17 patients admitted to an intensive coronary care unit for premonitory syndrome or acute myocardial infarction were divided into four groups (premonitory syndrome, non-transmural infarction, transmural infarction with and without inflammation) on the basis of electrocardiographic findings and total CK activity. Serum levels of CK and CK2, myoglobin, ASAT and ALAT, LDH, haptoglobin, CRP and alpha-1 acid glycoprotein were determined daily for ten days. Patients with premonitory syndrome had no significant increase in markers of cytolysis or myoglobin. In acute myocardial infarction, regardless of clinical type, time course of peak values for biologic factors assayed was as follows: D0: myoglobin; D1: CK and CK2; D0 to D2: ASAT; D2 to D5: LDH and CRP; D5 to D6: ALAT; D4 to D7: haptoglobin and alpha-1 acid glycoprotein. These parameters may increase with size of myocardial necrosis and association with an inflammatory syndrome (CK, LDH, CRP and alpha-1 acid glycoprotein). They may be predictive of poor prognosis (LDH at peak CK concentrations). Some determinations, both more difficult to perform and less specific, have a particular value: prompt diagnosis of myocardial necrosis and detection of early repeat infarction by myoglobin assay, retrospective diagnosis by inflammatory protein assays when total CK has returned to normal.
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Evidence-Based Assessment of Tourette Syndrome.
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Division of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Center for Developmental Behavioral Health, Department of Psychiatry, Kennedy Krieger Institute, Baltimore, MD, USA; Center for OCD, Anxiety, and Related Disorders for Children (COACH), Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address:
Tourette syndrome and persistent tic disorders (collectively, TS) are impairing childhood-onset neuropsychiatric conditions. Utilizing evidence-based assessments (EBA) is standard for effective and accurate screening, diagnosis, and monitoring of TS. EBAs consist of brief screening instruments, structured/semi-structured clinician-administered interviews, self-report, and parent-report and child-report.
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