Constitutional features of connective tissue as a risk factor of chronic pain in adolescents

2016 ◽  
Vol 7 (3) ◽  
pp. 63-69
Author(s):  
Vadim G Arsentev ◽  
Ekaterina A Voloshina ◽  
Elena V Vyutrih ◽  
Yuriy S Sergeev ◽  
Nikolai P Shabalov

A total of 504 male adolescents aged 14-18, cadet schools students were examined to identify primary head pain and functional abdominal pain. A 4-stage-blind clinical laboratory and case-control psychological examination, in which are formed two groups: basic - 90 boys with primary head pain and functional abdominal pain, and 93 healthy children (control group). Total number of teens with headaches was 76 (48 isolated headaches and 28 - headaches in conjunction with abdominal pain). The number of cadets with abdominal pain was 42, 14 was manifested monosemeiotic and 28 - in conjunction with headaches. Complex research revealed pathogenetic common primary headaches and functional abdominal pain, to identify risk factors for their development. The analysis of the results of complex examination adolescents univariate statistics significant association features of the connective tissue with the presence of primary headache, especially in combination with functional abdominal pain. Obtained significant differences in many biological, psychological and social characteristics. This fact indicates eligibility review genesis of functional disorders with painful symptoms in adolescents from the perspective of the biopsychosocial model. The present results indicate the importance of the state of the connective tissue as an essential component of the formation of predisposition to chronic pain. Other predictors of pain were advancing sexual development, emotional instability, additional sports classes.

2018 ◽  
Vol 2 ◽  
pp. 30-38
Author(s):  
Natalia Lukyanenko ◽  
Mariana Iskiv

Aim of the research: to establish the role of undifferentiated connective tissue dysplasia, as a manifestation of violation of fibrillogenesis, in the severity of the course of pyelonephritis in children. 154 children with pyelonephritis from 3 to 18 years were examined. As a result of catamnestic surveillance, they were divided into 2 groups: I – 92 persons, children with chronic pyelonephritis in which were diagnosed 3 or more episodes of relapse of pyelonephritis during the year, and II – 56 children with acute pyelonephritis, in which during the year no relapses were noted. The control group were 65 somatically healthy children of the same age (III - health-control). All children had a routine comprehensive clinical and laboratory examination and clinical and laboratory markers of a fibrillogenic disorder were established. In children with chronic pyelonephritis, the frequency of all analyzed complaints was significantly higher than in children with acute pyelonephritis without relapses: frequent headaches – 56.52 % versus 25.0 %, appetite loss – 28.26 % vs. 19.64 %, frequent abdominal pain – 52.17 % vr. 32.14 %, increased fatigue – 41.30 % vr. 28.57 %. In children with chronic pyelonephritis, phenotypic signs of undifferentiated connective tissue dysplasia (UCTD) were significantly more marked, such as joint hypermobility (in 52.0 % of children versus 5.4 %), asthenic body structure (59.0 % vs. 26.78 %), visual disturbance (84.8 % vs. 32.14 %), chest deformity (42.4 % vs. 8.9 %), scoliosis (52.17 % vs 10.7 %), arachnodactyly and predisposition to bleeding were observed only in children of the 1st group (22.5 % and 4.34 % respectively). In practically all children with chronic pyelonephritis, the values of free and bound oxyproline fractions in blood plasma were significantly increased (47.14±0.03 μmol/l and 40.08±0.03 μmol/l, respectively), according to arithmetic meanings, reliably differing from the data of children with acute pyelonephritis (17.65±0.01 μmol/l and 17.22±0.02 μmol/l), in which these oxyproline fractions were elevated only in 12.0 % and 16.0 % of the subjects. In 97.0 % of children with chronic pyelonephritis, the level of oxyproline in urine was elevated and significantly exceeded the level of excretion of oxyproline in urine in children with acute pyelonephritis. The presence of UCTD in a child plays an important role in the process of chronic pyelonephritis, and children with its manifestations have a heavier course of disease with frequent relapses, therefore, the presence of signs UCTD is prognostically unsuccessful, which dictates the need for the appointment of metabolic therapy in the first episodes of the disease in children, if they have clinical and laboratory manifestations of UCTD.


Cephalalgia ◽  
2013 ◽  
Vol 33 (16) ◽  
pp. 1311-1318 ◽  
Author(s):  
Francesco Margari ◽  
Elisabetta Lucarelli ◽  
Francesco Craig ◽  
Maria G Petruzzelli ◽  
Paola A Lecce ◽  
...  

Background Recurrent headache is common in childhood, but there is not a great amount of data on the associations between headaches and psychopathology in children. Objective The aim of this study is to examine the relationships between primary headaches and psychopathology in children, using both the categorical and dimensional assessment. Methods The sample consisted of 70 patients with primary headache compared to a matched sample of 50 healthy children. Psychiatric comorbidity was defined according to the diagnostic criteria of the Diagnostic and Statistical Manual of Disorders. Child psychopathology outcomes were assessed using child- and parent-reported standardized instruments. Results Internalizing and externalizing problems were significantly represented among children with headaches compared to the control group, respectively 63% and 27%, without significant differences between migraine and tension-type headache children. Moreover, a total of 26% of the children with a headache reported psychiatric comorbidity such as anxiety and mood disorders. Conclusion The dimensional approach improves accuracy in the recognition of emotional and behavioral problems compared to the categorical approach; however, the use of both of these approaches could be useful for clinical practice, treatment and research.


2017 ◽  
Vol 53 (1) ◽  
pp. 5-10
Author(s):  
Stanisław Pieczarkowski ◽  
Kinga Kowalska-Duplaga ◽  
Andrzej Wędrychowicz ◽  
Krzysztof Fyderek ◽  
Przemko Kwinta ◽  
...  

<i>Introduction:</i> Chronic abdominal pain in children is a very frequent and sometimes challenging diagnostic issue. Differential diagnosis in that cases is difficult and often connected with numerous, time-consuming, expensive, and frequently stressful diagnostic studies. The aim of the study was to establish whether fecal calprotectin concentration (FCC) and TNF-alpha may be useful in children with chronic abdominal pain to differentiate between inflammatory bowel disease (IBD), other inflammatory gastrointestinal disorders, and functional gastrointestinal disorders. Methods. The study included patients (median age 13 years), who were assigned to functional gastrointestinal disorders group (n=33); inflammatory gastrointestinal disorders other than IBD (n=71), children with IBD (n=37) and 22 healthy children served as a control group. The concertation of FCC and TNF-alpha in stool samples was measured using ELISA. <i>Results:</i> In healthy children and in children with functional disorders FCCs were below 100 μg/g. In patients with IBD FCCs and TNF-alpha were markedly elevated as compare to children with functional gastrointestinal disorders, however using ROC discrimination of IBD patients was significantly better using FCC than TNF-alpha. <i>Conclusion:</i> FCC is better test for differentiation between IBD, other inflammatory gastrointestinal disorders, and functional gastrointestinal disorders as compare to TNF-alpha concentration in stool. FCC as screening test in patients with chronic abdominal pain should allow to diminish unnecessary diagnostic in cases of functional gastrointestinal disorders.


Pain Medicine ◽  
2018 ◽  
Vol 20 (8) ◽  
pp. 1472-1478
Author(s):  
Marco Daniel Gulewitsch ◽  
Aiste Jusyte ◽  
Katja Weimer ◽  
Michael Schönenberg

Abstract Objective Functional abdominal pain (AP) is a prevalent issue in childhood and adolescence. The contribution of psychosocial factors in the development and maintenance of this health problem is rather unclear, and experimental studies about underlying mechanisms are lacking. This study investigates whether experimentally induced social exclusion decreases sensory and pain thresholds in children suffering from AP. Subjects Twenty children/adolescents with AP and 22 healthy controls. Methods Children/adolescents participated in the Cyberball paradigm, which affects an experience of social exclusion. Thermal sensory and pain thresholds were measured before and after Cyberball. Results Children/adolescents with AP showed a divergent reaction regarding their sensory threshold after social exclusion: The control group exhibited a tendency toward a decreased sensory threshold whereas the AP group remained stable. Concerning the pain threshold, no effect of social exclusion could be identified. The increase of both thresholds (“numbing”) after Cyberball was positively correlated with symptoms of mental health issues. Conclusions This is the first study to investigate changes in sensory and pain thresholds following painful social interactions in a sample of children/adolescents with a chronic pain condition. Results suggest that AP and control children differ in their reaction of sensory thresholds, which might indicate an altered processing of social exclusion. Replication and further methodological improvements are needed.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
O V Sidorovich ◽  
S Y U Elizarova ◽  
A V Khizhnyak ◽  
N A Kuznetsova ◽  
E E Prosova

Abstract   Within the framework of the research into pathological conditions and syndromes associated with undifferentiated connective tissue dysplasia (UCTD), an emphasis needs to be placed on the changes in heart rhythm. In puberty, the severity of neurovegetative disorders caused by the presence of UCTD might increase manifold. The features of heart rate variability (HRV) in pubertal children against the background of UCTD have been studied insufficiently and require more detailed analysis. This study aims to assess heart rate variability and tone of the autonomic nervous system (ANS) in puberty-aged children with UCTD. Two groups of children were examined, with methods including electrocardiography and cardiointervalography. The main group consisted of 36 puberty-aged children with UCTD, the control group consisted of 30 healthy children. ANS tone was assessed based on the HRV. In the control group of children aged 11, the value of variation range (VR) was 0.18±0.4, mode amplitude (MA) 35.2±2.4, stress index (IN) 72.8±4.3, which corresponds to the state of vegetative balance. As the puberty progresses, the state of eutonia is replaced by the activation of the sympathetic division of the ANS, which becomes most pronounced at the age of 13 years. In the control group of children aged 13, the value of VR was 0.08±0.02, MA 61.7±2.1, SI 210.6±8.6, which corresponds to moderate sympathicotonia. By the end of puberty, in healthy children, the severity of sympathetic activation begins to decrease, and at the age of 15 years, vegetative balance is again observed. However, this pattern is violated in children with UCTD. Upon entering puberty, moderate activation of the sympathetic division of the ANS is already observed in children with UCTD. At the age of 11 years in this group, the value of VR is 0.06±0.02, MA 72.4±3.1, SI 211.2±8.6. At the age of 13, pronounced sympathicotonia is observed, which is confirmed by the values of VR - 0.04±0.01, MA 80.2±4.3 and SI 34.3±14.7. By the end of puberty in children with UCTD, in contrast to the control group, the analyzed parameters indicate not an equilibrium of the ANS, but the predominance of parasympathetic activation. The research provides an insight into heart rate variability in puberty-aged children with UCTD. It was established that healthy children enter puberty in a state of equilibrium of the autonomic nervous system, which in the middle of puberty is replaced by moderate sympathicotonia, and then returns to its original values. Children with the presence of UCTD enter puberty with moderately pronounced sympathicotonia, which gradually increases to pronounced values and is replaced by moderate vagotonia. FUNDunding Acknowledgement Type of funding sources: None.


2021 ◽  
pp. 65-70
Author(s):  
I.A. Kozyro ◽  
◽  
А.V. Sukalo ◽  
О.A. Kondratenko ◽  

Damage of the cardiovascular system (cardiovascular disease, CVD) is the main cause of reduced life expectancy in children with chronic kidney disease (CKD). In the development of damage of the heart and blood vessels, both traditional factors and caused by impaired renal function, which appear already in the early stages of kidney disease, play a role. Purpose of the study: assessment of markers of the structure, function and metabolism of the heart and study of their changes in children, kidney transplant recipients. Materials and methods. 54 children, a kidney transplant recipients (Tx), who were under observation and treatment at the National Center for Pediatric Nephrology and Renal Replacement Therapy, Minsk 2nd Children's City Clinical Hospital, aged 3 to 17 years, were included in the study. The analysis of the data of the Tx group and conditionally divided subgroups: 1) with glomerular disease leading to the end stage of CKD (ESRD), n = 26; 2) with non-glomerular pathology, n = 27, in one patient the cause of ESRD was not specified. The control group consisted of healthy children from cardiology department without kidney pathology (n = 86). Results. Anamnestic, clinical, laboratory, immunological (serum concentration of T- and B-lymphocyte activation markers (RANTES and BAFF), proinflammatory (caspase 1, IL1fi and TNFa), vascular (VEGF) and tissue (TGF1p) growth factors), metabolic status (adyponectin, leptin, obestatin, vitamin D 25(OH)D), cardiospecific molecules (highly sensitive C-reactive protein (hsCRP), proBNP, transferrin, TSAT index), instrumental changes. Conclusion. Changes in the cardiovascular system in Tx are ambiguous. On the one hand, there is a significant improvement in the geometry of the myocardium and arterial hypertension, on the other hand, the atherogenic direction of metabolic changes and biochemical markers of CVD remains.


2015 ◽  
Vol 20 (4) ◽  
pp. 189-194 ◽  
Author(s):  
Julia Wager ◽  
Hannah Brehmer ◽  
Gerrit Hirschfeld ◽  
Boris Zernikow

BACKGROUND: There is little knowledge regarding the association between psychological factors and complex regional pain syndrome (CRPS) in children. Specifically, it is not known which factors precipitate CRPS and which result from the ongoing painful disease.OBJECTIVES: To examine symptoms of depression and anxiety as well as the experience of stressful life events in children with CRPS compared with children with chronic primary headaches and functional abdominal pain.METHODS: A retrospective chart study examined children with CRPS (n=37) who received intensive inpatient pain treatment between 2004 and 2010. They were compared with two control groups (chronic primary headaches and functional abdominal pain; each n=37), who also received intensive inpatient pain treatment. Control groups were matched with the CRPS group with regard to admission date, age and sex. Groups were compared on symptoms of depression and anxiety as well as stressful life events.RESULTS: Children with CRPS reported lower anxiety and depression scores compared with children with abdominal pain. A higher number of stressful life events before and after the onset of the pain condition was observed for children with CRPS.CONCLUSIONS: Children with CRPS are not particularly prone to symptoms of anxiety or depression. Importantly, children with CRPS experienced more stressful life events than children with chronic headaches or abdominal pain. Prospective long-term studies are needed to further explore the potential role of stressful life events in the etiology of CRPS.


2020 ◽  
pp. 36-41
Author(s):  
I. S. Lembryk ◽  
O. V. Tymoshchuk

Introduction. During the last twenty-five years the occurrence of obesity in children and teenagers has increased significantly. Materials and methods. 110 adolescents of 12–17 years old, with alimentary-constitutional obesity and involvement of pancreas and without its injury, as compared to the 30 healthy children of control group, were examined. The research provided determination of the sizes and elasticity of pancreas. The detection of the total cholesterol, high density lipoproteins and leptin level was carried out. Intensity of clinical symptoms (spastic pain in epigastrium and left subcostal arc; abdominal pain without localization, vomit without relief, general weakness) have been made accordingly to sum of points (from 0 to 3 points). If sum of points makes from 0 to 2 – intensive character of abdominal pain is low, from 3 to 5 points – it is high, from 5 to 10 points – it is very high. Normal level of amylase in a blood serum (Karavey’s method) is 12–32 g/(hour l), аnd diastase in urine – 20–160 g/(hour l). We made a screening test for elastase-I level by ELISA test. Normal activity of this enzyme in feces is 200 мkg/g. We have used sonographic method for detection of pancreatic diseases in obese children due to echo-structure of parotid gland. The analysis and statistical data processing were made by computer program "Statistica 7.0" and MS Excel XP. Research data. Physical inspection of our patients confirms prevalence of І degree over II degree obesity (52.7 % and 47.3 %, respectively; Р < 0.05). We have confirmed valid risk factor of pancreatic lesion in obese children – presence of diabetes mellitus type I in close relatives (80 % and 65 %, χ2 = 2,05; Р < 0.05). The changes of exocrine function of the pancreas in children with the stage II obesity were established. Echographic signs of the pancreas lesion in teenagers with obesity indicate the presence of functional changes: edema of head or entire edema, partial increase of parenchymal echogenicity, insufficient enlargement of the duct of Wirsung.


2020 ◽  
Author(s):  
Tut Galai ◽  
Hadar Moran-Lev ◽  
Shlomi Cohen ◽  
Amir Ben-Tov ◽  
Dina Levy ◽  
...  

Abstract Background Functional abdominal pain (FAP) disorders are one of the most common gastrointestinal disorders in children. We aimed to define the association between obesity and functional abdominal pain (FAP) disorders and to assess differences between overweight/obese children and normal weight children with FAP disorders.Methods We conducted a retrospective study of children (2-18 years old) with a clinical diagnosis of FAP who were followed-up in our pediatric gastroenterology unit between 1/2016-10/2018. FAP disorders were defined according to the ROME IV criteria. Body mass index (BMI) percentiles were defined by CDC standards. Patients with BMIs ≥85% were designated as being overweight/obese. A healthy control group was obtained from the 2015-2016 Israel national health survey.Results Data from 173 children with FAP disorders (median age 11.5 years, 114 females) were included. Seventy-one children (41%) were classified as having abdominal pain-NOS, 67 (38.7%) as having irritable bowel syndrome (IBS), and 35 (20.2%) has having functional dyspepsia. Fifty-three children (30.6%) were classified as being overweight/obese. Adolescents with FAP disorders had a significantly higher prevalence of overweight/obesity compared to controls (39.5% vs. 30%, respectively, p = 0.04). Overweight FAP children were older [12.4 (range 9.8-15.3) vs. 10.8 (7.4-14.1) years, p = 0.04] and had more hospitalizations due to FAP (20.8% vs. 7.6%, p = 0.01) compared to normal weight FAP children.Conclusions Children with FAP had higher prevalence of overweight/obesity compared to healthy controls. Future studies are warranted to raise awareness of weight issues in FAP and determine the effect of weight loss on FAP.


Introduction. Current treatment technologies, a significant place is occupied by the issue of interaction between a doctor and a patient. The aim of this study was to determine the level of compliance in children with chronic pathology. Materials and methods. 87 children aged 6 to 17 years were examined, among whom 32 children had idiopathic juvenile arthritis (JIA), 30 children had type 1 diabetes mellitus (DM1) and 25 apparently healthy children made up the control group. All children were interviewed using the Compliance Level Questionnaires for children with chronic pathology or healthy children. All statistical analyzes were performed using the s/n SPSS 17 4a 180844250981. Results. The study of compliance features in patients with IJA showed that the majority (84.4 %) of children had high compliance to treatment, which was much more common than in children with diabetes mellitus (р < 0,01) and control group (р < 0,02). Half of the children with DM1 also had a high level of general compliance. When assessing the structure of compliance in patients with diabetes, moderate levels of all components were found. Children of this group are characterized by an indefinite social position, they act according to the situation. Emotional instability is a typical manifestation. The study of the level of compliance in children of the control group revealed low indicators of general compliancy to the doctor's actions. Each component corresponded to the average level. It was in these children that low indicators of social and behavioral patterns were found, which indicates a negativity towards the treatment process and medical manipulations. Conclusions: 1. Patients with chronic pathology have a higher level of compliance than patients in the control group, which indicates a significant impact on the child's life of the presence of a chronic disease. 2. The level of compliance differs in various chronic diseases, may depend on the characteristics of subjective feelings and medical manipulations. 3. Female patients have a higher level of adherence to treatment, which dictates the need to take into account the gender of the child in the daily work of the doctor, and pay more attention to careful communication with boys.


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