Caring for patients with brain tumor: the patient and care giver perspectives.

BACKGROUND: Patients with brain tumors form a heterogeneous group in terms of clinical presentation and pathology. However, the impact of the disease on patients' families is often more homogenous and frequently quite profound. A considerable body of literature is available on the management of brain tumors and recently, the National Institute for Clinical Excellence has developed guidelines on the care of brain tumor patients that should improve the overall outcome for the patient from both the disease and psychological aspects. OBJECTIVES: An increasing number of studies have attempted to address the impact of the disease on the care givers and relatives of these patients, but few have considered the problem simultaneously from both the patient's and care giver's perspective. In this study, we analyzed the psychosocial and general health of brain tumor patients and related this to the care givers. MATERIALS AND METHODS: This is a questionnaire-based postal survey of 168 patients and their relatives. We examined how the health and psychological well-being of the caregiver may affect the quality of care. RESULTS: There is significant physical, social, and psychosocial morbidity associated with caring for brain tumor patients. Patients worry about their care givers and this constitutes additional stress for the patient. CONCLUSIONS: No constructive and lasting improvement can be made to the quality of life of patients with brain tumor until the health and welfare of their care givers are factored into the care package. With better service to the patient, it is hoped that the burden of care will lighten for the care givers.

Active oxygen generation in gamma-irradiated whole seedlings of Cicer arietinum L.

Whole seedlings of Cicer arietinum L. when exposed to 819 Gy gamma-radiation, were found to emit ultraweak intensity luminescence. The phenomenon was oxygen-dependent, and the intensity of emission could be suppressed by post-irradiation treatment with catalase, superoxide dismutase, and ascorbic acid. Deuterium oxide and luminol amplified the emission intensity. These results suggest that singlet oxygen is a cause of the emission during the post-irradiation phase.

Underwater medicine: a neglected area in Accident and Emergency specialist training.

We have evaluated the available medical care to sports divers by a postal questionnaire sent to consultants and senior registrars in Accident and Emergency medicine in the UK, assessing their training in underwater medicine. Replies were received from 60 of 96 consultants (63%) and 32 of 58 (55%) senior registrars. Thirty-two per cent of consultants and 50% of senior registrars had previous personal experience in managing an underwater diving accident. Thirty per cent of consultants and only 19% of senior registrars had prior formal postgraduate training in underwater medicine. Twenty-seven per cent of consultants and 13% of senior registrars replying did not know the pattern of referral for specialist advice nor where the nearest recompression chamber was to be found. We believe that more formal postgraduate training in underwater medicine is needed by A and E medical staff. Furthermore, clear guidelines about emergency management and patterns of referral for diving accidents should be displayed prominently in all A and E departments.

A variant of the syndrome of spinal arachnoid cysts with multiple congenital defects.

We report an apparently unique case of multiple spinal intradural arachnoid cysts in association with distichiasis, late onset lower limb lymphoedema, and previously unrecognized features of associated bilateral megaureters, Arnold Chiari malformation with hydrocephalus and syringomyelia. The literature on this unusual group of congenital malformations is reviewed.

Microdiscectomy.

Despite the introduction of microdiscectomy some fifteen years ago, the spread of this procedure amongst surgeons who operate on discs has been disappointingly slow. The overall impression of the impact which this operation has made on the surgery of lumbar discs is considerable and the authors recommend that this should now be the standard operation for disc sciatica, especially as the operation can now be performed as an outpatient procedure.

Bone flap replacement vs acrylic cranioplasty: a clinical audit.

A 5-year retrospective study comparing bone flap replacement with acrylic cranioplasty was carried out. There was no significant difference in the high infection rates associated with the two procedures. We suggest that antibiotic-impregnated acrylic cranioplasty may be the safest and best surgical procedure based on the orthopaedic experience with gentamicin-impregnated cement in joint replacement surgery.