History of mood and anxiety disorders affects return to work and return to sports after rotator cuff repair.

INTRODUCTION: After rotator cuff repair (RCR), return to work and return to sports is affected by various psychosocial factors. The role of one of these factors - mood and anxiety disorders (MAD) - is still not clear. The primary objective of this study was to determine the influence of prior MAD on the return to work and return to sports after RCR. Our hypothesis was that patients with a history of MAD would take longer to return to work and to sports after RCR, and the rate of return would be lower, than for patients without MAD. MATERIALS AND METHODS: This was a retrospective single-center study of patients who underwent arthroscopic RCR (distal supraspinatus tear). Patients who were employed and those who participated in sports before the surgery were included in the "working" and "sports" groups, respectively. The primary outcomes were the time to return to work and return to sports after surgery. The secondary outcomes were the ratio of patients returning to work and to sports at 3, 6 and 12 months; rate of return to same level of sports; need to change or stop working or sports. The effects of prior MAD on these various outcomes were determined using Bayesian multivariate analysis. RESULTS: The "working" group consisted of 158 patients (of which 16.5% had MAD) and the "sports" group consisted of 118 patients (of which 17.8% had MAD). In those with a history of MAD, return to work was 21±11 weeks later and the return to sports was 17±8 weeks later than in those without MAD. There was a 98% probability that return to work or return to sports was delayed by at least 4 weeks in patients with history of MAD. The likelihood that patients with prior MAD who undergo RCR will completely abandon their sport was 2.8 times higher (OR=2.8 [1; 7.8]). CONCLUSION: We found a negative influence of prior MAD on the return to work and return to sports after RCR. LEVEL OF EVIDENCE: III; retrospective case-control study.

Link between excessive social media use and psychiatric disorders.

Mental health disorders are an emerging challenge with the progressively increasing usage of social media platforms. Social media use is the second leading cause of disability among psychiatric disorders. A great deal of literature has tried to establish links between social media exposure and mental health diseases. However, there is a need to discuss the current literature that presents crucial perspectives on social media-induced psychiatric disorders to establish a holistic, evidence-based approach for their prevention and treatment. The use of social networks is strongly correlated with the development of anxiety and other psychological problems such as depression, insomnia, stress, decreased subjective happiness, and a sense of mental deprivation. The majority of the cited literature predicts that the likelihood of social media-induced mental health problems is directly proportional to the amount of time spent on these sites, the frequency of usage, and the number of platforms being used. Various possible explanations have been implicated, including a negative impact on self-esteem through unhealthy comparisons, social media burnout, stress, lack of emotional regulation due to social media preoccupation, and development of social anxiety due to decreased real-life social interactions. It has been postulated that increased social media use is driven by preexisting anxiety and is a coping strategy. This era of progressively increasing digitalization, the recent trend of a dramatic shift toward online social life, and the desire to get social attention is expected to take a gruesome toll on the population's mental health, which therefore warrants more attention to mental health care.

History of mood and anxiety disorders does not affect the outcomes of arthroscopic rotator cuff repair.

BACKGROUND: A pre-existing mood and anxiety disorder (MAD) is often present in patients with rotator cuff pathology, but its presumed negative effect on the outcomes has not been demonstrated. AIM OF STUDY AND HYPOTHESIS: The primary objective of this study was to evaluate how a history of MAD affects the clinical outcomes 1 year after arthroscopic rotator cuff repair (RCR). The secondary objectives were to evaluate how a history of MAD affects tendon healing, analgesic consumption and the occurrence of complications. MATERIALS AND METHODS: The study population consisted of 219 patients (mean age 54.5±6.6 years) who underwent arthroscopic repair for a distal supraspinatus tendon tear, with 17% (38/219) presenting an history of MAD (depression, unspecified mood disorder, anxiety, and bipolar disorder). Using univariate and multivariate analyses, the joint range of motion, Constant score, analgesic consumption, occurrence of complications during the first postoperative year and tendon healing at 1 year (MRI or CT arthrography) were compared between the two groups (with or without MAD). RESULTS: The Constant score was lower preoperatively in patients with history of MAD (-4 points, p=.04) but there were no significant differences between the two groups at the various postoperative follow-up time points (p>.05). No significant difference was found between the two groups of patients in their analgesic consumption at the various postoperative time points (p>.05), tendon healing at 1 year (p=.17) or the occurrence of postoperative complications (p=.59). DISCUSSION/CONCLUSION: Pre-existing MAD had no effect on the clinical outcomes after arthroscopic RCR at 1 year and no effect on tendon healing, analgesic consumption or the occurrence of complications in our study population. LEVEL OF EVIDENCE: III; retrospective case-control study.

Prevalence and determinants of psychosocial disorders in children and adolescents with asthma in Enugu, Nigeria: a comparative cross-sectional study.

OBJECTIVE: Like most chronic illnesses, childhood asthma has a significant impact on the child's overall psychosocial well-being. Psychosocial disorders occur in children with uncontrolled asthma making their asthma control more difficult. We aimed to determine the prevalence and determinants of psychosocial disorders in children and adolescents with asthma. METHODS: A comparative cross-sectional study of children and adolescents (aged 6 to 17 years with and without asthma) was conducted in a Nigerian tertiary health facility. The Revised Children Manifest Anxiety Scale (RCMAS) and Center for Epidemiological Studies-Depression Scale for Children (CES-DC) were used to screen for anxiety and depression respectively. RESULTS: A total of 190 (95 asthma and 95 non-asthma) children were studied. Anxiety occurred in 15 (15.8%) of asthma and four (4.2%) of non-asthma children, OR 95% CI =4.3 (1.4-13.4). Forty-five (47.4%) of asthma and 32 (33.7%) of non-asthma children had depression (OR 95% CI =1.8 (0.9-3.2). Asthma was significantly associated with social problems such as difficulty in making friends (OR 95% CI = 58.5 (3.5-979.9); restriction from daily activities (OR 95% CI =34.0 (2.0-578.5); stigma from peers (OR 95% CI = 18.6 (1.1-326.2); and strengthened and overprotective relationship with parents, (OR 95% CI = 26.0 (1.5-447.8). Poor asthma control was significantly associated with restriction from play, OR (95%CI) = 0.12 (0.04-0.32); anxiety, OR 95%CI = 18.26 (3.80-87.76) and depression, OR 95%CI = 4.57 (1.85-11.33). CONCLUSIONS: Children with asthma are more prone to psychosocial disorders than their non-asthma counterparts. Poor asthma control influenced the psychosocial well-being of children with asthma negatively.

The incidence and causes of acute hospitalizations and emergency room visits in adolescents with type 1 diabetes mellitus prior to and during the COVID-19 pandemic: a single-centre experience.

INTRODUCTION: Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases in childhood. Because acute glycaemic com-plications account for most concerns in the management of T1DM in children, special attention during the challenging time of the global COVID-19 pandemic is required to prevent deteriorations resulting in acute hospitalization. AIM OF THE STUDY: is to assess how the COVID-19 pandemic influenced the incidence and causes of acute hospitalizations and emergency room visits in adolescents with established type 1 diabetes mellitus, and to characterize the admitted population. MATERIAL AND METHODS: The study was conducted as a retrospective evaluation of acute hospitalizations of 39 T1DM patients between 15 and 17 years of age in the period 2018-2021. RESULTS: No difference was noted in the incidence of acute hospitalizations and DKA or the biochemical parameters of adolescents with T1DM between the pre-COVID (23 patients in 2018-2019) and COVID period (16 patients in 2020-2021). It is, howev-er, worth underlying that 6/11 (55%) patients hospitalised in 2021 experienced diabetes deterioration as a result of emo-tional distress - a phenomenon that was not present in the pre-COVID era. After excluding of the hospitalizations due to psy-chosocial causes, a significant decrease in the number of acute hospitalizations in the COVID period was observed. CONCLUSIONS: We suppose that increased parental supervision during the pandemic might have prevented some of the episodes of severe disease decompensation, but this was masked by the sharp increase in hospitalizations due to emotional distress. Our data confirmed that psycho-emotional status is an important factor in the treatment of T1DM.

A review of burn symptoms and potential novel neural targets for non-invasive brain stimulation for treatment of burn sequelae.

Burn survivors experience myriad associated symptoms such as pain, pruritus, fatigue, impaired motor strength, post-traumatic stress, depression, anxiety, and sleep disturbance. Many of these symptoms are common and remain chronic, despite current standard of care. One potential novel intervention to target these post burn symptoms is transcranial direct current stimulation (tDCS). tDCS is a non-invasive brain stimulation (NIBS) technique that modulates neural excitability of a specific target or neural network. The aim of this work is to review the neural circuits of the aforementioned clinical sequelae associated with burn injuries and to provide a scientific rationale for specific NIBS targets that can potentially treat these conditions. We ran a systematic review, following the PRISMA statement, of tDCS effects on burn symptoms. Only three studies matched our criteria. One was a feasibility study assessing cortical plasticity in chronic neuropathic pain following burn injury, one looked at the effects of tDCS to reduce pain anxiety during burn wound care, and one assessed the effects of tDCS to manage pain and pruritus in burn survivors. Current literature on NIBS in burn remains limited, only a few trials have been conducted. Based on our review and results in other populations suffering from similar symptoms as patients with burn injuries, three main areas were selected: the prefrontal region, the parietal area and the motor cortex. Based on the importance of the prefrontal cortex in the emotional component of pain and its implication in various psychosocial symptoms, targeting this region may represent the most promising target. Our review of the neural circuitry involved in post burn symptoms and suggested targeted areas for stimulation provide a spring board for future study initiatives.

Impact of Psychosocial Profile on Alopecia Areata in Pediatric Patients: A Case Control Study from A Tertiary Care Hospital in Eastern Uttar Pradesh.

BACKGROUND: Alopecia areata (AA) is a common form of nonscarring alopecia characterized by patchy loss of hair from the scalp and body. It is a complex outcome of factors such as autoimmunity, genetic factors, infectious diseases, as well as psychological factors, such as stress, personality type, familial conditions. Around 20% of patients are in the pediatric age group, and 60% of the patients develop AA before the age of 20 years. AIM: The present study looked into the impact of psychosocial factors in AA. MATERIALS AND METHODS: This was a case-control study conducted over a period of 1 year. One hundred and two patients and age and gender-matched control group between the ages of 2 and 14 years were included. A questionnaire was administered to identify the stress arising due to personal or familial conditions, school-related issues, psychotrauma or illness, and accidents prior to developing AA. Age and gender-matched patients with other dermatoses with low psychosomatic component to it and unlikely to be influenced by stress were selected as control. RESULT: Fifty-three patients (52 %) were male and 49 were female (48 %). Fifty-five (53.9%) patients were in the age group of 10 to 14 years. Forty (39.2%) children had multiple patches. Onset was <5 months in 30 patients (29.4%). Forty-nine (48%) children reported stress due to school-related issues compared to 13 (12.7%) in the control group. Eighteen (17.6%) children had familial issues compared to 6 (0.05%) in the control group. Nineteen children (18.6%) had multiple stressors. Sixty-nine (67.6%) patients related their disease to a stress component compared to 33 (32.3%) who could not relate to any stress. A significant association was noted between examination pressure and academic performance with onset of AA compared to control (P < 0.05%), which was stronger among female compared to male. CONCLUSION: The psychological profile and comorbidities have a significant impact on the onset or recidivism of AA. Impact of a stressful personal or family life, parental pressure to perform better in school, and psychological vulnerability can significantly contribute to the onset or exacerbation of AA.

El embarazo en la adolescencia desde las perspectivas salud y sociedad / Adolescence pregnancy from the viewpoint health and society

Introducción: la gestación en la adolescencia continúa siendo un problema importante para los profesionales de la salud, ya que el embarazo en este período tiene importantes consecuencias sociales y de salud sobre la madre adolescente y su hijo. Objetivo: analizar la repercusión del embarazo en la adolescencia desde las perspectivas de salud y sociedad. Métodos: teóricos, con un enfoque socio-histórico y lógico en el análisis y síntesis documental relacionada con las diversas revisiones realizadas a literaturas nacionales e internacionales. Conclusiones: el embarazo en la adolescencia constituye un problema social vigente y en ascenso, con serias afectaciones sobre la salud y calidad de vida de este grupo poblacional, cuyo impacto es psicosocial, por lo que se necesita un abordaje integral por un equipo interdisciplinario capacitado en la atención de los adolescentes, en específico, de la maternidad-paternidad responsable(AU)

Introduction: The gestation in adolescence continuous is being an important problem for professionals of health because pregnancy on this period has important social and vital consequences for the adolescent mother and her child. Objective: To analyze impact of adolescence pregnancy from the viewpoint health and society. Methods: Theoretical methods were used, with a historical and logical approach in the documentary analysis and synthesis related to different bibliographical revisions made to national and international literatures Conclusions: We can finish that pregnancy in adolescence constitute today a valid social problem and continuous growing with serious affectations on health and quality of life of this population group, impact of adolescent pregnancy is psychosocial for that attention is necessary an integral boarding by a disciplinant and qualified team on attention of adolescents and in this specific aspect of responsible motherhood-paternity(AU)

El embarazo en la adolescencia desde las perspectivas salud y sociedad / Adolescence pregnancy from the viewpoint health and society

Introducción: la gestación en la adolescencia continúa siendo un problema importante para los profesionales de la salud, ya que el embarazo en este período tiene importantes consecuencias sociales y de salud sobre la madre adolescente y su hijo. Objetivo: analizar la repercusión del embarazo en la adolescencia desde las perspectivas de salud y sociedad. Métodos: teóricos, con un enfoque socio-histórico y lógico en el análisis y síntesis documental relacionada con las diversas revisiones realizadas a literaturas nacionales e internacionales. Conclusiones: el embarazo en la adolescencia constituye un problema social vigente y en ascenso, con serias afectaciones sobre la salud y calidad de vida de este grupo poblacional, cuyo impacto es psicosocial, por lo que se necesita un abordaje integral por un equipo interdisciplinario capacitado en la atención de los adolescentes, en específico, de la maternidad-paternidad responsable(AU)

Introduction: The gestation in adolescence continuous is being an important problem for professionals of health because pregnancy on this period has important social and vital consequences for the adolescent mother and her child. Objective: To analyze impact of adolescence pregnancy from the viewpoint health and society. Methods: Theoretical methods were used, with a historical and logical approach in the documentary analysis and synthesis related to different bibliographical revisions made to national and international literatures Conclusions: We can finish that pregnancy in adolescence constitute today a valid social problem and continuous growing with serious affectations on health and quality of life of this population group, impact of adolescent pregnancy is psychosocial for that attention is necessary an integral boarding by a disciplinant and qualified team on attention of adolescents and in this specific aspect of responsible motherhood-paternity(AU)

Occupational Stress, Salivary Cortisol, and Periodontal Disease: A Clinical and Laboratory Study.

BACKGROUND: Periodontitis is a multifactorial disease, commonly associated with most of the lifestyle diseases. In the recent years, the association between periodontitis with occupational stress has evolved in various studies in many developed settings. This study aims at studying the prevalence of periodontal disease and its relationship with job stress among industrial labor workers covered under Employee's State Insurance Corporation Scheme. MATERIALS AND METHODS: The study included 180 subjects who were informed about the research goals, and also requested to sign consents. The questionnaire included parts from the generic job stress questionnaire from the National Institute of Job Stress and Health. Dental examinations based on community periodontal index protocol were done using WHO probe. Participants with moderate to severe periodontitis (score 3, 4) were informed about the salivary cortisol test. The saliva samples were collected and transported to the lab. Data were entered in EPI info 3.1.1 and analyzed in SPSS 14. The Chi-square analysis was done to measure association, and logistic regression analysis was done to identify the independent association of job stress to periodontitis. RESULTS: The study shows that 48% of the participants reported to have job stress, and 55% had periodontitis. The mean salivary cortisol level was 3.42 ng/dl. The results also indicated a higher odds of having low levels of salivary cortisol among those who reported job stress. Bi-variant regression analyses show the relationship of periodontitis with job stress to be much higher on controlling for other risk factors. The odds of having periodontitis in relation to positive job stress were 6 times higher than those who did not have positive job stress. CONCLUSIONS: This study shows a high prevalence of job stress related periodontitis among industrial workers in India. This research recommends the health and labor ministry to improve access to dental care especially in rural areas and include psychiatric units and oral health care as a part of primary health care. The factories administration should encourage recreation and retreat of the workers so as to reduce the level of stress at work. The factory administrations were recommended to have counselors to help their employees.