RESUMEN
The purpose of this study was to determine the impact of various prognostic factors on survival in spinal cord gliomas treated with radiation. Fifty-three patients with spinal cord gliomas irradiated at three major institutions were studied. Fifty-one patients were classified as having ependymoma, astrocytoma, or both. Two patients were classified as having gliomas (otherwise unspecified). Eleven patients had complete resection of their tumor. Biopsy or partial resection was done in the remaining patients. All patients received external beam radiation. Information on these patients was placed in a central database file and analyzed for the effect of several prognostic factors on survival. Overall survival of the entire group was 76.9% and 61.5% at 5 and 10 years, respectively. Pathologic status significantly affected survival (p = 0.03). Patients with ependymomas had a 5-year survival of 93.8% and a 10-year survival of 67.5%. Patients with astrocytoma had a 5-year survival of 64.2% and a 10-year survival of 54%. Univariate analysis showed pathology and the presence of cysts (p = 0.038) to significantly affect survival. Age, sex, location of the primary, extent of surgery radiation dose, and number of involved segments did not affect survival. On multivariate analysis, astrocytic pathology, involvement of more than five segments, male sex, and the absence of cysts (in or adjacent to the tumor) were associated with a significantly inferior survival. This study confirms the importance of pathology and number of segments involved in determining outcome or survival. The presence of cysts adjacent to or within the tumor was found to be associated with an improvement in survival.
Asunto(s)
Glioma/radioterapia , Neoplasias de la Médula Espinal/radioterapia , Adolescente , Adulto , Anciano , Astrocitoma/patología , Astrocitoma/radioterapia , Astrocitoma/cirugía , Biopsia , Niño , Preescolar , Quistes , Ependimoma/patología , Ependimoma/radioterapia , Ependimoma/cirugía , Femenino , Glioma/patología , Glioma/cirugía , Humanos , Lactante , Masculino , Persona de Mediana Edad , Análisis Multivariante , Pronóstico , Dosificación Radioterapéutica , Radioterapia Adyuvante , Radioterapia de Alta Energía , Estudios Retrospectivos , Neoplasias de la Médula Espinal/patología , Neoplasias de la Médula Espinal/cirugía , Análisis de SupervivenciaRESUMEN
A psychoeducation program in an acute care inpatient psychiatric setting involves schizophrenic patients and their families in a range of educational interventions that are responsive to their particular strengths and vulnerabilities. Patients receive one-on-one instruction about their illness from a psychiatrist and the nursing staff and learn community living skills in classes and tutorials conducted by occupational therapists. Families discuss ways of coping with the patients' illness in a series of meetings with a social worker, and they attend workshops led by a team of clinicians and an administrator, who advise them of current perspectives on the illness and its management and about how to negotiate the mental health system. A mental health library keeps staff, family, and patients abreast of recent literature about schizophrenia. The authors believe the program prepares patients to live in the community better than do programs whose goals are limited to symptom reduction or crisis intervention.
Asunto(s)
Intervención en la Crisis (Psiquiatría) , Terapia Familiar/métodos , Educación del Paciente como Asunto/métodos , Esquizofrenia/rehabilitación , Adaptación Psicológica , Adolescente , Adulto , Anciano , Terapia Combinada , Hospitales , Humanos , Persona de Mediana Edad , Grupo de Atención al Paciente , Rehabilitación Vocacional/métodos , Psicología del EsquizofrénicoRESUMEN
The influx of consumer literature about schizophrenia and other mental disorders has inspired the establishment of a Mental Health Resources Library at a psychiatric hospital. Used by patients, their families and friends, and hospital staff, it is an educative resource to understand and cope better with mental illness and its treatment, human development issues, and concerns of daily living. In describing the Mental Health Resources Library, this paper provides a background of its funding and organization, reactions of the library users, and future directions for expansion and utilization. An annotated list of volumes in the library is included.
Asunto(s)
Hospitales Psiquiátricos , Bibliotecas de Hospitales/organización & administración , Trastornos Mentales/terapia , Salud Mental , Educación del Paciente como Asunto , Bibliografías como Asunto , Hospitales con más de 500 Camas , Humanos , Ciudad de Nueva YorkRESUMEN
The amount of information in the psychiatric field has increased to such an extent that a specialized library is an essential part of the mental health facility. Guidelines are presented for establishing a psychiatric library, including staffing, budgeting, physical layout, and selection and handling of books, reference materials, journals and annuals, microfilm and microfiche, and audiovisuals. The expertise of the librarian is the single most important factor in determining the quality of the collection and the services provided, the author believes. Because of escalating costs, developing a cooperative library network of small, specialized mental health collections may be the most productive course for the future.
Asunto(s)
Bibliotecas/organización & administración , Psiquiatría , Humanos , Administración de Biblioteca , Bibliotecología , Servicios de Biblioteca/organización & administraciónRESUMEN
The late Ilse Bry made numerous contributions to health science librarianship in the roles of scholar and librarian. Her professional interests lay in the literature and bibliography of the behavioral sciences; she served as Librarian of the New York Psychoanalytic Institute and later became the library associate in charge of the New York University Psychiatric Library. Upon leaving active librarianship Ilse Bry continued to work as a meticulous bibliographer and as Editor of the Mental Health Book Review Index.