Zobrazení zdroje stránky Nealrosendal8275

Objective The purpose of this study is to determine the association between presence of chronic pain and school functioning among school aged children (6-17▒y) using the most recent United States national data. Methods Secondary data analyses of the 2016-2017 National Survey of Children's Health. Parents (n=48,254) reported on whether their child had chronic pain over the past 12 months. Parents also reported on school functioning including (1) engagement with school, (2) number of school days missed, (3) problems at school, (4) repeating a grade, and (5) diagnosis of a learning disability. Children with chronic pain were compared to children without chronic pain using multivariate logistic regression models. We also stratified analysis according to age and sex. Results In multivariate analyses, children with pain were more likely to have low school engagement (adjusted odds ratio (OR) 1.4, 95% confidence interval (CI) 1.0-1.9), be chronically absent (OR 4.2, 95%CI 3.0-5.8), have school related problems (OR 1.9, 95%CI 1.5-2.3), repeat a grade (OR 1.4, 95%CI 1.0-2.0), and be diagnosed with a learning disability (OR 1.6, 95%CI 1.1-2.5). In stratified analyses, associations between chronic pain and school measures were strongest among adolescents (15-17▒y of age) and males. Discussion This study extends evidence linking chronic pain status to poorer school functioning in a large, national sample. [https://www.selleckchem.com/products/stattic.html Selleck Stattic] Poor school functioning is a pressing public concern affecting children with chronic pain. Health care providers, educators, policy makers, and families should work together to ensure that needs are met for this vulnerable population.Background Chronic low back pain (cLBP) is the leading cause of disability, with a significant societal cost. It disproportionately affects Non-Hispanic Blacks and individuals of lower socioeconomic status (SES). The biopsychosocial framework has been used to study and manage cLBP, yet disparities persist. Objectives To assess whether self-identified race moderated the relationship between perceived social status and cLBP outcomes (pain interference and pain severity) and investigate whether race moderated the indirect relationship between perceived social status and pain outcomes via depressive symptoms. Method 57 Blacks and 48 Whites with cLBP were recruited as part of a large ongoing study. Depressive symptoms, objective and subjective measures of SES, and pain outcomes were measured. Hayes' moderated mediation model was used to estimate conditional direct and indirect relationship between these variables. Result On average Black reported significantly more pain interference (4.12 (SD=2.65) vs. 2.95 (SD=2.13)) and severity (5.57 (SD=2.27) versus 3.99 (SD=1.99) than white participants, (P less then 0.05). Race moderated the association between perceived social status and pain interference higher social status decreases pain interference for White participants, but that trend was not observed in Black participants. Moreover, race moderated association of perceived social status with depressive symptoms (P less then 0.001); which mediates the effects of perceived social status on pain outcomes. Conclusion Higher perceived social status is associated with less severe depressive symptoms, which in turn is associated with less pain severity and less pain interference for Whites but not for Blacks with cLBP. The recent outbreak of 2019 severe acute respiratory syndrome coronavirus-2 is having major repercussions on healthcare services provision in Italy and worldwide. Data suggest the virus has a strong impact on the cardiovascular system, and cardiac imaging will play an important role in patients affected by coronavirus disease-2019. Although paediatric patients are mildly affected, they represent a clear accelerator in spreading the virus, and healthcare workers are at higher risk of infection. The aim of this position paper is to provide clinical recommendation regarding the execution of imaging investigations for the cardiac diagnostic work-up of paediatric patients with suspected or confirmed infection.Aims Chronic kidney dysfunction (CKD) and persistent congestion influence heart failure prognosis, but little is known about the role of inflammation in this association. We assessed the relationship between inflammatory biomarkers, persistent congestion and CKD and their prognostic implications in patients with acute heart failure. Methods We enrolled 97 hospitalised patients (mean age 66 ± 12 years, ejection fraction 30 ± 8%) with acute heart failure. Before discharge, congestion was assessed using a heart failure scoring system on the basis of Framingham criteria. Circulating levels of high-sensitivity C-reactive protein, TGF-β-1, IL-1, IL-6, IL-10, TNF-α, soluble tumour necrosis factor receptor type 1 and 2 were measured. Patients were divided into four groups according to the presence of CKD (estimated glomerular filtration rate less then 60 ml/min/1.73 m) and congestion (Framingham heart failure score ≥2). The primary end point was the combination of death and rehospitalisation for acute heart failure. Results During a median follow-up of 32 months, 37 patients died and 14 were rehospitalised for acute heart failure. Patients with CKD and congestion had significantly higher TNF-α (P = 0.037), soluble tumour necrosis factor receptor type 1 (P = 0.0042) and soluble tumour necrosis factor receptor type 2 (P = 0.001), lower TGF-β-1 (P = 0.02) levels, and the worst outcome (P less then 0.0001). Congestion (P = 0.01) and CKD (P = 0.02) were independent predictors of the end-point together with N-terminal prohormone of brain natriuretic peptide (P = 0.002) and TNF-α (P = 0.004). TNF-α attenuated the direct relation between CKD, congestion and outcome, explaining 40% of the difference in the outcome. Conclusion In patients hospitalised with acute heart failure, the prognostic impact of persistent congestion and CKD is associated with increased cytokine levels, which may also interfere with the outcome.Objective The aim of this study was to assess the association of early menopause with diabetes and the mediating effect of abdominal obesity. Methods This cross-sectional study was conducted among 5,693 participants. The data from the second follow-up (2015) of the China Health and Retirement Longitudinal Study were used. Participants self-reported their age at menopause and were divided into three age groups (54 years) according to the 10th, 10th to 90th, and 90th percentiles, with a menopausal age of 45 to 54 years serving as reference. The total effect was decomposed into direct and indirect (mediating) effects using logistic regression based on the Karlson-Holm-Breen method. Results Compared to the menopausal age of 45 to 54 years, early menopause ( less then 45 years) was associated with diabetes (odds ratio = 2.19, 95% CI 1.29-3.69) among Chinese women. The mediating effect of early menopause ( less then 45 years) on diabetes was 4.98% (P = 0.321) for abdominal obesity. Conclusions Early menopause may be associated with diabetes among Chinese women.