Brain functional and structural changes in diabetic children. How can intellectual development be optimized in type 1 diabetes?

The neuropsychological functioning of people with type 1 diabetes (T1D) is of key importance to the effectiveness of the therapy, which, in its complexity, requires a great deal of knowledge, attention, and commitment. Intellectual limitations make it difficult to achieve the optimal metabolic balance, and a lack of this alignment can contribute to the further deterioration of cognitive functions. The aim of this study was to provide a narrative review of the current state of knowledge regarding the influence of diabetes on brain structure and functions during childhood and also to present possible actions to optimize intellectual development in children with T1D. Scopus, PubMed, and Web of Science databases were searched for relevant literature using selected keywords. The results were summarized using a narrative synthesis. Disturbances in glucose metabolism during childhood may have a lasting negative effect on the development of the brain and related cognitive functions. To optimize intellectual development in children with diabetes, it is essential to prevent disorders of the central nervous system by maintaining peri-normal glycemic levels. Based on the performed literature review, it seems necessary to take additional actions, including repeated neuropsychological evaluation with early detection of any cognitive dysfunctions, followed by the development of individual management strategies and the training of appropriate skills, together with complex, multidirectional environmental support.

Intellectual development in children with type 1 diabetes Disturbances in glucose metabolism during childhood may have a lasting negative effect on the development of the brain and related cognitive functions. To optimize intellectual development in children with type 1 diabetes, it is essential to prevent disorders of the central nervous system by maintaining close to normal glycemic levels. Based on the performed literature review, it seems necessary to take additional actions, including repeated neuropsychological evaluation with early detection of cognitive dysfunctions, followed by the development of individual management strategies, and the training of appropriate skills, together with complex, multidirectional environmental support.

Neuropsychological Aspects of Children's Somatic Disorders in Chronic Diseases: Diabetes and Short Stature in the Developmental Period.

Intellectual functioning studies carried out amongst children indicate that chronic diseases like type 1 diabetes and growth hormone deficiency (GHD), may, but do not necessarily, result in intellectual loss. Cognitive functions may decline as a child becomes older, as a disease persists over time and/or due to non-compliance with treatment recommendations or high stress levels. This study aimed to assess the cognitive functioning of children and youths with T1D and GHD-related short stature compared to healthy children. METHODS: The study was carried out on 88 children with type 1 diabetes, 38 children suffering from short stature caused by (GHD), as well as a control group comprising 40 healthy children. Weschler's tests were applied to measure intellectual and cognitive functions. RESULTS: The results suggest that for children suffering from type 1 diabetes and short stature, their chronic childhood diseases per se do not impair cognitive development. It was observed that the higher the age of chronically ill children and the longer the disease persists, the lower their scores in individual cognitive subtests. For healthy children, age is correlated with the acquisition of particular skills and higher scores in specific subtests. CONCLUSIONS: On the basis of qualitative analysis of the cognitive functions subject to the study and close clinical observation of chronically ill children, we have been able to conclude that chronic diseases may alter cognitive functioning.

Psychosomatic symptoms associated with traumatic events experienced in medical students.

OBJECTIVES: Many facts indicate the important role of psychosomatic symptoms that occur due to traumatic events. This study is an analysis of the coexistence of psychosomatic symptoms and traumatic events. Though not every person taking part in these events develops a fully symptomatic post-traumatic stress disorder (PTSD), psychosomatic symptoms with a strong psychological component are observed in many. This study focuses on a comparison of the intensity of somatization, anxiety, depression, and distress of medical university students, who encountered a traumatic event and those who have not experienced trauma. MATERIAL AND METHODS: The data was collected from 594 students of different academic majors at the Poznan University of Medical Sciences, Poland. The participants were asked if they had experienced situations that caused psychological trauma as well as about the intensity of their psychosomatic symptoms. The data was collected with 2 questionnaires: Post-traumatic Stress Diagnostic Scale and Four-Dimensional Symptom Questionnaire. RESULTS: The study reveals that 78% of students experienced a traumatic event, in 15% moderate and severe symptoms of PTSD are observed, 45% presents average and high stress levels, 23% experiences symptoms of depression, whereas 30% has anxiety and 26% somatic symptoms. CONCLUSIONS: Studies show that experiencing traumatic events in life is linked to the higher intensity of an/the entire range of psychosomatic symptoms. Int J Occup Med Environ Health. 2023;36(5):606-17.

Mental Health Outcomes Associated with COVID-19 Pandemic in a Group of Health Care Professionals.

Analysis of health care workers' stress levels during the COVID-19 virus pandemic, and whether there is a relationship between health care workers' stress levels and mental health in the context of coping with stress. One hundred and seventy professionally active health care workers took part in the study: doctors (n=41), nurses (n=114) and paramedics (n = 15). On average, study subjects were 37 years old and had 14 years of work experience. The following were used in this questionnaire-based study: General Health Questionnaire (GHQ-28), Perceived Stress Scale (PSS-10), Mini-COPE - Coping Inventory. The research group experienced high levels of stress. Nurses experienced the most acute stress. Increasing stress levels are accompanied by an intensification of psychopathological symptoms (insomnia and depression). Older individuals and those with more years worked at work experienced less psychopathological symptoms. Non-adaptive stress coping methods (e.g. use of psychoactive substances) resulted in deteriorating mental health within the research group. Habitual use of non-adaptive strategies may bring relief in the short term in the form of reduced negative consequences of stress transactions and facilitate mobilisation or just sufficient performance at work. However, in the longer term, it may lead to deteriorating health. The obtained data shows that positive reinterpretation, age and length of work track record constitute protective factors against deteriorating health.

Maternal anxiety in relation to growth failure and growth hormone treatment in children.

Health disorders in mothers and their children are subject to mutual influences arising from the nature of mother-child relationship. The aim of the study was to analyze the issue of anxiety amongst mothers of short children in aspect of growth hormone (GH) therapy in Poland.The study was based on a group of 101 mothers of originally short-stature children: 70 with GH deficiency treated with recombinant human GH and 31 undergoing the diagnostic process, without any treatment. Collected medical data included the child's gender, height and weight, chronological age, bone age delay, and GH therapy duration. For all children the height SDS (standard deviation score of height) and BMI SDS (standard deviation score of body mass index) were calculated. The Spielberger State-Trait Anxiety Inventory (STAI) was used to evaluate anxiety levels among the recruited mothers. Obtained results revealed low trait anxiety levels in all mothers, with no statistically significant differences between the groups. State anxiety levels were significantly higher in mothers of children without diagnosis and treatment than in mothers of children receiving appropriate therapy. Significantly lower levels of maternal state anxiety were observed during the first stage of the GH therapy, and they were further reduced in mothers of children treated for more than 4 years.Growth failure in Polish children is not associated with high maternal anxiety as a personality trait, but lack of diagnosis and lack of appropriate treatment seem to generate high levels of anxiety as a transient state in mothers. The initiation of GH therapy induces a substantial reduction of maternal state anxiety, and the duration of this treatment causes its further decrease. Mothers of short children undergoing diagnostic process could benefit from psychological support, but it seems to be unnecessary when their children are treated with GH.

Changes in cognitive functions in a girl with severe acquired hypothyroidism in comparison to the healthy twin sister.

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Attention and memory impairments in pediatric patients with cystic fibrosis and inflammatory bowel disease in comparison to healthy controls.

The main aim of the study was to analyze and compare attention and memory performance in pediatric patients with cystic fibrosis (CF), inflammatory bowel disease (IBD) and in healthy controls. 28 patients with CF, 30 patients with IBD and 30 healthy subjects took part in the study (all in age range of 7-17). All subjects were in intellectual norm. To analyze the functioning of attention, the d2 Test of Attention by Brickenkamp (d2 test) was applied. Memory performance was assessed using the Benton Visual Retention Test (BVRT) and the Trial of 10 words. The CF and IBD groups committed significantly more errors in the d2 test than the healthy controls. The CF group also had significantly higher fluctuation rates and received significantly lower scores in overall concentration performance than the control group. Patients with CF made more mistakes and had fewer correct memory projections in BVRT than the healthy controls. Patients with IBD committed significantly more errors in BVRT than the control group. Patients with CF and IBD also got significantly lower scores in the Trial of 10 words than the control group. Pediatric patients with CF and IBD performed more poorly than the healthy controls on attention and memory tests. More distinct cognitive impairments were observed in the CF group. Further research is needed to find the underlying mechanisms and clinical and/or functional significance of observed cognitive deficits.

Reduced iron parameters and cognitive processes in children and adolescents with DM1 compared to those with standard parameters.

Anemia in patients with diabetes is not scarce and may contribute to the complications of the disease. The risk of iron deficiency parameters in child sufferers of diabetes type 1, observed in studies, can lead to cognitive impairment. The aim of the study was to determine whether children and adolescents with diabetes type 1, in whom reduced ferric parameters are observed in control tests, may also show reduced cognitive performance. The study included 100 children with diabetes type 1 at the age of 6-17 years. During control tests, patients' morphological blood parameters were measured: red blood cells (RBC), hemoglobin, glycosylated hemoglobin, hematocrit, RBC volume, the molar mass of hemoglobin in RBC (MCH), mean corpuscular hemoglobin in RBC and iron concentrations in serum using flame atomic absorption spectroscopy and the Wechsler Intelligence Scale for Children (WISC-R). Results in the group of children with a diabetes type 1 significantly lower concentration of three ferric parameters affect the non-verbal intelligence measured with WISC-R. The prevalence of reduced ferric parameters justifies further screening in all children with diabetes type 1 and taking up appropriate preventive measures to reduce the risk of their occurrence.

An Assessment of the Consumption of Energy and Selected Minerals and Their Content in the Hair of Children Aged 1-4 Years.

The aim of this study was to assess the consumption of energy and selected minerals (Ca, Mg, Fe, Zn, Cu) and their content in the hair of children aged 1-4 years. Seventy-five children were divided into three age subgroups: 12-24-month-olds, 25-36-month-olds and 37-48-month-olds. The data on energy intake and consumption of nutrients were obtained by means of a nutritional interview. The content of elements in the hair was measured by means of flame atomic absorption spectrometry (AAS) with an AAS-3 spectrophotometer (Zeiss). The daily food rations of children aged 12-36 months were characterised by adequate energy value, but the values of Ca and K were too low, whereas the content of Mg, Zn and Cu was high. On the other hand, the daily food rations of children aged 37-48 months provided sufficient amounts of Mg and Zn, but the value of Cu was too high, whereas energy, Ca, K and Fe were too low. About 42.7% of the children under study were characterised by an abnormal state of nutrition. An inadequately balanced diet needs to be corrected by educating parents or guardians in appropriate nutrition. There are significant correlations (r > 0.9) between the supply of Ca in the diet of children aged 1-4 years and the content of this element in their hair.

The occurrence of iron-deficiency anemia in children with type 1 diabetes.

OBJECTIVE: A higher risk for iron deficiency, which can lead to anemia, has been noticed in children with early stages of type 1 diabetes. Anemia in diabetes is not uncommon and thus may contribute to disease complications. The aim of the study was to determine the influence of type 1 diabetes incidence on the manifestation of iron-deficiency anemia. MATERIALS AND METHODS: The study included 100 children with type 1 diabetes, aged 6 to 17 years. The diagnosis of type 1 diabetes in all patients was made on the basis of clinical symptoms and, at a later stage, on the basis of the occurrence of islet cell autoantibodies. The patients were divided into groups according to the duration of the disease: those with newly diagnosed type 1 diabetes (ND), those who have the disease for 1 to 3 years (FMD), those who have it for 4 to 6 years (SMD), and those who have it for more than 6 years (LD). Morphological parameters of blood have been measured by means of the flame atomic absorption spectrometry method: red blood cells (RBC), hemoglobin (HGB), acetylated HGB, hematocrit (HCT), RBC volume (mean corpuscular volume [MCV]), HGB mass in RBC (mean corpuscular HGB [MCH]), mean HGB content in RBC (MCH concentration), and serum iron concentration. RESULTS: In the ND children, significantly lower concentrations of HCT and HGB as well as the amount of RBC and MCV have been shown, in comparison with the children who have type 1 diabetes longer: for HGB, compared with the FMD children; for HCT, compared with the SMD and LD children; for RBC, compared with the LD children; and for MCV, compared with the SMD children. Some significant inverse correlation has been observed in the MCH concentration in comparison with the children who have type 1 diabetes for more than 1 year. It has been shown that, when compared with the FMD, SMD, and LD children, more ND children are characterized by the coexistence of at least 3 reduced values of the morphological blood parameters associated with iron-deficiency anemia (26%, 17%, 7%, and 3%, respectively). At the same time, it has been found that the mean iron concentration in the blood serum of the ND group is significantly lower than that of the SMD and LD groups. CONCLUSIONS: The incidence of anemia in the early stages of the disease justifies conducting the screening in all children with type 1 diabetes and taking appropriate preventive measures toward the patients at risk for iron-deficiency anemia.

The serum zinc, copper, iron, and chromium concentrations in epileptic children.

To assess whether epileptic children have abnormal values of some trace elements, the aim of this preliminary study was to assess the serum zinc (Zn), copper (Cu), iron (Fe), and chromium (Cr) concentrations in 23 children with initial recognition of epilepsy before beginning of pharmacological therapy in comparison with a healthy control group of 25 children, according to the gender. The study demonstrated that epilepsy decreases levels of Zn and Cr concentrations in all patients, and Fe level in girls, and increases level of Cu in all patients. The frequency distribution of these metals was significantly different in epileptic patients than in healthy subjects. There is a conclusion that status of trace elements in epileptic children needs to be monitored.

[Smoking from the perspective of positive psychology]. / Palenie papierosów z perspektywy psychologii pozytywnej.

Cigarette smoking remains a significant problem on a global scale. Positive psychology is blazing new trails in researching the mutual relation between health and disease, stressing the promotion of positive factors supporting health. The crucial point in this perspective is examining the factors, that assists healthy behaviours. The paper is an introduction to the research on the sense of happiness and emotionality in the currently cigarette addicted, never-smokers and past smokers. Studies clearly show that in people who threw smoking level of happiness and awareness of owns emotions are the highest compared to those never smokers and smokers.