The Child Tourette Syndrome Impairment Scale (CTIM) rates 37 problems in school, social, and home domains separately for tics and for comorbid diagnoses. However, a shorter version would be easier to implement in busy clinics. Using published data from 85 children with Tourette syndrome, 92 controls, and parents, factor analysis was used to generate a "mini-CTIM" composed of 12 items applied to tic and comorbid diagnoses. Child- and parent-rated mini-CTIM scores were compared and correlated across raters and accounting for clinician-rated tic severity and presence of attention-deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). The mini-CTIM achieved domain Cronbach alphas ranging from 0.71 to 0.94 and intra-item correlation coefficients ranging from 0.84 to 0.96. The resulting scale correlated with clinician-rated tic severity and reflected the presence of ADHD and OCD. The mini-CTIM appears promising as a practical assessment tool for tic- and non-tic-related impairment in children with Tourette syndrome.
Slipped capital femoral epiphysis was produced in 9 matched pairs of fresh-frozen pig femurs (1-year-old pigs) by twisting the femoral head about the femoral neck axis. Each matched pair was fixed with a single steel cannulated screw on one side and 2 screws contralaterally, after which the perichondrium was removed before retesting. Double-screw fixation without the perichondrium provided 43% of the stiffness and 74% of the strength of the intact physis in torsion and approximately double the stiffness and strength of single-screw fixation (P<0.004). This information may be of use to the surgeon concerned about rotational stability in unstable slipped capital femoral epiphysis.
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