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[en] Aim: To systematically review the currently available high quality evidence evaluating treatments for moist desquamation in radiotherapy patients. Design: Systematic literature review. Methods: Electronic databases, websites, reference lists, key journals and conference proceedings were searched. Attempts were also made to uncover unpublished material. Relevant studies proceeded to data extraction and quality assessment. Results: Twenty studies were found; 10 were eligible for inclusion. Although many studies were small, none had unacceptably poor quality. No meta-analysis was undertaken as the studies were not homogenous in their interventions or methods. No convincing evidence for any intervention was found. Conclusion: Despite being recommended by many guidelines (College of Radiographers Summary of Intervention for Acute Radiotherapy Induced Skin Reactions in Cancer Patients (London, 2001); NHS Quality Improvement Scotland Best Practice Statement: Skincare of Patients Receiving Radiotherapy (Edinburgh, 2004)); there is mixed evidence concerning the use of hydrogels and hydrocolloid dressings. However, improved patient comfort was sometimes seen, which is arguably equally important. There was limited evidence to support other interventions. Further research is urgently needed.
[en] The rapid growth in the use of ultrasound as a diagnostic imaging technology over the past forty years, has led to a demand for a workforce with the appropriate skills to perform and interpret the scans. In the UK, ultrasound investigations now comprise the largest group of all diagnostic imaging examinations.1 However, there remains no statutory regulation of the practice of sonography in the UK, and little recognition of the considerable training that many practitioners have undertaken to obtain the skills to become safe and competent sonographers. Many in the field consider that this should change, and are working to obtain professional status for the practice of sonography.2–5 Although the Health Care Professions Council (HCPC) has recommended regulation of sonography practice, this is unlikely to happen in the near future. This paper discusses the evolution of sonography practice and explores some of the complex issues associated with the professionalisation of sonography
Background and PurposeData on safety and efficacy of periprocedural use of heparin are limited during treatment of acute ischemic stroke patients with anterior circulation tandem occlusion. This study aimed to investigate the impact of heparin use during endovascular therapy of anterior circulation tandem occlusions on the functional and safety outcomes.
MethodsA retrospective analysis of the multicenter observational TITAN registry was performed. Patients with anterior circulation tandem occlusion and treated with endovascular therapy (EVT) were included, with or without extracranial carotid intervention. We divided patients into two groups based on periprocedural heparin use (heparin vs. non-heparin). The dose of intravenous unfractionated heparin ranged from 1500 to 2500 I.U. Primary study endpoint was 90-day Modified Rankin Scale (mRS). Secondary study endpoint included angiographic and safety endpoints such as hemorrhagic complications. A propensity-score-matched analysis was performed.
ResultsAmong 369 patients, heparin was used in 68 patients (18.4%). In the propensity-score-matched cohort, favorable outcome (mRS 0–2) occurred in 51.3% in heparin group and 58.0% in non-heparin group (matched OR, 0.76; 95% CI, 0.32–1.78; P = 0.52). Similar result was found in propensity-score-adjusted cohort (adjusted OR, 0.72; 95%CI, 0.39–1.32; P = 0.28). Likewise, there was no difference in the rate of successful reperfusion (mTICI 2b-3) (propensity-score-adjusted OR, 1.03; 95%CI, 0.50–2.09; P = 0.93) neither in safety endpoints between the two groups.
ConclusionsPeriprocedural heparin use during EVT of anterior circulation tandem occlusions was not associated with better functional, angiographic or safety outcomes. These findings are applicable for low doses of heparin, and further studies are warranted.
[en] Objective: To investigate the vascular vagovagal reflexes (VVRs) during interventional approach of peripheral arterial disease (PAD). Methods: Twelve patients with VVRs during intervention of 528 patients with peripheral arterial diseases were analyzed retrospectively. Results: The 12 patients with VVRs belonging to mixed type, included 2 cases of occurrence during intervention and 10 cases after intervention. All patients recovered well without adverse reaction. Conclusion: VVRs should always be looking after and prompt management be ready in hand. (authors)
[en] The DGT/AS 04 circular defines a series of concepts concerning laws and regulations applicable to ionizing radiations. The most important concepts are: the different types of workers, the organization of radiation protection in the enterprise, the training of the staff, the assessment of the radiation risks, the obligations of the employer, the medical follow-up of the staff. It appears that about 300.000 workers in more than 40.000 enterprises are concerned by this legislation. The decree of 22. September, 2010 concerns the information that is requested by the ASN (French Authority for Nuclear Safety) when an enterprise addresses a demand for fabricating, using or detaining radionuclides or devices containing them. This document gives comments on some points and can be considered as a practical help. (A.C.)
[en] Complete test of publication follows. Interventional cardiology is recognized as a radiological practice connected with high level of patient skin doses as well as also with excessive exposure levels for physicians performing the examinations. Pediatrics represents a comparatively small, though increasing fraction of the overall number of the cardiac examinations, however the combination of higher radiation doses to children and the much larger lifetime risk per unit dose of radiation applied to children results in lifetime cancer mortality attributable to the radiation exposures from catheterization, which is significantly higher in children than in adults. Due to the limited published data on radiation doses to pediatric patients undergoing the cardiac catheterization procedure, the purpose of our study was to analyze the radiation load of patients and the occupational doses in Pediatric Cardiology Center in Bratislava where Siemens Cathcor 4.1 (biplane) is working with an undercouch image intensifier and DAP recording possibility. In our study 124 pediatric patients were included, aged from several weeks to 18 years, undergoing heart catheterization. For each procedure age, sex, weight and height were noted, and corresponding DAP, together with applied voltage, mAs, cine frames and fluoroscopy times were recorded. The study was performed within SENTINEL project under FP6 program of EC.
[en] The book Oncology in the primary health care, constitutes an important contribution to the prevention and treatment of cancer, from a very comprehensive assessment. It's a disease that is the second leading cause of death in our country, to much pain and suffering is for the patient and their family. The book has a very useful for basic health equipment approach, since it emphasizes that cancer can be prevented if achieved in the population changes in lifestyle. The book is valued not correct food as responsible for one third of all cancers. Currently important research being developed in relation to psiconeuroinmuno-Endocrinology, who is studying the association between psychological factors and the development of cancer valuing that kept stress and depression reduces the antitumor activity of the immune system; that made programs with encouraging results where the treatment of cancer has joined elements of psychotherapy, immunotherapy and the use of the biotherapy. The focus of the book fills an important place in the primary health care and is an indispensable guide for professionals at this level of care (author)
[en] Aim: To review the provision of out-of-hours interventional radiology (IR) services in the London Strategic Health Authority (SHA). Materials and methods: All 29 acute hospitals in the London SHA were contacted between November 2008 and January 2009. A questionnaire based on the Royal College of Radiologists (RCR) guidelines assessed the provision of out-of-hours IR services. An 'ad-hoc' service was defined as on-call provision where not all the radiologists could perform intervention: If IR was required out of hours, an interventionalist came in when off-duty or the patient was transferred. Results: Seventeen out of the 29 (59%) hospitals provided ad-hoc out-of-hours services, eight (28%) provided a 24-hour rota, and four (14%) provide no out-of-hours cover. No ad-hoc service had formal transfer arrangements to a centre providing a 24 h service. Only two hospitals providing a 24 h service had six radiologists on the rota. Conclusion: Strategic planning for out-of-hours IR across London is recommended. This is likely to be welcomed by the hospitals involved, allowing informal arrangements to be formalized, and collaboration to provide comprehensive regional networks, provided appropriate funding is made available. A national audit is recommended; it is unlikely these findings are unique to London.