Open-label study comparing the efficacy and tolerability of aripiprazole and haloperidol in the treatment of pediatric tic disorders

Due to its unique pharmacodynamic properties of dopamine partial agonist activity, and its association with few and mild side effects, aripiprazole is a candidate atypical antipsychotic for patients with tic disorders. This open-label study compared the efficacy and tolerability of aripiprazole with haloperidol, a typical antipsychotic widely used to treat patients with tic disorders. Forty-eight children and adolescents with tic disorders were recruited from the outpatient clinic at South Korea and treated with aripiprazole (initial dose, 5.0 mg/d; maximum dose 20 mg/d) or haloperidol (initial dose, 0.75 mg/d; maximum dose, 4.5 mg/d) for 8 weeks. Treatment efficacy was measured using the yale global tic severity scale (YGTSS), and tolerability was measured using the extrapyramidal symptom rating scale (ESRS) and an adverse effects checklist. Total tic scores as measured by the YGTSS decreased over time in both groups (p < 0.001) without any significant differences between groups. ESRS scores were significantly higher in the haloperidol group during the 4 weeks after commencement of medication (p < 0.05). These results indicate that aripiprazole may be a promising drug in the treatment of children and adolescents with tic disorders. Further controlled studies are needed to determine the efficacy and tolerability of aripiprazole in these patients

Human-induced changes to the global ocean water masses and their time of emergence

The World Ocean is rapidly changing, with global and regional modification of temperature and salinity, resulting in widespread and irreversible impacts. While the most pronounced observed temperature and salinity changes are located in the upper ocean, changes in water masses at depth have been identified and will probably strengthen in the future. Here, using 11 climate models, we define when anthropogenic temperature and salinity changes are expected to emerge from natural variability in the ocean interior along density surfaces. The models predict that in 2020, 20–55% of the Atlantic, Pacific and Indian basins have an emergent anthropogenic signal; reaching 40–65% in 2050 and 55–80% in 2080. The well-ventilated Southern Ocean water masses emerge very rapidly, as early as the 1980–1990s, while the Northern Hemisphere water masses emerge in the 2010–2030s. Our results highlight the importance of maintaining and augmenting an ocean observing system capable of detecting and monitoring persistent anthropogenic changes

European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment

To develop a European guideline on pharmacologic treatment of Tourette syndrome (TS) the available literature was thoroughly screened and extensively discussed by a working group of the European Society for the Study of Tourette syndrome (ESSTS). Although there are many more studies on pharmacotherapy of TS than on behavioral treatment options, only a limited number of studies meets rigorous quality criteria. Therefore, we have devised a two-stage approach. First, we present the highest level of evidence by reporting the findings of existing Cochrane reviews in this field. Subsequently, we provide the first comprehensive overview of all reports on pharmacological treatment options for TS through a MEDLINE, PubMed, and EMBASE search for all studies that document the effect of pharmacological treatment of TS and other tic disorders between 1970 and November 2010. We present a summary of the current consensus on pharmacological treatment options for TS in Europe to guide the clinician in daily practice. This summary is, however, rather a status quo of a clinically helpful but merely low evidence guideline, mainly driven by expert experience and opinion, since rigorous experimental studies are scarce

ER-Bound Protein Tyrosine Phosphatase PTP1B Interacts with Src at the Plasma Membrane/Substrate Interface

PTP1B is an endoplasmic reticulum (ER) anchored enzyme whose access to substrates is partly dependent on the ER distribution and dynamics. One of these substrates, the protein tyrosine kinase Src, has been found in the cytosol, endosomes, and plasma membrane. Here we analyzed where PTP1B and Src physically interact in intact cells, by bimolecular fluorescence complementation (BiFC) in combination with temporal and high resolution microscopy. We also determined the structural basis of this interaction. We found that BiFC signal is displayed as puncta scattered throughout the ER network, a feature that was enhanced when the substrate trapping mutant PTP1B-D181A was used. Time-lapse and co-localization analyses revealed that BiFC puncta did not correspond to vesicular carriers; instead they localized at the tip of dynamic ER tubules. BiFC puncta were retained in ventral membrane preparations after cell unroofing and were also detected within the evanescent field of total internal reflection fluorescent microscopy (TIRFM) associated to the ventral membranes of whole cells. Furthermore, BiFC puncta often colocalized with dark spots seen by surface reflection interference contrast (SRIC). Removal of Src myristoylation and polybasic motifs abolished BiFC. In addition, PTP1B active site and negative regulatory tyrosine 529 on Src were primary determinants of BiFC occurrence, although the SH3 binding motif on PTP1B also played a role. Our results suggest that ER-bound PTP1B dynamically interacts with the negative regulatory site at the C-terminus of Src at random puncta in the plasma membrane/substrate interface, likely leading to Src activation and recruitment to adhesion complexes. We postulate that this functional ER/plasma membrane crosstalk could apply to a wide array of protein partners, opening an exciting field of research

Contemporary approaches to the treatment of tics in Tourette syndrome Abordagem contemporânea para o tratamento de tiques na síndrome de Tourette

Tic disorders are relatively common disorders of childhood. The tics range from mild to severe and show a fluctuating course over time. Moreover, in most cases, the tics tend to decline in number and frequency by early adulthood. Given this range of severity and natural history, tics may not require treatment. When tics are frequent, forceful and cause interference in everyday life, medication is indicated. Several medications have been used in the treatment of tics, but only a few have been carefully studied. This paper reviews the range of medications that have been used in the treatment of tics and provides practical information about clinical management of children and adolescents with tic disorders.<br>Os transtornos coréicos são relativamente comuns durante a infância. Os automatismos apresentam graus variáveis, de leve a grave, e flutuam ao longo do tempo. Além disso, na maioria dos casos, os automatismos tendem a diminuir em número e freqüência no início da vida adulta. Dada a gravidade variável e sua história natural, muitas vezes não é necessário tratar os automatismos. O tratamento medicamentoso está indicado quando as manifestações são freqüentes, vigorosas e interferem com a vida diária. Vários medicamentos têm sido usados no tratamento dos automatismos, mas apenas alguns deles vêm sendo estudados a fundo. O artigo revisa a variedade de medicamentos que vêm sendo usados no tratamento dos automatismos e proporciona informações práticas para o tratamento clínico de crianças e adolescentes com transtornos coréicos