Healthy Peers Research Articles

9 Exploration of Predictors of Cognitive Flexibility Performance in Long-Term Survivors of Childhood Brain Tumor

Objective:Survivors of childhood brain tumor are historically thought to perform worse on measures of executive functioning, including cognitive flexibility (CF; e.g., set-shifting), when compared to their peers. Commonly utilized measures, such as subtests from the Delis-Kaplan Executive Function System (D-KEFS), have baseline conditions that attempt to measure performances independent of but critical for CF tasks (e.g., motor speed on trail making, letter fluency on verbal fluency). However, in research, conditions measuring CF are often included in analyses without accounting for these important baseline conditions. The aim of the current study is to explore differences in CF performance between survivors and their healthy peers when controlling for baseline conditions. The variance explained by each baseline condition on CF condition performance in survivors is also explored.Participants and Methods:A sample of 107 long-term survivors of childhood brain tumor (Mage=21.81, SD=5.99, 50.5% female) and 142 healthy controls (Mage= 23.25, SD=6.61, 61.3% female) were administered the Trail Making Test (TMT), Color-Word Interference (CWI), and Verbal Fluency (VF) subtests from the D-KEFS. For the TMT, baseline conditions include visually scanning for a target, motor speed, and letter and number sequencing. For the CWI subtest, baseline conditions include rapid color naming, word reading, and reading words in a different colored ink. On the VF subtest, baseline conditions include rapidly naming words with a specific letter and from a specific category. An analysis of covariance was conducted for each subtest to determine if groups differed in performance on the CF condition (i.e., Number-Letter Switching, Inhibition/Switching, Category Switching Accuracy) when controlling for baseline conditions. In survivors only, linear regressions investigated the amount of variance explained by each baseline condition on the CF conditions of each subtest.Results:Groups did not differ in CF performance of each subtest when controlling for baseline conditions (ps>.10). Across subtests, baseline conditions significantly predicted CF performance in survivors. On the TMT, Letter Sequencing (p=.003, unique-R2=.05), but not Visual Scanning, Number Sequencing, or Motor Speed, was a significant predictor of Number-Letter Sequencing performance (p<.001, R2=.50). On the CWI subtest, Word Reading (p<.001, unique-R2=.09) and Inhibition (p<.001, unique-R2=.05), but not Color Naming, were significant predictors of Inhibition/Switching performance (p<.001, R2=.67). On the VF subtest, Letter Fluency (p=.009, unique-R2=.06) and Category Fluency (p<.001, unique-R2=.08) were significant predictors of Category Switching Accuracy performance (p<.001, R2=.37).Conclusions:Findings suggest that CF may not differ between survivors and their healthy peers, but that other factors of executive functioning, such as processing speed, drive performance differences on measures of CF. As these tasks rely heavily on speed, survivors may be slower than their healthy counterparts, but may not perform worse on set-shifting. In addition, these results highlight the importance of controlling for lower-order processes in analyses to help isolate CF performance and more accurately characterize potential differences between groups. While replication of findings in survivors and other clinical groups (e.g., congenital heart disease, traumatic brain injury) is still needed, this work can help inform which processes are most important to account for, which is not yet established.

Health-related quality of life among adolescents with type 1 diabetes since the second wave of the COVID-19 pandemic in Germany

ObjectiveThe COVID-19 pandemic had an impact on everyday life and in general, reduced the health-related quality of life (HRQoL) of adolescents. In this study, we assess the HRQoL of adolescents...

Adolescents and young adults with oncohematological disease: use of social networks, impact of SARS-COV-2, and psychosocial well-being.

Adolescents and young adults (AYA) with oncohematological diseases could have important psychosocial difficulties that could be worsened by the effects of the COVID19 pandemic. At this developmental stage, it is also important to assess the use of social networks (SNs). This study aims to investigate the type of social network use and the consequences of the COVID19 period. These patients are compared with matched healthy peers. After the informant consent signature, the adolescents completed a series of self-report questionnaires on the use of SNs, on communication preferences, on social anxiety and on Covid19 impact through the online platform of LimeSurvey. Most of the adolescents belonged to the 18-20 age group (42.5%), were female (62%) and mainly off therapy (72%). Adolescents spent more than 2 h/day on Instagram and 1 h and half on Whatsapp, while Tik Tok use was on average 1 h/day, especially used by younger patients (r = -0.33, p = 0.023). Males used Twitch (t45 = -2.06, p = 0.05) and Youtube (t45 = -2.18, p = 0.03) for longer than females. AYA in therapy used more Tik Tok (U = 137.50; p = 0.03), Ask/Tellonym (U = 172.50; p = 0.05) and Twitch (U = 144; p = 0.017) than those off therapy. Healthy AYA showed lower levels of exposure (Z = -4.17; p = 0.00001) and impact (Z = -5.12; p = 0.00001) to Covid19, while the level of social anxiety is comparable and is in the normal range in both groups. Some clinical considerations and suggestions could be given based on these empirical results to health professionals in the care of AYA cancer patients.

Brain language networks and cognitive outcomes in children with frontotemporal lobe epilepsy.

Pediatric frontal and temporal lobe epilepsies (FLE, TLE) have been associated with language impairments and structural and functional brain alterations. However, there is no clear consensus regarding the specific patterns of cerebral reorganization of language networks in these patients. The current study aims at characterizing the cerebral language networks in children with FLE or TLE, and the association between brain network characteristics and cognitive abilities. Twenty (20) children with FLE or TLE aged between 6 and 18 years and 29 age- and sex-matched healthy controls underwent a neuropsychological evaluation and a simultaneous functional near-infrared spectroscopy and electroencephalography (fNIRS-EEG) recording at rest and during a receptive language task. EEG was used to identify potential subclinical seizures in patients. We removed these time intervals from the fNIRS signal to investigate language brain networks and not epileptogenic networks. Functional connectivity matrices on fNIRS oxy-hemoglobin concentration changes were computed using cross-correlations between all channels. Group comparisons of residual matrices (=individual task-based matrix minus individual resting-state matrix) revealed significantly reduced connectivity within the left and between hemispheres, increased connectivity within the right hemisphere and higher right hemispheric local efficiency for the epilepsy group compared to the control group. The epilepsy group had significantly lower cognitive performance in all domains compared to their healthy peers. Epilepsy patients' local network efficiency in the left hemisphere was negatively associated with the estimated IQ (p = 0.014), suggesting that brain reorganization in response to FLE and TLE does not allow for an optimal cognitive development.

Отношения с матерью и сверстниками у детей предподросткового возраста с сахарным диабетом

<p style="text-align: justify;">The paper examines the relationship of children with insulin-dependent diabetes (type 1 diabetes) with their mother and peers. The study involved 30 children aged 10–12 years (M=11.26; SD=0.69), and their mothers. 14 mother–child pairs formed the experimental group of children with type 1 diabetes; 16 mother–child pairs were included in the control group. The methods used were "Parent-child interaction"; the "Family relationship test"; the "My usual day with a child" essay; the "My usual day with mom" conversation with the child; the "Features of interaction with the parent" questionnaire for teachers; the "Features of communication of the child" questionnaire for teachers and educators; a modified version of the "Unfinished sentences" methodology. The results of the study suggest that control, exactingness, guardianship on the part of the mother can act as a way of coping with the situation of the child's illness. Mothers of children with diabetes are more focused on their own feelings and experiences; the main target of their concern is the health and education of the child. It is noted that children with diabetes, when interacting with peers, more often than healthy peers, demonstrate conformity, a friendly or neutral attitude, preferring to avoid situations of conflict or to solve them with the help of an adult. The links between the low competence of a child with type 1 diabetes in the ability to negotiate with peers, take leadership positions, and a "cooperating" relationship with the mother were revealed. Maternal control and hyper-indulgence in relation to healthy children is associated with a low level of interaction of the child with peers, his ability to solve communicative tasks.</p>

Sexuality among young Danes treated for mental health problems: Baseline findings in a nationwide cohort study

Mental health problems are common among adolescents and young adults (AYA), but although sexuality plays a central role in the transition from adolescence to adulthood, associations between such problems and sexuality have only been sparsely researched in AYA. The aim of this study was to investigate the association between mental health problems and various outcomes related to body and sexuality, romantic relationships, sexual functioning, and sexual risk behaviors among AYA. We used questionnaire data from 8696 Danish AYA aged 15–24 years who participated in the nationwide cohort study Project SEXUS at baseline in 2017–2018. Logistic regression analyses yielded demographically weighted, age-adjusted odds ratios for associations between mental health problems and sexual outcomes. Female AYA treated for mental health problems reported more active sex lives than other women. Treatment for mental health problems was associated with statistically significantly increased odds ratios for several sexual dysfunctions, and treated AYA significantly more often reported sexual debut before age 15 years, high sex partner numbers, sexual victimization, unsafe sex, sexually transmitted infections, induced abortions, discontentment with the appearance of body and genitalia, gender non-conformity, same-sex sexual experience, and non-heterosexual identity. Compared to healthy peers, AYA treated for mental health problems constitute a vulnerable group at increased risk of sexual adversities. Healthcare professionals should acknowledge these possible sexual challenges and offer relevant counselling to reduce the risk of adverse sexual outcomes in this group.

Hydrotherapy as an example of a supporting method for children and adolescents with autism spectrum disorder

Nowadays, the use of the hydrotherapy method in children and adolescents with autism spectrum disorder (ASD) is a little-known phenomenon. The aim of this article is an attempt to discuss hydrotherapy as an example of a supporting method that can be used in children and adolescents with ASD. This paper presents the most important issues related to the method of hydrotherapy. Research shows that children and adolescents with ASD are less likely to engage in physical activity than their healthy peers. As a result, it can lead to health problems. Regular exercise and physical activity contribute to a better mental and physical well-being of the individual. The use of hydrotherapy brings many positive effects, so it is worth getting to know it better.

Рівень розвитку статичної рівноваги тіла дітей із вадами слуху як передумова розробки технології проєктування та реалізації методичних прийомів «штучного керуючого середовища» в процесі адаптивного фізичного виховання

Topicality. The analysis of indicators of the ability to maintain static balance of the body in children with hearing impairment, conducted by experts, shows that these indicators have statistically significant differences compared to their practically healthy peers. The Aim of the Study is assessment of the level of development of static balance of the body of children aged 7–10 years old with hearing impairment according to the test of E.Y. Bondarevskyi. 72 children aged 7–10 years with hearing impairments took part in the scientific study. Among them are girls (n = 39) and boys (n = 33). The following Methods were used to solve the tasks: analysis of scientific and methodical literature, survey, pedagogical testing, pedagogical observations, pedagogical experiment, mathematical methods. Research Results. Examination of the obtained experimental data shows that among the 7-year-old boys with hearing impairments, there were no such ones who had a sufficient level of development of static body balance (distribution according to the level of educational achievements of static body balance, according to E. Y. Bondarevskyi’s test, with eyes closed); in 50,0 % sufficient and in 50,0 % – the initial level of development of static balance of the body was recorded. At the same time, among the 8-year-old boys, the following distribution was observed according to the levels of static balance of the body: 12,5 % – average level, 87,5 % – initial level. The study showed that among 9-year-old boys with hearing impairments, 22,2 % are characterized by sufficient, 55,6 % – average, and 22,2 % – initial level of the studied quality. A sufficient level of static body balance was recorded in 25,0 %, average – also in 25,0 %, initial – in 50,0 % of the examined 10-year-old boys. Conclusions. In the process of conducting a pedagogical experiment, we identified distinctive features of the level of development of static balance of the body of children aged 7-10 years with hearing impairment according to the E. Y. Bondarevskyi test.

When two Z-scores meet—analysis of exercise capacity of children and adolescents with Kawasaki disease by a new Z-score model of coronary artery and a new Z-score evaluating peak oxygen consumption

BackgroundCoronary artery (CA) Z-score system is widely used to define CA aneurysm (CAA). Children and adolescents after acute stage of Kawasaki disease (KD-CA) have a higher risk of developing CAAs if their CA Z-score ≥ 2.5. Z-score system of peak oxygen consumption (Peak VO2 Z-score) allows comparisons across ages and sex, regardless of body size and puberty. We aimed to compare the exercise capacity (EC) indicated by peak VO2 Z-score during cardiopulmonary exercise testing (CPET) directly between KD-CA with different CA Z-score.MethodsKD-CA after acute stage who received CPET in the last 5 years were retrospectively recruited. CA Z-score was based on Lambda-Mu-Sigma method. Max-Z was the maximum CA Z-score of different CAs. KD children with Max-Z < 2.5 and ≥ 2.5 were defined as KD-1 and KD-2 groups, respectively. Peak VO2 Z-score was calculated using the equation established based on Hong Kong Chinese children and adolescent database.ResultsOne hundred two KD-CA were recruited (mean age: 11.71 ± 2.57 years). The mean percent of measured peak VO2 to predicted value (peak PD%) was 90.11 ± 13.33. All basic characteristics and baseline pulmonary function indices were comparable between KD-1 (n = 87) and KD-2 (n = 15). KD-1 had significantly higher peak VO2 Z-score (p = .025), peak PD% (p = .008), peak metabolic equivalent (p = .027), and peak rate pressure product (p = .036) than KD-2.ConclusionsKD-CA had slightly reduced EC than healthy peers. KD-CA with Max-Z ≥ 2.5 had significantly lower peak EC than those < 2.5. Max-Z is potentially useful follow-up indicator after acute stage of KD.

Activities of Daily Living, Physical Activity, Physical Fitness and Quality of Life in Children with Congenital Heart Disease: A Case-Control Study.

Despite reports of reduced physical fitness in children with congenital heart disease (CHD), no specific performance evaluations for activities of daily living have been conducted. The aim was to compare the activities of daily living, quality of life, posture, physical fitness and physical activity levels of children with CHD with healthy controls (HC). The study included 30 children aged 6-14 diagnosed with moderate or severe CHD and 30 age-sex-matched HC. The sociodemographic and clinical data of the participants were recorded. All participants went through several tests, namely the TGlittre-P test for activities of daily living, the 6-minute walk test (6MWT) for functional capacity, the Fitnessgram test battery for physical fitness, the hand dynamometer for measuring grip strength, the pedometer for measuring physical activity, and both the child and parents reported the Pediatric Quality of Life Inventory (PedsQL) for evaluating the quality of life, in addition to posture analyses. Values of p < 0.05 were considered statistically significant. Individuals with CHD had a longer TGlittre-P test completion time and a shorter 6MWT distance than HC (TGlittre-P: CHD 3.45 [3.24-4.02]min vs. HC 3.10 [2.57-3.23]min, 6MWT: CHD 514.00 [412.50-566.00]m vs. HC 591.50 [533.00-631.00]m). For the CHD group, sit-ups, push-ups, trunk lift, and sit-and-reach test scores within the Fitnessgram battery, grip strength, posture, and quality of life scores were lower than those for the HC group. Physical activity levels were similar in the groups. The performance of activities of daily living, functional capacity, physical fitness, posture, and quality of life of children with moderate and severe CHD were affected compared to healthy peers.

Psychosocial Determinants of Sleep Behavior and Healthy Sleep Among Adolescents: A Two-Wave Panel Study.

To date, it remains unknown which psychosocial determinants identified by several leading behavior change theories are associated with different sleep parameters among adolescents. Therefore, this study investigates whether changes in knowledge about healthy sleep, attitude toward healthy sleep and going to bed on time, self-efficacy to engage in healthy sleep behavior, perceived parental and peer norms, perceived barriers (e.g., worrying, fear of missing out), and perceived support (e.g., bedtime rules, encouragement) related to healthy sleep are associated with changes in adolescents' sleep duration on school days and free days and sleep quality over a period of 1 year. Two-wave data of 1648 Flemish adolescents (mean age = 15.01, SD = 0.65, 46.3% female) were analyzed using linear models. Increased levels of parental social support, positive attitude towards and perceived advantages of healthy sleep, norm-knowledge, and perceived peer behavior were associated with sleep duration, with parental social support having the strongest association. Increased levels of perceived barriers were associated with decreased levels of sleep quality parameters, and increased levels of self-efficacy, positive attitude, and parental modeling were associated with improved sleep quality parameters, with perceived barriers having the strongest association. The current results indicate that behavior change theories are useful in the context of adolescent sleep behavior and suggest that perceived parental support (i.e., bedtime rules) and perceived barriers are most strongly associated with adolescents' sleep duration and/or quality.

Resilience in Mild Cognitive Impairment (MCI): Examining the Level and the Associations of Resilience with Subjective Wellbeing and Negative Affect in Early and Late-Stage MCI.

The current study examines the relationship between the cognitive state of participants [healthy-early mild cognitive impairment (MCI)-late MCI], some subjective wellbeing factors (positive emotions, engagement, positive relationships, meaning in life, accomplishment, and negative emotions), and negative psychological outcomes (depression, anxiety, stress), as well as psychological resilience. We expected that people with advanced MCI would perceive increased negative psychological outcomes, poorer psychological resilience, and lower levels of subjective wellbeing in contrast to early MCI and healthy participants. The study involved 30 healthy, 31 early, and 28 late MCI individuals. A series of questionnaires have been applied to assess the aforementioned constructs. To examine the hypotheses of the study, path analysis (EQS program) was applied. Results showed that early MCI persons maintain the same levels of positive emotions and feelings of accomplishment with healthy peers. Late-stage patients present those feelings in a diminished form, which adversely impacts psychological resilience. Individuals with early and late MCI exhibit negative emotions and stress that impact their resilience; however, those with early MCI experience greater stress, negative emotions, depression, and anxiety. These findings may be utilized to design psychological interventions for resilience enhancement and support brain health in elderly adults who are at risk of neurodegeneration.

Is There any Connection Between ADHD and the Additives in Sweetened Beverages?

BACKGROUND: Sweetened beverages (SBs) have been linked to attention deficit hyperactivity disorder (ADHD), possibly because they contain sugar, caffeine, artificial colors, sweeteners, and preservatives. OBJECTIVE: The goal of this study was to show how SBs affect ADHD and to investigate the potential contribution of the various ingredients in SBs to this effect. METHODS: The study consisted of 239 children, ranging from 6 to 10 years old, divided into two groups: 111 with ADHD, diagnosed by a doctor in the Child and Adolescent Psychiatry Clinic, and 128 in the control group, who were selected from schools. The modified Food Consumption Frequency Questionnaire (FFQ) with 17 sweetened beverages was used in the assessment of beverage consumption. The consumption record was taken together with the brands of the beverages and the label information of the products was examined and the amounts of sugar, caffeine, artificial colors, sweeteners and preservatives in the beverages were calculated. Maximum food additives consumed (mg/day/kg b.w.) values of food additives were calculated according to body weight. To establish the relationship between ADHD and beverage consumption, logistic regression analysis was conducted. RESULTS: Children with ADHD consumed more fruit juice, carbonated beverages, flavored beverages, sugary milk, sugar, caffeine, sodium benzoate and potassium sorbate compared to their healthy peers (p &lt; 0.05). The logistic regression analysis revealed that drinking fruit juice, sugary milk, carbonated beverages, and flavored drinks was significantly associated with ADHD (p &lt; 0.01). CONCLUSION: The consumption of sweetened beverages containing sugar, caffeine, and food additives could potentially effect children’s behavior.

Translation, reliability, and validation of the Dutch Safe Use of Mobility Aid Checklist (SUMAC-NL) for walker use in people living with dementia

Background: People with dementia have a yearly risk of falling of 60 to 80 percent. Therefore, a walker is often recommended. However, the use of a walker in people with dementia is associated with a threefold increased odds of falls compared to their healthy peers. Better advice and training could reduce fall risk. Therefore, a tool to assess functional walking skills with a walker is needed. The SUMAC was developed to fill this gap. So far, there is no Dutch instrument available that can assess functional walking skills with a walker in people with dementia. Methods: Reliability was evaluated by scoring videos of people with dementia (n = 9) using a walker performing the SUMAC-NL. ICC was used to assess inter-rater and test-retest reliability. An expert panel (n = 8) evaluated the content validity using the content validity index (CVI) and the content validity ratio (CVR). Results: Inter-rater reliability of the SUMAC-NL was statistically significant for the PF domain (ICC = 0.94, 95%CI (0.84, 0.98, p &lt; 0.001) and for the EQ domain (ICC = 0.79, 95%CI (0.49 – 0.95), p &lt; 0.001). Test-retest reliability was statistically significant for both the PF domain (ICC = 0.95, 95%CI (0.89, 0.99), p &lt; 0.001) and EQ domain (ICC = 0.92, 95%CI (0.82, 0.98), p &lt; 0.001). The SUMAC-NL shows content validity with a CVI &gt;0.79 for both domains and a CVR of 0.53 on the PF domain and 0.78 on the EQ domain. Conclusions: The SUMAC-NL shows good to excellent reliability and content validity for both the PF and the EQ domain. The SUMAC-NL seems to be a promising tool to assess walking with a walker in people with dementia in the Netherlands.

Health-related quality of life in a systematically assessed cohort of children and adults with urea cycle disorders

PurposeIndividuals with urea cycle disorders (UCDs) may develop recurrent hyperammonemia, episodic encephalopathy, and neurological sequelae which can impact Health-related Quality of Life (HRQoL). To date, there have been no systematic studies of HRQoL in people with UCDs. MethodsWe reviewed HRQoL and clinical data for 190 children and 203 adults enrolled in a multicenter UCD natural history study. Physical and psychosocial HRQoL in people with UCDs were compared to HRQoL in healthy people and people with phenylketonuria (PKU) and diabetes mellitus. We assessed relationships between HRQoL, UCD diagnosis, and disease severity. Finally, we calculated sample sizes required to detect changes in these HRQoL measures. ResultsIndividuals with UCDs demonstrated worse physical and psychosocial HRQoL than their healthy peers and peers with PKU and diabetes. In children, HRQoL scores did not differ by diagnosis or severity. In adults, individuals with decreased severity had worse psychosocial HRQoL. Finally, we show that a large number of individuals would be required in clinical trials to detect differences in HRQoL in UCDs. ConclusionIndividuals with UCDs have worse HRQoL compared to healthy individuals and those with PKU and diabetes. Future work should focus on the impact of liver transplantation and other clinical variables on HRQoL in UCDs.

Circumferential Approach to Congenital Kyphoscoliosis with Hemivertebra: Adding on Rather than Resecting Could Be a Better Option in Older Adolescents

To present a new technique combining anterior release with allograft insertion and lateral fixation at the concave side of the curve, preserving the hemivertebra and posterior bilateral transpedicular fixation in patients with congenital kyphoscoliosis (CKS) who were not operated on until late adolescence, including long-term follow-up of patients, and a discussion of the literature on CKS with hemivertebra. Two patients with CKS concomitant with hemivertebra underwent circumferential (anterior-posterior) instrumentation and fusion using a new technique. Patient 1 underwent a 2-stage operation, first anterior then posterior. Patient 2 was operated on circumferentially in 1 session. Both patients had >10 years of follow-up showing solid fusion of their operated spine segments. The patients were pain-free, and their body heights were comparable to healthy peers. In our circumferential approach, we successfully integrated the hemivertebrae in anterior fusions rather than resecting them in older adolescents with CKS. This technique decreased bleeding, shortened operative time, and promised potential benefits compared with the available techniques in the literature.

Mechanisms of ventilatory limitation to maximum exercise in children and adolescents with chronic airway diseases.

Exercise intolerance is common in chronic airway diseases (CAD), but its mechanisms are still poorly understood. The aim of this study was to evaluate exercise capacity and its association with lung function, ventilatory limitation, and ventilatory efficiency in children and adolescents with cystic fibrosis (CF) and asthma when compared to healthy controls. Cross-sectional study including patients with mild-to-moderate asthma, CF and healthy children and adolescents. Anthropometric data, lung function (spirometry) and exercise capacity (cardiopulmonary exercise testing) were evaluated. Primary outcomes were peak oxygen consumption (VO2 peak), forced expiratory volume in 1 s (FEV1 ), breathing reserve (BR), ventilatory equivalent for oxygen consumption (VE /VO2 ) and for carbon dioxide production (VE /VCO2 ), both at the ventilatory threshold (VT1 ) and peak exercise. Mean age of 147 patients included was 11.8 ± 3.0 years. There were differences between asthmatics and CF children when compared to their healthy peers for anthropometric and lung function measurements. Asthmatics showed lower VO2 peak when compared to both healthy and CF subjects, although no differences were found between healthy and CF patients. A lower BR was found when CF patients were compared to both healthy and asthmatic. Both CF and asthmatic patients presented higher values for VE /VO2 and VE /VCO2 at VT1 when compared to healthy individuals. For both VE /VO2 and VE /VCO2 at peak exercise CF patients presented higher values when compared to their healthy peers. Patients with CF achieved good exercise capacity despite low ventilatory efficiency, low BR, and reduced lung function. However, asthmatics reported reduced cardiorespiratory capacity and normal ventilatory efficiency at peak exercise. These results demonstrate differences in the mechanisms of ventilatory limitation to maximum exercise testing in children and adolescents with CAD.

The effect of the physical exercise on the redox status of chil- dren with repaired congenital heart diseases

Purpose. Evaluation of the impact of the physical rehabilitation program with the inclusion of ubidecarenone on the redox status in children with repaired congenital heart diseases. Material and methods. Markers of free radical oxidation (lactate, pyruvate, lactate-to-pyruvate ratio) and antioxidant system (catalase, reduced glutathione and glutathione peroxidase) were studied in 84 children, including 48 children with repaired congenital heart diseases and 36 healthy peers. The main group consisted of 28 patients who performed a rehabilitation program using physical activity in combination with taking ubidecarenone for a year, the comparison group consisted of 20 children who received only ubidecarenone. Results. After the rehabilitation program was completed, both the main group and the comparison group had a significant (p &lt; 0.05) decrease in lactate levels, the ratio of lactate to pyruvate, and an increase in catalase and reduced RBC glutathione. The group of children who performed physical exercises had significantly lower levels of markers of free radical oxidation and higher values of markers of the antioxidant system than the patients from the comparison group. Conclusion. There are free radical oxidation and the antioxidant system impairments in children with repaired congenital heart diseases. The use of ubidecarenone reduces oxidative stress and increases antioxidant protection in children with repaired congenital heart diseases. The inclusion of physical activity in the rehabilitation program for children with repaired congenital heart diseases improves the redox status and increases the effectiveness of rehabilitation.

The effect of aquatic and land exercise on the mental well-being of women following breast cancer surgery-comparative study.

Women after surgical treatment of breast cancer are less likely to engage in physical activity and may exhibit depressive symptoms even for many years post-treatment. The aim of the study was to compare the impact of 6months aquatic and land exercise on mental well-being of women after breast cancer surgery. The study was based on a survey which involved a total of 90 women ≥ 50years of age (including 60 subjects after treatment of breast cancer ≥ 2years after surgery and 30 healthy control). The study participants were divided into three groups, i.e. women attending general exercise sessions in a gym (A, n = 30), participating in aquatic exercise (B, n = 30), as well as healthy female peers reporting no regular physical exercise for the period of 6months (C, n = 30). The present data were acquired using standardized questionnaires designed to assess physical activity (IPAQ-SF), mental well-being (WHO-5) and level of anxiety, i.e., Generalized Anxiety Disorder Questionnaire (GAD-7). Both the aquatic and land exercise had positive effect on mental well-being of woman after breast cancer surgery and there were no significant differences between them. Analysis of the anxiety level (GAD-7) confirms that women after breast cancer treatment were more exposed to a feeling of generalised anxiety disorder, i.e. 8.67 vs. 6.73, 4.5 (p = 0.001). The results of WHO-5 index were significantly higher in the A and B groups comparing to healthy control, i.e. 13.27 vs. 14.18; 10.10 (p < 0.001), but the obtained results still indicate the low self-esteem of the study group. Women after breast cancer surgery who regularly participated in aquatic exercise were engaged in more vigorous physical activity compared to the other groups, i.e. 1049.33 vs. 521.33; 860.00 MET min/week (p = 0.001). Regardless of the type of physical activity, 6months aquatic and land exercise contributed to improved mental well-being and ensured adequate levels of moderate physical activity of woman after BC surgery. Regular physical activity is crucial in the rehabilitation after mastectomy and can be an effective treatment to achieve beneficial mental outcomes.

Assessment of the ovarian reserve in patients with beta-thalassemia major: a prospective longitudinal study

Repeated blood transfusions in women with beta-thalassemia major (BTM) may lead to iron overload and increase oxidative stress, consequently resulting in ovarian damage. The aim was to evaluate alterations in ovarian reserve in transfusion-dependent BTM patients over a time period of one year and to compare levels of anti-Mullerian hormone (AMH) in women with BTM and their healthy peers. This longitudinal prospective study was conducted in women with transfusion-dependent BTM at a tertiary level hospital. The hospital database was interogated for women diagnosed with BTM between 1996 and 2021. AMH levels were assessed at baseline and one year later. Forty-one women with BTM were identified, of whom 25 (60.9%) had amenorrhea and 16 (39.1%) had normal cycles. The mean AMH level of all women was 2.7±1.8 ng/mL at baseline, significantly lower than the age-matched nomogram value of 4.0±0.4 ng/mL for a healthy population (p=0.001). The baseline AMH level of patients with amenorrhea were significantly lower than patients with normal menstrual cycles (2.1±1.8 vs. 3.6±1.5 ng/mL, p=0.009). After one-year follow-up, there was a trend towards a decrease in the AMH levels of patients with normal menstrual cycles. Serum AMH values are decreased in patients with transfusion-dependent BTM. BTM patients should be educated about the possible effects of repeated blood transfusions on fertility.