Genotype-Environment Interaction in ADHD: Genetic Predisposition Determines the Extent to Which Environmental Influences Explain Variability in the Symptom Dimensions Hyperactivity and Inattention.

Although earlier research has shown that individual differences on the spectrum of attention deficit hyperactivity disorder (ADHD) are highly heritable, emerging evidence suggests that symptoms are associated with complex interactions between genes and environmental influences. This study investigated whether a genetic predisposition [Note that the term 'genetic predisposition' was used in this manuscript to refer to an estimate based on twin modeling (an individual's score on the latent trait that resembles additive genetic influences) in the particular population being examined.] for the symptom dimensions hyperactivity and inattention determines the extent to which unique-environmental influences explain variability in these symptoms. To this purpose, we analysed a sample drawn from the Twins Early Development Study (TEDS) that consisted of item-level scores of 2168 16-year-old twin pairs who completed both the Strengths and Difficulties Questionnaire (SDQ; Goodman, in J Child Psychol Psychiatry 38:581-586, 1997) and the Strength and Weaknesses of ADHD Symptoms and Normal Behavior (SWAN; Swanson, in Paper presented at the meeting of the American Psychological Association, Los Angeles, 1981) questionnaire. To maximize the psychometric information to measure ADHD symptoms, psychometric analyses were performed to investigate whether the items from the two questionnaires could be combined to form two longer subscales. In the estimation of genotype-environment interaction, we corrected for error variance heterogeneity in the measurement of ADHD symptoms through the application of item response theory (IRT) measurement models. A positive interaction was found for both hyperactivity (e.g., [Formula: see text] = 2.20 with 95% highest posterior density interval equal to [1.79;2.65] and effect size equal to 3.00) and inattention (e.g., [Formula: see text] = 2.16 with 95% highest posterior density interval equal to [1.56;2.79] and effect size equal to 3.07). These results indicate that unique-environmental influences were more important in creating individual differences in both hyperactivity and inattention for twins with a genetic predisposition for these symptoms than for twins without such a predisposition.

Management of syncope in the Emergency Department: a European prospective cohort study (SEED).

BACKGROUND AND IMPORTANCE: In 2018, the European Society of Cardiology (ESC) produced syncope guidelines that for the first-time incorporated Emergency Department (ED) management. However, very little is known about the characteristics and management of this patient group across Europe. OBJECTIVES: To examine the prevalence, clinical presentation, assessment, investigation (ECG and laboratory testing), management and ESC and Canadian Syncope Risk Score (CSRS) categories of adult European ED patients presenting with transient loss of consciousness (TLOC, undifferentiated or suspected syncope). DESIGN: Prospective, multicentre, observational cohort study. SETTINGS AND PARTICIPANTS: Adults (≥18 years) presenting to European EDs with TLOC, either undifferentiated or thought to be of syncopal origin. MAIN RESULTS: Between 00:01 Monday, September 12th to 23:59 Sunday 25 September 2022, 952 patients presenting to 41 EDs in 14 European countries were enrolled from 98 301 ED presentations (n = 40 sites). Mean age (SD) was 60.7 (21.7) years and 487 participants were male (51.2%). In total, 379 (39.8%) were admitted to hospital and 573 (60.2%) were discharged. 271 (28.5%) were admitted to an observation unit first with 143 (52.8%) of these being admitted from this. 717 (75.3%) participants were high-risk according to ESC guidelines (and not suitable for discharge from ED) and 235 (24.7%) were low risk. Admission rate increased with increasing ESC high-risk factors; 1 ESC high-risk factor; n = 259 (27.2%, admission rate=34.7%), 2; 189 (19.9%; 38.6%), 3; 106 (11.1%, 54.7%, 4; 62 (6.5%, 60.4%), 5; 48 (5.0%, 67.9%, 6+; 53 (5.6%, 67.9%). Furthermore, 660 (69.3%), 250 (26.3%), 34 (3.5%) and 8 (0.8%) participants had a low, medium, high, and very high CSRS respectively with respective admission rates of 31.4%, 56.0%, 76.5% and 75.0%. Admission rates (19.3-88.9%), use of an observation/decision unit (0-100%), and percentage high-risk (64.8-88.9%) varies widely between countries. CONCLUSION: This European prospective cohort study reported a 1% prevalence of syncope in the ED. 4 in 10 patients are admitted to hospital although there is wide variation between country in syncope management. Three-quarters of patients have ESC high-risk characteristics with admission percentage rising with increasing ESC high-risk factors.

The Relation Between Anti-Fat Stereotypes and Anti-Fat Prejudices: The Role of Gender as a Moderator.

Research suggests that people attribute more negative traits to individuals with obesity than to non-obese individuals, and that females with obesity are seen more negatively than males. The theory also suggests that stereotypes are cognitive predecessors of prejudices. The aims of this research were to examine the latent structure underlying anti-fat stereotypical traits, differences in perceiving individuals with obesity and non-obese individuals, male and female individuals with obesity, as well as the role of anti-fat stereotypes in anti-fat prejudices. The sample consisted of 106 respondents (Male = 16; Female = 86; Mean age = 19.98), who graded stimuli photographs of male and female individuals (with obesity and average-weight) on series of anti-fat stereotypical traits on two occasions, and filled in Anti-fat prejudices questionnaire. The data were analyzed through EFA and CFA, ANOVA, and structural equation modeling (moderation). Four factors behind stereotypical traits were extracted: Positive social image, Perceived lack of self-care, Perceived persistence, and Antipathy. It has been shown that respondents gave stimuli photographs of individuals with obesity lower scores on Positive social image and Perceived persistence, and higher scores on Perceived lack of self-care and Antipathy. The same results were obtained for females within the subsample of individuals with obesity. Furthermore, it has been shown that certain anti-fat stereotypes (Positive social image, Perceived lack of self-care, and Perceived persistence) predict anti-fat prejudices, and that gender was a significant moderator of the effect of Perceived lack of self-care on anti-fat prejudices. We can conclude that individuals with obesity are indeed seen in a more negative light than non-obese individuals, and that this is more pronounced for females with obesity, which is in accordance with previous studies. Moreover, the results suggest the possible role of anti-fat stereotypes as cognitive predecessors of anti-fat prejudices, and that gender of individuals with obesity has an effect on this relationship.

[Reliability of the thyroid stimulating hormone receptor antibodies level determination in diagnosing and prognosing of autoimmune hyperthyroidism].

BACKGROUND/AIM: Graves disease (GD) is defined as hyperthyroidism with diffuse goiter caused by immunogenic disturbances. Antibodies to the thyroid stimulating hormone (TSH) receptors of thyroid gland (TRAb) have crucial pathogenetic importance in the development and maintenance of autoimmune hyperthyroidism. The aim of this study was to identify sensitivity, specificity, positive an negative predictive velue of TRAb level in sera of patients with GD as well as to estimate significance of TRAb level for remission and GD relapses occurrence. METHODS: We studied prospectively and partly retrospectively 149 patients, 109 female and 40 male patients, 5-78 years old, in the period 1982-2007. There were 96 patients with GD. The control group consisted of 53 patients, 21 with hyperthyroidism of second etiology and 32 patients on amiodarone therapy, with or without thyroid dysfunction TRAb was measured by radioreceptor assay (TRAK Assay and DYNO Test TRAK Human Brahms Diagnostica GMBH). RESULTS: According to the results the sensitivity (Sn) of TRAb test was 80%, specificity (Sp) 100%, positive predictive value (PP) 100% and negative predictive value (NP) 83%. Also, the Sn of hTRAb test was 94%, Sp 100%, PP 100% and NP 94%. Our results show that an increased level of TRAb/hTRAb at the beginning of the disease and the level at the end of medical therapy is associated with an increased number of GD relapses and a shorter remission duration. CONCLUSION: Detection and measurement of TRAb in serum is a very sensitive method for diagnosing GD and very highly specific in vitro method for differential diagnosis of various forms of hyperthyroidism. Clinical significance of differentiating various forms of hyperthyroidism, using this in vitro assay, lays in adequate therapeutic choice for these entities.

Amiodaron treatment and thyroid autoimmunity markers.

Autoimmune diseases of the thyroid gland (ADTG) which include, Graves' disease, Hashimoto thyroiditis, primary hypothyroidism with atrophic thyroiditis, postpartum thyroiditis and 'silent' thyroiditis, are characterized by the presence of serum thyroid autoantibodies (TAB). Thyroid autoantibodies are not rare even in the general population of all ages, and their presence in women is 5 times more than in men. The aim of our study was to define the prevalence of thyroid autoantibodies in patients on chronic treatment by amiodarone (AMD), an antiarrhythmic drug rich in iodine, with a potential cytotoxic effect. We have used a section study during a period of two years. Ninety six consecutive patients under AMD treatment were studied, 55 men and 41 women (mean age 62.2 years, range 26-82 years) who referred to us to study their thyroid function. Our results showed that antithyroid antibodies in patients under AMD treatment, with or without thyroid dysfunction, were in similar concentrations as in the general population. A statistically significant greater frequency of increased thyroid peroxidase antibodies (TPOAb) was present in female patients under AMD treatment. When AMD treatment lasted longer than 24 months, the TPOAb were statically higher as compared to those patients under AMD treatment for less than 24 months.