Global Assessment of Functioning (GAF): properties and frontier of current knowledge

Background  

Global Assessment of Functioning (GAF) is well known internationally and widely used for scoring the severity of illness in psychiatry. Problems with GAF show a need for its further development (for example validity and reliability problems). The aim of the present study was to identify gaps in current knowledge about properties of GAF that are of interest for further development. Properties of GAF are defined as characteristic traits or attributes that serve to define GAF (or may have a role to define a future updated GAF).     

Vascular plasticity in cerebrovascular disorders

Cerebral ischemia remains a major cause of morbidity and mortality with little advancement in subacute treatment options. This review aims to cover and discuss novel insight obtained during the last decade into plastic changes in the vasoconstrictor receptor profiles of cerebral arteries and microvessels that takes place after different types of stroke. Receptors like the endothelin type B, angiotensin type 1, and 5-hydroxytryptamine type 1B/1D receptors are upregulated in the smooth muscle layer of cerebral arteries after different types of ischemic stroke as well as after subarachnoid hemorrhage, yielding rather dramatic changes in the contractility of the vessels. Some of the signal transduction processes mediating this receptor upregulation have been elucidated. In particular the extracellular regulated kinase 1/2 pathway, which is activated early in the process, has proven to be a promising therapeutic target for prevention of vasoconstrictor receptor upregulation after stroke. Together, those findings provide new perspectives on the pathophysiology of ischemic stroke and point toward a novel way of reducing vasoconstriction, neuronal cell death, and thus neurologic deficits after stroke.     

Control of carcinoid syndrome with hepatic artery embolization

Eighteen patients with metastatic carcinoid were treated by hepatic artery embolization with Gelfoam or polyvinyl alcohol foam for control of the carcinoid syndrome. Seventeen showed subjective or objective clinical improvement, including less skin flushing, diarrhea, and bronchospasm. Fourteen showed improvement in biochemical indices, including decreased urinary 5-hydroxyindoleacetic acid levels. The mean life span of the treated patients from the first episode of flushing to the time of this report was 5.4 years, and half of the patients are still alive. This survival time compares favorably with previous reports of survival of 3.2 years from the onset of flushing.     

Autosomal dominant cerulean cataract is associated with a chain termination mutation in the human beta-crystallin gene CRYBB2

Congenital cataracts are a common major abnormality of the eye that frequently cause blindness in infants. At least a third of all cases are familial; autosomal dominant congenital cataract (ADCC) appears to be the most common familial form in the Western world. Cerulean cataracts have peripheral bluish and white opacifications in concentric layers with occasional central lesions arranged radially. Although the opacities may be observed during fetal development and childhood, usually visual acuity is only mildly reduced until adulthood, when lens extraction is generally necessary. We have been studying a family (ADCC- 1) with cerulean blue ADCC, in which the affected daughter of a first cousin mating was presumed to be homozygous for the cataract gene. Recently, we mapped an ADCC gene in this family to a region of chromosome 22 containing three beta-crystallin genes. Here we report that a chain-termination mutation in CRYBB2 is associated with ADCC in this family.      

Evaluation of predominant risk factors for type 2 diabetes mellitus among out-patients in two Nigerian secondary health facilities

BackgroundPrevention of type 2 diabetes is enabled by identification and effective management of risk factors.ObjectivesTo evaluate the predominant risks for type 2 diabetes and identify persons at highest risk in a population; to facilitate the understanding of implications for practice.MethodsCross-sectional survey using Canadian diabetes risk assessment questionnaire was conducted among non-diabetic persons who visited two secondary hospitals. SPSS version 18 was used for data analysis.ResultsA total of 300 respondents participated in the study, with 25.7% having family history of type 2 diabetes, while 160 (53.3%) were at high risk of developing the disease. Males (62.5%), overweight (65.1%) and obese (82.6%) participants, were at higher risk. Others found to be at high risk were respondents with high waist circumference (55.6%), respondents who did not exercise (77.0%), those who did not eat fruits/vegetable daily (54.4%), those with high blood pressure (67.5%) and those who have had raised blood sugar in the past (71.0%).ConclusionMajority of the study participants was at high risk for type 2 diabetes, male participants had higher risks and lifestyles/habits were the major risks for developing the disease..