Unmet Needs and Burden of Caregivers of Patients Being Evaluated for a Liver Transplant Are Similar to Those of Cancer Caregivers.

BACKGROUND: The caregivers (CG) of patients with serious illnesses often experience stress and psycho-social issues. High burden is expected for CG of patients for whom liver transplant (LT) is the only curative option. This study aims to measure the burden, unmet needs, and quality of life (QoL) of CG of patients being evaluated for LT. METHODS: This cross-sectional study enrolled CG of patients being evaluated for LT. CaTCoN (Caregiving Tasks, Consequences and Needs Questionnaire) was used to assess caregiving consequences and needs related to interactions with healthcare professionals (HCPs). ZBI-12 (Zarit Burden Interview) was used to assess CG burden, and PROMIS-29 (Patient Reported Outcomes Measurement Information System) to assess QoL. Caregivers completed the study instruments in person, while they were in the clinic. CaTCoN scores from our study were compared with cancer caregivers' historical data. RESULTS: 18 CG were enrolled, mean age 54 [14] years; 72% were white and 77% were women. 61% worked full time; 45% provided >20 hours of care per week. Two-thirds cared for patients with alcoholic liver disease. All CaTCoN scores were no different from CGs of cancer patients (all P > .05). The total ZBI score (mean SD 12.4 [8.3]) did not differ from published scores for CG of cancer patients (12.0 [8.5]). 44% had high (≥12) ZBI scores reflecting "high burden." Their PROMIS-29 T scores, compared to those with low burden, showed more anxiety (P = .01), depression (P = .04), fatigue (P = .02) and deteriorated social function (P = .009). Physical function and social function were diminished among these CGs compared to the general population (P < .0001). CONCLUSION: CGs of patients being evaluated for LT suffer from high burden similar to cancer CGs and have reduced physical and social function. Despite the small sample size, the data completion rate was almost 100%.

Effects of pentylenetetrazole-induced seizures on metabolomic profiles of rat brain.

Epilepsy is one of the most common neurological disorders and approximately one-third of patients with epilepsy are resistant to treatment. In order to develop our understanding of the metabolic changes occurring during seizure a metabolomic approach was employed. Using a pentylenetetrazole (PTZ) kindling model of epilepsy metabolomic analysis of brain extracts from the cerebellum, brain stem, prefrontal cortex and hippocampus was performed. Principal component analysis (PCA) of the (1)H NMR derived data revealed a distinct metabolic profile for each brain region. In order to assess the changes occurring following seizure partial least square discriminant analysis (PLS-DA) models for each brain region for PTZ-kindled and control animals were constructed. For all the brain regions good predictive models were built and the discriminating metabolites were identified. Results following one injection of PTZ indicated that the changes observed in the cerebellum and hippocampus were mainly due to seizure. In the hippocampus of PTZ-kindled animals the metabolites changing included lactate, succinate, GABA, NAA, choline and taurine. Analysis of the cerebellum of PTZ-kindled animals revealed changes in lactate, myo-inositol, choline, GABA, creatine, succinate, phosphocholine and GPC. Overall, the results indicate that seizure may be associated with an increase in energy demand, altered neurotransmitter balance and an increase in neuronal loss and gliosis.