A neurological presentation caused by brain metastases in a dog with interventricular septal hemangiosarcoma.

BACKGROUND: Brain metastases are well known for disseminated hemangiosarcoma involving the right atrium/auricle. CASE REPORT: An 8-year-old male Australian Shepherd Dog presented with a 3-day history of circling to the left. A neurological examination revealed obtunded mentation, right hemi-inattention, bilateral strabismus towards the left side and absent physiological nystagmus. In addition, the dog had muffled heart sounds on auscultation and exercise-induced weakness. Laboratory findings included hypercoagulability and marked elevation in the C-reactive protein concentration. Electrocardiography detected a sinus rhythm with right bundle-branch block and ventricular bigeminy. Echocardiography revealed an extensive interventricular septal mass. Due to the grave prognosis, the owners elected for euthanasia, and a complete necropsy was performed. The main pathological findings were an interventricular septal and left ventricular hemangiosarcoma, with metastases in the brain, lungs, spleen and adrenal glands. No evidence of tumour infiltration was found in the right atrium. CONCLUSION: To the authors' knowledge, this is the first report of neurological signs due to confirmed brain metastases in a dog with interventricular septal hemangiosarcoma. Although the right atrium is the main location for cardiac hemangiosarcoma, the interventricular septum should be evaluated in all cases.

The effect of a hospital-based counseling service on the physical recovery of surgical and medical patients.

This study evaluated the effects of a hospital-based counseling service on the physical recovery of surgical and medical patients. Their recovery was measured in terms of days on antibiotics, days to return to normal temperature, normal pulse and oral intake, and days on intravenous (IV) feeding. The effects of the sex, age, seriousness of physical problem, recovery rate, and digestive vs. genital system involvement of patients on these recovery measures were also monitored. Seriousness of physical problem proved to be the best predictor of patient recovery but, when its effects were controlled for, some beneficial effects of the counseling were observed.

An evaluation of three crisis intervention programmes for general hospital patients.

Three crisis intervention programmes were implemented on the basis of prior research and observation with patients in a general hospital. Programme 1 had been designed to decrease their anxiety and depression, programme 2 to decrease their indirectly expressed anger and increase anger which was directly expressed, and programme 3 to decrease the feelings of helplessness and increase their levels of competence. Examination of the psychological states of the sample of ill and injured patients on admission showed that those who were judged to have a poor counselling prognosis were found, as hypothesized, to be highly anxious, depressed and helpless, and to be expressing their anger only indirectly. The goals of the programmes therefore seem to have been appropriately selected to meet the psychological needs of the patients. After crisis intervention counselling, these differences on admission were no longer apparent on discharge or on follow-up 12 months later. Programme 1 did not prove differentially effective on discharge or follow-up. Programme 2 was not found to be more effective than the other programmes on discharge but, as hypothesized, was associated with direct expression of anger and decreased anxiety and depression more at follow-up. Programme 3 increased patients' expressions of competence and decreased their anxiety more on discharge; but on follow-up it proved more liable to maintain their depression than to have beneficial effects.

Sex differences in the psychological reactions of medical and surgical patients to crisis intervention counseling: sauce for the goose may not be sauce for the gander.

The psychological reactions of 259 female and 130 male medical and surgical patients were examined. Both when they were discharged and when they were followed up 12 months later, women who received crisis intervention counseling during their hospitalisation showed the predicted psychological gains when compared with non-counseled women. They expressed fewer feelings of helplessness and more of competence in the short term and fewer feelings of anxiety and helplessness in the long term. Men showed some improvements in the short term but fewer in the long term when, although they later expressed more feelings of competence, there were also more of helplessness. Women and men also showed the predicted benefits of counseling similarly in fewer indirect expressions of anger on both occasions. They also showed less anxiety on discharge and fewer depressive feelings on follow-up. Explanations of the sex differences in terms of sex role stereotypes, the extent of each patient's crisis and possible methodological artefacts were considered.

Crisis intervention: an experimental study of the effects of a brief period of counselling on the anxiety of relatives of seriously injured or ill hospital patients.

This study was designed to examine the effects of anxiety levels, as measured by the Gottschalk & Gleser (1969) and the Viney & Westbrook (1976) content analysis scales, of a brief period of supportive counselling of relatives who arrived at a hospital emergency admitting ward with a seriously ill or injured patient. Verbal samples were taken for analysis from the subjects before and after a period of counselling (or a period of no counselling for the control group). The results showed that the initial anxiety levels for subjects in both groups was very high. For both the psychoanalytically oriented Gottschalk & Gleser anxiety scale and the Viney & Westbrook scale of cognitive anxiety there was a decrease in the level of anxiety for the counselled group compared with the non-counselled group. The results showed that such crisis intervention in hospitals for relatives who accompany patients to the hospital can reduce their very high levels of diffuse and generalized anxiety.