Pain in Tourette Syndrome-Children’s and Parents’ Perspectives

Tourette Syndrome (TS) is a neurodevelopmental condition characterized by the presence of tics and associated behavioral problems. Yale Global Tic Severity Scale (YGTSS), The PedsQL Pediatric Pain Questionnaire, and Pediatric Pain Coping Inventory were used to assess the severity of tics, the severity of the pain, the location of the pain and pain coping strategies both from children’s and parents’ perspectives. Sixty percent of children demonstrated pain (past or present); the pain was reported by 72% of parents raising children with TS. The pain most commonly was cervical, throat, shoulder, ocular, and joint pain; most children declared pain located in more than one part of the body. Consistency between the declarations of children and their parents in coping with pain was observed. Pain should be recognized as a common comorbid aspect of tic disorders in childhood and therapeutic treatment must include the reduction of pain caused by tics.

Well-being among PhD candidates

OBJECTIVES

The aim of the pilot study was to demonstrate that PhD students declare lower psychological well-being, and more often complain about psychosomatic symptomsand illnesses compared to individuals who did not continue education after university.

METHODS

A total of 270 participants were involved in the study: 135 PhD students (mean age = 30.03 years) and 135 control individuals (mean age = 30.13 years) who did not continue education beyond their master's degree. The following methods were used: a sociodemographic survey taking into account a list of illnesses and psychosomatic symptoms, the General Health Questionnaire (GHQ-28) and the SPP-25.

RESULTS

The results were calculated using ANOVA. The results show a significantly higher severity of the following: somatic symptoms (F = 12.913; p < 0.001), anxiety and insomnia (F =19.769;p < 0.001), behavioral disorders (F =8.782;p = 0.003), symptoms of depression (F = 8.560; p = 0.004) among PhD students when compared with individuals who chose not to continue education.

CONCLUSIONS

The results suggest that PhD students demonstrate a significantly lower level of general mental well-being, a higher level of behavioral disorders, somatic symptoms, anxiety and sleep problems, as well as depressive symptoms - compared to individuals who did not continue education after achieving a master's degree.

Circulating chemerin level may be associated with early vascular pathology in obese children without overt arterial hypertension - preliminary results

Background Elevated chemerin level is observed in patients with arterial hypertension. The aim of the study was to determine the relationship between chemerin level, and parameters of blood pressure and arterial stiffness in children and adolescents with obesity but without arterial hypertension. Methods In 23 children with obesity (13 girls, mean age 9.3, SD 1.9, mean BMI SDS 3.9, SD 1.7) 24 h ABPM (Spacelabs 90,217, USA), common carotids and abdominal aorta intima media thickness measurements (Voluson 730, GE Medical System 8.5 and 3.5 MHz probes), body composition analysis (Tanita BC 418 S MA, Tokyo, Japan) were performed. Glucose, triglycerides, total, LDL and HDL cholesterol, liver enzymes, uric acid, creatinine, sodium, insulin and chemerin levels were assessed in blood sample taken after a 12-h fasting period. Results There was a significant correlation of circulating chemerin level with systolic blood pressure load in ABPM (r=0.5, p<0.05). Conclusion Elevated chemerin level may be associated with increased systolic blood pressure in obese children.

Depression in Tourette Syndrome

OBJECTIVES

The aim of the study is to show relationship between severity of depressive symptoms and the severity of tics, declared feeling of stigmatization and feelings about the body.

METHODS

The study included 13 people with Tourette syndrome and 13 people in a comparative group - matching method, taking into account compatibility of gender, age, number of years of education, and size of the place of residence. The study used: Polish adaptation of the Yale Global Tic Severity Scale (YGTSS), Questionnaire for Measuring Depression (Kwestionariusz do Pomiaru Depresji -KPD), Perceived Stigmatization Questionnaire (PSQ), Questionnaire of feelings about the body.

RESULTS

Wilcoxon signed-rank test analysis showed that the declared general depression rate is significantly higher in the group of people with Tourette syndrome (Z = - 2.691; p < 0.01). The indicator differentiating the declared feeling of stigmatization among people with TS was the feeling of embarrassment due to other people's stare/the stare of bystanders (ZG) (Z = - 1.888; p < 0.05). The general assessment of one's body image is not different in the group of people with TS and comparative group, but two important factors have been distinguished: "My body is alien to me" (Z = - 1.897; p < 0.05), "It is difficult for me to understand changes in my body" (Z = 1.950; p < 0.05).

CONCLUSIONS

It is concluded that the severity of tics, the feeling of stigmatization and selected body image indexes are related to both the general severity of symptoms of depression and its individual indicators.

[Preliminary results of reproductive system function assessment in young men after Hodgkin's disease therapy]

The introduction of modern methods of combined therapy: chemotherapy and radiotherapy, allows the cure more than 90% of children and adolescents with Hodgkin's disease (HD). However, the intensive treatment carries the risk of early and late complications. One of the late effects is gonadal dysfunction which may develop in men as well as in women. In this report preliminary results of testicular function assessment in young men after HD therapy. Testicular function was evaluated in 24 young men (age: 10.6-18.2 years, median 14.6 years at the beginning of treatment, and 18.5-24.6 years, median 21.4 years at the end of therapy) treated between January 1, 1999 and December 31, 2009. in Department of Pediatric Oncology and Hematology PAIP JU-CM in Kraków, according to PGP-HD-97 protocol. Multidrug chemotherapy combined with low-dose involved-field radiotherapy (15-25 Gy) was used in treatment in 21 men, and 3 other men were treated with chemotherapy only. Therapy was completed in all analyzed patients. Physical examination and Tanner stages of pubic hair and genital development were recorded as well as the plasma levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone (TST) were measured in all patients. Testicular volumes were measured in 14 men. The study was conducted between January 1, 2009 and December 31, 2009. All men reached Tanner stages of pubic hair and genital development appropriate for their age. One hundred and fourteen measurements of hormones levels were performed in all of patients. At least one abnormal result of measurements was found in 16/24 (66.7%) of men. The most frequent abnormality was the increased level of FSH (in 15 patients, 60.5% of FSH measurements). Abnormal results of measurements were found in 14/20 (70%) patients who received 6 chemotherapy cycles and in 2/4 patients treated with 3-4 cycles. Within the group of patients with abnormal results eight men previously received subdiaphragmatic region radiotherapy. Semen analysis was performed in one man and revealed azoospermia. Initial results of reproductive system assessment indicate the impairment of testicular function depending on intensity of treatment. Further observation and repeated gonadal function tests (including semen analysis) are needed in young men with completed HD treatment. These studies are essential especially for young people who intend to have children.

[Arterial wave velocity and coronary risk factors in patients with type-2 diabetes]

Arterial compliance is a significant prognostic factor of cardiovascular risk. Elevated serum homocysteine level is related to increased oxidative stress and impaired endothelial function. The aim of the study was to evaluate factors influencing arterial compliance in patients with diabetes. We examined 30 patients with type 2 diabetes. In each patient we performed measurements of arterial compliance, blood pressure, serum lipids, glucose and homocysteine concentration and microalbuminuria. Serum lipids were determined by enzymatic methods, using Boehringer-Mannheim reagents, homocysteine levels by ELISA, using Bio-Rad reagents, HbA1c by HPLC method and microalbuminuria by immunonephelometric method. Arterial compliance assessment was based on measurements of pulse wave velocity (PWV), registered on femoral and carotid arteries (mean of 20 measurements), using automatic sensor (Fukuda) and Complior system. The mean age of patients was 62.2 +/- 8.1 years, BMI 30.0 +/- 3.4 kg/m2, waist to hip ratio (WHR) 0.9 +/- 0.09, mean diabetes duration 14.1 +/- 7.5 years, and HbA1c level 7.7 +/- 1.5%. Mean cholesterol, HDL-cholesterol and triglyceride serum concentrations were as follows: 5.7 +/- 1, 2 mmol/l; 1.32 +/- 0.43 mmol/ll and 1.8 +/- 1.0 mmol/l, and homocysteine levels 16.3 +/- 3.9 mmol/l. Arterial compliance significantly correlated with age (r = 0.52, p = 0.007), homocysteine concentration (r = 0.47, p = 0.015), WHR(r = 0.47, p = 0.015) and creatinine levels (r = 0.51, p = 0.016). The results of the study suggest that in patients with type 2 diabetes arterial compliance is associated not only with age but also with serum homocysteine levels and renal function parameters.

[Ultrasonic noninvasive examination of the human cerebrovascular system using the vascular impedance method]

The authors employed input vascular impedance measurements, based on the non-invasive ultrasound measurements of blood flow and pressure in common carotid artery, to evaluate human cerebro-vascular system. An analysis involved a 4-element substitute model of vascular system which included: compliance, inertia, vascular resistance, and peripheral resistance. Preliminary clinical examination of both sick and healthy individuals indicate that total real resistance measured in the common carotid artery depends on the patency of branching arteries. At the same time, ratio of vascular resistance Ro do peripheral resistance Rp may be an indicator of the atheromatous lesions to the arteries below measurement point. Ratio Ro greater than 0.5 is being considered as an index of pathology.

[Evaluation of the condition of patients with post-stroke hemiplegia and the progress in their rehabilitation]

The authors describe a method of documentation for assessing the condition of the patient on the basis of own experiences with over 1200 patients after stroke and a review of the pertinent literature. In a comprehensive evaluation of the condition of the patient after beginning of rehabilitation treatment and after its completion the participants were: the attending physician, a neuropsychologist, a kinesitherapeutist and a logopedist. All aspects having an influence on the functional state were taken into consideration: motor ability, contact with the surroundings, psychic state, sphincter control, cardiovascular efficiency, ventilatory efficiency, sensory function, general functioning. This method makes possible a reliable, objective and comparable documentation to be obtained, which facilitates assessment of the progression in treatment and the methods used in the treatment.