Risk Factors In Children Research Articles

Epidemiology of Allergic Diseases and Risk Factors in Children: A Population based Study in 2022

The International Study of Asthma and Allergies in Childhood (ISAAC) investigated the worldwide prevalence of allergic disease and risk factors. Korea has also participated in several ISAAC surveys: three nationwide surveys in 1995, 2000 and 2010. Research on school aged children will be a helpful to understand the epidemiology of the allergic diseases in the pediatric population. In this perspective, we researched the prevalence and risk factors of allergic diseases in school aged children in Korea.

DOP24 Early life exposures and risk for inflammatory bowel disease: a nested case-control study in Quebec, Canada

Abstract Background Early childhood is an important period for the establishment of gut microbiota. Most early life risks or protective factors for inflammatory bowel disease are likely to act through an effect on the gut microbiota. The aim of this study was to estimate the associations between exposures in infancy (birth until 3 years of age) such as breastfeeding, antibiotic treatment, presence of domestic pets, and passive smoking, and the occurrence of inflammatory bowel diseases. Methods This case-control study was nested within the Quebec Birth Cohort on Immunity and Health. Cases and controls were identified among persons born in Quebec in 1970-1974 based on their health services from 1983 to 2014 using validated algorithms. All cases and randomly selected controls were invited to participate in a web or telephone questionnaire. Participation rates were 47% among controls (n=946), and respectively 52% (n=1212) and 55% (n=570) among cases of Crohn’s disease and ulcerative colitis. Logistic regression models were used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI), separately for Crohn’s disease and ulcerative colitis. Each exposure was analyzed in a multiple regression model adjusted for relevant covariates identified with a directed acyclic graph. Results Adjusting for perinatal and sociodemographic characteristics, the risk for Crohn’s disease or ulcerative colitis did not differ in subjects who were exclusively breastfed compared to non-breastfed subjects. Partial breastfeeding (breastfeeding combined with infant formula) was not associated with Crohn’s disease (OR=1.03, 95% CI: 0.76-1.40), but an increase in the odds of ulcerative colitis (OR=1.40, 95% CI: 0.99-1.99) was observed as compared with no breastfeeding. Early introduction of solid foods was associated with higher odds of Crohn’s disease (introduction at 3-6 months compared with >6 months: OR=1.35; 95% CI: 1.05-1.78), but not of ulcerative colitis (OR=1.06; 95% CI: 0.77-1.46). Antibiotic use and the presence of domestic pets were not associated with either Crohn’s disease or ulcerative colitis. Passive smoking was associated with increased odds of Crohn’s disease (OR=1.23; 95% CI: 1.00-1.51), but not ulcerative colitis (OR=0.96; 95% CI: 0.75-1.22). Conclusion Differences were noticed in early childhood risk factors for Crohn’s disease and ulcerative colitis. Early introduction of solid foods and passive smoking increased the risk of Crohn’s disease, whereas there was a trend of increased risk of ulcerative colitis with partial as compared with no breastfeeding. The results for partial breastfeeding and early introduction of solid foods are novel and will require further investigation.

Assessing Psychosocial Risk Factors in Children with Sickle Cell Disease

Background and Objective: Most patients with sickle cell disease (SCD) in U.S. identify as Black/African American. This is an important psychosocial risk factor to consider given well-documented systemic racism in medicine resulting in disparate health outcomes, particularly for individuals managing a chronic health condition like SCD. The purpose of our research is to determine the level of psychosocial risk factors in children with SCD at Riley Hospital and assess the utility of Psychosocial Assessment Tools (PATs) in this setting. 
 Methods: The PAT is a validated caregiver-report screener administered as part of the clinical visit. Each PAT is scored by the SCD Social Worker to provide tailored resources to families. Scores are stratified into 3 risk tiers indicating level of psychosocial intervention necessary- Universal, Targeted, or Clinical. Descriptive analyses were performed to determine patient and caregiver demographics, experiences, beliefs, and overall risk categorization.
 Results: There were 141 completed PATs for analysis. Ninety-five percent of the patients identified as Black/African-American with an average age of 8.57 years (0-22 years). Most caregivers were Black, single women over 21 with at least a high school degree. Sixty-seven percent of patients fell into the Universal range, 29% in the Targeted range, and 4% in the Clinical range. The Family Structures/Resources Subscore had the highest average, and includes questions about insurance coverage, transportation, and money problems. Forty-six percent of families reported some form of financial difficulty, with housing, utility bills, and car costs as the most common.
 Conclusion and Impact: Implementation of a psychosocial risk screener in the SCD clinic identified financial challenges for almost half of families, allowing for timely resource support. Many of these families, however,were categorized as Universal, indicating that distribution of resources must not be based on total PAT score alone. Future steps include evaluating the effect of resource provision at SCD visits on improving barriers to care.

Scoping review protocol of multicomponent interventions to address cardiometabolic disease risk among Pacific Islander children.

Multicomponent interventions can reduce cardiometabolic disease (CMD) risk factors in childhood; however, little synthesis of the literature has taken place in the Pacific region. Pacific Islanders experience a disproportionately high prevalence of CMD risk factors, yet interventions have been slow to reach many communities. We present this protocol for a scoping review to identify and summarize existing multicomponent interventions to address CMD risk in Pacific Islander children. Eligible interventions will (1) address CMD risk factors (including but not limited to obesity, hyperglycemia, dyslipidemia, elevated blood pressure, and/or health behaviors) in 2-to-12-year-old Pacific Islander children, and (2) be multi-component (including at least two lifestyle/behavior change strategies to address CMD risk factors). To investigate existing interventions for adaptation and potential use in Pacific Islander communities, we will search Scopus, MEDLINE ALL (Ovid), EMBASE (Ovid), Yale-licensed Web of Science Core Collection, Cochrane Library, CINAHL (EBSCOhost), ProQuest Dissertations & Theses Global, Global Health (EBSCO), non-indexed Pacific journals, grey literature, government reports, and clinical trial registrations. The Joanna Briggs Institute Manual for Evidence Synthesis and the Preferred Reporting Items for Scoping Reviews will guide data extraction, evidence mapping, synthesis, and reporting of information including study population, intervention components, behavioral changes, health and implementation outcomes, theoretical frameworks, and evaluation measures. Formal ethical approval is not required. The dissemination strategy will include peer-reviewed journal publications and presentations. Synthesis of existing multicomponent interventions for Pacific Islander children will help to identify best practices that could be replicated, adapted, or combined.

The Use of Cavitron Ultrasonic Surgical Aspirator for High-Risk Neuroblastoma with Image-Defined Risk Factors in Children.

Aim of the study: The cavitron ultrasonic surgical aspirator (CUSA) has gained popularity in adult surgical oncology, but its application in children is limited to liver surgery and neurosurgical procedures. The complete resection of neuroblastoma with image-defined risk factors (IDRFs) is still considered one of the most difficult procedures to achieve in pediatric surgical oncology, with a high morbidity rate and potential risk of intraoperative mortality. The aim of our study is to describe the application of ultrasonic dissection in neuroblastoma with IDRFs. Methods: A retrospective study was performed, analyzing patients operated on from 2000 to 2018. Patient characteristics, resection completeness, and postoperative surgical and oncology outcomes were analyzed. Main results: Twenty-six patients with high-risk neuroblastoma and IDRFs were operated on in the study period with a CUSA. A complete macroscopic resection was performed in 50% of patients, while the other half was operated on with minimal residual (<5 mL). Six post-operative complications occurred without the need for surgery (Clavien−Dindo < 3). The overall survival was 50%, with a median follow-up of 69.6 months (5.6−140.4). Conclusions: The application of the CUSA in neuroblastoma with IDRFs can be considered an effective and safe alternative technique to achieve a radical resection.

Caffeine consumption as a risk factor for childhood and adolescence migraine.

Caffeine consumption is a risk factor for chronic daily headache, but few studies have addressed relationships between pediatric patient caffeine levels and headache severity. We examined associations between serum and urine caffeine levels and headache severity in childhood and adolescence migraine cases. Levels of caffeine and caffeine metabolites in serum and urine samples were determined by LC-MS/MS. Wilcoxon rank-sum test was used for comparisons of age, sleep time, headache severity, caffeine consumption, and caffeine detection. Spearman's rank correlation coefficient (ρ) was calculated for associations. Correlations with ρ≥ 0.3 and differences with p< 0.05 were considered statistically significant. Of the 40 patients studied, 34 declared caffeine consumption and 6 declared no caffeine consumption. These two groups did not differ significantly in any of the above clinical parameters. LC-MS/MS analysis of both serum and urine samples revealed 9 caffeine-negative (level <0.0625 μM) and 31 caffeine-positive cases. HIT-6 score was higher (p= 0.033) for the caffeine-positive vs. caffeine-negative group. Caffeine was detected by LC-MS/MS in serum and/or urine for 3 of the 6 patients who declared no caffeine consumption. No significant correlations were observed among age, sleep times, headache severity score, or levels of caffeine and caffeine metabolites. 31 of 40 (77.5%) cases of childhood/ adolescence migraine showed serum and urine caffeine-positivity based on LC-MS/MS. HIT-6 score, a measure of headache severity, was significantly higher for caffeine-positive vs. -negative cases. Symptoms of childhood/ adolescence migraine were exacerbated by caffeine consumption.

Early childhood sleep problems predict increased risk for the later development of suicidal thoughts.

Suicidal thoughts and behaviors in youth are an escalating and immediate public health concern. To better understand youth suicidal thoughts and behaviors, it is important to identify risk factors in early childhood that predict the later emergence of youth suicidal thoughts and behaviors. Research with adults and adolescents has identified sleep disturbances as a risk factor for suicidal thoughts and behaviors, but this has yet to be examined in early childhood. Using a prospective, 17-year longitudinal design, the current study explored the association between early childhood sleep disturbances and concurrent and later suicidal thoughts and behaviors (in separate models) across childhood and adolescence. Results indicate that sleep problems in early childhood are associated with increased probability for suicidal thoughts after age 8, even when controlling for prior and concurrent depression severity. Our findings suggest that early childhood sleep difficulties warrant increased clinical attention and management, as they may contribute to the maintenance and exacerbation of suicidal thoughts over time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Risk factors for developmental vulnerability: Insight from population-level surveillance using the Early Development Instrument

Objectives Population-level studies may elucidate the most promising intervention targets to prevent negative outcomes of developmental vulnerability in children. This study aims to bridge the current literature gap on identifying population-level developmental vulnerability risk factors using combined social and biological/health information. Methods This study assessed developmental vulnerability among kindergarten children using the 2016 Early Development Instrument (EDI) and identified risk factors of developmental vulnerability using EDI data cross-linked to a population-wide administrative health dataset. A total number of 23,494 children aged 5–6 were included (48% female). Prenatal, neonatal, and early childhood risk factors for developmental vulnerability were investigated, highlighting the most important ones contributing to early development. Results The main risk factors for developmental vulnerability were children with a history of mental health diagnosis (risk ratio = 1.46), biological sex–male (risk ratio = 1.51), and poor socioeconomic status (risk ratio = 1.58). Conclusion Our study encompasses both social and health information in a populational-level representative sample of Alberta, Canada. The results confirm evidence established in other geographic regions and jurisdictions and demonstrate the association between perinatal risk factors and developmental vulnerability. Based on these results, we argue that the health system should adopt a multilevel prevention and intervention strategy, targeting individual, family, and community together.

Exploring the clinical features and risk factors for children tinea capitis complicated with allergic diseases.

Tinea capitis, atopic dermatitis and allergic rhinitis are the most common disorders endured by prepubescent children. Dermatophyte infections have been linked to allergic disorders, such as increased sensitivity to dermatophytes in patients with atopic dermatitis. To explore the correlation between tinea capitis and allergic diseases in children and to analyse their risk factors. This study monitored epidemiological changes in childhood tinea capitis and risk factors for whom with allergic disease in a single centre in three consecutive five-year intervals by reviewing clinical data and multivariate logistic data analysis. Between 2007 and 2022, there were 127 children patients with tinea capitis, the mean age was 4.83 years, and the male-to-female ratio was 1.76:1. Zoophilic Microsporum canis and Trichophyton mentagrophytes were the most prevalent pathogens, and the proportions remained relatively constant every 5 years. There were 34 (26.8%) children with tinea capitis complicated with allergic disease, among them 14 children with atopic dermatitis/eczema, 13 with allergic rhinitis, 8 urticaria, 6 food allergies and 1 allergic asthma. Male, kerion, zoophilic species infections and animal contact history were prevalent features in allergic disease combined with tinea capitis. Patients with tinea capitis plus allergic disease mostly had a family history with similar complications. M. canis and T. mentagrophytes were the most prevalent pathogens of tinea capitis in the last 15 years; atopic dermatitis/eczema and allergic rhinitis were the most frequently associated allergic diseases. Male, kerion, zoophilic pathogen and animal contact history are risk factors.

Maternal iron status in early pregnancy and childhood body fat measures and cardiometabolic risk factors: A population-based prospective cohort

BackgroundWhether maternal iron status during pregnancy is associated with cardiometabolic health in the offspring is poorly known. ObjectivesWe aimed to assess the associations of maternal iron status during early pregnancy with body fat measures and cardiometabolic risk factors in children aged 10 y. MethodsIn a population-based cohort study among 3718 mother–child pairs, we measured ferritin, transferrin, and transferrin saturation during early pregnancy. We obtained child BMI, fat mass index, and android/gynoid fat mass ratio by DXA, subcutaneous fat index, visceral fat index, pericardial fat index, and liver fat fraction by magnetic resonance imaging and assessed systolic and diastolic blood pressure, serum lipids, glucose, insulin, and CRP at 10 y. ResultsA one-standard deviation score (SDS) higher maternal ferritin was associated with lower fat mass index [difference −0.05 (95% CI: −0.08, −0.02) SDS] and subcutaneous fat index [difference −0.06 (95% CI: −0.10, −0.02) SDS] in children. One-SDS higher maternal transferrin was associated with higher fat mass index [difference 0.04 (95% CI: 0.01, 0.07) SDS], android/gynoid fat mass ratio [difference 0.05 (95% CI: 0.02, 0.08) SDS], and subcutaneous fat index [difference 0.06 (95% CI: 0.02, 0.10) SDS] in children. Iron status during pregnancy was not consistently associated with organ fat and cardiometabolic risk factors at 10 y. ConclusionsMaternal lower ferritin and higher transferrin in early pregnancy are associated with body fat accumulation and distribution but are not associated with cardiometabolic risk factors in childhood. Underlying mechanisms and long-term consequences warrant further study.

A population-based study of unintentional injury and premature death among non-imprisoned and imprisoned youth offenders

BackgroundYouth offenders have a high risk of being injured or dying prematurely. However, few studies have considered the role of imprisonment and potential childhood risk factors for these high rates. AimTo examine the risk of unintentional injury and premature death in non-imprisoned and imprisoned youth offenders, and to examine the role of parental criminal convictions and psychiatric disorders and own childhood psychiatric disorders. MethodsAll individuals (N = 1,839,711) born in Sweden between 1978 and 1996 were identified using Swedish population-based registers. The exposure was criminal conviction between ages 15–20 years of age. ResultsImprisoned youth offenders had the highest risk for unintentional injury (HR = 2.29 [2.19–2.40]) and premature death (HR = 10.76 [9.52–12.16]), followed by nonimprisoned youth offenders, compared to non-convicted youth. All childhood risk factors increased the risk for these outcomes among non-imprisoned youth offenders. Among imprisoned youth offenders, parental criminal convictions and parental psychiatric disorders increased the risk for unintentional injury, and parental psychiatric disorders and own childhood psychiatric disorders increased the risk for premature death. ConclusionsOur study shows there are robust modifiable childhood risk factors for injury and mortality among youth offenders. However, the importance of them to assess risk may differ between non-imprisoned and imprisoned youth offenders.

Factors Associated With Persistence of Severe Asthma From Late Adolescence to Early Adulthood

To determine risk factors in childhood that predict severe persistent asthma in late adolescence and early adulthood.Patients aged 5 to 12 years with mild to moderate asthma and a positive methacholine challenge enrolled in the Childhood Asthma Management Program (CAMP) trial.The CAMP participants above who had data available from late adolescence to early adulthood were included. The first study visit at age 18 years was used to determine asthma activity in late adolescence, whereas the first study at age 22 years was used to determine asthma activity in early adulthood. The American Thoracic Society definition of severe asthma was used for patients on high dose inhaled corticosteroids and the National Asthma Education and Prevention Program Expert Panel Report (NAEPP EPR) 3 definition of severe asthma was used for those not receiving high dose inhaled corticosteroids. Additional criteria for intermittent and persistent asthma were included. The following factors were analyzed: secondhand smoke exposure, maternal smoking during pregnancy, body mass index percentile, hay fever, eczema, food allergy, parental asthma being sensitized and exposed to any perennial aeroallergen, bronchial hyperreactivity, prebronchodilator FEV1/FVC ratio, post bronchodilator FEV1/FVC ratio, bronchial hyperresponsiveness to methacholine challenge, log10 of serum total IgE and log10 of serum absolute eosinophil count. Characteristics were compared from baseline to late adolescence and from baseline to early adulthood.Six hundred eighty-two CAMP participants were included. Of these participants, severe asthma was present in 81 (12%) participants in late adolescence and 131 (19%) participants in early adulthood. Half of the patients with severe asthma in late adolescence continued to have severe asthma into early adulthood. About 18% of patients improved severity, 61% did not change, and 21% of patients worsened in severity from late adolescence to early adulthood. The postbronchodilator percent predicted FEV1 and pre and post bronchodilator FEV1/FVC ratio significantly decreased from childhood to late adolescence and from late adolescence to early adulthood (P < .0001), whereas prebronchodilator FEV1 values increased from childhood to late adolescence (P < .0001) and stabilized in early adulthood (P = .040). Bronchodilator reversibility and bronchial hyperresponsiveness each decreased from childhood to late adolescence (P < .0001), whereas bronchial hyperresponsiveness also significantly decreased from childhood to early adulthood (P = .0003). Patients with persistent and severe asthma had higher serum IgE in late adolescence and were more likely to have a positive aeroallergen skin test, along with sensitization and exposure to perennial allergens in childhood. Significant factors in early childhood that were associated with persistence of severe asthma from late adolescence to early adulthood included a younger age, male sex, no reported hay fever, a low prebronchodilator FEV1/FVC ratio, a low postbronchodilator FEV1/FVC ratio, and a physician diagnosis of moderate asthma during the screening period. Notably, for every 5% decrease in post bronchodilator FEV1/FVC ratio in childhood, the odds of severe asthma persistence increased by 2.36-fold (P < .0001) as well as maternal smoking during pregnancy increased odds of severe asthma persistence by 3.17-fold (P = .020). There was a strong association between a reduced-growth lung function trajectory and severe asthma persistence.Lower FEV1/FVC ratio in childhood and maternal smoking during pregnancy were the strongest predictors for severe asthma between late adolescence and early adulthood.Understanding early factors for persistence of asthma into adulthood can help develop targeted primary prevention measures such as reduction of smoking during pregnancy as well as early intervention measures with therapies to preserve lung function in childhood.URL: www.pediatrics.org/cgi/doi/10.1542/peds.10.1164/rccm.202010-3763OC

Developmental cascade models linking contextual risks, parenting, and internalizing symptoms: A 17-year longitudinal study from early childhood to emerging adulthood.

Although internalizing problems are the most common forms of psychological distress among adolescents and young adults, they have precursors in multiple risk domains established during childhood. This study examined cascading risk pathways leading to depression and anxiety symptoms in emerging adulthood by integrating broad contextual (i.e., multiple contextual risks), parental (i.e., negative parenting), and child (i.e., internalizing behaviors) characteristics in early and middle childhood. We also compared common and differential pathways to depression and anxiety symptoms depending on the conceptualization of symptom outcomes (traditional symptom dimension vs. bifactor dimensional model). Participants were 235 children (109 girls) and their families. Data were collected at 3, 6, 10, and 19 years of child age, using multiple informants and contexts. Results from a symptom dimension approach indicated mediation pathways from early childhood risk factors to depression and anxiety symptoms in emerging adulthood, suggesting common and distinct risk processes between the two disorders. Results from a bifactor modeling approach indicated several indirect pathways leading to a general internalizing latent factor, but not to symptom-specific (i.e., depression, anxiety) latent factors. Our findings highlighted comparative analytic approaches to examining transactional processes associated with later internalizing symptoms and shed light on issues of early identification and prevention.

Ophthalmic care of adults born preterm and full-term-results from the Gutenberg Prematurity Eye Study (GPES) : Premature birth and ophthalmological care

Prematurity and the presence of retinopathy of prematurity (ROP) increase the risk for the occurrence of amblyogenic risk factors in childhood and adolescence. The aim of the present study was to evaluate ocular morbidities and the ophthalmological care of former preterm and full-term persons in adulthood. The Gutenberg prematurity eye study (GPES) is aretrospective cohort study with aprospective ophthalmological examination of individuals formerly born preterm and full term between 1969 and 2002 (now aged 18-52years). All participants underwent adetailed ophthalmological examination and were asked about the frequency of ophthalmological care. Participants were grouped into those with normal gestational age (GA) ≥ 37 weeks (control group), preterm individuals without ROP and GA 33-36 weeks (group2), GA 29-32 weeks (group3), GA ≤ 28weeks (group4), and those with ROP without treatment (group5) and with ROP with treatment (group6). All participants were asked if they had an ophthalmological examination within the last 12months. In total, data from 140 term and 310 preterm adults were included in the present study. Strabismus was present in 2.1 % (3/140), 6.6 % (9/137), 17.4 % (16/92), 11.1 % (2/18), 27.1 % (13/48) and 60 % (9/15) in groups1-6, respectively. The proportion of subjects with an ophthalmological examination within the last 12months was highest in the groups of extremely preterm persons with and without ROP compared with the control group. Overall, 33.3 % (1/3) of the term and 57.1 % (28/49) of the preterm subjects with strabismus and 0 % (0/3) of the term and 46.9 % (15/32) of the preterm individuals with amblyopia had an ophthalmological examination within the past 12months. Extremely preterm adults with and without postnatal ROP showed the highest rate of eye diseases as well as the highest rate of ophthalmological check-ups within the last 12months. This suggests that extremely preterm adults particularly with the occurrence of postnatal ROP perceive more frequent ophthalmological check-ups throughout their lives.

Cardiovascular Risk Factors in Children and Adolescents with Type 1 Diabetes Mellitus: The Role of Insulin Resistance and Associated Genetic Variants

Introduction: Type 1 diabetes (T1D) is associated with an increased risk of cardiovascular disease. Insulin resistance is an important cardiovascular risk factor (CVRF), also in subjects with T1D, but the influence of the genetic predisposition of insulin resistance on cardiovascular risk is still unknown in T1D. We aimed to determine whether a genetic score composed of six variants, previously associated with insulin resistance and type 2 diabetes (T2D) risk, associates with insulin sensitivity and known CVRFs in children and adolescents with T1D. Materials and Methods: 330 children and adolescents (174 males; mean age 15.7 ± 3.5 years) with T1D were genotyped for the following genetic variants: rs1801278 (IRS1), rs1044498 (ENPP1), rs2295490 (TRIB3), rs1801282 (PPARG), rs780094 (GCKR), and rs35767 (IGF1). An additive genetic risk score (GRS) and cardiovascular risk score (CVRS) were calculated. Anthropometric, glycemic control, insulin sensitivity, blood pressure, and biochemical parameters were assessed. Multivariate regression between evaluated phenotypes and GRS was performed. Results: We found a significant association between the GRS and estimated insulin sensitivity (β = −0.027 [−0.040 to −0.013], R² = 0.86, p≤ 0.001), diastolic blood pressure (β = 0.68 [0.08–1.27], R² = 0.20, p = 0.026), triglycerides (β = 4.26 [1.74–6.77], R² = 0.13, p = 0.001), waist to height ratio (β = 0.003 [0.001–0.006], R² = 0.75, p = 0.010), non-HDL-cholesterol (β = 3.63 [1.39–5.87], R² = 0.12, p = 0.002), and CVRS (β = 0.063 [0.008–0.118], R² = 0.19, p = 0.025), independent of age, sex, BMI, pubertal stage, diabetes duration, glycated hemoglobin, type of treatment, and total insulin requirement. The addition of the GRS to established clinical risk factors significantly improved the discriminatory capability of the regression model for predicting subjects with more CVRFs (C-statistic 0.89 [95% CI: 0.84–0.95] versus 0.83 (0.73–0.93); p = 0.037). Conclusions: Insulin resistance and T2D risk-associated genetic variants influence insulin sensitivity and known CVRFs in children and adolescents with T1D.

Evaluation of depression, anxiety and posttraumatic stress response levels of children and adolescents treated with COVID-19.

The present study showed that COVID-19 infection is a significant risk factor for psychopathology in children and adolescents. •COVID-19 causes multiple physical complications in the body along with significant harmful physiologic mental health effects.After being diagnosed with COVID-19, paediatric and adolescent patients have been engaging in social isolation. • Shutdowns, school closings, minimizing social interaction, and isolating behaviour are some of the measures used to control the pandemic.For kids to develop into healthy individuals, they need social interaction and a safe environment. •The present study showed that COVID-19 infection is a significant risk factor for childhood and adolescent psychopathology.Based on our scaling system, 10% of patients had depression.Forty-four percent of patients' CPTS-RI was above the normal limit, while 4% had a severe stress reaction level.In the female patient population, SCARED and CPTS-RI were significantly high. • These patients need to be evaluated and monitored by paediatric and adolescent psychiatry clinics simultaneously with paediatric clinics.

Clinical Trial Data: Both Parents Having Psychiatric Symptoms as Risk Factor for Children's Mental Illness.

Children of mentally ill parents represent a particularly vulnerable risk group for the development of mental illness. This study examines whether there is a predictive association between children's psychiatric symptomatology and (1) the clinical diagnosis according to the International Statistical Classification of Diseases and Related Health Problems (ICD-10) of their mentally ill parent as well as (2) to families both parents showing psychiatric symptoms. The study is part of the multicenter controlled trial project "Children of Mentally Ill Parents" (CHIMPS). For this purpose, the psychiatric symptomatology of the mentally ill parent (N = 196) and his or her partner (N = 134) as well as the psychiatric symptomatology of their children aged 4 to 18 years (N = 290) was measured using clinical rated ICD-10-diagnosis, self-rated Brief Symptom Inventory (BSI), and Child Behavior Checklist (CBCL). Using multilevel analyses, the severity of the parental psychiatric symptomatology (BSI) was identified as a significant predictor of children's psychiatric symptomatology (CBCL). Children of parents with a personality disorder (ICD-10) were not more affected than children of parents with another ICD-10-diagnosis. However, children with two parents showing psychiatric symptoms (CBCL) were significantly more affected than children with one mentally ill parent. The results of this study support the well-known view that parental mental illness is a risk factor for children's psychiatric symptoms. Therefore, increased support, especially in high-risk families, both parents having psychiatric symptoms, is highly necessary and should be implemented in the future psychotherapeutic family care.

CKD Stage/Duration and Cardiovascular (CV) Risk Factors in Children With Proteinuric Glomerulopathies (GD)

CKD Stage/Duration and Cardiovascular (CV) Risk Factors in Children With Proteinuric Glomerulopathies (GD)

Cumulative Environmental Risk in Early Life: Associations With Schizotypy in Childhood.

Psychotic disorders are associated with a growing number of recognized environmental exposures. Cumulative exposure to multiple environmental risk factors in childhood may contribute to the development of different patterns of schizotypy evident in early life. Hypotheses were that distinct profiles of schizotypy would have differential associations with a cumulative score of environmental risk factors. We prospectively examined the relationship between 19 environmental exposures (which had demonstrated replicated associations with psychosis) measured from the prenatal period through to age 11 years, and 3 profiles of schizotypy in children (mean age = 11.9 years, n = 20 599) that have been established in population data from the New South Wales-Child Development Study. Multinomial logistic regression was used to examine associations between membership in each of 3 schizotypy profiles (true schizotypy, introverted schizotypy, and affective schizotypy) and exposure to a range of 19 environmental risk factors for psychosis (both individually and summed as a cumulative environmental risk score [ERS]), relative to children showing no risk. Almost all environmental factors were associated with at least 1 schizotypy profile. The cumulative ERS was most strongly associated with the true schizotypy profile (OR = 1.61, 95% CI = 1.52-1.70), followed by the affective (OR = 1.33, 95% CI = 1.28-1.38), and introverted (OR = 1.32, 95% CI = 1.28-1.37) schizotypy profiles. Consistent with the cumulative risk hypothesis, results indicate that an increased number of risk exposures is associated with an increased likelihood of membership in the 3 schizotypy profiles identified in middle childhood, relative to children with no schizotypy profile.

Prefrontal influences on the function of the neural circuitry underlying anxious temperament in primates.

Anxious temperament, characterized by heightened behavioral and physiological reactivity to potential threat, is an early childhood risk factor for the later development of stress-related psychopathology. Using a well-validated nonhuman primate model, we tested the hypothesis that the prefrontal cortex (PFC) is critical in regulating the expression of primate anxiety-like behavior, as well as the function of subcortical components of the anxiety-related neural circuit. We performed aspiration lesions of a narrow 'strip' of the posterior orbitofrontal cortex (OFC) intended to disrupt both cortex and axons entering, exiting and coursing through the pOFC, particularly those of the uncinate fasciculus (UF), a white matter tract that courses adjacent to and through this region. The OFC is of particular interest as a potential regulatory region because of its extensive reciprocal connections with amygdala, other subcortical structures and other frontal lobe regions. We validated this lesion method by demonstrating marked lesion-induced decreases in the microstructural integrity of the UF, which contains most of the fibers that connect the ventral PFC with temporal lobe structures as well as with other frontal regions. While the lesions resulted in modest decreases in threat-related behavior, they substantially decreased metabolism in components of the circuit underlying threat processing. These findings provide evidence for the importance of structural connectivity between the PFC and key subcortical structures in regulating the functions of brain regions known to be involved in the adaptive and maladaptive expression of anxiety.