Neuropsychological disorders in patients with brain tumor

Very few studies have utilized specific criteria to assess mental disorders in brain tumor patients. This study aimed to diagnose mental disorders in this population using DSM-IV [depression, sleep, and mood] criteria. From March 2007 to July 2009, the surgically treated patients with intracranial neoplasm were included in the study. These patients were examined in an ambulatory neuro-oncology clinic setting using a structured psychiatric interview which followed current DSM-IV diagnostic criteria. This study is based on the clinical data of 89 patients with brain tumor. The mean age was 42.2 years old. Fifty five percent [55%] of the patients were male. In our study, the prevalence of mild depression was about 30% for males and 38% for females. Before tumor operation, severe anxious as well as severe obsessivecompulsive symptoms were present in 14% of males. In females, 29% of the subjects had reported to have severe anxiousness and 25% severe obsessive symptoms. Depressive symptoms as well as anxious and obsessive psychopathology were shown to be prevalent signs among patients with brain tumor. The associated factors are tumor location, patient's premorbid psychiatric status, cognitive symptoms and adaptive or maladaptive response to stress

Depression in the nurses of the special wards versus nurses of the general wards, a comparative study

Depression is one of the most common and serious disorders that threaten human physical and psychological health. The incidence of depression in nurses who work in special wards compared to general wards has been debated for a longtime. In this study, we planned to compare the rate of depression and related factors between these two groups. Questionnaires about demographic factors, duration of daily work time and marital status were distributed randomly among 200 nurses working in special wards and 200 nurses working in general wards in 3 hospitals affiliated to Shahid Beheshti University [Modarres, Taleghani, Shohadaye Tajrish hospitals] in the summer and autumn 2006. The causes of admission of the patients were determined to assess their role in the occurrence of depression. To analyze depression, Beck depression inventory [BDI] score was used and the related intervening factors were compared between the two groups. The two groups were similar in sex [p=0.12], duration of daily work time [p=0.18] and marital status [p=0.23]. The major cause of admission in special wards was malignancy [33.3%] which was significantly higher than the rate of cancer patients in general wards [7.8%, p=0.03] [Table 1] Mean BDI score in special wards' nurses and in general wards' nurses was 9.3 +/- 7.36 and 1 +/- 6.66, respectively. All nurses had some degrees of anxiety and stress, but there was no significant difference in the incidence of depression; however, it seems that exposure to numerous stressful experiences over a life time of nursing and a lack of control over these experiences contributed to the high level of anxiety and depression seen in all nursing groups. Although the intensive wards' nurses were more involved with cancer patients compared to general wards' nurses, the rate of depression did not show any significant differences in the two groups. Therefore, dealing with hopeless cancer patients did not increase the rate of depression in intensive wards' nursing stuff and the intensive care environment does not seem to be more stressful for nursing staff in comparison with general care units

Disproportionate correlation between imaging and outcome in an infant with cerebral abscess

Brain abscesses represent organized foci of suppuration within the parenchyma. Here we report a 3 month-old girl with a very huge complicated cerebral abscess, and the course of treatment given. The patient's recovery was excellent. The follow up MRI showed only subtle porencephalic changes as the only parenchymal sequelae, which may be due to CNS plasticity in infants

[Lateral sacral meningocele presentation as a gluteal mass]

Lateral meningocele is a rare spinal dysraphism known to occur in patients with neurofibromatosis or Marfan's syndrome. Although this commonly occurs in the thoracic or sometimes in the cervical region, localization at the sacral spine is very infrequent. In this paper we present our case with isolated lateral sacral meningocele with spinal communication through iliac bone. In addition, a review of literature associated with this entity is presented

1470 cases of sarcoma referring to Imam Khomeini hospital during an 11-year period

Sarcoma is a malignant neoplasm arising in mesenchymal tissue. It comprises 1% of adult malignancies and 15% of childhood neoplasms. The present study was designed to review the clinical characteristics of 1470 sarcoma cases and related predictors of out come, relapse and survival. For this retrospective study, 1470 medical files of patients with sarcoma who were referred during 1991-2002 to Imam Khomeini Hospital were studied. Sarcoma comprised 11% of all cases referring to our hospital. The mean age of patients with sarcoma was 30 years and male to female ratio was 3/2. Bone to soft tissue sarcoma ratio was 3.1 in children and 1.3 in adults. Osteosarcoma, Ewing and rhabdomyosarcoma presented 83% of children tumors, however, in adults osteosarcoma, synovial sarcoma and malignant fibrous histocytoma [MFH] were the most common subtypes. The main prognostic factors for survival were tumor size, margin of surgery, neurovascular involvement in pathological report, initial metastasis and complete response to initial therapy. Adjuvant radiotherapy, small tumor size, curative surgery with chemotherapy and free surgical margins were significantly associated with reduced recurrence. Complete response to primary therapy is the main independent variable of overall survival of patients. Earlier diagnosis and experienced team including surgical, medical and radiotherapy oncologist is needed for better response and longer survival rate