scholarly journals Childhood Trajectories of Hyperactivity/Inattention Symptoms and Diurnal Cortisol in Middle Adolescence: Results from a UK Birth Cohort

2021 ◽  
pp. 108705472110367
Author(s):  
Dongying Ji ◽  
Eirini Flouri ◽  
Efstathios Papachristou ◽  
Marta Francesconi
Keyword(s):  
General Population ◽  
Hpa Axis ◽  
Cortisol Awakening Response ◽  
Daily Output ◽  
Hyperactivity Disorder ◽  
Symptom Trajectories ◽  
Basal Cortisol ◽  
Morning Cortisol ◽  
General Population Cohort ◽  
Middle Adolescence

Objective Children with attention-deficit/hyperactivity disorder (ADHD) show hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis. Whether the association between hyperactivity/inattention symptoms with HPA axis dysfunction holds in the general child population too is not clear. Method We assessed associations between longitudinal trajectories of hyperactivity/inattention symptoms during ages 4 to 13 years and basal cortisol profiles at age 15 in a British general population cohort. Results Adolescents with persistently high levels of hyperactivity/inattention symptoms since childhood showed lower total morning cortisol and a smaller diurnal decline, even after adjusting for confounders. No associations were found between any of the symptom trajectories and cortisol awakening response, diurnal slope or daily output of cortisol. Conclusion This study provides evidence for hypocortisolism among adolescents with chronic hyperactivity/inattention symptoms in the general population.

scholarly journals Endocannabinoid system mediates the association between gut-microbial diversity and anhedonia/amotivation in a general population cohort

2021 ◽  
Author(s):  
Amedeo Minichino ◽  
Matthew A. Jackson ◽  
Marta Francesconi ◽  
Claire J. Steves ◽  
Cristina Menni ◽  
...  
Keyword(s):  
General Population ◽  
Microbial Diversity ◽  
Gut Microbiome ◽  
Endocannabinoid System ◽  
Alpha Diversity ◽  
Serum Levels ◽  
Population Cohort ◽  
Random Intercept ◽  
General Population Cohort ◽  
Antidepressant Use

AbstractAnhedonia and amotivation are debilitating symptoms and represent unmet therapeutic needs in a range of clinical conditions. The gut-microbiome-endocannabinoid axis might represent a potential modifiable target for interventions. Based on results obtained from animal models, we tested the hypothesis that the endocannabinoid system mediates the association between gut-microbiome diversity and anhedonia/amotivation in a general population cohort. We used longitudinal data collected from 786 volunteer twins recruited as part the TwinsUK register. Our hypothesis was tested with a multilevel mediation model using family structure as random intercept. The model was set using alpha diversity (within-individual gut-microbial diversity) as predictor, serum and faecal levels of the endocannabinoid palmitoylethanolamide (PEA) as mediator, and anhedonia/amotivation as outcome. PEA is considered the endogenous equivalent of cannabidiol, with increased serum levels believed to have anti-depressive effects, while increased stool PEA levels, reflecting increased excretion, are believed to have opposite, detrimental, effects on mental health. We therefore expected that either reduced serum PEA or increased stool PEA would mediate the association between microbial diversity and anhedonia amotivation. Analyses were adjusted for obesity, diet, antidepressant use, sociodemographic and technical covariates. Data were imputed using multiple imputation by chained equations. Mean age was 65.2 ± 7.6; 93% of the sample were females. We found a direct, significant, association between alpha diversity and anhedonia/amotivation (β = −0.37; 95%CI: −0.71 to −0.03; P = 0.03). Faecal, but not serum, levels of the endocannabinoid palmitoylethanolamide (PEA) mediated this association: the indirect effect was significant (β = −0.13; 95%CI: −0.24 to −0.01; P = 0.03), as was the total effect (β = −0.38; 95%CI: −0.72 to −0.04; P = 0.03), whereas the direct effect of alpha diversity on anhedonia/amotivation was attenuated fully (β = −0.25; 95%CI: −0.60 to 0.09; P = 0.16). Our results suggest that gut-microbial diversity might contribute to anhedonia/amotivation via the endocannabinoid system. These findings shed light on the biological underpinnings of anhedonia/amotivation and suggest the gut microbiota-endocannabinoid axis as a promising therapeutic target in an area of unmet clinical need.

Treatment of attention deficit/hyperactivity disorder in children with CHD

2021 ◽  
pp. 1-4
Author(s):  
Alyson R. Pierick ◽  
Melodie Lynn ◽  
Courtney M. McCracken ◽  
Matthew E. Oster ◽  
Glen J. Iannucci
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
General Population ◽  
Adverse Events ◽  
Supraventricular Tachycardia ◽  
Medical Therapy ◽  
Attention Deficit ◽  
Case Reports ◽  
Single Centre ◽  
Hyperactivity Disorder ◽  
Increased Risk

Abstract Introduction: The prevalence of attention deficit/hyperactivity disorder in the general population is common and is now diagnosed in 4%–12% of children. Children with CHD have been shown to be at increased risk for attention deficit/hyperactivity disorder. Case reports have led to concern regarding the use of attention deficit/hyperactivity disorder medications in children with underlying CHD. We hypothesised that medical therapy for patients with CHD and attention deficit/hyperactivity disorder is safe. Methods: A single-centre, retrospective chart review was performed evaluating for adverse events in patients aged 4–21 years with CHD who received attention deficit/hyperactivity disorder therapy over a 5-year span. Inclusion criteria were a diagnosis of CHD and concomitant medical therapy with amphetamines, methylphenidate, or atomoxetine. Patients with trivial or spontaneously resolved CHD were excluded from analysis. Results: In 831 patients with CHD who received stimulants with a mean age of 12.9 years, there was only one adverse cardiovascular event identified. Using sensitivity analysis, our median follow-up time was 686 days and a prevalence rate of 0.21% of adverse events. This episode consisted of increased frequency of supraventricular tachycardia in a patient who had this condition prior to initiation of medical therapy; the condition improved with discontinuation of attention deficit/hyperactivity disorder therapy. Conclusion: The incidence of significant adverse cardiovascular events in our population was similar to the prevalence of supraventricular tachycardia in the general population. Our single-centre experience demonstrated no increased risk in adverse events related to medical therapy for children with attention deficit/hyperactivity disorder and underlying CHD. Further population-based studies are indicated to validate these findings.

scholarly journals Ambient air pollutants are associated with morning serum cortisol in overweight and obese Latino youth in Los Angeles

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
C. M. Toledo-Corral ◽  
T. L. Alderete ◽  
M. M. Herting ◽  
R. Habre ◽  
A. K. Peterson ◽  
...  
Keyword(s):  
Hpa Axis ◽  
Air Pollutants ◽  
Latino Youth ◽  
Serum Cortisol ◽  
Ambient Air ◽  
Pubertal Status ◽  
Ambient Air Pollutants ◽  
Morning Cortisol ◽  
Morning Serum Cortisol ◽  
Cortisol Levels

Abstract Background Hypothalamic-pituitary-adrenal (HPA)-axis dysfunction has been associated with a variety of mental health and cardio-metabolic disorders. While causal models of HPA-axis dysregulation have been largely focused on either pre-existing health conditions or psychosocial stress factors, recent evidence suggests a possible role for central nervous system activation via air pollutants, such as nitrogen dioxide (NO2), ozone (O3) and particulate matter (PM). Therefore, in an observational study of Latino youth, we investigated if monthly ambient NO2, O3, and PM with aerodynamic diameter ≤ 2.5 (PM2.5) exposure were associated with morning serum cortisol levels. Methods In this cross-sectional study, morning serum cortisol level was assessed after a supervised overnight fast in 203 overweight and obese Latino children and adolescents (female/male: 88/115; mean age: 11.1 ± 1.7 years; pre-pubertal/pubertal/post-pubertal: 85/101/17; BMI z-score: 2.1 ± 0.4). Cumulative concentrations of NO2, O3 and PM2.5 were spatially interpolated at the residential addresses based on measurements from community monitors up to 12 months prior to testing. Single and multi-pollutant linear effects models were used to test the cumulative monthly lag effects of NO2, O3, and PM2.5 on morning serum cortisol levels after adjusting for age, sex, seasonality, social position, pubertal status, and body fat percent by DEXA. Results Single and multi-pollutant models showed that higher O3 exposure (derived from maximum 8-h exposure windows) in the prior 1–7 months was associated with higher serum morning cortisol (p < 0.05) and longer term PM2.5 exposure (4–10 months) was associated with lower serum morning cortisol levels (p < 0.05). Stratification by pubertal status showed associations in pre-pubertal children compared to pubertal and post-pubertal children. Single, but not multi-pollutant, models showed that higher NO2 over the 4–10 month exposure period associated with lower morning serum cortisol (p < 0.05). Conclusions Chronic ambient NO2, O3 and PM2.5 differentially associate with HPA-axis dysfunction, a mechanism that may serve as an explanatory pathway in the relationship between ambient air pollution and metabolic health of youth living in polluted urban environments. Further research that uncovers how ambient air pollutants may differentially contribute to HPA-axis dysfunction are warranted.

ApoE and vascular disease – resequencing and genotyping in a general population cohort

2021 ◽  
Vol 331 ◽  
pp. e53-e54
Author(s):  
K.L. Rasmussen ◽  
A. Tybjærg-Hansen ◽  
B.G. Nordestgaard ◽  
R. Frikke-Schmidt
Keyword(s):  
General Population ◽  
Vascular Disease ◽  
Population Cohort ◽  
General Population Cohort

Predictors of Back Pain in a General Population Cohort

Spine ◽  
2004 ◽  
Vol 29 (1) ◽  
pp. 70-77 ◽  
Author(s):  
Jacek A. Kopec ◽  
Eric C. Sayre ◽  
John M. Esdaile
Keyword(s):  
Back Pain ◽  
General Population ◽  
Population Cohort ◽  
General Population Cohort

scholarly journals Medical Allocations to Persons with Special Needs during a Bioterrorism Event

2016 ◽  
Vol 8 (3) ◽  
Author(s):  
Donald E Brannen ◽  
Melissa Branum ◽  
Sejal Pawani ◽  
Sandy Miller ◽  
Jeanne Bowman ◽  
...  
Keyword(s):  
Public Health ◽  
General Population ◽  
Special Needs ◽  
Vaccination Campaign ◽  
Persons With Disabilities ◽  
Willingness To Serve ◽  
Ice Storms ◽  
Population Cohort ◽  
Disaster Survivors ◽  
General Population Cohort

After the bioterrorism-anthrax attacks of 2001, individual public health officials were tasked with planning population-wide medicine dispensing. This planning started with assumptions and then evaluations of seasonal immunization clinics. Research of the 2009 H1N1 pandemic-vaccination campaign showed that an adequately prepared public health system could have prevented over 16% of flu-associated hospitalizations. The 2011 ice storms revealed difficulties with sheltering medically fragile persons with disabilities. Later research showed that training and preparedness levels increased responders’ willingness to serve. Also, when triaging disaster survivors to general shelters, medical shelters, or mental health services; sorting to community mass care services improved up to 15% when past traumatic effects, personal care assistance, or service methodology were accounted for. The number of persons who are disabled and dependent on electric medical equipment are increasing. This current study compared the time it takes to dispense medication to two different cohorts: a general-population cohort (n=31) and a special-needs cohort (n=30). The cohort comprised entirely of persons with special needs took 4.1 compared to 2.48 minutes per person in a general population cohort (p=.057). A person with any special needs took 3.73 versus 2.43 minutes for a person with no special needs (p=.082). Modeling of service times per station and cohort type found significant delays at the medical station among persons in the general population who are pregnant (840 seconds, p=.002) and persons in the special needs cohort with a language barrier (750 seconds, p=.001).

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