levels of interleukin (IL)-6 were significantly elevated in obesity throughout the entire postprandial response (p<0.05). Numerous metabolites, namely acylcarnitines, biogenic amines, and glycerophospholipids were significantly downregulated postprandially, whereas amino acids were predominantly elevated, in obesity compared to NW. Correlational analyses revealed strong (-0.5> Spearman rho > 0.5) and significant (p<0.05) associations between tumour necrosis factor- α, IL-6, and IL-8 and an atherogenic lipid/lipoprotein phenotype, and adiposity and IR, while IL-1β, IL-18, monokine induced by interferon-γ, and IL-10 were strongly associated with bile acid species in the postprandial state. Conclusion Adolescents with obesity and IR exhibit significant fasting and postprandial dysregulation of several inflammatory and metabolic markers integral to lipid metabolism. These data may offer novel subclinical biomarkers for early metabolic and cardiovascular diseases, such as postprandial dyslipidemia, in at-risk adolescents.

The impact of genital warts on sexual function and sexuality-related distress in late adolescence.

Adolescence is a transition period during which sexual experiences gain importance. Genital warts are sexually transmitted lesions that have been shown to negatively affect sexual perception. This study aimed to evaluate the impact of genital warts on female sexual function and sexuality-related distress in adolescence. A total of 90 female adolescents between the ages of 17 and 21 who had regular sexual intercourse with heterosexual partners were included in this prospective case-control study. Female Sexual Function Index, Arizona Sexual Experiences Scale, and Female Sexual Distress Scale-Revised scores of adolescents with genital warts (n = 45) were compared to healthy subjects (n = 45). Total Female Sexual Function Index and Arizona Sexual Experiences Scale scores revealed significant dysfunction in adolescents with genital warts (20.7 ± 4.13 (20.9) vs. 28.2 ± 3.51 (28.7), p < 0.0001; 17.1 ± 3.61 (17) vs. 13.02 ± 3.01 (13), p < 0.0001, respectively). Total Female Sexual Distress Scale-Revised score was significantly decreased in the presence of genital warts (23.82 ± 9.73 (23) vs. 8.8 ± 7.38 (6), p < 0.0001). Significant correlations were found between the total Female Sexual Distress Scale-Revised score and the total Female Sexual Function Index score, and the Arizona Sexual Experiences Scale score (r = -0.78, p < 0.0001; r = 0.68, p < 0.0001, respectively). This study revealed that genital warts have significantly unfavorable effects on sexuality in adolescence leading to sexual dysfunction as well as sexuality-related distress. Regarding to the present findings, promoting sexual health in addition to physical well-being may increase success in clinical management of genital warts.

Physical and mental health impacts during COVID-19 quarantine in adolescents with preexisting chronic immunocompromised conditions

ObjectiveTo evaluate physical and mental health indicators in adolescents with preexisting chronic immunocompromised conditions during coronavirus disease 2019 (COVID-19) quarantine. MethodsA cross-sectional study included 355 adolescents with chronic conditions and 111 healthy adolescents. An online self-rated survey was used to investigate socio-demographic features, healthcare routine, and the quarantine impact on physical and mental health. The validated self-reported version of the Strengths and Difficulties Questionnaire (SDQ) was also applied. ResultsThe median of age [14 (10–18) vs. 15 (10–18) years, p = 0.733] and frequencies of female (61% vs. 60%, p = 0.970) were similar between adolescents with preexisting chronic conditions and healthy adolescents during quarantine of COVID-19 pandemic. The frequencies of abnormal total difficulties score of SDQ were similar in patients and controls (30% vs. 31%, p = 0.775). Logistic regression analysis showed that being female (OR = 1.965; 95% CI = 1.091–3.541, p = 0.024), fear of underlying disease activity/complication (OR = 1.009; 95%CI = 1.001–1.018, p = 0.030) were associated with severe psychosocial dysfunction in adolescents with chronic conditions, whereas school homework (OR = 0.449; 95% CI = 0.206–0.981, p = 0.045) and physical activity (OR = 0.990; 95% CI = 0.981–0.999, p = 0.030) were protective factors. Further analysis of patients with chronic immunocompromised conditions and previous diagnosis of mental disorders (9%) compared with patients without diagnosis showed higher median of total difficulties score (p = 0.001), emotional (p = 0.005), conduct (p = 0.007), peer problems (p = 0.001) and hyperactivity (p = 0.034) in the former group. ConclusionAdolescents with preexisting chronic immunocompromised conditions during COVID-19 quarantine were not at higher risk of adverse health indicators. Being female, fear of underlying disease activity/complication, and household members working outside of the home were relevant issues for adolescents with preexisting chronic conditions. This study reinforces the need to establish mental health strategies for teens with chronic conditions, particularly during the pandemic.

Neurocognitive Dysfunctions in Adolescents with Chronic HCV infection

Abstract Introduction Globally, in 2015, an estimated 71 million people represented 1% of the world’s population including 5 million children, were living with chronic HCV infection, with the highest prevalence in the WHO Eastern Mediterranean region and the European region. Aim Primary objective was to assess the frequency of neurocognitive dysfunctions in children and adolescent with chronic HCV infection. Subject and Methods This prospective case–control study included forty adolescents with HCV recruited from the regular attendants of the Pediatrics Hospital, Ain Shams University and 20 healthy children from outpatient clinic. Psychiatric interviews and assessments were conducted by experienced qualified psychologist. Results Twenty adolescent with chronic HCV infection who fulfilled the inclusion criteria, were treatment naïve were recruited (Group1). They were five girls (25%) and fifteen boys (75%), their mean ages were 13.6 ± 2.37 years, were assessed before receiving Daclatasvir/Sofosbuvir, orally direct antiviral agents. They had statistically significant lower performance IQ and its subsets, verbal IQ and its subsets and total IQ as well as higher level of conduct, socializes aggression, attention problem, psychotic behavior, depression inventory and anxiety scale than control. Conclusion HCV may play a major role in cognition affection and the effect was more pronounced on the untreated HCV patients.

Фактори формування різних типів діастолічного наповнення лівого шлуночка в підлітків із патологією міокарда

Мета: вивчення головних компонентів формування порушеного діастолічного наповнення лівого шлуночка в підлітків із патологією міокарда. Матеріали та методи. Обстежено 110 підлітків із патологією міокарда віком 13–18 років, серед яких 40 — із порушенням ритму серця, 40 — із диспластичною кардіоміопатією, 30 — із первинною артеріальною гіпертензією. Морфофункціональні параметри серця вивчалися за допомогою ультразвукового дослідження за стандартною методикою. Функцію діастоли лівого шлуночка вивчали в імпульсному допплерівському режимі з картируванням трансмітрального потоку з верхівкового доступу чотирикамерного серця. Для адекватної оцінки діастолічної функції лівого шлуночка і визначення найбільш ранніх її порушень підліткам проводилася проба з ізометричним навантаженням. На підставі отриманих результатів підлітки були розподілені за показником співвідношення Е/А. З метою виявлення прихованих загальних факторів, що пояснюють зв’язок між показниками, було застосовано факторний аналіз, а саме метод головних компонент. Усі статистичні процедури проводили з використанням пакетів прикладних програм Statgrafics Centurion. Результати. На початкових етапах становлення діастолічної дисфункції міокарда лівого шлуночка серця в підлітків значну роль відіграє низка факторів, що можна умовно позначити як геометричний, функціональний та нейрогуморальний фактори, які включаються послідовно в патологічний процес. Так, при формуванні 1-го типу діастолічної дисфункції лівого шлуночка на першому місці знаходиться нейрогуморальний фактор, а саме активація симпатоадреналової системи, далі в патологічний процес залучається периферичний судинний тонус та, як наслідок, геометричний фактор — зміна розмірів лівого передсердя. При формуванні 2-го типу діастолічної дисфункції лівого шлуночка в процес послідовно залучається ренін-ангіотензинова система, а саме ренін, функціональний фактор представлено показниками загального периферичного судинного опору та хвилинного об’єму, а геометричний складається з діаметра лівого передсердя та кінцево-діастолічного розміру лівого шлуночка. Формування 3-го типу діастолічної дисфункції лівого шлуночка відбувається під впливом таких складових нейрогуморальної системи, як ренін та ангіотензин II, потім послідовно в процес залучаються периферичний судинний тонус та геометричний фактор у вигляді показників діаметра лівого передсердя та кінцево-діастолічного розміру лівого шлуночка. Отже, на початкових етапах становлення діастолічної дисфункції лівого шлуночка в підлітків із патологією міокарда значну роль відіграють симпатоадреналова система, периферичний судинний тонус та функція лівого передсердя, а далі послідовно підключається ренін-ангіотензинова система, що викликає підвищення жорсткості міокарда та, як наслідок, включення в патологічний процес не тільки лівого передсердя, але й структури (кінцево-діастолічний об’єм) і функції лівого шлуночка серця (ударний об’єм).

Maternal bonding impairment predicts personality disorder features in adolescence: The moderating role of child temperament and sex.

Research has shown associations between adverse parenting experiences and (borderline) personality disorder ([B]PD). A biopsychosocial model suggests that child characteristics and the environment interact in the development of symptoms. However, prospective data in this aspect are limited. This study focused on maternal bonding impairment (MBI; 2 weeks postpartum) and its interactions with child temperament (age 5) and child sex as predictors of BPD symptoms and general personality dysfunction in adolescence. Participants were 64 mother-child dyads from a community sample who took part in a 14-year longitudinal study. Higher MBI was a significant predictor of general personality dysfunction as defined in Criterion A of the alternative model for PD of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Interactions showed that the effect of MBI on general personality dysfunction was decreased for children higher in harm avoidance and increased for children higher in novelty seeking. There was also a negative main effect of harm avoidance on (B)PD features. Regarding BPD symptoms, the MBI × Child Sex interaction indicated differential susceptibility. Girls' but not boys' BPD symptoms were dependent on maternal bonding. Our results indicate that children at risk of developing personality pathology can be identified early in life. They stress the importance of early relationship disturbances in the development of personality pathology and refine the understanding of differential susceptibility factors in the context of MBI and PD symptom development. Our findings can be applied to target at-risk dyads for selective early prevention based on temperament and maternal bonding. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Optimizing Graft Extraction From the Femoral Condyle for Fresh Osteochondral Allograft Transplantation in Treating Osteochondritis Dissecans of the Capitellum: Best Fit Based on Radius of Curvature.

Osteochondritis dissecans (OCD) of the capitellum is a common cause of pain and dysfunction in adolescents that engage in repetitive elbow loading. For large, unstable lesions fresh osteochondral allograft transplantation (FOCAT) from the femoral condyle has been described as an effective treatment. Current practice involves significant guesswork in obtaining an appropriately sized graft, with anatomic variations resulting in poor graft fit. No studies currently exist that analyze and identify the best distal femur FOCAT graft site to repair OCD lesions of the capitellum based on the radius of curvature (ROC) and simulated matching. Computed tomography scans of the elbow were used to estimate the subchondral bone ROC of capitella in adolescents aged 11 to 21 years. The capitellar location used corresponds to the most commonly reported site of OCD lesions in the elbow. Computed tomography scans of the lower extremity were used to estimate the subchondral bone ROC of 4 potential donor femoral condyle grafts. ROC from distinct regions at the posterior section of both the medial and lateral femoral condyles were measured: 2 areas representing 10 mm grafts from the center (MC1 and LC1), and 2 areas estimating 10 mm grafts posterior and adjacent to the physeal scar (MC2 and LC2). Intraobserver and interobserver reliability measurements were preformed to corroborate precision and validate the method. The mean ROC of healthy subchondral bone at the region of the capitellum were OCD lesions most commonly occur was 9.79±1.39 mm. The mean ROC of MC1 was 18.61±2.26 mm. The average ROC of the MC2 was 15.23±1.43 mm. The average ROC of LC1 was 16.47±1.34 mm. The average ROC of LC2 was 18.19±3.09 mm. After 15,000 simulated condyle-to-capitellar site matchings based on these measurements, a good fit graft was achieved at a frequency of 15%. No site measured from the femoral condyle demonstrated a subchondral ROC that exactly matched the subchondral ROC of the capitellum at the center location where OCD lesions most commonly occur; of the locations measured, a 10 mm section from MC2 demonstrated the closest match. On the basis of this analysis, extracting a graft from MC2 has the potential to further optimize FOCAT fit to the capitellum. Level III.