Tic Group Research Articles

Telemedicine Integrated Care Versus In-Person Care Mode for Patients With Short Stature: Comprehensive Comparison of a Retrospective Cohort Study.

Telemedicine has demonstrated efficacy as a supplement to traditional in-person care when treating certain diseases. Nevertheless, more investigation is needed to comprehensively assess its potential as an alternative to in-person care and its influence on access to care. The successful treatment of short stature relies on timely and regular intervention, particularly in rural and economically disadvantaged regions where the disease is more prevalent. This study evaluated the clinical outcomes, health-seeking behaviors, and cost of telemedicine integrated into care for children with short stature in China. Our study involved 1241 individuals diagnosed with short stature at the pediatric outpatient clinic of Peking University Third Hospital between 2012 and 2023. Patients were divided into in-person care (IPC; 1183 patients receiving only in-person care) and telemedicine integrated care (TIC; 58 patients receiving both in-person and virtual care) groups. For both groups, the initial 71.43% (average of 58 percentages, with each percentage representing the ratio of patients in the treatment group) of visits were categorized into the pretelemedicine phase. We used propensity score matching to select individuals with similar baseline conditions. We used 7 variables such as age, gender, and medical insurance for the 1:5 closest neighbor match. Eventually, 115 patients in the IPC group and 54 patients in the TIC group were selected. The primary clinical outcome was the change in the standard height percentage. Health-seeking behavior was described by visit intervals in the pre- and post-telemedicine phases. The cost analysis compared costs both between different groups and between different visit modalities of the TIC group in the post-telemedicine phase. In terms of clinical effectiveness, we demonstrated that the increase in height among the TIC group (ΔzTIC=0.74) was more substantial than that for the IPC group (ΔzIPC=0.51, P=.01; paired t test), while no unfavorable changes in other endpoints such as BMI or insulin-like growth factor 1 (IGF-1) levels were observed. As for health-seeking behaviors, the results showed that, during the post-telemedicine phase, the IPC group had a visit interval of 71.08 (IQR 50.75-90.73) days, significantly longer than the prior period (51.25 [IQR 34.75-82.00] days, P<.001; U test), whereas the TIC group's visit interval remained unchanged. As for the cost per visit, there was no difference in the average cost per visit between the 2 groups nor between the pre- and post-telemedicine phases. During the post-telemedicine phase, within the TIC group, in-person visits had a higher average total cost, elevated medical and labor expenses, and greater medical cost compared with virtual visits. We contend that the rise in medical visits facilitated by integrating telemedicine into care effectively restored the previously constrained number of medical visits to their usual levels, without increasing costs. Our research underscores that administering prompt treatment may enable physicians to seize a crucial treatment opportunity for children with short stature, thus attaining superior results.

Predictive value of systemic immune inflammation index combined with coagulation index in traumatic coagulopathy in patients with severe trauma

Summary Background: To explore the predictive value of systemic immune inflammation index combined with coagulation index in traumatic coagulation disease (TIC) in patients with severe trauma. Methods: The clinical data of patients with severe trauma treated in our hospital from January 2022 to December 2022 were retrospectively selected. According to the outcome of TIC, the patients were divided into TIC group and non-TIC group, TIC group (n = 50) and non-TIC group (n = 50). The general data, SII and individual indexes of the two groups were compared, and the influencing factors of TIC were analyzed by multivariate Logistics regression. ROC analysis of systemic immune inflammation index combined with blood coagulation index to predict traumatic coagulation in patients with severe trauma. Results: There was no significant difference in general data between the two groups. SII in TIC group was significantly higher than that in non-TIC group. NEU, PLT count, APTT, FIB D and PT in TIC group were higher than those in non-TIC group, while LYM, FIB was lower than that in non-TIC group. Logistics regression analysis showed that APTT, D-Dimer, FIB, PT and SII were independent influencing factors of TIC in patients with severe trauma. The area under the curve of TIC in patients with severe trauma with SII combined with coagulation index was 0.883, and the standard error was 0.032 (95%CI:0.8195~0.9461). The best cut-off value was 0.65.The sensitivity and specificity were 80.3, 84.2 respectively. Conclusions: SII combined with coagulation index has high predictive value for TIC in patients with severe trauma. By monitoring these indexes, we can more accurately predict the occurrence of TIC and take effective treatment measures in time.

Ticagrelor, but Not Clopidogrel, Attenuates Hepatic Steatosis in a Model of Metabolic Dysfunction-Associated Steatotic Liver Disease.

Previous studies have suggested that platelets are associated with inflammation and steatosis and may play an important role in liver health. Therefore, we evaluated whether antiplatelet agents can improve metabolic disorder-related fatty liver disease (MASLD). The mice used in the study were fed a high-fat-diet (HFD) and were stratified through liver biopsy at 18 weeks. A total of 22 mice with NAFLD activity scores (NAS) ≥ 4 were randomly divided into three groups (HFD-only, clopidogrel (CLO; 35 mg/kg/day), ticagrelor (TIC; 40 mg/kg/day) group). And then, they were fed a feed mixed with the respective drug for 15 weeks. Blood and tissue samples were collected and used in the study. The TIC group showed a significantly lower degree of NAS and steatosis than the HFD group (p = 0.0047), but no effect on the CLO group was observed. Hepatic lipogenesis markers' (SREBP1c, FAS, SCD1, and DGAT2) expression and endoplasmic reticulum (ER) stress markers (CHOP, Xbp1, and GRP78) only reduced significantly in the TIC treatment group. Inflammation genes (MCP1 and TNF-α) also decreased significantly in the TIC group, but not in the CLO group. Nile red staining intensity and hepatic lipogenesis markers were reduced significantly in HepG2 cells following TIC treatment. Ticagrelor attenuated NAS and hepatic steatosis in a MASLD mice model by attenuating lipogenesis and inflammation, but not in the CLO group.

The Effect of Different Ageing Protocols on the Shear Bond Strength of the Ceromer Indirect Composite on Two Different Substructure Materials.

The evolution of restorative materials in prosthodontics has led to the emergence of indirect composite resins, including ceromers, as alternatives to traditional metal-ceramic restorations. However, research gaps exist regarding the impact of ageing protocols on the bond strength of ceromer composites to different metal substructures, necessitating further investigation in this area. This study aimed to determine the effect of five different ageing protocols on the shear bond strength (SBS) of ceromer indirect composites on two different substructures. In this in vitro study, 120 metallic discs (10 × 2 mm) were cast from cobalt-chromium (Co-Cr) alloy (n = 60) and spark erosion treated from grade V titanium (n = 60). Each sample was sandblasted. The M.L. primer (Shofu, Germany) and layers of opaque were applied to the surface following the manufacturer's instructions. A special jig (6 × 2 mm) was placed on each disc. The ceromer was condensed in it and light-cured separately for 90 s. Following polishing, specimens were separated into five ageing groups: distilled water (as a control), thermal cycling, tea, coffee, and gastric acid immersion. All samples were placed in 37°C incubation for 28 days for distilled water, coffee, and tea, and 7 days for gastric acid immersion and thermal cycling for 5000 cycles (5-55°C). A universal test machine was used to measure the SBS. The samples were evaluated for failure modes using stereomicroscopy. Data were analyzed using one-way analysis of variance (ANOVA) (P < 0.05). According to one-way ANOVA, the mean SBS (MPa) between the two groups was compared in each ageing protocol, and there were no significant differences between the Co-Cr-C and Ti-C groups (P > 0.05). The most frequent mode of failure in all groups was mixed. Applying the ageing protocols, the type of substructure material had no significant effect on the SBS of the ceromer indirect composite except for tea immersion.

Cytokine levels reflect tic symptoms more prominently during mild phases

Tic disorder is a neuropsychiatric condition that affects 3% of all children and can have a significant impact on their quality of life. Cytokines, interferons, interleukins, lymphokines, and tumor necrosis factors are involved in the neuroinflammatory circuitry of tic disorders. This study aimed to identify the cytokines involved in the pathogenesis of tic disorders. We enrolled 44 patients with tic disorder and 38 healthy controls. Patients were free of psychotropic medications for at least 3 weeks. Whole blood samples were analyzed using a Luminex® human cytokine multiplex assay kit. Patients were divided into groups with “mild tics” and “above moderate tics” based on Yale Global Tic Severity Scale (YGTSS) scores for comparison. The final analysis included 35 patients (28 male and 7 female) and 31 controls (20 male and 11 female). In the mild tic group, interleukin (IL)-12 p70 negatively correlated with motor tic scores. Granulocyte-macrophage colony-stimulating factor, IL-4, IL-8, and tumor necrosis factor (TNF)-α were positively correlated to phonic tic scores. IL-12 p40 and TNF-α were positively correlated to total tic scores. IL-12 p70 and IL-17a negatively correlated to impairment scores and total YGTSS scores. Tic disorder patients and healthy controls exhibit different cytokine profiles. Only patients with mild symptoms exhibit significant correlations, suggesting that the correlations between cytokine levels and tic symptoms are more relevant during the mild or remission phases. Our results present the importance of IL-1β and TNF-α, among others, but the identification of key cytokines are still necessary.

Benefit of Catheter Ablation for Atrial Fibrillation in Heart Failure Patients with Different Etiologies.

(1) Background: A plethora of studies have elucidated the safety and efficacy of catheter ablation (CA) for patients afflicted with atrial fibrillation (AF) and concomitant reduction in left ventricular ejection fraction (LVEF). Nevertheless, the literature on the benefits of CA in the specific etiological context of heart failure (HF) remains limited. This study delineates a comparative assessment of outcomes for patients with AF and reduced LVEF across the primary etiologies. (2) Methods: Our inquiry encompassed 216 patients diagnosed with congestive heart failure and an LVEF of less than 50 percent who were referred to our institution for circumferential pulmonary vein isolation (CPVI) between the years 2016 and 2020. The selection criteria included a detailed medical history while excluding those suffering from valvular disease, congenital heart disease, and hypertrophic cardiomyopathy. In an effort to scrutinize varying etiologies, patients were stratified into three categories: dilated cardiomyopathy (DCM, n = 56, 30.6%), ischemic cardiomyopathy (ICM, n = 68, 37.2%), and tachycardia-induced cardiomyopathy (TIC, n = 59, 32.2%). (3) Results: Following an average (±SD) duration of 36 ± 3 months, the prevalence of sinus rhythm was 52.1% in the DCM group, 50.0% in the ICM group, and 68.14% in the TIC group (p = 0.014). This study revealed a significant disparity between the DCM and TIC groups (p = 0.021) and the ICM and TIC groups (p = 0.007), yet no significant distinction was discerned between the TIC and ICM groups (p = 0.769). Importantly, there were no significant variations in the application of antiarrhythmic drugs or recurrence of procedures among the three groups. The mortality rates were 14.29% for the DCM group and 14.71% for the ICM group, which were higher than the 3.39% observed in the TIC group (DCM vs. TIC p = 0.035 (HR = 4.50 (95%CI 1.38-14.67)), ICM vs. TIC p = 0.021 (HR = 5.00 (95%CI 1.61-15.50))). A noteworthy enhancement in heart function was evidenced in the TIC group in comparison to the DCM and ICM groups, including a higher LVEF (p < 0.001), diminution of LV end-diastolic diameter (p < 0.001), and an enhanced New York Heart Association classification (p = 0.005). Hospitalization rates for heart failure were discernibly lower in TIC patients (0.98 (0,2) times) relative to those with DCM (1.74 (0,3) times, p < 0.01) and TIC (1.78 (0,4) times, p < 0.001). Patients with paroxysmal atrial fibrillation and brief episodes were found to achieve superior clinical outcomes through a catheter ablation strategy. (4) Conclusion: Patients diagnosed with TIC demonstrated a more pronounced benefit from catheter ablation compared to those with DCM and ICM. This encompassed an augmented improvement in cardiac function, an enhanced maintenance of sinus rhythm, and a reduced mortality rate.

Comparison of Ticagrelor Monotherapy and Ticagrelor plus Aspirin Among Patients with Acute Coronary Syndrome Combined with High-Risk of Gastrointestinal Bleeding after PCI: a Retrospective Cohort Study.

No studies to date have specifically examined the efficacy of P2Y12 inhibitor monotherapy in acute coronary syndrome (ACS) patients exhibiting a high risk of gastrointestinal (GI) bleeding following percutaneous coronary intervention (PCI). This was a retrospective cohort study of ACS exhibiting a high GI bleeding risk after PCI admitted to the Affiliated Hospital of Jiangnan University from August 2016-December 2019. Of the 308 enrolled patients, 269 were found eligible and were assigned to the ticagrelor monotherapy (TIC) arm (n=128) and to ticagrelor plus aspirin(TIC+ASP) arm (n=141) treatment for a 1-year period. The primary study outcome was a composite endpoint including bleeding academic research consortium (BARC) type 2, 3, or 5 bleeding and adverse cardiac or cerebrovascular events. 8 (6.3%) in the TIC group and 14 (9.9%) in the combination treatment group reached the primary ischemic endpoint within 1 year with no significant difference between these groups. BARC type 2/3/5 bleeding events affected significantly more patients in the combination group relative to the TIC group (38[27.0%] vs 11[8.6%], P <0.001). As the follow-up interval was prolonged, the cumulative BARC type 2/3/5 bleeding incidence in the TIC group remained significantly below that in the combination treatment group (P<0.05). These results indicate that TIC is associated with a lower risk of clinically relevant bleeding events among ACS with a high risk of GI bleeding after PCI relative to combination TIC+ASP treatment, while ischemic outcomes in these two groups were similar.

Echocardiographic pattern of left ventricular function recovery in tachycardia-induced cardiomyopathy patients

Abstract Background Tachycardia-induced Cardiomyopathy (TIC) represents a reversible type of cardiomyopathy (CM) that is underdiagnosed. Prior pilot studies suggested a specific left ventricular (LV) function recovery pattern in TIC patients. Cardiac chamber remodeling in TIC, however, remains incompletely understood. Purpose We aimed to explore differences in LV dimensions and functional recovery in TIC patients when compared to a control group of patients with other forms of CM and functional recovery. Methods We identified patients with reduced left ventricular ejection fraction (≤50%) and/or atrial fibrillation or flutter treated between 2015 and 2022. Patients had at least two serial transthoracic echocardiographies (TTE). The minimal interval between the TTEs had to be at least 3 months, and the left ventricular ejection fraction (LVEF) had to either improve (≥15% in absolute value) or normalize (LVEF at follow-up ≥50%). Patients were then divided into two groups: A) patients with atrial fibrillation or atrial flutter at baseline and sinus rhythm at follow-up. These patients were assumed to have TIC. B) Patients with sinus rhythm at both baseline and follow-up, consisting of patients with other forms of CM. The change in ventricular dimensions and function (indexed left ventricular end-systolic – LVESDI, end-diastolic diameters – LVEDDI – and volumes – LVEDVI, LVEF, and fractional shortening – FS) were compared within and across group A and B at baseline and at follow-up. The groups were compared using Kruskal (for independent data) and Wilcoxon (for paired data) tests. A p&amp;lt;0.05 was considered significant. Results A total of 261 patients were included (34% female, median age 68 years). The median time between TTEs was 25 months. 104 (39.8%) patients were considered to suffer from TIC and 157 (60.2%) patients were considered to suffer from other forms of CM. The changes in ventricular dimensions and function in both groups are shown in Figure 1 and Table 1. The TIC group showed no improvement in LVEDVI from baseline to the follow-up examination, while the control group showed significant improvement in LVEDVI (1.7% [−24.7, 22.8] vs. 12.4% [−7.1, 29.3], p=0.008). There was no difference in LVEDDI recovery between TIC and control patients (1.7% [−7.3, 10.3] versus 3.1% [−5.4, 10.2], p=0.578). Conclusions TIC patients have a specific pattern of functional recovery with similar improvements in systolic function and diameters compared with patients with other CMs, while diastolic parameters remained impaired. Funding Acknowledgement Type of funding sources: None.

Rapid onset functional tic-like behaviours in children and adolescents during COVID-19: Clinical features, assessment and biopsychosocial treatment approach.

AimTo report the prevalence and clinical characteristics of children with rapid onset functional tic‐like behaviours during the COVID‐19 pandemic.MethodsSingle centre, retrospective cohort study of children (<18 years) referred to the tic clinic from January 2018 to July 2021. We calculate the prevalence of newly diagnosed functional tics, and compare the clinical features to chronic tic disorder/Tourette syndrome (CTD/TS).ResultsA total of 185 new patients were referred to the tic clinic between 2018 and 2021. There was a significant increase in the percentage of functional tics in 2020 and 2021 (2% in 2018, 5.6% in 2019, 10.6% in 2020 and 36% in 2021). Differences between functional tics (n = 22) and CTD/TS (n = 163) include female predominance (100 vs. 28%, P < 0.0001), later age of onset (mean age 13.8 vs. 6.8 years, P < 0.0001) and higher rates of anxiety/depression (95 vs. 41%, P < 0.0001). The functional tic group were more likely to present with coprolalia‐like behaviours (77 vs. 10%, P < 0.0001), complex phrases (45 vs. 0.6%, P < 0.0001), copropraxia (45 vs. 2%, P < 0.0001), self‐injury (50 vs. 4%, P < 0.0001), hospitalisation/emergency visits (36 vs. 2%, P < 0.0001) and school absenteeism (56 vs. 7%, P < 0.0001). A total of 18.2% of patients with functional tics reported preceding exposure to social media content involving tics.ConclusionsThere is an increase in adolescent females presenting with rapid onset functional tic‐like behaviours during the COVID‐19 pandemic. We highlight differences in clinical features between the functional tic group and CTD/TS to aid diagnosis and management in the community. Based on our findings, we propose a mixed model of neuropsychiatric vulnerability and social media contagion in this group of adolescents with functional tics.

A COMPARATIVE STUDY OF LEVELS OF HIGH SENSITIVITY CREACTIVE PROTEIN (hs-CRP) IN DIABETIC AND NON- DIABETIC POPULATION OF CENTRAL INDIA

Background: Diabetes mellitus is the most common metabolic disorder characterized by metabolic abnormalities and long term complications. It is characterized by hyperglycemia resulting from defect in insulin secretion and in its action. It has become a leading cause of morbidity and mortality world over. hs- CRP is a marker of low-grade inammation and it is raised in patients with type 2 DM. The present study was undertaken with the objective of studying the relation of High Sensitivity CRP (hs-CRP) in patients of type 2 Diabetes Mellitus and in non-diseased population. Methods: This was a comparative observational study, conducted at Diabetic clinic, Index Medical College, Indore during August 2014 to July 2015. Cases and control were selected as per the inclusion criteria. Statistical analysis was done using SPSS v20. Mean age of the group was 48years. The mean hs CRP in the diabe Results: tic group was 0.45 compared with 0.35, in the control group. hs CRP levels are directly related to insulin resistance and is Conclusion: highly associated with diabetic population.

Syntactic Solutions for Subjunctive Clauses in the English Version of Cien Años de Soledad

Abstract: This study investigates a contrast between Spanish subjunctive clauses and their English correspondences in a Márquez’s novel. English resorts to different grammatical solutions in order to convey the subjunctive character of the clause. The linguistic variations are going to be analysed in this paper from two perspectives: syntactic and semantic. The investigation aims at examining parallel constructions in the original and the rendition of Márquez’s novel and classifying them into the corresponding syntactic groups. It intends to trace the semantic contexts of subjunctive occurrences in the English text.Resumen: Este estudio compara el modo subjuntivo en español y sus correspondencias inglesas en la novela de Gabriel G. Márquez. El modo subjuntivo en español difiere sensiblemente del inglés. Se analizan en este trabajo las distintas soluciones lingüisticas desde dos perspectivas: sintáctica y semántica. Se examinan las construcciones paralelas en la versión original y en la traducción de la novela de Márquez y se clasi can según sus propiedades sintácticas. Se intenta encontrar los contextos semánticos de las ocurrenciasdel subjuntivo en el texto inglés.

Genetic Polymorphism of CYP2C19 and Inhibitory Effects of Ticagrelor and Clopidogrel Towards Post-Percutaneous Coronary Intervention (PCI) Platelet Aggregation in Patients with Acute Coronary Syndromes.

BackgroundThe aim of this study was to observe the effects of genetic polymorphism of CYP2C19 on inhibitory effects of ticagrelor (Tic) and clopidogrel (Clo) towards post-percutaneous coronary intervention (PCI) platelet aggregation (IPA) and major cardiovascular events (MACE) in patients with acute coronary syndromes (ACS).Material/MethodsFrom August 2013 to March 2014, 166 patients with ACS undergoing PCI were selected. The patients were randomly grouped into the Tic group and the Clo group. IPA was detected by thromboelastography (TEG) at 1 week after taking the pills. Genotyping of CYP2C19 gene was determined by analysis of gene sequence detection. Patients were followed up for 1 month and MACE was observed.ResultsThe total IPA in the Clo group was significantly increased compared with the Tic group (P<0.05). The IPAs in the 3 subgroups of Clo group were all significantly increased compared with the 3 subgroups of the Tic group (all P<0.05). MACE was not significantly different between Clo and Tic groups (P>0.05). MACE had no significant difference among the 3 subgroups of the Tic group (P>0.05). MACE in the low metabolism subgroup of the Clo group was significantly increased compared with the fast metabolism subgroup and middle metabolism subgroup of Clo group (P<0.05). MACE was not significant different between the fast metabolism subgroup and the middle metabolism subgroup of the Clo group (P>0.05). MACE in the low metabolism subgroup of the Tic group was significantly decreased compared with the low metabolism subgroup of the Clo group (P<0.05).ConclusionsTicagrelor has a better effect on inhibition platelet aggregation than Clopidogrel in ACS patients undergoing PCI.

Impact of Gender, Age at Onset, and Lifetime Tic Disorders on the Clinical Presentation and Comorbidity Pattern of Obsessive-Compulsive Disorder in Children and Adolescents.

Obsessive-compulsive disorder (OCD) is a heterogeneous disorder; therefore, there is a need for identifying more homogeneous subtypes. This study aimed to examine the clinical characteristics and comorbidity pattern of a large sample of pediatric OCD subjects, and to examine the impact of gender, age at onset, and lifetime tic disorders on the clinical presentation and comorbidity pattern. A total of 110 children and adolescents diagnosed with OCD were assessed using the Kiddle Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL) for psychiatric comorbidity, and a clinical data form was filled out. The cutoff for differentiating prepubertal from adolescent onset was 11 years of age. A total of 83.6% of the subjects had at least one comorbid psychiatric disorder. Oppositional defiant disorder and contamination/somatic obsessions were significantly higher in males (p=0.036 and p=0.03, respectively) than in females. Depressive disorders and religious obsessions were significantly higher in the adolescent-onset group (p=0.02, p=0.05, respectively) whereas disruptive behavior disorders were higher in the prepubertal-onset group (p=0.037). Disruptive behavior disorders were significantly more frequent in the tic (+) group than in tic (-) group (p=0.021). There were differences in the comorbidity pattern and clinical expression between genders and between prepubertal and adolescent-onset cases. Findings of this study supported the introduction of tic-related OCD as a specifier in Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5), and the necessity of a detailed assessment of other psychiatric disorders in youth with OCD.

In Vitro and In Vivo Effect of 5-FC Combined Gene Therapy with TNF-α and CD Suicide Gene on Human Laryngeal Carcinoma Cell Line Hep-2

This study was aimed to investigate the effect of combined cancer gene therapy with exogenous tumor necrosis factor-alpha (TNF-α) and cytosine deaminase (CD) suicide gene on laryngeal carcinoma cell line Hep-2 in vitro and in vivo. Transfection of the recombinant eukaryotic vectors of pcDNA3.1 (+) containing TNF-α and/or CD into Hep-2 cells resulted in expression of TNF-α and/or CD gene in vitro. The significant increase in apoptotic Hep-2 cells and decrease of Hep-2 cell proliferation were observed using 5-FC treatment combined with TNF-a expression by CD/5-FC suicide system. Moreover, bystander effect was also observed in the TNF-α and CD gene co-expression group. Laryngeal squamous cell carcinoma (LSCC) mice model was established by using BALB/c mice which different transfected Hep-2 cells with pcDNA3.1 (+) containing TNF-α and/or CD were applied subcutaneously. So these mice are divided into four groups, namely, Hep-2/TIC group; Hep-2/CD group; Hep-2/TNF-α group; Hep-2/0 group. At day 29 after cell inoculation, volume of grafted tumor had significant difference between each two of them (P<0.05). These results showed that the products of combined CD and TNF-α genes inhibited the growth of transplanted LSCC in mice model. So by our observed parameters and many others results, we hypothesized that 5-FC combined gene therapy with TNF-αand CD suicide gene should be an effective treatment on Laryngeal carcinoma.

Childhood Cancer Incidence in Cuba, 2001 to 2003

Estimating childhood cancer incidence globally is hampered by lack of reliable data and uniform age limits for classifying and analyzing data reported. In Cuba, cancer data has been systematically gathered and processed by the National Cancer Registry (NCR) since 1964. The International Classification of Childhood Cancer (ICCC) is currently recommended for registering neoplasms in the population aged < or =19 years. Cancer incidence data published by the Cuban Ministry of Public Health, however, uses ICCC diagnostic groups for the population aged <15 years, and topographic sites for the population aged > or =15 years. The objectives of this study are to describe cancer incidence in the Cuban population aged < or =19 years in 2001-2003 using the ICCC, as well as geographic distribution of incidence by sex and by principal diagnostic groups. A descriptive study of cancer incidence in the population aged < or =19 years was conducted using NCR data for 2001-2003. ICCC diagnostic groups and subgroups were used, and 5 age groups (<1, 1-4, 5-9, 10-14 and 15-19 years) were analyzed. Total incidence and percentages for each diagnostic group were calculated. Number of cases in each diagnostic group and subgroup was also recorded by age group, and age-specific rates per 100,000 population aged < or =19 years (ASR) and age-adjusted rates to the standard world population aged < or =19 years (AAR) were calculated. AARs for leukemias, lymphomas and central nervous system (CNS) tumors were used to analyze childhood cancer risk by sex and geographical distribution in the country's 14 provinces and Isle of Youth Special Municipality. In 2001-2003, the NCR reported 1285 new cancer cases in the population aged < or =19 years for an overall incidence of 13.9 per 100,000 population aged < or =19 years (AAR). Highest risk was found in children aged <1 year with an ASR of 21.9 per 100,000 population aged < or =19 years. Leukemias, lymphomas and central nervous system tumors comprised 61.1% of new cases, and geographic distribution of these diagnostic groups varied by sex. Childhood cancer risk was highest for males in Ciego de Avila, Villa Clara and the Isle of Youth Special Municipality and highest for females in Sancti Spiritus, Villa Clara and Cienfuegos. Incidence of childhood cancer in Cuba conforms to rates reported internationally and to the incidence pattern most common in Latin America. Further research is recommended to examine risk factors influencing geographical variations in incidence within Cuba.

`I'm Cured But….'

The current qualitative research studied representations of illness posttreatment from a heart transplant group, a panic disorder group, and a tic disorder group. All three groups were preoccupied with perceptions about the impact of the illness, perception of self and the perception of how others view the ill person. The heart transplant group seem to adopt an active style of coping compared to the panic disorder group who presented a more passive, anticipatory mode of coping, and the tic group who were preoccupied with control over the perceptions of others. This qualitative information could help optimize adaptation strategies.

Tourette syndrome and chronic tics in a sample of children and adolescents

Forty-eight subjects with Tourette syndrome (M 36, F 12; mean age 11.2 years) and 48 with chronic tic disorder (M 33, F 15; mean age 12.1 years) were recruited in order to study the vertical transmission within families of a vulnerability to tic disorders or to other psychiatric disorders, the role of adverse pre- and perinatal events, and the presence of comorbid psychiatric conditions. As control group, 30 matched, psychiatrically unaffected subjects (M 20, F 10; mean age 10.8 years) were chosen. Screening measures included detailed anamnestic data, focused on family history of tics and other psychiatric disorders, prenatal events and birth. Subjects and parents were also questioned about psychiatric comorbidity. Group differences were compared using Fisher Test. Subjects with Tourette syndrome and those with chronic tic were similar to each other and different from controls in family history of tic disorders, pre- and perinatal events, and some comorbid psychiatric disorders (attention deficit hyperactivity disorder, sleep problems, and mood disorders). Tourette syndrome and chronic tic group were different in family history of obsessive-compulsive disorder and in comorbidity for obsessive-compulsive disorder and other anxiety disorders. Tourette syndrome and obsessive-compulsive disorder were significantly associated in this sample. These findings seem to indicate that Tourette syndrome and chronic tic disorder are part of the same disease entity, with Tourette syndrome being a more severe and complex form of tic disorder.

Impulsivity in obsessive-compulsive disorder: comparisons with other anxiety disorders and within tic-related subgroups

This study investigated the relationship between impulsivity and obsessive-compulsive disorder (OCD). The Barratt Impulsiveness Scale (BIS) was used to examine (i) levels of impulsivity in individuals with OCD, panic disorder, and social phobia, as well as in nonclinical controls, and (ii) the relationship between tics and impulsivity in patients with OCD. Patients in all anxiety disorder groups reported higher levels of impulsiveness than controls, with no differences among clinical groups. OCD patients with tics reported higher levels of impulsiveness than those without tics, primarily due to elevations on the cognitive impulsiveness subscale—a finding that was related to increased severity of obsessions in the tic group. These findings do not support a clear relationship between impulsivity and OCD, but point to possible confusion between state versus trait impulsivity in the OCD literature, as well as threats to interpretability posed by overlapping criteria for symptoms and traits.

Preparation and motor potentials in chronic Tic and Tourette Syndromes

Many studies have found that people with tic disorder show more difficulty when inhibiting an automated than a controlled response. Furthermore, although normal motor threshold and excitability are present, but reduced or impaired, motor inhibition seems manifest in patients with tic. In order to localize this inhibition impairment in tic disorder the present study examine two response-locked ERPs: the Bereitschaft (preparation BP) and the motor potentials (MP). The simple tic group showed faster BP latency and smaller amplitude than control and complex tic group and did not show a corresponding change in values with practice or with automated or controlled condition. The MP amplitudes revealed that whereas both controls and complex tic disorder showed a decrease in amplitude during control condition for both blocks, simple tic showed larger amplitude. Our ERP results are in agreement with RT results of a previous study. The explanation could lie with modulation in motor excitation inhibition circuits and seems worse in simple tics where the movements are more automatic and nonvoluntary.

Discriminant validity of the MMPI-Borderline Personality Disorder scale.

Discriminant validity of the MMPI-Borderline Personality Disorder scale.