While research has shown community-based psychiatric care to be as good as, or better than, hospital-based care, generalisation to clinical practice has been difficult. This prospective, randomised controlled study examined a community-based approach feasible within NHS conditions. Ninety-four patients were randomly allocated to experimental and 78 to control treatments and followed for one year. The groups were well matched apart from an excess of psychotic control patients. No differences in clinical or social functioning outcome were found. Both groups improved substantially on clinical measures in the first six weeks, with some slow consolidation thereafter. There were three suicides in the control group and one in the experimental group. Access to care was better in the experimental group (93% attended assessment) than in the control group (75% attended assessment).

No abstract

It has been calculated that to achieve an adequate concentration of a drug for a therapeutically significant period of time in the central core of a 6 cm diameter glioblastoma multiforme at a depth of 1-3 cm from the perfused rim, a plasma level would have to be maintained at therapeutic concentrations for 10-24 hours.' This is difficult to achieve clinically which perhaps goes some way to explaining the disappointing results of chemotherapy in the treatment of human cerebral gliomas. Cerebral gliomas are unique in one particular respect in that in no other tumour is there such a clear kinetic difference between the neoplastic and the normal tissue. The limited effectiveness of certain cell cycle specific drugs such as bleomycin in the treatment of human cerebral gliomas might be due therefore in part to the difficulty in maintaining adequate therapeutic concentrations of drug at the tumour site, rather than an inate ineffectiveness of the drug. Bleomycin has been found to be very effective in the treatment of human ectodermally derived tumours2 and animal

No abstract