Radiation dose profile in 125I brachytherapy: an 8-year review.

The use of episcleral plaques containing radioactive 125I seeds for brachytherapy treatment of selected retinoblastoma cases of patients is being done in Riyadh, Saudi Arabia since 1994. There are about three to four patients per year. A total of 31 patients were treated with a tumour dose in the range of 40-60 Gy using 8 seeds of 125I each from 1994 to 2002. This study determines the trend of occupational doses received by surgeons, anaesthesiologists and nurses and the dose rate profile around the eyes. Only 3% of the 275 persons monitored for Hp(10) have measurable doses with a weighted average of 4 microSv and 7% of the 175 persons monitored for Hp(0.07) have measurable doses with a weighted average of 0.3 mSv. The dose rate is maximum (110 microSv h(-1)) at the point of contact with the eye plaque and reduces to approximately 40% on the side of the other eye.

Intraocular cancers.

1. Retinoblastoma is the most common primary intraocular cancer of children. It occurs in unilateral and bilateral forms. 2. Approximately 40% of all cases are associated with a heritable defect in chromosome 13. 3. Malignant melanoma is the most common primary intraocular malignant tumor among adults. 4. Unlike retinoblastoma, primary intraocular malignant melanoma is almost exclusively a monocular, unifocal disease without hereditary transmission.

The power of humor and play as nursing interventions for a child with cancer: a case report.

Many benefits of humor and play have been documented in the literature. The purpose of this Case Report was to assess the benefits of humor and play with a 5-year-old retinoblastoma patient in an ambulatory care setting. The use of humor in the forms of tickling, joke-telling, play on words, funny movies, silly stickers, and medical play was found to be helpful in decreasing the anxiety of a pediatric oncology patient during insertion of his Infusaport needle. This article reviews the benefits of humor and play and provides a brief discussion of the developmental aspects of humor and play theory. Implications for further nursing research in the area of humor interventions are also discussed. The promotion of appropriate humor and play use by all health care professionals is encouraged.

Genetic teaching for the retinoblastoma patient.

Retinoblastoma is the most common primary intraocular tumor in children. Retinoblastoma can be hereditary (familial) or nonhereditary (nonfamilial). Nurses who have an understanding of the genetic patterns for retinoblastoma can participate in the counseling of these patients. A chart is provided as a tool for teaching patients about family patterns of retinoblastoma.

Ocular complications related to breast cancer.

One in 10 women will be affected by breast cancer in their lifetime. The potential for loss of vision from breast cancer metastases to the eye will affect a small proportion of these women. Ocular complications related to these metastases and cancer treatments (drugs, irradiation) and the psychosocial support for the patient and family make the role of the ophthalmic nurse an extremely important one. This article will review these issues.

Nursing implications of visual fields in successfully treated retinoblastoma patients.

Very little data has been published on the long term peripheral vision of patients diagnosed and successfully treated for retinoblastoma. Nursing should address the patient's response to vision-conserving treatment and their adaptation to decreased peripheral vision. Computerized Humphrey's Central 30/Peripheral 30-60 visual fields were performed on ten patients (all with greater than ten year follow-up) who were successfully treated for retinoblastoma. All ten visual fields revealed an absolute and relative scotoma in the affected eye. Visual field loss was always worse than one would have predicted based upon the fundus examination of the tumor(s). Decisions for treatment must be based upon an interdisciplinary approach of nursing and medicine to evaluate patient survival and visual outcome. Nursing interventions include utilizing the visual field as a teaching aid, preparing the patient and the family for potential future visual loss and adaptation of lifestyle, and providing emotional support and realistic reassurance.

Retinoblastoma: a hereditary tumor in children.

Retinoblastoma, a malignant intraocular tumor of infancy and childhood, originates from primitive embryonal retinal cells. The cause of retinoblastoma is the loss or deletion of genetic information from the long arm of chromosome 13. Retinoblastoma has a hereditary form characterized by bilateral and multifocal tumors, and a nonheritable form that presents with a single tumor.

Retinoblastoma.

Retinoblastoma, although a rare childhood cancer, is the most common primary malignant intraocular tumor of infancy and early childhood. In 75% of the cases, retinoblastoma is unilateral, and in 25% of the cases, retinoblastoma is bilateral. Presenting signs and symptoms of retinoblastoma, genetics, diagnostic tests, and their implications are reviewed in this paper. Treatment options for retinoblastoma (enucleation, external beam radiation, radioactive plaque, cryotherapy, photocoagulation, and chemotherapy) and their nursing care are discussed. Finally, second tumors such as osteosarcomas are discussed.

Unusual presenting signs of retinoblastoma: a case study.

In the US, leukocoria is the most common presenting sign of retinoblastoma, and strabismus is the second most common finding. Retinoblastoma less frequently presents as an inflammatory process involving the eye or orbit, which often masks the symptoms of retinoblastoma. Children who present with leukocoria strabismus, hypopyon, heterochromia, rubeosis, hyphema, or an orbital cellulitis should be referred to an ophthalmologist for a dilated fundus examination of both eyes, under general anesthesia if necessary, to rule out the possibility of a retinoblastoma in the differential diagnosis.

The clinical nurse anesthetist as diagnostic sleuth.

Two cases are presented where observations made during anesthetic management led to appropriate diagnoses that otherwise might not have occurred in a timely fashion. In the first case, an early diagnosis of myasthenia gravis was facilitated; while in the second case, an improbable response led to rethinking of the initial diagnosis. The role of the nurse anesthetist in being alert to the consequences of unusual clinical and theoretical responses on behalf of the patient is depicted.