Correlates of the DSM-III-R global assessment of functioning scale in patients attending a child and adolescent psychiatric service

Sex, socioeconomic status, intelligence, a clinical symptom score, and an index of abnormal psychosocial situations as proposed by a recent WHO draft were studied as correlates of the Global Assessment of Functioning Scale (GAFS), which comprises Axis V of theDSM-III-R. Whereas all parameters correlated significantly with the GAFS score, only total symptom domain score displayed a meaningful association. It was concluded that the GAFS contributes significantly to clinical information as an independent source.

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Zusammenfassung Es wurden ein klinischer Symptomwert, ein Index für abnorme psychosoziale Situationen gemäß einem unlängst erschienenen WHO-Dokument, Geschlecht, sozioökonomischer Status und Intelligenz als Korrelate der Global Assessment of Functioning Scale (GAFS) untersucht, welche die Achse V des DSM-III-R bildet. Während alle Parameter

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Résumé Le sexe, le statut socio-économique, l'intelligence, le score des symptômes cliniques, et un index de situations psychosociales anormales proposés par un récent projet del'OMS furent étudiés en corrélation avec l'évaluation globale de l'échelle de fonctionnement (Global Assessment of Functioning Scale G.A.F.S.) qui correspond à l'axe V du DSM III R. Tandis que tous les paramètres sont corrélés significativement avec un score GAFS, seul le score symptomatique total n'offre pas d'association significative. Les auteurs ont conclu que le GAFS contribue significativement à l'information clinique en tant que source indépendante.

     

Role of surgery in colorectal cancer liver metastases

Colorectal carcinoma (CRC) is the third most common cancer, and approximately 35%-55% of patients with CRC will develop hepatic metastases during the course of their disease. Surgical resection represents the only chance of long-term survival. The goal of surgery should be to resect all metastases with negative histological margins while preserving sufficient functional hepatic parenchyma. Although resection remains the only chance of long-term survival, management strategies should be tailored for each case. For patients with extensive metastatic disease who would otherwise be unresectable, the combination of advances in medical therapy, such as systemic chemotherapy (CTX), and the improvement in surgical techniques for metastatic disease, have enhanced prognosis with prolongation of the median survival rate and cure. The use of portal vein embolization and preoperative CTX may also increase the number of patients suitable for surgical treatment. Despite current treatment options, many patients still experience a recurrence after hepatic resection. More active systemic CTX agents are being used increasingly as adjuvant therapy either before or after surgery. Local tumor ablative therapies, such as microwave coagulation therapy and radiofrequency ablation therapy, should be considered as an adjunct to hepatic resection, in which resection cannot deal with all of the tumor lesions. Formulation of an individualized plan, which combines surgery with systemic CTX, is a necessary task of the multidisciplinary team. The aim of this paper is to discuss different approaches for patients that are treated due to CRC liver metastasis.     

Red cell distribution width to platelet ratio: New and promising prognostic marker in acute pancreatitis

AIM: To evaluate the accuracy of red cell distribution width (RDW) to platelet ratio (RPR) to predict in-hospital mortality in acute pancreatitis (AP).METHODS: Between January 2010 and June 2012, 102 patients with AP were recruited to the study. In this retrospective cohort study, for all subjects, demographic data on hospital admission, AP etiology, co-morbid diseases, organ failure assessment, laboratory parameters and length of hospital stay were examined. Additionally, we used a non-invasive prediction method in addition to the RPR to evaluate the disease severity. Multivariate logistic regression analyses were used to evaluate the impact of RPR on hospital admission to predict mortality.RESULTS: The male-female ratio (59/43) was 1.37 with a median age of 56.5 years (17-89 years). In both univariate and multivariate analyses, RDW and RPR were presented as independent and significant variables on admission to predict mortality. The RPR obtained on hospital admission was persistently higher among non-survivors than among survivors (P < 0.0001). The median RPR was 0.000087 in the non-survivor group and 0.000058 in the survivor group. RPR with a cutoff value of 0.000067 presented an area under the curve of 0.783 (95%CI: 0.688-0.878) in receiver operating characteristic curves and could predict the mortality of approximately 80% of the patients.CONCLUSION: We identified RPR as a valuable, novel laboratory test to predict mortality in AP.     

Diagnostic Significance of Serum Eotaxin-1 Level in Gastric Cancer Patients

Introduction. Gastric cancer is the second cause of cancer-related deaths worldwide. Delayed diagnosis leads to high mortality rates. Eotaxin-1 was originally discovered as an eosinophil-selective chemoattractant and may play a role in a number of chronic inflammatory diseases, cancer, and other gastrointestinal disorders. The aim of this study was to analyse diagnostic and prognostic significance of serum eotaxin-1 (s-eotaxin-1) levels in gastric cancer. Methods. Sixty gastric cancer patients and 69 healthy subjects were included into the study. S-eotaxin-1 levels were compared with clinicopathological features and outcomes in gastric cancer. Results. Serum levels of eotaxin-1 in gastric cancer patients were significantly higher than controls (74.51 ± 16.65 pg/mL versus 16.79 ± 5.52 pg/mL, respectively (P < 0.001)). The s-eotaxin-1 levels did not differ significantly with histopathological grade, tumor-node-metastasis (TNM) stage, tumor localization, lymph node metastases, positive lymph node ratio, size, perineural and perivascular invasion. So there is no relationship found between s-eotaxin-1 level and prognosis. Conclusion. S-eotaxin-1 levels may be used as an easily available biomarker for gastric cancer risk and may alert physicians for early diagnosis. Due to the limited number of patients included in this study, larger cohort studies are warranted to validate the diagnostic value of s-eotaxin-1 level in gastric cancer.     

Black Grape and Garlic Extracts Protect Against Cyclosporine A Nephrotoxicity

The aim of this study was to determine if the natural antioxidant foods, dried black grape and garlic, protect against cyclosporine nephrotoxicity. Forty-two Sprague–Dawley rats were given Cyclosporine A (CsA) orally for 10 days, with the antioxidant food supplementation begun 3 days before CsA treatment and continued during the study period (totaling 13 days). In each group (control, CsA alone, CsA plus black grape, CsA plus aqueous garlic extract, aqueous garlic extract alone and black grape alone), there were 7 animals. At the end of the study period, the animals were sacrificed; their kidneys were removed and prepared for biochemical and histopathological investigations. Oxidant (xanthine oxidase enzyme and malondialdehyde) and antioxidant (superoxide dismutase, glutathione peroxidase and catalase enzymes) parameters were measured in the kidney tissues of the groups. Histopathological examinations of the tissues were also performed.

It has been found that CsA creates oxidant load to the kidneys through both xanthine oxidase activation and impaired antioxidant defense system, which accelerates oxidation reactions in the kidney tissue. Supplementation with either dried black grape or aqueous garlic extract led to reduced malondialdehyde level in the kidney tissue possibly, by preventing oxidant reactions. In conclusion, the results suggest that impaired oxidant/antioxidant balance may play part in the CsA-induced nephrotoxicity, and some foods with high antioxidant power may ameliorate this toxicity, in agreement with studies with antioxidant vitamins.     

Effects of garlic and black grape extracts on the activity of adenosine deaminase from cancerous and noncancerous human urinary bladder tissues

Aim Possible effects of garlic (Allium sativum) and black grape (Fructus vitis minuta) with known antioxidant potential on adenosine deaminase (ADA) activities were investigated in cancerous and noncancerous human bladder tissues. Methods The effects of garlic and black grape extracts on adenosine deaminase (ADA) activities were measured in 20 pairs of cancer and adjacent normal human bladder tissues with and without pre-incubation with garlic and black grape extracts at different concentrations. Results No significant difference was observed between ADA activities in cancerous and non cancerous bladder tissues without plant extract (5.85 ± 3.78 versus 7.63 ± 2.88, respectively). At the 1/3 and 1/1 plant extract/bladder tissue homogenate ratios, the garlic extract completely abolished the ADA activity in both cancerous and noncancerous tissues. At the 1/3 plant extract/bladder tissue homogenate ratio, the black grape extract decreased the activity significantly as compared to without extract (2.01 ± 1.30 versus 5.85 ± 3.78; p < 0.05 for cancerous tissue and 2.10 ± 1.66 versus 7.63 ± 2.88; p < 0.05 for noncancerous tissue) and, at the 1/1 plant extract/bladder tissue homogenate ratio, completely abolished the activity. Conclusion Our results show that garlic and black grape have potential to inhibit ADA activity in both cancerous and adjacent normal human bladder tissues.We suggest that this might be rational basis for the uses of garlic and black grape in the complementary therapy of urinary bladder cancer.