WorldWideScience

Sample records for clinical radiobiological experience

  1. Postoperative radiotherapy in DBCG during 30 years. Techniques, indications and clinical radiobiological experience

    Energy Technology Data Exchange (ETDEWEB)

    Overgaard, Marie; Juul Christensen, Jens (Dept. of Oncology and Dept. of Medical Physics, Aarhus Univ. Hospital, Aarhus (Denmark))

    2008-05-15

    During the time period 1977-2007 postoperative radiotherapy in DBCG has varied considerably with regard to techniques and indications together with changes in the extent of surgery and adjuvant systemic therapy. The radiation treatment has been developed on the basis of clinical, radiophysical and radiobiological principles, encompassing also practical problems such as available equipment in the different centres and at times lack of sufficient machine capacity. The paper focus especially on the comprehensive work done prior to the DBCG 82 b and c studies, in order to optimize radiotherapy in all aspects prior to the evaluation of the efficacy of this treatment modality. The results from these trials did succeed in clear evidence that radiotherapy has an important role in the multidisciplinary treatment of early breast cancer. In parallel to these studies a new and challenging use of radiotherapy after breast conserving surgery was evaluated in the DBCG TM 82 protocol. The experience obtained with different techniques in this study formed the basis for the current principles of radiotherapy after lumpectomy. Reduction of radiation related morbidity has been a major issue for the DBCG radiotherapy group, and in this aspect several studies, including quality control visits, have been carried out to make the relevant modifications and to evaluate deviations from the guidelines between the centres. The background for the changes in radiotherapy is described for each of the programme periods as well as future perspectives which will include further refinements of the target and adjustments of dose and fractionation in selected patients

  2. Radiobiological and clinical aspects of neutron therapy

    International Nuclear Information System (INIS)

    Radiobiological investigations and their interpretation are discussed. The history of neutrontherapy, the results of RBE-investigations in man as well as clinical results are given. The hypothesis on reaction of human tissue and tumours towards neutron irradiation is presented. (A.S.)

  3. Dosimetry for radiobiology experiments at GANIL

    Science.gov (United States)

    Durantel, Florent; Balanzat, Emmanuel; Cassimi, Amine; Chevalier, François; Ngono-Ravache, Yvette; Madi, Toiammou; Poully, Jean-Christophe; Ramillon, Jean-Marc; Rothard, Hermann; Ropars, Frédéric; Schwob, Lucas; Testard, Isabelle; Saintigny, Yannick

    2016-04-01

    Mainly encouraged by the increasing application of ion beams for cancer treatment (hadron-therapy) including carbon beams, the use of heavy ion facilities for radiobiology is expanding rapidly today. As an alternative to dedicated centers for treatment and medical research, accelerators like GANIL offer the possibility to undertake such experiments. Since 20 years, CIMAP, reinforced 15 years ago by the biological host laboratory LARIA, has been receiving researchers in radiobiology and assisted them in performing experiments in different fields such as hadron-therapy, space radioprotection and fundamental biological and physico-chemical mechanisms. We present here a short description of the beam line and the on-line equipments that allow the automatic irradiation of up to 24 biological samples at once. We also developed an original on-line beam monitoring procedure for low ion flux (low dose rates) based on the measurement of the K-shell X-rays emitted from a thin iron foil. This detector is calibrated on an absolute scale before each experiment by counting etched tracks on an irradiated CR39 polymer plate. We present the performances and limits of this method and finally give typical fluence (dose) uncertainties for a standard irradiation in radiobiology.

  4. Experimental radiotherapy and clinical radiobiology. Vol. 20. Proceedings

    International Nuclear Information System (INIS)

    The proceedings include contributions on the following issues: laser driven proton accelerators on the way for radiotherapy, radiobiological evaluation of new radiations; molecular factors of radiation response; biological targeting; EGFR epidermal growth factor receptor/targeting - combined internal and external irradiation, radiobiology of normal tissues; dose-volume histograms for the radiotherapy: curves without radiobiological relevance or important information for the therapy planning; HPV (human papilloma virus) and radiation sensitivity of HNSCC (head and neck squamous cell carcinomas): evidence, radiobiological mechanism, clinical consequences and perspectives; mechanisms of action and intertumoral heterogeneity of response to EGFR inhibition in radiotherapy of solid tumors; evaluation of biomarkers for radiotherapy.

  5. Radiobiology

    International Nuclear Information System (INIS)

    This text-book (electronic book - multi-media CD-ROM) constitutes a course-book - author's collection of lectures. It consists of 13 lectures in which the reader acquaints with the basis of radiobiology: Introduction to radiobiology; Physical fundamentals of radiobiology; Radiation of cells; Modification of radiation damage of cells; Reparation of radiation damage of cells; Radiation syndromes and their modification; Radiation injury; Radiation damage of tissues; Effect of radiation on embryo and fetus; Biological effects of incorporated radionuclides; Therapy of acute irradiation sickness; Delayed consequences of irradiation; Radiation oncology and radiotherapy. This course-book may be interesting for students, post-graduate students of chemistry, biology, physics, medicine as well as for teachers, scientific workers and physicians. (author)

  6. Hypofractionation in prostate cancer: radiobiological basis and clinical appliance.

    Science.gov (United States)

    Mangoni, M; Desideri, I; Detti, B; Bonomo, P; Greto, D; Paiar, F; Simontacchi, G; Meattini, I; Scoccianti, S; Masoni, T; Ciabatti, C; Turkaj, A; Serni, S; Minervini, A; Gacci, M; Carini, M; Livi, L

    2014-01-01

    External beam radiation therapy with conventional fractionation to a total dose of 76-80 Gy represents the most adopted treatment modality for prostate cancer. Dose escalation in this setting has been demonstrated to improve biochemical control with acceptable toxicity using contemporary radiotherapy techniques. Hypofractionated radiotherapy and stereotactic body radiation therapy have gained an increasing interest in recent years and they have the potential to become the standard of care even if long-term data about their efficacy and safety are not well established. Strong radiobiological basis supports the use of high dose for fraction in prostate cancer, due to the demonstrated exceptionally low values of α / β . Clinical experiences with hypofractionated and stereotactic radiotherapy (with an adequate biologically equivalent dose) demonstrated good tolerance, a PSA control comparable to conventional fractionation, and the advantage of shorter time period of treatment. This paper reviews the radiobiological findings that have led to the increasing use of hypofractionation in the management of prostate cancer and briefly analyzes the clinical experience in this setting. PMID:24999475

  7. Hypofractionation in Prostate Cancer: Radiobiological Basis and Clinical Appliance

    Directory of Open Access Journals (Sweden)

    M. Mangoni

    2014-01-01

    Full Text Available External beam radiation therapy with conventional fractionation to a total dose of 76–80 Gy represents the most adopted treatment modality for prostate cancer. Dose escalation in this setting has been demonstrated to improve biochemical control with acceptable toxicity using contemporary radiotherapy techniques. Hypofractionated radiotherapy and stereotactic body radiation therapy have gained an increasing interest in recent years and they have the potential to become the standard of care even if long-term data about their efficacy and safety are not well established. Strong radiobiological basis supports the use of high dose for fraction in prostate cancer, due to the demonstrated exceptionally low values of α/β. Clinical experiences with hypofractionated and stereotactic radiotherapy (with an adequate biologically equivalent dose demonstrated good tolerance, a PSA control comparable to conventional fractionation, and the advantage of shorter time period of treatment. This paper reviews the radiobiological findings that have led to the increasing use of hypofractionation in the management of prostate cancer and briefly analyzes the clinical experience in this setting.

  8. In vitro irradiation system for radiobiological experiments

    International Nuclear Information System (INIS)

    Although two-dimensional (2-D) monolayer cell cultures provide important information on basic tumor biology and radiobiology, they are not representative of the complexity of three-dimensional (3-D) solid tumors. In particular, new models reproducing clinical conditions as closely as possible are needed for radiobiological studies to provide information that can be translated from bench to bedside. We developed a novel system for the irradiation, under sterile conditions, of 3-D tumor spheroids, the in vitro model considered as a bridge between the complex architectural organization of in vivo tumors and the very simple one of in vitro monolayer cell cultures. The system exploits the same equipment as that used for patient treatments, without the need for dedicated and highly expensive instruments. To mimic the passage of radiation beams through human tissues before they reach the target tumor mass, 96-multiwell plates containing the multicellular tumor spheroids (MCTS) are inserted into a custom-built phantom made of plexiglass, the material most similar to water, the main component of human tissue. The system was used to irradiate CAEP- and A549-derived MCTS, pre-treated or not with 20 μM cisplatin, with a dose of 20 Gy delivered in one session. We also tested the same treatment schemes on monolayer CAEP and A549 cells. Our preliminary results indicated a significant increment in radiotoxicity 20 days after the end of irradiation in the CAEP spheroids pre-treated with cisplatin compared to those treated with cisplatin or irradiation alone. Conversely, the effect of the radio- chemotherapy combination in A549-derived MCTS was similar to that induced by cisplatin or irradiation alone. Finally, the 20 Gy dose did not affect cell survival in monolayer CAEP and A549 cells, whereas cisplatin or cisplatin plus radiation caused 100% cell death, regardless of the type of cell line used. We set up a system for the irradiation, under sterile conditions, of tumor cells

  9. Experimental radiotherapy and clinical radiobiology. Vol. 22. Proceedings

    International Nuclear Information System (INIS)

    The proceedings of the 25th symposium on experimental radiotherapy and clinical radiobiology include papers on the following issues: radiotherapy individualization based on imaging; pre-clinic imaging and new experimental methods; methods and models, micromilieu and metabolism, combined therapy; secondary tumors following radiotherapy; radiogenic effects in normal tissue; resistance mechanism of tumors and normal tissue; personalized radio-oncology - which biological data are needed; pre-clinic and personalized radio-oncology; biomarkers - pre-clinic and translational; translational examinations for personalized radio-oncology.

  10. Experimental radiotherapy and clinical radiobiology. Vol. 18. Proceedings

    International Nuclear Information System (INIS)

    The proceedings on experimental radiotherapy and clinical radiobiology contain two review articles (prediction of normal tissue reactions after radiotherapy, ?H2AX foci as a marker for DNA double-strand breaks) and 34 contributions to the following topics: Hypoxia and molecular mechanisms of radiation resistance; biological imaging of the tumor micromilieu; DNA repair, genomic instability and carcerogenesis; molecular factors of radiation resistance; actual controversial discussion on possible irradiation caused metastasis risk enhancement; EGFR inhibition and irradiation; biology of experimental radiation/ normal tissue toxicity

  11. In vitro irradiation station for broad beam radiobiological experiments

    Science.gov (United States)

    Wéra, A.-C.; Riquier, H.; Heuskin, A.-C.; Michiels, C.; Lucas, S.

    2011-12-01

    The study of the interaction of charged particles with living matter is of prime importance to the fields of radiotherapy, radioprotection and space radiobiology. Particle accelerators and their associated equipment are proven to be helpful tools in performing basic science in all these fields. Indeed, they can accelerate virtually any ions to a given energy and flux and let them interact with living matter either in vivo or in vitro. In this context, the University of Namur has developed a broad beam in vitro irradiation station for use in radiobiological experiments. Cells are handled in GLP conditions and can be irradiated at various fluxes with ions ranging from hydrogen to carbon. The station is mounted on a 2 MV tandem accelerator, and the energy range can be set up in the linear energy transfer (LET) ranges that are useful for radiobiological experiments. This paper describes the current status of the hardware that has been developed, and presents results related to its performance in term of dose-rate, energy range and beam uniformity for protons, alpha particles and carbon ions. The results of clonogenic assays of A549 lung adenocarcinoma cells irradiated with protons and alpha particles are also presented and compared with literature.

  12. In vitro irradiation station for broad beam radiobiological experiments

    Energy Technology Data Exchange (ETDEWEB)

    Wera, A.-C., E-mail: anne-catharine.wera@fundp.ac.be [NAmur Research Institute for LIfe Sciences (NARILIS), Research Centre for the Physics of Matter and Radiation (PMR), University of Namur-FUNDP (Belgium); Riquier, H., E-mail: helene.riquier@fundp.ac.be [NAmur Research Institute for LIfe Sciences (NARILIS), Unite de Recherche de Biologie Cellulaire (URBC), University of Namur-FUNDP, Rue de Bruxelles, 61, B-5000 Namur (Belgium); Heuskin, A.-C., E-mail: anne-catherine.heuskin@fundp.ac.be [NAmur Research Institute for LIfe Sciences (NARILIS), Research Centre for the Physics of Matter and Radiation (PMR), University of Namur-FUNDP (Belgium); Michiels, C., E-mail: carine.michiels@fundp.ac.be [NAmur Research Institute for LIfe Sciences (NARILIS), Unite de Recherche de Biologie Cellulaire (URBC), University of Namur-FUNDP, Rue de Bruxelles, 61, B-5000 Namur (Belgium); Lucas, S., E-mail: stephane.lucas@fundp.ac.be [NAmur Research Institute for LIfe Sciences (NARILIS), Research Centre for the Physics of Matter and Radiation (PMR), University of Namur-FUNDP (Belgium)

    2011-12-15

    The study of the interaction of charged particles with living matter is of prime importance to the fields of radiotherapy, radioprotection and space radiobiology. Particle accelerators and their associated equipment are proven to be helpful tools in performing basic science in all these fields. Indeed, they can accelerate virtually any ions to a given energy and flux and let them interact with living matter either in vivo or in vitro. In this context, the University of Namur has developed a broad beam in vitro irradiation station for use in radiobiological experiments. Cells are handled in GLP conditions and can be irradiated at various fluxes with ions ranging from hydrogen to carbon. The station is mounted on a 2 MV tandem accelerator, and the energy range can be set up in the linear energy transfer (LET) ranges that are useful for radiobiological experiments. This paper describes the current status of the hardware that has been developed, and presents results related to its performance in term of dose-rate, energy range and beam uniformity for protons, alpha particles and carbon ions. The results of clonogenic assays of A549 lung adenocarcinoma cells irradiated with protons and alpha particles are also presented and compared with literature.

  13. Experimental radiotherapy and clinical radiobiology. Vol. 20. Proceedings; Experimentelle Strahlentherapie und Klinische Strahlenbiologie. Bd. 20. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, Michael; Dahm-Daphi, Jochen; Dikomey, Ekkehard; Petersen, Cordula; Rodemannn, Hans-Peter; Zips, Daniel (eds.)

    2011-07-01

    The proceedings include contributions on the following issues: laser driven proton accelerators on the way for radiotherapy, radiobiological evaluation of new radiations; molecular factors of radiation response; biological targeting; EGFR epidermal growth factor receptor/targeting - combined internal and external irradiation, radiobiology of normal tissues; dose-volume histograms for the radiotherapy: curves without radiobiological relevance or important information for the therapy planning; HPV (human papilloma virus) and radiation sensitivity of HNSCC (head and neck squamous cell carcinomas): evidence, radiobiological mechanism, clinical consequences and perspectives; mechanisms of action and intertumoral heterogeneity of response to EGFR inhibition in radiotherapy of solid tumors; evaluation of biomarkers for radiotherapy.

  14. Studies in the radiobiology of osteoradionecrosis and their clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Marx, R.E.; Johnson, R.P.

    1987-10-01

    The radiobiology of osteoradionecrosis is a complex of cellular death and cellular functional impairments from radiation energy transfers. Four studies of irradiated patients and a data base from 536 patients with osteoradionecrosis revealed separate pathophysiologic conditions for osteoradionecrosis induced by early trauma, osteoradionecrosis induced by late trauma, and spontaneous osteoradionecrosis. A large body of data suggested useful clinical guidelines for the management of irradiated patients. The guidelines, in part, include a recommendation for deferring radiation treatment for 21 days after tissue wounding, if possible; a relative contraindication to wounding tissue during a radiation course; a recommendation for the use of hyperbaric oxygen before wounding; and a strong recommendation to provide comprehensive dental care to the irradiated patient.

  15. Characterization and performances of DOSION, a dosimetry equipment dedicated to radiobiology experiments taking place at GANIL

    CERN Document Server

    Boissonnat, G; Balanzat, E; Boumard, F; Carniol, B; Colin, J; Cussol, D; Etasse, D; Fontbonne, C; Frelin, A -M; Hommet, J; Peronnel, J; Salvador, S

    2016-01-01

    Currently, radiobiology experiments using heavy ions at GANIL(Grand Acc\\'el\\'erateur National d'Ions Lourds) are conducted under the supervision of the CIMAP (Center for research on Ions, MAterials and Photonics). In this context, a new beam monitoring equipment named DOSION has been developed. It allows to perform measurements of accurate fluence and dose maps in near real time for each biological sample irradiated. In this paper, we present the detection system, its design, performances, calibration protocol and measurements performed during radiobiology experiments. This setup is currently available for any radiobiology experiments if one wishes to correlate one's own sample analysis to state of the art dosimetric references.

  16. Dosimetry for radiobiological experiments using energetic heavy ions

    International Nuclear Information System (INIS)

    The availability of the Bevalac facility of energetic heavy ions with range greater than the size of small mammals makes possible the determination of the biological effects of relatively well defined high LET, whole body irradiation. With the increasing application of high-energy heavy ions in radiobiology there is a corresponding need to develop reliable techniques of both relative and absolute absorbed dose measurement. This paper describes dosimetry studies by the Health Physics Department of the Lawrence Berkeley Laboratory with activation detectors, ionization chambers, nuclear emulsion, thermoluminescent dosimeters and X-ray film. The application of these techniques to an experiment designed to study the leukemogenic effect of the whole-body irradiation of mice by 250 MeV/amu carbon ions is briefly described. Values of absorbed dose in tissue, obtained during this experiment, with a nitrogen filled ionization chamber and 7LiF thermoluminescent dosimeters are compared and shown to be in good agreement. As a result of this work a value for the average energy to produce an ion pair (W) in nitrogen by 250 MeV/amu 6+C ions of 37 +- eV was determined. Values of the efficiency of 7LiF relative to 60Co γ-rays for ions with dE/dx in the range 110-260 MeV g-1 cm2 are reported

  17. Optimisation of exposure conditions for in vitro radiobiology experiments

    International Nuclear Information System (INIS)

    Despite the long history of using cell cultures in vitro for radiobiological studies, there is to date no study specifically addressing the dosimetric implications of flask selection and exposure environment in clonogenic assays. The consequent variability in dosimetry between laboratories impedes the comparison of results. In this study we compare the dose to cells adherent to the base of three types of commonly used culture flasks or plates. The cells are exposed to a 6MV clinical photon beam using either an open or a half blocked field. The depth of medium in each flask is varied with the medium surrounding the flask either water or air. The results show that the dose to the cells is more affected by the scattering conditions surrounding the flasks than by the level of filling within the flask. It is recommended that water or a water equivalent phantom material is used to surround the flasks or plates to approximate full scatter conditions at the cell layer. However for modulated fields, surrounding the 24 well plates with water-equivalent material is inadequate because of the large volume of air surrounding individual wells. Our results stress the importance of measuring the dose for new experimental configurations.

  18. Skin carcinomas: Radiobiological principles, radiotherapeutic techniques and clinical management

    International Nuclear Information System (INIS)

    Purpose/Objective: The course will be divided into three major topics: (1) Review of radiobiological principles as they apply to the radiotherapeutic management of skin carcinomas; (2) review of radiotherapeutic techniques including beam qualities, beam collimation, tissue dose profiles, and the relative indications of external beam irradiation vs. brachytherapy; (3) comprehensive review of the tumor biology of skin malignancies, including malignant melanoma, and of the relative indications for radiotherapeutic and/or surgical management. (1) Review of critical data which have led to currently applied principles of time-dose-volume concepts in the radiotherapeutic management of skin carcinomas. Emphasis will be placed on the relative importance of fraction size and overall treatment time on tumor control probability and acute and late normal tissue toxicity. (2) Considering that radiotherapy in the management of skin carcinomas is often used to minimize patient disfiguration and to preserve critical body functions (e.g. eye lids) the technical aspects of radiotherapy delivery are most critical. Careful evaluation of the extent of the lesions including evaluation of their depth of invasion will determine the quality of the radiation beams, orthovoltage and low energy electrons being the most useful. Beam harding for orthovoltage beams and secondary and tertiary (skin) collimation of appropriate electron beams are critical. For more extensive and deeply invasive lesions contour-shaping through customized bolus material is essential. Equally important is the familiarity with custom shielding of critical structures, such as eyes, ears, oral cavity and central nervous system structures. Brachytherapy applications in the treatment of skin carcinomas is limited but should be considered when implants with high dose uniformity can be constructed. (3) The discussion of clinical management will start with a discussion of properties and routes of spread of the diverse

  19. Skin carcinomas: Radiobiological principles, radiotherapeutic techniques and clinical management

    International Nuclear Information System (INIS)

    Purpose/Objective: The course will be divided into three major topics: (1) Review of radiobiological principles as they apply to the radiotherapeutic management of skin carcinomas: (2) review of radiotherapeutic techniques including beam qualities, beam collimation, tissue dose profiles, and the relative indications of external beam irradiation vs. brachytherapy; (3) comprehensive review of the tumor biology of skin malignancies, including malignant melanoma, and of the relative indications for radiotherapeutic and/or surgical management. (1) Review of critical data which have lead to currently applied principles of time-dose-volume concepts in the radiotherapeutic management of skin carcinomas. Emphasis will be placed on the relative importance of fraction size and overall treatment time on tumor control probability and acute and late normal tissue toxicity. (2) Considering that radiotherapy in the management of skin carcinomas is often used to minimize patient disfiguration and to preserve critical body functions (e.g. eye lids) the technical aspects of radiotherapy delivery are most critical. Careful evaluation of the extent of the lesions including evaluation of their depth of invasion will determine the quality of the radiation beams, orthovoltage and low energy electrons being the most useful. Beam harding for orthovoltage beams and secondary and tertiary (skin) collimation of appropriate electron beams are critical. For more extensive and deeply invasive lesions contour-shaping through customized bolus material is essential. Equally important is the familiarity with custom shielding of critical structures, such as eyes, ears, oral cavity and central nervous system structures. Brachytherapy applications in the treatment of skin carcinomas is limited but should be considered when implants with high dose uniformity can be constructed. (3) The discussion of clinical management will start with a discussion of tumor biological properties of the diverse malignant

  20. Skin carcinomas: radiobiological principles, radiotherapeutic techniques and clinical management

    International Nuclear Information System (INIS)

    Purpose/Objective: The course will be divided into three major topics: (1) Review of radiobiological principles as they apply to the radiotherapeutic management of skin carcinomas; (2) review of radiotherapeutic techniques including beam qualities, beam collimation, tissue dose profiles, and the relative indications of external beam irradiation vs. brachytherapy; (3) comprehensive review of the tumor biology of skin malignancies, including malignant melanoma, and of the relative indications for radiotherapeutic and/or surgical management. (1) Review of critical data which have lead to currently applied principles of time-dose-volume concepts in the radiotherapeutic management of skin carcinomas. Emphasis will be placed on the relative importance of fraction size and overall treatment time on tumor control probability and acute and late normal tissue toxicity. (2) Considering that radiotherapy in the management of skin carcinomas is often used to minimize patient disfiguration and to preserve critical body functions (e.g. eye lids) the technical aspects of radiotherapy delivery are most critical. Careful evaluation of the extent of the lesions including evaluation of their depth of invasion will determine the quality of the radiation beams, orthovoltage and low energy electrons being the most useful. Beam harding for orthovoltage beams and secondary and tertiary (skin) collimation of appropriate electron beams are critical. For more extensive and deeply invasive lesions contour-shaping through customized bolus material is essential. Equally important is the familiarity with custom shielding of critical structures, such as eyes, ears, oral cavity and central nervous system structures. Brachytherapy applications in the treatment of skin carcinomas is limited but should be considered when implants with high dose uniformity can be constructed. (3) The discussion of clinical management will start with a discussion of tumor biological properties of the diverse malignant

  1. Realization of radiobiological in vitro cell experiments at conventional X-ray tubes and unconventional radiation sources

    OpenAIRE

    Beyreuther, Elke

    2010-01-01

    More than hundred years after the discovery of X-rays different kinds of ionizing radiation are ubiquitous in medicine, applied to clinical diagnostics and cancer treatment as well. Irrespective of their nature, the widespread application of radiation implies its precise dosimetric characterization and detailed knowledge of the radiobiological effects induced in cancerous and normal tissue. Starting with in vitro cell irradiation experiments, which define basic parameters for the subsequent t...

  2. Experimental radiotherapy and clinical radiobiology. Vol. 8, special issue 1. Proceedings

    International Nuclear Information System (INIS)

    The publication contains the abstracts of all papers and posters presented at the symposium. The headings were as follows: Radiobiology of the lung, mediation of radiation damage in the lung, clinical studies, future clinical directions, as well as documentation and management. (MG)

  3. Realization of radiobiological in vitro cell experiments at conventional X-ray tubes and unconventional radiation sources

    International Nuclear Information System (INIS)

    More than hundred years after the discovery of X-rays different kinds of ionizing radiation are ubiquitous in medicine, applied to clinical diagnostics and cancer treatment as well. Irrespective of their nature, the widespread application of radiation implies its precise dosimetric characterization and detailed knowledge of the radiobiological effects induced in cancerous and normal tissue. Starting with in vitro cell irradiation experiments, which define basic parameters for the subsequent tissue and animal studies, the whole multi-stage process is completed by clinical trials that translate the results of fundamental research into clinical application. In this context, the present dissertation focuses on the establishment of radiobiological in vitro cell experiments at unconventional, but clinical relevant radiation qualities. In the first part of the present work the energy dependent biological effectiveness of photons was studied examining low-energy X-rays (≤ 50 keV), as used for mammography, and high-energy photons (≥ 20 MeV) as proposed for future radiotherapy. Cell irradiation experiments have been performed at conventional X-ray tubes providing low-energy photons and 200 kV reference radiation as well. In parallel, unconventional quasi-monochromatic channeling X-rays and high-energy bremsstrahlung available at the radiation source ELBE of the Forschungszentrum Dresden-Rossendorf were considered for radiobiological experimentation. For their precise dosimetric characterization dosimeters based on the thermally stimulated emission of exoelectrons and on radiochromic films were evaluated, whereas just the latter was found to be suitable for the determination of absolute doses and spatial dose distributions at cell position. Standard ionization chambers were deployed for the online control of cell irradiation experiments. Radiobiological effects were analyzed in human mammary epithelial cells on different subcellular levels revealing an increasing amount

  4. Realization of radiobiological in vitro cell experiments at conventional X-ray tubes and unconventional radiation sources

    Energy Technology Data Exchange (ETDEWEB)

    Beyreuther, Elke

    2010-09-10

    More than hundred years after the discovery of X-rays different kinds of ionizing radiation are ubiquitous in medicine, applied to clinical diagnostics and cancer treatment as well. Irrespective of their nature, the widespread application of radiation implies its precise dosimetric characterization and detailed knowledge of the radiobiological effects induced in cancerous and normal tissue. Starting with in vitro cell irradiation experiments, which define basic parameters for the subsequent tissue and animal studies, the whole multi-stage process is completed by clinical trials that translate the results of fundamental research into clinical application. In this context, the present dissertation focuses on the establishment of radiobiological in vitro cell experiments at unconventional, but clinical relevant radiation qualities. In the first part of the present work the energy dependent biological effectiveness of photons was studied examining low-energy X-rays (≤ 50 keV), as used for mammography, and high-energy photons (≥ 20 MeV) as proposed for future radiotherapy. Cell irradiation experiments have been performed at conventional X-ray tubes providing low-energy photons and 200 kV reference radiation as well. In parallel, unconventional quasi-monochromatic channeling X-rays and high-energy bremsstrahlung available at the radiation source ELBE of the Forschungszentrum Dresden-Rossendorf were considered for radiobiological experimentation. For their precise dosimetric characterization dosimeters based on the thermally stimulated emission of exoelectrons and on radiochromic films were evaluated, whereas just the latter was found to be suitable for the determination of absolute doses and spatial dose distributions at cell position. Standard ionization chambers were deployed for the online control of cell irradiation experiments. Radiobiological effects were analyzed in human mammary epithelial cells on different subcellular levels revealing an increasing amount

  5. Experimental radiotherapy and clinical radiobiology. Vol. 22. Proceedings; Experimentelle Strahlentherapie und Klinische Strahlenbiologie. Bd. 25. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, Michael; Krause, Mechthild [Universitaetsklinikum Technische Univ. Dresden (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radiologie; Cordes, Nils [Universitaetsklinikum Technische Univ. Dresden (Germany). OncoRay - Nationales Zentrum fuer Strahlenforschung in der Radioonkologie; Helmholtz-Zentrum Dresden-Rossendorf e.V., Dresden (Germany); Petersen, Cordula [Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie; Rodemann, H. Peter [Universitaetsklinikum Tuebingen (Germany). Sektion fuer Strahlenbiologie; Rothkamm, Kai [Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany). Lab. fuer Strahlentherapie und Experimentelle Radioonkologie; Zips, Daniel (ed.) [Tuebingen Univ. (Germany). Universitaetsklinik fuer Radioonkologie

    2016-05-01

    The proceedings of the 25th symposium on experimental radiotherapy and clinical radiobiology include papers on the following issues: radiotherapy individualization based on imaging; pre-clinic imaging and new experimental methods; methods and models, micromilieu and metabolism, combined therapy; secondary tumors following radiotherapy; radiogenic effects in normal tissue; resistance mechanism of tumors and normal tissue; personalized radio-oncology - which biological data are needed; pre-clinic and personalized radio-oncology; biomarkers - pre-clinic and translational; translational examinations for personalized radio-oncology.

  6. Feasibility of BNCT radiobiological experiments at the HYTHOR facility

    Science.gov (United States)

    Esposito, J.; Ceballos, C.; Soncin, M.; Fabris, C.; Friso, E.; Moro, D.; Colautti, P.; Jori, G.; Rosi, G.; Nava, E.

    2008-06-01

    HYTHOR (HYbrid Thermal spectrum sHifter tapirO Reactor) is a new thermal-neutron irradiation facility, which was installed and became operative in mid 2005 at the TAPIRO (TAratura PIla Rapida potenza 0) fast reactor, in the Casaccia research centre (near Rome) of ENEA (Ente per le Nuove tecnologie Energia ed Ambiente). The facility has been designed for in vivo radiobiological studies. In HYTHOR irradiation cavity, 1-6 mice can be simultaneously irradiated to study skin melanoma treatments with the BNCT (boron neutron capture therapy). The therapeutic effects of HYTHOR radiation field on mouse melanoma has been studied as a preliminary investigation before studying the tumour local control due to boron neutron capture effect after boronated molecule injection. The method to properly irradiate small animals has been precisely defined. Results show that HYTHOR radiation field is by itself effective in reducing the tumour-growth rate. This finding has to be taken into account in studying the effectiveness of new 10B carriers. A method to properly measure the reduction of the tumour-growth rate is reported and discussed.

  7. Actual issues of clinical radiobiology and their experimental study

    International Nuclear Information System (INIS)

    Information being collector for some tens years in frame of clinical study of radiation effects in man in broad range of dose and exposure variant has been summarised and systematized. It has been formulated the questions which could be answered under only clinical observation with many difficulties: diagnostical and prognostical criteria for evaluation of therapy efficiency in non-bonemarrow syndrome of acute radiation disease choice and confirmaty of methods of bonemarrow syndrome therapy in overlethal range of dose; improving of preclinical examination of means and methods of acute radiation syndrome prophylaxis and treatment; comparative analysis of the role of various radiation factory in development of oncological and severe somatic disease and possibility of these effects modification. Some limitations in extrapolation of experimental data onto clinical practice has been discussed and optimal forms of cooperation are shown

  8. Experimental radiotherapy and clinical radiobiology. Vol. 22. Proceedings; Experimentelle Strahlentherapie und Klinische Strahlenbiologie. Bd. 22. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, Michael; Cordes, Nils; Dikomey, Ekkehard; Krause, Mechthild; Petersen, Cordula; Rodemannn, H. Peter; Zips, Daniel (eds.)

    2013-03-01

    The proceedings of the 22th Symposium on experimental radiotherapy and clinical radiotherapy contain lectures and poster on the following issues: Radiation induced immuno-targeting of tumors; targeting in the radiotherapy; biomarkers; targeting; radio-oncological therapy of rectal carcinoma - contribution of radiobiology for therapy optimization; biomarkers for radiation sensibility; resistance mechanisms of tumors; resistance mechanisms of normal tissue; micro ambience, P13L inhibition in radiotherapy: improvement of the local tumor control by molecular mechanisms or the influence of the tumor micro-ambience? DNA repair; radiation effects and technical development.

  9. Experimental radiotherapy and clinical radiobiology. Vol. 18. Proceedings; Experimentelle Strahlentherapie und Klinische Strahlenbiologie. Bd. 18. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, Michael; Dahm-Daphi, Jochen; Dikomey, Ekkehard; Petersen, Cordula; Rodemann, H. Peter; Zips, Daniel (eds.)

    2009-07-15

    The proceedings on experimental radiotherapy and clinical radiobiology contain two review articles (prediction of normal tissue reactions after radiotherapy, ?H2AX foci as a marker for DNA double-strand breaks) and 34 contributions to the following topics: Hypoxia and molecular mechanisms of radiation resistance; biological imaging of the tumor micromilieu; DNA repair, genomic instability and carcerogenesis; molecular factors of radiation resistance; actual controversial discussion on possible irradiation caused metastasis risk enhancement; EGFR inhibition and irradiation; biology of experimental radiation/ normal tissue toxicity.

  10. Radiobiological experiments with plant seeds aboard the biosatellite Kosmos 1887

    Science.gov (United States)

    Anikeeva, I. D.; Vaulina, E. N.; Kostina, L. N.; Marenny, A. M.; Portman, A. I.; Rusin, S. V.; Benton, E. V.

    1990-01-01

    The effects of spaceflight factors on the seeds of Arabidopsis thaliana and Crepis capillaris were studied provided with various protective measures: the seeds were located inside the satellite and in open space, protected with aluminium foil and also exposed without the foil cover. When the seeds were in open space without any protection, their viability was found to be suppressed; the survival rate and fertility of plants grown from these seeds were also diminished. An increase in the frequency of chromosome aberrations (CA) and in the number of multiple injuries was registered in this case. Experiments with the aluminium foil shielding showed a decrease in the suppression of the seeds' viability, but mutational changes were found to be even more increased, while the survival and fertility of the plants decreased. An increase in the thickness of shielding resulted in a decrease in the effects up to the level of the control, except for the effects connected with CA and fertility of the plants. Analysis of the results shows that these impairments can be ascribed to the action of single heavy charged particles (HCP). The seeds can be thus regarded as an integral biological 'dosimeter' which allows estimation of the total effects of radiation, ecological and biological factors.

  11. Radiobiological experiments with plant seeds aboard the biosatellite Cosmos 1887

    Science.gov (United States)

    Benton, E. V.; Anikeeva, I. D.; Akatov, Yu. A.; Vaulina, E. N.; Kostina, L. N.; Marenny, A.; Portman, A. I.; Rusin, S. V.

    1995-01-01

    The effects of spaceflight factors on the seeds of Arabidopsis thaliana and Crepis capillaris were studied. The seeds were located inside the satellite in an open space, protected with aluminum foil and also exposed without the foil cover. When the seeds were in open space without any protection, their viability was found to be suppressed; the survival rate and fertility of plants grown from these seeds were also diminished. An increase in the frequency of chromosome aberrations (CA) and in the number of multiple injuries was registered in this case. Experiments with the aluminum foil shielding showed a decrease in the suppression of the seeds' viability, but mutational changes were found to be even more increased, while the survival rate and fertility of the plants decreased. An increase in the thickness of shielding resulted in a decrease in the effects up to the level of the control, except for the effects connected with CA and fertility of the plants. Analysis of the results shows that these impairments can be ascribed to the action of single heavy charged particles (HCP). The seeds can thus be regarded as an integral biological 'dosimeter' which allows estimation of the total effects of radiation, ecological and biological factors.

  12. Bringing the heavy: carbon ion therapy in the radiobiological and clinical context

    International Nuclear Information System (INIS)

    Radiotherapy for the treatment of cancer is undergoing an evolution, shifting to the use of heavier ion species. For a plethora of malignancies, current radiotherapy using photons or protons yields marginal benefits in local control and survival. One hypothesis is that these malignancies have acquired, or are inherently radioresistant to low LET radiation. In the last decade, carbon ion radiotherapy facilities have slowly been constructed in Europe and Asia, demonstrating favorable results for many of the malignancies that do poorly with conventional radiotherapy. However, from a radiobiological perspective, much of how this modality works in overcoming radioresistance, and extending local control and survival are not yet fully understood. In this review, we will explain from a radiobiological perspective how carbon ion radiotherapy can overcome the classical and recently postulated contributors of radioresistance (α/β ratio, hypoxia, cell proliferation, the tumor microenvironment and metabolism, and cancer stem cells). Furthermore, we will make recommendations on the important factors to consider, such as anatomical location, in the future design and implementation of clinical trials. With the existing data available we believe that the expansion of carbon ion facilities into the United States is warranted

  13. Development of a compact laser-produced plasma soft X-ray source for radiobiology experiments

    Science.gov (United States)

    Adjei, Daniel; Ayele, Mesfin Getachew; Wachulak, Przemyslaw; Bartnik, Andrzej; Wegrzynski, Łukasz; Fiedorowicz, Henryk; Vyšín, Luděk; Wiechec, Anna; Lekki, Janusz; Kwiatek, Wojciech M.; Pina, Ladislav; Davídková, Marie; Juha, Libor

    2015-12-01

    A desk-top laser-produced plasma (LPP) source of soft X-rays (SXR) has been developed for radiobiology research. The source is based on a double-stream gas puff target, irradiated with the focused beam of a commercial Nd:YAG laser. The source has been optimized to get a maximum photon emission from LPP in the X-ray "water window" spectral wavelength range from 2.3 nm (i.e., an absorption edge of oxygen) to 4.4 nm (i.e., an absorption edge of carbon) (280-540 eV in photon energy units) by using argon gas-puff target and spectral filtering by free-standing thin foils. The present source delivers nanosecond pulses of soft X-rays at a fluence of about 4.2 × 103 photons/μm2/pulse on a sample placed inside the vacuum chamber. In this paper, the source design, radiation output characterization measurements and initial irradiation experiments are described. The source can be useful in addressing observations related to biomolecular, cellular and organisms' sensitivity to pulsed radiation in the "water window", where carbon atoms absorb X-rays more strongly than the oxygen, mostly present in water. The combination of the SXR source and the radiobiology irradiation layout, reported in this article, make possible a systematic investigation of relationships between direct and indirect action of ionizing radiation, an increase of a local dose in carbon-rich compartments of the cell (e.g., lipid membranes), an experimental estimation of a particular role of the Auger effect (in particular in carbon atoms) in the damage to biological systems, and the study of ionization/excitation-density (LET - Linear Energy Transfer) and dose-rate effects in radiobiology.

  14. Radiation-induced cataract-genesis: pathophysiologic, radiobiological and clinical aspects

    International Nuclear Information System (INIS)

    Cataract-genesis is a widely reported late effect of irradiated crystalline lens. In this review the authors discussed the different aspects of radiation cataract pathogenesis, and the different mechanisms involved in the lens opacification, particularly the epithelium modifications such as epithelial cell death. The authors also reported the influence of radiation exposure on cataract formation following total body irradiation TBI) and autologous or allogeneic bone marrow transplantation for hematologic malignancies. Moreover, the radiobiological parameters are not studied for the crystalline lens of human. We applied for the first time the linear quadratic (LQ) and biological effective dose (BED) concept to TBI data. The calculated value of α/β of 1 Gy is in the range of the values reported for the other late responding tissues. The other risk factors for cataract development after TBI such as age, gender, central nervous system boost, long-term steroid therapy and heparin administration are discussed. In terms of cataract or sicca syndrome prevention, numerous compounds have been successfully tested in experimental models or used for the prevention of radiation-induced xerostomia in patients treated for head and neck cancer. However, none of them has been clinically evaluated for ocular radiation late effects prevention. In this report the authors discussed some of the radioprotectors potentially interesting for radiation-induced cataract or sicca syndrome prevention. (author)

  15. Studies of SSNTDs made from LR-115 in view of their applicability in radiobiological experiments with alpha particles

    Energy Technology Data Exchange (ETDEWEB)

    Doerschel, B. E-mail: doerschel@physik.tu-dresden.de; Hermsdorf, D.; Pieck, S.; Starke, S.; Thiele, H.; Weickert, F

    2003-06-01

    Radiobiological studies on cell monolayers irradiated by charged particles need to determine the number and position of particle traversals. Solid state nuclear track detectors used as basic substrate for the cell layers are in principle suitable for this purpose. The detector foils must be as thin as possible but still guaranteeing mechanical stability. Two types of LR-115, red coloured and colourless, were tested in the present work. The studies aimed at optimisation of the etching conditions and determination of the registration efficiency for alpha particles in a wide range of energies and angles of incidence. Specific requirements have to be fulfilled for application of the detector foils under the environmental conditions of radiobiological experiments. Most important are biocompatibility between detector and cells and registration properties insensible against special treatments, as UV sterilisation and cell plating prior to irradiation as well as cell incubation after the irradiation. The experimental studies performed with alpha particles showed that environmental conditions of radiobiological experiments do not change the registration properties of LR-115 detectors significantly.

  16. Clinical radiobiology of glioblastoma multiforme. Estimation of tumor control probability from various radiotherapy fractionation schemes

    Energy Technology Data Exchange (ETDEWEB)

    Pedicini, Piernicola [I.R.C.C.S.-Regional-Cancer-Hospital-C.R.O.B, Unit of Nuclear Medicine, Department of Radiation and Metabolic Therapies, Rionero-in-Vulture (Italy); Department of Radiation and Metabolic Therapies, I.R.C.C.S.-Regional-Cancer-Hospital-C.R.O.B, Unit of Radiotherapy, Rionero-in-Vulture (Italy); Fiorentino, Alba [Sacro Cuore - Don Calabria Hospital, Radiation Oncology Department, Negrar, Verona (Italy); Simeon, Vittorio [I.R.C.C.S.-Regional-Cancer-Hospital-C.R.O.B, Laboratory of Preclinical and Translational Research, Rionero-in-Vulture (Italy); Tini, Paolo; Pirtoli, Luigi [University of Siena and Tuscany Tumor Institute, Unit of Radiation Oncology, Department of Medicine Surgery and Neurological Sciences, Siena (Italy); Chiumento, Costanza [Department of Radiation and Metabolic Therapies, I.R.C.C.S.-Regional-Cancer-Hospital-C.R.O.B, Unit of Radiotherapy, Rionero-in-Vulture (Italy); Salvatore, Marco [I.R.C.C.S. SDN Foundation, Unit of Nuclear Medicine, Napoli (Italy); Storto, Giovanni [I.R.C.C.S.-Regional-Cancer-Hospital-C.R.O.B, Unit of Nuclear Medicine, Department of Radiation and Metabolic Therapies, Rionero-in-Vulture (Italy)

    2014-10-15

    The aim of this study was to estimate a radiobiological set of parameters from the available clinical data on glioblastoma (GB). A number of clinical trial outcomes from patients affected by GB and treated with surgery and adjuvant radiochemotherapy were analyzed to estimate a set of radiobiological parameters for a tumor control probability (TCP) model. The analytical/graphical method employed to fit the clinical data allowed us to estimate the intrinsic tumor radiosensitivity (α), repair capability (b), and repopulation doubling time (T{sub d}) in a first phase, and subsequently the number of clonogens (N) and kick-off time for accelerated proliferation (T{sub k}). The results were used to formulate a hypothesis for a scheduleexpected to significantly improve local control. The 95 % confidence intervals (CI{sub 95} {sub %}) of all parameters are also discussed. The pooled analysis employed to estimate the parameters summarizes the data of 559 patients, while the studies selected to verify the results summarize data of 104 patients. The best estimates and the CI{sub 95} {sub %} are α = 0.12 Gy{sup -1} (0.10-0.14), b = 0.015 Gy{sup -2} (0.013-0.020), α/b = 8 Gy (5.0-10.8), T{sub d} = 15.4 days (13.2-19.5), N = 1 . 10{sup 4} (1.2 . 10{sup 3} - 1 . 10{sup 5}), and T{sub k} = 37 days (29-46). The dose required to offset the repopulation occurring after 1 day (D{sub prolif}) and starting after T{sub k} was estimated as 0.30 Gy/day (0.22-0.39). The analysis confirms a high value for the α/b ratio. Moreover, a high intrinsic radiosensitivity together with a long kick-off time for accelerated repopulation and moderate repopulation kinetics were found. The results indicate a substantial independence of the duration of the overall treatment and an improvement in the treatment effectiveness by increasing the total dose without increasing the dose fraction. (orig.) [German] Schaetzung eines strahlenbiologischen Parametersatzes auf der Grundlage klinischer Daten bei

  17. Radiobiology in clinical radiation therapy part II: current practice and new horizons

    International Nuclear Information System (INIS)

    Objective: This course is designed for residents in radiation oncology, preparing for their boards. It includes the physics and chemistry of the absorption of radiation, a description of the biological systems used to obtain a quantitative relationship between dose and biological effect, as well as a review of the basic principles in radiation biology that have been established. The multifraction regimens used in conventional radiotherapy were developed empirically, but can be understood in terms of radiobiological principles. Dividing the dose into many fractions reduces biological effectiveness due to repair of sublethal damage; this occurs in both tumors and normal tissues. Fractionation allows re-oxygenation to occur in tumors and so increases the effectiveness of a given total dose. Fractionation also leads to sensitization by reassortment of cycling tumor cells into radiosensitive phases of the cycle. Laboratory research also provides a rationale for modifications of existing fractionation protocols. The dose response relationship for late responding tissues is more 'curved' than for acute or early effects. Consequently the use of multiple fractions allows a greater separation of early and late effects in normal tissues. This has led to the introduction of hyperfractionation and accelerated treatment. Both involve two treatments per day (BID) but based on quite different rationales. The limitation of protraction is cell proliferation in the tumor, which may be accelerated as the tumor shrinks. Measurements of cell kinetics can identify fast growing tumors that may benefit from accelerated treatment. Hypoxia was early identified as a cause of resistance to cell killing x-rays. This led to development of electron affinic compounds as radiosensitizers of hypoxic cells. The new trend is the development of bioreductive drugs that are specifically cytotoxic to hypoxic cells i.e. hypoxic cytotoxins, but which still need to be combined with radiation. Fast neutrons

  18. Radiobiology in clinical radiation therapy - Part II: Current practice and new horizons

    International Nuclear Information System (INIS)

    Objective: This course is designed for residents in radiation oncology, preparing for their boards. The principles described in Part I are used to explain current practices in radiation oncology and as a basis for new initiatives. The multifraction regimens used in conventional radiotherapy were developed empirically, but can be understood in terms of radiobiological principles. Dividing the dose into many fractions reduces biological effectiveness due to repair of sublethal damage; this occurs in both tumors and normal tissues. Fractionation allows re-oxygenation to occur in tumors and so increases the effectiveness of a given total dose. Fractionation also leads to sensitization by reassortment of cycling tumor cells into radiosensitive phases of the cycle. Laboratory research also provides a rationale for modifications of existing fractionation protocols. The dose response relationship for late responding tissues is more 'curved' than for acute or early effects. Consequently the use of multiple fractions allows a greater separation of early and late effects in normal tissues. This has led to the introduction of hyperfractionation and accelerated treatment. Both involve two treatments per day (BID) but based on quite different rationales. The limitation of protraction is cell proliferation in the tumor, which may be accelerated as the tumor shrinks. Measurements of cell kinetics can identify fast growing tumors that may benefit from accelerated treatment. Hypoxia was early identified as a cause of resistance to cell killing by x-rays. This led to the development of electron affinic compounds as radiosensitizers of hypoxic cells. The new trend is the development of bioreductive drugs that are specifically cytotoxic to hypoxic cells i.e. hypoxic cytotoxins, but which still need to be combined with radiation. Fast neutrons were initially introduced, too, in an attempt to overcome the perceived problems of hypoxia, but clinical trials now are based on the premise

  19. Automation of the particle dosimetry and the dose application for radiobiological experiments at a vertical proton beam

    CERN Document Server

    Moertel, H; Eyrich, W; Fritsch, M; Distel, L

    2002-01-01

    A facility with a vertical beam for radiobiological experiments with low-energy protons has been setup at the Tandem accelerator at Erlangen. This energy region is optimal to investigate the biological effects of the linear energy transfer in the Bragg region under physiological conditions. A new automated data acquisition system for dosimetry and monitoring based on a personal computer was developed and optimized for this setup. A specially designed sample holder offers possibilities of cooling or changing of atmosphere during irradiation. First irradiations of biological samples have shown the functionality of the setup.

  20. Automation of the particle dosimetry and the dose application for radiobiological experiments at a vertical proton beam

    Science.gov (United States)

    Mörtel, H.; Georgi, J.; Eyrich, W.; Fritsch, M.; Distel, L.

    2002-08-01

    A facility with a vertical beam for radiobiological experiments with low-energy protons has been setup at the Tandem accelerator at Erlangen. This energy region is optimal to investigate the biological effects of the linear energy transfer in the Bragg region under physiological conditions. A new automated data acquisition system for dosimetry and monitoring based on a personal computer was developed and optimized for this setup. A specially designed sample holder offers possibilities of cooling or changing of atmosphere during irradiation. First irradiations of biological samples have shown the functionality of the setup.

  1. Radiobiology of Radiosurgery for the Central Nervous System

    Directory of Open Access Journals (Sweden)

    Antonio Santacroce

    2013-01-01

    Full Text Available According to Leksell radiosurgery is defined as “the delivery of a single, high dose of irradiation to a small and critically located intracranial volume through the intact skull.” Before its birth in the early 60s and its introduction in clinical therapeutic protocols in late the 80s dose application in radiation therapy of the brain for benign and malignant lesions was based on the administration of cumulative dose into a variable number of fractions. The rationale of dose fractionation is to lessen the risk of injury of normal tissue surrounding the target volume. Radiobiological studies of cell culture lines of malignant tumors and clinical experience with patients treated with conventional fractionated radiotherapy helped establishing this radiobiological principle. Radiosurgery provides a single high dose of radiation which translates into a specific toxic radiobiological response. Radiobiological investigations to study the effect of high dose focused radiation on the central nervous system began in late the 50s. It is well known currently that radiobiological principles applied for dose fractionation are not reproducible when single high dose of ionizing radiation is delivered. A review of the literature about radiobiology of radiosurgery for the central nervous system is presented.

  2. Cancer radiobiology

    International Nuclear Information System (INIS)

    The work i have done in this dissertation, was mainly aimed at the literature review of radiotherapy radiobiology discussing the cure of tumours with ionizing radiation, from both the biological and physical point of view. The first chapter an introduction about the radiotherapy and includes: definition, working dose, benefit of radiotherapy, risk of radiotherapy, external and internal radiotherapy and treatment planing. In chapter two the theories of radiobiology and main effects caused by the radiation in the interaction with the biological matter were explained, the damages caused by the use of low and high LET (linear energy transfer) particles to mammalian cells were discussed. And discuss a therapeutic advantage may be gained by one of four hypothetical mechanism: repair the damage of DAN, so when sublethal injury can be repaired if no further hits are sustained. Also the reoxygenation of tumor is important for its effects on stabilization of free radicals produced by ionizing radiation. Hypoxic cells generally require an increased dose of radiation for lethal effect, redistribution, within the cell cycle depends on location of cells and their radiosensitivity also cells undergoing DNA synthesis, the S phase, are much more radioresistant than cells in other phase of the cell cycle, and repopulation of tumor cells is indicator of the surviving cells respond by increased regeneration or repopulation. Repopulation is a greater problem with rapidly proliferating tumors than slower growing neoplasms. These mechanisms are known as the classical four R's of radiation biology. One of the important applications of radiobiology is the radiotherapy and cancer treatment, experimental and theoretical studies in radiation biology contribute to the development of radiotherapy, in this dissertation we discussed the dose response relation so as the size of the tumor increases, and the dose needed for local control like wise increases, the risk of injury to normal tissue

  3. With the Radiobiology Group

    CERN Multimedia

    1980-01-01

    The Radiobiology Group carries out experiments to study the effect of radiation on living cells. The photo shows the apparatus for growing broad beans which have been irradiated by 250 GeV protons. The roots are immersed in a tank of running water (CERN Weekly Bulletin 26 January 1981 and Annual Report 1980 p. 160). Karen Panman, Marilena Streit-Bianchi, Roger Paris.

  4. Development of a compact laser-produced plasma soft X-ray source for radiobiology experiments

    Czech Academy of Sciences Publication Activity Database

    Adjei, D.; Ayele, M.G.; Wachulak, P.; Bartnik, A.; Wegrzynski, L.; Fiedorowicz, H.; Vyšín, Luděk; Wiechec, A.; Lekki, J.; Kwiatek, W.M.; Pina, L.; Davídková, Marie; Juha, Libor

    2015-01-01

    Roč. 364, Dec (2015), s. 27-32. ISSN 0168-583X R&D Projects: GA ČR(CZ) GBP108/12/G108; GA ČR GA13-28721S EU Projects: European Commission(XE) 284464 - LASER LAB-EUROPE Institutional support: RVO:68378271 ; RVO:61389005 Keywords : laser -produced plasma * soft X-rays * radiobiology * gas puff target * water window Subject RIV: BL - Plasma and Gas Discharge Physics Impact factor: 1.124, year: 2014

  5. Studies of UV-cured CR-39 recording properties in view of its applicability in radiobiological experiments with alpha particles

    International Nuclear Information System (INIS)

    In radiobiology, low doses of high-LET radiation correspond to a few particle traversals through the cell population. Therefore, for studies on cell monolayers irradiated with a low dose of α-particles, it is extremely useful if the number and position of particle traversals can be determined. In this study we describe a new method, based on UV-curing, to obtain a 10μm thick CR-39 grafted onto a 2.5μm thick PolyEthylene Terephtalate (PET). This thin double polymeric layer, used as a dish base, has a regular and reproducible detector thickness which can be traversed by 3.5MeV α-particles, with a sufficient residual energy to traverse mammalian cells attached to the base. The recording properties of a PET-CR-39 dish, together with a demonstration of its use for radiobiological experiments, are presented. This new tool allows the precise determination of single-track impact parameters at a sub-cellular level.

  6. Modern concepts for basic radiobiological factors characterizing tumor tissue radiosensitivity

    International Nuclear Information System (INIS)

    Traditionally radiotherapy is prescribed at doses consistent with the expected therapeutic response and tolerance of tumor and normal tissues without consideration to individual differences in radiosensitivity. However, the basic radiobiological knowledge and clinical experience along this line point to significant variations in the observed therapeutic results. It has been established that cells and tissues under experimental and clinical conditions manifest a wide spectrum of individual radiosensitivity. The aim of this survey is to outline the current concepts for the basic radiobiological factors influencing tumor radiosensitivity. A thorough discussion is done of the essence, mechanisms of action, methods of determination and measurement, and effect on the prognosis in patients with malignant diseases of a number of radiobiological factors, such as: tumor-cell proliferation, apoptosis, tumor hypoxia and neovascularization. Although the knowledge of the mechanisms of radiosensitivity is constantly expanding, its clinical implementation is still rather limited. The true role of radiosensitivity in predicting the therapeutic response should be more accurately defined. (authors)

  7. Determination of radiobiological parameters for the safe clinical application of BNCT

    International Nuclear Information System (INIS)

    In the present report the effects of BNCT irradiation on the skin and spinal cord of Fischer 344 rats, for known concentrations of 10B in the blood and these normal tissues, are compared with the effects of the neutron beam alone or photon irradiation. The biological effectiveness of irradiation in the presence of the capture agents BSH and BPA have been compared. Irradiations were carried out using the thermal beam of the Brookhaven Medical Research Reactor (BMRR). Therapy experiments were also carried out as part of this study, using the rat 9L-gliosarcoma cell line, in order to establish the potential therapeutic advantage that might be achieved using the above capture agents. This cell line grows as a solid tumor in vivo as well as in vitro. The implications of these findings, with respect to the clinical use of the Petten HBII based epithermal neutron beam, will be discussed

  8. Basic radiobiology

    International Nuclear Information System (INIS)

    Radiobiology, a branch of science concerned with the action of ionizing radiation on biological tissues and living organisms, is a combination of two disciplines: radiation physics and biology. For use in radiobiology and radiation protection the physical quantity that is useful for defining the quality of an ionizing radiation beam is the linear energy transfer (LET). In contrast to the stopping power, which focuses attention on the energy loss by an energetic charged particle moving through a medium, the LET focuses attention on the linear rate of energy absorption by the absorbing medium as the charged particle traverses the medium. When cells are exposed to ionizing radiation the standard physical effects between radiation and the atoms or molecules of the cells occur first and the possible biological damage to cell functions follows later. The biological effects of radiation result mainly from damage to the DNA, which is the most critical target within the cell; however, there are also other sites in the cell that, when damaged, may lead to cell death

  9. Proceedings of the international conference on radiation biology and clinical applications: a molecular approach towards innovations in applied radiobiology and a workshop on strategies in radiation research

    International Nuclear Information System (INIS)

    Innovations in radiotherapy approaches to cancer and radiation biology research is of growing interest in radiation researchers to conduct preclinical studies at their centers and translating the results as soon as possible to clinical radiotherapy practice. Recent papers have greatly enriched the current knowledge of radiation oncology, especially radiobiology and molecular oncology, and this has radically changed the oncology practice in radiation therapy in just a few years. The conference theme highlights the molecular and cellular responses within tissue and higher levels of mammalian biological organization. New experimental radiobiology research to underpin current and future regulatory decisions setting workplace exposure limits. To develop rapid, high-precision analytical methods that assess radiation exposure doses from clinical samples and thus aid in the triage and medical management of radiological casualties. Innovative approaches to improve the accuracy, dose range, ease of use, and speed of classical biodosimetry. Papers relevant to INIS are indexed separately

  10. Transformation of Physical DVHs to Radiobiologically Equivalent Ones in Hypofractionated Radiotherapy Analyzing Dosimetric and Clinical Parameters: A Practical Approach for Routine Clinical Practice in Radiation Oncology

    Directory of Open Access Journals (Sweden)

    Zoi Thrapsanioti

    2013-01-01

    Full Text Available Purpose. The purpose of this study was to transform DVHs from physical to radiobiological ones as well as to evaluate their reliability by correlations of dosimetric and clinical parameters for 50 patients with prostate cancer and 50 patients with breast cancer, who were submitted to Hypofractionated Radiotherapy. Methods and Materials. To achieve this transformation, we used both the linear-quadratic model (LQ model and the Niemierko model. The outcome of radiobiological DVHs was correlated with acute toxicity score according to EORTC/RTOG criteria. Results. Concerning the prostate radiotherapy, there was a significant correlation between RTOG acute rectal toxicity and ( and ( dosimetric parameters, calculated for  Gy. Moreover, concerning the breast radiotherapy there was a significant correlation between RTOG skin toxicity and dosimetric parameter, calculated for both  Gy ( and  Gy (. The new tool seems reliable and user-friendly. Conclusions. Our proposed model seems user-friendly. Its reliability in terms of agreement with the presented acute radiation induced toxicity was satisfactory. However, more patients are needed to extract safe conclusions.

  11. Direct evaluation of radiobiological parameters from clinical data in the case of ion beam therapy: an alternative approach to the relative biological effectiveness

    International Nuclear Information System (INIS)

    The relative biological effectiveness (RBE) concept is commonly used in treatment planning for ion beam therapy. Whether models based on in vitro/in vivo RBE data can be used to predict human response to treatments is an open issue. In this work an alternative method, based on an effective radiobiological parameterization directly derived from clinical data, is presented. The method has been applied to the analysis of prostate cancer trials with protons and carbon ions. Prostate cancer trials with proton and carbon ion beams reporting 5 year-local control (LC5) and grade 2 (G2) or higher genitourinary toxicity rates (TOX) were selected from literature to test the method. Treatment simulations were performed on a representative subset of patients to produce dose and linear energy transfer distribution, which were used as explicative physical variables for the radiobiological modelling. Two models were taken into consideration: the microdosimetric kinetic model (MKM) and a linear model (LM). The radiobiological parameters of the LM and MKM were obtained by coupling them with the tumor control probability and normal tissue complication probability models to fit the LC5 and TOX data through likelihood maximization. The model ranking was based on the Akaike information criterion. Results showed large confidence intervals due to the limited variety of available treatment schedules. RBE values, such as RBE = 1.1 for protons in the treated volume, were derived as a by-product of the method, showing a consistency with current approaches. Carbon ion RBE values were also derived, showing lower values than those assumed for the original treatment planning in the target region, whereas higher values were found in the bladder. Most importantly, this work shows the possibility to infer the radiobiological parametrization for proton and carbon ion treatment directly from clinical data. (paper)

  12. Feasibility study on the use of polyallyldiglycol-carbonate cell dishes in TUNEL assay for alpha particle radiobiological experiments

    Science.gov (United States)

    Chan, K. F.; Yum, E. H. W.; Wan, C. K.; Fong, W. F.; Yu, K. N.

    2007-08-01

    In the present work, we have studied the feasibility of a method based on polyallyldiglycol-carbonate (PADC) films to investigate the effects of alpha particles on HeLa cervix cancer cells. Thin PADC films with thickness of about 20 μm were prepared from commercially available CR-39 films by chemical etching to fabricate custom-made petri dishes for cell culture, which could accurately record alpha particle hit positions. A special method involving "base tracks" for aligning the images of cell nuclei and alpha particle hits has been proposed, so that alpha particle transversals of cell nuclei can be visually counted. Radiobiological experiments were carried out to induce DNA damages, with the TdT-mediated d UTP Nick- End Labeling (TUNEL) fluorescence method employed to detect DNA strand breaks. The staining results were investigated by flow cytometer. The preliminary results showed that more strand breaks occurred in cells hit by alpha particles with lower energies. Moreover, large TUNEL positive signals were obtained even with small percentages of cells irradiated and TUNEL signals were also obtained from non-targeted cells. These provided evidence for the bystander effect.

  13. Feasibility study on the use of polyallyldiglycol-carbonate cell dishes in TUNEL assay for alpha particle radiobiological experiments

    Energy Technology Data Exchange (ETDEWEB)

    Chan, K.F. [Department of Physics and Materials Science, City University of Hong Kong, Tat Chee Avenue, Kowloon Tong, Hong Kong (China); Yum, E.H.W. [Department of Physics and Materials Science, City University of Hong Kong, Tat Chee Avenue, Kowloon Tong, Hong Kong (China); Wan, C.K. [Department of Biology and Chemistry, City University of Hong Kong, Tat Chee Avenue, Kowloon Tong, Hong Kong (China); Fong, W.F. [Research and Development Division, School of Chinese Medicine, Hong Kong Baptist University, Baptist University Road, Kowloon Tong, Hong Kong (China); Yu, K.N. [Department of Physics and Materials Science, City University of Hong Kong, Tat Chee Avenue, Kowloon Tong, Hong Kong (China)]. E-mail: peter.yu@cityu.edu.hk

    2007-08-15

    In the present work, we have studied the feasibility of a method based on polyallyldiglycol-carbonate (PADC) films to investigate the effects of alpha particles on HeLa cervix cancer cells. Thin PADC films with thickness of about 20 {mu}m were prepared from commercially available CR-39 films by chemical etching to fabricate custom-made petri dishes for cell culture, which could accurately record alpha particle hit positions. A special method involving 'base tracks' for aligning the images of cell nuclei and alpha particle hits has been proposed, so that alpha particle transversals of cell nuclei can be visually counted. Radiobiological experiments were carried out to induce DNA damages, with the TdT-mediated dUTP Nick-End Labeling (TUNEL) fluorescence method employed to detect DNA strand breaks. The staining results were investigated by flow cytometer. The preliminary results showed that more strand breaks occurred in cells hit by alpha particles with lower energies. Moreover, large TUNEL positive signals were obtained even with small percentages of cells irradiated and TUNEL signals were also obtained from non-targeted cells. These provided evidence for the bystander effect.

  14. Radiobiology in clinical radiation therapy - Part IV: Long term risks - Carcinogenic, hereditary, and teratogenetic effects

    International Nuclear Information System (INIS)

    The long-term risks induced by radiation are of much concern to patients and clinicians alike. As an example, perceived radiation risks are frequently cited in a woman's decision to choose a radical mastectomy over lumpectomy + radiation. In consequence, the actual radiation risks are often considerably overstated, or unreasonably downplayed. In this lecture we will discuss just what is known about the long term risks following radiotherapy, both from the human experience and from the laboratory. We will discuss risks both to the patient and to radiotherapy personnel. A good deal is known about the carcinogenic effects of high and low doses of radiation, in large part thanks to the careful study of the survivors of the atomic bombing in Japan, as well as studies of individuals exposed to medical x rays. It is possible to make an estimate, which is probably good to within a factor of, perhaps, three to five, of the cancer risks faced by a patient of a particular age and sex who is going to undergo a particular radiotherapeutic regimen. It is also possible to make an estimate of the risks faced by radiotherapy and nursing staff exposed to low doses. Brachytherapy related risk estimates are likely to be somewhat more uncertain, due to the poorly known sparing effects of the low dose rates used; for the radiotherapy personnel in brachytherapy, because of the doses which can be received, the risks can be quite significant. A recent complication in external-beam radiotherapy is the advent of high-energy linacs, which can produce a significant fast neutron dose which, dose for dose, may be ten to fifty times more carcinogenic than gamma rays. Data relating to the risks of hereditary effects of radiation come almost entirely from laboratory experiments in animals. Studies involving several million mice form the basis of most of our current understanding of hereditary effects. The results of these studies indicate that radiation is a relatively inefficient mutagen. The

  15. Radiobiology in clinical radiation therapy: Long term risks - Carcinogenic, hereditary, and teratogenetic effects

    International Nuclear Information System (INIS)

    The long-term risks induced by radiation are of much concern to patients and clinicians alike. As an example, perceived radiation risks are frequently cited in a woman's decision to choose a radical mastectomy over lumpectomy + radiation. In consequence, the actual radiation risks are often considerably overstated, or unreasonably downplayed. In this lecture we will discuss just what is known about the long term risks following radiotherapy, both from the human experience and from the laboratory. We will discuss risks both to the patient and to radiotherapy personnel. A good deal is known about the carcinogenic effects of high and low doses of radiation, in large part thanks to the careful study of the survivors of the atomic bombing in Japan, as well as studies of individuals exposed to medical x rays. It is possible to make an estimate, which is probably good to within a factor of, perhaps, three to five, of the cancer risks faced by a patient of a particular age and sex who is going to undergo a particular radiotherapeutic regimen. It is also possible to make an estimate of the risks faced by radiotherapy and nursing staff exposed to low doses. Brachytherapy related risk estimates are likely to be somewhat more uncertain, due to the poorly known sparing effects of the low dose rates used; for the radiotherapy personnel in brachytherapy, because of the doses which can be received, the risks can be quite significant. A recent complication in external-beam radiotherapy is the advent of high-energy linacs, which can produce a significant fast neutron dose which, dose for dose, may be ten to fifty times more carcinogenic than gamma rays. Data relating to the risks of hereditary effects of radiation come almost entirely from laboratory experiments in animals. Studies involving several million mice form the basis of most of our current understanding of hereditary effects. The results of these studies indicate that radiation is a relatively inefficient mutagen. The

  16. Toxicological and radiobiological investigations using tissue cultures: Substitute and supplement for animal experiments

    International Nuclear Information System (INIS)

    Experiments are carried out on cell cultures with the aim of researching the biochemistry, sub-cellular distribution and toxicity of radio-nuclides and heavy metals. Investigations with the advanced tissue culture system of the multi-cellular spheroids are used to obtain reliable data on radiation tolerance and the origin of cancers in specific tissue conditions. In particular, there are reports on the results of chelate formation for treating cadmium poisoning and for the decorporation of radio-nuclides (Pu poisoning) and on radiation biology examination of Xeroderma Pigmentosum and the histology of cells of carcinoma of the cervix and hepatozytes. (DG)

  17. SU-E-J-233: A Facility for Radiobiological Experiments in a Large Magnetic Field

    Energy Technology Data Exchange (ETDEWEB)

    Carlone, M; Heaton, R; Keller, H [Princess Margaret Hospital, Toronto, ON (Canada); University of Toronto, Toronto, ON (Canada); Wouters, B [Ontario Cancer Institute, Toronto, ON (Canada); University of Toronto, Toronto, ON (Canada); Jaffray, D [Princess Margaret Hospital, Toronto, ON (Canada); Ontario Cancer Institute, Toronto, ON (Canada); University of Toronto, Toronto, ON (Canada)

    2014-06-01

    Purpose: There is considerable interest in developing medical linear accelerators with integrated image guidance by MRI. Less work has been done on the fundamental biology of cell survival in the presence of a strong magnetic field. The purpose of this work is to describe an experimental system capable of measuring cell survival response in the types of MRI-linac systems currently under development. Methods: We have integrated a cobalt irradiator with a solenoid magnet. The solenoid magnet has inner diameter of 10 cm. To enable measurement of the biological effects as a function of depth, we are utilizing the sliced gel technique, in which cells are embedded and fixed within a gelatin matrix. Irradiated cells at defined positions (sub mm resolution) can subsequently be recovered and assessed for cell survival or other biological effects. Results: The magnetic field profile in the solenoid has a peak magnetic field 36 cm below the top edge of the magnet bore and can be placed at and SAD of 100 cm. At a solenoid current of 35 A, the peak magnetic field is 0.25 T. The dose rate of the cobalt irradiator is 16 cGy/min at 100 cm SAD. EBT3 film was used to demonstrate the system functionality. It was irradiated at 1 cm depth at 100 cm SSD with a 4×4 field to 1.5 Gy in a 0.25 T magnetic field. The dose profile was similar between this film and the control exposure without magnetic field. Conclusion: Integrating a cobalt irradiator with a high field magnet is demonstrated. The magnetic field at the cobalt defining head was minimal and did not interfere with the functioning of this unit. Cell survival experiments can be reproduced exactly in the presence or absence of a magnetic field since a resistive magnet is used.

  18. Non-extensive radiobiology

    Science.gov (United States)

    Sotolongo-Grau, O.; Rodriguez-Perez, D.; Antoranz, J. C.; Sotolongo-Costa, O.

    2011-03-01

    The expression of survival factors for radiation damaged cells is based on probabilistic assumptions and experimentally fitted for each tumor, radiation and conditions. Here we show how the simplest of these radiobiological models can be derived from the maximum entropy principle of the classical Boltzmann-Gibbs expression. We extend this derivation using the Tsallis entropy and a cutoff hypothesis, motivated by clinical observations. A generalization of the exponential, the logarithm and the product to a non-extensive framework, provides a simple formula for the survival fraction corresponding to the application of several radiation doses on a living tissue. The obtained expression shows a remarkable agreement with the experimental data found in the literature, also providing a new interpretation of some of the parameters introduced anew. It is also shown how the presented formalism may have direct application in radiotherapy treatment optimization through the definition of the potential effect difference, simply calculated between the tumour and the surrounding tissue.

  19. Microirradiation techniques in radiobiological research

    Indian Academy of Sciences (India)

    Guido A Drexler; Miguel J Ruiz-Gómez

    2015-09-01

    The aim of this work is to review the uses of laser microirradiation and ion microbeam techniques within the scope of radiobiological research. Laser microirradiation techniques can be used for many different purposes. In a specific condition, through the use of pulsed lasers, cell lysis can be produced for subsequent separation of different analytes. Microsurgery allows for the identification and isolation of tissue sections, single cells and subcellular components, using different types of lasers. The generation of different types of DNA damage, via this type of microirradiation, allows for the investigation of DNA dynamics. Ion microbeams are important tools in radiobiological research. There are only a limited number of facilities worldwide where radiobiological experiments can be performed. In the beginning, research was mostly focused on the bystander effect. Nowadays, with more sophisticated molecular and cellular biological techniques, ion microirradiation is used to unravel molecular processes in the field of radiobiology. These include DNA repair protein kinetics or chromatin modifications at the site of DNA damage. With the increasing relevance of charged particles in tumour therapy and new concepts on how to generate them, ion microbeam facilities are able to address unresolved questions concerning particle tumour therapy.

  20. Proton Radiobiology

    Energy Technology Data Exchange (ETDEWEB)

    Tommasino, Francesco [GSI Helmholtzzentrum für Schwerionenforschung, Department of Biophysics, Darmstadt 64291 (Germany); Durante, Marco, E-mail: m.durante@gsi.de [GSI Helmholtzzentrum für Schwerionenforschung, Department of Biophysics, Darmstadt 64291 (Germany); Technische Universität Darmstadt, Institut für Festkörperphysik, Darmstadt 64291 (Germany)

    2015-02-12

    In addition to the physical advantages (Bragg peak), the use of charged particles in cancer therapy can be associated with distinct biological effects compared to X-rays. While heavy ions (densely ionizing radiation) are known to have an energy- and charge-dependent increased Relative Biological Effectiveness (RBE), protons should not be very different from sparsely ionizing photons. A slightly increased biological effectiveness is taken into account in proton treatment planning by assuming a fixed RBE of 1.1 for the whole radiation field. However, data emerging from recent studies suggest that, for several end points of clinical relevance, the biological response is differentially modulated by protons compared to photons. In parallel, research in the field of medical physics highlighted how variations in RBE that are currently neglected might actually result in deposition of significant doses in healthy organs. This seems to be relevant in particular for normal tissues in the entrance region and for organs at risk close behind the tumor. All these aspects will be considered and discussed in this review, highlighting how a re-discussion of the role of a variable RBE in proton therapy might be well-timed.

  1. Proton Radiobiology

    Directory of Open Access Journals (Sweden)

    Francesco Tommasino

    2015-02-01

    Full Text Available In addition to the physical advantages (Bragg peak, the use of charged particles in cancer therapy can be associated with distinct biological effects compared to X-rays. While heavy ions (densely ionizing radiation are known to have an energy- and charge-dependent increased Relative Biological Effectiveness (RBE, protons should not be very different from sparsely ionizing photons. A slightly increased biological effectiveness is taken into account in proton treatment planning by assuming a fixed RBE of 1.1 for the whole radiation field. However, data emerging from recent studies suggest that, for several end points of clinical relevance, the biological response is differentially modulated by protons compared to photons. In parallel, research in the field of medical physics highlighted how variations in RBE that are currently neglected might actually result in deposition of significant doses in healthy organs. This seems to be relevant in particular for normal tissues in the entrance region and for organs at risk close behind the tumor. All these aspects will be considered and discussed in this review, highlighting how a re-discussion of the role of a variable RBE in proton therapy might be well-timed.

  2. Basic Radiobiology. Chapter 2

    International Nuclear Information System (INIS)

    Radiobiology is the study (both qualitative and quantitative) of the actions of ionizing radiations on living matter. Since radiation has the ability to cause changes in cells which may later cause them to become malignant, or bring about other detrimental functional changes in irradiated tissues and organs, consideration of the associated radiobiology is important in all diagnostic applications of radiation. Additionally, since radiation can lead directly to cell death, consideration of the radiobiological aspects of cell killing is essential in all types of radiation therapy

  3. Radiobiology software for educational purpose

    International Nuclear Information System (INIS)

    To understand radio-nuclide therapy and the basis of radiation protection, it is essential to understand radiobiology. With limited time for classroom teaching and limited time and resources for radiobiology experiments students do not acquire firm grasp of theoretical mathematical models and experimental knowledge of target theory and Linear quadratic models that explain nature of cell survival curves. We believe that this issue might be addressed with numerical simulation of cell survival curves using mathematical models. Existing classroom teaching can be reoriented to understand the subject using the concept of modeling, simulation and virtual experiments. After completion of the lecture, students can practice with simulation tool at their convenient time. In this study we have developed software that can help the students to acquire firm grasp of theoretical and experimental radiobiology. The software was developed using FreeMat ver 4.0, open source software. Target theory, linear quadratic model, cell killing based on Poisson model have been included. The implementation of the program structure was to display the menu for the user choice to be made and then program flows depending on the users choice. The program executes by typing 'Radiobiology' on the command line interface. Students can investigate the effect of radiation dose on cell, interactively. They can practice to draw the cell survival curve based on the input and output data and they can also compare their handmade graphs with automatically generated graphs by the program. This software is in the early stage of development and will evolve on user feedback. We feel this simulation software will be quite useful for students entering in the nuclear medicine, radiology and radiotherapy disciplines. (author)

  4. The significance of the choice of radiobiological (NTCP) models in treatment plan objective functions

    International Nuclear Information System (INIS)

    Full text: A Clinician's discrimination between radiation therapy treatment plans is traditionally a subjective process, based on experience and existing protocols. A more objective and quantitative approach to distinguish between treatment plans is to use radiobiological or dosimetric objective functions, based on radiobiological or dosimetric models. The efficacy of models is not well understood, nor is the correlation of the rank of plans resulting from the use of models compared to the traditional subjective approach. One such radiobiological model is the Normal Tissue Complication Probability (NTCP). Dosimetric models or indicators are more accepted in clinical practice. In this study, three radiobiological models, Lyman NTCP, critical volume NTCP and relative seriality NTCP, and three dosimetric models, Mean Lung Dose (MLD) and the Lung volumes irradiated at lOGy (V|0) and 20Gy (V20), were used to rank a series of treatment plans using, harm to normal (Lung) tissue as the objective criterion. None of the models considered in this study showed consistent correlation with the Radiation Oncologists plan ranking. If radiobiological or dosimetric models are to be used in objective functions for lung treatments, based on this study it is recommended that the Lyman NTCP model be used because it will provide most consistency with traditional clinician ranking.

  5. Simulations of a vacuum window and in-beam ion detection for use in radiobiological experiments with 50 MeV particle beams

    International Nuclear Information System (INIS)

    The vacuum window and in-beam ion detection of a radiobiological endstation have been studied using the Monte Carlo particle transport code MCNPX 2.5.0, investigating the effects of different elements on an incident beam of 50 MeV protons. The scattering and energy spread as well as secondary particle generation are analysed. A 200 nm thick silicon nitride vacuum window was found to have the least effect on the incident beam, giving an energy spread of 5.01(8)× 10−4 MeV. Placing a silicon pixel detector before the sample caused scattering of the beam of around 15 μm in radius; too much to be used for experiments targeting individual nuclei

  6. Conservative surgery and adjuvant radiation therapy in the management of adult soft tissue sarcoma of the extremities: clinical and radiobiological results

    International Nuclear Information System (INIS)

    Purpose: The outcome of adult patients with soft tissue sarcoma of the extremities treated with conservative surgery and adjuvant irradiation was evaluated to (a) determine the appropriate treatment volume and radiation dosage in the postoperative setting, and (b) correlate in vitro radiobiological parameters obtained prior to therapy with clinical outcome. Methods and Materials: Sixty-four consecutive adult patients with soft tissue sarcoma of the extremities (40 lower, 24 upper) who underwent conservative surgery and adjuvant irradiation (7 preoperative, 50 postoperative, 7 perioperative) between 1978 and 1991 were reviewed. The initial radiation field margin surrounding the tumor bed/scar was retrospectively analyzed in all postoperative patients. Initial field margins were < 5 cm in 12 patients, 5-9.9 cm in 32 and ≥ 10 cm in 6. Patients with negative pathological margins were initially treated with traditional postoperative doses (64-66 Gy); however, in later years the postoperative dose was reduced to 60 Gy. Thirteen cell lines were established prior to definite therapy, and radiobiological parameters (multitarget and linear-quadratic) were obtained and correlated with outcome. Results: Postoperative patients treated with an initial field margin of < 5 cm had a 5-year local control of 30.4% vs. 93.2% in patients treated with an initial margin of ≥ 5 cm (p = 0.0003). Five-year local control rates were similar in patients treated with initial field margins of 5-9.9 cm (91.6%) compared with those treated with ≥ 10 cm margins (100%) (p = 0.49). While postoperative patients receiving < 60 Gy had a worse local control than those receiving ≥ 60 Gy (p = 0.08), no difference was seen in local control between patients receiving less than traditional postoperative doses (60-63.9 Gy) (74.4%) vs. those receiving 64-66 Gy (87.0%) (p = 0.5). The local control of patients treated in the later years of the study, with strict attention to surgical and radiotherapeutic

  7. Radiobiological Research in JINR

    CERN Document Server

    Krasavin, E A

    2000-01-01

    The results of long-term radiobiological and radiation-genetical research in DRRR (Division of Radiobiology) are summarized. The different radiation-induced effects in bacteria, yeasts, mammalian and human cells after irradiation by gamma-rays and heavy charged particles are considered. The important role of DNA repair processes in biological effectiveness of different types of radiation were shown. The data on mutagenic action of such kinds of radiation on pro- and eukaryotic cells were analyzed. On the basis of our data the hypersensitivity of human and mammalian chromosomes after low doses of gamma-rays (10-20 sGy) was revealed. The radiobiological effect of ^{211}At - methylene blue complex on human melanoma cells was studied. The extremely high effectiveness of this complex on melanoma cells was shown.

  8. Radiobiology with heavy charged particles: a historical review

    Energy Technology Data Exchange (ETDEWEB)

    Skarsgard, L.D. [Dept. of Medical Biophysics, B.C. Cancer Research Centre and TRIUMF, Vancouver (Canada)

    1997-09-01

    The presentation will attempt to briefly review some of radiobiological data on the effects of heavy charged particles and to discuss the influence of those studies on the clinical application which followed. (orig./MG)

  9. Research in Radiobiology

    International Nuclear Information System (INIS)

    This document contains the tables of contents for the reports published by the University of Utah Radiobiology Laboratory from 1953--1987. Also included is a keyword index for the reports, and references for all books, book and symposia chapters and journal article published by Laboratory staff between 1950 and 1988

  10. Department of Radiobiology - foreword

    International Nuclear Information System (INIS)

    The research program of the Department of Radiobiology of the Niewodniczanski Institute of Nuclear Physics is performed by two laboratories: 1/Laboratory of Neutron Therapy and Applied in Radiobiology Therapy and Agriculture. 2/ Laboratory of Radiation and Environmental Mutagenesis. The aim of the first mentioned Laboratory is to determine the Relative Biological Effectiveness (RBE) of fast 5.6 MeV neutrons with regard to regime of fractionation. Our goal is to reduce the number of fraction of neutron therapy what makes possible increasing the total dose. The second mentioned Laboratory engages in research on the mutagenesis in rape-seed in vitro regeneration of dihaploids and pollen grains. The object is to find how much fast neutrons, X and γ-rays irradiations stimulate the dihaploide production and to determine their reaction in flower buds microspores and anther cultures. (author)

  11. Comparison of cytogenetic effects in bone marrow of mice after the flight on the biosatellite "BION-M1" and the ground-based radiobiological experiment

    Science.gov (United States)

    Dorozhkina, Olga; Vorozhtsova, Svetlana; Ivanov, Alexander

    2016-07-01

    During space flight, the astronauts are exposed to radiation exposure at low doses with low dose rates, so one of the actual areas of Radiobiology is research of action of ionizing radiation in low and ultra-low doses. Violation of the chromosome apparatus of living biosystems, ranging from viruses and bacteria to humans, is the most reliable evidence of exposure to ionizing radiation. In this regard, the study of cytogenetic damage in the cells of humans and animals is central to space radiobiology (Fedorenko B.S., 2006). In experiment "BION - M1" by anaphase method was determined level of chromosomal aberrations in bone marrow cells of tibia of mice. Flight duration biosatellite "BION - M1" (Sychev V.N. et al., 2014) was 30 days in Earth orbit. Euthanasia of experimental animals was carried out after 12 hours from the moment of landing satellite by method of cervical dislocation. The level of chromosomal aberrations in vivarium-housed control mice was 1,75 ± 0,6% and 1,8 ± 0,45%, while the mitotic index 1,46 ± 0,09% and 1,53 ± 0,05%. The content of animals in the experiment with onboard equipment led to some increase in aberrant mitosis (2,3 ± 0,4%) and reduction of the mitotic index (1,37 ± 0,02%). In the flight experiment "BION-M1" was a statistically significant increase in level of chromosome aberrations (29,7 ± 4,18%) and a decrease in the mitotic index (0,74 ± 0,07%). According to VA Shurshakova (2014), the radiation dose to mice ranged from 32 to 72 mGy and relate to a range of small doses (ICRP, 2012). In this connection we conducted a series of experiments in the ground conditions, the aim of which was the study of earliest effects of ionizing radiation in vivo in mice irradiated with low doses of γ-irradiation of 10 to 200 mGy in the first 24 hours after exposure, i.e. within the first post-radiation exposure cell cycle. Studies were carried out on adult female mice outbred ICR (CD-1) - SPF category at the age of 4-4.5 months with an average

  12. Beam-Port Design of a Radiobiological Dosimetry Experiment for 10B-Enhanced 252Cf Brachytherapy

    International Nuclear Information System (INIS)

    It has been previously suggested that the incorporation of 10B-labeled drugs into tumor cells might significantly increase the dose to the peripheral tumor cells in 252Cf brachytherapy. The dose enhancement comes from the thermal neutron capture reactions of 10B(n, α)7Li. As a new cancer treatment modality, this so-called 10und B-und Enhanced 252und Cf und Brachyund therapy (BECBT) is currently being commercialized by Isotron. One of the challenges for implementing BECBT has been to determine the maximum tolerable dose (MTD) to the normal tissue surrounding a tumor. Because the relative biological effectiveness for the 10B(n, α)7Li reaction products is greater than that for fission neutrons, the MTD should decrease as 10B concentration increases for BECBT. To more precisely determine the MTD for BECBT, we intend to conduct both in vitro (cell culture) and in vivo (rat) experiments with a 50-mg 252Cf source. We will use cell survival fraction and normal brain necrosis as the biological end points for the cell-culture experiments and rat experiments, respectively. To carry out these experiments, the neutron field to which the samples are exposed must contain a significant portion of thermal neutrons. The rat experiments further require the use of a very small and well-collimated neutron beam to effectively irradiate the rat brain while minimizing the dose to its whole body. This paper discusses the design criteria for the experimental neutron beam port and the computational work leading to its optimal configuration

  13. Development of radiobiology for oncology-a personal view

    International Nuclear Information System (INIS)

    When I came into radiotherapy in 1950, I was puzzled that some patients were treated to 3000 rads (cGy) in 3 weeks but others received 4000 in 5 or 6000 in 6 weeks. When I asked why, there were no convincing answers given, except 'this is what we usually do'. It wasn't until I went to a course on 'Radiobiology for Radiotherapy' in Cambridge that I learnt about the basic theories of Douglas Lea and the very considerable history of research into radiobiology and clinical radiotherapy. And there were still some questions outstanding, such as the relative importance of intracellular repair between 'daily' fractions, whether a 2 day gap each week was a good or a bad idea, and the role of proliferation, if any, during irradiation. I thought that a few simple animal experiments might help to give answers! That led me to a continuing interest in these questions and answers, which has taken me more than 50 years to pursue. This is the very personal story of what I saw happening in the subject, decade by decade. I was happy to experience all this together with scientists in many other countries, and our own, along the way. (review)

  14. The Fundamentals of Imaging Physics and Radiobiology

    CERN Document Server

    Selman, Joseph

    2000-01-01

    Like its well-known predecessor, this new and expanded Ninth Edition presents numerous important changes, beginning with the title and continuing throughout the text. Drawing on current knowledge and his own extensive experience, Dr. Selman provides a thorough revision and overview of each previously included chapter. Definitions, foundations, and principles are presented along with changes in methods and procedures. The text presents five new chapters on computed tomography, radioactivity and diagnostic nuclear medicine, radiobiology, protection in radiology/health physics, and nonradiologic

  15. Radiation Protection Research: Radiobiology

    International Nuclear Information System (INIS)

    The main objectives of research in the field of radiobiology and epidemiology performed at the Belgian Nuclear Research Centre SCK-CEN are (1) to study cancer mortality in nuclear workers in Belgium; to document the feasibility of retrospective cohort studies in Belgium; (2) to participate in the IARC study; (3) to elucidate the molecular basis of the effects of ionising radiation in the mammalian embryo during the early phases of its development; (4) to assess the genetic risk of maternal exposure to ionizing radiation; (5) to elucidate the cellular mechanisms leading to brain damage after prenatal irradiation; (6) to advise authorities and to provide the general population with adequate information concerning the health risk arising from radiation exposure. Progress and major achievements in these topical areas in 1999 are reported

  16. Radiation Protection Research: Radiobiology

    Energy Technology Data Exchange (ETDEWEB)

    Desaintes, C

    2000-07-01

    The main objectives of research in the field of radiobiology and epidemiology performed at the Belgian Nuclear Research Centre SCK-CEN are (1) to study cancer mortality in nuclear workers in Belgium; to document the feasibility of retrospective cohort studies in Belgium; (2) to participate in the IARC study; (3) to elucidate the molecular basis of the effects of ionising radiation in the mammalian embryo during the early phases of its development; (4) to assess the genetic risk of maternal exposure to ionizing radiation; (5) to elucidate the cellular mechanisms leading to brain damage after prenatal irradiation; (6) to advise authorities and to provide the general population with adequate information concerning the health risk arising from radiation exposure. Progress and major achievements in these topical areas in 1999 are reported.

  17. Neutron radiobiology revisited

    International Nuclear Information System (INIS)

    The present paper reviews the experimental results of normal tissue and tumour studies in animals. The dose per fraction dependence of the RBE in normal tissues has been long recognised, together with the steeper increase of RBE at low doses for late responding tissues compared with acute reactions. The dose dependence for tumours is more complex, because of hypoxia and reoxygenation, as well as differences in repair capability after high LET damage. A comparison of tumour and normal tissue RBE values shows that there is little experimental evidence for a therapeutic advantage at clinically relevant doses. In particular, the RBE for slow growing tumours is even lower than that for the faster growing mouse tumours. The reasons for the loss of expected neutron benefits in clinically relevant experiments are discussed. The disappointing prospects for neutrons are contrasted with the current multifactorial approaches to overcoming resistance to more conventional low LET radiations, including acceleration, hyperfractionation and several types of hypoxic cell radiosensitizers. (orig.)

  18. Toward a national consensus: teaching radiobiology to radiation oncology residents

    International Nuclear Information System (INIS)

    Purpose: The ASTRO Joint Working Group on Radiobiology Teaching, a committee composed of members having affiliations with several national radiation oncology and biology-related societies and organizations, commissioned a survey designed to address issues of manpower, curriculum standardization, and instructor feedback as they relate to resident training in radiation biology. Methods and Materials: Radiation biology instructors at U.S. radiation oncology training programs were identified and asked to respond to a comprehensive electronic questionnaire dealing with instructor educational background, radiation biology course content, and sources of feedback with respect to curriculum planning and resident performance on standardized radiation biology examinations. Results: Eighty-five radiation biology instructors were identified, representing 73 radiation oncology residency training programs. A total of 52 analyzable responses to the questionnaire were received, corresponding to a response rate of 61.2%. Conclusion: There is a decreasing supply of instructors qualified to teach classic, and to some extent, clinical, radiobiology to radiation oncology residents. Additionally, those instructors with classic training in radiobiology are less likely to be comfortable teaching cancer molecular biology or other topics in cancer biology. Thus, a gap exists in teaching the whole complement of cancer and radiobiology curricula, particularly in those programs in which the sole responsibility for teaching falls to one faculty member (50% of training programs are in this category). On average, the percentage of total teaching time devoted to classic radiobiology (50%), clinical radiobiology (30%), and molecular and cancer biology (20%) is appropriate, relative to the current makeup of the board examination. Nevertheless large variability exists between training programs with respect to the total number of contact hours per complete radiobiology course (ranging from

  19. Radiobiology and Epidemiology

    Energy Technology Data Exchange (ETDEWEB)

    Desaintes, C; Holmstock, L

    2001-04-01

    The main objectives of research in the field of radiobiology and epidemiology performed at the Belgian Nuclear Research Centre SCK-CEN are: (1) to study cancer mortality in nuclear workers in Belgium and to co-ordinate the Belgian contribution to the 'International Collaborative Study of Cancer Risk among Radiation Workers in the Nuclear Industry'; (2) to elucidate the molecular basis of individual susceptibility to ionizing radiation in mammalian embryo during the early phases of its development; (3) to assess the genetic risk of maternal exposure to ionizing radiation; (4) to elucidate the cellular mechanisms leading to brain damage after prenatal irradiation; (5) to monitor the early variations of gene expression induced by ionising radiation and cytokines; (6) to evaluate the use of cytokines and natural substances for improving radiotherapy protocols; (6) to advise authorities and to provide the general population with adequate information concerning the health risk arising from radiation exposure. Progress and major achievements in these topical areas in 2000 are reported.

  20. Radiobiology and Epidemiology

    International Nuclear Information System (INIS)

    The main objectives of research in the field of radiobiology and epidemiology performed at the Belgian Nuclear Research Centre SCK-CEN are: (1) to study cancer mortality in nuclear workers in Belgium and to co-ordinate the Belgian contribution to the 'International Collaborative Study of Cancer Risk among Radiation Workers in the Nuclear Industry'; (2) to elucidate the molecular basis of individual susceptibility to ionizing radiation in mammalian embryo during the early phases of its development; (3) to assess the genetic risk of maternal exposure to ionizing radiation; (4) to elucidate the cellular mechanisms leading to brain damage after prenatal irradiation; (5) to monitor the early variations of gene expression induced by ionising radiation and cytokines; (6) to evaluate the use of cytokines and natural substances for improving radiotherapy protocols; (6) to advise authorities and to provide the general population with adequate information concerning the health risk arising from radiation exposure. Progress and major achievements in these topical areas in 2000 are reported

  1. Radiobiology and isotopic imaging

    International Nuclear Information System (INIS)

    This 6. workshop occurs after more than 10 years of meaningful scientific exchanges between the National Institute of Radiological Sciences and the Life Science Division of the French Atomic Commission. The aim of the workshops held alternatively in Japan and France every two years is to promote new collaboration and stimulate exchange of scientists. In this respect, encouraging results have been obtained, since young scientists are currently working at the partner's institution; this is highlighted this year, with the presentation of their results as speakers from each country. New projects are under way to enlarge scientific collaboration. This sixth workshop will allocate three days to specialized working groups within the laboratories at the various locations of the Life Science Division. We hope that all participants will take this opportunity to develop further collaborative research activities in connection with the recent major advances in the field of radiobiology and medical imaging. Such a meeting appears of high interest within the context of new nuclear energy developments

  2. Monte Carlo role in radiobiological modelling of radiotherapy outcomes

    Science.gov (United States)

    El Naqa, Issam; Pater, Piotr; Seuntjens, Jan

    2012-06-01

    Radiobiological models are essential components of modern radiotherapy. They are increasingly applied to optimize and evaluate the quality of different treatment planning modalities. They are frequently used in designing new radiotherapy clinical trials by estimating the expected therapeutic ratio of new protocols. In radiobiology, the therapeutic ratio is estimated from the expected gain in tumour control probability (TCP) to the risk of normal tissue complication probability (NTCP). However, estimates of TCP/NTCP are currently based on the deterministic and simplistic linear-quadratic formalism with limited prediction power when applied prospectively. Given the complex and stochastic nature of the physical, chemical and biological interactions associated with spatial and temporal radiation induced effects in living tissues, it is conjectured that methods based on Monte Carlo (MC) analysis may provide better estimates of TCP/NTCP for radiotherapy treatment planning and trial design. Indeed, over the past few decades, methods based on MC have demonstrated superior performance for accurate simulation of radiation transport, tumour growth and particle track structures; however, successful application of modelling radiobiological response and outcomes in radiotherapy is still hampered with several challenges. In this review, we provide an overview of some of the main techniques used in radiobiological modelling for radiotherapy, with focus on the MC role as a promising computational vehicle. We highlight the current challenges, issues and future potentials of the MC approach towards a comprehensive systems-based framework in radiobiological modelling for radiotherapy.

  3. Radiation monitoring considerations for radiobiology facilities

    International Nuclear Information System (INIS)

    Battelle, Pacific Northwest Laboratories, conducts a wide variety of radiobiology and radioecology research in a number of facilities on the Hanford Reservation. Review of radiation monitoring problems associated with storage, plant and animal experiments, waste handling and sterile facilities shows that careful monitoring, strict procedural controls and innovative techniques are required to minimize occupational exposure and control contamination. Although a wide variety of radioactivity levels are involved, much of the work is with extremely low level materials. Monitoring low level work is mundane and often impractical but cannot be ignored in today's ever tightening controls

  4. Melanomas: radiobiology and role of radiation therapy

    International Nuclear Information System (INIS)

    Purpose/Objective: This course will review the radiobiology of malignant melanoma (MM) and the clinical use of radiation therapy for metastatic melanoma and selected primary sites. The course will emphasize the scientific principles underlying the clinical treatment of MM. Introduction: The incidence of malignant melanoma has one of the fastest growth rates in the world. In 1991, there were 32,000 cases and 7,000 deaths from MM in the United States. By the year 2000, one of every 90 Americans will develop MM. Wide local excision is the treatment of choice for Stage I-II cutaneous MM. Five-year survival rates depend on (a) sex: female-63%, male-40%; (b) tumor thickness: t 4 mm-25%; (c) location: extremity-60%, trunk-41%; and (d) regional lymph node status: negative-77%, positive-31%. Despite adequate surgery, 45-50% of all MM patients will develop metastatic disease. Radiobiology: Both the multi-target model: S = 1-(1-e-D/Do)n and the linear quadratic mode: -In(S) = alpha x D + beta x D2 predict a possible benefit for high dose per fraction (> 400 cGy) radiation therapy for some MM cell lines. The extrapolation number (n) varies from 1-100 for MM compared to other mammalian cells with n=2-4. The alpha/beta ratios for a variety of MM cell lines vary from 1 to 33. Other radiobiologic factors (repair of potentially lethal damage, hypoxia, reoxygenation, and repopulation) predict a wide variety of clinical responses to different time-dose prescriptions including high dose per fraction (> 400 cGy), low dose per fraction (200-300 cGy), or b.i.d. therapy. Based on a review of the radiobiology of MM, no single therapeutic strategy emerges which could be expected to be successful for all tumors. Time-Dose Prescriptions: A review of the retrospective and prospective clinical trials evaluating various time-dose prescriptions for MM reveals: (1) MM is a radiosensitive tumor over a wide range of diverse time-dose prescriptions; and (2) The high clinical response rates to a

  5. In vivo tumor radiobiology of heavy charged particles

    International Nuclear Information System (INIS)

    The response of tumor cells systems to irradiation with carbon, neon and argon beams at various positions in the plateau and extended-peak regions of the Bragg ionization curve is being evaluated from experiments conducted both in vivo and in vitro. The radiobiological end points being studied include: tumor volume response, cellular survival after tumor irradiation in situ, and cell-kinetic parameters

  6. Harmonization of radiobiological assays: why and how?

    International Nuclear Information System (INIS)

    The International Atomic Energy Agency has made available a technical manual for cytogenetic biodosimetry assays (dicentric chromosome aberration (DCA) and cytokinesis-block micronucleus (CBMN) assays) used for radiation dose assessment in radiation accidents. The International Standardization Organization, which develops standards and guidelines, also provides an avenue for laboratory accreditation, has developed guidelines and recommendations for performing cytogenetic biodosimetry assays. Harmonization of DCA and CBMN assays, has improved their accuracy. Double-blinded inter-laboratory comparison studies involving several networks have further validated DCA and CBMN assays and improved the confidence in their potential use for radiation dose assessment in mass casualties. This kind of international harmonization is lacking for pre-clinical radiobiology assays. The widely used pre-clinical assays that are relatively important to set stage for clinical trials include clonogenic assays, flow-cytometry assays, apoptotic assays, and tumor regression and growth delay assays. However, significant inter-laboratory variations occur with respect to data among laboratories. This raises concerns on the reliability and reproducibility of preclinical data that drives further development and translation. Lack of reproducibility may stem from a variety of factors such as poor scientist training, less than optimal experimental design, inadequate description of methodology, and impulse to publish only the positive data etc. Availability of technical manuals, standard operating procedures, accreditation avenues for laboratories performing such assays, inter-laboratory comparisons, and use of standardized protocols are necessary to enhance reliability and reproducibility. Thus, it is important that radiobiological assays are harmonized for laboratory protocols to ensure successful translation of pre-clinical research on radiation effect modulators to help design clinic trials with

  7. Preparation of intravenous cytostatic mixtures: one-year work experience at the Pharmaceutical Service of the Nacional Institute of Oncology and Radiobiology

    International Nuclear Information System (INIS)

    From October 2006 to September 2007, which marked the beginning of the preparation of intravenous cytostatic mixtures by the Pharmaceutical Service of the National Institute of Oncology and Radiobiology, a number of results were achieved and then considered for analysis in this paper. The selected indicators included the number of detected and/or avoided medication errors, cytostatics consumption, therapies recovered through centralized preparation and the implementation of Good Practices of Preparation and Pharmacy. The results were compared with those of similar periods of time in previous years. It was observed that the involvement of the pharmacist in the oncological chemotherapy team contributed to recovering costly therapies such as 80 mg Docetaxel, 300 mg Paclitaxel and 150 mg Transtuzomab ampules. One hundred and twenty one patients could potentially benefit from these therapies, mainly those suffering breast cancer. The consumption of cytostatic drugs such as 1 mg Vincristine and 15 mg Bleomycin ampules decreased; the application of technical and economic control evidenced an increased use of 200 mg Cyclophosphamide and 10 mg Cisplatine ampules. Besides, 1,3% medication errors in prescription was detected and avoided, although this is still a high figure. It was concluded that the involvement of a pharmacist in the medical team improves the quality of service in those hospitals that care for oncological patients. It was suggested that a pharmacist should be incorporated into the medical teams of other hospital centers throughout the country since this encourages the implementation of Good Practices of Preparation and contributes to minimizing medication errors. (Author)

  8. Radiobiological characteristic of tritium-labelled lysine

    International Nuclear Information System (INIS)

    Experiments on mice and rats injected with tritium-labeled lysine have revealed that one day after injection about 80% of the label was retained in organs and tissues as tissue-bound tritium. Retention curves for tritium in the body were decomposed into two exponentials. The biological half-lives of tritium-labeled lysine in various tissues exceed half-lives of other tritiated amino acids and of triated water. The average dose in different tissues following injection of tritiated lysine exceeds that from equal of tritium oxide (THO) by 1.5-8 times. Contribution of the tissue-bound tritium in dose is about 90%. radiobiological experiments showed strong genetic and citotoxic effects in male mice after injection of tritium-labeled lysine

  9. Radiotherapy treatment planning linear-quadratic radiobiology

    CERN Document Server

    Chapman, J Donald

    2015-01-01

    Understand Quantitative Radiobiology from a Radiation Biophysics PerspectiveIn the field of radiobiology, the linear-quadratic (LQ) equation has become the standard for defining radiation-induced cell killing. Radiotherapy Treatment Planning: Linear-Quadratic Radiobiology describes tumor cell inactivation from a radiation physics perspective and offers appropriate LQ parameters for modeling tumor and normal tissue responses.Explore the Latest Cell Killing Numbers for Defining Iso-Effective Cancer TreatmentsThe book compil

  10. New clinical experience with tramadol.

    Science.gov (United States)

    Sunshine, A

    1994-01-01

    The analgesic efficacy of tramadol has been recently reassessed as part of a new clinical development programme to support an application for registration in the USA. This article reviews the results of single dose and short term studies of oral tramadol 50, 75, 100 and 150 mg in various acute pain conditions. In a double-blind single dose study conducted in 161 patients with severe pain following caesarean section, tramadol 75 and 150 mg and the combination of paracetamol 650 mg with dextropropoxyphene napsylate 100 mg were shown to be effective and statistically superior to placebo. The results from this and 17 other similar studies in patients with pain after surgery (n = 1594) or dental extraction (n = 1859) including other comparators were included in a pooled analysis. Tramadol 100 mg was the optimal single dose for acute pain and tramadol 50 mg showed similar analgesic efficacy to codeine 60 mg. Multiple dose short term studies (n = 520) with tramadol 50, 75 and 100 mg demonstrated a statistically significant and dose-dependent reduction in the consumption of either ibuprofen or morphine as escape medication. New pharmacokinetic data show that steady-state plasma tramadol concentrations reached after oral administration of 50 mg doses every 6 hours are similar to those obtained after administration of a 100 mg single oral dose (250 micrograms/L). This rationale is supported by the results of long term studies in which the average daily dose of tramadol was approximately 250 mg. PMID:7517826

  11. Natural orifice surgery: initial clinical experience

    OpenAIRE

    Horgan, Santiago; Cullen, John P; Talamini, Mark A.; Mintz, Yoav; Ferreres, Alberto; Jacobsen, Garth R.; Sandler, Bryan; Bosia, Julie; Savides, Thomas; Easter, David W.; Savu, Michelle K.; Ramamoorthy, Sonia L.; Whitcomb, Emily; Agarwal, Sanjay; Lukacz, Emily

    2009-01-01

    Background Natural orifice translumenal endoscopic surgery (NOTES) has moved quickly from preclinical investigation to clinical implementation. However, several major technical problems limit clinical NOTES including safe access, retraction and dissection of the gallbladder, and clipping of key structures. This study aimed to identify challenges and develop solutions for NOTES during the initial clinical experience. Methods Under an Institutional Review Board (IRB)-approved protocol, patients...

  12. Meson radiobiology and therapy

    International Nuclear Information System (INIS)

    High-linear energy transfer radiation (neutrons, heavy ions, and pions) have a greater relative biological effectiveness than low-linear energy transfer radiation by depositing a high density of ionization in irradiated cells. This overcomes the protective effect of oxygen; decreases the variation in sensitivity among the several stages of the cell cycles; and, inhibits the repair of sublethal damage as compared to x-rays, gamma rays, electrons and protons. Negative pi mesons (pions), appear particularly suited for radiation therapy as their penetration and depth-dose profiles lend themselves to shaping the high dose area to the tumor size and location. Preliminary biological experiments with pions produced at the Los Alamos Meson Physics Facility studied cell survival at various radiation depths and cell cycle sensitivity. Histologic study of data from the first human experiments indicated severe tumor cell destruction by pions as compared to x-rays in treating malignant melanoma skin nodules, without increased effects on dermal elements. (U.S.)

  13. The European Radiobiology Archives (ERA), its present status, relation to other radiobiology archives and future development

    International Nuclear Information System (INIS)

    The European Radiobiology Archives (ERA) in cooperation with the US (National Radiobiology Archives, NRA) and Japanese (Japanese Radiobiology Archives, JRA) aim to collect most of the information still available in Europe on long-term animal experiments - including some selected human studies suitable for comparison with animal data - and to make them available to the scientific community for further analysis. Presently, the archives contain a description of the exposure conditions, animal strains, etc from ∝350.000 individuals, and data on survival and pathology are available from ∝200.000 individuals. These data are incorporated in an ACCESS 2000 database, which also includes means (forms with underlying computer code) for browsing through the data, searching for groups given certain treatments, using specific animal strains or age, etc. Other forms allow the selection of experimental groups, their evaluation by some statistical programs and their export for further detailed studies by interested scientists. The forms also allow researchers to combine groups and to pool diseases into larger classes, e.g. all malignant tumours, all lung tumours etc., features that are important when studies from different laboratories are to be evaluated. The use of the database is illustrated by an example on the selection and preparation for further analysis of data dealing with the effects of 224Ra. The collection of data will continue in the future; and the archives will liase with similar ventures such as the European 'pathbase'. The user interface will be developed further for accessibility and user friendliness and be continuously adjusted to the current state of the art of hardware and software. The archives are to be transferred to the Bundesamt fuer Strahlenschutz (BfS), Neuherberg, Germany under the sponsorship of the European Commission and in collaboration with the European Late Effect Project Group (EULEP). (orig.)

  14. Military radiobiology: A perspective

    International Nuclear Information System (INIS)

    Acute medical consequences affecting military personnel fall into two major classes: early events affecting performance and later more lethal events associated with single and combined injuries. If cells survive the radiation insult, they have the capability for repair. But the patient must survive fluid loss, infection, and bleeding defects until this can occur. Although no one can ever eliminate the incomprehensible destruction of human life associated with the use of nuclear weapons, significant medical advances can be achieved that will increase the performance and recovery of persons exposed to these weapons. Furthermore, these medical advances will go far toward improving the life and functioning of persons undergoing radiotherapy, trauma, accidental exposures, or a variety of other clinical situations. In the near future, the military battlefield will move into another dimension - space. Once outside the geomagnetic shield of the earth, military prsonnel will be exposed to a formidable array of new radiations. Among the new radiations will be high solar energy, solar particles and flares, and heavy nuclei from galactic cosmic arrays. Associated stresses will be microgravity, vibration, and isolation. To protect man in these new environments will truly challenge our ingenuity. This book looks at various medical consequences we face as a result of nuclear energy

  15. Canadian experience with structured clinical examinations.

    OpenAIRE

    Grand'Maison, P.; Lescop, J; Brailovsky, C. A.

    1993-01-01

    The use of structured clinical examinations to improve the evaluation of medical students and graduates has become significantly more common in the past 25 years. Many Canadian medical educators have contributed to the development of this technique. The Canadian experience is reviewed from the introduction of simulated-standardized patients and objective-structured clinical examinations to more recent developments and the use of such examinations for licensure and certification.

  16. The clinical experiences of dyslexic healthcare students

    International Nuclear Information System (INIS)

    This paper reflects on the experiences of healthcare students with dyslexia in order to raise awareness of the potential challenges for dyslexic student radiographers and their clinical educators. With widening participation policies it is likely that the number of student radiographers with specific learning difficulties such as dyslexia will continue to increase. A review of the literature associated with dyslexia in healthcare education was performed in order to provide an overview of the current position. Although Higher Education Institutions (HEIs) have embraced the support and learning opportunities for dyslexic students at university, evidence would suggest that this is not reflected in the clinical departments. The current literature strongly suggests that since the risk of errors with clinical information is far more significant within the clinical placement, there is an immediate requirement for greater understanding, robust support and risk assessment systems. This review considers the problems experienced by dyslexic students, coping strategies they employ and the possible implications for clinical radiography education.

  17. The clinical experiences of dyslexic healthcare students

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, Fred [Directorate of Radiography, School of Health Care Professions, University of Salford, Allerton Building, Salford, Greater Manchester M6 6PU (United Kingdom)], E-mail: f.j.murphy@salford.ac.uk

    2009-11-15

    This paper reflects on the experiences of healthcare students with dyslexia in order to raise awareness of the potential challenges for dyslexic student radiographers and their clinical educators. With widening participation policies it is likely that the number of student radiographers with specific learning difficulties such as dyslexia will continue to increase. A review of the literature associated with dyslexia in healthcare education was performed in order to provide an overview of the current position. Although Higher Education Institutions (HEIs) have embraced the support and learning opportunities for dyslexic students at university, evidence would suggest that this is not reflected in the clinical departments. The current literature strongly suggests that since the risk of errors with clinical information is far more significant within the clinical placement, there is an immediate requirement for greater understanding, robust support and risk assessment systems. This review considers the problems experienced by dyslexic students, coping strategies they employ and the possible implications for clinical radiography education.

  18. Early experiences of accredited clinical informatics fellowships.

    Science.gov (United States)

    Longhurst, Christopher A; Pageler, Natalie M; Palma, Jonathan P; Finnell, John T; Levy, Bruce P; Yackel, Thomas R; Mohan, Vishnu; Hersh, William R

    2016-07-01

    Since the launch of the clinical informatics subspecialty for physicians in 2013, over 1100 physicians have used the practice and education pathways to become board-certified in clinical informatics. Starting in 2018, only physicians who have completed a 2-year clinical informatics fellowship program accredited by the Accreditation Council on Graduate Medical Education will be eligible to take the board exam. The purpose of this viewpoint piece is to describe the collective experience of the first four programs accredited by the Accreditation Council on Graduate Medical Education and to share lessons learned in developing new fellowship programs in this novel medical subspecialty. PMID:27206458

  19. Optimal fractionation from radiobiological view

    International Nuclear Information System (INIS)

    Not only in animal experiments but also from analyses of clinical data important knowledge could be obtained in recent years, that deal with the course of biological processes in tumor and normal tissue during fractionated irradiation. Relevant are differences in the capacity for recovery from sublethal radiation injury and in repopulation. Chronically reacting normal tissues show a clearly higher repair capacity than tumors, that can be used for hyperfractionation with reduced single dosis. However, strong attention must be given to repairing time, that the selective benefit is not endangered by incomplete recovery. On the other side clinical analyses have confirmed that the stem cell repopulation - going on in several tumor types, so e.g. in squamous cell carcinomas, during the time of conventional treatment - can make a considerable contribution to radioresistance. The actual level of knowledge justifies further clinical experiments with unconventional fractionation, especially with accelerated hyperfractionation. (author)

  20. Challenges in radiobiological modeling: can we decide between LQ and LQ-L models based on reviewed clinical NSCLC treatment outcome data?

    International Nuclear Information System (INIS)

    To study the dose-response of stage I non-small-cell lung cancer (NSCLC) in terms of long-term local tumor control (LC) after conventional and hypofractionated photon radiotherapy, modeled with the linear-quadratic (LQ) and linear-quadratic-linear (LQ-L) approaches and to estimate the clinical α/β ratio within the LQ frame. We identified studies of curative radiotherapy as single treatment through MedLine search reporting 3-year LC as primary outcome of interest. Logistic models coupled with the biologically effective dose (BED) at isocenter and PTV edge according to both the LQ and LQ-L models with α/β = 10 Gy were fitted. Additionally, α/β was estimated from direct LQ fits. Thirty one studies were included reporting outcome of 2319 patients. The LQ-L fit yielded a significant value of 11.0 ± 5.2 Gy for the dose threshold (Dt) for BED10 at the isocenter. The LQ and LQ-L fits did not differ substantially. Concerning the estimation of α/β, the value obtained from the direct LQ fit for the complete fractionation range was 3.9 [68 % CI: 2.2–9.0] Gy (p > 0.05). Both LQ and LQ-L fits can model local tumor control after conventionally and hypofractionated irradiation and are robust methods for predicting clinical effects. The observed dose-effect for local control in NSCLC is weaker at high doses due to data dispersion. For BED10 values of 100–150 Gy in ≥3 fractions, the differences in isoeffects predicted by both models can be neglected. The online version of this article (doi:10.1186/s13014-016-0643-5) contains supplementary material, which is available to authorized users

  1. Radiobiology

    International Nuclear Information System (INIS)

    The effects of metridazole and nitroimidazole on the survival time of cultured hamster cells following exposure to various doses and dose rates of 60Co γ radiation or neutrons were studied. Both were found to increase the radiosensitivity of the cells. Data are included on the modifying effects of neutron spectra, energy levels, LET, OER, dose, and dose fractionation schedules on the γ and neutron sensitivity of cultured hamster cells. Studies on the sensitivity of cultured hamster cells and normal liver and hepatoma cells to hyperthermia and hypoxia, with and without the added effects of x irradiation showed that heat treatment at 430C enhanced the radiosensitivity of the cells, with hypoxic cells being the most sensitive. A system was developed for the study of radioinduced carcinogenesis in cultured hamster embryo cells. Preliminary data are presented on the dose response relationships for transformation following exposure to x radiation or neutrons. (U.S.)

  2. First year clinical tutorials: students’ learning experience

    Directory of Open Access Journals (Sweden)

    Burgess A

    2014-11-01

    Full Text Available Annette Burgess,1 Kim Oates,2 Kerry Goulston,2 Craig Mellis1 1Central Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; 2Sydney Medical School, The University of Sydney, Sydney, NSW, Australia Background: Bedside teaching lies at the heart of medical education. The learning environment afforded to students during clinical tutorials contributes substantially to their knowledge, thinking, and learning. Situated cognition theory posits that the depth and breadth of the students' learning experience is dependent upon the attitude of the clinical teacher, the structure of the tutorial, and the understanding of tutorial and learning objectives. This theory provides a useful framework to conceptualize how students' experience within their clinical tutorials impacts their knowledge, thinking, and learning. Methods: The study was conducted with one cohort (n=301 of students who had completed year 1 of the medical program at Sydney Medical School in 2013. All students were asked to complete a three-part questionnaire regarding their perceptions of their clinical tutor's attributes, the consistency of the tutor, and the best features of the tutorials and need for improvement. Both quantitative and qualitative data were collected and analyzed using descriptive statistics. Results: The response rate to the questionnaire was 88% (265/301. Students perceived that their tutors displayed good communication skills and enthusiasm, encouraged their learning, and were empathetic toward patients. Fifty-two percent of students reported having the same communications tutor for the entire year, and 28% reported having the same physical examination tutor for the entire year. Students would like increased patient contact, greater structure within their tutorials, and greater alignment of teaching with the curriculum. Conclusion: Situated cognition theory provides a valuable lens to view students' experience of learning within the

  3. Radiobiological comparison of pions and heavy ions

    International Nuclear Information System (INIS)

    The physical and radiobiological differences between some aspects of pions and heavy ions are discussed, followed by a discussion of acute and late effects of high LET radiations compared to low LET radiations

  4. Fundamental aspects of LET in radiobiology

    International Nuclear Information System (INIS)

    Some of the radiobiological features of radiation studies using radiations with different distributions of LET or y have been discussed, with emphasis on the areas of doubt. A considerable amount of data can be explained reasonably well, but some very basic questions remain unanswered, such as how much radiation injury is due to damage to DNA and why does OER go down as LET rises. Further studies using radiations of different LET are essential to help solve basic problems in radiobiology

  5. Novel Radiobiological Gamma Index for Evaluation of 3-Dimensional Predicted Dose Distribution

    Energy Technology Data Exchange (ETDEWEB)

    Sumida, Iori, E-mail: sumida@radonc.med.osaka-u.ac.jp [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Yamaguchi, Hajime; Kizaki, Hisao; Aboshi, Keiko; Tsujii, Mari; Yoshikawa, Nobuhiko; Yamada, Yuji [Department of Radiation Oncology, NTT West Osaka Hospital, Osaka (Japan); Suzuki, Osamu; Seo, Yuji [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Isohashi, Fumiaki [Department of Radiation Oncology, NTT West Osaka Hospital, Osaka (Japan); Yoshioka, Yasuo [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Ogawa, Kazuhiko [Department of Radiation Oncology, NTT West Osaka Hospital, Osaka (Japan)

    2015-07-15

    Purpose: To propose a gamma index-based dose evaluation index that integrates the radiobiological parameters of tumor control (TCP) and normal tissue complication probabilities (NTCP). Methods and Materials: Fifteen prostate and head and neck (H&N) cancer patients received intensity modulated radiation therapy. Before treatment, patient-specific quality assurance was conducted via beam-by-beam analysis, and beam-specific dose error distributions were generated. The predicted 3-dimensional (3D) dose distribution was calculated by back-projection of relative dose error distribution per beam. A 3D gamma analysis of different organs (prostate: clinical [CTV] and planned target volumes [PTV], rectum, bladder, femoral heads; H&N: gross tumor volume [GTV], CTV, spinal cord, brain stem, both parotids) was performed using predicted and planned dose distributions under 2%/2 mm tolerance and physical gamma passing rate was calculated. TCP and NTCP values were calculated for voxels with physical gamma indices (PGI) >1. We propose a new radiobiological gamma index (RGI) to quantify the radiobiological effects of TCP and NTCP and calculate radiobiological gamma passing rates. Results: The mean RGI gamma passing rates for prostate cases were significantly different compared with those of PGI (P<.03–.001). The mean RGI gamma passing rates for H&N cases (except for GTV) were significantly different compared with those of PGI (P<.001). Differences in gamma passing rates between PGI and RGI were due to dose differences between the planned and predicted dose distributions. Radiobiological gamma distribution was visualized to identify areas where the dose was radiobiologically important. Conclusions: RGI was proposed to integrate radiobiological effects into PGI. This index would assist physicians and medical physicists not only in physical evaluations of treatment delivery accuracy, but also in clinical evaluations of predicted dose distribution.

  6. Experimental radiotherapy and clinical radiobiology. Vol. 16

    International Nuclear Information System (INIS)

    The following topics were dealt with: DNA repair as therapeutical target in radiation therapy, biological imaging and tumor microenvironment, molecular factors of radiation therapy, molecular factors and modulation of the radiation reaction of normal tissues, experimental tumor therapy, EGFR inhibition, the endothel cell as primary target of radiation therapy, molecular and cellular foundations of the radiation biology of protons and ions. (HSI)

  7. Nursing students' perceptions of clinical experience.

    Science.gov (United States)

    Windsor, A

    1987-04-01

    Senior nursing students were interviewed in this study to better understand the clinical learning experience from the students' point of view. Results of the study revealed that the nursing students were indeed learning in their clinical experience. The major categories of learning were classified as nursing skills, time management, and professional socialization. The quality of learning was reportedly affected by the quality of the student's preparation, characteristics of the instructor, and the variety of clinical opportunities to which students were exposed. The data also reflected a pattern of student development which was separated into three stages. The first stage was permeated with anxiety and obsession with the rules of task performance. The second stage was a difficult transition period where students struggled with identifying the roles of nurses. During the final stage, the students become more comfortable with performing nursing tasks and become interested in expanding their role and becoming more independent. As the students strived for independence, they identified more closely with staff nurses and withdrew from instructors. PMID:3035128

  8. Pre-therapeutic radiobiological experiments performed at Cyclone with d(50)-Be neutrons. Comparison of RBE/absorbed dose relationships obtained for several biological criteria

    International Nuclear Information System (INIS)

    The RBE/absorbed dose relationships for d(50)-Be neutrons were determined for several biological criteria. Irradiations were performed with the isochronous cyclotron Cyclone at Louvain-la-Neuve. Neutrons are produced by bombarding a thick beryllium target with 50MeV deuterons. This energy is to be used for the clinical applications. As first biological criterion, early intestinal tolerance was assessed in BALB/c mice from LD50 determination. Abdomen only was irradiated in order to avoid interference from the bone marrow syndrome. For single fraction irradiation, an RBE value of 1.8+-0.2 was observed (LD50 neutron absorbed dose: 525 rad). Fractionated irradiation had to be used to study smaller doses per fraction. The RBE increases progressively with decreasing dose and reaches 2.8 for a neutron absorbed dose of 80 rad (i.e. for a gamma absorbed dose of about 225 rad). A further RBE increase is unlikely since, for smaller absorbed doses, the survival curve for gamma rays nearly coincides with its initial tangent. The RBE/absorbed dose relationships observed for several mammalian cell lines in vitro, although they have a rather similar shape, show significant differences. For a neutron absorbed dose of 100 rad, the RBE is about 3 for EMT6 mouse cancer cells and 2 for HF19 human fibroblasts. For chromosome aberrations in Allium cepa onion roots, observed RBE values are much higher than for mammalian cell lethality. The RBE increases regularly from 7 to 12 with decreasing neutron dose from 40 to 10 rad. Two criteria were selected: (i) the mean number of aberrations (mainly breaks) per cell in anaphase and telophase, and (ii) the fraction of cells in anaphase and telophase having at least one aberration. For growth delay in Vicia faba, the RBE increases from 2.8 to 4.4 when the neutron absorbed dose decreases from 90 to 20 rad. (author)

  9. Radiobiology and radiation protection. Recent developments and future trends in radiobiology

    International Nuclear Information System (INIS)

    The 28th annual meeting of the Fachverband fuer Strahlenschutz, held from October 23 - 25, 1996 in Hannover, discussed the various aspects of the leading theme, radiation protection and radiobiology, recent developments and future trends in radiobiology. The papers presented in the proceedings volume address the three main aspects: (1) Mechanisms of the radiation effects - molecular and cellular mechanisms, genetic and prenatal radiation effects, cancerogenesis and mutagenesis; (2) Novel methods in radiobiology research: microdosimetry from the biological angle, novel methods in molecular biology including computerized simulation of DNA, methods of biological dosimetry, radiobiological aspects of neutrons and other densely ionizing radiation (Pt, Rn); (3) Knowledge and concepts for radiological protection: individual radiosensitivity, radiobiological aspects in medical applications of ionizing radiation, accidents in industry, radiation exposure in aeronautics and astronautics. (vhe)

  10. Clinical experience with PACS: Digital radiology

    International Nuclear Information System (INIS)

    We present our experience during the first 21 months of using hospital-wide network technology and digital archiving in connection with digital radiology in the Radiology Department at the SMZO/Danube hospital in Vienna. This means digital generation, archiving and distribution of radiographs as well as monitor reporting embedded in HIS and RIS. The clinical use of PACS demands full integration of all subsystems and modalities in a digital way, as was first realized at the Danube Hospital. With this approach, a reduction in radiation dose, improved communication and thus a reduction in the length of hospital stay and health care cost are attained. (orig.)

  11. Radiobiological foundation of thermal neutron capture treatment

    International Nuclear Information System (INIS)

    Five radiobiological problems in thermal neutron capture treatment were considered on the basis of experimental data. As a result of an experiment of irradiation using thermal neutron generated by an atomic pile of Kyoto University, RBE of thermal neutron on cultured B-16 melanoma cells was determined to 2.43. Cultured B-16 melanoma cells did not recovered from sublethal damage when fractionated irradiation of thermal neutron was performed. To know additive effects of 10B-compounds, an amount of 10B-boric acid equivalent to 5 μg/ml of 10B was administered to culture medium for melanoma cells before the irradiation. As a result, Do values when 10B-boric acid was administered before irradiation were 3.3 times as much as those when only thermal neutron was irradiated, and RBE of thermal neutron when 10B-boric acid was administered was 3.04 RBE of 10B(n, α)7Li reaction (3.43) was also calculated. It was pointed out that it was difficult to estimate absorbed dose precisely by 10B(n, α)7Li reaction. It was also necessary to know the movement from proliferation to differentiation of cells accurately when neutron capture treatment using differential plasma of cancer cells was performed. (Tsunoda, M.)

  12. Fast neutron dosimetry ip radiobiological experiment

    International Nuclear Information System (INIS)

    The distribution of absorbed dose in organs and tissues of animals and other biological ob ects irradiated with fast neutrons in WWR-M nuclear reactor is studied. The method of differential homogeneous ionization chambers suggested for the separate determination of neutron and γ-components of tissue dose, is used. To determine the value of tissue dose at this or that depth of the subject investigated, appropriate phanthoms and the technique of microcondensator chambers are used. Sources of errors of measurements are analyzed. The study of distribution of deep absorbed doses in tissue-equivalent phanthoms has permitted to make definite conclusions and recommendations relatively to optimum conditions of irradiation with fast neutrons of different biological objects

  13. Radiobiological effects of metallic nanoparticles

    International Nuclear Information System (INIS)

    Full text: Radiobiological effects of nanoparticles and its cellular mechanism in normal tissue regeneration are investigated. About 2 nm diameter gold nanoaprticies are used in this study with bovine endothelial eells as normal cells and glioma type cells. The imtdiation was conducted using Spring8 synchrotron in Japan and the cell culture studies were performed at the school of Medical Sciences RMIT-University. AuNPs accelerate eells migration esp cially normal endothelial cells. This effect has been observed when AuNPs are introduced into the cells and the cells impregnated with AuNPs migrate faster than the ones without AuNPs. The cells with AuNPs have been found to fill in gaps created in cultures about five times faster than those without AuNPs. The effects have been observed with gaps generated by radiations or when such gaps are made by scratehes 'wounds'. Filling of artificial scratch have been found to be much faster than radiation created gaps. Two aspects of this phenomenon are given; one is biology based where it is thought of disrupts caused by such particles to the cells eytoskeleton org nisation and hence induces different chemical pathways promoting cells motility. The other reason (physics) can be due to Coulomb repulsion force generated by polarised cells pushing the cells into gaps and also cell-polarisation could lead into cells symmetr breaking hence accelerating their motion. Conclusion Radiotherapy treatment efficiency can be improve by using AuNps where dose can be enhance to kill the tumour cells and at the same time helping normal cells to regenerate.

  14. Radiobiological compensation: A case study of uterine cervix cancer with concurrent chemotherapy

    Science.gov (United States)

    Herrera, Higmar; Yañez, Elvia; López, Jesús

    2012-10-01

    The case of a patient diagnosed with uterine cervix cancer is presented as an example of the clinical application of the radiobiological compensation method implemented at Centro Estatal de Cancerología de Durango. Radiotherapy treatment was initially modified to compensate for the chemotherapy component and, as medical complications arose during treatment delivery resulting in an 18 days gap, new compensation followed. All physical and radiobiological assumptions to calculate the Biologically Effective Dose in the external beam and brachytherapy parts of the treatment are presented. Good local control of the tumor was achieved, the theoretical tolerance limits for the organs at risk were not surpassed and the patient manifested no extensive morbidity.

  15. Radiobiological compensation: A case study of uterine cervix cancer with concurrent chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Herrera, Higmar; Yanez, Elvia; Lopez, Jesus [Centro Estatal de Cancerologia de Durango, Victoria de Durango, Durango (Mexico); ISSSTE General Hospital Dr. Santiago Ramon y Cajal, Victoria de Durango, Durango (Mexico)

    2012-10-23

    The case of a patient diagnosed with uterine cervix cancer is presented as an example of the clinical application of the radiobiological compensation method implemented at Centro Estatal de Cancerologia de Durango. Radiotherapy treatment was initially modified to compensate for the chemotherapy component and, as medical complications arose during treatment delivery resulting in an 18 days gap, new compensation followed. All physical and radiobiological assumptions to calculate the Biologically Effective Dose in the external beam and brachytherapy parts of the treatment are presented. Good local control of the tumor was achieved, the theoretical tolerance limits for the organs at risk were not surpassed and the patient manifested no extensive morbidity.

  16. Actual problems of toxicology and radiobiology. Russian scientific conference with international participation. Book of abstracts

    International Nuclear Information System (INIS)

    The collection contains abstracts of the Russian scientific conference with international participation, which took place May 19-20, 2011 in St. Petersburg. Proceedings of the conference include a general description of the chemical and radiological factors of nature, questions of radiation ecology and ecotoxicology. Modern methods of toxicological and radiobiological researches, including evaluation of radiation and chemical risks, mechanisms of development, pathogenesis, clinical features, diagnosis and treatment of various forms of toxic and radiation processes are under consideration. Current approaches to prevention and early therapy of chemical and radiation injuries are given. Issues of radiation and chemical safety, as well as the problems of training in toxicology and radiobiology are discussed

  17. National Radiobiology Archives distributed access programmer's guide

    International Nuclear Information System (INIS)

    The National Radiobiology Archives is a comprehensive effort to gather, organize, and catalog original data, representative specimens, and supporting materials related to significant radiobiology studies. This provides researchers with information for analyses which compare or combine results of these and other studies and with materials for analysis by advanced molecular biology techniques. This Programmer's Guide document describes the database access software, NRADEMO, and the subset loading script NRADEMO/MAINT/MAINTAIN, which comprise the National Laboratory Archives Distributed Access Package. The guide is intended for use by an experienced database management specialist. It contains information about the physical and logical organization of the software and data files. It also contains printouts of all the scripts and associated batch processing files. It is part of a suite of documents published by the National Radiobiology Archives

  18. Clinical Experience in TCM Treatment of Insomnia

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Insomnia is a sleeping disorder that affects 1 in 10 Americans and around 50% of the seniors. It is often more prevalent in women. Since September 11, 2005 these estimations have increased. Insomnia can affect not only your energy level and mood, but your health as well because sleep helps bolster your immune system. Insomnia is characterized by: 1) difficulty in falling asleep; 2) waking up frequently during the night with difficulty of returning to sleep; 3) waking up too early in the morning; and 4) with unrefreshing sleep, the patient has a low spirit, palpation, poor memory, viscera function disorder. All these seriously affect the patient's life and work. The following is an account of the authors' clinical TCM experience in treating insomnia.

  19. Application of SSNTDs in radiobiological investigations aboard recoverable satellites.

    Science.gov (United States)

    Huang, R Q; Gu, R Q; Li, Q

    1997-01-01

    In recent years some Biostack experiments including a wide spectrum of biological objects have been devoted to study of the radiobiological effects on dry seeds aboard recoverable satellites. Some impressive phenomena have been observed. Clearly, the large amount of energy deposited by the highly ionizing heavy nuclei of cosmic rays is the principal reason for the induced aberrations of the chromosomes of wheat root tip cells. A methodical description of the experimental arrangement and procedure of handling and evaluation of given. The preliminary physical and biological results from the experimental "wheat seeds" are presented. PMID:11541794

  20. Toxicological and radiobiological characteristics of some S -derivatives of meprin

    International Nuclear Information System (INIS)

    Structural variants with radiobiological properties of alpha-mercaptopropinolylglycine (α-MPG, thiol, meprin) are searched with the aim of revealing preparations with increased radioprotective properties. Results of studying toxicologic and radioprotective properties of a number of synthesized compounds-thiosulphate (TSPG) isothiouranium (ITPG) diethyldithiocarbamate (DDTCPG) and thiophosphate (TPPG) α-MPG derivatives, are presented. The experiments on mice have shown that PSPG has low toxicity and satisfactory radioprotective activity when introduced 4 hours before irradiation. DDTCPG brings about a slight protective effect in the dose of 1300 mg/kg it does not produce radioprotective effect. Low toxicity and high radioprotective TPPG effect prove the necessity of its further study

  1. Nurses' experiences of clinical commissioning group boards.

    Science.gov (United States)

    Allan, Helen; O'Driscoll, Mike; Savage, Jan; Lee, Gay; Dixon, Roz

    2016-06-15

    Aim To explore the experience of governing body nurses appointed to clinical commissioning group (CCG) boards; how they perform their responsibilities; and their perceived effectiveness in ensuring safe, patient-centred care and the factors that influence their effectiveness. Method This was a small pilot study using a mixed methods approach. There were four phases of the study: literature review, qualitative data collection (interviews), quantitative data collection (survey), and final data analysis. Findings In the early stages of the formation of CCGs, few governing body nurses had relevant experience to meet the needs of a strategic role, and many of these nurses had no proper job description, too little time to carry out their responsibilities, little management support, and unequal access to training, development, formal support or supervision compared to GP colleagues. Two working patterns or models of work of governing body nurses emerged: the full-time integrated executive statutory role and the part-time non-executive statutory role. Quality and quality assurance were the most frequently cited roles or responsibilities of governing body nurses in CCGs, and their highest priority was to improve the population's health. Conclusion The role of governing body nurse has emerged at a time of organisational change, and following extensive criticism of nursing and nurses in the media. Nurses' roles and experiences are affected by these contextual events and by the emerging structures and diversity of CCGs. Further research is required into the leadership role of governing body nurses, succession planning, and the effectiveness of their relationships with other senior nurses. PMID:27305258

  2. Estimation of the radiobiological and kinetic factors of radiosensitivity and radiocurability of metastases of squamous cell carcinoma of the larynx to neck lymph nodes

    International Nuclear Information System (INIS)

    The usefulness of theoretical model of tumour growth and experimental methods of kinetic and radiobiological factors for analysis of clinical data to improve the effectiveness of dose fractionation are checked. 176 refs., 27 figs., 19 tabs. (author)

  3. Evolution of radiobiological models in radiation oncology

    International Nuclear Information System (INIS)

    Predicting treatment outcome to radiotherapy from in-vitro radiobiological parameters and utilizing the BED approach helps to tailor individual patient treatments and design new promising treatment protocols for patients in whom unfavorable treatment outcome is anticipated. This paper presents the present status of the LQ model of dose effect relationship

  4. National Radiobiology Archives Distributed Access user's manual

    International Nuclear Information System (INIS)

    This User's Manual describes installation and use of the National Radiobiology Archives (NRA) Distributed Access package. The package consists of a distributed subset of information representative of the NRA databases and database access software which provide an introduction to the scope and style of the NRA Information Systems

  5. Soft x rays for radiobiological studies

    International Nuclear Information System (INIS)

    Lethal effects and chromosome aberrations induced in cells exposed to low energy (soft) X rays demonstrated that these relatively low energy X rays are just as effective as those of higher energy for radiobiological studies, and even more effective for irradiating cultured mammalian cells than laboratory animals. (author)

  6. Decontamination and decorporation: the clinical experience

    International Nuclear Information System (INIS)

    Decontamination and decorporation are quite interrelated when dealing with a contaminated person. Some clinical experiences from a transuranium production facility are offered. Skin decontamination is accomplished by washing with detergent and water. Stubborn cases are treated with sodium hypochlorite followed by rinsing, and emery cloth is used on more stubborn nail or finger pad contamination. If inhaled, the usual skin cleansing followed by nasal douche with normal saline decontaminates reachable areas and one of the DTPA salts given via aerosol both decontaminates and decorporates the inner recesses. Saline laxative reduces the time inhaled, and ingested particles remain in the gastro-intestinal tract. Conservatism prevails in general, but most persons found to have inhaled contamination are given a single chelation within the hour of discovery and if subsequently found to have over 10% M.P.P.B. of a soluble actinide are offered further chelation. Single dose chelation has been found to be relatively innocuous and usually sufficient. The longest case of chelation therapy spanned 2-1/4 years and encompassed 123 doses of CaNa-DTPA

  7. Decontamination and decorporation: the clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    Poda, G.A.

    1979-01-01

    Decontamination and decorporation are quite interrelated when dealing with a contaminated person. Some clinical experiences from a transuranium production facility are offered. Skin decontamination is accomplished by washing with detergent and water. Stubborn cases are treated with sodium hypochlorite followed by rinsing, and emery cloth is used on more stubborn nail or finger pad contamination. If inhaled, the usual skin cleansing followed by nasal douche with normal saline decontaminates reachable areas and one of the DTPA salts given via aerosol both decontaminates and decorporates the inner recesses. Saline laxative reduces the time inhaled, and ingested particles remain in the gastro-intestinal tract. Conservatism prevails in general, but most persons found to have inhaled contamination are given a single chelation within the hour of discovery and if subsequently found to have over 10% M.P.P.B. of a soluble actinide are offered further chelation. Single dose chelation has been found to be relatively innocuous and usually sufficient. The longest case of chelation therapy spanned 2-1/4 years and encompassed 123 doses of CaNa-DTPA.

  8. Transmyocardial laser revascularization. Early clinical experience

    Directory of Open Access Journals (Sweden)

    Oliveira Sérgio Almeida de

    1999-01-01

    Full Text Available OBJECTIVE: To analyze the initial clinical experience of transmyocardial laser revascularization (TMLR in patients with severe diffuse coronary artery disease. METHODS: Between February, 1998 and February, 1999, 20 patients were submitted to TMLR at the Heart Institute (InCor, University of São Paulo Medical School, Brazil, isolated or in association with conventional coronary artery bypass graft (CABG. All patients had severe diffuse coronary artery disease, with angina functional class III/IV (Canadian Cardiovascular Society score unresponsive to medical therapy. Fourteen patients were submitted to TMLR as the sole therapy, whereas 6 underwent concomitant CABG. Fifty per cent of the patients had either been previously submitted to a CABG or to a percutaneous transluminal coronary angioplasty (PTCA. Mean age was 60 years, ranging from 45 to 74 years. RESULTS: All patients had three-vessel disease, with normal or mildly impaired left ventricular global function. Follow-up ranged from 1 to 13 months (mean 6.6 months, with no postoperative short or long term mortality. There was significant symptom improvement after the procedure, with 85% of the patients free of angina, and the remaining 15 % of the patients showing improvement in functional class, as well as in exercise tolerance. CONCLUSION: This novel technique can be considered a low risk alternative for a highly selected group of patients not suitable for conventional revascularization procedures.

  9. Pre-clinical medical student experience in a pediatric pulmonary clinic

    OpenAIRE

    Saba, Thomas G.; Hershenson, Marc B.; Arteta, Manuel; Ramirez, Ixsy A.; Mullan, Patricia B; Owens, Sonal T.

    2015-01-01

    Objective: Our objective was to evaluate the educational value of introducing pre-clinical medical students to pediatric patients and their families in a subspecialty clinic setting.Methods: First- and second-year medical students at the University of Michigan seeking clinical experience outside of the classroom attended an outpatient pediatric pulmonary clinic. Evaluation of the experience consisted of pre- and post-clinic student surveys and post-clinic parent surveys with statements employ...

  10. An irradiation facility with a vertical beam for radiobiological studies

    CERN Document Server

    Besserer, J; Dellert, M; Gahn, C; Moosburger, M; Pemler, P; Quicken, P; Distel, L; Schuessler, H

    1999-01-01

    A vertical beam facility for radiobiological experiments was designed and constructed at the Munich Tandem-Accelerator Laboratory. The main part of the facility is a 90 deg. dipole magnet bending the beam of protons or heavy particles into a vertical upward direction, which is advantageous for wet-cell irradiation. After collimation the beam is spread out passively by thin scattering foils and dynamically by magnetic coils. A homogeneity of the radiation field better than +-5% has been achieved over the diameter of the exit window of 60 mm. The dose rate can be widely adjusted from single particles to more than 10 sup 1 sup 0 particles (i.e. hundreds of Grays) per second. The dose measurement is based on single-particle counting and on standard dosimeters. The detector system for dosimetry and irradiation control is described. In a first radiobiological experiment the cell survival of chinese hamster cells was measured after irradiation with 22.7 MeV protons and compared with the X-ray result.

  11. Satisfaction and improvement of clinical experiment of student radiotechnologists

    International Nuclear Information System (INIS)

    Clinical experiment is a set of experience to help student acquire technic, attitude and knowledge by participating in the clinical work. The radiotechnologists who are employed in departments of radiology serve as clinical instructors. Their responsibilities include teaching students them to become competent radiotechnologist. Clinical instructors often have no formal preparation in teaching student. The purpose of this study is to review some principals that will help clinical instructors support and foster the professional development of student radiotechnologists. The clinical instructor should be able to identify the qualities of instructor, the characteristics of feedback and use facilitation skills when is evaluated student performance. And the survey was performed to evaluate the satisfaction of student participated in clinical experiment, the purpose of this research is to fine the problems and improvements in clinical experiment of student radiotechnologist in Korea

  12. Radiobiological ideas and radiotherapeutic practice

    International Nuclear Information System (INIS)

    A review lecture covering the following topics: oxygen effect; radiotherapy in hyperbaric oxygen; low dose rate photon irradiation; densely ionizing radiations; hyperthermia; hypoxic cell sensitizers; fractionated radiotherapy; and rationale and methodology of prospective concomitant controlled clinical trials. (author)

  13. Workshop on radiobiological effectiveness of neutrons

    International Nuclear Information System (INIS)

    The radiobiological effectiveness (RBE) of neutrons has become the subject of some heated discussions in both scientific and radiation-protection oriented communities. This has become especially so since the realization that neutron exposures of A-bomb survivors in Hiroshima were considerably lower than previously assumed, thus ''devaluating'' the importance of what we thought was a solid human data base. At the same time, more recent data from radiobiological research appeared to indicate that, at least for some biological endpoints, the RBE of neutrons at low doses and low dose rates was increased dramatically compared to the RBE at higher dose and dose rates. As a consequence, the protection of health against neutrons became a subject of some urgency. The objective of this workshop was to evaluate the existing data base in order to determine the need for additional research in this field. 22 refs., 3 figs., 6 tabs

  14. Scientific projection paper for space radiobiological research

    International Nuclear Information System (INIS)

    A nationale for the radiobiological research requirements for space is rooted in a national commitment to the exploration of space, mandated in the form of the National Space Act. This research is almost entirely centered on man; more specifically, on the effects of the space radiation environment on man and his protection from them. The research needs discussed in this presentation include the space radiation environment; dosimetry; radiation biology-high LET particles (dose/response); and operational countermeasures

  15. Radiobiological models of normal tissue reactions

    International Nuclear Information System (INIS)

    Purpose: The present review summarizes radiobiological models of normal tissue responses to radiation and their consequences for potential therapeutic interventions. Material and Methods: Common radiobiological principles and pathogenetic models can be established for classes of tissues. These models may support the development of general modalities, both therapeutic and supportive, for the modulation of these responses. Results: The stem cell concept, based on studies in standard tissue culture, describes the clonogenic survival after radiation treatment. The factors affecting cell survival are summarized as the 4 Rs of radiotherapy. Based on the stem cell concept, the reactions of normal tissue to ionising radiation were considered a consequence exclusively of the proliferative sterilisation of cells of a given target cell population. Once stem cells are inactivated, responses develop in a passive manner. However, recent studies into the pathogenesis of radiation tissue injury have clearly shown that numerous postirradiation events occur during the symptom-free latent time in irradiated cells and tissues, which modulate the manifestation of damage. These are summarized by models of tissue radiation pathology. Conclusions: Cellular radiobiology and the tissue models based on the stem cell concept assume that exclusively the sterilisation of target cells is the radiation effect which results in both acute and late tissue responses. As a consequence, the radiation sensitivity can only be modulated by modification of radiobiological parameters at the time of irradiation, while at later time points only symptomatic treatment can be applied. Tissue radiation pathology, in contrast, allows for post-irradiation modification of the manifestation of radiation sequelae in tissues. (orig.)

  16. Dengue fever outbreak: a clinical management experience

    International Nuclear Information System (INIS)

    To determine the frequency of dengue as a cause of fever and compare the clinical and haematological characteristics of Dengue-probable and Dengue-proven cases. All patients with age above 14 years, who were either hospitalized or treated in medical outdoor clinic due to acute febrile illness, were evaluated for clinical features of Dengue Fever (DF), Dengue haemorrhagic fever (DHF) and Dengue Shock Syndrome (DSS). Patients showing typical clinical features and haematological findings suggestive of Dengue fever (As per WHO criteria) were evaluated in detail for comparison of probable and confirmed cases of Dengue fever. All other cases of acute febrile illness, not showing clinical features or haematological abnormalities of Dengue fever, were excluded. The clinical and laboratory features were recorded on SPSS 11.0 programme and graded where required, for descriptive and statistical analysis. Out of 5200 patients with febrile illness, 107 (2%) presented with typical features of DF, 40/107 (37%) were Dengue-proven while 67/107 (63%) were Dengue-probable. Out of Dengue-proven cases, 38 were of DF and 2 were of DHF. Day 1 temperature ranged from 99-105 degreeC (mean 101 degree C). Chills and rigors were noticed in 86 (80%), myalgia in 67%, headache in 54%, pharyngitis in 35%, rash in 28%, and bleeding manifestations in 2% cases. Hepatomegaly in 1(0.5%), lymphadenopathy in 1 (0.5%) and splenomegaly in 12 (11.2%) cases. Leucopoenia (count 40 U/L in 57% cases. Frequency of clinically suspected dengue virus infection was 107 (2%), while confirmed dengue fever cases were 40 (0.8%) out of 5200 fever cases. Fever with chills and rigors, body aches, headache, myalgia, rash, haemorrhagic manifestations, platelet count, total leukocyte count, and ALT, are parameters to screen the cases of suspected dengue virus infection, the diagnosis cannot be confirmed unless supported by molecular studies or dengue specific IgM. (author)

  17. Particle beam therapy for cancer. A radiobiological perspective

    International Nuclear Information System (INIS)

    As for the particle beam therapy, there is to theoretical evidence by radiobiology. The particle beam therapy becomes high precision by development of the medicine engineering. We demonstrated the past contribution for the particle beam therapy and recent knowledge about radiobiological phenomenon such as (1) DNA damage and the repair, (2) cell killing effect, (3) metastasis, and (4) therapeutic gain. Finally, we discuss it about the radiobiological perspective for the particle beam therapy. (author)

  18. Clinical decision-making: physicians' preferences and experiences

    OpenAIRE

    White Martha; Pollack Lance; Murray Elizabeth; Lo Bernard

    2007-01-01

    Abstract Background Shared decision-making has been advocated; however there are relatively few studies on physician preferences for, and experiences of, different styles of clinical decision-making as most research has focused on patient preferences and experiences. The objectives of this study were to determine 1) physician preferences for different styles of clinical decision-making; 2) styles of clinical decision-making physicians perceive themselves as practicing; and 3) the congruence b...

  19. Clinical Engineering: Experiences of assisted professional practices

    International Nuclear Information System (INIS)

    In the curricula of the Biomedical Engineering career of the Facultad de Ciencias Exactas y TecnologIa of the Universidad Nacional de Tucuman, Argenitna, there are the Assisted Professional Practices. Within this framework, the students have the possibility of performing practices in the clinic Sanatorio 9 de Julio. One of the objectives of these practices is to apply the concepts, methods and procedures studied along the career in the field work under real work conditions. From the point of view of the host institution, the objective is to improve the performance of the different services and areas applying the tools of Biomedical Engineering. The present work shows an example of such practices where an equipment preliminary analysis was made, its use and maintenance corresponding to the surgical unit of the clinic

  20. Clinical Engineering: Experiences of assisted professional practices

    Science.gov (United States)

    Langone, Luis; Vanetta, Marcos; Vazquez, Marcelo; Rotger, Viviana; Olivera, Juan Manuel

    2007-11-01

    In the curricula of the Biomedical Engineering career of the Facultad de Ciencias Exactas y Tecnología of the Universidad Nacional de Tucumán, Argenitna, there are the Assisted Professional Practices. Within this framework, the students have the possibility of performing practices in the clinic Sanatorio 9 de Julio. One of the objectives of these practices is to apply the concepts, methods and procedures studied along the career in the field work under real work conditions. From the point of view of the host institution, the objective is to improve the performance of the different services and areas applying the tools of Biomedical Engineering. The present work shows an example of such practices where an equipment preliminary analysis was made, its use and maintenance corresponding to the surgical unit of the clinic.

  1. Closed-loop Neurostimulation: The Clinical Experience

    OpenAIRE

    Sun, Felice T.; Morrell, Martha J.

    2014-01-01

    Neurostimulation is now an established therapy for the treatment of movement disorders, pain, and epilepsy. While most neurostimulation systems available today provide stimulation in an open-loop manner (i.e., therapy is delivered according to preprogrammed settings and is unaffected by changes in the patient’s clinical symptoms or in the underlying disease), closed-loop neurostimulation systems, which modulate or adapt therapy in response to physiological changes, may provide more effective ...

  2. Clinical biophysics

    Energy Technology Data Exchange (ETDEWEB)

    Anbar, M.; Spangler, R.A.; Scott, P.

    1985-01-01

    Chapters are included on clinical decision making, principles of biomedical engineering, computers and their medical uses, clinical radiobiology, diagnostic x-ray radiology, clinical applications of ultrasonics, nuclear medicine, NMR imaging, diagnostic imaging, bioelectric techniques in diagnosis and therapy, biophysical aspects of the clinical laboratory, and biophysical aspects of modern surgery.

  3. Mesenchymal stem cells: from experiment to clinic

    Directory of Open Access Journals (Sweden)

    Otto William R

    2011-09-01

    Full Text Available Abstract There is currently much interest in adult mesenchymal stem cells (MSCs and their ability to differentiate into other cell types, and to partake in the anatomy and physiology of remote organs. It is now clear these cells may be purified from several organs in the body besides bone marrow. MSCs take part in wound healing by contributing to myofibroblast and possibly fibroblast populations, and may be involved in epithelial tissue regeneration in certain organs, although this remains more controversial. In this review, we examine the ability of MSCs to modulate liver, kidney, heart and intestinal repair, and we update their opposing qualities of being less immunogenic and therefore tolerated in a transplant situation, yet being able to contribute to xenograft models of human tumour formation in other contexts. However, such observations have not been replicated in the clinic. Recent studies showing the clinical safety of MSC in several pathologies are discussed. The possible opposing powers of MSC need careful understanding and control if their clinical potential is to be realised with long-term safety for patients.

  4. Radiobiological work using a negative pion beam at the Rutherford Laboratory 1971-76

    International Nuclear Information System (INIS)

    The subject is discussed in two sections: physics experiments (including, inter alia, dose measurement, LET distribution, radiation products of spallation); radiobiological studies (including separate reports as follows: review of experimental programme; some in vivo effects of negative pions in mice; survival and recovery of Hela cells in vitro; negative pion dose-response curves for frozen Hela cells; response of vicia faba to irradiation with negative pions; pion experiments with chromosome aberrations). (U.K.)

  5. Insomnia: clinical experience with zolpidem (sanval

    Directory of Open Access Journals (Sweden)

    Yakov Iosifovich Levin

    2010-01-01

    Full Text Available The paper describes the present view of the problem of insomnia and gives a classification of sleep disorders and basic methods for their drug and non-drug therapy. Emphasis is placed on the role of the objective sleep study - polysomnography. The use of the current hypnotics belonging to a three Zs group and the minimization of administration of benzodiazepines are most important in pharmacotherapy for insomnia. The results of a clinical polysomnographic study of the effect of Zolpidem (Sanval in patients with insomnia are presented. The subjective evaluation of the beneficial effect of a 10-day course of Sanval is confirmed by the objective studies of the sleep pattern undergoing positive changes in the most important indicators, such as the process of falling asleep, the time of intrasleep awakenings, and the duration of Δ-sleep. The high safety and good tolerability of Sanval permit the latter to be assessed as an effective agent for the treatment of insomnia.

  6. [Euthanasia--experiences from Norwegian pain clinics].

    Science.gov (United States)

    Meidell, N K; Naess, A C

    1998-10-10

    This survey focuses on the subject of euthanasia. A questionnaire was sent to 90 doctors working in pain clinics in Norwegian hospitals. 60 doctors (67%) returned the questionnaire. Only 18 doctors (30%) had ever received a request for euthanasia. The patients who requested euthanasia suffered from refractory pain, depression, fear of pain and fear of becoming helpless. 67% of the doctors were satisfied with the present Norwegian law, while 13% favoured a liberalization of the law. Only 5% were willing to comply with the patient's request for euthanasia under today's law. One third of the doctors would leave the decision to an officially appointed "board" if euthanasia were to become legalized. A majority wanted a doctor to commit the actual procedure, but there were also suggestions that a lawyer or other lay person should carry out the act of euthanasia. Our conclusion is that the closer the patient-doctor relationship is, the more opposed the doctor is to euthanasia. PMID:9816949

  7. Digital mammography: Experiences in clinical application

    International Nuclear Information System (INIS)

    Target: In 1989 in the Kantonal Hospital of Lucerne conventional film-screen mammography was replaced by digital mammography. With the support of a retrospective study, it was checked whether or not digital mammography represents an equally valid diagnostic procedure in daily routine. Methods: 1204 patients were examined using digital mammography. A reevaluation of these patients was carried out using clinical and r[iological routine controls. [ditionally a r[iological and histological examination was performed in 127 cases in which excisional biopsies h[ been done, paying particular attention to detail perception. Results: The sensitivity of digital mammography achieved a total of 85%, whereas the accuracy was 81%. With [ditional use of ultrasound and galactography the sensitivity attained 91%. By reevaluation the sensitivity amounted to 87%, the accuracy remaining at 81%. The positive predictive value was especially high with 76% and 77%. Conclusion: Digital mammography offers satisfactory diagnostic performance. (orig.)

  8. Investigations on the quality of treatment plans for carbon ion radiotherapy. Beam delivery systems and radiobiological models

    Energy Technology Data Exchange (ETDEWEB)

    Gillmann, Clarissa

    2014-07-01

    In a worldwide effort in research and development, radiation therapy with carbon ions has evolved to a technologically challenging but clinically very promising treatment option for cancer patients. To further improve patient benefit, optimal use of the physical and biological characteristics of carbon ions as well as of the available technologies should be made. The present thesis investigates the impact of different beam delivery systems and radiobiological models on the quality of treatment plans in carbon ion radiotherapy. The results of the study may provide pointers as to the role and the possible future implementation of the different techniques and radiobiological models in existing and upcoming particle therapy centers.

  9. Operation and Maintenance of the National Radiobiology Archives

    Energy Technology Data Exchange (ETDEWEB)

    Dr. Anthony C. James; Stacey L. McCord

    2012-03-07

    The National Radiobiology Archives (NRA) are an archival program, started in 1989, to collect, organize and maintain data, laboratory notebooks, and animal tissue specimens from government (Department of Energy and its predecessor agencies) sponsored radiobiology life-span animal studies. These unique records, histopathology slides and paraffin embedded tissue blocks are maintained in a central facility and are available for further research study. The materials include electronic and paper records for each of more than 6,000 life-span-observations on dogs as well as details of major studies involving nearly 30,000 mice. Although these studies were performed over many years and at different laboratories with differing data management systems, the NRA has translated them into a standardized set of relational database tables. These can be distributed to interested individuals on written request. Specific Aims are: (1) To Maintain the Archive of Written Records from the Animal Experiments - The USTUR continued to maintain the NRA archives which consist of approximately 175 storage boxes containing laboratory notebooks, animal exposure records, animal pathologic records, and radiographs. These were stored in a 6,000 square foot leased facility in Richland, WA. Additionally, through a collaboration with Pacific Northwest National Laboratory's (PNNL) Low Dose Program, many of these records were scanned into digital files. These totaled 34 GB of data, which are saved in 2,407 separate PDF files that are organized by box number and animal identification number. (2) To Maintain the Archive of Animal Tissues at Washington State University - The USTUR continued to house the NRA dog tissue collection in the leased facility. The NRA tissue collection consisted of pathology slides and tissue blocks. Approximately 25% of the laboratory facility was dedicated to the storage of the NRA materials. (3) To Organize the Datasets of These Animals in the Context of Other Datasets so

  10. Radiobiological studies using gamma and x rays.

    Energy Technology Data Exchange (ETDEWEB)

    Potter, Charles Augustus; Longley, Susan W.; Scott, Bobby R. [Lovelace Respiratory Research Institute, Albuquerque, NM; Lin, Yong [Lovelace Respiratory Research Institute, Albuquerque, NM; Wilder, Julie [Lovelace Respiratory Research Institute, Albuquerque, NM; Hutt, Julie A. [Lovelace Respiratory Research Institute, Albuquerque, NM; Padilla, Mabel T. [Lovelace Respiratory Research Institute, Albuquerque, NM; Gott, Katherine M. [Lovelace Respiratory Research Institute, Albuquerque, NM

    2013-02-01

    There are approximately 500 self-shielded research irradiators used in various facilities throughout the U.S. These facilities use radioactive sources containing either 137Cs or 60Co for a variety of biological investigations. A report from the National Academy of Sciences[1] described the issues with security of particular radiation sources and the desire for their replacement. The participants in this effort prepared two peer-reviewed publications to document the results of radiobiological studies performed using photons from 320-kV x rays and 137Cs on cell cultures and mice. The effectiveness of X rays was shown to vary with cell type.

  11. Physics and radiobiology of nuclear medicine

    CERN Document Server

    Saha, Gopal B

    2010-01-01

    From a distinguished author comes this new edition for technologists, practitioners, residents, and students in radiology and nuclear medicine. Encompassing major topics in nuclear medicine from the basic physics of radioactive decay to instrumentation and radiobiology, it is an ideal review for Board and Registry examinations. The material is well organized and written with clarity. The book is supplemented with tables and illustrations throughout. It provides a quick reference book that is concise but comprehensive, and offers a complete discussion of topics for the nuclear medicine and radi

  12. New developments in fundamental and applied radiobiology

    International Nuclear Information System (INIS)

    The 23rd Annual Meeting of the European Society for Radiation Biology was held in Dublin, Eire, 23-26 September 1990. Papers presented were grouped into two themes:- (a) Promoting areas where new developments in cell and molecular biology are fundamentally altering concepts of radiation action (papers on radiation induced mutagenesis and transformations, dosimetry and risk, DNA damage and repair, low dose/low dose rate effects, and non-ionising radiation). (b) Areas where radiobiological information is directly important to the topic (papers on food irradiation, diagnostic imaging, environmental radiation, radiotherapy, and the oxygen effect). (UK)

  13. Generalized calculus in radiobiology: Physical implications

    CERN Document Server

    Sotolongo-Grau, O; Antoranz, J C; Sotolongo-Costa, Oscar

    2009-01-01

    Non-extensive statistical physics has allowed to generalize mathematical functions such as exponential and logarithms. The same framework is used to generalize sum and product so that the operations allow a more fluid way to work with mathematical expressions emerging from non-additive formulation of statistical physics. In this work we employ the generalization of the exponential, logarithm and product to obtain a formula for the survival fraction corresponding to the application of several radiation doses on a living tissue. Also we provide experimental recommendations to determine the universal characteristics of living tissues in interaction with radiation. These results have a potential application in radiobiology and radiation oncology.

  14. Cartap hydrochloride poisoning: A clinical experience

    Directory of Open Access Journals (Sweden)

    Hari K Boorugu

    2012-01-01

    Full Text Available Cartap hydrochloride, a nereistoxin analog, is a commonly used low toxicity insecticide. We describe a patient who presented to the emergency department with alleged history of ingestion of Cartap hydrochloride as an act of deliberate self-harm. The patient was managed conservatively. To our knowledge this is the first case report of Cartap hydrochloride suicidal poisoning. Cartap toxicity has been considered to be minimal, but a number of animal models have shown significant neuromuscular toxicity resulting in respiratory failure. It is hypothesized that the primary effect of Cartap hydrochloride is through inhibition of the [ 3 H]-ryanodine binding to the Ca 2+ release channel in the sarcoplasmic reticulum in a dose-dependent manner and promotion of extracellular Ca 2+ influx and induction of internal Ca 2+ release. This results in tonic diaphragmatic contraction rather than paralysis. This is the basis of the clinical presentation of acute Cartap poisoning as well as the treatment with chelators namely British Anti Lewisite and sodium dimercaptopropane sulfonate.

  15. CLINICAL EXPERIENCE WITH METABOLIC THERAPY FOR BRAIN ISCHEMIA

    Directory of Open Access Journals (Sweden)

    M. Kh. Shurdumova

    2013-01-01

    Full Text Available The paper describes clinical experience with metabolic therapy, including neuroprotective drugs and antioxidants, for cerebrovascular diseases.It gives the results of basic Russian and foreign clinical studies of ethylmethylhydroxypyridoxine succinate and choline alfoscerate and discusses their efficacy and routes of administration.

  16. CLINICAL EXPERIENCE WITH METABOLIC THERAPY FOR BRAIN ISCHEMIA

    Directory of Open Access Journals (Sweden)

    M. Kh. Shurdumova

    2014-07-01

    Full Text Available The paper describes clinical experience with metabolic therapy, including neuroprotective drugs and antioxidants, for cerebrovascular diseases.It gives the results of basic Russian and foreign clinical studies of ethylmethylhydroxypyridoxine succinate and choline alfoscerate and discusses their efficacy and routes of administration.

  17. Tinnitus: clinical experience of the psychosomatic connection

    Directory of Open Access Journals (Sweden)

    Salviati M

    2014-02-01

    the lack of coping capabilities can play a critical role in the clinical history of patients affected by severe tinnitus.Keywords: tinnitus, psychosomatics, stress, psychopathological dimensions, personality

  18. Eosinophilic gastroenteritis: Clinical experience with 15 patients

    Institute of Scientific and Technical Information of China (English)

    Ming-Jen Chen; Cheng-Hsin Chu; Shee-Chan Lin; Shou-Chuan Shih; Tsang-En Wang

    2003-01-01

    AIM: To evaluate the clinic features of eosinophilicgastroenteritis and to examine the diagnosis, treatment,long-term outcome of this disease.METHODS: Charts with a diagnosis of eosinophilicgastroenteritis from 1984 to 2002 at Mackay Memorial Hospital were reviewed retrospectively. There were 15 patients diagnosed with eosinophilic gastroenteritis. The diagnosis was established in 13 by histologic evaluation of endoscopic biopsy or operative specimen and in 2 by radiologic imaging and the presence of eosinophilic ascites.RESULTS: All the patients had gastrointestinal symptoms and 12 (80 %) had hypereosinophilia (absolute eosinophil count 1 008 to 31 360/cm3). The most common symptoms were abdominal pain and diarrhea. Five of the 15 patients had a history of allergy. Seven patients had involvement of the mucosa, 2 of muscularis, and 6 of subserosa. One with a history of seafood allergy was successfully treated with an elimination diet. Another patient improved spontaneously after fasted for several days. The remaining 13 patients were treated with oral prednisolone, 10 to 40 mg/day initially,which was then tapered. The symptoms in all the patients subsided within two weeks. Eleven of the 15 patients were followed up for more than 12 months (12 to 104 months,mean 48.7), of whom 5 had relapses after discontinuing steroids (13 episodes). Two of these patients required longterm maintenance oral prednisolone (5 to 10 mg/day).CONCLUSION: Eosinophilic gastroenteritis is a rare condition of unclear etiology characterized by relapses and remissions. Short courses of corticosteroids are the mainstay of treatment, although some patients with relapsing disease require long-term low-dose steroids.

  19. Ameloblastoma: Our clinical experience with 68 cases

    Directory of Open Access Journals (Sweden)

    Benjamin Fomete

    2014-01-01

    Full Text Available Introduction: In this environment, previous workers have reported on the challenges of managing large sized ameloblastoma of the jaws with less than adequate facilities. The aim of this review is to present the management of 68 cases of ameloblastoma with emphasis on surgical care. Materials and Methods: Retrospective survey of case notes of patients with histopathologic diagnosis of ameloblastoma (using the criteria of Barnes et al., 2005 seen between January 2006 and August 2010 at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria was undertaken. Data collected includes histopathological diagnosis, age, gender, clinical information on site of lesion, form of intubation and surgical procedure performed. Results: Out of 94 patients, 68 with histological diagnosis of ameloblastoma (59 mandibular and 9 maxillary were operated within the study period. The remainder (26 was not treated in hospital. Among 68 patients treated, more were males (38 than females (30, giving a male to female ratio of 1.3:1. The age range was between 14 and 74 years (mean-standard deviation. The duration of the symptoms ranged from 7 months to 24 years, most were follicular ameloblastoma (n = 13 followed by acanthomatous type (n = 7. Endotracheal intubation was the most common (n = 55 followed by fiber optic laryngoscopy (n = 8. The surgical approach most used was extended Risdon with intraoral (n = 24 followed by extended Risdon with lip split and intraoral (n = 17. Segmental resection (en block formed the bulk of our procedures (n = 22 followed by subtotal mandibulectomy (n = 16. Conclusion: The treatment of ameloblastoma remains controversial. Its destructive nature has left patients with wide defects difficult to reconstruct.

  20. Lagged Syndesmotic Fixation: Our Clinical Experience.

    Science.gov (United States)

    Kwaadu, Kwasi Yiadom; Fleming, Justin James; Salmon, Trudy

    2015-01-01

    Ankle fractures are very common, and although algorithms are in place for osseous management, consensus has not been reached regarding treatment of associated ligamentous injuries. Although tibiofibular syndesmotic stabilization can be done using different forms of fixation, the biomedical literature has long emphasized the risk of long-term restriction of ankle mobility with the use of lagged transfixation. However, when reduction cannot be maintained with positional fixation, we found that lagging the syndesmotic screw helped to maintain the reduction without causing functional restriction. In this report, we describe our experience with patients who had undergone lagged tibiofibular transfixation and were available for short- to intermediate-term follow-up to assess ankle function. A total of 31 patients (32.63% of 95 consecutive patients) were available at a mean of 34.87 (range 18 to 52) months to complete the American Orthopedic Foot and Ankle Society ankle-hindfoot questionnaire. The mean score was 88.38 (range 42 to 100) points at a mean follow-up interval of 34.87 (range 18 to 52) months. Of 31 patients, 19 had an AOFAS score of 90 points, 9 an AOFAS score of 80 to 89 points, 2 an AOFAS score of 60 to 69 points, and 1 an AOFAS score of ankle kinematics than positional syndesmotic fixation. PMID:25736445

  1. Clinical Positioning Space: Residents' Clinical Experiences in the Outpatient Oncology Clinic.

    Science.gov (United States)

    Williams, Lars H; Christensen, Mette K; Rytter, Carsten; Musaeus, Peter

    2015-09-01

    In this article, we present a case study of residents' clinical experiences and communication in outpatient oncology consultations. We apply positioning theory, a dynamic alternative to role theory, to investigate how oncology residents and patients situate themselves as persons with rights and duties. Drawing from seven qualitative interviews and six days of observation, we investigate the residents' social positioning and their conversations with patients or supervisors. Our focus is on how (a) relational shifts in authority depend on each situation and its participants; (b) storylines establish acts and positions and narratively frame what participants can expect from a medical consultation viewed as a social episode; and (c) the positioning of rights and duties can lead to misunderstandings and frustrations. We conclude that residents and patients locate themselves in outpatient conversations as participants who jointly produce and are produced by patients' and nurses' storylines about who should take responsibility for treatment. PMID:25288406

  2. Heavy Charged Particle Radiobiology: Using Enhanced Biological Effectiveness and Improved Beam Focusing to Advance Cancer Therapy

    OpenAIRE

    Allen, Christopher; Borak, Thomas B.; Tsujii, Hirohiko; Jac A Nickoloff

    2011-01-01

    Ionizing radiation causes many types of DNA damage, including base damage and single- and double-strand breaks. Photons, including X-rays and γ-rays, are the most widely used type of ionizing radiation in radiobiology experiments, and in radiation cancer therapy. Charged particles, including protons and carbon ions, are seeing increased use as an alternative therapeutic modality. Although the facilities needed to produce high energy charged particle beams are more costly than photon facilitie...

  3. Pre-clinical medical student experience in a pediatric pulmonary clinic

    Directory of Open Access Journals (Sweden)

    Thomas G. Saba

    2015-11-01

    Full Text Available Objective: Our objective was to evaluate the educational value of introducing pre-clinical medical students to pediatric patients and their families in a subspecialty clinic setting. Methods: First- and second-year medical students at the University of Michigan seeking clinical experience outside of the classroom attended an outpatient pediatric pulmonary clinic. Evaluation of the experience consisted of pre- and post-clinic student surveys and post-clinic parent surveys with statements employing a four-point Likert scale as well as open-ended questions. Results: Twenty-eight first-year students, 6 second-year students, and 33 parents participated in the study. Post-clinic statement scores significantly increased for statements addressing empathic attitudes, confidence communicating with children and families, comfort in the clinical environment, and social awareness. Scores did not change for statements addressing motivation, a sense of team membership, or confidence with career goals. Students achieved their goals of gaining experience interacting with patients, learning about pulmonary diseases, and observing clinic workflow. Parents felt that they contributed to student education and were not inconvenienced. Conclusions: Students identified several educational benefits of exposure to a single pediatric pulmonary clinic. Patients and families were not inconvenienced by the participation of a student. Additional studies are warranted to further investigate the value of this model of pre-clinical medical student exposure to subspecialty pediatrics.

  4. BNL ACCELERATOR-BASED RADIOBIOLOGY FACILITIES

    Energy Technology Data Exchange (ETDEWEB)

    LOWENSTEIN,D.I.

    2000-05-28

    For the past several years, the Alternating Gradient Synchrotron (AGS) at Brookhaven National Laboratory (USA) has provided ions of iron, silicon and gold, at energies from 600 MeV/nucleon to 10 GeV/nucleon, for the US National Aeronautics and Space Administration (NASA) radiobiology research program. NASA has recently funded the construction of a new dedicated ion facility, the Booster Applications Facility (BAF). The Booster synchrotron will supply ion beams ranging from protons to gold, in an energy range from 40--3,000 MeV/nucleon with maximum beam intensities of 10{sup 10} to 10{sup 11} ions per pulse. The BAF Project is described and the future AGS and BAF operation plans are presented.

  5. Physics and radiobiology of nuclear medicine

    CERN Document Server

    Saha, Gopal B

    2013-01-01

    The Fourth Edition of Dr. Gopal B. Saha’s Physics and Radiobiology of Nuclear Medicine was prompted by the need to provide up-to-date information to keep pace with the perpetual growth and improvement in the instrumentation and techniques employed in nuclear medicine since the last edition published in 2006. Like previous editions, the book is intended for radiology and nuclear medicine residents to prepare for the American Board of Nuclear Medicine, American Board of Radiology, and American Board of Science in Nuclear Medicine examinations, all of which require a strong physics background. Additionally, the book will serve as a textbook on nuclear medicine physics for nuclear medicine technologists taking the Nuclear Medicine Technology Certification Board examination.

  6. Basics of radiobiology and nuclear medicine

    International Nuclear Information System (INIS)

    The authors successively reveal the topics of the biological impact of radiation (radiobiology) and the diagnostic and the therapeutic application of radiopharmaceuticals (nuclear medicine). Data on the influence of radiation on subcellular, cellular, tissue and organ level are given, on early and late radiation changes, as well. Indication for the application of the different radionuclide methods in the diagnosis of the diseases in the endocrinology, nephrology, cardiology, gastroenterology, haematology of lungs, bones, tumors are pointed out and the main trends of the growing therapeutical use of nuclear medicine are presented. The aim is to teach students the nuclear medicine methods in the complex investigation of the patients, his preliminary preparation and the biological impact of radiation and its risk. Self assessment test for students are proposed and a literature for further reading

  7. Bystander effects and their implications for clinical radiation therapy: Insights from multiscale in silico experiments.

    Science.gov (United States)

    Powathil, Gibin G; Munro, Alastair J; Chaplain, Mark A J; Swat, Maciej

    2016-07-21

    Radiotherapy is a commonly used treatment for cancer and is usually given in varying doses. At low radiation doses relatively few cells die as a direct response to radiation but secondary radiation effects, such as DNA mutation or bystander phenomena, may affect many cells. Consequently it is at low radiation levels where an understanding of bystander effects is essential in designing novel therapies with superior clinical outcomes. In this paper, we use a hybrid multiscale mathematical model to study the direct effects of radiation as well as radiation-induced bystander effects on both tumour cells and normal cells. We show that bystander responses play a major role in mediating radiation damage to cells at low-doses of radiotherapy, doing more damage than that due to direct radiation. The survival curves derived from our computational simulations showed an area of hyper-radiosensitivity at low-doses that are not obtained using a traditional radiobiological model. PMID:27084360

  8. Exploring nursing students’ experience of peer learning in clinical practice

    OpenAIRE

    Ravanipour, Maryam; Bahreini, Masoud; Ravanipour, Masoumeh

    2015-01-01

    Background: Peer learning is an educational process wherein someone of the same age or level of experience level interacts with other students interested in the same topic. There is limited evidence specifically focusing on the practical use of peer learning in Iran. The aim of this study was to explore nursing students’ experiences of peer learning in clinical practice. Materials and Methods: A qualitative content analysis was conducted. Focus groups were used to find the students’ experienc...

  9. Early clinical experience: do students learn what we expect?

    NARCIS (Netherlands)

    Helmich, E.; Bolhuis, S.; Laan, R.F.J.M.; Koopmans, R.T.C.M.

    2011-01-01

    CONTEXT: Early clinical experience is thought to contribute to the professional development of medical students, but little is known about the kind of learning processes that actually take place. Learning in practice is highly informal and may be difficult to direct by predefined learning outcomes.

  10. The European Radiobiology Archives (ERA) - Content, structure and use illustrated by an example

    International Nuclear Information System (INIS)

    The European Radiobiology Archives (ERA), supported by the European Commission and the European Late Effect Project Group (EULEP), together with the US National Radiobiology Archives (NRA) and the Japanese Radiobiology Archives (JRA) have collected all information still available on long-term animal experiments, including some selected human studies. The archives consist of a database in Microsoft Access, a web site, databases of references and information on the use of the database. At present, the archives contain a description of the exposure conditions, animal strains, etc. from ∼350,000 individuals; data on survival and pathology are available from ∼200,000 individuals. Care has been taken to render pathological diagnoses compatible among different studies and to allow the lumping of pathological diagnoses into more general classes. 'Forms' in Access with an underlying computer code facilitate the use of the database. This paper describes the structure and content of the archives and illustrates an example for a possible analysis of such data. (authors)

  11. Student nurses experience of learning in the clinical environment.

    Science.gov (United States)

    Papastavrou, Evridiki; Lambrinou, Ekaterini; Tsangari, Haritini; Saarikoski, Mikko; Leino-Kilpi, Helena

    2010-05-01

    The clinical learning environment is a complex social entity that influences student learning outcomes in the clinical setting. Exploration of this environment gives insight into the educational functioning of the clinical areas and allows nurse teachers to enhance students' opportunities for learning. Since Cyprus is undergoing major reforms in nursing education, building on the experience and knowledge gained, this study aims to explore the present clinical situation and how this would impact on nursing education moves to the university. As nursing education would take on a different approach, it is assumed the learning approach would also be different, and so utilization of the clinical environment would also be improved. Six hundred and forty five students participated in the study. Data were collected by means of the clinical learning environment and supervision instrument. A statistically significant correlation was found between the sub-dimensions "premises of nursing care" and "premises of learning" indicating that students are relating learning environment with the quality of nursing care and patient relationships. The ward atmosphere and the leadership style of the manager were rated as less important factors for learning. The majority of students experienced a group supervision model, but the more satisfied students were those with a "personal mentor" that was considered as the most successful mentor relationship. The findings suggest more thorough examination and understanding of the characteristics of the clinical environment that are conductive to learning. PMID:19700368

  12. Solvent/detergent plasma: pharmaceutical characteristics and clinical experience.

    Science.gov (United States)

    Liumbruno, Giancarlo Maria; Franchini, Massimo

    2015-01-01

    The solvent/detergent treatment is an established virus inactivation technology that has been industrially applied for manufacturing plasma derived medicinal products for almost 30 years. Solvent/detergent plasma is a pharmaceutical product with standardised content of clotting factors, devoid of antibodies implicated in transfusion-related acute lung injury pathogenesis, and with a very high level of decontamination from transfusion-transmissible infectious agents. Many clinical studies have confirmed its safety and efficacy in the setting of congenital as well as acquired bleeding disorders. This narrative review will focus on the pharmaceutical characteristics of solvent/detergent plasma and the clinical experience with this blood product. PMID:24844804

  13. Heavy-ion tumor therapy: Physical and radiobiological benefits

    Science.gov (United States)

    Schardt, Dieter; Elsässer, Thilo; Schulz-Ertner, Daniela

    2010-01-01

    High-energy beams of charged nuclear particles (protons and heavier ions) offer significant advantages for the treatment of deep-seated local tumors in comparison to conventional megavolt photon therapy. Their physical depth-dose distribution in tissue is characterized by a small entrance dose and a distinct maximum (Bragg peak) near the end of range with a sharp fall-off at the distal edge. Taking full advantage of the well-defined range and the small lateral beam spread, modern scanning beam systems allow delivery of the dose with millimeter precision. In addition, projectiles heavier than protons such as carbon ions exhibit an enhanced biological effectiveness in the Bragg peak region caused by the dense ionization of individual particle tracks resulting in reduced cellular repair. This makes them particularly attractive for the treatment of radio-resistant tumors localized near organs at risk. While tumor therapy with protons is a well-established treatment modality with more than 60 000 patients treated worldwide, the application of heavy ions is so far restricted to a few facilities only. Nevertheless, results of clinical phase I-II trials provide evidence that carbon-ion radiotherapy might be beneficial in several tumor entities. This article reviews the progress in heavy-ion therapy, including physical and technical developments, radiobiological studies and models, as well as radiooncological studies. As a result of the promising clinical results obtained with carbon-ion beams in the past ten years at the Heavy Ion Medical Accelerator facility (Japan) and in a pilot project at GSI Darmstadt (Germany), the plans for new clinical centers for heavy-ion or combined proton and heavy-ion therapy have recently received a substantial boost.

  14. Heavy-ion tumor therapy: Physical and radiobiological benefits

    Energy Technology Data Exchange (ETDEWEB)

    Schardt, Dieter; Elsaesser, Thilo; Schulz-Ertner, Daniela [GSI Helmholtzzentrum fuer Schwerionenforschung mbH (GSI), D-64291 Darmstadt (Germany); Markus-Krankenhaus, MVZ Radiologisches Institut, D-60431 Frankfurt/M. (Germany)

    2010-01-15

    High-energy beams of charged nuclear particles (protons and heavier ions) offer significant advantages for the treatment of deep-seated local tumors in comparison to conventional megavolt photon therapy. Their physical depth-dose distribution in tissue is characterized by a small entrance dose and a distinct maximum (Bragg peak) near the end of range with a sharp fall-off at the distal edge. Taking full advantage of the well-defined range and the small lateral beam spread, modern scanning beam systems allow delivery of the dose with millimeter precision. In addition, projectiles heavier than protons such as carbon ions exhibit an enhanced biological effectiveness in the Bragg peak region caused by the dense ionization of individual particle tracks resulting in reduced cellular repair. This makes them particularly attractive for the treatment of radio-resistant tumors localized near organs at risk. While tumor therapy with protons is a well-established treatment modality with more than 60 000 patients treated worldwide, the application of heavy ions is so far restricted to a few facilities only. Nevertheless, results of clinical phase I-II trials provide evidence that carbon-ion radiotherapy might be beneficial in several tumor entities. This article reviews the progress in heavy-ion therapy, including physical and technical developments, radiobiological studies and models, as well as radiooncological studies. As a result of the promising clinical results obtained with carbon-ion beams in the past ten years at the Heavy Ion Medical Accelerator facility (Japan) and in a pilot project at GSI Darmstadt (Germany), the plans for new clinical centers for heavy-ion or combined proton and heavy-ion therapy have recently received a substantial boost.

  15. Biophysical and biomathematical adventures in radiobiology

    International Nuclear Information System (INIS)

    Highlights of my biophysical and biomathematical adventures in radiobiology is presented. Early adventures involved developing ''state-vector models'' for specific harmful effects (cell killing, life shortening) of exposure to radiation. More recent adventures led to developing ''hazard-function models'' for predicting biological effects (e.g., cell killing, mutations, tumor induction) of combined exposure to different toxicants. Hazard-function models were also developed for predicting harm to man from exposure to large radiation doses. Major conclusions derived from the modeling adventures are as follows: (1) synergistic effects of different genotoxic agents should not occur at low doses; (2) for exposure of the lung or bone marrow to large doses of photon radiation, low rates of exposure should be better tolerated than high rates; and (3) for some types of radiation (e.g., alpha particles and fission neutrons), moderate doses delivered at a low rate may be more harmful than the same dose given at a high rate. 53 refs., 7 figs

  16. Physical and cellular radiobiological properties of heavy ions in relation to cancer therapy applications

    International Nuclear Information System (INIS)

    A variety of experiments have been carried out in vitro on several mammalian cell lines with carbon, neon, silicon and argon beams at 14 and 24 cm depth penetration. The results of these experiments substantiate the conceptual basis for physical and radiobiological advantages of accelerated heavy-ion beams in cancer therapy. The best biologically effective depth dose ratio for situations corresponding to therapy needs can be obtained with accelerated carbon beams. The depression of the oxygen effect with silicon or argon ion beams is greater than that achievable with neutrons or pions, or with heavy ions of lower atomic number

  17. Clinical experience of therapy with cyclotron neutrons at the University of Washington

    International Nuclear Information System (INIS)

    Proper clinical evaluation of fast neutron teletherapy of human cancers will be difficult and time-consuming and will require extension over many years. Fast neutron teletherapy may not have significant advantage over modern conventional supervoltage/megavoltage radiation therapy. A negative answer will be acceptable only if based on sound evidence. If fast neutron teletherapy has an advantage over modern conventional radiation therapy, the advantage may be small and tumor- and site-specific. Detection of a small advantage will require study of a large number of patients and this will be possible only in carefully planned cooperative clinical trials. The study of a large number of patients over a long period will require installation of dedicated neutron generators in research-oriented medical centers. Cooperative clinical trials must be preceded by careful definition of target tumors, normal tissue tolerances, reasonable doses and advantageous patterns of application. Any improvement in local tumor control attributed to fast neutron teletherapy might be dissipated by a concurrent increase in treatment-related sequelae. Much related physics and radiobiology remains to be done and must be supported concurrent with the clinical programs

  18. Fisheries Radiobiology and the Discharge of Radioactive Wastes

    International Nuclear Information System (INIS)

    In the United Kingdom authorizations to discharge radioactive wastes are granted by the Minister of Housing and Local Government, the Minister of Agriculture, Fisheries and Food, and by the Secretary of State for Scotland. The hazards arising from contamination of aquatic animals and plants concern the Department of Fisheries ; before authorizations to discharge liquid wastes have been given, the Department has made independent forecasts of permissible levels of discharge based on extensive studies carried out in its research vessels and radiobiological laboratory: for example, where fish have been affected this has meant studies of fish populations and fish migration: uptake of radioactivity by fish : public consumption of fish : commercial distribution of affected fish: L.D.50: effects of radiation on tissue, etc. In the course of such work there has been close consultation with the Atomic Energy Authority, and agreement with the Atomic Energy Authority about the safety factor to be incorporated during the first two years of discharge. During these two years, monitoring data collected by the Atomic Energy Authority and the Ministry of Agriculture, Fisheries and Food enable checks and revisions of the original estimates to be made, and at the end of that time formal authorizations, based on operating experience, are issued. (author)

  19. Clinical Experience of Medical Students at University Sains Malaysia

    OpenAIRE

    Quah, Ban Seng; Malik, Alam Sher; Simpson, Hamish

    2000-01-01

    Experience of acute medical, surgical conditions, and clinical procedures of undergraduate students were assessed via a questionnaire survey during the final week of the 1993/1998 programme at the School of Medical Sciences, Univestiti Sains Malaysia. Individual performances were assessed by a scoring system. One hundred and twenty four students responded, (response rate 97%). More than 90% had seen myocardial infarction, cerebrovascular accident, pneumonia, respiratory distress, gastroenteri...

  20. Influence of light source and clinical experience on shade matching

    OpenAIRE

    GÁSPÁRIK, CRISTINA; TOFAN, ALINA; CULIC, BOGDAN; BADEA, MÎNDRA; DUDEA, DIANA

    2014-01-01

    Introduction Shade is one of the most important attributes when evaluating the success of a restoration. Several factors can influence the visual shade matching process, and therefore the outcome of the final restoration. Objectives 1. to assess the importance of clinical experience on shade matching accuracy; 2. to assess the influence of two standard light sources on the ability to match shade tabs; 3. to identify the area in a VITA Classical shade guide where matching errors are most likel...

  1. DNA-abzymes in autoimmune diseases in clinic and experiment

    Directory of Open Access Journals (Sweden)

    T E Naumova

    2003-01-01

    Full Text Available DNA-abzymes enzymes in autoimmune diseases in clinic and experiment T.E. Naumova, O.M. Durova, A.G. Gabibov, Z.S. Alekberova, S. V. Suchkov DNA-hydrolyzing autoantibodies (AAB or DNA-abzymes can be found in autoimmune diseases in clinic and experiment. Technology of serum express screening for presence of DNA abzymes is described. Comparative study of DNA-hydrolising activity in patients with different forms of systemic and organ-specific autoimmune diseases was performed. Blood of clinically healthy donors was usually free of IgG DNA-abzymes. DNA-abzymes were most often revealed in patients with systemic lupus erythematosus (SLE and rheumatoid arthritis (RA less often in patients with organ-specific forms of autoimmune disturbances. The results of the study confirm the hypothesis of autoimmune origin of IgG DNA abzymes and demonstrate the possibility to use them in clinical practice for monitoring to disease activity in SLE and RA.

  2. Clinical decision-making: physicians' preferences and experiences

    Directory of Open Access Journals (Sweden)

    White Martha

    2007-03-01

    Full Text Available Abstract Background Shared decision-making has been advocated; however there are relatively few studies on physician preferences for, and experiences of, different styles of clinical decision-making as most research has focused on patient preferences and experiences. The objectives of this study were to determine 1 physician preferences for different styles of clinical decision-making; 2 styles of clinical decision-making physicians perceive themselves as practicing; and 3 the congruence between preferred and perceived style. In addition we sought to determine physician perceptions of the availability of time in visits, and their role in encouraging patients to look for health information. Methods Cross-sectional survey of a nationally representative sample of U.S. physicians. Results 1,050 (53% response rate physicians responded to the survey. Of these, 780 (75% preferred to share decision-making with their patients, 142 (14% preferred paternalism, and 118 (11% preferred consumerism. 87% of physicians perceived themselves as practicing their preferred style. Physicians who preferred their patients to play an active role in decision-making were more likely to report encouraging patients to look for information, and to report having enough time in visits. Conclusion Physicians tend to perceive themselves as practicing their preferred role in clinical decision-making. The direction of the association cannot be inferred from these data; however, we suggest that interventions aimed at promoting shared decision-making need to target physicians as well as patients.

  3. Proceedings of the 4th Radiobiological conference with international participation 2008

    International Nuclear Information System (INIS)

    Scientific conference deals with problems in radiobiology, photobiology and radio-environmental sciences. The Conference included the following sessions: (i): Radiobiology; (ii) Biology. Proceedings contains thirty-two papers dealing with the scope of INIS

  4. Estimation of Radiobiologic Parameters and Equivalent Radiation Dose of Cytotoxic Chemotherapy in Malignant Glioma

    International Nuclear Information System (INIS)

    Purpose: To determine the radiobiologic parameters for high-grade gliomas. Methods and Materials: The biologic effective dose concept is used to estimate the α/β ratio and K (dose equivalent for tumor repopulation/d) for high-grade glioma patients treated in a randomized fractionation trial. The equivalent radiation dose of temozolomide (Temodar) chemotherapy was estimated from another randomized study. The method assumes that the radiotherapy biologic effective dose is proportional to the adjusted radiotherapy survival duration of high-grade glioma patients. Results: The median tumor α/β and K estimate is 9.32 Gy and 0.23 Gy/d, respectively. Using the published surviving fraction after 2-Gy exposure (SF2) data, and the above α/β ratio, the estimated median α value was 0.077 Gy-1, β was 0.009 Gy-2, and the cellular doubling time was 39.5 days. The median equivalent biologic effective dose of temozolomide was 11.03 Gy9.3 (equivalent to a radiation dose of 9.1 Gy given in 2-Gy fractions). Random sampling trial simulations based on a cure threshold of 70 Gy in high-grade gliomas have shown the potential increase in tumor cure with dose escalation. Partial elimination of hypoxic cells (by chemical hypoxic cell sensitizers or carbon ion therapy) has suggested that considerable gains in tumor control, which are further supplemented by temozolomide, are achievable. Conclusion: The radiobiologic parameters for human high-grade gliomas can be estimated from clinical trials and could be used to inform future clinical trials, particularly combined modality treatments with newer forms of radiotherapy. Other incurable cancers should be studied using similar radiobiologic analysis

  5. Radiobiological and PK assays at advance Centre for Training Research and Education in Cancer (ACTREC)

    International Nuclear Information System (INIS)

    Radiobiological, pharmacokinetic and biodistribution studies are of paramount importance for drug development and more so in the development of newer radiation modulators. Radiobiological studies have now graduated from simple cell survival and viability assays to more complex molecular and imaging studies to study radiation modulation both in in-vitro and in-vivo models. Tata Memorial Centre and its research centre (ACTREC) is a premiere cancer centre in India dedicated to cancer research. The Department of Radiation Oncology treats approximately 7000 new patients in a year and is uniquely placed to do both translational radiation and clinical research in the field of drug development. The Clinical Biology Lab of the Department of Radiation Oncology at ACTREC in collaboration with other labs at ACTREC has standardized cell survival assays, DNA damage assays such as Gamma H2AX assay (by flow as well as confocal microscopy), Micronuclei assay and COMET assays using CASP software for quantification. We have also done apoptotic assays. These assays have been conducted for development newer drug formulations (for e.g liposomal radiosensitizers). We also have a strong imaging division having sophisticated microscopes (confocal and single molecule super resolution microscopes) for in-vitro optical imaging and a dedicated preclinical PET/CT/SPECT for in-vivo imaging. The clinical 3T MRI and PET/CT is being used to study the effect of hypoxia in various cancers

  6. National Radiobiology Archives distributed access programmer's guide

    Energy Technology Data Exchange (ETDEWEB)

    Prather, J. C. [Linfield Coll., McMinnville, OR (United States); Smith, S. K.; Watson, C. R. [Pacific Northwest Lab., Richland, WA (United States)

    1991-12-01

    The National Radiobiology Archives is a comprehensive effort to gather, organize, and catalog original data, representative specimens, and supporting materials related to significant radiobiology studies. This provides researchers with information for analyses which compare or combine results of these and other studies and with materials for analysis by advanced molecular biology techniques. This Programmer's Guide document describes the database access software, NRADEMO, and the subset loading script NRADEMO/MAINT/MAINTAIN, which comprise the National Laboratory Archives Distributed Access Package. The guide is intended for use by an experienced database management specialist. It contains information about the physical and logical organization of the software and data files. It also contains printouts of all the scripts and associated batch processing files. It is part of a suite of documents published by the National Radiobiology Archives.

  7. Radiobiological and radioecological studies with the unicellular marine algae Acetabularia, Batophora and Dunaliella

    International Nuclear Information System (INIS)

    Radiobiological studies of the biological and chemical effects of X-rays on the marine algae Acetabularia and Batophora and the incorporation of 3H in Acetabularia and Dunaliello were performed. It was shown that the main morphogenetic process of Acetabularia and Batophora are affected by the radiations. Experiments with tritiated water revealed that Acetabularia cells are unable to concentrate 3H. However, a significant amount of this radionuclide is incorporated into the genetic material of the cells. When organically bound 3H is supplied to Acetabularia or Dunaliello, a selective accumulation of some substances is observed. (H.K.)

  8. [Radiobiological aspects of diagnostic X-ray use in dentistry].

    Science.gov (United States)

    Hoogeveen, R C; van den Aardweg, G J M J

    2015-05-01

    Soon after the discovery of X-rays, it became clear that their use can cause detrimental effects. The field of radiobiology deals with these detrimental effects. In this article, the theoretical concepts of radiobiology relevant to diagnostic X-ray use are presented. The effects of radiation on living tissues, the relationship between dose and effect, and a translation of these effects into the dental application are discussed. X-rays cannot be considered to be harmless even when used at the relatively low doses as in dentistry. If applied with justification and optimization, the risk to the patient will, however, be small. PMID:26210221

  9. Running a postmortem service - a business case and clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, Marta C.; Whitby, Elspeth; Fink, Michelle A.; Collett, Jacquelene M.; Offiah, Amaka C. [Western Bank, Academic Unit of Child Health, Sheffield Children' s NHS Foundation Trust, University of Sheffield, Sheffield (United Kingdom)

    2015-04-01

    The purpose of the postmortem examination is to offer answers to explain the cause and manner of death. In the case of perinatal, infant and paediatric postmortem examinations, the goal is to identify unsuspected associated features, to describe pathogenic mechanisms and new conditions, and to evaluate the clinical management and diagnosis. Additionally, the postmortem examination is useful to counsel families regarding the probability of recurrence in future pregnancies and to inform family planning. Worldwide the rate of paediatric autopsy examinations has significantly declined during the last few decades. Religious objections to postmortem dissection and organ retention scandals in the United Kingdom provided some of the impetus for a search for non-invasive alternatives to the traditional autopsy; however, until recently, imaging studies remained an adjunct to, rather than a replacement for, the traditional autopsy. In 2012, Sheffield Children's Hospital National Health Service Foundation Trust set up the service provision of minimally invasive fetal, perinatal and neonatal autopsy, while a postmortem imaging service has been running in Melbourne, Australia, since 2008. Here we summarise the essentials of a business case and practical British and Australian experiences in terms of the pathological and radiologic aspects of setting up a minimally invasive clinical service in the United Kingdom and of developing a clinical postmortem imaging service as a complementary tool to the traditional autopsy in Australia. (orig.)

  10. Running a postmortem service - a business case and clinical experience

    International Nuclear Information System (INIS)

    The purpose of the postmortem examination is to offer answers to explain the cause and manner of death. In the case of perinatal, infant and paediatric postmortem examinations, the goal is to identify unsuspected associated features, to describe pathogenic mechanisms and new conditions, and to evaluate the clinical management and diagnosis. Additionally, the postmortem examination is useful to counsel families regarding the probability of recurrence in future pregnancies and to inform family planning. Worldwide the rate of paediatric autopsy examinations has significantly declined during the last few decades. Religious objections to postmortem dissection and organ retention scandals in the United Kingdom provided some of the impetus for a search for non-invasive alternatives to the traditional autopsy; however, until recently, imaging studies remained an adjunct to, rather than a replacement for, the traditional autopsy. In 2012, Sheffield Children's Hospital National Health Service Foundation Trust set up the service provision of minimally invasive fetal, perinatal and neonatal autopsy, while a postmortem imaging service has been running in Melbourne, Australia, since 2008. Here we summarise the essentials of a business case and practical British and Australian experiences in terms of the pathological and radiologic aspects of setting up a minimally invasive clinical service in the United Kingdom and of developing a clinical postmortem imaging service as a complementary tool to the traditional autopsy in Australia. (orig.)

  11. General Practitioners’ responses to global climate change - lessons from clinical experience and the clinical method

    Directory of Open Access Journals (Sweden)

    Blashki Grant

    2012-08-01

    Full Text Available Abstract Background Climate change is a global public health problem that will require complex thinking if meaningful and effective solutions are to be achieved. In this conceptual paper we argue that GPs have much to bring to the issue of climate change from their wide-ranging clinical experience and from the principles underpinning their clinical methods. This experience and thinking calls forth particular contributions GPs can and should make to debate and action. Discussion We contend that the privileged experience and GP way of thinking can make valuable contributions when applied to climate change solutions. These include a lifetime of experience, reflection and epistemological application to first doing no harm, managing uncertainty, the ability to make necessary decisions while possessing incomplete information, an appreciation of complex adaptive systems, maintenance of homeostasis, vigilance for unintended consequences, and an appreciation of the importance of transdisciplinarity and interprofessionalism. Summary General practitioners have a long history of public health advocacy and in the case of climate change may bring a way of approaching complex human problems that could be applied to the dilemmas of climate change.

  12. Managing medical images and clinical information: InCor's experience.

    Science.gov (United States)

    Furuie, Sergio S; Rebelo, Marina S; Moreno, Ramon A; Santos, Marcelo; Bertozzo, Nivaldo; Motta, Gustavo H M B; Pires, Fabio A; Gutierrez, Marco A

    2007-01-01

    Patients usually get medical assistance in several clinics and hospitals during their lifetime, archiving vital information in a dispersed way. Clearly, a proper patient care should take into account that information in order to check for incompatibilities, avoid unnecessary exams, and get relevant clinical history. The Heart Institute (InCor) of São Paulo, Brazil, has been committed to the goal of integrating all exams and clinical information within the institution and other hospitals. Since InCor is one of the six institutes of the University of São Paulo Medical School and each institute has its own information system, exchanging information among the institutes is also a very important aspect that has been considered. In the last few years, a system for transmission, archiving, retrieval, processing, and visualization of medical images integrated with a hospital information system has been successfully created and constitutes the InCor's electronic patient record (EPR). This work describes the experience in the effort to develop a functional and comprehensive EPR, which includes laboratory exams, images (static, dynamic, and three dimensional), clinical reports, documents, and even real-time vital signals. A security policy based on a contextual role-based access control model was implemented to regulate user's access to EPR. Currently, more than 10 TB of digital imaging and communications in medicine (DICOM) images have been stored using the proposed architecture and the EPR stores daily more than 11 GB of integrated data. The proposed storage subsystem allows 6 months of visibility for rapid retrieval and more than two years for automatic retrieval using a jukebox. This paper addresses also a prototype for the integration of distributed and heterogeneous EPR. PMID:17249400

  13. Clinicians’ experiences of becoming a clinical manager: a qualitative study

    Directory of Open Access Journals (Sweden)

    Spehar Ivan

    2012-11-01

    Full Text Available Abstract Background There has been an increased interest in recruiting health professionals with a clinical background to management positions in health care. We know little about the factors that influence individuals’ decisions to engage in management. The aim of this study is to explore clinicians’ journeys towards management positions in hospitals, in order to identify potential drivers and barriers to management recruitment and development. Methods We did a qualitative study which included in-depth interviews with 30 clinicians in middle and first-line management positions in Norwegian hospitals. In addition, participant observation was conducted with 20 of the participants. The informants were recruited from medical and surgical departments, and most had professional backgrounds as medical doctors or nurses. Interviews were analyzed by systemic text condensation. Results We found that there were three phases in clinicians’ journey into management; the development of leadership awareness, taking on the manager role and the experience of entering management. Participants’ experiences suggest that there are different journeys into management, in which both external and internal pressure emerged as a recurrent theme. They had not anticipated a career in clinical management, and experienced that they had been persuaded to take the position. Being thrown into the position, without being sufficiently prepared for the task, was a common experience among participants. Being left to themselves, they had to learn management “on the fly”. Some were frustrated in their role due to increasing administrative workloads, without being able to delegate work effectively. Conclusions Path dependency and social pressure seems to influence clinicians’ decisions to enter into management positions. Hospital organizations should formalize pathways into management, in order to identify, attract, and retain the most qualified talents. Top managers

  14. Toxicological characteristics and primary radiobiological screening of Cystizid-M

    International Nuclear Information System (INIS)

    The toxic and radioprotective properties of the potential radioprotector of the mollecular combination Cystisid-M (cysteamine-adenosin-5'-monophosphate - CAM) were investigated. The experiments were carried out on male mice C57BI irradiated with 137Cs source. The intraperitoneal administration of 1000 mg/kg b.w. and 500 mg/kg b.w., injected 15 min prior to the irradiation with 8,5 Gr (LD90/30) was performed, and orally 3000 mg/kg b.w. and 1500 mg/kg b.w. was introduced into the stomach 45 min prior to the irradiation with 8,2 Gr (LD83/30). The radioprotective effect of CAM was recorded according to: individual survival curves up to the 30th day; the biometrical coefficients 'ALPHA' (the individual survival expectancy in the population); and S30 (the group survival expectancy). At the intraperitoneal administration of the protector the values of LD50 = 1390 mg/kg b.w. and MPD (maximum permissible dose) = 1200 mg/kg b.w. were found. At the oral administration these doses were LD50/3 = 4630 mg/kg b.w. and MPD = 3500 mg/kg b.w. It was established that CAM injected intraperitoneally in a dose of 1000 mg/kg b.w. ensured 75% survival of the protected mice against 10% of the control ones, increased the mean survival of the deceased and reduced the percentage of the animals died during the height of the bone marrow syndrome. The twofold lower dose exetted a considerably slighter effect. At oral administration the protector did not significantly modify the survival of the animals. The data obtained revealed the perspectiveness of the tested protective agent radiobiological investigations are required

  15. Proceedings of 19. symposium on experimental radiotherapy and clinical radiobiology

    International Nuclear Information System (INIS)

    The proceedings include review contributions on radio-oncology, and new radiation technologies and molecular prediction; and poster sessions on the following topics: hypoxia; molecular mechanisms of radiation resistance; molecular targeting; DNA repair; biological imaging; biology of experimental radiations; normal tissue toxicity; modern radiotherapy; tumor hypoxia and metabolic micro milieu; immune system and radiotherapy.

  16. Hypofractionation in Prostate Cancer: Radiobiological Basis and Clinical Appliance

    OpenAIRE

    Mangoni, M; Desideri, I.; Detti, B.; Bonomo, P; Greto, D.; Paiar, F.; Simontacchi, G.; Meattini, I.; Scoccianti, S.; Masoni, T.; Ciabatti, C.; Turkaj, A.; Serni, S.; Minervini, A.; Gacci, M.

    2014-01-01

    External beam radiation therapy with conventional fractionation to a total dose of 76–80 Gy represents the most adopted treatment modality for prostate cancer. Dose escalation in this setting has been demonstrated to improve biochemical control with acceptable toxicity using contemporary radiotherapy techniques. Hypofractionated radiotherapy and stereotactic body radiation therapy have gained an increasing interest in recent years and they have the potential to become the standard of care eve...

  17. New radiobiological, radiation risk and radiation protection paradigms

    International Nuclear Information System (INIS)

    The long-standing conventional paradigm for radiobiology has formed a logical basis for the standard paradigm for radiation risk of cancer and heritable effects and, from these paradigms, has developed the internationally applied system for radiation protection, but with many simplifications, assumptions and generalizations. A variety of additional radiobiological phenomena that do not conform to the standard paradigm for radiobiology may have potential implications for radiation risk and radiation protection. It is suggested, however, that the current state of knowledge is still insufficient for these phenomena, individually or collectively, to be formulated systematically into a new paradigm for radiobiology. Additionally, there is at present lack of direct evidence of their relevance to risk for human health, despite attractive hypotheses as to how they might be involved. Finally, it remains to be shown how incorporation of such phenomena into the paradigm for radiation protection would provide sufficient added value to offset disruption to the present widely applied system. Further research should aim for better mechanistic understanding of processes such as radiation-induced genomic instability (for all radiation types) and bystander effects (particularly for low-fluence high-LET particles) and also priority should be given to confirmation, or negation, of the relevance of the processes to human health risks from radiation.

  18. Radiobiological researches on Dianthus caryophyllus L. carnation chimeras

    International Nuclear Information System (INIS)

    This research thesis reports a radiobiological study of Dianthus periclinal chimeras performed by submitting plants and plant cuttings at different physiological stages to cobalt-60 gamma irradiation under different dose conditions and rates. The effects of these treatments are studied while growing the so-processed plants and by microscopic examination of sections of irradiated meristems

  19. Biometrical analysis in radiobiological works of N.V. Luchnik

    International Nuclear Information System (INIS)

    The contribution of the famous Russian geneticist and biophysics N.V. Luchnik into biometrical analysis of radiobiological data is discussed. His works on radiation mortality of mice (2) and the process of post-radiation repair of chromosome aberrations (10) are thoroughly observed. The conclusion of necessity to develop biometrical analysis as separate part of biometry is made

  20. The ATM gene and the radiobiology of ataxia-telangiectasia

    International Nuclear Information System (INIS)

    Ataxia-telangiectasia (A-T) is the classic human genetic disease involving severe ionizing radiation sensitivity and as such has been intensely studied by radiation biologists over the years. Unlike its counterpart for UV light sensitivity -xeroderma pigmentosum - A-T has no obvious DNA repair defect; and there has been much speculation as to the mechanism underlying the altered radioresponses associated with this disease. The gene defective in A-T (ATM) has recently been cloned, and its primary coding sequence determined. The primary sequence of the ATM protein suggests that it has some regulatory functions related to cellular radioresponse and maintenance of genomic stability, and shares these functions with a growing family of other proteins in various organisms. At this juncture it is appropriate to review our current knowledge about the radiobiology of A-T and reflect on the possible radiobiological mechanisms that are suggested by the ATM gene itself. This article will attempt briefly to review current knowledge about the radiobiology of A-T and to introduce new speculations about underlying radiobiological mechanisms that are suggested by the primary amino acid sequence of the predicted ATM gene product. (Author)

  1. Research in radiobiology. Annual report, Internal Irradiation Program

    International Nuclear Information System (INIS)

    The annual progress report for the Radiobiology Division of the University of Utah College of Medicine is presented. Summaries of twenty-four projects concerning the metabolism, dosimetry and toxicity of a variety of actinide elements in beagles or rats are given. Individual papers within this report have been separately indexed and abstracted for the data base

  2. Tritium radiobiology research in the US DOE program

    International Nuclear Information System (INIS)

    The history of the original US Atomic Energy Commission, its replacement, the Energy Research and Development Administration, and the present Department of Energy's interest and sponsorship of tritium radiobiology is reviewed beginning in 1971 and continuing through 1986. In particular, the four remaining US Department of Energy, Division of Health and Environmental Research programs are described in some detail

  3. National Radiobiology Archives Distributed Access user's manual

    Energy Technology Data Exchange (ETDEWEB)

    Watson, C.; Smith, S. (Pacific Northwest Lab., Richland, WA (United States)); Prather, J. (Linfield Coll., McMinnville, OR (United States))

    1991-11-01

    This User's Manual describes installation and use of the National Radiobiology Archives (NRA) Distributed Access package. The package consists of a distributed subset of information representative of the NRA databases and database access software which provide an introduction to the scope and style of the NRA Information Systems.

  4. Evidence for intermittent radiobiological hypoxia in experimental tumour systems

    International Nuclear Information System (INIS)

    This paper describes flow and static fluorescence cytometry techniques to visualize and quantitate acute radiobiological hypoxia resulting from transient fluctuation in tumour blood flow in experimental tumour systems. The application of these techniques in two murine tumour systems provides evidence that such hypoxia exists and reduces the effectiveness of single doses of radiation. Possible mechanisms for and implications of these findings are discussed. (author)

  5. Psychometric validation of satisfaction with simulated clinical learning experience evaluation – corrections (SSCLEE-C

    Directory of Open Access Journals (Sweden)

    Desiree A. Díaz

    2016-03-01

    Originality/value: The Satisfaction with Simulated Clinical Learning Experience Evaluation – Corrections (SSCLEE-C is the only instrument available for ongoing assessment of correctional nurse satisfaction with simulated clinical learning experiences.

  6. Junior nursing students' experiences of vertical violence during clinical rotations.

    Science.gov (United States)

    Thomas, Sandra P; Burk, Renee

    2009-01-01

    Horizontal violence is a form of workplace violence, a phenomenon that is prevalent in the nursing profession. Research has revealed a variety of negative peer-to-peer behaviors that lower morale and lead to turnover. However, little research has been conducted on "eating our young" (violence occurring between individuals with unequal power, such as staff nurse and student). We propose "vertical violence" as the appropriate term when abusive registered nurse (RN) behavior is directed towards students. We report a content analysis of stories written by junior nursing students about incidents of injustice perpetrated by staff RNs during their clinical experiences. Four levels of injustice were described. Nursing leadership, both in hospitals and educational institutions, must become engaged in efforts to eradicate vertical violence towards students. PMID:19631065

  7. 42 CFR 482.80 - Condition of participation: Data submission, clinical experience, and outcome requirements for...

    Science.gov (United States)

    2010-10-01

    ...) Standard: Clinical experience. To be considered for initial approval, an organ-specific transplant center..., clinical experience, and outcome requirements for initial approval of transplant centers. 482.80 Section... Hospitals Transplant Center Data Submission, Clinical Experience, and Outcome Requirements §...

  8. Preparatory study of a ground-based space radiobiology program in Europe

    Science.gov (United States)

    Durante, M.; Kraft, G.; O'Neill, P.; Reitz, G.; Sabatier, L.; Schneider, U.

    Space radiation has long been acknowledged as a potential showstopper for long duration manned interplanetary missions. Our knowledge of biological effects of cosmic radiation in deep space is almost exclusively derived from ground-based accelerator experiments with heavy ions in animal or in vitro models. In an effort to gain more information on space radiation risk and to develop countermeasures, NASA initiated several years ago a Space Radiation Health Program, which is currently supporting biological experiments performed at the Brookhaven National Laboratory. Accelerator-based radiobiology research in the field of space radiation research is also under way in Russia and Japan. The European Space Agency (ESA) has recently established an ambitious exploration program (AURORA), and within this program it has been decided to include a space radiation research program. Europe has a long tradition in radiobiology research at accelerators, generally focussing on charged-particle cancer therapy. This expertise can be adapted to address the issue of space radiation risk. To support research in this field in Europe, ESA issued a call for tender in 2005 for a preliminary study of investigations on biological effects of space radiation (IBER). This study will provide guidance on future ESA-supported activities in space radiation research by identifying the most appropriate European accelerator facilities to be targeted for cooperation, and by drafting a roadmap for future research activities. The roadmap will include a prioritisation of research topics, and a detailed proposal for experimental campaigns for the following 5 10 years.

  9. Dasatinib first-line: Multicentric Italian experience outside clinical trials.

    Science.gov (United States)

    Breccia, Massimo; Stagno, Fabio; Luciano, Luigiana; Abruzzese, Elisabetta; Annunziata, Mario; D'Adda, Mariella; Maggi, Alessandro; Sgherza, Nicola; Russo-Rossi, Antonella; Pregno, Patrizia; Castagnetti, Fausto; Iurlo, Alessandra; Latagliata, Roberto; Cedrone, Michele; Di Renzo, Nicola; Sorà, Federica; Rege-Cambrin, Giovanna; La Nasa, Giorgio; Scortechini, Anna Rita; Greco, Giovanna; Franceschini, Luca; Sica, Simona; Bocchia, Monica; Crugnola, Monica; Orlandi, Esther; Guarini, Attilio; Specchia, Giorgina; Rosti, Gianantonio; Saglio, Giuseppe; Alimena, Giuliana

    2016-01-01

    Dasatinib was approved for the treatment of chronic phase (CP) chronic myeloid leukemia (CML) patients in first line therapy based on the demonstration of efficacy and safety reported in patients enrolled in clinical trials. We describe a multicentric Italian "real-life" experience of dasatinib used as frontline treatment outside clinical trials. One hundred and nine patients (median age 54 years) were treated from January 2012 to December 2013. Increased incidence of high risk patients were detected according to stratification (26% according to Sokal score, 19% according to Euro score and 16% according to EUTOS) when compared to company sponsored studies. Median time from diagnosis to start of dasatinib was 18 days. Ten patients received unscheduled starting dose (6 patients 50mg and 4 patients 80 mg QD), whereas 99 patients started with 100mg QD. At 3 months, 92% of patients achieved a BCR-ABL ratio less than 10%. At 6 months, the rate of CCyR was 91% and the rate of MR3 was 40%, with 8% of the patients reaching MR4.5. Ninety-three patients were evaluable at 12 months: the rate of MR3 was 62%, with MR4.5 being achieved by 19% of the patients. At a median follow-up of 12 months, 27 patients (24.7%) were receiving the drug at reduced dose. Two patients (1.8%) experienced a lymphoid blast crisis and the overall incidence of resistance was 8%. As regards safety, the major side effects recorded were thrombocytopenia, neutropenia and pleural effusions, which occurred in 22%, 10% and 8% of patients, respectively. Present results, achieved in a large cohort of patients treated outside clinical trials, further confirm the efficacy and safety of dasatinib as firstline treatment in CML. PMID:26643920

  10. Dabigatran in Secondary Stroke Prevention: Clinical Experience with 106 Patients

    Directory of Open Access Journals (Sweden)

    Alicia DeFelipe-Mimbrera

    2014-01-01

    Full Text Available Introduction. Our aim was to analyze our clinical experience with dabigatran etexilate in secondary stroke prevention. Methods. We retrospectively included patients starting dabigatran etexilate for secondary stroke prevention from March 2010 to December 2012. Efficacy and safety variables were registered. Results. 106 patients were included, median follow-up of 12 months (range 1–31. Fifty-six females (52.8%, mean age 76.4 (range 50–95, SD 9.8, median CHADS2 4 (range 2–6, CHA2DS2-VASc 5 (range 2–9, and HAS-BLED 2 (range 1–5. Indication for dabigatran etexilate was ischemic stroke in 101 patients and acute cerebral hemorrhage (CH due to warfarin in 5 (4.7%. Dabigatran etexilate 110 mg bid was prescribed in 71 cases (67% and 150 mg bid was prescribed in the remaining. Seventeen patients (16% suffered 20 complications during follow-up. Ischemic complications (10 were 6 transient ischemic attacks (TIA, 3 ischemic strokes, and 1 acute coronary syndrome. Hemorrhagic complications (10 were CH (1, gastrointestinal bleeding (6, mild hematuria (2, and mild metrorrhagia (1, leading to dabigatran etexilate discontinuation in 3 patients. Patients with previous CH remained uneventful. Three patients died (pneumonia, congestive heart failure, and acute cholecystitis and 9 were lost during follow-up. Conclusions. Dabigatran etexilate was safe and effective in secondary stroke prevention in clinical practice, including a small number of patients with previous history of CH.

  11. Antioxidant vitamins in atherosclerosis--animal experiments and clinical studies.

    Science.gov (United States)

    Ozkanlar, Seckin; Akcay, Fatih

    2012-01-01

    Atherosclerotic heart diseases are universal problems in modern society. Oxidative damage to lipids is a primary cause of atherosclerosis. There are many choices for treatment, but no definite recommendations to prevent the occurrence of the disease. There is a relationship between atherosclerotic risk factors and increased vascular production of reactive oxygen species (ROS). Oxidized low-density lipoproteins (LDL) and ROS may directly cause endothelial dysfunction by reducing endothelial nitric oxide (NO) bioavailability. Vitamin E can to some degree prevent the consequences of oxidized LDL, and vitamin C provides NO synthase activity. Although prolonged use of vitamin A, C, and E supplementation in pharmaceutical forms has been proven to be effective in preventing atherosclerosis in animal experiments, this has not yet been demonstrated in clinical trials with human beings. It should be taken into account that the evidence has been gathered from young/adult experimental animals with early stages of arthrosclerosis and from in-vitro studies, while most of the clinical trials have involved older patients with late stages of the disease. Prolonged use of vitamins in the diet has not yet been recommended in human beings. There is some indication that a diet rich in antioxidant fruit and vegetables may be beneficial in the prevention of cardiovascular events. PMID:23214308

  12. Medical academia clinical experiences of Ward Round Teaching curriculum

    Directory of Open Access Journals (Sweden)

    Fariba Haghani

    2014-01-01

    Full Text Available Background: Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members′ experience on Ward Round Teaching content. Methods and Materials: This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9. Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation.Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability were employed (Guba and Lincoln. Results: Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1 tangible teachings (analytic intelligence, technical intelligence, legal duties and (2 implied teachings (professionalism, professional discipline, professional difficulties. Conclusion: Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners.

  13. Clinical experience of medical students at university sains malaysia.

    Science.gov (United States)

    Quah, B S; Malik, A S; Simpson, H

    2000-01-01

    Experience of acute medical, surgical conditions, and clinical procedures of undergraduate students were assessed via a questionnaire survey during the final week of the 1993/1998 programme at the School of Medical Sciences, Univestiti Sains Malaysia. Individual performances were assessed by a scoring system. One hundred and twenty four students responded, (response rate 97%). More than 90% had seen myocardial infarction, cerebrovascular accident, pneumonia, respiratory distress, gastroenteritis, coma, and snake bite. Less than 33% had witnessed acute psychosis, diabetic ketoacidosis, acute hepatic failure, status epilepticus, near drowning, hypertensive encephalopathy, acute haemolysis or child abuse.Acute surgical/obstetrics cases, seen by >90% students, included fracture of long bones, head injury, acute abdominal pain, malpresentation and foetal distress. Less than 33% had observed epistaxis, sudden loss of vision, peritonitis or burns. Among operations only herniorrhaphy, Caesarian section, internal fixation of fracture and cataract extraction were seen by >80% students. The main deficits in clinical procedures are in rectal and vaginal examinations, urine collection and microscopic examinations. The performance of individual students, assessed by a scoring system, showed 15 students had unacceptably low scores (181.4/230, 70%) and 5 had superior scores (197.6/230, 80%). PMID:22844212

  14. Treatment with neutrons: hadron therapy part 2: physical basis and clinical experience; Le traitement par neutrons: hadrontherapie parie 2: bases physiques et experience clinique

    Energy Technology Data Exchange (ETDEWEB)

    Noel, G.; Feuvret, L.; Ferrand, R.; Mazeron, J.J. [Centre de Protontherapie d' Orsay, 91 (France); Mazeron, J.J. [Centre des Tumeurs, Groupe Hospitalier Universitaire Pitie-Salpetriere, 75 - Paris (France)

    2003-10-01

    Neutrons have radiobiological characteristics, which differ from those of conventional radiotherapy beams (photons) and which offer a theoretical advantage over photons to fight radioresistance by the differential relative biological effect of them between normal and tumour tissues. Neutron therapy beneficed of great interest between 1975 and 1985. Many of phase III trials were conducted and indications have been definitively deducted of them. After briefly describing the properties of neutron beams, this review discusses the indication of neutron therapy on the basis of the clinical results. Salivary, prostate tumours and sarcomas are the main indications of neutron therapy. In concern to the prostate cancers, other alternative treatments reduce the neutron therapy field. For sarcomas, the lack of randomized trials limits the impact of the interest of neutrons. For other tumours, the ratio benefice/risk of neutron therapy is inferior to these obtained with photons and they could not be considered like classical indications. (authors)

  15. Preliminary results in the application of radiobiological models in the evaluation of radiotherapy plans

    International Nuclear Information System (INIS)

    Notwithstanding the limitations of radiobiological models in the clinical application, its use is becoming more widespread in order to quantitatively assess the bioequivalence of different regimens of irradiation, the effective comparison between different treatment plans by estimating the probability tumor control (TCP) or the probability of normal tissue complication (NTCP), or solve problems, such as the rescheduling of treatments in case of failure. The response to irradiation in the tissues at risk (OARS) depends on factors such as volume irradiated or its organizational structure and behavior can vary for a given dose distribution. Another important aspect is the sensitivity of these models to the variation of parameters (a, a / β, proliferation, clonogenic density, etc.) Measuring the difference between-subjects. Commercial planning systems do not always possible to estimate the biological response of the OARS and CTV. This study presents an assessment of the results of two applications (free ware) and Albireo Target BIOPLAN Cygnus X1 that calculate statistical parameters of the DVH: equivalent uniform dose (EUD), equivalent biological dose (BED), medium dose and other to estimate TCP (Poisson model) and NTCP (Lyman-models-Kutcker Burman and relative seriality) for the calculation of the objective functions: the probability of uncomplicated control (UTCP) based on generalized EUD (f). We studied the response of both systems to the variation of relevant radiobiological parameters and the shape of the DVH. (author)

  16. How Clinical Instructors Can Enhance the Learning Experience of Physical Therapy Students in an Introductory Clinical Placement

    Science.gov (United States)

    Cole, Beverley; Wessel, Jean

    2008-01-01

    Purpose: There is little understanding of how physical therapy students are influenced by clinical instructors (CIs) particularly at the outset of their clinical learning. The purpose of this study was to evaluate physical therapy students' perceptions of their learning experiences during an introductory clinical placement. Methods: Subjects were…

  17. Digital breast tomosynthesis (DBT): initial experience in a clinical setting

    International Nuclear Information System (INIS)

    false-positive findings. The side-by-side feature analysis showed higher conspicuity scores for tomosynthesis compared to conventional 2D for cancers presenting as spiculated masses and distortions. Conclusion: Tomosynthesis is a promising new technique. Our preliminary clinical experience shows that there is a potential for increasing the sensitivity using this new technique, especially for cancers manifesting as spiculated masses and distortions

  18. Non-invasive prenatal chromosomal aneuploidy testing--clinical experience: 100,000 clinical samples.

    Directory of Open Access Journals (Sweden)

    Ron M McCullough

    Full Text Available OBJECTIVE: As the first laboratory to offer massively parallel sequencing-based noninvasive prenatal testing (NIPT for fetal aneuploidies, Sequenom Laboratories has been able to collect the largest clinical population experience data to date, including >100,000 clinical samples from all 50 U.S. states and 13 other countries. The objective of this study is to give a robust clinical picture of the current laboratory performance of the MaterniT21 PLUS LDT. STUDY DESIGN: The study includes plasma samples collected from patients with high-risk pregnancies in our CLIA-licensed, CAP-accredited laboratory between August 2012 to June 2013. Samples were assessed for trisomies 13, 18, 21 and for the presence of chromosome Y-specific DNA. Sample data and ad hoc outcome information provided by the clinician was compiled and reviewed to determine the characteristics of this patient population, as well as estimate the assay performance in a clinical setting. RESULTS: NIPT patients most commonly undergo testing at an average of 15 weeks, 3 days gestation; and average 35.1 years of age. The average turnaround time is 4.54 business days and an overall 1.3% not reportable rate. The positivity rate for Trisomy 21 was 1.51%, followed by 0.45% and 0.21% rate for Trisomies 18 and 13, respectively. NIPT positivity rates are similar to previous large clinical studies of aneuploidy in women of maternal age ≥ 35 undergoing amniocentesis. In this population 3519 patients had multifetal gestations (3.5% with 2.61% yielding a positive NIPT result. CONCLUSION: NIPT has been commercially offered for just over 2 years and the clinical use by patients and clinicians has increased significantly. The risks associated with invasive testing have been substantially reduced by providing another assessment of aneuploidy status in high-risk patients. The accuracy and NIPT assay positivity rate are as predicted by clinical validations and the test demonstrates improvement in the

  19. A Short Version of the Revised ‘Experience of Close Relationships Questionnaire’: Investigating Non-Clinical and Clinical Samples

    OpenAIRE

    Wongpakaran, Tinakon; Wongpakaran, Nahathai

    2012-01-01

    Aim: This study seeks to investigate the psychometric properties of the short version of the revised ‘Experience of Close Relationships’ questionnaire, comparing non-clinical and clinical samples. Methods: In total 702 subjects participated in this study, of whom 531 were non-clinical participants and 171 were psychiatric patients. They completed the short version of the revised ‘Experience of Close Relationships’ questionnaire (ECR-R-18), the Perceived Stress Scale-10(PSS-10), the Rosenberg ...

  20. DEGRO practical guidelines for radiotherapy of non-malignant disorders. Part I: physical principles, radiobiological mechanisms, and radiogenic risk

    International Nuclear Information System (INIS)

    Synopsis of the introductory paragraph of the DEGRO consensus S2e-guideline recommendations for the radiotherapy of benign disorders, including physical principles, radiobiological mechanisms, and radiogenic risk. This work is based on the S2e-guideline recommendations published November 14, 2013. The basic principles of radiation physics and treatment delivery, evaluation of putative underlying radiobiological mechanisms, and the assessment of genetic and cancer risk following low-dose irradiation will be presented. Radiation therapy of benign diseases is performed according to similar physical principles as those governing treatment of malignant diseases in radiation oncology, using the same techniques and workflows. These methods comprise usage of orthovoltage X-ray units, gamma irradiation facilities, linear accelerators (LINACs), and brachytherapy. Experimental in vitro and in vivo models recently confirmed the clinically observed anti-inflammatory effect of low-dose X-irradiation, and implicated a multitude of radiobiological mechanisms. These include modulation of different immunological pathways, as well as the activities of endothelial cells, mono- and polymorphonuclear leukocytes, and macrophages. The use of effective dose for radiogenic risk assessment and the corresponding tumor incidence rate of 5.5 %/Sv are currently controversially discussed. Some authors argue that the risk of radiation-induced cancers should be estimated on the basis of epidemiological data. However, such data are rarely available at present and associated with high variability. Current radiobiological studies clearly demonstrate a therapeutic effectiveness of radiation therapy used to treat benign diseases and implicate various molecular mechanisms. Radiogenic risks should be taken into account when applying radiation treatment for benign diseases. (orig.)

  1. Alpha-particle radiobiological experiments using thin CR-39 detectors

    International Nuclear Information System (INIS)

    The present paper studied the feasibility of applying comet assay to evaluate the DNA damage in individual HeLa cervix cancer cells after alpha-particle irradiation. We prepared thin CR-39 detectors (<20 μm) as cell-culture substrates, with UV irradiation to shorten the track formation time. After irradiation of the HeLa cells by alpha particles, the tracks on the underside of the CR-39 detector were developed by chemical etching in (while floating on) a 14 N KOH solution at 37 deg. C. Comet assay was then applied. Diffusion of DNA out of the cells could be generally observed from the images of stained DNA. The alpha-particle tracks corresponding to the comets developed on the underside of the CR-39 detectors could also be observed by just changing the focal plane of the confocal microscope. (authors)

  2. Non-immune hydrops fetalis: Clinical experience in newborn infants

    Directory of Open Access Journals (Sweden)

    Pejić Katarina

    2011-01-01

    Full Text Available Introduction. Non-immune hydrops fetalis is a condition of excessive accumulation of extravascular fluid without identifiable circulating antibody to erythrocytes membrane antigens. In newborn infants it is characterized by skin oedema and pleural, pericardial or peritoneal effusion. In the era of routine Rh immunization for the prevention of foetal erythroblastosis, non-immune pathophysiologic mechanisms are presented in 76-87% of all hydropic newborns. Non-immune hydrops fetalis can be associated with numerous and various disorders. The mortality rate may exceed 50%. This study was aimed at presenting our clinical experience in treating newborn infants with non-immune hydrops fetalis. Material and methods. A retrospective-prospective study included newborn infants with non-immune hydrops fetalis, who were treated in the Neonatal Intensive Care Unit of Mother and Child Health Institute of Serbia between January 1, 2001 and October 31, 2010. All valid data about aetiology, diagnosis, clinical course and outcome were recorded. Results. The diagnosis of non-immune hydrops fetalis was made in 11 newborns. The etiologic diagnosis was established in 8 patients: anaemia due to fetomaternal transfusion in 4 patients and conatal cytomegalovirus infection, intracranial haemorrhage, isolated pulmonary lymphangiectasia and diffuse skin and mediastinal lymphangiomatosis in the remaining 4 patients. Conclusion. Non-immune hydrops of newborn infant is associated with a high mortality rate and requires complex diagnostic and therapeutic procedures. An optimal management of neonates with non-immune hydrops fetalis demands a multidisciplinary approach to the treatment in a neonatal intensive care unit.

  3. Development of a soft X-ray microprobe for single cell radiobiology

    Institute of Scientific and Technical Information of China (English)

    CHEN Liang; YAN Jingwen; JIANG Shiping; YU Yang

    2009-01-01

    An X-ray microprobe for radiobiological studies was developed which deliver precise doses of radiation to the selected individual cells. The facility used synchrotron radiation as soft X-ray source. A zone plate combining with a pinhole produced a fine probe from bending magnet for single cell irradiating with defined doses. The diameter of microprobe at the target position was about 2 μm by scanning a knife-edge with an AXUV photo diode. The fluxes of soft X-rays at 516.7 eV (2.4 nm) were about 5.4×104 photons/s.100mA measured with the photo diode. The absorbed dose rate for typical yeast cells was about 11.34 Gy/s with the storage current of 100 mA. A preliminary experiment for yeast cells irradiation has shown that the microprobe had a definite biological effect for radiobiological investigations. The soft X-ray microprobe at "water window" region has provided a useful tool for single cell irradiating damage and a capability of individually irradiating a certain numbers of cells each time.

  4. Assessment of radiobiological metrics applied to patient-specific QA process of VMAT prostate treatments.

    Science.gov (United States)

    Clemente-Gutiérrez, Francisco; Pérez-Vara, Consuelo; Clavo-Herranz, María H; López-Carrizosa, Concepción; Pérez-Regadera, José; Ibáñez-Villoslada, Carmen

    2016-01-01

    VMAT is a powerful technique to deliver hypofractionated prostate treatments. The lack of correlations between usual 2D pretreatment QA results and the clini-cal impact of possible mistakes has allowed the development of 3D verification systems. Dose determination on patient anatomy has provided clinical predictive capability to patient-specific QA process. Dose-volume metrics, as evaluation crite-ria, should be replaced or complemented by radiobiological indices. These metrics can be incorporated into individualized QA extracting the information for response parameters (gEUD, TCP, NTCP) from DVHs. The aim of this study is to assess the role of two 3D verification systems dealing with radiobiological metrics applied to a prostate VMAT QA program. Radiobiological calculations were performed for AAPM TG-166 test cases. Maximum differences were 9.3% for gEUD, -1.3% for TCP, and 5.3% for NTCP calculations. Gamma tests and DVH-based comparisons were carried out for both systems in order to assess their performance in 3D dose determination for prostate treatments (high-, intermediate-, and low-risk, as well as prostate bed patients). Mean gamma passing rates for all structures were bet-ter than 92.0% and 99.1% for both 2%/2 mm and 3%/3 mm criteria. Maximum discrepancies were (2.4% ± 0.8%) and (6.2% ± 1.3%) for targets and normal tis-sues, respectively. Values for gEUD, TCP, and NTCP were extracted from TPS and compared to the results obtained with the two systems. Three models were used for TCP calculations (Poisson, sigmoidal, and Niemierko) and two models for NTCP determinations (LKB and Niemierko). The maximum mean difference for gEUD calculations was (4.7% ± 1.3%); for TCP, the maximum discrepancy was (-2.4% ± 1.1%); and NTCP comparisons led to a maximum deviation of (1.5% ± 0.5%). The potential usefulness of biological metrics in patient-specific QA has been explored. Both systems have been successfully assessed as potential tools for evaluating the clinical

  5. Biological wound dressings sterilized with gamma radiation: Mexican clinical experience

    Science.gov (United States)

    Martínez-Pardo, M. E.; Ley-Chávez, E.; Reyes-Frías, M. L.; Rodríguez-Ferreyra, P.; Vázquez-Maya, L.; Salazar, M. A.

    2007-11-01

    Biological wound dressings sterilized with gamma radiation, such as amnion and pig skin, are a reality in Mexico. These tissues are currently processed in the tissue bank and sterilized in the Gamma Industrial Irradiation Plant; both facilities belong to the Instituto Nacional de Investigaciones Nucleares (ININ) (National Institute of Nuclear Research). With the strong support of the International Atomic Energy Agency, the bank was established at the ININ and the Mexican Ministry of Health issued its sanitary license on July 7, 1999. The Quality Management System of the bank was certified by ISO 9001:2000 on August 1, 2003; the scope of the system is "Research, Development and Processing of Biological Tissues Sterilized with Gamma Radiation". At present, more than 150 patients from 16 hospitals have been successfully treated with these tissues. This paper presents a brief description of the tissue processing, as well as the present Mexican clinical experience with children and adult patients who underwent medical treatment with radiosterilized amnion and pig skin, used as biological wound dressings on burns and ocular surface disorders.

  6. Radiochemotherapy of malignant glioma in adults. Clinical experiences

    Energy Technology Data Exchange (ETDEWEB)

    Kortmann, R.D.; Jeremic, B.; Plasswilm, L.; Bamberg, M. [Dept. for Radiation Oncology, Univ. of Tuebingen (Germany); Weller, M. [Dept. of Neurology, Univ. of Tuebingen (Germany)

    2003-04-01

    Background: Standard treatment in patients with malignant glioma consists of surgery and postoperative radiotherapy. A high early recurrence rate, particularly in glioblastoma, has led to the investigation of additional chemotherapy. Material and Methods: Recent results of radiochemotherapy published in the literature were reviewed with respect to outcome in phase II and III trials. Based on these experiences, aspects of future strategies were discussed. Results: 3 decades of intensive research had, unfortunately, little impact on the overall results. While early prospective studies established adjuvant nitrosoureas, particularly BCNU, as suitable adjuvant to surgery and postoperative radiotherapy, further studies largely concentrated on combined chemotherapeutic protocols, mostly procarbazine, CCNU and vincristine (PCV), which was shown to prolong survival in anaplastic astrocytoma. The recent MRC study, however, showed no effect for adjuvant PCV in grade III and IV malignant glioma. Only in high-grade glioma with an oligodendroglial component, additional chemotherapy may be of a decisive benefit. The introduction of newer drugs such as paclitaxel, temozolomide, or gemcitabine demonstrated no decisive advantage. Different modes of application and sequencing of radiotherapy and chemotherapy are presently actively investigated, but failed to substantially improve outcome. Conclusions: Therefore, search for newer and more effective drugs continues, as well as for ''optimal'' administration and sequencing, especially from the standpoint of accompanying acute and late toxicity. Finally, recent endeavors focused on basic research such as angiogenesis, migration and invasion, or induction of cell differentiation, but these strategies are still away from broader clinical investigation. (orig.)

  7. Biological wound dressings sterilized with gamma radiation: Mexican clinical experience

    International Nuclear Information System (INIS)

    Biological wound dressings sterilized with gamma radiation, such as amnion and pig skin, are a reality in Mexico. These tissues are currently processed in the tissue bank and sterilized in the Gamma Industrial Irradiation Plant; both facilities belong to the Instituto Nacional de Investigaciones Nucleares (ININ) (National Institute of Nuclear Research). With the strong support of the International Atomic Energy Agency, the bank was established at the ININ and the Mexican Ministry of Health issued its sanitary license on July 7, 1999. The Quality Management System of the bank was certified by ISO 9001:2000 on August 1, 2003; the scope of the system is 'Research, Development and Processing of Biological Tissues Sterilized with Gamma Radiation'. At present, more than 150 patients from 16 hospitals have been successfully treated with these tissues. This paper presents a brief description of the tissue processing, as well as the present Mexican clinical experience with children and adult patients who underwent medical treatment with radiosterilized amnion and pig skin, used as biological wound dressings on burns and ocular surface disorders

  8. Single photon emission computed tomography: A clinical experience

    International Nuclear Information System (INIS)

    In the past decade, single photon emission computed tomography (SPECT) has evolved from an experimental technique used only in academic settings to a routine clinical examination performed in many community hospitals. Responding to reports of increased diagnostic efficacy, many nuclear medicine physicians have chosen to make SPECT imaging a routine technique for bone, liver, spleen, heart, and brain imaging. However, the enthusiasm for SPECT is not universal. Most nuclear medicine physicians continue to rely primarily on planar imaging, with little or no routine use of SPECT. This milieu has left many physicians asking themselves the following practical questions: Can SPECT be done easily in my hospital? Will not doing SPECT reduce the competitiveness of my nuclear medicine laboratory? The authors' experience at an institution heavily committed to SPECT for over 5 years may be helpful in answering these types of questions. The first rotating gamma camera at the Milwaukee Regional Medical Center was installed in late 1981. At present the authors have eight gamma cameras, of which four routinely perform SPECT examinations. Between 1981 and 1986, over 4,000 SPECT examinations have been performed

  9. Normothermic donor heart perfusion: current clinical experience and the future.

    Science.gov (United States)

    Messer, Simon; Ardehali, Abbas; Tsui, Steven

    2015-06-01

    Following the first successful heart transplant in 1967, more than 100,000 heart transplants have been carried out worldwide. These procedures have mostly relied on cold ischaemic preservation of the donor heart because this simple technique is inexpensive and relatively reliable. However, the well-known limitations of cold ischaemic preservation imposes significant logistical challenges to heart transplantation which put a ceiling on the immediate success on this life-saving therapy, and limits the number of donor hearts that can be safely transplanted annually. Although the theoretical advantages of normothermic donor heart perfusion have been recognised for over a century, the technology to transport donor hearts in this state has only been developed within the last decade. The Organ Care System (OCS) which is designed and manufactured by TransMedics Inc. is currently the only commercially available device with this capability. This article reviews the history of normothermic heart perfusion and the clinical experience with the TransMedics OCS to date. We have also attempted to speculate on the future possibilities of this innovative and exciting technology. PMID:24853906

  10. Optimization in brachytherapy with the implementation of Radiobiology

    International Nuclear Information System (INIS)

    In the brachytherapy planning treatments with High dose rates (HDR), the optimization algorithms used are based in dosimetric considerations and/or geometric ones, ignoring the radiobiological response of the tissue treated. In this work we wish to show the implementation of radiobiological concepts in the optimization. Assuming that the subtiles differences that result in the dose distribution among the different optimization models which are not visible in an isodose plane, it is studied how is classically make it , the quality implant through natural histograms about dose volumes and the resulting parameters. Also is studied the necrosis probability which may be caused by the choice of some optimization model, allowing with this the choice of the best implant. (Author)

  11. Amchitka radiobiological program progress report, January 1976--December 1976

    International Nuclear Information System (INIS)

    The Amchitka Radiobiological Program is a continuing program to collect biological and environmental samples for radiometric analyses. Results of analyses for samples collected during 1976 include gamma-emitting radionuclides in air filters, freshwater, birds, lichens, marine algae, marine invertebrates, fish, aufwuchs, and freshwater moss and plants; 90Sr in rats, birds, and soil; 239240Pu in sand, soil, marine algae and fish; and tritium (3H) in seawater, freshwater, and biological organisms

  12. Radiobiology Department. Report of Activities 1977-1980

    International Nuclear Information System (INIS)

    The different research activities carried out by the Radiobiology Department of the CNEA over the 4-year period 1977-1980 are summarized. These activities were devoted to the study of the effects of radiation on different biological systems, to the search for adequate experimental models, and to the development of techniques permiting a correct evaluation of the information obtained. Topics covered are genetics, microbiology, somatic effects of radiation, pathology and the operation of the animal's house. (M.E.L.)

  13. (RadioBiological Optimization of External-Beam Radiotherapy

    Directory of Open Access Journals (Sweden)

    Alan E. Nahum

    2012-01-01

    Full Text Available “Biological optimization” (BIOP means planning treatments using (radiobiological criteria and models, that is, tumour control probability and normal-tissue complication probability. Four different levels of BIOP are identified: Level I is “isotoxic” individualization of prescription dose at fixed fraction number. is varied to keep the NTCP of the organ at risk constant. Significant improvements in local control are expected for non-small-cell lung tumours. Level II involves the determination of an individualized isotoxic combination of and fractionation scheme. This approach is appropriate for “parallel” OARs (lung, parotids. Examples are given using our BioSuite software. Hypofractionated SABR for early-stage NSCLC is effectively Level-II BIOP. Level-III BIOP uses radiobiological functions as part of the inverse planning of IMRT, for example, maximizing TCP whilst not exceeding a given NTCP. This results in non-uniform target doses. The NTCP model parameters (reflecting tissue “architecture” drive the optimizer to emphasize different regions of the DVH, for example, penalising high doses for quasi-serial OARs such as rectum. Level-IV BIOP adds functional imaging information, for example, hypoxia or clonogen location, to Level III; examples are given of our prostate “dose painting” protocol, BioProp. The limitations of and uncertainties inherent in the radiobiological models are emphasized.

  14. Modification of radiobiological effects of 171 MeV protons by elements of physical protection

    Science.gov (United States)

    Bulinina, Taisia; Shurshakov, Vyacheslav; Ivanov, Alexander; Molokanov, Alexander

    2016-07-01

    Space radiation includes protons of various energies. Physical protection is effective in the case of low energy protons (50-100 MeV) and becomes insufficient for radiation with a high part of high-energy protons. In the experiment performed on outbred mice, the purpose of the study was to evaluate the radiobiological effect of 171 MeV protons and protons modified by elements of physical protection of the spacecraft, on a complex of indicators of the functional condition of the system hematopoiesis and the central nervous system in 24 hours after irradiation at 20 cGy dose. The spacecraft radiation protection elements used in the experiment were a construction of wet hygiene wipes called a «protective curtain», and a glass plate imitating an ISS window. Mass thickness of the " protective curtain" in terms of water equivalent was ̴ 6,2 g/cm2. Physical shielding along the path of 171 MeV protons increases their linear energy transfer leading to the absorbed dose elevation and strengthening of the radiobiological effect. In the experiment, the two types of shielding together raised the absorbed dose from 20 to 23.2 cGy. Chemically different materials (glass and water in the wipes) were found to exert unequal modifying effects on physical and biological parameters of the proton-irradiated mice. There was a distinct dose-dependent reduction of bone marrow cellularity within the dose range from 20 cGy to 23.2 cGy in 24 hours after exposure. No modifying effect of the radiation protection elements on spontaneous motor activity was discovered when compared with entrance protons. The group of animals protected by the glass plate exhibited normal orientative-trying reactions and weakened grip with the forelimbs. The effects observed in the experiment indicate the necessity to carry out comprehensive radiobiological researches (physical, biological and mathematical) in assessing the effects of physical protection, that are actual for ensuring radiation safety of crews in

  15. An eight-year clinic experience with clozapine use in a Parkinson's disease clinic setting.

    Directory of Open Access Journals (Sweden)

    Nawaz Hack

    Full Text Available BACKGROUND: To examine our eight year clinic-based experience in a Parkinson's disease expert clinical care center using clozapine as a treatment for refractory psychosis in Parkinson's disease (PD. METHODS: The study was a retrospective chart review which covered eight years of clozapine registry use. Statistical T-tests, chi-square, correlations and regression analysis were used to analyze treatment response for potential associations of age, disease duration, and Hoehn & Yahr (H&Y score, and degree of response to clozapine therapy. RESULTS: There were 36 participants included in the analysis (32 PD, 4 parkinsonism-plus. The characteristics included 30.6% female, age 45-87 years (mean 68.3±10.15, disease duration of 17-240 months (mean 108.14±51.13 and H&Y score of 2 to 4 (mean 2.51±0.51. The overall retention rate on clozapine was 41% and the most common reasons for discontinuation were frequent blood testing (28%, nursing home (NH placement (11% and leucopenia (8%. Responses to clozapine across the cohort were: complete (33%, partial (33%, absent (16%, and unknown (16%. Age (r = -0.36, p0.05. CONCLUSIONS: This single-center experience highlights the challenges associated with clozapine therapy in PD psychosis. Frequent blood testing remains a significant barrier for clozapine, even in patients with therapeutic benefit. Surprisingly, all patients admitted to a NH discontinued clozapine due to logistical issues of administration and monitoring within that setting. Consideration of the barriers to clozapine therapy will be important to its use and to its continued success in an outpatient setting.

  16. Treatment plan comparison between helical tomotherapy and MLC-based IMRT using radiobiological measures

    Science.gov (United States)

    Mavroidis, Panayiotis; Costa Ferreira, Brigida; Shi, Chengyu; Lind, Bengt K.; Papanikolaou, Nikos

    2007-07-01

    The rapid implementation of advanced treatment planning and delivery technologies for radiation therapy has brought new challenges in evaluating the most effective treatment modality. Intensity-modulated radiotherapy (IMRT) using multi-leaf collimators (MLC) and helical tomotherapy (HT) are becoming popular modes of treatment delivery and their application and effectiveness continues to be investigated. Presently, there are several treatment planning systems (TPS) that can generate and optimize IMRT plans based on user-defined objective functions for the internal target volume (ITV) and organs at risk (OAR). However, the radiobiological parameters of the different tumours and normal tissues are typically not taken into account during dose prescription and optimization of a treatment plan or during plan evaluation. The suitability of a treatment plan is typically decided based on dosimetric criteria such as dose-volume histograms (DVH), maximum, minimum, mean and standard deviation of the dose distribution. For a more comprehensive treatment plan evaluation, the biologically effective uniform dose ({\\bar{\\bar{D}}}) is applied together with the complication-free tumour control probability (P+). Its utilization is demonstrated using three clinical cases that were planned with two different forms of IMRT. In this study, three different cancer types at different anatomical sites were investigated: head and neck, lung and prostate cancers. For each cancer type, a linac MLC-based step-and-shoot IMRT plan and a HT plan were developed. The MLC-based IMRT treatment plans were developed on the Philips treatment-planning platform, using the Pinnacle 7.6 software release. For the tomotherapy HiArt plans, the dedicated tomotherapy treatment planning station was used, running version 2.1.2. By using {\\bar{\\bar{D}}} as the common prescription point of the treatment plans and plotting the tissue response probabilities versus {\\bar{\\bar{D}}} for a range of prescription doses

  17. Modeling detector response in solid-state systems for radiation therapy and radiobiology

    International Nuclear Information System (INIS)

    -filled proportional counters (TEPC) where it is anticipated that intercomparisons with experiment will help to validate the use of such codes for the microdosimetry predictions on the sub-cellular scale in radiobiological systems. Monte Carlo based microdosimetry calculations are also expected to assist in explaining LET dependencies found in many solid-state detector systems. (Author)

  18. Laser Ablation Of Atrial Fibrillation: Mid-term Clinical Experience

    Directory of Open Access Journals (Sweden)

    Li Poa, MD

    2009-08-01

    Full Text Available Background: Atrial Fibrillation is known to account for one third of all the strokes caused in the US in the population above the age of 70. Patients treated with the surgical Cox MAZE operation have been shown to have a 150 fold decrease in the incidence of stroke over an 18 year period. However, the original Cox MAZE although extremely successful in treating atrial fibrillation and decreasing the incidence of strokes was not performed widely because of complexity and invasiveness of the procedure. A variety of alternative energy based curative ablation strategies are now available for more minimally invasive therapeutic management of atrial fibrillation (AF. In this communication, we report our clinical experience in AF therapy utilizing laser energy ablation technology. Methods: Fifty two consecutive AF patients underwent concomitant or isolated ablation prior to any coexisting cardiac procedures that included CABG (coronary artery bypass surgery, MV (mitral valve or AV (aortic valve repairs. All patients had an epicardially based ablation pattern with basic lesions being en bloc box type pulmonary vein isolation which included the antral surface of the left atrium, directed ganglionectomies of the the right anterior and inferior ganglions, posteriomedial ablation of the IVC ( inferior vena cava, and a right isthmus ablation. Twenty seven patients had ligation of their left atrial appendage, 14 patients had resection of the ligament of Marshall, and three patients had endocardial placed lesions of a mitral annular connecting type lesion. In order to maintain the patients in normal sinus rhythm (NSR, electrical cardioversion and anti-arrhythmic drugs were employed as required. Results: At a median follow-up of 250 days, 44 of the total 52 patients (84.6% exhibited NSR.. No complications or mortality were reported due to the laser procedure. Conclusion: Laser ablation was successfully and safely used for endocardial and epicardial AF ablation

  19. Hypo-fractionated treatment in radiotherapy: radio-biological models Tcp and NTCP

    International Nuclear Information System (INIS)

    At the present time the breast cancer in Mexico has the first place of incidence of the malignant neoplasia s in the women, and represents 11.34% of all the cancer cases. On the other hand, the treatments for cancer by means of ionizing radiations have been dominated under the approaches of the medical radio-oncologists which have been based on test and error by many years. The radio-biological models, as the Tcp, NTCP and dosimetric variables, for their clinical application in the conventional radiotherapy with hypo-fractionation have as purpose predicting personalized treatment plans that they present most probability of tumor control and minor probability of late reactions, becoming this way support tools in the decisions taking for the patient treatments planning of Medical Physicists and Radio-oncologists. (Author)

  20. SU-E-T-399: Determination of the Radiobiological Parameters That Describe the Dose-Response Relations of Xerostomia and Disgeusia From Head and Neck Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To estimate the radiobiological parameters that describe the doseresponse relations of xerostomia and disgeusia from head and neck cancer radiotherapy. To identify the organs that are best correlated with the manifestation of those clinical endpoints. Finally, to evaluate the goodnessof- fit by comparing the model predictions against the actual clinical results. Methods: In this study, 349 head and neck cancer patients were included. For each patient the dose volume histograms (DVH) of parotids (separate and combined), mandible, submandibular glands (separate and combined) and salivary glands were calculated. The follow-up of those patients was recorded at different times after the completion of the treatment (7 weeks, 3, 7, 12, 18 and 24 months). Acute and late xerostomia and acute disgeusia were the clinical endpoints examined. A maximum likelihood fitting was performed to calculate the best estimates of the parameters used by the relative seriality model. The statistical methods of the error distribution, the receiver operating characteristic (ROC) curve, the Pearson's test and the Akaike's information criterion were utilized to assess the goodness-of-fit and the agreement between the pattern of the radiobiological predictions with that of the clinical records. Results: The estimated values of the radiobiological parameters of salivary glands are D50 = 25.2 Gy, γ = 0.52, s = 0.001. The statistical analysis confirmed the clinical validity of those parameters (area under the ROC curve = 0.65 and AIC = 38.3). Conclusion: The analysis proved that the treatment outcome pattern of the patient material can be reproduced by the relative seriality model and the estimated radiobiological parameters. Salivary glands were found to have strong volume dependence (low relative seriality). Diminishing the biologically effective uniform dose to salivary glands below 30 Gy may significantly reduce the risk of complications to the patients irradiated for

  1. SU-E-T-399: Determination of the Radiobiological Parameters That Describe the Dose-Response Relations of Xerostomia and Disgeusia From Head and Neck Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Mavroidis, P; Stathakis, S; Papanikolaou, N [University of Texas Health Science Center, UTHSCSA, San Antonio, TX (United States); Peixoto Xavier, C [University of Coimbra, Coimbra, Coimbra (Portugal); Costa Ferreira, B [University of Aveiro, Coimbra, Coimbra (Portugal); Khouri, L; Carmo Lopes, M do [IPOCFG, EPE, Coimbra, Coimbra (Portugal)

    2014-06-01

    Purpose: To estimate the radiobiological parameters that describe the doseresponse relations of xerostomia and disgeusia from head and neck cancer radiotherapy. To identify the organs that are best correlated with the manifestation of those clinical endpoints. Finally, to evaluate the goodnessof- fit by comparing the model predictions against the actual clinical results. Methods: In this study, 349 head and neck cancer patients were included. For each patient the dose volume histograms (DVH) of parotids (separate and combined), mandible, submandibular glands (separate and combined) and salivary glands were calculated. The follow-up of those patients was recorded at different times after the completion of the treatment (7 weeks, 3, 7, 12, 18 and 24 months). Acute and late xerostomia and acute disgeusia were the clinical endpoints examined. A maximum likelihood fitting was performed to calculate the best estimates of the parameters used by the relative seriality model. The statistical methods of the error distribution, the receiver operating characteristic (ROC) curve, the Pearson's test and the Akaike's information criterion were utilized to assess the goodness-of-fit and the agreement between the pattern of the radiobiological predictions with that of the clinical records. Results: The estimated values of the radiobiological parameters of salivary glands are D50 = 25.2 Gy, γ = 0.52, s = 0.001. The statistical analysis confirmed the clinical validity of those parameters (area under the ROC curve = 0.65 and AIC = 38.3). Conclusion: The analysis proved that the treatment outcome pattern of the patient material can be reproduced by the relative seriality model and the estimated radiobiological parameters. Salivary glands were found to have strong volume dependence (low relative seriality). Diminishing the biologically effective uniform dose to salivary glands below 30 Gy may significantly reduce the risk of complications to the patients irradiated for

  2. Mobile communication. Radiobiology problems and danger evaluation

    International Nuclear Information System (INIS)

    The actual problem of the effect of mobile radio communication on the healths of cellular telephone users is discussed. Dosimetric data of the specific absorbed rate of electromagnetic field in a human head during cellular telephone using. Results of physiological, biochemical, clinical and physiological investigations of the effect of electromagnetic field of cellular telephones on the health stable of volunteers are analyzed. It is found out that MPL of power density for the user of cellular telephone is equal to 100 μW/cm2

  3. Radiobiology of the acute radiation syndrome

    International Nuclear Information System (INIS)

    Acute radiation syndrome or acute radiation sickness is classically subdivided into three sub syndromes: the hematopoietic, gastrointestinal and neurovascular syndrome but many other tissues can be damaged. The time course and severity of clinical signs and symptoms are a function of the overall body volume irradiated, the inhomogeneity of dose exposure, the particle type, the absorbed dose and the dose rate. Classical pathophysiology explain the failure of each of these organs and the timing of appearance of their signs and symptoms due to radiation-induced cytocidal effects of a great number of parenchymal cells of hierarchically organized tissues. Contemporaneously, many other radiation-induced effects has been described and all of them may lead to tissue injury with their corresponding signs and symptoms that can be expressed after short or long period of time. Radiation-induced multi-organ involvement is thought to be due to radiation-induced systemic inflammatory response mediated by released pro-inflammatory cytokines. (authors)

  4. TREATMENT OF HYPERTENSION IN PREGNANCY: GUIDELINES AND CLINICAL EXPERIENCE

    Directory of Open Access Journals (Sweden)

    O. V. Gaisenok

    2015-09-01

    Full Text Available Topical issues of the treatment of hypertension in pregnancy are presented. Examples from clinical practice are discussed as well as possible medical treatment of hypertension in pregnant women taking into account actual recommendations.

  5. Photoacoustic Imaging in Oncology: Translational Preclinical and Early Clinical Experience.

    Science.gov (United States)

    Valluru, Keerthi S; Wilson, Katheryne E; Willmann, Jürgen K

    2016-08-01

    Photoacoustic imaging has evolved into a clinically translatable platform with the potential to complement existing imaging techniques for the management of cancer, including detection, characterization, prognosis, and treatment monitoring. In photoacoustic imaging, tissue is optically excited to produce ultrasonographic images that represent a spatial map of optical absorption of endogenous constituents such as hemoglobin, fat, melanin, and water or exogenous contrast agents such as dyes and nanoparticles. It can therefore provide functional and molecular information that allows noninvasive soft-tissue characterization. Photoacoustic imaging has matured over the years and is currently being translated into the clinic with various clinical studies underway. In this review, the current state of photoacoustic imaging is presented, including techniques and instrumentation, followed by a discussion of potential clinical applications of this technique for the detection and management of cancer. (©) RSNA, 2016. PMID:27429141

  6. Developing a leadership pipeline: the Cleveland Clinic experience

    OpenAIRE

    Hess, Caryl A.; Barss, Christina; Stoller, James K

    2014-01-01

    The complexity of health care requires excellent leadership to address the challenges of access, quality, and cost of care. Because competencies to lead differ from clinical or research skills, there is a compelling need to develop leaders and create a talent pipeline, perhaps especially in physician-led organizations like Cleveland Clinic. In this context, we previously reported on a cohort-based physician leadership development course called Leading in Health Care and, in the current report...

  7. Radiobiological studies with the nematode Caenorhabditis elegans. Genetic and developmental effects of high LET radiation

    Science.gov (United States)

    Nelson, G. A.; Schubert, W. W.; Marshall, T. M.

    1992-01-01

    The biological effects of heavy charged particle (HZE) radiation are of particular interest to travellers and planners for long-duration space flights where exposure levels represent a potential health hazard. The unique feature of HZE radiation is the structured pattern of its energy deposition in targets. There are many consequences of this feature to biological endpoints when compared with effects of ionizing photons. Dose vs response and dose-rate kinetics may be modified, DNA and cellular repair systems may be altered in their abilities to cope with damage, and the qualitative features of damage may be unique for different ions. The nematode Caenorhabditis elegans is being used to address these and related questions associated with exposure to radiation. HZE-induced mutation, chromosome aberration, cell inactivation and altered organogenesis are discussed along with plans for radiobiological experiments in space.

  8. Radiobiological studies with the nematode Caenorhabditis elegans. Genetic and developmental effects of high LET radiation

    International Nuclear Information System (INIS)

    The biological effects of heavy charged particle (HZE) radiation are of particular interest to travellers and planners for long-duration space flights where exposure levels represents a potential health hazard. The unique feature of HZE radiation is the structured pattern of its energy deposition in targets. There are many consequences of this feature to biological endpoints when compared with effects of ionizing photons. Dose vs response and dose-rate kinetics may be modified, DNA and cellular repair systems may be altered in their abilities to cope with damage, and the qualitative features of damage may be unique for different ions. The nematode Caenorhabditis elegans is being used to address these and related questions associated with exposure to radiation. HZE-induced mutation, chromosome aberration, cell inactivation and altered organogenesis are discussed along with plans for radiobiological experiments in space. (author)

  9. Heavy charged particle radiobiology: using enhanced biological effectiveness and improved beam focusing to advance cancer therapy.

    Science.gov (United States)

    Allen, Christopher; Borak, Thomas B; Tsujii, Hirohiko; Nickoloff, Jac A

    2011-06-01

    Ionizing radiation causes many types of DNA damage, including base damage and single- and double-strand breaks. Photons, including X-rays and γ-rays, are the most widely used type of ionizing radiation in radiobiology experiments, and in radiation cancer therapy. Charged particles, including protons and carbon ions, are seeing increased use as an alternative therapeutic modality. Although the facilities needed to produce high energy charged particle beams are more costly than photon facilities, particle therapy has shown improved cancer survival rates, reflecting more highly focused dose distributions and more severe DNA damage to tumor cells. Despite early successes of charged particle radiotherapy, there is room for further improvement, and much remains to be learned about normal and cancer cell responses to charged particle radiation. PMID:21376738

  10. Childhood victimisation and developmental expression of non-clinical delusional ideation and hallucinatory experiences: victimisation and non-clinical psychotic experiences

    OpenAIRE

    Lataster, Tineke; van Os, Jim; Drukker, Marjan; Henquet, Cécile; Feron, Frans; Gunther, Nicole; Myin-Germeys, Inez

    2006-01-01

    Victimisation in childhood may be associated with adult psychosis. The current study examined this association in the crucial developmental period of early adolescence and investigated whether (1) unwanted sexual experiences, and (2) being bullied, were associated with non-clinical delusional ideation and hallucinatory experiences in a general population sample of 14 year olds.

  11. Radiobiological speculations on therapeutic total body irradiation

    International Nuclear Information System (INIS)

    Unexpected total body irradiation (TBI) of human beings, involved in nuclear warfare or in accidents in nuclear reactors can be lethal. In the 1950s, bone marrow transplantation was discovered as a potentially life saving procedure after TBI in the dose range of 5.0 to 12.0 Gy. Since that time, deliberate or therapeutic TBI has been used to condition patients with a lethal bone marrow disorder for bone marrow replacement. The therapeutic ratio of TBI followed by bone marrow transplantation is small. Many potentially lethal complications can occur, such as acute TBI side effects, late TBI side effects or immunological complications of bone marrow transplantation such as graft versus host disease or graft rejection. The benefits of TBI and bone marrow transplantation are that they offer a chance for cure of previously lethal bone marrow disorders. The optimal parameters for TBI remain to be defined. The review discusses the current clinical and experimental animal data, as they relate to the future definition of less toxic TBI procedures with a better therapeutic ratio. Different TBI procedures are required for patients with malignant vs. non-malignant disorders or for patients with histoincompatible vs. histocompatible bone marrow donors.77 references

  12. How to Conduct Clinical Qualitative Research on the Patient's Experience

    Science.gov (United States)

    Chenail, Ronald J.

    2011-01-01

    From a perspective of patient-centered healthcare, exploring patients' (a) preconceptions, (b) treatment experiences, (c) quality of life, (d) satisfaction, (e) illness understandings, and (f) design are all critical components in improving primary health care and research. Utilizing qualitative approaches to discover patients' experiences can…

  13. An Enzymatic Clinical Chemistry Laboratory Experiment Incorporating an Introduction to Mathematical Method Comparison Techniques

    Science.gov (United States)

    Duxbury, Mark

    2004-01-01

    An enzymatic laboratory experiment based on the analysis of serum is described that is suitable for students of clinical chemistry. The experiment incorporates an introduction to mathematical method-comparison techniques in which three different clinical glucose analysis methods are compared using linear regression and Bland-Altman difference…

  14. Review of clinical experience with ion beam radiotherapy

    OpenAIRE

    Jensen, A D; Münter, M W; Debus, J.

    2011-01-01

    The article describes both the early development of oncology as a core discipline at the University of Heidelberg Hospital and the first steps towards ion beam treatment, from the pilot project carried out in co-operation with the Gesellschaft für Schwerionenforschung Darmstadt to the initial start-up of clinical service at the Heidelberg Heavy Ion Centre (HIT). We present an overview, based on data published in the literature, of the available clinical evidence relating the use of ion beam t...

  15. VI Congress on radiation research (radiobiology, radioecology, radiation safety). Abstracts. Volume 2 (sections VIII-XIV)

    International Nuclear Information System (INIS)

    The collection contains abstracts at the VI Congress on radiation research, in which program is included various aspects of ionizing and non-ionizing radiations on living organisms, problems of radioecology and radiation safety of humans and the environment. The Congress is dedicated to the 25th anniversary of the Chernobyl accident . Several reports have summarized the 25-year study of the effects of the accident, formulated forecasts and the main directions of further research. The second volume includes reports in sections : radioecology, combined effect of radiation and other environmental factors, agricultural radioecology, radiobiology of heavy ions, theoretical problems of radiobiology, systematic radiobiology. Radiobiology of non-ionizing radiation, biological effects, electromagnetic safety and regulation, radiobiological and radioecological education are discussed

  16. Differences in Clinical Experiences of ADN and BSN Students.

    Science.gov (United States)

    Oermann, Marilyn H.

    1998-01-01

    In a study of 211 associate degree (AD) and 204 baccalaureate nursing students, AD students reported significantly higher stress in clinical practice. Stress for both groups increased as they progressed. Instructors were the predominant source of stress. Students had the most difficulty coping with the demands of patient care and the clinical…

  17. Clinical Experience in TCM Treatment of Chronic Cervicitis

    Institute of Scientific and Technical Information of China (English)

    周宜强; 范宏宇

    2002-01-01

    @@ Chronic cervicitis is a common disease in the female reproductive system, which may be the inducing factor for carcinoma of uterine cervix. It is clinically manifested by sticky and foul leukorrhagia, contact hemorrhage, pain in the lower limbs or lumbosacral region, dysmenorrhea and infertility.

  18. Managing University Clinical Partnership: Learning from International Experience

    Science.gov (United States)

    Davies, Stephen; Smith, Tom

    2004-01-01

    Dialogue between the leaders of academic clinical organisations in different countries has revealed that the core elements of the partnership between universities and health care systems are remarkably consistent across national boundaries. There is now an impetus to move beyond analysis of common challenges and towards strategies for success that…

  19. Dr. Lin Zhu's Clinical Experience in Treating Mental Disorders

    Institute of Scientific and Technical Information of China (English)

    Ma Xueqing; Wang Xinzhong

    2005-01-01

    @@ Mental disorders are mainly caused by the emotional factors. Chief physician Lin Zhu, a famous TCM doctor in Beijing, is very good at treating this kind of disorders. The following is a summary of Prof. Lin's experience in this aspect.

  20. Improving biological relevancy of transcriptional biomarkers experiments by applying the MIQE guidelines to pre-clinical and clinical trials.

    Science.gov (United States)

    Dooms, M; Chango, A; Barbour, E; Pouillart, P; Abdel Nour, A M

    2013-01-01

    The "Minimum Information for the Publication of qPCR Experiments" (MIQE [3]) guidelines are very much targeted at basic research experiments and have to our knowledge not been applied to qPCR assays carried out in the context of clinical trials. This report details the use of the MIQE qPCR app for iPhone (App Store, Apple) to assess the MIQE compliance of one clinical and five pre-clinical trials. This resulted in the need to include 14 modifications that make the guidelines more relevant for the assessment of this special type of application. We also discuss the need for flexibility, since while some parameters increase experimental quality, they also require more reagents and more time, which is not always feasible in a clinical setting. PMID:22910527

  1. Juvenile nasopharyngeal angiofibroma: Clinical diagnosis and treatment experience

    Directory of Open Access Journals (Sweden)

    Sladoje Radmila

    2002-01-01

    Full Text Available Juvenile nasopharyngeal angiofibroma is an infrequent epi-pharyngeal tumor necessitating particular diagnostic and therapeutic procedures in comparison to other benign epipharyngeal tumors due to its expansive growth tendency. Our retrospective study is aimed at presenting clinical casuistry of the tumor in order to evaluate modern diagnostic and therapeutic possibilities. The study included 13 male patients, aged 13-24 years, who were hospitalized, diagnostically assessed and surgically treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia over the period 1990 - June 2001. The following parameters were analyzed: sex, age groups, preoperative symptoms of the disease, diagnostic methods, embolization, local tumor spreading, number and time of tumor relapses and surgical approach.

  2. Clinical use of Insulin Degludec: Practical Experience and Pragmatic Suggestions

    OpenAIRE

    Sanjay Kalra; Yashdeep Gupta

    2015-01-01

    Insulin degludec (IDeg) is an ultralong acting basal insulin. IDeg has unique pharmacokinetic and pharmacodynamic properties which allow once a daily dosage, at any time of the day. Its use is associated with a significantly lower risk of hypoglycemia. This review discusses the pragmatic use of IDeg, based on available evidence. A complete search of all nine original research papers (BEGIN® clinical trial program) pertaining to IDeg, listed in PubMed, was made to prepare this article.

  3. Experiences with cerebrospinal fluid analysis in Dutch memory clinics

    OpenAIRE

    Spies, P.E.; Slats, D.; Ramakers, I.; Verhey, F.R.J.; Olde Rikkert, M.G.M.

    2011-01-01

    BACKGROUND: Evidence on cerebrospinal fluid (CSF) analysis to demonstrate Alzheimer's disease has not yet been implemented in diagnostic guidelines. METHODS: We investigated the use of CSF analysis in a survey amongst all known memory clinics in the Netherlands, of which 85 of 113 (75.2%) responded. RESULTS: Sixty per cent of respondents used CSF analysis in 5% (median) of patients. The analysis almost always confirmed the working diagnosis in 68.4% and sometimes changed it in 28.2%. Complica...

  4. Clinical course of ectopic pregnancy: A single-center experience

    OpenAIRE

    Aqueela Ayaz; Sameh Emam; Mian Usman Farooq

    2013-01-01

    OBJECTIVES: The objective was to highlight the frequency, clinical profile, and predisposing factors of ectopic pregnancy (EP) in a general hospital. MATERIALS AND METHODS: This descriptive study was conducted at the Obstetrics and Gynaecology department of Hera General hospital, Makkah, Saudi Arabia, from July 1, 2009 to December 29, 2010. Data were collected on chief medical complaints, sociodemographic characteristics, past obstetrics and gynecological history, management done, and outcome...

  5. Clinical experience with a PACS module in pediatric radiology

    International Nuclear Information System (INIS)

    This paper describes a PACS module for pediatric radiology that has thus far been used to conduct daily X-ray rounds as well as for fast patient reviews during all hours of the day. The clinical operation of this system including patient registration, image acquisition, image management, and patient case reviews is presented. A PACS system operator is responsible for the daily maintenance of the system. These responsibilities are outlined

  6. The First Experience of Clinical Practice on Psychology Students’ Imaginary

    OpenAIRE

    Sueli Regina Gallo-Belluzzo; Elisa Corbett; Tania Maria Jose Aiello-Vaisberg

    2013-01-01

    Considering the academic development of the psychologist as a complex process which articulates the transmission of scientific knowledge and changes in imaginative activity, we psychoanalytically investigate the collective imaginary of Psychology students regarding the first clinical consultation. We conducted a group interview with 52 undergraduate students, using the Thematic Story-Drawing Procedure as a way to open a dialogical field. The material obtained, through the psychoanalytical met...

  7. Targeted Therapies for Lung Cancer: Clinical Experience and Novel Agents

    OpenAIRE

    Larsen, Jill E.; Cascone, Tina; Gerber, David E.; Heymach, John V; Minna, John D.

    2011-01-01

    Although lung cancer remains the leading cancer killer in the United States, recently a number of developments indicate future clinical benefit. These include evidence that computed tomography–based screening decreases lung cancer mortality, the use of stereotactic radiation for early-stage tumors, the development of molecular methods to predict chemotherapy sensitivity, and genome-wide expression and mutation analysis data that have uncovered oncogene “addictions” as important therapeutic ta...

  8. Chest wall tuberculosis - A clinical and imaging experience

    International Nuclear Information System (INIS)

    Tuberculous infection of the thoracic cage is rare and is difficult to discern clinically or on radiographs. This study aims to describe the common sites and the imaging appearances of chest wall tuberculosis. A retrospective review of the clinical and imaging records of 12 confirmed cases of thoracic cage tuberculosis (excluding that of the spine), seen over the last 7 years, was performed. Imaging studies available included radiographs, ultrasonographies (USGs), and computed tomography (CT) scans. Pathological confirmation was obtained in all cases. All patients had clinical signs and symptoms localized to the site of involvement, whether it was the sternum, sternoclavicular joints, or ribs. CT scan revealed sternal destruction in three patients and osteolytic lesions with sclerosis of the articular surfaces of the sternoclavicular joints in two patients. In five patients with rib lesions, USG elegantly demonstrated the bone destruction underlying the cold abscess. All cases were confirmed to be of tuberculous origin by pathology studies of the aspirated/curetted material, obtained by CT / USG guidance. Tuberculous etiology should be considered for patients presenting with atypical sites of skeletal inflammation. CT scan plays an important role in the evaluation of these patients. However, the use of USG for demonstrating rib destruction in a chest wall cold abscess has so far been under-emphasized, as has been the role of CT and USG guided aspiration in confirming the aetiology

  9. Knowledge Management: Experiences in Academic and Clinic Environments

    Directory of Open Access Journals (Sweden)

    Martha Torres Narváez

    2014-05-01

    Full Text Available This article describes the knowledge management practices derived from clinical research, and some hospitals and academic institutions in Colombia. The profile of these institutions and the variables involved in knowledge management and research are presented. Objective: Exploring the practices that some Colombian institutions have to build or strengthen their capacity to con-duct clinical research. Materials and methods: We conducted an exploratory study by consulting a convenience sample, the use of specific practices in knowledge management. In a documentary analysis on knowledge management. The information was obtained of primary sources by semi-structured interview applied to selected key players. Results: In the institutions that participated in the study, it was observed as determinants in knowledge management: structure and strategic management, intellectual capital, technological resources, and the continuity and sustainability of the processes. Conclusion: Include research processes in services delivery institutions is criti¬cal to improving the quality of health care and encourage their intellectual capital. Colombia has institutions working with determination to the generation of knowledge from clinical practice.

  10. A radiobiological review on melatonin. A novel radioprotector

    International Nuclear Information System (INIS)

    Complete text of publication follows. For the sake of improvement in radiation therapy, radiobiology plays a crucial role through explaining observed phenomena, and suggesting improvements to existing therapies. Due to the damaging effects of ionizing radiation, radiobiologists have long been interested in identifying novel, nontoxic, effective, and convenient compounds to protect humans against radiation induced normal tissue injuries. Melatonin (N-acetyl-5-methoxytryptamine), the chief secretory product of the pineal gland in the brain, has been documented to ameliorate the oxidative injuries due to ionizing radiation. This article reviews different features that make melatonin a potentially useful radioprotector. Moreover, based on radiobiological models we hypothesize that melatonin may postpone the saturation of repair enzymes which leads to repairing more induced damage by repair system and more importantly allows the use of higher doses of radiation during radiotherapy to get a better therapeutic ratio. The implications of the accumulated observations suggest by virtue of melatonin's radioprotective and anticancer effects; it is time to use it as a radioprotector both for radiation workers and patients suffering from cancer either alone for cancer inhibition or in combination with traditional radiotherapy for getting a favorable efficacy/toxicity ratio during the treatment. Although compelling evidence suggests that melatonin may be effective for a variety of disorders, the optimum dose of melatonin for human radioprotection is yet to be determined by further research. We propose that, in the future melatonin improve therapeutic ratio in radiation oncology.

  11. Some applications of radiation chemistry to biochemistry and radiobiology

    International Nuclear Information System (INIS)

    In this chapter illustrate the use of radiation chemistry as a tool in investigating biologically important radical reactions, and also outline some studies of models for radiobiological damage. Because aqueous solutions usually offer the most important matrix, an appreciation of the main features of water radiolysis will be essential. Most of the illustrations involve pulse radiolysis, and some familiarity with chemical kinetics is assumed. In addition to these and other chapters in this book, readers find the proceedings of a recent NATO Advanced Study Institute most useful. The authors shall not try to review here all the applications of radiation chemistry to biochemistry and biology, but they will illustrate, using selected examples, the main principles and practical advantages and problems. Another recent volume covers the main contributions of flash photolysis and pulse radiolysis to the chemistry of biology and medicine, complementing earlier reviews. Papers from symposia on radical processes in radiobiology and carcinogenesis, and on super-oxide dismutases, and proceedings of recent international congresses of radiation research, together with the other publications referred to above will enable the reader to gain a comprehensive overview of the role of radicals in biological processes and the contributions of radiation chemistry

  12. Influence of oxygen on the chemical stage of radiobiological mechanism

    Science.gov (United States)

    Barilla, Jiří; Lokajíček, Miloš V.; Pisaková, Hana; Simr, Pavel

    2016-07-01

    The simulation of the chemical stage of radiobiological mechanism may be very helpful in studying the radiobiological effect of ionizing radiation when the water radical clusters formed by the densely ionizing ends of primary or secondary charged particle may form DSBs damaging DNA molecules in living cells. It is possible to study not only the efficiency of individual radicals but also the influence of other species or radiomodifiers (mainly oxygen) being present in water medium during irradiation. The mathematical model based on Continuous Petri nets (proposed by us recently) will be described. It makes it possible to analyze two main processes running at the same time: chemical radical reactions and the diffusion of radical clusters formed during energy transfer. One may study the time change of radical concentrations due to the chemical reactions running during diffusion process. Some orientation results concerning the efficiency of individual radicals in DSB formation (in the case of Co60 radiation) will be presented; the influence of oxygen present in water medium during irradiation will be shown, too.

  13. A Comparison of a Traditional Clinical Experience to a Precepted Clinical Experience for Baccalaureate-Seeking Nursing Students in Their Second Semester

    OpenAIRE

    Linda Dune; Renae Schumann; Kristin Ownby; David Kohne

    2012-01-01

    The shortage of nursing faculty has contributed greatly to the nursing workforce shortage, with many schools turning away qualified applicants because there are not enough faculty to teach. Despite the faculty shortage, schools are required to admit more students to alleviate the nursing shortage. Clinical groups in which preceptors are responsible for student learning extend faculty resources. Purpose. To determine the effectiveness of an alternative clinical experience (preceptorship). Meth...

  14. Radiobiologic comparison of helical tomotherapy, intensity modulated radiotherapy, and conformal radiotherapy in treating lung cancer accounting for secondary malignancy risks

    International Nuclear Information System (INIS)

    The aim of the present study is to examine the importance of using measures to predict the risk of inducing secondary malignancies in association with the clinical effectiveness of treatment plans in terms of tumor control and normal tissue complication probabilities. This is achieved by using radiobiologic parameters and measures, which may provide a closer association between clinical outcome and treatment delivery. Overall, 4 patients having been treated for lung cancer were examined. For each of them, 3 treatment plans were developed based on the helical tomotherapy (HT), multileaf collimator-based intensity modulated radiation therapy (IMRT), and 3-dimensional conformal radiation therapy (CRT) modalities. The different plans were evaluated using the complication-free tumor control probability (p+), the overall probability of injury (pI), the overall probability of control/benefit (pB), and the biologically effective uniform dose (D¯¯). These radiobiologic measures were used to develop dose-response curves (p-D¯¯ diagram), which can help to evaluate different treatment plans when used in conjunction with standard dosimetric criteria. The risks for secondary malignancies in the heart and the contralateral lung were calculated for the 3 radiation modalities based on the corresponding dose-volume histograms (DVHs) of each patient. Regarding the overall evaluation of the different radiation modalities based on the p+ index, the average values of the HT, IMRT, and CRT are 67.3%, 61.2%, and 68.2%, respectively. The corresponding average values of pB are 75.6%, 70.5%, and 71.0%, respectively, whereas the average values of pI are 8.3%, 9.3%, and 2.8%, respectively. Among the organs at risk (OARs), lungs show the highest probabilities for complications, which are 7.1%, 8.0%, and 1.3% for the HT, IMRT, and CRT modalities, respectively. Similarly, the biologically effective prescription doses (DB¯¯) for the HT, IMRT, and CRT modalities are 64.0, 60.9, and 60.8 Gy

  15. Radiobiologic comparison of helical tomotherapy, intensity modulated radiotherapy, and conformal radiotherapy in treating lung cancer accounting for secondary malignancy risks

    Energy Technology Data Exchange (ETDEWEB)

    Komisopoulos, Georgios [Department of Medical Physics, Medical School, University of Patras, Patras (Greece); Mavroidis, Panayiotis, E-mail: mavroidis@uthscsa.edu [Department of Radiation Oncology, University of Texas Health Sciences Center at San Antonio, San Antonio, TX (United States); Department of Medical Radiation Physics, Karolinska Institutet and Stockholm University, Stockholm (Sweden); Rodriguez, Salvador; Stathakis, Sotirios; Papanikolaou, Nikos [Department of Radiation Oncology, University of Texas Health Sciences Center at San Antonio, San Antonio, TX (United States); Nikiforidis, Georgios C.; Sakellaropoulos, Georgios C. [Department of Medical Physics, Medical School, University of Patras, Patras (Greece)

    2014-01-01

    The aim of the present study is to examine the importance of using measures to predict the risk of inducing secondary malignancies in association with the clinical effectiveness of treatment plans in terms of tumor control and normal tissue complication probabilities. This is achieved by using radiobiologic parameters and measures, which may provide a closer association between clinical outcome and treatment delivery. Overall, 4 patients having been treated for lung cancer were examined. For each of them, 3 treatment plans were developed based on the helical tomotherapy (HT), multileaf collimator-based intensity modulated radiation therapy (IMRT), and 3-dimensional conformal radiation therapy (CRT) modalities. The different plans were evaluated using the complication-free tumor control probability (p{sub +}), the overall probability of injury (p{sub I}), the overall probability of control/benefit (p{sub B}), and the biologically effective uniform dose (D{sup ¯¯}). These radiobiologic measures were used to develop dose-response curves (p-D{sup ¯¯} diagram), which can help to evaluate different treatment plans when used in conjunction with standard dosimetric criteria. The risks for secondary malignancies in the heart and the contralateral lung were calculated for the 3 radiation modalities based on the corresponding dose-volume histograms (DVHs) of each patient. Regarding the overall evaluation of the different radiation modalities based on the p{sub +} index, the average values of the HT, IMRT, and CRT are 67.3%, 61.2%, and 68.2%, respectively. The corresponding average values of p{sub B} are 75.6%, 70.5%, and 71.0%, respectively, whereas the average values of p{sub I} are 8.3%, 9.3%, and 2.8%, respectively. Among the organs at risk (OARs), lungs show the highest probabilities for complications, which are 7.1%, 8.0%, and 1.3% for the HT, IMRT, and CRT modalities, respectively. Similarly, the biologically effective prescription doses (D{sub B}{sup ¯¯}) for the

  16. Suicide Loss Survivors' Experiences with Therapy: Implications for Clinical Practice.

    Science.gov (United States)

    Sanford, Rebecca; Cerel, Julie; McGann, Vanessa; Maple, Myfanwy

    2016-07-01

    Over two-thirds of suicide loss survivors, those who have lost a loved one to suicide, seek individual therapy following their loss. However, nothing is known about what survivors find helpful about therapy or how therapy impacts their grief. An online survey was conducted June 2012-March 2013 with a convenience sample of 197 survivors primarily from the USA and Australia to develop a better understanding of treatment seeking loss survivors and their experiences in therapy. Questions explored the experience of the suicide death, the therapy received after the loss, and insights about improving therapy for loss survivors. Participants were generally positive about their therapy experiences. However, respondents endorsed symptoms of PTSD, though many did not report a formal diagnosis from a provider, suggesting a discrepancy that could lead to inadequate treatment of symptoms. The findings provide an understanding of treatment seeking loss survivors, along with implications for therapists treating this population. PMID:27074845

  17. Medical students' emotional development in early clinical experience: a model.

    Science.gov (United States)

    Helmich, Esther; Bolhuis, Sanneke; Laan, Roland; Dornan, Tim; Koopmans, Raymond

    2014-08-01

    Dealing with emotions is a critical feature of professional behaviour. There are no comprehensive theoretical models, however, explaining how medical students learn about emotions. We aimed to explore factors affecting their emotions and how they learn to deal with emotions in themselves and others. During a first-year nursing attachment in hospitals and nursing homes, students wrote daily about their most impressive experiences, explicitly reporting what they felt, thought, and did. In a subsequent interview, they discussed those experiences in greater detail. Following a grounded theory approach, we conducted a constant comparative analysis, collecting and then interpreting data, and allowing the interpretation to inform subsequent data collection. Impressive experiences set up tensions, which gave rise to strong emotions. We identified four 'axes' along which tensions were experienced: 'idealism versus reality', 'critical distance versus adaptation', 'involvement versus detachment' and 'feeling versus displaying'. We found many factors, which influenced how respondents relieved those tensions. Their personal attributes and social relationships both inside and outside the medical community were important ones. Respondents' positions along the different dimensions, as determined by the balance between attributes and tensions, shaped their learning outcomes. Medical students' emotional development occurs through active participation in medical practice and having impressive experiences within relationships with patients and others on wards. Tensions along four dimensions give rise to strong emotions. Gaining insight into the many conditions that influence students' learning about emotions might support educators and supervisors in fostering medical students' emotional and professional development. PMID:23949724

  18. Pathophysiology, clinical manifestation and management of angioedema - our experience

    Directory of Open Access Journals (Sweden)

    Aleksić Aleksandra

    2015-01-01

    Full Text Available Introduction. Angioedema is characterized by subcutaneous and/or submucosal swelling usually localized to the lips, eyelids, tongue, oral cavity, larynx and pharynx. Various types of angioedema, caused by different pathophysiologic mechanisms, can have the same or very similar clinical picture and require different diagnostic and therapeutic procedures. The immediate threat to life as a result of rapidly developed edema of the pharynx and larynx with airway obstruction requires endotracheal intubation or emergency tracheotomy. Standard therapy, which includes epinephrine, second-generation antihistamines and steroids, is not effective in the treatment of all types of angioedema. Objective. On the basis of the clinical presentation and course of angioedema, this retrospective study was aimed at contributing to a better understanding of the etiopathogenesis of the disease and at helping determine the most effective available treatment modalities. Methods. This retrospective study included patients treated under the diagnosis of angioedema of the upper aerodigestive tract between 2000 and 2012 in the Department of Otorhinolaryngology, Clinical Center of Banja Luka. Results. A total of 76 subjects were included in the study. The average age was 62.8 years. There were 40 (52.6% male and 36 (47.4% female patients. The largest number of patients (44.7% had type II angioedema. Almost half of the patients or 36 patients (47.4% were on treatment with an angiotensinconverting enzyme inhibitor (ACEi, but there was no statistically significant difference under the total number of patients (p=0.678. Conclusion. Better understanding of pathophysiologic mechanisms and the adoption of diagnostic protocols contributes to more effective treatment of angioedema.

  19. Clinical spectrum of hypopituitarism in India: A single center experience

    Directory of Open Access Journals (Sweden)

    Abhay Gundgurthi

    2012-01-01

    Full Text Available Objectives: There is paucity of information regarding clinical profile of hypopituitarism from India. We report the clinical profile of hypopituitarism from a tertiary center in North India. Materials and Methods: This study was carried out in patients attending our endocrine center between January 2010 and December 2011. All new patients were studied prospectively and those registered before January 2010 retrospectively. Relevant clinical, hormonal, and imaging data were collected. Dynamic testing for pituitary functions was carried out as necessary. Hormonal deficiencies were defined as per prevailing recommendations. Results: This study included 113 subjects. The mean age was 38.6 ± 17.8 years (range, 4 - 76 years. There were 78 (69% males and 35 females (31%. There were 22 subjects aged ≤18 years (childhood and adolescence and 91 adults (>18 years. Visual disturbances were the most common presenting complaint (33%, though headache was the most common symptom (81%. Fifteen percent presented with pituitary apoplexy. Tumors comprised of 84% of cases. Hypogonadism (97% was the most common abnormality seen followed by hypothyroidism (83.2%, hypoadrenalism (79.6%, growth hormone deficiency (88.1% of the 42 patients tested, and diabetes insipidus (13.3%. Panhypopituitarism was seen in 104 (92% patients. There were no cases of hypopituitarism secondary to traumatic brain injury, subarachnoid hemorrhage, central nervous system infections, or cranial irradiation to extrasellar tumors. Conclusion: The most common cause of hypopituitarism at tertiary care center is pituitary tumors and the commonest presenting complaint is visual symptoms. Panhypopituitarism is present in 92% cases.

  20. Use of the NASA Space Radiation Laboratory at Brookhaven National Laboratory to Conduct Charged Particle Radiobiology Studies Relevant to Ion Therapy.

    Science.gov (United States)

    Held, Kathryn D; Blakely, Eleanor A; Story, Michael D; Lowenstein, Derek I

    2016-06-01

    Although clinical studies with carbon ions have been conducted successfully in Japan and Europe, the limited radiobiological information about charged particles that are heavier than protons remains a significant impediment to exploiting the full potential of particle therapy. There is growing interest in the U.S. to build a cancer treatment facility that utilizes charged particles heavier than protons. Therefore, it is essential that additional radiobiological knowledge be obtained using state-of-the-art technologies and biological models and end points relevant to clinical outcome. Currently, most such ion radiotherapy-related research is being conducted outside the U.S. This article addresses the substantial contributions to that research that are possible at the NASA Space Radiation Laboratory (NSRL) at Brookhaven National Laboratory (BNL), which is the only facility in the U.S. at this time where heavy-ion radiobiology research with the ion species and energies of interest for therapy can be done. Here, we briefly discuss the relevant facilities at NSRL and how selected charged particle biology research gaps could be addressed using those facilities. PMID:27195609

  1. Lokomat: Clinical training and experience in a neurorehabilitation hospital

    DEFF Research Database (Denmark)

    Riberholt, Christian Gunge

    2014-01-01

    This presentation aims to give insight into the daily work of walking rehabilitation of patients with severe acquired brain injury (ABI) using the Lokomat© system. The lokomat system offers a high number of repetitions (steps) pr. training session with less physical stress on therapists compared to...... literature lack randomized controlled trials in ABI. Furthermore few trials have specifically investigated the most optimal training strategy for different groups of neurological patients This presentation aims at highlighting some of the strategies and clinical challenges using an evidence-based approach to...

  2. Clinical experience with the THYBIA-assay (TSH-receptorautoantibodies)

    International Nuclear Information System (INIS)

    With a radioreceptorassay (THYBIA-assay) autoantibodies against TSH-receptors were determined among 17 patients with untreated toxic diffuse goiters and in 50 patients with non immunogenic thyroid diseases (33 healthy controls, respectively patients with euthyroid diffuse or nodular goiters as well as 17 patients with toxic regional autonomy). The upper limit of normal is a THYBIA-titer F = 20%. According to the good correlation of positive THYBIA-titers with Graves' ophthalmopathy, clinical secondary criterias and the results of another radioreceptorassays (TRAK-assay) the tested radioreceptorassay seems to be useful in the differentiation of immunogenic and non immunogenic toxic diffuse goiter. (orig.)

  3. The osmotic tissue expander: a three-year clinical experience.

    Science.gov (United States)

    Obdeijn, Miryam C; Nicolai, Jean-Philippe A; Werker, Paul M N

    2009-09-01

    Closure of defects after trauma or excision of neoplasms is a basic skill in plastic surgery. Local, regional and distant flaps lead to additional scars. Skin recruitment by serial excision or skin expansion is a less damaging option for defects that must be closed. Advantages of tissue expansion include good colour and texture match. Disadvantages are the need for a second operation, use of an implant with the attendant risk of infection, time needed for inflation of the device, repeat visits to the clinic, and punctures to inflate the expander. To overcome the last disadvantage, an osmotic expander was developed in Germany in 1999 by OSMED GmbH (Ilmenau). PMID:18755643

  4. Clinical experience with the percutaneously inserted Amplatz vena caval filter

    International Nuclear Information System (INIS)

    The Amplatz filter is a 14-F vena caval filter designed for percutaneous insertion and retrieval. Thirty filters were inserted. The indications for placement were anticoagulant failure (four cases) and contraindication to anticoagulation (26 cases). Radiologic, pathologic, or clinical follow-up (average, 10 months) was available in 27 patients. Results include one case of recurrent pulmonary embolism (4%), nine cases of caval thrombosis (33%), and two cases of deep venous thrombosis in the insertion leg (7%). Filter migration did not occur in any case. The Amplatz filter is easily inserted and well tolerated by the patient. Although effective in preventing recurrent pulmonary embolism, it has a relatively high incidence of caval thrombosis

  5. Nursing experience in clinical endovascular treatment for renal artery aneurysms

    International Nuclear Information System (INIS)

    Objective: To discuss the standardized clinical nursing measures for patients receiving endovascular treatment of renal artery aneurysms. Methods: The clinical data of 9 patients with renal artery aneurysm, who were admitted to authors' hospital during the period from Jan. 2010 to Aug. 2011 and received endovascular treatment, were retrospectively analyzed. The related nursing points as well as the received endovascular. Results: A total of 9 cases with renal artery aneurysm were treated nursing measures were summarized. Results: A total of 9 cases with renal artery aneurysm were with interventional management, including embolization (n = 6), stent implantation (n = 2) and stent implantation together with coil embolization (n = 1). The mean hospitalization time was (10±2) days. Postoperative retention of urine was observed in one patient and postoperative retroperitoneal hemorrhage occurred in another patient. Neither nursing-related nor operation-related complications occurred. Conclusion: Standardized perioperative nursing care for patients with renal artery aneurysm can surely help enhance the patient's tolerance to the surgery, and effectively prevent the complications. (authors)

  6. [First clinical experiences with ceramic ball attachments for overdentures].

    Science.gov (United States)

    Büttel, Adrian E; Schmidli, Fredy; Marinello, Carlo P; Lüthy, Heinz

    2008-01-01

    In this prospective clinical study on 40 patients with similar clinical conditions (edentulous jaw with 2 interforaminal implants) commercially available ceramic ball attachments (ruby) were compared to commercial titanium ball attachments. The primary aim of the study was to measure the wear of the ball attachments after being 1 year in function. However, in the course of the study already after 7 to 12 months multiple failures with ceramic ball attachments occurred. Twelve (28%) of 43 ceramic ball attachments had to be replaced, mostly because of fractures (8) of the ceramic ball. It seems that ceramic ball attachments of the investigated design are not able to withstand normal intraoral stresses. The short-term susceptibility to fractures didn't allow to examine the ceramic-inherent features such as compressive strength and wear resistance. Furthermore, a secure connection between a titan base and a ceramic ball seems to be challenging. Based on these results, in implant-retained removable prosthesis the use of metal-based retainers is still recommended, although during maintenance a higher wear has to be expected. This wear can be compensated by either activating or changing the matrix or the patrix. PMID:18293602

  7. Respiratory infections: clinical experiences with the new quinolones.

    Science.gov (United States)

    Davies, B I; Maesen, F P

    1987-12-11

    Nearly 300 patients, admitted to hospital with acute purulent exacerbations of chronic respiratory disease, have been treated with various newer quinolones: 26 patients received enoxacin, 50 pefloxacin, 80 ciprofloxacin and 143 ofloxacin. Dosages varied from 400 mg once daily to 1000 mg twice daily. orally for five to 10 days. Patients were evaluated bacteriologically and clinically before, during and after treatment. Nearly all infections associated with Haemophilus influenzae and/or Branhamella catarrhalis were successfully eradicated. Some Streptococcus pneumoniae infections relapsed, some could not be eradicated, and a number of patients developed new infections with these organisms. Approximately half of the Pseudomonas aeruginosa infections were eradicated. Nearly all patients received concomitant theophylline but this only caused serious problems in those given 600 mg doses of enoxacin twice daily. Five patients given ciprofloxacin had to discontinue because of unwanted effects (mostly hallucinations), one patient given pefloxacin had gastric pain and two patients given ofloxacin developed a skin rash. Apart from the theophylline interaction, the unwanted effects did not appear to be dose-related. The best overall clinical results were noted after 800 mg doses of ofloxacin once daily for seven days. PMID:3438151

  8. Translating comparative effectiveness research into clinical practice: the UK experience.

    Science.gov (United States)

    Walley, Tom

    2012-01-22

    Comparative effectiveness research (CER) is not new but its potential to improve the effectiveness of healthcare has not yet been exploited in the US. Other countries such as the UK have more experience of this. Key points of the UK experience are summarized here and some possible pointers for the US are drawn. These include the following: how to go beyond the evidence and apply judgements to make recommendations with authority and in a timely manner; how to implement these recommendations; how to identify suitable topics; and how to be open and transparently fair to all stakeholders. The quality of the science of CER is key but this needs developing, and not just in biomedical or statistical terms but also in how to understand public expectations, and how to implement its recommendations. A key issue is the role of health economics, which seems to have been marginalized by the CER legislation, but perhaps this is more apparent than real. Clearly this is a matter for much further debate. It is hard to see how CER can deliver its potential without active consideration of both benefits and costs. Although other countries have more experience of this than does the US, the context for such work is always very specific and the US will have to find its own way, while trying to avoid some of the errors made elsewhere. PMID:22268389

  9. CLINICAL AND MICROBIOLOGICAL STUDY OF OTOMYCOSIS : OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Venugopal

    2015-06-01

    Full Text Available Otomycosis is fungal infection of external auditory canal, which is common throughout the world. Otomycosis may be refractory to treatment prescribed and hence challenges the clinician. AIM: To identify the organism causing otomycosis and to explore speci fic predisposing factors and treatment. MATERIALS AND METHODS: This is a descriptive study of cases of otomycosis attending ENT outpatient department of Govt. Medical College, Thiruvananthapuram which were evaluated clinically and microbiologically for one year. RESULT AND CONCLUSION: The commonest predisposing factor for otomycosis is trauma due to self - cleaning and water entering the ear. Common in females. Common presentation is itching of ear and ear ache. Commonest organism isolated is Aspergillus Nige r. Usually respond to treatment with topical antifungal agent especially clotrimazole. Most of the cases responded satisfactorily with topical clotrimazole.

  10. Clinical Experience in Application of the Point Wangu

    Institute of Scientific and Technical Information of China (English)

    杨西永

    2002-01-01

    Wangu (GB 12) is a point of the Gallbladder Channel of Foot Shaoyang, located in the depression posteroinferior to the temporal process. And it is a hui point of Foot Taiyang and Shaoyang Channels, with the effects of eliminating pathogenic wind and heat, and tranquilizing the mind. This point is located superior to the attachment point of the sternocleidomastoid muscle, in which there distribute the stem of the lesser occipital nerve, and branches of the posterior auricular artery and vein. It can be needled perpendicularly 0.5-1 cun deep. In clinical practice, the author has applied the point for treatment of various diseases, and obtained quite satisfactory therapeutic results. The following is a report of some illustrative cases.

  11. Experience in the Clinical Application of Naokong (GB19)

    Institute of Scientific and Technical Information of China (English)

    陆汎

    2005-01-01

    @@ Naokong (GB19) is located 1.5 cun above Fengchi (GB20) and at the level with Naohu (GV17) in the depression of the lateral side of the external occipital protuberance. It belongs to the Gallbladder Channel of Foot Shaoyang, and is a crossing point of the Foot Shaoyang Channel and the Yangwei Channel. As is said in A Collection of Gems in Acupuncture and Moxibustion, Naokong (GB19) is indicated for emaciation due to over strain and stress, fever, neck rigidity, unbearable pain in the head, heavy eyes and palpitation as well as xenophthalmia and rhinalgia caused by epileptic seizure in severe cases. In clinical practice, the author has adopted Naokong (GB 19) as the main point in treating some obstinate diseases and obtained quite good therapeutic effects.

  12. Clinical Experience in Acupuncture Treatment of Allergic Rhinitis

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yan-qiu

    2009-01-01

    Objective:To observe the clinical effects of acupuncture for allergic rhinitis.Methods:The body acupuncture, auricular seed-embedding and microwave irradiation were adopted for treatment of allergic rhinitis due to various causative factors, such as cold and insufficiency of the lung-qi weakening the body resistance, insufficiency of the spleen-qi with lucid yang failing to rise, insufficiency of the kidney-yang failing to warm the body surface, and the heat accumulated in the lung channels giving invading the nose.Results:After treatment, the symptoms and signs disappeared in all illustrative cases, with no recurrence found after a one-year follow-up.Conclusion:Acupuncture may help to improve the blood rheology indexes with an increased volume of blood flow, and regulate the immunological function of the human body, thus giving therapeutic effects for allergic rhinitis.

  13. Conducting Family Nursing in Heart Failure outpatient clinics: Nurses experiences

    DEFF Research Database (Denmark)

    Voltelen, Barbara; Konradsen, Hanne; Østergaard, Birte

    Aim: This study aimed to explore what was documented during structured Family Nursing (FN) conversations with patients diagnosed with Heart Failure and their families, and to gain knowledge about the nurses’ experiences conducting FN. Background: Patients with HF face many challenges, and so do...... from throughout the FN intervention and a Focus group interview with 6 nurses who were conducting the conversations. Content analyses of all text material dealt with both manifest and latent content, and were analyzed through a deductive and inductive process. Results: Enabling bonding emerged as the...

  14. Experience with the Implementation of Clinical Pharmacy Services and Processes in a University Hospital in Belgium.

    Science.gov (United States)

    Somers, Annemie; Claus, Barbara; Vandewoude, Koen; Petrovic, Mirko

    2016-03-01

    This article summarizes the experience with the development of clinical pharmacy services in the Ghent University Hospital in Belgium. Implementation of clinical pharmacy services in Belgian hospitals has not been evident because these activities were initially not structurally financed. The aim is to describe the strengths and weaknesses of the clinical pharmacy development process, and the milestones that enhanced the progress. Furthermore, the organisation of clinical pharmacy in the Ghent University Hospital is explained, including back- and front-office activities, seamless pharmaceutical care and medication safety improvement. Some working methods, procedures and tools are explained for different clinical pharmacy services. In particular, the clinical pharmacy projects for geriatric patients as well as the preparation of clinical pharmacy services for the accreditation process are explained. We also reflect on the organisation model and the future development of clinical pharmacy, taking into consideration facilitators and potential barriers. PMID:26922733

  15. Clinical spectrum and outcome of pulmonary nocardiosis: 5-year experience

    Science.gov (United States)

    Singh, Akashdeep; Chhina, Deepinder; Soni, RK; Kakkar, Chandan; Sidhu, US

    2016-01-01

    Background: Pulmonary nocardiosis is a rare but a life-threatening infection caused by Nocardia spp. The diagnosis is often missed and delayed resulting in delay in appropriate treatment and thus higher mortality. Aim: In this study, we aim to evaluate the clinical spectrum and outcome of patients with pulmonary nocardiosis. Methods: A retrospective, 5-year (2009–2014) review of demographic profile, risk factors, clinical manifestations, imaging findings, treatment, and outcome of patients with pulmonary nocardiosis admitted to a tertiary care hospital. Results: The median age of the study subjects was 54 years (range, 16–76) and majority of them (75%) were males. The risk factors for pulmonary nocardiosis identified in our study were long-term steroid use (55.6%), chronic lung disease (52.8%), diabetes (27.8%), and solid-organ transplantation (22.2%). All the patients were symptomatic, and the most common symptoms were cough (91.7%), fever (78%), and expectoration (72%). Almost two-third of the patients were initially misdiagnosed and the alternative diagnosis included pulmonary tuberculosis (n = 7), community-acquired pneumonia (n = 5), lung abscess (n = 4), invasive fungal infection (n = 3), lung cancer (n = 2), and Wegener's granulomatosis (n = 2). The most common radiographic features were consolidation (77.8%) and nodules (56%). The mortality rate for indoor patients was 33% despite treatment. Higher mortality rate was observed among those who had brain abscess (100.0%), HIV positivity (100%), need for mechanical ventilation (87.5%), solid-organ transplantation (50%), and elderly (age > 60 years) patients (43%). Conclusion: The diagnosis of pulmonary nocardiosis is often missed and delayed resulting in delay in appropriate treatment and thus high mortality. A lower threshold for diagnosing pulmonary nocardiosis needs to be exercised, in chest symptomatic patients with underlying chronic lung diseases or systemic immunosuppression, for the early diagnosis

  16. EPID based in vivo dosimetry system: clinical experience and results.

    Science.gov (United States)

    Celi, Sofia; Costa, Emilie; Wessels, Claas; Mazal, Alejandro; Fourquet, Alain; Francois, Pascal

    2016-01-01

    Mandatory in several countries, in vivo dosimetry has been recognized as one of the next milestones in radiation oncology. Our department has implemented clinically an EPID based in vivo dosimetry system, EPIgray, by DOSISOFT S.A., since 2006. An analysis of the measurements per linac and energy over a two-year period was performed, which included a more detailed examination per technique and treat-ment site over a six-month period. A comparison of the treatment planning system doses and the doses estimated by EPIgray shows a mean of the differences of 1.9% (± 5.2%) for the two-year period. The 3D conformal treatment plans had a mean dose difference of 2.0% (± 4.9%), while for intensity-modulated radiotherapy and volumetric-modulated arc therapy treatments the mean dose difference was -3.0 (± 5.3%) and -2.5 (± 5.2%), respectively. In addition, root cause analyses were conducted on the in vivo dosimetry measurements of two breast cancer treatment techniques, as well as prostate treatments with intensity-modulated radiotherapy and volumetric-modulated arc therapy. During the breast study, the dose differences of breast treatments in supine position were correlated to patient setup and EPID positioning errors. Based on these observations, an automatic image shift correc-tion algorithm is developed by DOSIsoft S.A. The prostate study revealed that beams and arcs with out-of-tolerance in vivo dosimetry results tend to have more complex modulation and a lower exposure of the points of interest. The statistical studies indicate that in vivo dosimetry with EPIgray has been successfully imple-mented for classical and complex techniques in clinical routine at our institution. The additional breast and prostate studies exhibit the prospects of EPIgray as an easy supplementary quality assurance tool. The validation, the automatization, and the reduction of false-positive results represent an important step toward adaptive radiotherapy with EPIgray. PMID:27167283

  17. Minimally invasive transforaminal lumbar interbody fusion—indications and clinical experience

    Directory of Open Access Journals (Sweden)

    Akshay Hari

    2016-01-01

    Conclusions: Our clinical experience along with a review of the medical literature indicates that TLIF can be effectively and safely performed in a minimally invasive fashion for a wide variety of indications.

  18. Student Pharmacists’ Clinical Interventions in Advanced Pharmacy Practice Experiences at a Community Nonteaching Hospital

    OpenAIRE

    Shogbon, Angela O.; Lundquist, Lisa M.

    2014-01-01

    Objective. To assess student pharmacists’ clinical interventions in advanced pharmacy practice experiences (APPEs) at a community nonteaching hospital and evaluate completed interventions based on the type of documentation method used.

  19. [Cystinic nephrolythiasis: clinical experience and new diagnostic and therapeutic perspectives].

    Science.gov (United States)

    Gentili, Anna; Ria, Paolo; Lupo, Antonio; Fabris, Antonia

    2016-01-01

    Cystinuria is an inherited autosomal recessive disease with a prevalence 1:7000 and typical age of onset in the second decade of life. This nephrolithiasis is not always well known and well studied and for this reason it is often underdiagnosed. Cystinuria is characterized by increased urinary excretion of cystine and dibasic amino acids (lysine, ornithine, arginine) caused by defective transport of these amino acids across the luminal membrane of proximal tubule and small intestine cells. Two mutated genes responsible of this tubular defect are SLC3A1 on chromosome 2 and SLC7A9 on chromosome 19. Clinical manifestations of cystinuria are essentially those related to stones formation and their movement across the urinary tract, like flank pain/abdomen pain and hematuria, as occurred in other nephrolithiasis types. Diagnosis is based on biochemical urine analysis, stone analysis and imaging. Genetic study of this disease may be a new and stimulating approach to better understand the defects and identify new therapeutic targets. A wider knowledge and a more detailed approach to cystinuria may help to ameliorate patients quality of life, to prevent recurrences and complications and to develop more specific and adequate treatments. PMID:27374390

  20. The universal serial bus endoscope: design and initial clinical experience.

    Science.gov (United States)

    Hernandez-Zendejas, Gregorio; Dobke, Marek K; Guerrerosantos, Jose

    2004-01-01

    Endoscopic forehead lift is a well-established procedure in aesthetic plastic surgery. Many agree that currently available video-endoscopic equipment is bulky, multipieced and sometimes cumbersome in the operating theater. A novel system, the Universal Serial Bus Endoscope (USBE) was designed to simplify and reduce the number of necessary equipment pieces in the endoscopic setup. The USBE is attached by a single cable to a Universal Serial Bus (USB) port of a laptop computer. A built-in miniaturized cold light source provides illumination. A built-in digital camera chip enables procedure recording. The real-time images and movies obtained with USBE are displayed on the computer's screen and recorded on the laptop's hard disk drive. In this study, 25 patients underwent endoscopic browlift using the USBE system to test its clinical usefulness, all with good results and without complications or need for revision. The USBE was found to be reliable and easier to use than current video-endoscope equipment. The operative time needed to complete the procedure by the authors was reduced approximately 50%. The design and main technical characteristics of the USBE are presented. PMID:15383889

  1. The First Experience of Clinical Practice on Psychology Students’ Imaginary

    Directory of Open Access Journals (Sweden)

    Sueli Regina Gallo-Belluzzo

    2013-09-01

    Full Text Available Considering the academic development of the psychologist as a complex process which articulates the transmission of scientific knowledge and changes in imaginative activity, we psychoanalytically investigate the collective imaginary of Psychology students regarding the first clinical consultation. We conducted a group interview with 52 undergraduate students, using the Thematic Story-Drawing Procedure as a way to open a dialogical field. The material obtained, through the psychoanalytical method, resulted in the creation/gathering of four affective-emotional meaning fields: “I came, I saw and I conquered”, “I know that I (do not know”, “I survived and I will save” and “I am and I do”, from which we see an emotionally immature imaginary about the meeting with the patient, since students are more self-centered than concerned with the patient. The overall situation indicates the need for care regarding student academic development, in order to encourage a more mature approach toward the suffering of the other.

  2. [Brain-Computer Interface: the First Clinical Experience in Russia].

    Science.gov (United States)

    Mokienko, O A; Lyukmanov, R Kh; Chernikova, L A; Suponeva, N A; Piradov, M A; Frolov, A A

    2016-01-01

    Motor imagery is suggested to stimulate the same plastic mechanisms in the brain as a real movement. The brain-computer interface (BCI) controls motor imagery by converting EEG during this process into the commands for an external device. This article presents the results of two-stage study of the clinical use of non-invasive BCI in the rehabilitation of patients with severe hemiparesis caused by focal brain damage. It was found that the ability to control BCI did not depend on the duration of a disease, brain lesion localization and the degree of neurological deficit. The first step of the study involved 36 patients; it showed that the efficacy of rehabilitation was higher in the group with the use of BCI (the score on the Action Research Arm Test (ARAT) improved from 1 [0; 2] to 5 [0; 16] points, p = 0.012; no significant improvement was observed in control group). The second step of the study involved 19 patients; the complex BCI-exoskeleton (i.e. with the kinesthetic feedback) was used for motor imagery trainings. The improvement of the motor function of hands was proved by ARAT (the score improved from 2 [0; 37] to 4 [1; 45:5] points, p = 0.005) and Fugl-Meyer scale (from 72 [63; 110 ] to 79 [68; 115] points, p = 0.005). PMID:27188145

  3. Clinical experience with apixaban in atrial fibrillation: implications of AVERROES

    Directory of Open Access Journals (Sweden)

    De Caterina R

    2011-07-01

    Full Text Available Raffaele De CaterinaInstitute of Cardiology and Center of Excellence on Aging, G d’Annunzio University, Chieti, G Monasterio Foundation, Pisa, ItalyAbstract: Atrial fibrillation is an extremely common arrhythmia, which substantially increases the risk of stroke and thromboembolism. Prevention of stroke and thromboembolism is therefore an important part of the management of atrial fibrillation. Guidelines until now have recommended that patients with atrial fibrillation receive some form of antithrombotic therapy, ie, a vitamin K antagonist or aspirin, with a preference for anticoagulants in most cases. However, current treatments are suboptimal, and despite the recommendations, many patients do not receive adequate thromboprophylaxis, because they are considered, for various reasons, “unsuitable” to receive a vitamin K antagonist. In this patient population, apixaban, a new oral anticoagulant inhibiting activated coagulation factor X, administered in fixed doses and without anticoagulation monitoring, has undergone testing against aspirin in the recently published AVERROES trial. This paper addresses the strengths and limitations of this trial and the practical relevance of the new clinical information it provides.Keywords: atrial fibrillation, apixaban, thromboprophylaxis 

  4. Experiences and barriers to implementation of clinical practice guideline for depression in Korea

    OpenAIRE

    Yang, Jaewon; Han, Changsu; Yoon, Ho-Kyoung; Pae, Chi-Un; Kim, Min-Jeong; Park, Sun-Young; Ahn, Jeonghoon

    2013-01-01

    Background Clinical guidelines can improve health-care delivery, but there are a number of challenges in adopting and implementing the current practice guidelines for depression. The aim of this study was to determine clinical experiences and perceived barriers to the implementation of these guidelines in psychiatric care. Methods A web-based survey was conducted with 386 psychiatric specialists to inquire about experiences and attitudes related to the depression guidelines and barriers influ...

  5. Eating disorders - knowledge, attitudes, management and clinical experience of Norwegian dentists

    OpenAIRE

    Johansson, Ann-Katrin; Johansson, Anders; Nohlert, Eva; Norring, Claes; Åstrøm, Anne N; Tegelberg, Åke

    2015-01-01

    Background: The purpose of this study was to investigate knowledge, attitudes and clinical experience with regard to patients with eating disorders (ED) among Norwegian dentists. Methods: In 2010, a questionnaire was sent to all dentists in Norway (N = 4282) comprising 33 questions related to demographics of the participating dentists, their knowledge of ED (general and oral health aspects), clinical experience, attitudes and perceived management preferences. Results: The participation rate w...

  6. Psychotic experiences in a mental health clinic sample: implications for suicidality, multimorbidity and functioning.

    OpenAIRE

    Kelleher, Ian; Devlin, Nina; Wigman, Johanna Tw; Kehoe, Anne; Murtagh, Aileen; Fitzpatrick, Carol; Cannon, Mary

    2014-01-01

    BACKGROUND: Recent community-based research has suggested that psychotic experiences act as markers of severity of psychopathology. There has, however, been a lack of clinic-based research. We wished to investigate, in a clinical sample of adolescents referred to a state-funded mental health service, the prevalence of (attenuated or frank) psychotic experiences and the relationship with (i) affective, anxiety and behavioural disorders, (ii) multimorbid psychopathology, (iii) global functionin...

  7. The South African Military Nursing College Pupil Enrolled Nurses’ experiences of the clinical learning environment

    OpenAIRE

    Ernestina M. Caka; Sebi Lekalakala-Mokgele

    2013-01-01

    The study focused on the clinical learning experiences of Pupil Enrolled Nurses (PENs) within the military health service. The purpose of the research was to explore and describe the learning experiences of PENs within the Military health clinical learning environment. An explorative, descriptive, contextual design which is qualitative in nature was used to guide the study. The military as a training institution prides itself on preparing nurses both as soldiers and nurses, this could be both...

  8. Eating disorders - knowledge, attitudes, management and clinical experience of Norwegian dentists

    OpenAIRE

    Johansson, Ann-Katrin; Johansson, Anders; Nohlert, Eva; Norring, Claes; Åstrøm, Anne N; Tegelberg, Åke

    2015-01-01

    Background The purpose of this study was to investigate knowledge, attitudes and clinical experience with regard to patients with eating disorders (ED) among Norwegian dentists. Methods In 2010, a questionnaire was sent to all dentists in Norway (N = 4282) comprising 33 questions related to demographics of the participating dentists, their knowledge of ED (general and oral health aspects), clinical experience, attitudes and perceived management preferences. Results The participation rate was ...

  9. The Impact of Clinical Experiences from Athletic Training Student and Preceptor Perspectives

    Science.gov (United States)

    Benes, Sarah S.; Mazerolle, Stephanie M.; Bowman, Thomas G.

    2014-01-01

    Context: Clinical education is an integral part of athletic training programs. This is where students should develop their professional identities and become socialized into the profession. Understanding the student and preceptor perspectives of the impact that clinical experiences have on students can provide valuable insight into this aspect of…

  10. Psychotic experiences in a mental health clinic sample : implications for suicidality, multimorbidity and functioning

    NARCIS (Netherlands)

    Kelleher, I.; Devlin, N.; Wigman, J. T. W.; Kehoe, A.; Murtagh, A.; Fitzpatrick, C.; Cannon, M.

    2014-01-01

    Background Recent community-based research has suggested that psychotic experiences act as markers of severity of psychopathology. There has, however, been a lack of clinic-based research. We wished to investigate, in a clinical sample of adolescents referred to a state-funded mental health service,

  11. Experiences of Student Speech-Language Pathology Clinicians in the Initial Clinical Practicum: A Phenomenological Study

    Science.gov (United States)

    Nelson, Lori A.

    2011-01-01

    Speech-language pathology literature is limited in describing the clinical practicum process from the student perspective. Much of the supervision literature in this field focuses on quantitative research and/or the point of view of the supervisor. Understanding the student experience serves to enhance the quality of clinical supervision. Of…

  12. Students' Experiences of Clinic-Based Learning during a Final Year Veterinary Internship Programme

    Science.gov (United States)

    Matthew, Susan M.; Taylor, Rosanne M.; Ellis, Robert A.

    2010-01-01

    This study investigated veterinary students' experiences of clinic-based learning (CBL) during a comprehensive final year internship programme. Open-ended surveys (n = 93) were used to gather qualitative data about students' conceptions of what is learned during CBL and their approaches to learning in clinics. Phenomenography was used for detailed…

  13. Role of Clinical Education Experiences on Athletic Training Students' Development of Professional Commitment

    Science.gov (United States)

    Mazerolle, Stephanie M.; Dodge, Thomas

    2015-01-01

    Context: Limited evidence exists on the role clinical education can play in the development of athletic training student commitment for the profession. Objective: Investigating the role clinical education experiences play on the development of passion for athletic training. Design: Exploratory qualitative study. Setting: Athletic training…

  14. Philosophy of veterinary radiobiology twenty years after the Chernobyl disaster

    International Nuclear Information System (INIS)

    The basic objective is to provide safe foodstuffs. This approach has connection with the food chain protection including the diagnostics and the acute radiation disease therapy at the farm animals. The extra significance is given to the research of technologies which can reduce the activity of the contaminated foodstuffs. In the field of the ionizing radiation effect research in live organisms attention should be devoted to the new alternative bio-tests. The low-dose effect or the interaction with other negative physical and chemical aspects of the environment is mainly considered. In cooperation with human medicine, it is necessary to develop radiotherapy and to study the effects of therapy and radiotherapy. From the standpoint of perspective technologies, it is advisable to focus on irradiation of the foodstuffs in veterinary radiobiology. (authors)

  15. Dictionary of radiation protection, radiobiology and nuclear medicine

    International Nuclear Information System (INIS)

    Radiation protection, including aspects of radiobiology, nuclear medicine, and nuclear legislation, has an important role within nuclear research and the use of radioactive materials. Radiation protection comprises all measures and efforts to prevent the unwanted distribution and negative influence of ionizing radiation, especially where the human organism and the living environment are involved. The increasing role of radiation protection is reflected by the foundation of institutes in all industrial countries to control such radiant energy and prevent radiation damage. Nowadays ionizing radiation is employed on a large scale for basic investigations in biochemistry, molecular biology and genetics, in soil tests, fertilization problems and pest control in agriculture, as well as for medicinal diagnoses and therapy. This dictionary is a thematic enlargement of the four-language 'Dictionary of Nuclear Engineering', compiled by the same author. It comprises about 12,000 terms in each language. (orig.)

  16. Autoimmune Hemolytic Anemia in Children: Mayo Clinic Experience.

    Science.gov (United States)

    Sankaran, Janani; Rodriguez, Vilmarie; Jacob, Eapen K; Kreuter, Justin D; Go, Ronald S

    2016-04-01

    We studied 35 pediatric patients with autoimmune hemolytic anemia seen at Mayo Clinic from 1994 to 2014. The median age was 10.0 years and 65.7% were males. Most had warm antibodies (80.0%) and some secondary to viral (14.3%) or autoimmune disorders (31.4%). Seven (20.0%) patients presented with Evans syndrome, 3 of whom also had common variable immunodeficiency. The median hemoglobin at diagnosis was 6.1 g/dL and 62.8% patients required red cell transfusions. The severity of anemia was worse among children below 10 years (median 5.5 vs. 7.0 g/dL, P=0.01). Steroid was the initial treatment for 88.5% patients, with overall response rate of 82.7% (68.5% complete, 14.2% partial) and median response duration of 10.7 months (range, 0.2 to 129.7+ mo). After median follow-up of 26.6 months, 8 (22.8%) patients relapsed. Salvage treatments included splenectomy, intravenous immunoglobulin, rituximab, and mycophenolate mofetil. Infectious complications occurred in 9 (25.7%) patients and 1 patient died of cytomegalovirus infection. Four patients had cold agglutinin disease and 3 (75.0%) responded to steroids. Autoimmune hemolytic anemia is a rare disorder in pediatric population and most respond well to steroids regardless of the type of antibody. Infectious complications are common and screening for immunodeficiency is recommended among those with Evans syndrome. PMID:26925716

  17. Clinical trial experience using erythropoietin during radiation therapy

    International Nuclear Information System (INIS)

    Oncologists have several reasons for trying to maintain or increase hemoglobin levels in their patients during therapy. Relief of the symptoms of anemia, including fatigue and dyspnea, are traditional, well-accepted indications. A newer rationale is to enhance the efficacy of radiation therapy and/or chemotherapy in controlling tumors. A laboratory animal study found that administration of recombinant human erythropoietin (rHuEPO) increased intratumoral median oxygen levels and diminished the proportion of measurements in the very low (<3 mm Hg) range. Hemoglobin level is a strong independent prognostic factor for tumor control by radiation therapy. The hemoglobin level at the end of radiation therapy is a stronger prognostic factor than is the hemoglobin level at the start of therapy. Numerous clinical trials have utilized rHuEPO during radiation with or without concurrent chemotherapy. All 4 trials which enrolled patients with low hemoglobin levels (<12 to 13.5 g/dl) found that rHuEPO significantly increased hemoglobin within 2 weeks and that hemoglobin levels continued to rise until the end of rHuEPO treatment. rHuEPO was efficacious in limiting the decrease in hemoglobin and use of packed red blood cell transfusion in the one reported trial in which it was used in patients with initially normal hemoglobin levels during intensive concurrent radiation and chemotherapy. One trial found a statistically significant improvement in complete pathologic response rate after neoadjuvant chemoradiotherapy with the use of rHuEPO. rHuEPO has a potentially large role to play in the care of the cancer patient. (orig.)

  18. Clinical Experience with Chitosan Matrix and Cultured Fibroblasts for Burns

    Directory of Open Access Journals (Sweden)

    Gaziza Danlybayeva

    2014-12-01

    Full Text Available Introduction. Burns are an important public health challenge due to the frequency of getting burns in day-to-day life, occupational hazards, and catastrophes. Treatment of burns is complex and is associated with high morbidity and mortality. Duration and complexity of burn treatment require finding new ways of curing and rehabilitating burns. The result of burn treatment plays a significant role in post-traumatic status of a patient and his or her consequent adaptation in society. Chitosan is a natural safe non-toxic product compatible with human tissues, characterized by hydrosorbid, anticoagulant, antibacterial, and wound healing features. The study aims to  show a clinical application of chitosan-pectin scaffold with cultured human skin fibroblasts in the treatment of deep burns.Methods. The substrate was prepared by dissolving 3% chitosan in 0.5N acetic acid, which was then mixed with 3% solution of pectin dissolved in distillated water. Chitosan film was formed in a Petri dish for 20-24 hours at 20-25 °C. After drying the film, cultured allogeneic fibroblasts (patent number RK-25091 were seeded on its surface.Results. The results from an in vitro culture study showed that human allogeneic fibroblasts could adhere well and grow on the selected scaffold with a typical morphology. During autodermoplasty surgery, cultured allogeneic fibroblasts were applied on granulating wounds of 9 patients with IIIA to IVB degree burns and limited donor resources. Wounds treated with the fibroblast-seeded scaffold among all patients provided the highest level of re-epithelialization (day 5, in comparison to cell-free scaffold (day 7 and untreated surface of wounds (day 10.Conclusion. Our results indicate the potential use of chitosan for wound healing due to its allogenic fibroblast adherence to scaffolding as well as high epithelization. This warrants further studies on chitosan for use in wounds resulting from third and fourth degree burns.

  19. Clinical experience of surgical intervention for severe acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Xu Yuan; Shao Qinshu; Yang Jin; Yu Xiaojun; Xu Ji

    2014-01-01

    Background The controversy on the treatment strategy for severe acute pancreatitis (SAP) has never stopped for the past century.Even now surgical procedures play a decisive role in the treatment of SAP,especially in managing the related complications,but the rational indications,timing,and approaches of surgical intervention for SAP are still inconclusive.Methods Clinical data of 308 SAP patients recruited during January 2000-January 2013,including 96 conservatively treated cases plus 212 surgically intervened cases,were comparatively analyzed.Based on the initial surgical intervention time,the surgical intervention group was split into two:early intervention group (within 2 weeks) 103 cases,and late intervention group (after 2 weeks) 109 cases.Results In the conservative treatment group,the cure rate was 82.29% (79/96),the death rate was 13.54% (13/96),and 4 cases self-discharged,while in the surgical intervention group,the cure rate was 84.43% (179/212) and the death rate was 10.85% (23/212) with 10 cases self-discharged.The difference was of no statistical significance between these two groups (P >0.05).In surgical intervention group,the death rate 15.53% (16/103) in the early surgical intervention group was higher than that of late surgical intervention group 6.42% (7/109),and the difference was statistically significant (P <0.05).Conclusions Both conservative treatment and surgical intervention play important roles in the treatment of SAP,and the indication,timing,and procedure should be strictly followed.Surgery earlier than 2 weeks after onset of the disease is not recommended in patients with necrotizing pancreatitis only when there are specific indications,such as multiple organ failure,which does not improve despite active treatment,and in those who develop abdominal compartment syndrome.

  20. Clinical course of ectopic pregnancy: A single-center experience

    Directory of Open Access Journals (Sweden)

    Aqueela Ayaz

    2013-01-01

    Full Text Available Objectives: The objective was to highlight the frequency, clinical profile, and predisposing factors of ectopic pregnancy (EP in a general hospital. Materials and Methods: This descriptive study was conducted at the Obstetrics and Gynaecology department of Hera General hospital, Makkah, Saudi Arabia, from July 1, 2009 to December 29, 2010. Data were collected on chief medical complaints, sociodemographic characteristics, past obstetrics and gynecological history, management done, and outcome of management. Data were analyzed using Microsoft Office Excel (version 2007. Results: Out of total 7564 pregnancies, 44 (0.58% patients were diagnosed as EP. Out of 44, 22 (50% patients presented within 24 h of onset of symptoms. Mean age was 28 ± 7 years. Multigravida were predominant in 25 (57%, and 21 (48% had gestational age of 6-8 weeks at the time of presentation; the common presenting features were amenorrhea (41, 93.2%, abdominal pain (39, 88.6%, and tenderness (38, 86%. Previous pelvic surgery (13, 29.5%, infertility treatment (11, 25%, and pelvic inflammatory disease (10, 22.7% were the common predisposing factors. Twenty-five (57% presented with ruptured EP and were operated within 24 h, and the remaining were kept under observation till further diagnosis. After confirming the diagnosis, 12/19 underwent laparoscopy, whereas 7/19 received medical treatment. Surgery confirmed fallopian tube pregnancies in 35 (94.5%. No mortality was observed. Conclusion: Previous pelvic surgeries were the major etiological factor for EP. Other factors were infertility treatment and pelvic inflammatory disease. The most common site of EP was fallopian tubes.

  1. Clinical experience in the use of marginal donor hearts

    Institute of Scientific and Technical Information of China (English)

    XIE Ai-ni; DONG Nian-guo; ZHANG Kai-lun; XIA Jia-hong; XIAO Shi-liang; SUN Zong-quan

    2011-01-01

    Background Although heart transplantation has become a standard therapy for end-stage heart disease, there are few published studies regarding the use of transplant organs from marginal donors. Here we describe the clinical outcome we have obtained using marginal donor hearts.Methods We analyzed 21 cases of orthotropic heart transplantation for end-stage heart disease performed in our department between September 2008 and July 2010. Of these patients, six received hearts from marginal donors and the remainder received standard-donor hearts. The two groups were compared in terms of both mortality and the incidence of perioperative complications such as infection, acute rejection, and right heart insufficiency.Results The 1-year survival rate of both groups was 100%. Only one death was recorded in standard-donor group during follow-up. Patients who received marginal donor hearts (83%) experienced more early complications than did the standard-donor-heart group (13%), but the mortality of the two groups was the same. The duration of post-ICU stay was greater in the marginal donor group than in the standard-donor group, (35.5±17.4) days and (21.7±2.6) days, respectively (P <0.05).Conclusions The use of marginal donor hearts increases the number of patients who can receive and benefit from transplants. However, it may introduce an increased risk of early complications, thus care should be taken both in the choice of patients who will receive marginal donor hearts and in the perioperative treatment of those for whom the procedure is performed.

  2. Respiratory dynamic CT of the lung: initial clinical experience

    International Nuclear Information System (INIS)

    We applied spiral CT to evaluate the dynamic changes of regional ventilation of the lung in normal subjects and abnormal patients. This study includes normal subjects (n = 5) and patients with chronic obstructive pulmonary disease (n = 4), small air-way disease (n = 3), diffuse panbronchiolitis (n = 4), and tracheobronchial tuberculosis (n = 2). Time-continuous scan data at a fixed level during forced vital capacity maneuver (10-12 seconds) were obtained and images were reconstructed retrospectively by using 0.67 second scan data per image. The reconstructed images were displayed in a cine mode. Time-density curves were plotted and were correlated with clinical diagnosis. In normal subjects, mean attenuation difference between full inspiration and full expiration was 145.8 HU and mean time interval between 20% expiration and 80% expiration was 2.04 seconds. In chronic obstructive lung disease, mean attenuation difference between full inspiration and full expiration was 21.2 HU and mean time interval between 20% expiration and 80% expiration was 3.63 seconds. In small air-way disease, mosaic-pattern hyperlucency and normal portion of lung showed mean attenuation differences between 20% expiration and 80% expiration to be 49.8 HU and 167.0 HU, respectively. In diffuse panbronchiolitis, centrilobular region and normal portion of lung showed mean attenuation differences between 20% expiration and 80% expiration to be 35.4 HU and 79.3 HU, respectively. Respiratory dynamic CT is an updated technique which enable imaging of the functional status of the lung parenchyma. It may be useful in differentiation and quantitation of variable obstructive lung diseases

  3. Clinical experiences with three different designs of ankle prostheses.

    Science.gov (United States)

    Rippstein, Pascal F

    2002-12-01

    Until 1995, fusion was in our institution the only rational surgical option for a severe ankle arthrosis. Consistent reports about good mid- and long-term results with ankle replacement allowed us to change our minds. Ankle replacement became the gold standard and fusion was then almost totally banished. Because ankle arthrosis can be morphologically different from one patient to another, we soon believed that one single type of ankle prosthesis would not be the universal optimal solution for all patients. We therefore divided the ankle arthrosis into three groups. Each group shows the best solution from each of the ankle prostheses with which we had gained experience (Agility, STAR, and BP). The Agility prosthesis, which was indicated for ankles with extremely damaged geometry, did not restore sufficiently the ankle motion. Preoperatively stiff ankles remained stiff postoperatively. Additionally, significant residual pain was more likely to occur in those patients. These cases did not show significant advantages compared with ankle fusion, especially from a functional point of view. Fusion for these stiff ankles is therefore today our first treatment of choice. In our experience, the malleolar joints do not have to be replaced. Even a severe arthrosis at this level does not produce significant pain, provided that osteophytes have been removed and joint height has been restored by the implanted prosthesis. It is our strong belief that these malleolar joints are also less sensitive to pain, similar to the femoropatellar joint. For these reasons, a replacement of the malleolar joints and the resurfacing of the talar sides is not necessary. Leaving the talar sides untouched requires less bone resection and makes the implantation of the talar component easier. Although we obtained good results with the STAR prosthesis, we progressively abandoned it because of these reasons, and we preferred the BP prosthesis. The BP prosthesis works on the same biomechanic principle as

  4. Method for validating radiobiological samples using a linear accelerator

    International Nuclear Information System (INIS)

    There is an immediate need for rapid triage of the population in case of a large scale exposure to ionizing radiation. Knowing the dose absorbed by the body will allow clinicians to administer medical treatment for the best chance of recovery for the victim. In addition, today's radiotherapy treatment could benefit from additional information regarding the patient's sensitivity to radiation before starting the treatment. As of today, there is no system in place to respond to this demand. This paper will describe specific procedures to mimic the effects of human exposure to ionizing radiation creating the tools for optimization of administered radiation dosimetry for radiotherapy and/or to estimate the doses of radiation received accidentally during a radiation event that could pose a danger to the public. In order to obtain irradiated biological samples to study ionizing radiation absorbed by the body, we performed ex-vivo irradiation of human blood samples using the linear accelerator (LINAC). The LINAC was implemented and calibrated for irradiating human whole blood samples. To test the calibration, a 2 Gy test run was successfully performed on a tube filled with water with an accuracy of 3% in dose distribution. To validate our technique the blood samples were ex-vivo irradiated and the results were analyzed using a gene expression assay to follow the effect of the ionizing irradiation by characterizing dose responsive biomarkers from radiobiological assays. The response of 5 genes was monitored resulting in expression increase with the dose of radiation received. The blood samples treated with the LINAC can provide effective irradiated blood samples suitable for molecular profiling to validate radiobiological measurements via the gene-expression based biodosimetry tools. (orig.)

  5. A statistical method for descriminating between alternative radiobiological models

    International Nuclear Information System (INIS)

    Radiobiological models assist understanding of the development of radiation damage, and may provide a basis for extrapolating dose-effect curves from high to low dose regions. Many models have been proposed such as multitarget and its modifications, enzymatic models, and those with a quadratic dose response relationship (i.e. αD + βD2 forms). It is difficult to distinguish between these because the statistical techniques used are almost always limited, in that one method can rarely be applied to the whole range of models. A general statistical procedure for parameter estimation (Maximum Liklihood Method) has been found applicable to a wide range of radiobiological models. The curve parameters are estimated using a computerised search that continues until the most likely set of values to fit the data is obtained. When the search is complete two procedures are carried out. First a goodness of fit test is applied which examines the applicability of an individual model to the data. Secondly an index is derived which provides an indication of the adequacy of any model compared with alternative models. Thus the models may be ranked according to how well they fit the data. For example, with one set of data, multitarget types were found to be more suitable than quadratic types (αD + βD2). This method should be of assitance is evaluating various models. It may also be profitably applied to selection of the most appropriate model to use, when it is necessary to extrapolate from high to low doses

  6. Refined testicular dosimetry and radiobiology in radionuclide therapy

    International Nuclear Information System (INIS)

    The full text of the publication follows. The testes are one of the most radiosensitive organs. They constitute an important critical target tissue both for external and internal exposure during diagnostic or therapeutic use of radionuclides. The testis consists of an egg-shaped tissue containing a large number of lobules. These are occupied by one to four seminiferous tubules, where the spermatogenesis takes place, i.e. the complex process where germ cells proliferate and transform into spermatozoa. The testicular cells have different sensitivity to radiation with the highest sensitivity of the undifferentiated spermatogonia close of the basal cell layer, and lowest sensitivity of the more mature sperm cells migrating towards the lumen. Exposure of the testis may occur due to radiopharmaceutical administration in patients either for therapy or diagnostic purposes, which may result in considerable high absorbed dose to the testis and may harm the testicular germ cells. In general the mean absorbed dose to the whole testis is estimated, which has been reported for different radionuclides and radiopharmaceuticals in the literature. However, due to the difference in radiosensitivity of the germ cells the absorbed doses to each type of cells in the seminiferous epithelium is of importance for a radiobiological interpretation. Testicular dosimetry on the cellular level is a complex matter and has not yet been addressed. The aim of this project was to design a small-scale anatomy model for calculation of S-factors (Gy MBq-1) for different source-target combinations, i.e. the interstitial tissue and different germ cells of the seminiferous epithelium. Based on this small-scale anatomy model it should be possible to estimate radiobiological effects based on radioactivity distribution determined by autoradiography, calculated differentiated absorbed doses, and known radiosensitivity of the different germ cells. The novel small-scale anatomy model will be presented and its

  7. The radiobiology/radiation protection interface in healthcare

    International Nuclear Information System (INIS)

    The current knowledge of radiation effects is reviewed and implications for its application in healthcare considered. The 21st L H Gray conference gathered leading experts in radiobiology, radiation epidemiology, radiation effect modelling, and the application of radiation in medicine to provide an overview of the subject. The latest radiobiology research in non-targeted effects such as genomic instability and the bystander effect challenge the old models, but the implications for health effects on humans are uncertain. Adaptive responses to external stresses, of which radiation is one, have been demonstrated in cells and animal models, but it is not known how these might modify human dose-effect relationships. Epidemiological evidence from the Japanese A-bomb survivors provides strong evidence that there is a linear relationship between the excess risk of cancer and organ dose that extends from about 50 mSv up to 2.5 Sv, and results from pooled data for multiple epidemiological studies indicate that risks extend down to doses of 20 mSv. Thus linear extrapolation of the A-bomb dose-effect data provides an appropriate basis for radiological protection standards at the present time. Risks from higher dose diagnostic procedures fall within the range in which health effects can be demonstrated. There is therefore reason for concern about the rise in the number of computed tomography (CT) scans performed in many countries, and in particular the use of CT for screening of asymptomatic individuals. New radiotherapy techniques allow high dose radiation fields to be conformed more effectively to target volumes, and reduce doses to critical organs, but they tend to give a higher and more uniform dose to the whole body which may increase the risk of second cancer. It is important that radiation protection practitioners keep abreast of developments in understanding of radiation effects and advise the medical community about the implications of fundamental research when

  8. Strategies to improve the efficacy of radioimmunotherapy: Radiobiologic aspects

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate methods of improving the therapeutic index (dose to tumor/dose to normal organs) and, hence, the efficacy of radioimmunotherapy (RIT). One method investigated was to increase the biologic response for a given radiation dose to tumor. To enhance the biologic efficacy of the dose, initial studies focused on first understanding the radiobiology of RIT irradiation and determining what role factors, such as radiation repair, repopulation, and redistribution, play in determining RIT response. In vitro studies using 4 colon carcinoma cell lines have compared the radiobiologic efficacy of low dose-rate irradiation delivered by Yttrium-90 (Y-90) with conventional high dose-rate external beam irradiation (XRT). Results suggested that one factor which determined a cell's sensitivity to Y-90 irradiation was its ability to repair radiation sublethal damage. In vivo studies demonstrated that those cell lines which were more sensitive to Y-90 irradiation in vitro were also more sensitive to RIT in vivo. For a more radioresistant line, WiDr, RIT was approximately two-fold less effective than an equivalent dose of single fraction XRT, while for a more radiosensitive line, LS174T, RIT was approximately as effective as an equivalent dose of single fraction XRT. Therefore, a tumor's response to RIT in vivo appeared to be, in part, dependent on the tumor cell's ability to repair radiation damage. Finally, studies investigated strategies at enhancing the biologic efficacy of RIT irradiation by combining RIT with chemotherapy agents that can potentially inhibit radiation repair. Agents, such as 5-fluorouracil, appeared to be synergistic with RIT irradiation n vitro and may therefore prove promising in improving the therapeutic index of RIT

  9. Facilitative and obstructive factors in the clinical learning environment: Experiences of pupil enrolled nurses

    Directory of Open Access Journals (Sweden)

    Eucebious Lekalakala-Mokgele

    2015-02-01

    Full Text Available Background: The clinical learning environment is a complex social entity that influences student learning outcomes in the clinical setting. Students can experience the clinical learning environment as being both facilitative and obstructive to their learning. The clinical environment may be a source of stress, creating feelings of fear and anxiety which in turn affect the students’ responses to learning. Equally, the environment can enhance learning if experienced positively.Objectives: This study described pupil enrolled nurses’ experiences of facilitative and obstructive factors in military and public health clinical learning settings.Method: Using a qualitative, contextual, exploratory descriptive design, three focus group interviews were conducted until data saturation was reached amongst pupil enrolled nurses in a military School of Nursing.Results: Data analysed provided evidence that acceptance by clinical staff and affordance of self-directed learning facilitated learning. Students felt safe to practise when they were supported by the clinical staff. They felt a sense of belonging when the staff showed an interest in and welcomed them. Learning was obstructed when students were met with condescending comments. Wearing of a military uniform in the public hospital and horizontal violence obstructed learning in the clinical learning environment.Conclusion: Students cannot have effective clinical preparation if the environment is not conducive to and supportive of clinical learning, The study shows that military nursing students experience unique challenges as they are trained in two professions that are hierarchical in nature. The students experienced both facilitating and obstructing factors to their learning during their clinical practice. Clinical staff should be made aware of factors which can impact on students’ learning. Policies need to be developed for supporting students in the clinical learning environment.

  10. Stem Cell Therapy for Cardiovascular Disorders - Our Clinical Experience

    Directory of Open Access Journals (Sweden)

    Jayakrishnan AG

    2011-01-01

    Full Text Available Background: Autologous Bone Marrow stem Cell transplantation is a viable therapeutic option for patients with end stage heart failure due to cardiomyopathy of varied etiology as there are only limited treatment options other than cardiac transplantation. The rationale behind the application of stem cells in these patients include • Stem cells directly replace the affected cells by differentiation into the damaged cell type • Stem cells also exert Paracrine effects by secre tion of growth factors (VGEF,FGF-1to stimu late local cell growth•In addition to the above, stem cells release signaling factors which recruit stem cells from elsewhere by modulating the immune system.Materials and Methods: In this presentation we describe our study on a series of 13 patients who received isolated and expanded CD 34 cells from the bone marrow. Seven had ischemic dysfunction, three had dilated cardiomyopathy and three had primary pulmonary hypertension. Five patients received the stem cells via intracoronary injection, three directly into the myocardium and three intrapulmonary. Results: All patients showed functional improvement of the myocardium recorded by non-invasive investigations and improvement in the quality of life. Follow up period ranged from 6 months to 2 years. Conclusion: Our experience with bone marrow derived stem cells in patients with cardiomyopathy has been encouraging. More studies are planned in the future.

  11. Initial experience of the medical clinic of the education Casmu

    International Nuclear Information System (INIS)

    Full text: What happens when a patient (p te) is faced once treatment Q T? We know that for p te involves both how their family; face a charge of myths and half-truths; causing the treatment is so vivid apprehension as the disease itself. In this context the concern of the Department of Oncology Casmu arises; of give patients an area where the p te to receive information contribute to reaching the treatment of Q T in better condition. All patients will start treatment Q T for the first time; are cited for an interview at the Polyclinic of Education. It is coordinated delayed with respect to the talks with the Treating oncologist, in order to allow the patient to develop their doubts and to raise them. In the interview also involved the p te and his family, Oncology Residents Department, and a member of Campus Nursing thereof. the interview is divided into five modules: 1) Administrative Aspects 2) Nursing Care 3) Potential side effects. 4) Social Benefits 5) Resources Information. Between January 2003 and August 2004, 70 interviews were conducted education. the average length thereof was 30 minutes. Is in progress writing a brochure based on the questions most frequently asked by patients and their families; well as an evaluation of the experience

  12. Transitions from Clinical Experiences to Clinical Questions and then Research: Songwriting with Bereaved Pre-adolescent Children

    Directory of Open Access Journals (Sweden)

    Melina Roberts

    2006-11-01

    Full Text Available The purpose of this article is to describe the author’s personal transition from her clinical experiences working with bereaved children and adolescents, to clinical questions that arose during this time, and then to her current phase whereby she has commenced research to examine songwriting with bereaved children. This article includes relevant literature that discusses bereavement in childhood, songwriting in music therapy, and music therapy support for bereaved children and adolescents. A description about the author’s current research, that integrates the three areas highlighted in the literature, is also discussed.

  13. Imaging tissue hypoxia: clinical and pre-clinical experience with {sup 123}IAZA

    Energy Technology Data Exchange (ETDEWEB)

    Wiebe, L.I. [University of Alberta, Edmonton (Canada). Noujaim Institute for Pharmaceutical Oncology Research, Faculty of Pharmacy and Pharmaceutical Sciences

    1997-10-01

    The molecular mechanisms that underline the selective binding of iodazomycin arabinoside, IAZA, and related nitromidazoles are reviewed as a basis for interpretation of preclinical and clinical data for hypoxic binding of radioiodinated IAZA. Clinical data are presented for {sup 123}IAZA uptake in a number of pathologies including metastatic tumours, peripheral vascular disease in diabetes, muscle stress and rheumatoid arthritis. The results of studies to determine the influence of tumour type on uptake of {sup 123} I-IAZA in patients with a variety of deep-seated solid tumours will be presented. Correlations of hypoxia-dependent binding with {sup 99m}Tc-HMPAO perfusion images will be reviewed and early correlations of uptake to treatment response in cancer will be presented. Unusual features of {sup 123}I-IAZA biodistribution will also be discussed together with detailed pharmacokinetic and radiation dosimetry data for `2{sup 123}I- IAZA in normal volunteers 27 refs., 1 fig.

  14. Imaging tissue hypoxia: clinical and pre-clinical experience with 123IAZA

    International Nuclear Information System (INIS)

    The molecular mechanisms that underline the selective binding of iodazomycin arabinoside, IAZA, and related nitromidazoles are reviewed as a basis for interpretation of preclinical and clinical data for hypoxic binding of radioiodinated IAZA. Clinical data are presented for 123IAZA uptake in a number of pathologies including metastatic tumours, peripheral vascular disease in diabetes, muscle stress and rheumatoid arthritis. The results of studies to determine the influence of tumour type on uptake of 123 I-IAZA in patients with a variety of deep-seated solid tumours will be presented. Correlations of hypoxia-dependent binding with 99mTc-HMPAO perfusion images will be reviewed and early correlations of uptake to treatment response in cancer will be presented. Unusual features of 123I-IAZA biodistribution will also be discussed together with detailed pharmacokinetic and radiation dosimetry data for '2123I- IAZA in normal volunteers

  15. The cardiac troponins: uses in routine clinical practice. Experiences from GUSTO and other clinical trials.

    Science.gov (United States)

    Stubbs, P

    1998-11-01

    Recent advances in pharmacological and mechanical approaches to acute coronary syndromes have led to rapid changes in the management of patients admitted with acute coronary syndromes. These changes have been mirrored by the appearance of newer highly specific biochemical markers of myocardial damage particularly the cardiac troponins. When new biochemical markers become available it is the responsibility of the clinical chemist to evaluate them critically in terms of sensitivity, specificity, efficiency and analyzer precision, in the rigid setting of quality control that laboratories practise, and to compare them with other markers. When the data are shown to Clinical Cardiologists with supporting statements such as 'useful management tool' and 'can be used for early diagnosis of Myocardial Infarction', a different set of questions may need to be answered. The 'So what?' response is most frequent and is the most important hurdle that these newer biochemical markers have to overcome to convince physicians to change their current practice. This presentation will review the results of studies that have examined the potential clinical usefulness of the cardiac troponins with respect to diagnosis and risk stratification of patients admitted with suspected acute coronary syndromes. Any troponin variable that survives the 'so what' question has one further major hurdle to overcome. This is the requirement to inform physicians what different therapeutic strategies they should follow if the variable is present. Available clinical trial evidence about differing management options for patients according to their troponin status will be reviewed and outline management algorithms will be presented. Many questions remain unanswered and these will be included at the time points where they may be relevant. PMID:9857942

  16. Dosimetric measurements and radiobiological consequences of radioimmunotherapy in tumor bearing mice

    International Nuclear Information System (INIS)

    With the development of the hybridoma technology, the production of highly specific tumor associated monoclonal antibodies has provided new optimism for the adjuvant delivery of therapeutic radiation doses via radioimmunotherapy. The authors have used a modified form of the well-established TL dosimetry technology to measure the dose resulting from radioimmunotherapy experiments in tumor bearing mice. Their laboratory has designed and tested a miniature CaSO4:D TLD which fits conveniently inside a 20 gauge needle for the direct implantation of the dosimeter in an animal model undergoing radiolabeled antibody therapy. Direct measurement of absorbed dose from beta and gamma radiation in the animals may be obtained upon removal of the dosimeter at animal sacrifice or by surgery. This absorbed dose data may then be related to antibody affinity and localization data obtained by serial biodistribution studies. Using p96.5 melanoma antibody with a Brown Tumor Model in athymic mice, localization indices measured in the range of 2 to 4 and scored 4 to 7 days post antibody injection, yielded a tumor dose/whole body dose ratio of 1.10 +/- 0.04 (no enhancement). The dose to liver showed marker time-dependent enhancement relative to the whole body, however. An outline of suggested control radiobiological experiments to be performed in conjunction with radioimmunotherapy experiments has been included in order to provide comparative dose response data. 11 references, 14 figures, 3 tables

  17. Clinical trial experience using erythropoietin during radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lavey, R.S. [Radiation Oncology Program, Childrens Hospital Los Angeles, Univ. of Southern California, CA, Los Angeles (United States)

    1998-12-01

    Oncologists have several reasons for trying to maintain or increase hemoglobin levels in their patients during therapy. Relief of the symptoms of anemia, including fatigue and dyspnea, are traditional, well-accepted indications. A newer rationale is to enhance the efficacy of radiation therapy and/or chemotherapy in controlling tumors. A laboratory animal study found that administration of recombinant human erythropoietin (rHuEPO) increased intratumoral median oxygen levels and diminished the proportion of measurements in the very low (<3 mm Hg) range. Hemoglobin level is a strong independent prognostic factor for tumor control by radiation therapy. The hemoglobin level at the end of radiation therapy is a stronger prognostic factor than is the hemoglobin level at the start of therapy. Numerous clinical trials have utilized rHuEPO during radiation with or without concurrent chemotherapy. All 4 trials which enrolled patients with low hemoglobin levels (<12 to 13.5 g/dl) found that rHuEPO significantly increased hemoglobin within 2 weeks and that hemoglobin levels continued to rise until the end of rHuEPO treatment. rHuEPO was efficacious in limiting the decrease in hemoglobin and use of packed red blood cell transfusion in the one reported trial in which it was used in patients with initially normal hemoglobin levels during intensive concurrent radiation and chemotherapy. One trial found a statistically significant improvement in complete pathologic response rate after neoadjuvant chemoradiotherapy with the use of rHuEPO. rHuEPO has a potentially large role to play in the care of the cancer patient. (orig.) [Deutsch] In der Onkologie bestehen zahlreiche Gruende, die Haemoglobinkonzentration der Patienten waehrend der Therapie zu halten oder sogar anzuheben. Als anerkannte Indikation gilt hierbei die Besserung anaemiebedingter Symptome wie Muedigkeit und Dyspnoe, wobei jedoch neuere Ergebnisse darauf hinweisen, dass auch die Effizienz der Strahlen- und

  18. The Lived Experience and Training Needs of Librarians Serving at the Clinical Point-of-Care.

    Science.gov (United States)

    Lyon, Jennifer A; Kuntz, Gretchen M; Edwards, Mary E; Butson, Linda C; Auten, Beth

    2015-01-01

    This study examines the emotional experiences and perceptions of librarians embedded into clinical care teams and how those perceptions affect their training and preparation needs. Qualitative research methodologies were applied to textual data drawn from focus groups (n = 21), interviews (n = 2), and an online survey (n = 167), supplemented by quantitative survey data. Phenomenological results show librarians experience strongly affective responses to clinical rounding. Important factors include personal confidence; relationships with team members, patients, and families; and the stressful environment. Analysis of librarians' perceived educational needs indicates that training must address specialized subjects including medical knowledge, clinical culture, and institutional politics. PMID:26211792

  19. The Lived Experience and Training Needs of Librarians Serving at the Clinical Point-of-Care

    Science.gov (United States)

    Kuntz, Gretchen M.; Edwards, Mary E.; Butson, Linda C.; Auten, Beth

    2016-01-01

    This study examines the emotional experiences and perceptions of librarians embedded into clinical care teams and how those perceptions affect their training and preparation needs. Qualitative research methodologies were applied to textual data drawn from focus groups (n=21), interviews (n=2), and an online survey (n=167), supplemented by quantitative survey data. Phenomenological results show librarians experience strongly effective responses to clinical rounding. Important factors include personal confidence; relationships with team members, patients, and families; and the stressful environment. Analysis of librarians’ perceived educational needs indicates that training must address specialized subjects including medical knowledge, clinical culture, and institutional politics. PMID:26211792

  20. A study of the radiobiological modeling of the conformal radiation therapy in cancer treatment

    Science.gov (United States)

    Pyakuryal, Anil Prasad

    Cancer is one of the leading causes of mortalities in the world. The precise diagnosis of the disease helps the patients to select the appropriate modality of the treatments such as surgery, chemotherapy and radiation therapy. The physics of X-radiation and the advanced imaging technologies such as positron emission tomography (PET) and computed tomography (CT) plays an important role in the efficient diagnosis and therapeutic treatments in cancer. However, the accuracy of the measurements of the metabolic target volumes (MTVs) in the PET/CT dual-imaging modality is always limited. Similarly the external beam radiation therapy (XRT) such as 3D conformal radiotherapy (3DCRT) and intensity modulated radiation therapy (IMRT) is the most common modality in the radiotherapy treatment. These treatments are simulated and evaluated using the XRT plans and the standard methodologies in the commercial planning system. However, the normal organs are always susceptible to the radiation toxicity in these treatments due to lack of knowledge of the appropriate radiobiological models to estimate the clinical outcomes. We explored several methodologies to estimate MTVs by reviewing various techniques of the target volume delineation using the static phantoms in the PET scans. The review suggests that the more precise and practical method of delineating PET MTV should be an intermediate volume between the volume coverage for the standardized uptake value (SUV; 2.5) of glucose and the 50% (40%) threshold of the maximum SUV for the smaller (larger) volume delineations in the radiotherapy applications. Similarly various types of optimal XRT plans were designed using the CT and PET/CT scans for the treatment of various types of cancer patients. The qualities of these plans were assessed using the universal plan-indices. The dose-volume criteria were also examined in the targets and organs by analyzing the conventional dose-volume histograms (DVHs). The biological models such as tumor

  1. Nursing students’ perception of clinical learning experiences as provided by the nursing staff in the wards

    Directory of Open Access Journals (Sweden)

    N. R. C. TIakula

    1993-05-01

    Full Text Available A descriptive survey was carried out, using convenience and systematic sampling in order to better understand the manner in which student nurses perceive their clinical experience in the hospital. Data were collected from 80 subjects in 4 nursing colleges using a critical incident technique. Positive and negative experiences are described,

  2. What Students Really Learn: Contrasting Medical and Nursing Students' Experiences of the Clinical Learning Environment

    Science.gov (United States)

    Liljedahl, Matilda; Boman, Lena Engqvist; Fält, Charlotte Porthén; Bolander Laksov, Klara

    2015-01-01

    This paper explores and contrasts undergraduate medical and nursing students' experiences of the clinical learning environment. Using a sociocultural perspective of learning and an interpretative approach, 15 in-depth interviews with medical and nursing students were analysed with content analysis. Students' experiences are described using a…

  3. Using Case Study Analysis and Case Writing to Structure Clinical Experiences in a Teacher Education Program

    Science.gov (United States)

    Floyd, Deborah M.; Bodur, Yasar

    2005-01-01

    This study reports on the design and results of a two-semester study on the use of case study analysis and case writing in clinical experiences in an undergraduate teacher education program. Findings indicated that structured experiences with case studies and case writing increase preservice teachers' informed decision making on educational…

  4. Radiography students' clinical placement experiences in MRI: A phenomenological study

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to gain an insight into radiography students' clinical practice experiences within an MRI unit of a large teaching hospital in Malta. The underlying objectives of the study were to identify and explore the descriptions and meanings of the MRI clinical experiences of students. Methods: Five students, independently undergoing their clinical placements in MRI were asked to write a diary about their daily experiences. Each student then participated in a follow up interview. Data analysis was based on Husserls' phenomenological approach. Results: Eight themes emerged from the data analysed. Students described their experience as one mainly based on observation, where, during their placements, they observed radiographers at work. In this respect, students described their experience as lacking ‘hands on practice’. Students indicated that they felt uncomfortable, unsupervised and unwelcome most of the time. They also expressed the need to feel useful and part of the MRI team during their placement and so they tried to help the team in areas such as patient screening. This helped them build confidence. Learning in MRI was specifically based on the university tasks prescribed and possibly there was no motivation to learn more. The students also described their experience as varied and different when compared to other placements. Conclusion: This study provides a rare insight into radiography students' placement experiences in MRI and should enable the supervising radiographer and educator to obtain a deeper appreciation of the clinical placement experience

  5. Comprehensive Experiment--Clinical Biochemistry: Determination of Blood Glucose and Triglycerides in Normal and Diabetic Rats

    Science.gov (United States)

    Jiao, Li; Xiujuan, Shi; Juan, Wang; Song, Jia; Lei, Xu; Guotong, Xu; Lixia, Lu

    2015-01-01

    For second year medical students, we redesigned an original laboratory experiment and developed a combined research-teaching clinical biochemistry experiment. Using an established diabetic rat model to detect blood glucose and triglycerides, the students participate in the entire experimental process, which is not normally experienced during a…

  6. Knowledge evolution on effects of ionizing radiations on living being. New prospects of radiobiological researches

    International Nuclear Information System (INIS)

    The knowledge increase of all the steps going from the material radiation interaction to the risk evaluation, prevention and irradiation consequences treatment leads to new prospects in radiobiology research, such as the low doses effects. (A.B.)

  7. Recent trends in radiobiology of skin and repercussions for dose limitation and personal dosimetry

    International Nuclear Information System (INIS)

    Recent advances in the radiobiology of skin are reviewed with particular emphasis on those aspects relevant to the updating of radiological protection criteria for skin dose limitation which is currently being undertaken by the ICRP and NCRP. (author)

  8. Press breakfast, radiobiology stakes: an European context, Thursday 25 March 2004

    International Nuclear Information System (INIS)

    The radiobiology endeavours to know the ionizing radiations effects on living systems, particular at low doses exposures. The researches in this area contribute to the elaboration of international regulation on nuclear industry. The individual radiosensitivity is an other aspect of the research in radiobiology. These studies should allow the establishing of radiation protection standards founded on a direct approach and an individual estimation of the level of acceptable dose. (N.C.)

  9. Proceedings of scientific conference of young scientists 'Fundamental and applied problems of radiobiology and radioecology'

    International Nuclear Information System (INIS)

    This book contains modern views on mechanisms of biological effects of ionising radiation in low doses and peculiarities of radionuclide migration in different ecosystems which are based on experimental data in works of young scientists represented on research conference 'Fundamental and applied problems of radiobiology and radioecology'. Special attentions of this publication are investigations in fields of radiation genetics and biochemistry, medical an biological aspects of radiation exposure, plant radiobiology and radioecology

  10. Expertise in Clinical Psychology. The Effects of University Training and Practical Experience on Expertise in Clinical Psychology

    OpenAIRE

    Vollmer, Sabine; Spada, Hans; Caspar, Franz; Burri, Salome

    2013-01-01

    How do university training and subsequent practical experience affect expertise in clinical psychology? To answer this question we developed methods to assess psychological knowledge and the competence to diagnose, construct case conceptualizations, and plan psychotherapeutic treatment: a knowledge test and short case studies in a first study, and a complex, dynamically evolving case study in the second study. In our cross-sectional studies, psychology students, trainees in a certified postgr...

  11. Sequencing of Simulation and Clinic Experiences in an Introductory Pharmacy Practice Experience

    OpenAIRE

    Leon, Nicholas; Hajjar, Emily; DeSevo Bellottie, Gina

    2015-01-01

    Objective. To examine how the intrasemester sequencing of a simulation component, delivered during an ambulatory care introductory pharmacy practice experience (IPPE), affects student performance on a series of 3 assessments delivered during the second professional (P2) year.

  12. Radiograaff, a proton irradiation facility for radiobiological studies at a 4 MV Van de Graaff accelerator

    Energy Technology Data Exchange (ETDEWEB)

    Constanzo, J. [Université de Lyon, F-69622, Lyon (France); Université Lyon 1, Villeurbanne (France); CNRS/IN2P3, Institut de Physique Nucléaire de Lyon, F-69622 Villeurbanne (France); Fallavier, M., E-mail: m.fallavier@ipnl.in2p3.fr [Université de Lyon, F-69622, Lyon (France); Université Lyon 1, Villeurbanne (France); CNRS/IN2P3, Institut de Physique Nucléaire de Lyon, F-69622 Villeurbanne (France); Alphonse, G. [Université de Lyon, F-69622, Lyon (France); Université Lyon 1, Villeurbanne (France); Faculté de Médecine Lyon-Sud, LRCM, F-69921 Oullins (France); Hospices-Civils-de-Lyon, CHLS, F-69495 Pierre-Bénite (France); Bernard, C. [Université de Lyon, F-69622, Lyon (France); Université Lyon 1, Villeurbanne (France); CNRS/IN2P3, Institut de Physique Nucléaire de Lyon, F-69622 Villeurbanne (France); Battiston-Montagne, P. [Université de Lyon, F-69622, Lyon (France); Université Lyon 1, Villeurbanne (France); Faculté de Médecine Lyon-Sud, LRCM, F-69921 Oullins (France); Rodriguez-Lafrasse, C. [Université de Lyon, F-69622, Lyon (France); Université Lyon 1, Villeurbanne (France); Faculté de Médecine Lyon-Sud, LRCM, F-69921 Oullins (France); Hospices-Civils-de-Lyon, CHLS, F-69495 Pierre-Bénite (France); and others

    2014-09-01

    A horizontal beam facility for radiobiological experiments with low-energy protons has been set up at the 4 MV Van de Graaff accelerator of the Institut de Physique Nucléaire de Lyon. A homogeneous irradiation field with a suitable proton flux is obtained by means of two collimators and two Au-scattering foils. A monitoring chamber contains a movable Faraday cup, a movable quartz beam viewer for controlling the intensity and the position of the initial incident beam and four scintillating fibers for beam monitoring during the irradiation of the cell samples. The beam line is ended by a thin aluminized Mylar window (12 μm thick) for the beam extraction in air. The set-up was simulated by the GATE v6.1 Monte-Carlo platform. The measurement of the proton energy distribution, the evaluation of the fluence-homogeneity over the sample and the calibration of the monitoring system were performed using a silicon PIPS detector, placed in air in the same position as the biological samples to be irradiated. The irradiation proton fluence was found to be homogeneous to within ±2% over a circular field of 20 mm diameter. As preliminary biological experiment, two Human Head and Neck Squamous Carcinoma Cell lines (with different radiosensitivities) were irradiated with 2.9 MeV protons. The measured survival curves are compared to those obtained after X-ray irradiation, giving a Relative Biological Efficiency between 1.3 and 1.4.

  13. Radiograaff, a proton irradiation facility for radiobiological studies at a 4 MV Van de Graaff accelerator

    International Nuclear Information System (INIS)

    A horizontal beam facility for radiobiological experiments with low-energy protons has been set up at the 4 MV Van de Graaff accelerator of the Institut de Physique Nucléaire de Lyon. A homogeneous irradiation field with a suitable proton flux is obtained by means of two collimators and two Au-scattering foils. A monitoring chamber contains a movable Faraday cup, a movable quartz beam viewer for controlling the intensity and the position of the initial incident beam and four scintillating fibers for beam monitoring during the irradiation of the cell samples. The beam line is ended by a thin aluminized Mylar window (12 μm thick) for the beam extraction in air. The set-up was simulated by the GATE v6.1 Monte-Carlo platform. The measurement of the proton energy distribution, the evaluation of the fluence-homogeneity over the sample and the calibration of the monitoring system were performed using a silicon PIPS detector, placed in air in the same position as the biological samples to be irradiated. The irradiation proton fluence was found to be homogeneous to within ±2% over a circular field of 20 mm diameter. As preliminary biological experiment, two Human Head and Neck Squamous Carcinoma Cell lines (with different radiosensitivities) were irradiated with 2.9 MeV protons. The measured survival curves are compared to those obtained after X-ray irradiation, giving a Relative Biological Efficiency between 1.3 and 1.4

  14. Differential two colour X-ray radiobiology of membrane/cytoplasm yeast cells

    International Nuclear Information System (INIS)

    This report describes the experiment entitled 'Differential Two Colour X-Ray Radiobiology of Membrane/Cytoplasm Yeast Cells'; carried out at the Central Laser Facility (CLF) from the 6th January to the 3rd February 1997. The experiment, funded by the Framework IV Large-Scale Facilities Access Scheme, was proposed by Dr. M. Milani, Dipartimento di Scienza dei Materiali, University of Milan, Italy, and carried out by visiting researchers from his institute, the University of Modena and with technical support from the Central Laser Facility, Rutherford Appleton Laboratory. Experimental highlights: The development of an investigation technique based on the use of very soft X-ray in order to damage specific structures inside the cell structure (specifically cell wall and membrane); the use of pressure sensors as a diagnostics of cell response which allows to monitor cell response over a large range of times from fast response up to several hours; the use of dry yeast cells as an 'easy to handle' type of sample; the development of a simple model for X-ray dosimetry of the different cell compartments; the study of metabolic oscillation in yeast cell suspension and the observation of the oscillation frequency shift following an exposure to soft X-rays. (author)

  15. Collimator design for spatially-fractionated proton beams for radiobiology research

    Science.gov (United States)

    Lee, Eunsin; Meyer, Juergen; Sandison, George

    2016-07-01

    Preclinical and translational research is an imperative to improve the efficacy of proton radiotherapy. We present a feasible and practical method to produce spatially-modulated proton beams for cellular and small animal research for clinical and research facilities. The University of Washington (UW) 50.5 MeV proton research beamline hosting a brass collimation system was modeled using Monte Carlo simulations. This collimator consisted of an array of 2 cm long slits to cover an area of 2  ×  2 cm2. To evaluate the collimator design effects on dose rate, valley dose and the peak-to-valley dose ratios (PVDR) the following parameters were varied; slit width (0.1–1.0 mm), peak center-to-center distance (1–3 mm), collimator thickness (1–7 cm) and collimator location along the beam axis. Several combinations of slit widths and 1 mm spacing achieved uniform dose at the Bragg peak while maintaining spatial modulation on the beam entrance. A more detailed analysis was carried out for the case of a slit width of 0.3 mm, peak center-to-center distance of 1 mm, a collimator thickness of 5 cm and with the collimator flush against the water phantom. The dose rate at 5 mm depth dropped relative to an open field by a factor of 12 and produced a PVDR of 10.1. Technical realization of proton mini-beams for radiobiology small animal research is demonstrated to be feasible. It is possible to obtain uniform dose at depth while maintaining reasonable modulation at shallower depths near the beam entrance. While collimator design is important the collimator location has a strong influence on the entrance region PVDRs and on dose rate. These findings are being used to manufacture a collimator for installation on the UW cyclotron proton beam nozzle. This collimator will enable comparative studies on the radiobiological efficacy of x-rays and proton beams.

  16. An in vitro study of the radiobiological effects of flattening filter free radiotherapy treatments

    International Nuclear Information System (INIS)

    Flattening filter free (FFF) linear accelerators allow for an increase in instantaneous dose-rate of the x-ray pulses by a factor of 2–6 over the conventional flattened output. As a result, radiobiological investigations are being carried out to determine the effect of these higher dose-rates on cell response. The studies reported thus far have presented conflicting results, highlighting the need for further investigation. To determine the radiobiological impact of the increased dose-rates from FFF exposures a Varian Truebeam medical linear accelerator was used to irradiate two human cancer cell lines in vitro, DU-145 prostate and H460 non-small cell lung, with both flattened and FFF 6 MV beams. The fluence profile of the FFF beam was modified using a custom-designed Nylon compensator to produce a similar dose profile to the flattened beam (6X) at the cell surface but at a higher instantaneous dose-rate. For both cell lines there appeared to be no significant change in cell survival. Curve fitting coefficients for DU145 cells irradiated with constant average dose-rates were 6X: α = 0.09 ± 0.03, β = 0.03 ± 0.01 and 6FFF: α = 0.14 ± 0.13, β = 0.03 ± 0.02 with a significance of p = 0.75. For H460 cells irradiated with the same instantaneous dose-rate but different average dose-rate the fit coefficients were 6FFF (low dose-rate): α = 0.21 ± 0.11, 0.07 ± 0.02 and 6FFF (high dose-rate): α = 0.21 ± 0.16, 0.07 ± 0.03, with p = 0.79. The results indicate that collective damage behaviour does not occur at the instantaneous dose-rates investigated here and that the use of either modality should result in the same clinical outcome, however this will require further validation in vivo. (note)

  17. An in vitro study of the radiobiological effects of flattening filter free radiotherapy treatments

    Science.gov (United States)

    King, R. B.; Hyland, W. B.; Cole, A. J.; Butterworth, K. T.; McMahon, S. J.; Redmond, K. M.; Trainer, C.; Prise, K. M.; McGarry, C. K.; Hounsell, A. R.

    2013-03-01

    Flattening filter free (FFF) linear accelerators allow for an increase in instantaneous dose-rate of the x-ray pulses by a factor of 2-6 over the conventional flattened output. As a result, radiobiological investigations are being carried out to determine the effect of these higher dose-rates on cell response. The studies reported thus far have presented conflicting results, highlighting the need for further investigation. To determine the radiobiological impact of the increased dose-rates from FFF exposures a Varian Truebeam medical linear accelerator was used to irradiate two human cancer cell lines in vitro, DU-145 prostate and H460 non-small cell lung, with both flattened and FFF 6 MV beams. The fluence profile of the FFF beam was modified using a custom-designed Nylon compensator to produce a similar dose profile to the flattened beam (6X) at the cell surface but at a higher instantaneous dose-rate. For both cell lines there appeared to be no significant change in cell survival. Curve fitting coefficients for DU145 cells irradiated with constant average dose-rates were 6X: α = 0.09 ± 0.03, β = 0.03 ± 0.01 and 6FFF: α = 0.14 ± 0.13, β = 0.03 ± 0.02 with a significance of p = 0.75. For H460 cells irradiated with the same instantaneous dose-rate but different average dose-rate the fit coefficients were 6FFF (low dose-rate): α = 0.21 ± 0.11, 0.07 ± 0.02 and 6FFF (high dose-rate): α = 0.21 ± 0.16, 0.07 ± 0.03, with p = 0.79. The results indicate that collective damage behaviour does not occur at the instantaneous dose-rates investigated here and that the use of either modality should result in the same clinical outcome, however this will require further validation in vivo.

  18. Radiobiological modeling of interplay between accelerated repopulation and altered fractionation schedules in head and neck cancer

    Directory of Open Access Journals (Sweden)

    Marcu Loredana

    2009-01-01

    Full Text Available Head and neck cancer represents a challenge for radiation oncologists due to accelerated repopulation of cancer cells during treatment. This study aims to simulate, using Monte Carlo methods, the response of a virtual head and neck tumor to both conventional and altered fractionation schedules in radiotherapy when accelerated repopulation is considered. Although clinical trials are indispensable for evaluation of novel therapeutic techniques, they are time-consuming processes which involve many complex and variable factors for success. Models can overcome some of the limitations encountered by trials as they are able to simulate in less complex environment tumor cell kinetics and dynamics, interaction processes between cells and ionizing radiation and their outcome. Conventional, hyperfractionated and accelerated treatment schedules have been implemented in a previously developed tumor growth model which also incorporates tumor repopulation during treatment. This study focuses on the influence of three main treatment-related parameters, dose per fraction, inter fraction interval and length of treatment gap and gap timing based on RTOG trial data on head and neck cancer, on tumor control. The model has shown that conventionally fractionated radiotherapy is not able to eradicate the stem population of the tumor. Therefore, new techniques such as hyperfractionated/ accelerated radiotherapy schedules should be employed. Furthermore, the correct selection of schedule-related parameters (dose per fraction, time between fractions, treatment gap scheduling is crucial in overcoming accelerated repopulation. Modeling of treatment regimens and their input parameters can offer better understanding of the radiobiological interactions and also treatment outcome.

  19. Evaluation of radiobiological effects in 3 distinct biological models

    International Nuclear Information System (INIS)

    Full text of publication follows. The present work aims at sharing the process of development of advanced biological models to study radiobiological effects. Recognizing several known limitations and difficulties of the current monolayer cellular models, as well as the increasing difficulties to use advanced biological models, our group has been developing advanced biological alternative models, namely three-dimensional cell cultures and a less explored animal model (the Zebra fish - Danio rerio - which allows the access to inter-generational data, while characterized by a great genetic homology towards the humans). These 3 models (monolayer cellular model, three-dimensional cell cultures and zebra fish) were externally irradiated with 100 mGy, 500 mGy or 1 Gy. The consequences of that irradiation were studied using cellular and molecular tests. Our previous experimental studies with 100 mGy external gamma irradiation of HepG2 monolayer cells showed a slight increase in the proliferation rate 24 h, 48 h and 72 h post irradiation. These results also pointed into the presence of certain bystander effects 72 h post irradiation, constituting the starting point for the need of a more accurate analysis realized with this work. At this stage, we continue focused on the acute biological effects. Obtained results, namely MTT and clonogenic assays for evaluating cellular metabolic activity and proliferation in the in vitro models, as well as proteomics for the evaluation of in vivo effects will be presented, discussed and explained. Several hypotheses will be presented and defended based on the facts previously demonstrated. This work aims at sharing the actual state and the results already available from this medium-term project, building the proof of the added value on applying these advanced models, while demonstrating the strongest and weakest points from all of them (so allowing the comparison between them and to base the subsequent choice for research groups starting

  20. Nursing faculty teaching a module in clinical skills to medical students: a Lebanese experience

    Directory of Open Access Journals (Sweden)

    Abdallah B

    2014-11-01

    Full Text Available Bahia Abdallah,1 Jihad Irani,2 Silva Dakessian Sailian,1 Vicky George Gebran,1 Ursula Rizk1 1Nursing Program at the Faculty of Health Sciences, University of Balamand, 2Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon Abstract: Nursing faculty teaching medical students a module in clinical skills is a relatively new trend. Collaboration in education among medical and nursing professions can improve students' performance in clinical skills and consequently positively impact the quality of care delivery. In 2011, the Faculty of Medicine in collaboration with the Faculty of Health Sciences at the University of Balamand, Beirut, Lebanon, launched a module in clinical skills as part of clinical skills teaching to first-year medical students. The module is prepared and delivered by nursing faculty in a laboratory setting. It consists of informative lectures as well as hands-on clinical practice. The clinical competencies taught are hand-washing, medication administration, intravenous initiation and removal, and nasogastric tube insertion and removal. Around sixty-five medical students attend this module every year. A Likert scale-based questionnaire is used to evaluate their experience. Medical students agree that the module provides adequate opportunities to enhance clinical skills and knowledge and favor cross-professional education between nursing and medical disciplines. Most of the respondents report that this experience prepares them better for clinical rotations while increasing their confidence and decreasing anxiety level. Medical students highly appreciate the nursing faculties' expertise and perceive them as knowledgeable and resourceful. Nursing faculty participating in medical students' skills teaching is well perceived, has a positive impact, and shows nurses are proficient teachers to medical students. Cross professional education is an attractive model when it comes to teaching clinical skills in

  1. Clinical Outcome and Safety of Multilevel Vertebroplasty: Clinical Experience and Results

    Energy Technology Data Exchange (ETDEWEB)

    Mailli, Leto, E-mail: lmailli@hotmail.com; Filippiadis, Dimitrios K.; Brountzos, Elias N.; Alexopoulou, Efthymia; Kelekis, Nikolaos; Kelekis, Alexios [Attikon University Hospital, Second Department of Radiology, Athens University School of Medicine (Greece)

    2013-02-15

    To compare safety and efficacy of percutaneous vertebroplasty (PVP) when treating up to three vertebrae or more than three vertebrae per session. We prospectively compared two groups of patients with symptomatic vertebral fractures who had no significant response to conservative therapy. Pathologic substrate included osteoporosis (n = 77), metastasis (n = 24), multiple myeloma (n = 13), hemangioma (n = 15), and lymphoma (n = 1). Group A patients (n = 94) underwent PVP of up to three treated vertebrae (n = 188). Group B patients (n = 36) underwent PVP with more than three treated vertebrae per session (n = 220). Decreased pain and improved mobility were recorded the day after surgery and at 12 and 24 months after surgery per clinical evaluation and the use of numeric visual scales (NVS): the Greek Brief Pain Inventory, a linear analogue self-assessment questionnaire, and a World Health Organization questionnaire. Group A presented with a mean pain score of 7.9 {+-} 1.1 NVS units before PVP, which decreased to 2.1 {+-} 1.6, 2.0 {+-} 1.5 and 2.0 {+-} 1.5 NVS units the day after surgery and at 12 and 24 months after surgery, respectively. Group B presented with a mean pain score of 8.1 {+-} 1.3 NVS units before PVP, which decreased to 2.2 {+-} 1.3, 2.0 {+-} 1.5, and 2.1 {+-} 1.6 NVS units the day after surgery and at 12 and 24 months after surgery, respectively. Overall pain decrease and mobility improvement throughout the follow-up period presented no statistical significance neither between the two groups nor between different underlying aetiology. Reported cement leakages presented no statistical significance between the two groups (p = 0.365). PVP is an efficient and safe technique for symptomatic vertebral fractures independently of the vertebrae number treated per session.

  2. Clinical Engeneering Experience at the Hospital of the State University of Londrina

    OpenAIRE

    Ernesto Fernando Ferreyra Ramírez

    2002-01-01

    This paper describes the four-year experience of implementation of Clinical Engineering services at the Hospital of the State University of Londrina (HURNP/UEL). It was performed by the Electrical Engineering Department (DEEL), through a project involving lecturers and students from the Electrical and Civil Engineering Courses of the same university. The main objectives were the formation of human resources in the Clinical Engineering area and a positive contribution to the healthcare service...

  3. The experience of qualified nurses in assessing student nurses' clinical skills

    OpenAIRE

    Kelly, Mary

    2002-01-01

    The purpose of this study was to explore the experience of qualified nurses in assessing student nurses’ clinical skills. The writer’s interest in this area arose from the findings of reports in the UK and Ireland. These reports suggested that nurses do not feel adequately prepared for their roles in clinical assessment. The literature reviewed for this study highlights some of the difficulties surrounding assessment. Two areas identified are: lack of preparation for a role in assessment an...

  4. Student nurses’ perception of the clinical midwifery experience as a learning environment

    OpenAIRE

    R. Dürrheim

    1993-01-01

    The student nurse may have a different perception of her learning environment from that which the instructor intended. The purpose of the study was to determine the perception of student nurses of clinical midwifery experience as a teaming milieu. Student nurses in their third and fourth year at a nursing college in Transvaal were involved in the research. A literature study regarding factors that can influence clinical learning of student nurses in the midwifery units was done. Questionaires...

  5. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness

    OpenAIRE

    Doyle, Cathal; Lennox, Laura; Bell, Derek

    2013-01-01

    Objective To explore evidence on the links between patient experience and clinical safety and effectiveness outcomes. Design Systematic review. Setting A wide range of settings within primary and secondary care including hospitals and primary care centres. Participants A wide range of demographic groups and age groups. Primary and secondary outcome measures A broad range of patient safety and clinical effectiveness outcomes including mortality, physical symptoms, length of stay and adherence ...

  6. Three-dimensional radiobiological dosimetry (3D-RD) with 124I PET for 131I therapy of thyroid cancer

    International Nuclear Information System (INIS)

    Radioiodine therapy of thyroid cancer was the first and remains among the most successful radiopharmaceutical (RPT) treatments of cancer although its clinical use is based on imprecise dosimetry. The positron emitting radioiodine, 124I, in combination with positron emission tomography (PET)/CT has made it possible to measure the spatial distribution of radioiodine in tumors and normal organs at high resolution and sensitivity. The CT component of PET/CT has made it simpler to match the activity distribution to the corresponding anatomy. These developments have facilitated patient-specific dosimetry (PSD), utilizing software packages such as three-dimensional radiobiological dosimetry (3D-RD), which can account for individual patient differences in pharmacokinetics and anatomy. We highlight specific examples of such calculations and discuss the potential impact of 124I PET/CT on thyroid cancer therapy. (orig.)

  7. Clinical accompaniment: the critical care nursing students’ experiences in a private hospital

    Directory of Open Access Journals (Sweden)

    N. Tsele

    2000-09-01

    Full Text Available The quality of clinical accompaniment of the student enrolled for the post-basic diploma in Medical and Surgical Nursing Science: Critical Care Nursing (General is an important dimension of the educational/learning programme. The clinical accompanist/mentor is responsible for ensuring the student’s compliance with the clinical outcomes of the programme in accordance with the requirements laid down by the Nursing Education Institution and the South African Nursing Council. The purpose of this study was to explore and describe the experiences of the students enrolled for a post-basic diploma in Medical and Surgical Nursing Science: Critical Care Nursing (General, in relation to the clinical accompaniment in a private hospital in Gauteng. An exploratory, descriptive and phenomenological research design was utilised and individual interviews were conducted with the ten students in the research hospital. A content analysis was conducted and the results revealed both positive and negative experiences by the students in the internal and external worlds. The recommendations include the formulation of standards for clinical accompaniment of students. the evaluation of the quality of clinical accompaniment of students and empowerment of the organisation, clinical accompanists/mentors and clinicians.

  8. Why do we need a new paradigm in radiobiology?

    International Nuclear Information System (INIS)

    Over the past 20 or so years experimental evidence, which questions the fundamentals of some 50 years standing, of both biology and radiobiology has accrued. In order to accommodate this new evidence within a framework that encompasses existing knowledge, attention has to be paid to the organisational or epigenetic, features of the cell. In recent years the high dimensional dynamic attractor has emerged as a potential organisational or regulatory agent that represents phenotype. It is argued here that its limited robustness provides a modus operandi to account for stress induced genomic instability. When radiation deposition events act to overcome the robustness of a normal or 'home' attractor in the cell of an established species and cause a transition to a variant attractor or phenotype, the consequences are unrelated to any specific molecular damage to the genomic DNA. Rather they correspond to the loss of evolutionarily acquired stability (genotypic replicative integrity) and robustness. Such processes are termed type B events and give rise to a separate category of effects and risk to those associated with the conventional effects of radiation, type A effects. How type B risks might be assessed is discussed.

  9. Radiobiological basis of radiation protection and ICRP 2007 general recommendations

    International Nuclear Information System (INIS)

    The ICRP 2007 General Recommendations are based on the detailed review of the new information on the biological effects and risk evaluation done during the last decade. Most of this information reinforces the validity of earlier findings. Since the publication of ICRP 60 general recommendations in 1991(ICRP 1991b), sufficient new information on the health effects of ionizing radiations has accrued based on radiobiological and epidemiological studies (UNSCEAR 2000, ICRP Publication 99). There is an improvement in understanding the mechanistic aspects of the induction of radiation damage at cellular level. Biophysical studies based on Monte Carlo track structure codes have provided information on the nature of critical damage to DNA leading to the radiation effects at cellular level. Experimental work with model animal systems has provided information on the role of post irradiation repair processes and the genes influencing the process of radiation carcinogenesis. Longer follow up of A-Bomb survivors of Hiroshima and Nagasaki now provides a more reliable risk estimate based on the cancer incidence data and also a better model for the transfer of risk among different populations with varying frequency of background incidence. At present it is clear that the breast cancer contributes substantially to the radiation risk and provides quantitative risk estimates for brain and salivary glands. In the light of the new information, Tissue Weighting factors (WT) have been revised

  10. Amchitka Radiobiological Program. Final report, July 1970-December 1979

    International Nuclear Information System (INIS)

    The Amchitka Radiobiological Program, to collect biological and environmental samples for radiological analyses, began in 1970 and continued through 1979. The principal objective was to determine the extent of radionuclide contamination from worldwide atmospheric fallout and from the detonation of three underground nuclear tests on Amchitka. Leakage of radionuclides from the underground test sites would be suspected if the amount of contamination was significantly greater than could be attributed to worldwide fallout or if an unexpected assemblage of radionuclides was detected. No radionuclides from the underground sites were detected, except for tritium from the Long Shot test (1965) which produced increased tritium concentrations in surface water and freshwater plants near the test site. This final report compiles all previous data into one report and considers the temporal trends in these data. Two naturally occurring radionuclides, 40K and 7Be, were the most abundantly occurring radionuclides in most samples; in lichen samples either 137Cs or 144Ce had the highest activity. All samples were below applicable Radiation Protection Guides and by 1979 most samples were near or below the statistical detection limits. Increased concentrations of short-lived fallout radionuclides following the Chinese atmospheric tests were found in freshwater and seawater samples and in most indicator organisms

  11. Amchitka Radiobiological Program. Final report, July 1970-December 1979

    Energy Technology Data Exchange (ETDEWEB)

    Sibley, T.H.; Tornberg, L.D.

    1982-11-01

    The Amchitka Radiobiological Program, to collect biological and environmental samples for radiological analyses, began in 1970 and continued through 1979. The principal objective was to determine the extent of radionuclide contamination from worldwide atmospheric fallout and from the detonation of three underground nuclear tests on Amchitka. Leakage of radionuclides from the underground test sites would be suspected if the amount of contamination was significantly greater than could be attributed to worldwide fallout or if an unexpected assemblage of radionuclides was detected. No radionuclides from the underground sites were detected, except for tritium from the Long Shot test (1965) which produced increased tritium concentrations in surface water and freshwater plants near the test site. This final report compiles all previous data into one report and considers the temporal trends in these data. Two naturally occurring radionuclides, /sup 40/K and /sup 7/Be, were the most abundantly occurring radionuclides in most samples; in lichen samples either /sup 137/Cs or /sup 144/Ce had the highest activity. All samples were below applicable Radiation Protection Guides and by 1979 most samples were near or below the statistical detection limits. Increased concentrations of short-lived fallout radionuclides following the Chinese atmospheric tests were found in freshwater and seawater samples and in most indicator organisms.

  12. Radiobiological problems connected to exposure from cosmic radiation

    International Nuclear Information System (INIS)

    Civil aircrews are exposed to cosmic radiation where the radiation contains a hadronic high energy component. Although radiobiological studies based on X-rays, γ-rays, fast neutrons and ions of varying LET values have shown that the repair of sublethal damage takes place in living cells at low doses, this ability decreases with increasing LET so that maximum radiation effects is observed at about 120 keV/μm. Experimental studies of the biological significance of the strong nuclear interaction reactions via very high energy neutrons, stopped negative pi mesons give signs of an increased effectiveness at very low doses from the present data. The few results obtained indicate that a collapse of the repair-mechanisms might take place for these fundamental reaction in nature. It is stressed that the contribution to the dose at present days civil air transport from cosmic radiation is small and taken care of by the existing recommendation for radiation protection., 8 refs., 7 figs., 5 tabs

  13. Amchitka Radiobiological Program. Progress report, January-December 1978

    International Nuclear Information System (INIS)

    The Amchitka Radiobiological Program began in 1970 and is a continuing program to collect biological and environmental samples for radiometric analyses. This report is an account of the program for calendar year 1978. Results of analyses for samples collected in August 1978 have been added to the tables of Seymour and Johnson (1978) which summarize the Amchitka program from 1970 to 1977 and include analyses for: (1) gamma-emitting radionuclides in freshwater, birds, lichens, marine algae, marine invertebrates, fish, aufwuchs, and freshwater moss and plants; (2) strontium-90 (90Sr) in rats, birds, and soil; (3) 239, 240Pu in sand, soil, marine algae, and fish; and (4) tritium (3H) in seawater, freshwater, and biological organisms. Monitoring of background radiation with survey instruments was added to the Laboratory's program in 1974, and the results of the five annual surveys since that date are included in this report. Conclusions from the results of the recent analyses are a reiteration of the results stated in Nelson and Seymour (1975a); namely, (1) no new radionuclides are present; (2) the most abundant radionuclides are naturally occurring beryllium-7 (7Be) and potassium-40 (40K); (3) the trace quantities of fission products and induced radionuclides are from world fallout; and (4) a trace of 3H contamination remains in some Long Shot ponds, as previously reported. It is concluded that there were no radionuclides of Milrow or Cannikin origin in the water, plants, or animals of Amchitka Island

  14. [Radiobiological analysis of cancerogenic risk values in radioepidemiological investigations].

    Science.gov (United States)

    Rozhdestvenskiĭ, L M

    2008-01-01

    The aim of the present article consisted in critical analysis of the epidemiological approach to radiocancerogenic risk estimation in region of low level radiation (LLR). The estimation is making by means of mathematician models that ignore a principal difference in biological action of LLR and high level radiation (HLR). The main formal characteristic of LLR action is the presence of a plateau in beginning of a dose-effect curve of radiogenic risk. It may be argued by the following positions: repeating the plateau-phenomenon on various radiobiological effects, in different tests and bioobjects, first; a paradoxical trend of reciprocal ERR/Sv increasing regarding dose decreasing in region of plateau, second, and third, the increasing of the curvature in dose-effect curve beginning. The presence of a plateau is associated with the presence of a real radiogenic risk threshold. Besides, the analysis of processes influencing significantly the dynamics of initial radiation injury of biologically important macromolecules showed the preference in region of LLR those, decreasing/eliminating genome damages. There is follows from mentioned above a necessity to evaluate radiogenic risks in LLR region separately from HLR region. PMID:18825986

  15. Radiobiological study by using laser-driven proton beams

    Science.gov (United States)

    Yogo, A.; Sato, K.; Nishikino, M.; Mori, M.; Teshima, T.; Numasaki, H.; Murakami, M.; Demizu, Y.; Akagi, S.; Nagayama, S.; Ogura, K.; Sagisaka, A.; Orimo, S.; Nishiuchi, M.; Pirozhkov, A. S.; Ikegami, M.; Tampo, M.; Sakaki, H.; Suzuki, M.; Daito, I.; Oishi, Y.; Sugiyama, H.; Kiriyama, H.; Okada, H.; Kanazawa, S.; Kondo, S.; Shimomura, T.; Nakai, Y.; Tanoue, M.; Sugiyama, H.; Sasao, H.; Wakai, D.; Kawachi, T.; Nishimura, H.; Bolton, P. R.; Daido, H.

    2009-07-01

    Particle acceleration driven by high-intensity laser systems is widely attracting interest as a potential alternative to conventional ion acceleration, including ion accelerator applications to tumor therapy. Recent works have shown that a high intensity laser pulse can produce single proton bunches of a high current and a short pulse duration. This unique feature of laser-ion acceleration can lead to progress in the development of novel ion sources. However, there has been no experimental study of the biological effects of laser-driven ion beams. We describe in this report the first demonstrated irradiation effect of laser-accelerated protons on human lung cancer cells. In-vitro A549 cells are irradiated with a proton dose of 20 Gy, resulting in a distinct formation of γ-H2AX foci as an indicator of DNA double-strand breaks. This is a pioneering result that points to future investigations of the radiobiological effects of laser-driven ion beams. The laser-driven ion beam is apotential excitation source for time-resolved determination of hydroxyl (OH) radical yield, which will explore relationship between the fundamental chemical reactions of radiation effects and consequent biological processes.

  16. Amchitka Radiobiological Program progress report, January 1979-December 1979

    International Nuclear Information System (INIS)

    The objective of the Amchitka Radiobiological Program for the period 1970-1979 was to determine the extent of radionuclide contamination from world-wide atmospheric fallout and from the detonation of three underground nuclear blasts on Amchitka Island. The objective is achieved, by the collection and radiological analyses of biological and environmental samples and by background radiation measurements. Leakage of radionuclides from the underground sites of the Amchitka nuclear detonations would be suspected if the contamination was significntly greater than would be expected from world fallout. An account of the program from July 1970 to December 1978 has been given in nine previous reports from the Laboratory of Radiation Ecology to the Nevada Operations Office of the US Department of Energy. This report is an account of the program for calendar year 1979. The results of analyses of the samples collected in 1979 lead to the same conclusions as in previous years; i.e., there is no evidence that the radionuclide contamination at Amchitka Island is greater than would be expected from world fallout except for a slight contamination of the Long Shot Mud Pits with tritium

  17. Radiobiological research on carnation chimerae Dianthus Caryophyllus L

    International Nuclear Information System (INIS)

    A radiobiological study of periclinal carnation chimerae is carried out by subjecting whole plants and cuttings at different physiological stages to cobalt 60 gamma radiation under different dose and dose rate conditions. The effects of these treatments are observed during cultivation of the treated plants and by microscopic examination of irradiated meristem sections. The destruction of meristem cells in proportions varying with the irradiation conditions leads to structural changes in the chimerae; the more frequent change is the formation of genetically homogeneous stalks from different genotypes existing in the irradiated plant. Treatment by ionizing radiations is thus a practical means of detecting periclinical chimerae which, as in the case of carnations, are very common in plants grown by vegetative propagation. However since more than two independent meristem cell groups are usually present it is not possible by this method alone to define the distribution of the differentent genotypes in these groups; additional genetic studies or cell labelling such as chlorophyll or genoma mutations are then necessary

  18. Informed Practice: Students' Clinical Experiences in the Undergraduate Phase of an Accelerated Physician Assistant Program.

    Science.gov (United States)

    Dereczyk, Amy; DeWitt, Rachel

    2016-06-01

    This qualitative study explored the clinical experiences of students in an accelerated physician assistant (PA) program. The participants were either certified nursing assistants (CNAs) or emergency medical technicians-basic (EMTs-B). The study was designed to elicit (1) how the participants perceived their older patients and (2) how the participants' experiences might affect their own future communications, bedside manner, and clinical preparedness as PAs. This study used a focus group to explore students' clinical experiences before the graduate phase of their accelerated PA program. Five female and 2 male PA students (N = 7) participated in the study. All participants were 23 years old and worked as either a CNA or an EMT-B. Results fell into 2 basic themes: informing practice and forming relationships. Regarding the first theme, participants felt that their experience as entry-level health care providers allowed them to improve their communication skills and bedside manner and to provide greater comfort to patients. Regarding the second theme, participants gained appreciation for older people and began to recognize the knowledge deficits and learning needs of their patients. The results suggested that a student's clinical experience as a CNA or an EMT-B before entering a PA program has a positive effect on the student's personal and professional development. The participants acquired greater appreciation and respect for older patients and members of the health care team. PMID:27123599

  19. Impact of microgravity on radiobiological processes and efficiency of DNA repair

    Energy Technology Data Exchange (ETDEWEB)

    Horneck, G. [Radiation Biology Division, Institute of Aerospace Medicine, DLR German Aerospace Center, Linder Hohe, 51170 Cologne (Germany)

    1999-12-06

    To study the influence of microgravity on radiobiological processes in space, space experiments have been performed, using an on-board 1xg reference centrifuge as in-flight control. The trajectory of individual heavy ions was localized in relation to the biological systems by use of the Biostack concept, or an additional high dose of radiation was applied either before the mission or during the mission from an on-board radiation source. In embryonic systems, such as early developmental stages of Drosophila melanogaster and Carausius morosus, the occurrence of chromosomal translocations and larval malformations was dramatically increased in response to microgravity and radiation. It has been hypothesized that these synergistic effects might be caused by an interference of microgravity with DNA repair processes. However, recent studies on bacteria, yeast cells and human fibroblasts suggest that a disturbance of cellular repair processes in the microgravity environment might not be a complete explanation for the reported synergism of radiation and microgravity. As an alternative explanation, an impact of microgravity on signal transduction, on the metabolic/physiological state or on the chromatin structure at the cellular level, or modification of self-assembly, intercellular communication, cell migration, pattern formation or differentiation at the tissue and organ level should be considered.

  20. Medical and radiobiological applications at the research reactor TRIGA Mainz

    International Nuclear Information System (INIS)

    At the University of Mainz, Germany, a boron neutron capture therapy (BNCT) project has been started with the aim to expand and advance the research on the basis of the TAOrMINA protocol for the BNCT treatment of liver metastases of colorectal cancer. Irradiations take place at the TRIGA Mark II reactor. Biological and clinical research and surgery take place at the University and its hospital of Mainz. Both are situated in close vicinity to each other, which is an ideal situation for BNCT treatment, as similarly performed in Pavia, in 2001 and 2003. The application of BNCT to auto-transplanted organs requires development in the methodology, as well as regard to the irradiation facility and is part of the complex, interdisciplinary treatment process. The additional high surgical risk of auto-transplantation is only justified when a therapeutic benefit can be achieved. A BNCT protocol including explantation and conservation of the organ, neutron irradiation and re-implantation is logistically a very challenging task. Within the last years, research on all scientific, clinical and logistical aspects for the therapy has been performed. This includes work on computational modelling for the irradiation facility, tissue and blood analysis, radiation biology, dosimetry and surgery. Most recently, a clinical study on boron uptake in both healthy and tumour tissue of the liver and issues regarding dosimetry has been started, as well as a series of cell-biology experiments to obtain concrete results on the relative biological effectiveness (RBE) of ionizing radiation in liver tissue. (author)

  1. The South African Military Nursing College Pupil Enrolled Nurses’ experiences of the clinical learning environment

    Directory of Open Access Journals (Sweden)

    Ernestina M. Caka

    2013-06-01

    Full Text Available The study focused on the clinical learning experiences of Pupil Enrolled Nurses (PENs within the military health service. The purpose of the research was to explore and describe the learning experiences of PENs within the Military health clinical learning environment. An explorative, descriptive, contextual design which is qualitative in nature was used to guide the study. The military as a training institution prides itself on preparing nurses both as soldiers and nurses, this could be both challenging and exasperating for students, as the scopes are diverse. Being notably very hierarchical, the military’s rules constantly take precedence over nursing rules. For the duration of nursing training, students are allocated in the clinical learning area to acquire competencies such as problem solving, cognitive and psychomotor skills (Kuiper & Pesut 2003:383. Students learn how to merge theory and practice and apply theories in the practical sense. This is however, not done in isolation from the military codes, as they are intertwined. Attendance of military parades and drills are incorporated during this phase. This could create missed opportunities from the clinical learning as students are expected to leave the clinical setting for this purpose. Three focus group sessions were conducted and the experiences of the students, as narrated by themselves, yielded valuable insights. The researcher wrote field notes and assisted with the management of the audio tapes for easy retrieval of information. Data was analysed by the researcher, independent of the cocoder. Two themes relating to the PENs’ learning experiences emerged from the data analysed: (1 facilitators of clinical learning, (2 and barriers to clinical learning. The findings obtained depicted those factors which facilitated and obstructed student learning. These findings made it possible for the researcher to make recommendations concerning positive interventions which could be taken to

  2. Body Experience and Mirror Behaviour in Female Eating Disorders Patients and non Clinical Subjects

    OpenAIRE

    Michel Probst; Guido Pieters; Davy Vancampfort; Johan Vanderlinden

    2008-01-01

    Recently the attention for mirror exercises in therapies targeted specifically to body experience concerns has increased. This retrospective study will explore the mirror behaviour of anorexia nervosa (AN), bulimia nervosa (BN) and non-clinical female subjects (CG) and investigate whether mirror avoidance or checking are related to negative body experiences. The group of eating disorders consisted of 560 AN and 314 BN patients. The control group consisted of 1151 female subjects. The Body ...

  3. Women's Management of Recurrent Bacterial Vaginosis and Experiences of Clinical Care: A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Jade Bilardi

    Full Text Available Few data are available on how women manage recurring bacterial vaginosis (BV and their experiences of the clinical care of this condition. This study aimed to explore women's recurrent BV management approaches and clinical care experiences, with a view to informing and improving the clinical management of BV.A descriptive, social constructionist approach was chosen as the framework for the study. Thirty-five women of varying sexual orientation who had experienced recurrent BV in the past 5 years took part in semi-structured interviews.The majority of women reported frustration and dissatisfaction with current treatment regimens and low levels of satisfaction with the clinical management of BV. Overall, women disliked taking antibiotics regularly, commonly experienced adverse side effects from treatment and felt frustrated at having symptoms recur quite quickly after treatment. Issues in clinical care included inconsistency in advice, misdiagnosis and inappropriate diagnostic approaches and insensitive or dismissive attitudes. Women were more inclined to report positive clinical experiences with sexual health physicians than primary care providers. Women's frustrations led most to try their own self-help remedies and lifestyle modifications in an attempt to treat symptoms and prevent recurrences, including well-known risk practices such as douching.In the face of considerable uncertainty about the cause of BV, high rates of recurrence, unacceptable treatment options and often insensitive and inconsistent clinical management, women are trying their own self-help remedies and lifestyle modifications to prevent recurrences, often with little effect. Clinical management of BV could be improved through the use of standardised diagnostic approaches, increased sensitivity and understanding of the impact of BV, and the provision of evidence based advice about known BV related risk factors.

  4. An Exploration of Dental Students' Assumptions About Community-Based Clinical Experiences.

    Science.gov (United States)

    Major, Nicole; McQuistan, Michelle R

    2016-03-01

    The aim of this study was to ascertain which assumptions dental students recalled feeling prior to beginning community-based clinical experiences and whether those assumptions were fulfilled or challenged. All fourth-year students at the University of Iowa College of Dentistry & Dental Clinics participate in community-based clinical experiences. At the completion of their rotations, they write a guided reflection paper detailing the assumptions they had prior to beginning their rotations and assessing the accuracy of their assumptions. For this qualitative descriptive study, the 218 papers from three classes (2011-13) were analyzed for common themes. The results showed that the students had a variety of assumptions about their rotations. They were apprehensive about working with challenging patients, performing procedures for which they had minimal experience, and working too slowly. In contrast, they looked forward to improving their clinical and patient management skills and knowledge. Other assumptions involved the site (e.g., the equipment/facility would be outdated; protocols/procedures would be similar to the dental school's). Upon reflection, students reported experiences that both fulfilled and challenged their assumptions. Some continued to feel apprehensive about treating certain patient populations, while others found it easier than anticipated. Students were able to treat multiple patients per day, which led to increased speed and patient management skills. However, some reported challenges with time management. Similarly, students were surprised to discover some clinics were new/updated although some had limited instruments and materials. Based on this study's findings about students' recalled assumptions and reflective experiences, educators should consider assessing and addressing their students' assumptions prior to beginning community-based dental education experiences. PMID:26933101

  5. Why Clinical Experience and Mentoring Are Replacing Student Teaching on the Best Campuses. A White Paper

    Science.gov (United States)

    Fraser, James W.; Watson, Audra M.

    2014-01-01

    Woodrow Wilson Senior Fellow James W. Fraser and Audra Watson, the Foundation's Director of Mentoring and Induction Strategy, take a look at emerging trends in clinical preparation for new teachers. This new white paper is based on experience with the Woodrow Wilson Teaching Fellowships, and includes observations from some of the colleges and…

  6. Clinical experience with mycophenolate mofetil in systemic autoimmune conditions refractory to common immunosuppressive therapies

    OpenAIRE

    Bandelier, Cédric; Guerne, Pierre-André; Genevay, Stéphane; Finckh, Axel; Gabay, Cem

    2009-01-01

    OBJECTIVES: Standard therapies against inflammatory rheumatic diseases consist of immunosuppressive drugs with high toxicities and many side effects. Except in the treatment of systemic lupus erythematosus with renal involvement, controlled studies with mycophenolate mofetil (MMF) are lacking in other autoimmune and inflammatory systemic diseases. Here we describe our clinical experience with MMF in several unusual indications. METHODS: We collected data including serological findings, advers...

  7. Using a Web-Based Database to Record and Monitor Athletic Training Students' Clinical Experiences

    Science.gov (United States)

    Brown, Kirk W.; Williams, Lisa; Janicki, Thomas

    2008-01-01

    Objective: The purpose of this article is to introduce a documentation recording system employing the Microsoft Structured Query Language (MS-SQL) database used by the Athletic Training Education Program (ATEP) for recording and monitoring of athletic training student (ATS) clinical experiences and hours. Background: Monitoring ATSs clinical…

  8. [Personal experiences with induced abortions in private clinics in Northeast Brazil].

    Science.gov (United States)

    Silveira, Paloma; McCallum, Cecilia; Menezes, Greice

    2016-01-01

    Based on a qualitative study conducted in 2012, the article analyzes middle-class individuals' experiences with induced abortions performed in private clinics. Thirty-four stories of induced abortions were narrated by 19 women and five men living in two state capitals in Northeast Brazil. Thematic analysis revealed differences in types of clinics and care provided by the physicians. The article shows that abortion in private clinics fails to guarantee safe or humane care. The narratives furnish descriptions of diverse situations and practices, ranging from flaws such as lack of information on medicines to others involving severe abuses like procedures performed without anesthesia. The article concludes that criminalization of abortion in Brazil allows clinics to operate with no state regulation; it does not prevent women from having abortions, but exposes them to total vulnerability and violation of human rights. PMID:26958817

  9. The experience of graduated midwifery students about clinical education: A phenomenological study

    Directory of Open Access Journals (Sweden)

    R. Shahoei

    2013-06-01

    Full Text Available Introduction: Improvement and promotion of the quality of clinical education requires continuous assessment of the current situation, and also identifying the strengths and weaknesses. Students' views and ideas as learner can help future planning. This study aims to identify the experiences of midwifery graduates about factors affecting their clinical learning. Methods: A qualitative study using phenomenology approach was conducted. Ten midwifery graduates were selected based on purposive sampling and then interviewed. Data were analyzed by thematic analysis. Results: The extracted conceptual codes were classified into several main concepts. There were two main themes factors facilitating learning and factors preventing learning, and seven sub themes performance of instructor, pre-clinical training, students satisfaction, lack of peripheral facilities, lack of coordination of educational planning and behaviors of health care personnel. Conclusion: Trained human resources and equipment for midwifery educational planning are needed to provide a supportive learning atmosphere and promote the quality of clinical learning.

  10. Radiobiologic Parameters and Local Effect Model Predictions for Head-and-Neck Squamous Cell Carcinomas Exposed to High Linear Energy Transfer Ions

    International Nuclear Information System (INIS)

    Purpose: To establish the radiobiologic parameters of head-and-neck squamous cell carcinomas (HNSCC) in response to ion irradiation with various linear energy transfer (LET) values and to evaluate the relevance of the local effect model (LEM) in HNSCC. Methods and Materials: Cell survival curves were established in radiosensitive SCC61 and radioresistant SQ20B cell lines irradiated with [33.6 and 184 keV/n] carbon, [302 keV/n] argon, and X-rays. The results of ion experiments were confronted to LEM predictions. Results: The relative biologic efficiency ranged from 1.5 to 4.2 for SCC61 and 2.1 to 2.8 for SQ20B cells. Fixing an arbitrary D0 parameter, which characterized survival to X-ray at high doses (>10 Gy), gave unsatisfying LEM predictions for both cell lines. For D0 = 10 Gy, the error on survival fraction at 2 Gy amounted to a factor of 10 for [184 keV/n] carbon in SCC61 cells. We showed that the slope (smax) of the survival curve at high doses was much more reliable than D0. Fitting smax to 2.5 Gy-1 gave better predictions for both cell lines. Nevertheless, LEM could not predict the responses to fast and slow ions with the same accuracy. Conclusions: The LEM could predict the main trends of these experimental data with correct orders of magnitude while smax was optimized. Thus the efficiency of carbon ions cannot be simply extracted from the clinical response of a patient to X-rays. LEM should help to optimize planning for hadrontherapy if a set of experimental data is available for high-LET radiations in various types of tumors

  11. Radiobiological waste treatment-ashing treatment and immobilization with cement

    International Nuclear Information System (INIS)

    This report describes the results of the study on the treatment of radioactive biological waste in the China Institute for Radiation Protection (CIRP). The possibility of radiobiological waste treatment was investigated by using a RAF-3 type rapid ashing apparatus together with the immobilization of the resulted ash. This rapid ashing apparatus, developed by CIRP, is usually used for pretreatment of samples prior to chemical analysis and physical measurements. The results show that it can ash 3 kg of animal carcasses a batch, the ashing time is 5-7 h and the ash content is less than 4 wt%. The ashing temperature not exceeding 450 deg. C was used without any risk of high losses of radionuclides. The ash from the rapid ashing apparatus was demonstrated to be immobilized with ordinary silicate cement. The optimum cement/ash/water formulation of the cemented waste form was 35 ± 5 wt% cement, 29 ± 2 wt% water, and 36 ± 6 wt% ash. The performance of the waste form was in compliance with the technical requirements except for impact resistance. Mixing additives in immobilization formulations can improve the performance of the cemented ash waste form. The additives chosen were DH4A flow promoter as a cement additive and vermiculite or zeolite as a supplement. The recommended formulation, i.e. an improved formulation of the cemented ash waste form is that additives DH4A flow promoter and vermiculite (or zeolite) are added on the ground of optimum cement/ash/water formulation of the cemented waste form, the dosage of water, DH4A and vermiculite (or zeolite) is 70 wt%, 0.5 wt% and ≤ 5 wt% of the cement dosage, respectively. The cemented ash waste forms obtained meet all the requirements for disposal. (author). 12 refs, 7 figs, 13 tabs

  12. Radiobiological basis for setting neutron radiation safety standards

    International Nuclear Information System (INIS)

    Present neutron standards, adopted more than 20 yr ago from a weak radiobiological data base, have been in doubt for a number of years and are currently under challenge. Moreover, recent dosimetric re-evaluations indicate that Hiroshima neutron doses may have been much lower than previously thought, suggesting that direct data for neutron-induced cancer in humans may in fact not be available. These recent developments make it urgent to determine the extent to which neutron cancer risk in man can be estimated from data that are available. Two approaches are proposed here that are anchored in particularly robust epidemiological and experimental data and appear most likely to provide reliable estimates of neutron cancer risk in man. The first approach uses gamma-ray dose-response relationships for human carcinogenesis, available from Nagasaki (Hiroshima data are also considered), together with highly characterized neutron and gamma-ray data for human cytogenetics. When tested against relevant experimental data, this approach either adequately predicts or somewhat overestimates neutron tumorigenesis (and mutagenesis) in animals. The second approach also uses the Nagasaki gamma-ray cancer data, but together with neutron RBEs from animal tumorigenesis studies. Both approaches give similar results and provide a basis for setting neutron radiation safety standards. They appear to be an improvement over previous approaches, including those that rely on highly uncertain maximum neutron RBEs and unnecessary extrapolations of gamma-ray data to very low doses. Results suggest that, at the presently accepted neutron dose limit of 0.5 rad/yr, the cancer mortality risk to radiation workers is not very different from accidental mortality risks to workers in various nonradiation occupations

  13. SU-E-T-385: 4D Radiobiology

    Energy Technology Data Exchange (ETDEWEB)

    Fourkal, E; Hossain, M; Veltchev, I; Ma, C; Meyer, J; Horwitz, E [Fox Chase Cancer Center, Philadelphia, PA (United States); Nahum, A [Clatterbridge Centre for Oncology, Bebington (United Kingdom)

    2014-06-01

    Purpose: The linear-quadratic model is the most prevalent model for planning dose fractionation in radiation therapy in the low dose per fraction regimens. However for high-dose fractions, used in SRS/SBRT/HDR treatments the LQ model does not yield accurate predictions, due to neglecting the reduction in the number of sublethal lesions as a result of their conversion to lethal lesions with subsequent irradiation. Proper accounting for this reduction in the number of sublethally damaged lesions leads to the dependence of the survival fraction on the temporal structure of the dose. The main objective of this work is to show that the functional dependence of the dose rate on time in each voxel is an important additional factor that can significantly influence the TCP. Methods: Two SBRT lung plans have been used to calculate the TCPs for the same patient. One plan is a 3D conformal plan and the other is an IMRT plan. Both plans are normalized so that 99.5% of PTV volume receives the same prescription dose of 50 Gy in 5 fractions. The dose rate in each individual voxel is calculated as a function of treatment time and subsequently used in the calculation of TCP. Results: The calculated TCPs show that shorter delivery times lead to greater TCP, despite all delivery times being short compared to the repair half-time for sublethal lesions. Furthermore, calculated TCP(IMRT) =0.308 for the IMRT plan is smaller than TCP(3D) =0.425 for 3D conformal, even though it shows greater tumor hot spots and equal PTV coverage. The calculated TCPs are considerably lower compared to those based on the LQ model for which TCP=1 for both plans. Conclusion: The functional dependence of the voxel-by-voxel dose rate on time may be an important factor in predicting the treatment outcome and cannot be neglected in radiobiological modeling.

  14. Consequences of anorectal cancer atlas implementation in the cooperative group setting: Radiobiologic analysis of a prospective randomized in silico target delineation study

    International Nuclear Information System (INIS)

    Purpose: The aim of this study is to ascertain the subsequent radiobiological impact of using a consensus guideline target volume delineation atlas. Materials and methods: Using a representative case and target volume delineation instructions derived from a proposed IMRT rectal cancer clinical trial, gross tumor volume (GTV) and clinical/planning target volumes (CTV/PTV) were contoured by 13 physician observers (Phase 1). The observers were then randomly assigned to follow (atlas) or not-follow (control) a consensus guideline/atlas for anorectal cancers, and instructed to re-contour the same case (Phase 2). Results: The atlas group was found to have increased tumor control probability (TCP) after the atlas intervention for both the CTV (p < 0.0001) and PTV1 (p = 0.0011) with decreasing normal tissue complication probability (NTCP) for small intestine, while the control group did not. Additionally, the atlas group had reduced variance in TCP for all target volumes and reduced variance in NTCP for the bowel. In Phase 2, the atlas group had increased TCP relative to the control for CTV (p = 0.03). Conclusions: Visual atlas and consensus treatment guideline usage in the development of rectal cancer IMRT treatment plans reduced the inter-observer radiobiological variation, with clinically relevant TCP alteration for CTV and PTV volumes

  15. Idiopathic pulmonary fibrosis: from clinical trials to real-life experiences

    Directory of Open Access Journals (Sweden)

    Sergio Harari

    2015-09-01

    Full Text Available Randomised controlled clinical trials are fundamental in medicine to develop new effective drugs and new therapeutic regimens and are the strength of evidence-based medicine. These studies allow us to avoid the repetition of misleading experiences that have been reported in the past, where drugs or associations were utilised without compelling evidence and ultimately proven to be ineffective. In recent years, randomised clinical trials have been conducted and concluded for many rare diseases, including idiopathic pulmonary fibrosis. However, clinical trials do not always reflect the real-life scenario. Patients selected for clinical trials present fewer comorbidities, they fall between certain age limits, and the severity of their disease is defined; therefore, they do not always reflect the whole of the population affected by a specific disease. These are the reasons why we also need data that mirror real-life experience. The limitations that these kind of studies present are always several and the studies should be interpreted with caution, although they can fill the important gap between efficacy and effectiveness. In this article, we will review the existing clinical data on real-life treatment of idiopathic pulmonary fibrosis.

  16. Radiobiological parameters of four glioblastoma compared to four other histological types of human tumor xenografts in nude mice

    International Nuclear Information System (INIS)

    Purpose/Objective: Glioblastoma Multiforme (GBM) is a highly malignant tumor of the central nervous system with aggressive biological behavior and a fatal clinical outcome. Several radiobiological parameters might contribute to these poor results. In this study, we investigated seventeen biological parameters of four GBM xenografts and compared the results with four other histological types of human tumor xenografts in nude mice. Methods and Materials: Most of the xenografts retained the individual histological features of their original tumor types. Four GBM xenografts (U87, HP555, MMC1 and HGL21), two squamous cell carcinomas (SCC21 and FaDu), one soft tissue sarcoma (STS26T), and colon cancer (HCT15) xenografts were used. The tumors were implanted in the hindleg of 5-6 Gy WBI nude mice. The following parameters were investigated for most of the xenografts: fractionated TCD50 (the dose of radiation which controls 50% of the tumors) using 30 fractions in 15 days. The parameters pO2, IFP (interstitial fluid pressure), Tpot, SF2 (plastic and Courtenay), PE (plating efficiency), D0, GSH, TCD50 single dose in oxic and hypoxic conditions, the rate of metastasis in SCID mice, VDT (volume doubling time), spontaneous apoptosis, induced apoptosis after 30 and 60 Gy and p53 over-expression. Results: Using the t-test, there was a significantly less spontaneous apoptosis in GBM xenografts when compared with the other histological types. However, no significant difference was found between both groups of xenografts in the remaining biological parameters investigated. Conclusion: These data demonstrate that, with the exception of spontaneous apoptosis, no significant difference was found in fifteen biological parameters between GBM xenografts and the other histological types implanted into the subcutaneous tissue of nude mice. The data suggests that the classical radiobiological parameters cannot explain the poor response of GBM to radiation. Supported by NCI Grant CA13311

  17. Optically-guided frameless linac-based radiosurgery for brain metastases: clinical experience

    OpenAIRE

    Nath, Sameer K; Lawson, Joshua D.; Wang, Jia-Zhu; Simpson, Daniel R.; Newman, C. Benjamin; Alksne, John F.; Mundt, Arno J.; Murphy, Kevin T.

    2009-01-01

    The purpose of this study was to describe our clinical experience using optically-guided linear accelerator (linac)-based frameless stereotactic radiosurgery (SRS) for the treatment of brain metastases. Sixty-five patients (204 lesions) were treated between 2005 and 2008 with frameless SRS using an optically-guided bite-block system. Patients had a median of 2 lesions (range, 1–13). Prescription dose ranged from 14 to 22 Gy (median, 18 Gy) and was given in a single fraction. Clinical and radi...

  18. Psychiatric hospital nursing staff's experiences of participating in group-based clinical supervision:

    DEFF Research Database (Denmark)

    Buus, Niels; Angel, Sanne; Traynor, Michael;

    2010-01-01

    Group-based clinical supervision is commonly offered as a stress-reducing intervention in psychiatric settings, but nurses often feel ambivalent about participating. This study aimed at exploring psychiatric nurses' experiences of participating in groupbased supervision and identifying psychosocial...... reasons for their ambivalence. Semi-structured interviews were conducted with 22 psychiatric nurses at a Danish university hospital. The results indicated that participation in clinical supervision was difficult for the nurses because of an uncomfortable exposure to the professional community. The sense...... of exposure was caused by the particular interactional organisation during the sessions, which brought to light pre-existing but covert conflicts among the nurses....

  19. Systematic reviews of animal experiments demonstrate poor human clinical and toxicological utility.

    Science.gov (United States)

    Knight, Andrew

    2007-12-01

    The assumption that animal models are reasonably predictive of human outcomes provides the basis for their widespread use in toxicity testing and in biomedical research aimed at developing cures for human diseases. To investigate the validity of this assumption, the comprehensive Scopus biomedical bibliographic databases were searched for published systematic reviews of the human clinical or toxicological utility of animal experiments. In 20 reviews in which clinical utility was examined, the authors concluded that animal models were either significantly useful in contributing to the development of clinical interventions, or were substantially consistent with clinical outcomes, in only two cases, one of which was contentious. These included reviews of the clinical utility of experiments expected by ethics committees to lead to medical advances, of highly-cited experiments published in major journals, and of chimpanzee experiments--those involving the species considered most likely to be predictive of human outcomes. Seven additional reviews failed to clearly demonstrate utility in predicting human toxicological outcomes, such as carcinogenicity and teratogenicity. Consequently, animal data may not generally be assumed to be substantially useful for these purposes. Possible causes include interspecies differences, the distortion of outcomes arising from experimental environments and protocols, and the poor methodological quality of many animal experiments, which was evident in at least 11 reviews. No reviews existed in which the majority of animal experiments were of good methodological quality. Whilst the effects of some of these problems might be minimised with concerted effort (given their widespread prevalence), the limitations resulting from interspecies differences are likely to be technically and theoretically impossible to overcome. Non-animal models are generally required to pass formal scientific validation prior to their regulatory acceptance. In contrast

  20. DEGRO practical guidelines for radiotherapy of non-malignant disorders. Part I: physical principles, radiobiological mechanisms, and radiogenic risk

    Energy Technology Data Exchange (ETDEWEB)

    Reichl, Berthold [Hospital Weiden, Department of Radiotherapy and Radiation Oncology, Weiden (Germany); Block, Andreas [Hospital Dortmund, Institute for Medical Radiation Physics and Radiation Protection, Dortmund (Germany); Schaefer, Ulrich [Lippe Hospital, Dept. of Radiotherapy, Lemgo (Germany); Bert, Christoph; Mueller, Reinhold [University Hospitals Erlangen, Dept. of Radiation Oncology, Erlangen (Germany); Jung, Horst [University Hospital Hamburg-Eppendorf, Dept. of Radiotherapy and Radiation Oncology, Hamburg (Germany); Roedel, Franz [University Hospital Goethe-University, Dept. of Radiotherapy and Oncology, Frankfurt am Main (Germany); Collaboration: the German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD)

    2015-09-15

    Synopsis of the introductory paragraph of the DEGRO consensus S2e-guideline recommendations for the radiotherapy of benign disorders, including physical principles, radiobiological mechanisms, and radiogenic risk. This work is based on the S2e-guideline recommendations published November 14, 2013. The basic principles of radiation physics and treatment delivery, evaluation of putative underlying radiobiological mechanisms, and the assessment of genetic and cancer risk following low-dose irradiation will be presented. Radiation therapy of benign diseases is performed according to similar physical principles as those governing treatment of malignant diseases in radiation oncology, using the same techniques and workflows. These methods comprise usage of orthovoltage X-ray units, gamma irradiation facilities, linear accelerators (LINACs), and brachytherapy. Experimental in vitro and in vivo models recently confirmed the clinically observed anti-inflammatory effect of low-dose X-irradiation, and implicated a multitude of radiobiological mechanisms. These include modulation of different immunological pathways, as well as the activities of endothelial cells, mono- and polymorphonuclear leukocytes, and macrophages. The use of effective dose for radiogenic risk assessment and the corresponding tumor incidence rate of 5.5 %/Sv are currently controversially discussed. Some authors argue that the risk of radiation-induced cancers should be estimated on the basis of epidemiological data. However, such data are rarely available at present and associated with high variability. Current radiobiological studies clearly demonstrate a therapeutic effectiveness of radiation therapy used to treat benign diseases and implicate various molecular mechanisms. Radiogenic risks should be taken into account when applying radiation treatment for benign diseases. (orig.) [German] Zusammenfassung des einfuehrenden Kapitels der DEGRO-S2e-Leitlinie zur Strahlentherapie gutartiger Erkrankungen

  1. Experiences by student nurses during clinical placement in psychiatric units in a hospital

    OpenAIRE

    W.J.C. Van Rhyn; M.R. Gontsana

    2004-01-01

    An exploratory study was conducted with the aim of discovering and describing experiences of psychiatric nursing students during clinical placement in a psychiatric unit. For the purpose of the study an unstructured interview was conducted with each participant during their first placement in a psychiatric unit to identify the factors experienced as stressful. The results indicated that all eight participants experienced average to high stress. Sources of stress identified included, among oth...

  2. Diversifying Residents' Outpatient Psychiatry Experience: A Contemporary Model for Academic Outpatient Psychiatry Clinics

    OpenAIRE

    Huh, John; Goebert, Deborah A

    2010-01-01

    A diversified, outpatient experience is an important part of psychiatric training, yet challenging to attain. We describe a multiple, subspecialty psychiatry clinic model for 3rd year psychiatry residents. Evaluation findings based on its initial implementation indicated improved resident supervision, better therapeutic alliance and an overall increase in satisfaction. This model facilitates resident exposure to diverse patients and treatment modalities as well as faculty development of exper...

  3. Clinical experiences with molecular targeted therapy in lung cancer in China

    OpenAIRE

    Wang, Yan; Yan SUN

    2015-01-01

    In the past decade, a dramatic shift has been witnessed in cancer therapy in China. Although traditional cytotoxic chemotherapy still remains the treatment of choice for many malignancies, targeted therapies are now a component of treatment for many types of cancer, including lung cancer. As molecular target agents are widely used in clinical practice and relevant studies have been conducted, we have accumulated valuable experience in the treatment strategy for advanced non-small cell lung ca...

  4. Assessing decentering: Validation, psychometric properties and clinical usefulness of the Experiences Questionnaire in a Spanish sample

    OpenAIRE

    Soler Ribaudi, Joaquim; Franquesa, Alba; Feliu-Soler, Albert; Cebolla i Martí, Ausiàs Josep; García Campayo, Javier; Tejedor, Rosa; Demarzo, Marcelo; Baños Rivera, Rosa María; Pascual, Juan Carlos; Portella, María J.

    2014-01-01

    Decentering is defined as the ability to observe one’s thoughts and feelings in a detached manner. The Experiences Questionnaire (EQ) is a self-report instrument that originally assessed decentering and rumination. The purpose of this study was to evaluate the psychometric properties of the Spanish version of EQ-Decentering and to explore its clinical usefulness. The 11-item EQ-Decentering subscale was translated into Spanish and psychometric properties were examined in a sample of 921 adult ...

  5. Job preferences among clinical officers in public sector facilities in rural Kenya: a discrete choice experiment

    OpenAIRE

    Takemura, Toshio; Kielmann, Karina; Blaauw, Duane

    2016-01-01

    Background Clinical officers (COs), a mid-level cadre of health worker, are the backbone of healthcare provision in rural Kenya. However, the vacancy rate for COs in rural primary healthcare facilities is high. Little is known about factors motivating COs’ preferences for rural postings. Methods A discrete choice experiment (DCE) questionnaire was used with 57 COs at public health facilities in nine districts of Nyanza Province, Kenya. The questionnaire was developed on the basis of formative...

  6. Experiences of Newly Admitted Nursing Students in Theoretical and Clinical Practice

    OpenAIRE

    Lekkas, Elena; Mwanakayaya, Naomi; Uzoka, Zeal; Ogie-Osahon, Cynthia

    2016-01-01

    The clinical and classroom environment provides opportunities for student learning and widens the scope of them acquring competencies in the nursing profession. During the first year of nursing school, any unpleasant or delightful encounter by students in these environments of study may influence their learning outcome. The aim of this study was to find out the experiences of the first year nursing students in classroom and practice area as well as its consequence on their wellbeing and the c...

  7. Animal experiments scrutinised: systematic reviews demonstrate poor human clinical and toxicological utility.

    Science.gov (United States)

    Knight, Andrew

    2007-01-01

    The assumption that animal models are reasonably predictive of human outcomes provides the basis for their widespread use in toxicity testing and in biomedical research aimed at developing cures for human diseases. To investigate the validity of this assumption, the comprehensive "Scopus" biomedical bibliographic databases were searched for published systematic reviews of the human clinical or toxicological utility of animal experiments. Of 20 reviews examining clinical utility, authors concluded that the animal models were substantially consistent with or useful in advancing clinical outcomes in only two cases, and the conclusion in one case was contentious. Included were reviews of the clinical utility of experiments expected by ethics committees to lead to medical advances, of highly-cited experiments published in major journals, and of chimpanzee experiments - the species most likely to be predictive of human outcomes. Seven additional reviews failed to clearly demonstrate utility in predicting human toxicological outcomes such as carcinogenicity and teratogenicity. Consequently, animal data may not generally be assumed to be substantially useful for these purposes. Possible causes include interspecies differences, the distortion of experimental outcomes arising from experimental environments and protocols, and the poor methodological quality of many animal experiments evident in at least 11 reviews. No reviews existed in which a majority of animal experiments were of good quality. While the latter problems might be minimised with concerted effort, given their widespread nature, the interspecies limitations are likely to be technically and theoretically impossible to overcome. Yet, unlike non-animal models, animal models are not normally subjected to formal scientific validation. Instead of simply assuming they are predictive of human outcomes, the consistent application of formal validation studies to all test models is clearly warranted, regardless of their

  8. Voices from a minority: experiences of chinese male nursing students in clinical practice.

    Science.gov (United States)

    Chan, Z C Y; Lui, C W; Cheung, K L; Hung, K K; Yu, K H; Kei, S H

    2013-07-01

    In Hong Kong, males constituted only about 10.2% of the nursing workforce in 2010. The learning experiences of male nursing students in Hong Kong during their clinical practicum have rarely been explored. If these students cannot maintain their psychological well-being and psychological health in formal education and clinical placements, then their physical health will also suffer. This ethnographic qualitative study gave male nursing students in Hong Kong a chance to voice their experiences during their clinical practicum. Selected through snowball sampling, 18 male nursing students from a local university participated in individual face-to-face semistructured interviews. The data were processed with content analysis. The findings indicated that male students not only received more support and understanding from male rather than female members of staff but endured a certain amount of oppression while working in female wards. According to the students' comments on nursing culture, the work climate of male nursing students could be improved by reorganizing the clinical placements and providing extra support to male nursing students. PMID:23339129

  9. Rare clinical experiences for surgical treatment of melanoma with osseous metastases in Taiwan

    Directory of Open Access Journals (Sweden)

    Yang Rong-Sen

    2007-07-01

    Full Text Available Abstract Background Malignant melanoma occurs infrequently in Taiwan. Once it has progressed into osseous metastases, the prognosis is poor. There are no reported clinical experiences of surgical management in this area. Methods To improve our understanding of the rare clinical experiences, we retrospectively investigated clinical characteristics, radiological findings, treatment modalities, survival outcomes and prognoses of 11 Taiwanese patients with osseous metastasis of melanoma treated surgically at two national medical centers, National Taiwan University Hospital and National Cheng Kung University Hospital from January 1983 to December 2006. Results Six patients suffered from acral-lentiginous melanoma. Nine patients sustained multiple osseous metastases and most lesions were osteolytic. Nine patients also had sustained metastases to other organs including liver, lungs, lymph nodes, brain and spleen. Second malignancies including lung cancer, thyroid papillary carcinoma, renal cell carcinoma and cervical cancer co-existed in four patients. The interval from the initial diagnosis of melanoma to the clinical detection of osseous metastases varied from 0–37.8 months (mean 9.75 months. Metastatic melanoma was invariably fatal; the mean survival time from bone metastases to death was 5.67 months. Conclusion Due to the high morbidity and poor survival of Taiwanese patients with osseous metastases of melanoma, surgical treatment should be directed towards pain relief and the prevention of skeletal debilitation in order to maintain their quality of life.

  10. Body Experience and Mirror Behaviour in Female Eating Disorders Patients and non Clinical Subjects

    Directory of Open Access Journals (Sweden)

    Michel Probst

    2008-12-01

    Full Text Available Recently the attention for mirror exercises in therapies targeted specifically to body experience concerns has increased. This retrospective study will explore the mirror behaviour of anorexia nervosa (AN, bulimia nervosa (BN and non-clinical female subjects (CG and investigate whether mirror avoidance or checking are related to negative body experiences.The group of eating disorders consisted of 560 AN and 314 BN patients. The control group consisted of 1151 female subjects. The Body Attitude Test and the Eating Disorder Inventory subscales drive for thinness and body dissatisfaction were used. To explore the mirror behaviour, one item of the Body Attitude Test ‘I am observing my appearance in the mirror’ was used. Nonparametric analyses (Spearman rho correlations, Kruskal-Wallis and Mann Whitney test were used because of the categorical data.BN patients observed their body more often in the mirror than AN patients and the control subjects do. Age and BMI showed no significant main effect of mirror frequency. The relation between the frequency of mirror behaviour and body experience were significant but low (under .40. AN patients and control subjects with a mirror checking behaviour had a more negative body experience than those with mirror avoidance behaviour. In the BN group, no differences were found.There is support to integrate mirror exercises in a treatment of eating disorder patients. From a clinical point, mirror exercises are preferably combined with a body oriented therapy within a multidimensional cognitive behavioural approach. Recommendations for mirror exercises based on the clinical experience are given.

  11. Using Experience Sampling Methods/Ecological Momentary Assessment (ESM/EMA) in Clinical Assessment and Clinical Research: Introduction to the Special Section

    OpenAIRE

    Trull, Timothy J.; Ebner-Priemer, Ulrich W.

    2009-01-01

    This article introduces the special section on experience sampling methods and ecological momentary assessment in clinical assessment. We review the conceptual basis for experience sampling methods (ESM; Csikszentmihalyi & Larson, 1987) and ecological momentary assessment (EMA; Stone & Shiffman, 1994). Next, we highlight several advantageous features of ESM/EMA as applied to psychological assessment and clinical research. We provide a brief overview of the articles in this special section, ea...

  12. Working collaboratively to develop a patient experience definition and strategy to inform clinical commissioning

    Directory of Open Access Journals (Sweden)

    Kate Sanders

    2015-11-01

    Full Text Available Background: Major reforms in the NHS in England have resulted in the creation of Clinical Commissioning Groups, which put clinicians at the forefront of commissioning services. One of the shared strategic objectives of the NHS is ‘ensuring that people have a positive experience of care’. With this in mind, a piece of work was undertaken to develop a strategy to embed patient experience in the commissioning process. Aim: The overall aim of this work was to engage with patients, service users, carers, health and social care workers and representatives from the voluntary sector in north-west London, UK, to develop a shared definition of patient experience and a patient experience strategy to influence the clinical commissioning of care. Methods: A values-based approach was used to develop the definition and strategy, working collaboratively with clinicians, commissioners, patients, service users, carers and the community. The facilitation of this work was underpinned by four principles: working collaboratively; being evidence based; being asset based; and being continuous and iterative. The principles are described and also used to critique the process and outcomes. Conclusion: This work was stimulated by the recognition that practice development approaches could be applied to different contexts and settings, including clinical commissioning. It has the potential to draw clinical commissioning and clinical provision much closer together, with engagement, collaboration and decision making focused on improving the quality of care (experience, safety and outcomes for patients and their supporters. Implications for practice: •\tA values-based approach is an effective way of capturing the voice of patients, service users, carers and the community •\tThe voices of individuals and communities are crucial in shaping and influencing the development and commissioning of new models of care •\tGreater impact may have been achieved if we had worked

  13. Developing more positive attitudes towards mental health nursing in undergraduate students: part 2--The impact of theory and clinical experience.

    Science.gov (United States)

    Happell, B; Robins, A; Gough, K

    2008-09-01

    Previous research examining the impact of education on nursing students' attitudes towards mental health nursing as a career has highlighted clinical experience as the primary influencing factor and generally has not considered the impact of theory. The current study compared a cohort of second-year and a cohort of third-year nursing students from the same university. Second-year students had received more theory and clinical experience than their counterparts. Questionnaires were distributed to the total population of students before commencement of, and after completion of clinical placement. This paper examines students' perceived preparedness for and satisfaction with clinical experience, attitudes towards people with mental illness, and attitudes towards mental health nursing as a career option following the completion of differing amounts of theory and clinical experience. The results demonstrate some statistically significant differences with increased amounts of theory and clinical experience in the second-year cohort being positively influential. The findings suggest that an increased component of theoretical and clinical experience in psychiatric/mental health nursing is likely to produce more positive attitudes towards people with mental illness and psychiatric/mental health nursing. However, little difference in perceived preparedness for and satisfaction with clinical experience was noted between the two cohorts. PMID:18768004

  14. Radiological and Environmental Research Division, Center for Human Radiobiology. Annual report, July 1980-June 1981

    International Nuclear Information System (INIS)

    Separate abstracts were prepared for the 22 papers of this annual report of the Center for Human Radiobiology. Abstracts were not written for 2 appendices which contain data on the exposure and radium-induced malignancies of 2259 persons whose radium content has been determined at least once

  15. The first clinical experience on efficacy of topical flutamide on melasma compared with topical hydroquinone: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Adalatkhah H

    2015-08-01

    first clinical experience on efficacy of topical flutamide on melasma, it would be quite unreasonable to recommend clinical use of it before future studies replicate the results on its efficacy and safety. Keywords: Pigmentation disorders, topical, treatment, dermatology, anti-androgenic agents, acquired increased skin pigmentation, Melasma Area and Severity Index (MASI Mexamete

  16. Initial clinical experience with frameless stereotactic radiosurgery: analysis of accuracy and feasibility

    International Nuclear Information System (INIS)

    Purpose: To report on preliminary clinical experience with a novel image-guided frameless stereotactic radiosurgery system. Methods and Materials: Fifteen patients ranging in age from 14 to 81 received radiosurgery using a commercially available frameless stereotactic radiosurgery system. Pathologic diagnoses included metastases (12), recurrent primary intracranial sarcoma (1), recurrent central nervous system (CNS) lymphoma (1), and medulloblastoma with supratentorial seeding (1). Treatment accuracy was assessed from image localization of the stereotactic reference array and reproducibility of biteplate reseating. We chose 0.3 mm vector translation error and 0.3 degree rotation about each axis as the maximum tolerated misalignment before treating each arc. Results: The biteplates were found on average to reseat with a reproducibility of 0.24 mm. The mean registration error from CT localization was found to be 0.5 mm, which predicts that the average error at isocenter was 0.82 mm. No patient treatment was delivered beyond the maximum tolerated misalignment. The radiosurgery treatment was delivered in approximately 25 min per patient. Conclusion: Our initial clinical experience with stereotactic radiotherapy using the infrared camera guidance system was promising, demonstrating clinical feasibility and accuracy comparable to many frame-based systems

  17. Haemophilia in a real-world setting: the value of clinical experience in data collection.

    Science.gov (United States)

    Dolan, Gerry; Iorio, Alfonso; Jokela, Vuokko; Juusola, Kristian; Lassila, Riitta

    2016-02-01

    At the 8th Annual Congress of the European Association for Haemophilia and Allied Disorders (EAHAD) held in Helsinki, Finland, in February 2015, Pfizer sponsored a satellite symposium entitled: 'Haemophilia in a real-world setting: The value of clinical experience in data collection' Co-chaired by Riitta Lassila (Helsinki University Central Hospital, Helsinki, Finland) and Gerry Dolan (Guy's and St Thomas' Hospital, London, UK); the symposium provided an opportunity to explore the practical value of real-world data in informing clinical decision-making. Gerry Dolan provided an introduction to the symposium by describing what is meant by real-world data (RWD), stressing the role RWD can play in optimising patient outcomes in haemophilia and highlighting the responsibility of all stakeholders to collaborate in continuous data collection. Kristian Juusola (Oulu University Hospital, Oulu, Finland) then provided personal experience as a haemophilia nurse around patient views on adherence to treatment regimes, and how collecting insights into real-world use of treatment can shape approaches to improving adherence. The importance of elucidating pharmacokinetic parameters in a real-world setting was then explored by Vuokko Jokela (Helsinki University, Helsinki, Finland). Finally, Alfonso Iorio (McMaster University, Hamilton, Ontario, Canada) highlighted the importance of quality data collection in translating clinical reality into scientific advances. PMID:26809546

  18. Preliminary experience with small animal SPECT imaging on clinical gamma cameras.

    Science.gov (United States)

    Aguiar, P; Silva-Rodríguez, J; Herranz, M; Ruibal, A

    2014-01-01

    The traditional lack of techniques suitable for in vivo imaging has induced a great interest in molecular imaging for preclinical research. Nevertheless, its use spreads slowly due to the difficulties in justifying the high cost of the current dedicated preclinical scanners. An alternative for lowering the costs is to repurpose old clinical gamma cameras to be used for preclinical imaging. In this paper we assess the performance of a portable device, that is, working coupled to a single-head clinical gamma camera, and we present our preliminary experience in several small animal applications. Our findings, based on phantom experiments and animal studies, provided an image quality, in terms of contrast-noise trade-off, comparable to dedicated preclinical pinhole-based scanners. We feel that our portable device offers an opportunity for recycling the widespread availability of clinical gamma cameras in nuclear medicine departments to be used in small animal SPECT imaging and we hope that it can contribute to spreading the use of preclinical imaging within institutions on tight budgets. PMID:24963478

  19. Clinical and Histopathological Diagnosis of Glomus Tumor: An Institutional Experience of 138 Cases

    Science.gov (United States)

    Mravic, Marco; LaChaud, Gregory; Nguyen, Alan; Scott, Michelle A.; Dry, Sarah M.; James, Aaron W.

    2015-01-01

    Background Glomus tumors are relatively uncommon subcentimeteric benign perivascular neoplasms usually located on the fingers. With their blue-red color and common subungual location, they are commonly confused for vascular or melanocytic lesions. To date there is no comprehensive review of an institutional experience with glomus tumors. Methods A 14-year retrospective review of all cases within University of California, Los Angeles, with either a clinical or pathological diagnosis of glomus tumor was performed. Data obtained included demographic information, tumor description, pathological diagnoses, immunohistochemical studies, radiographic and treatment information, and clinical course. Rates of concordance between clinical and pathological diagnoses and an evaluation of overlap with other entities were assessed. Results Clinical diagnosis of glomus tumor showed concordance with a histopathological diagnosis (45.4% of cases). The most common alternate clinical diagnoses included lipoma, cyst, or angioma. A pathological diagnosis of glomus tumor was most common in the fourth to seventh decades of life. The most common presentation was a subcentimeter lesion on the digit. Deep-seated tumors had a strikingly increased risk for malignancy (33%). Radiological studies were not relied on frequently (18.2% of cases). Immunohistochemical analysis showed diffuse αSMA and MSA expression in nearly all cases (99% and 95%, respectively), with focal to diffuse CD34 immunostaining in 32% of cases. Discussion Our study illustrates trends in the clinical versus pathologic diagnoses of glomus tumor, common competing diagnoses, a difference in demographics than is commonly reported (older age groups most commonly affected), and important differences in the use adjunctive diagnostic tools including radiology and immunohistochemistry. PMID:25614464

  20. 3H-thymidine (3HTdR) incorporated into DNA; Dosimetric and radiobiological considerations

    International Nuclear Information System (INIS)

    Tritium can be selectively incorporated into DNA in vivo by administration of tritiated thymidine (3HTdR), and this labelled precursor is used widely and effectively in investigations on the mechanism of DNA synthesis, in studies on the kinetics of cell proliferation, and for the purpose of selective cell destruction. It is important, of course, to be aware of the threshold for toxicity of the isotope used in this manner. In addition, the unique dosimetric features involved present theoretical and practical problems, the solutions of which will shed light on mechanisms of radiobiology effect. The highly selective irradiation of the nucleus of those cells which incorporated 3HTdR at the time of DNA synthesis constitutes not only partial-body irradiation, but partial-cell irradiation, and homogeneity of exposure can be defined only in terms of subcellular dimensions. The toxicity of 3HTdR and the associated problems have been reviewed extensively. The object of the present paper is to: (a) evaluate from data in the literature and from data to be presented, whether observed effects from intranuclear 3H can be accounted for on the basis of calculated absorbed dose in rads to the cell nucleus, or, alternatively, whether additional factors deriving from the presence of the 3H in the DNA molecule must be invoked. In the latter case the biological effects would not be generally predictable on the basis of absorbed dose; and (b) to discuss the implications of the findings with respect to radiobiology and radiation protection. The conclusion is reached that while data are as yet inadequate for firm evaluation, biological effects of 3HTdR are those predictable on the basis of the average absorbed dose to the nucleus. The applicability of the absorbed dose concept can be evaluated satisfactorily only if adequate comparisons of the effect of incorporated 3HTdR can be made with a suitable standard external radiation such as X-rays, or possibly with the same isotope (3H

  1. Experiments in Laboratory of Nuclear Problems of Joint Institute for Nuclear Research in 1994-1995

    International Nuclear Information System (INIS)

    This book is a complication of the short status reports on current experiments on intermediate energy physics and on high energy physics. The projects of new facilities and the results of radiobiological researches are presented

  2. Effects of Anxiety on Novice Genetic Counseling Students' Experience of Supervised Clinical Rotations.

    Science.gov (United States)

    MacFarlane, Ian M; McCarthy Veach, Pat; Grier, Janelle E; Meister, Derek J; LeRoy, Bonnie S

    2016-08-01

    Supervised clinical experiences with patients comprise a critical component of genetic counseling student education. Previous research has found genetic counseling students tend to be more anxiety prone than the general population, and anxiety related to supervision has been found in genetic counseling and related fields. The present study investigated how anxiety affects the experience of supervision for genetic counseling students. Second year genetic counseling students were invited to participate through email invitations distributed via training directors of the 33 programs accredited at the time of the study by the American Board of Genetic Counseling. An initial online survey contained the trait scale of the State-Trait Anxiety Inventory to estimate anxiety proneness in this population and an invitation to participate in a 45-minute semi-structured phone interview focusing on students' experiences of supervision during their clinical rotations. High and low trait anxiety groups were created using STAI scores, and the groups' interview responses were compared using consensual qualitative research methodology (CQR; Hill 2012). The high anxiety group was more likely to describe problematic supervisory relationships, appreciate the supervisor's ability to help them when they get stuck in sessions, and feel their anxiety had a negative effect on their performance in general and in supervision. Common themes included supervisors' balancing support and guidance, the importance of feedback, ego-centric responses, and supervisors as focal points. The results of the present study are largely consistent with current literature. Further research findings and research, practice, and training recommendations are provided. PMID:27098419

  3. Psychotic experiences as indicators of suicidal ideation in a non-clinical college sample.

    Science.gov (United States)

    DeVylder, Jordan E; Thompson, Elizabeth; Reeves, Gloria; Schiffman, Jason

    2015-04-30

    Suicide is a leading cause of preventable death. Epidemiological studies have shown strong associations between sub-threshold psychotic experiences and risk for suicidal ideation and behavior. Screens designed to assess psychotic experiences may have clinical utility in improving suicide prevention efforts. In the current study, we hypothesized that the Prodromal Questionnaire-Brief (PQ-B) would reliably distinguish levels of suicidal ideation within a sample of college students (n=376). As predicted, PQ-B scores varied significantly across levels of suicidal ideation, both when treated as a raw count of sub-threshold psychotic experiences and when taking into account subjective distress associated with those symptoms. In addition, we explored the feasibility of developing a short screen based on the most discriminating items, finding that a six-item version of the PQ-B yielded higher accuracy for detecting elevated suicidal ideation over the full measure. The PQ-B has the potential for clinical utility in detecting groups that might be at increased risk for suicidal ideation. PMID:25746171

  4. Teledermatology with an integrated nurse - Led clinic on the Faroe Islands - 7 years' experience

    DEFF Research Database (Denmark)

    Bryld, L.E.; Heidenheim, M.; Dam, T.N.;

    2011-01-01

    photographs. Objectives To describe the patient population of the Faroe Islands dermatology clinic with respect to distribution of diagnoses, treatment, duration, response time and patient flow. Methods Case notes were drawn from all dermatology consultations managed during 2003-2009 through the national...... apart for an over-representation of the female gender in younger years. The disease spectrum is comparable with what has been reported in other outpatient clinics, except for the relative absence of skin cancer and pigmented lesions, for which regular outpatient consultation is reserved. Limitations The...... study is descriptive. Conclusions The experience derived suggests that teledermatology may serve as a near-adequate alternative to a regular private practice, if abstaining from treating minor common skin conditions and purely cosmetic conditions is acceptable. © 2010 The Authors....

  5. The clinical experience and results of total body irradiation for the cases of refractory leukemia

    International Nuclear Information System (INIS)

    Five patients suffering from refractory leukemia were treated by Cyclophosphamide and total body irradiation followed by bone marrow transplantation. Total body irradiation with 10 MV Linac x-ray (1000 - 1280 rad, peak absorbed dose) followed by bone marrow transplantation is considered to be a relatively safe procedure. The dose distribution of the total body irradiation shows clinically suitable homogeniety. Although there is no long-term survivor in this study, no relapse sign of leukemia was found at autopsy. Therefore, some possibility of cure can be expected from this experience. There are many problems such as Graft-versus-host disease, susceptability to infection, etc., but this combination therapy will be able to contribute to improve the clinical course of refractory leukemia. (author)

  6. Bipolar radiofrequency ablation for symptomatic giant (>10 cm) hepatic cavernous haemangiomas: Initial clinical experience

    International Nuclear Information System (INIS)

    Aim: To describe initial clinical experience with bipolar radiofrequency ablation (RFA) for symptomatic giant hepatic haemangiomas. Materials and methods: Four consecutive patients with a large-volume, symptomatic hepatic cavernous haemangioma of >10 cm were treated with bipolar RFA during laparotomy with ultrasound guidance. Complications were carefully noted. Clinical and radiological effectiveness were evaluated comparing baseline with 3 and 6 months follow-up of symptom assessments and upper abdominal magnetic resonance imaging (MRI) or computed tomography (CT). Results: RFA was successfully performed for all four giant haemangiomas. No major complications were observed. Peri-procedural shrinking was remarkable and intermediate-term volume reduction ranged from 58–92% after 6 months. Symptom relief after 6 months was complete in two patients and considerable in the other two. Conclusion: Preliminary results suggest intra-operative bipolar RFA to be a safe, feasible, and effective technique for treatment of giant symptomatic hepatic cavernous haemangiomas.

  7. Interprofessional education through shadowing experiences in multi-disciplinary clinical settings

    Directory of Open Access Journals (Sweden)

    Moore Ainsley E

    2010-12-01

    Full Text Available Abstract The World Health Organization has recently added Interprofessional Education (IPE to its global health agenda recognizing it as a necessary component of all health professionals' education. We suggest mandatory interprofessional shadowing experiences as a mechanism to be used by chiropractic institutions to address this agenda. IPE initiatives of other professions (pharmacy and medicine are described along with chiropractic. This relative comparison of professions local to our jurisdiction in Ontario, Canada is made so that the chiropractic profession may take note that they are behind other health care providers in implementing IPE. Interprofessional shadowing experiences would likely take place in a multi-disciplinary clinical setting. We offer an example of how two separate professions within a Family Health Team (FHT can work together in such a setting to enhance both student learning and patient care. For adult learners, using interprofessional shadowing experiences with learner-derived and active objectives across diverse health professional groups may help to improve the educational experience. Mandatory interprofessional shadowing experiences for chiropractors during their training can enhance future collaborative practice and provide success in reaching a goal common to each profession - improved patient care.

  8. SU-E-T-275: Radiobiological Evaluation of Intensity Modulated Radiotherapy Treatment for Locally Advanced Head and Neck Squamous Cell Carcinomas

    International Nuclear Information System (INIS)

    Purpose: To evaluate the radiobiological outcome of Intensity Modulated Radiotherapy Treatment (IMRT) for locally advanced head and neck squamous cell carcinomas using HART (Histogram Analysis in Radiation Therapy; J Appl Clin Med Phys 11(1): 137–157, 2010) program and compare with the clinical outcomes. Methods: We have treated 20 patients of stage III and IV HNSCC Oropharynx and hypopharynx with accelerated IMRT technique and concurrent chemotherapy. Delineation of tumor and normal tissues were done using Danish Head and Neck Cancer Group (DAHANCA) contouring guidelines and radiotherapy was delivered to a dose of 70Gy in 35 fractions to the primary and involved lymph nodes, 63Gy to intermediate risk areas and 56 Gy to lower risk areas, Monday to Saturday, 6 Days/week using 6 MV Photons with an expected overall treatment time of 6 weeks. The TCP and NTCP's were calculated from the dose-volume histogram (DVH) statistics using the Poisson Statistics (PS) and JT Lyman models respectively and the Resultwas correlated with clinical outcomes of the patients with mean follow up of 24 months. Results: Using HART program, the TCP (0.89± 0.01) of primary tumor and the NTCP for parotids (0.20±0.12), spinal cord (0.05±0.01), esophagus (0.30±0.2), mandible (0.35±0.21), Oral cavity (0.37±0.18), Larynx (0.30±0.15) were estimated and correlated with clinical outcome of the patients. Conclusion: Accelerated IMRT with Chemotherapy is a clinical feasible option in the treatment of locally advanced HNSCC with encouraging initial tumour response and acceptable acute toxicities. The correlation between the clinical outcomes and radiobiological model estimated parameters using HART programs are found to be satisfactory

  9. SU-E-T-275: Radiobiological Evaluation of Intensity Modulated Radiotherapy Treatment for Locally Advanced Head and Neck Squamous Cell Carcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Rekha Reddy, B.; Ravikumar, M.; Tanvir Pasha, C.R; Anil Kumar, M.R; Varatharaj, C. [Kidwai Memorial Institute of Oncology Bangalore, Karnataka (India); Pyakuryal, A [University Illinois at Chicago, Chicago, IL (United States); Narayanasamy, Ganesh [UTHSCSA, San Antonio, TX (United States)

    2014-06-01

    Purpose: To evaluate the radiobiological outcome of Intensity Modulated Radiotherapy Treatment (IMRT) for locally advanced head and neck squamous cell carcinomas using HART (Histogram Analysis in Radiation Therapy; J Appl Clin Med Phys 11(1): 137–157, 2010) program and compare with the clinical outcomes. Methods: We have treated 20 patients of stage III and IV HNSCC Oropharynx and hypopharynx with accelerated IMRT technique and concurrent chemotherapy. Delineation of tumor and normal tissues were done using Danish Head and Neck Cancer Group (DAHANCA) contouring guidelines and radiotherapy was delivered to a dose of 70Gy in 35 fractions to the primary and involved lymph nodes, 63Gy to intermediate risk areas and 56 Gy to lower risk areas, Monday to Saturday, 6 Days/week using 6 MV Photons with an expected overall treatment time of 6 weeks. The TCP and NTCP's were calculated from the dose-volume histogram (DVH) statistics using the Poisson Statistics (PS) and JT Lyman models respectively and the Resultwas correlated with clinical outcomes of the patients with mean follow up of 24 months. Results: Using HART program, the TCP (0.89± 0.01) of primary tumor and the NTCP for parotids (0.20±0.12), spinal cord (0.05±0.01), esophagus (0.30±0.2), mandible (0.35±0.21), Oral cavity (0.37±0.18), Larynx (0.30±0.15) were estimated and correlated with clinical outcome of the patients. Conclusion: Accelerated IMRT with Chemotherapy is a clinical feasible option in the treatment of locally advanced HNSCC with encouraging initial tumour response and acceptable acute toxicities. The correlation between the clinical outcomes and radiobiological model estimated parameters using HART programs are found to be satisfactory.

  10. Radiobiological evaluation of forward and inverse IMRT using different fractionations for head and neck tumours

    Directory of Open Access Journals (Sweden)

    Capela Miguel

    2010-06-01

    Full Text Available Abstract Purpose To quantify the radiobiological advantages obtained by an Improved Forward Planning technique (IFP and two IMRT techniques using different fractionation schemes for the irradiation of head and neck tumours. The conventional radiation therapy technique (CONVT was used here as a benchmark. Methods Seven patients with head and neck tumours were selected for this retrospective planning study. The PTV1 included the primary tumour, PTV2 the high risk lymph nodes and PTV3 the low risk lymph nodes. Except for the conventional technique where a maximum dose of 64.8 Gy was prescribed to the PTV1, 70.2 Gy, 59.4 Gy and 50.4 Gy were prescribed respectively to PTV1, PTV2 and PTV3. Except for IMRT2, all techniques were delivered by three sequential phases. The IFP technique used five to seven directions with a total of 15 to 21 beams. The IMRT techniques used five to nine directions and around 80 segments. The first, IMRT1, was prescribed with the conventional fractionation scheme of 1.8 Gy per fraction delivered in 39 fractions by three treatment phases. The second, IMRT2, simultaneously irradiated the PTV2 and PTV3 with 59.4 Gy and 50.4 Gy in 28 fractions, respectively, while the PTV1 was boosted with six subsequent fractions of 1.8 Gy. Tissue response was calculated using the relative seriality model and the Poisson Linear-Quadratic-Time model to simulate repopulation in the primary tumour. Results The average probability of total tumour control increased from 38% with CONVT to 80% with IFP, to 85% with IMRT1 and 89% with IMRT2. The shorter treatment time and larger dose per fraction obtained with IMRT2 resulted in an 11% increase in the probability of control in the PTV1 with respect to IFP and 7% relatively to IMRT1 (p Conclusions A significant improvement in treatment outcome was obtained with IMRT compared to conventional radiation therapy. The practical and biological advantages of IMRT2, employing a shorter treatment time, may

  11. Clients’ Experiences of a Band Group Project in Vantaa Drug Treatment Clinic

    OpenAIRE

    Pönkänen, Paula; Valkiala, Petri

    2011-01-01

    This study is a description of clients’ experiences of a band group project. The purpose of this qualitative study was to find out what the outcomes and effects of an anti-oppressive and client-centered music group could be for substitute treatment clients. The drug treatment clinic in Vantaa was lacking group activity. The idea for the band group came from the clients. This was an opportunity for us to study, learn and understand how important element music can be in this kind of shared inte...

  12. New emergency radiology unit in Ohtawara Red Cross Hospital. Clinical experience and workflow

    International Nuclear Information System (INIS)

    A 64-raw multislice computed tomography (64-MSCT) machine, a new 1.5-T magnetic resonance imaging (MRI) machine, a flat-panel detector X ray, and a digital X ray TV were installed at the Ohtawara Red Cross Hospital in September 2005. Here, we explain the usefulness of ''Traumatic Panscan'' enabled by 64-MSCT and introduce the clinical experience and workflow of the new diagnostic imaging unit. In emergency situations, diagnostic imaging can be useful for triage, since its protocol remains the same for every situation. (author)

  13. Applications of Botulinum Toxin at a Neurology Clinic: An Eleven-year Experience

    OpenAIRE

    Hasan Rıfat Koyuncuoğlu; Seden Demirci

    2016-01-01

    Objective: The aim of this study was to report our experience with Botulinum toxin (BoNT) in the treatment of various neurologic conditions. Materials and Methods: We conducted a retrospective analysis of 128 patients who received BoNT in our Neurology clinic during an 11-year period (January 2003 to December 2014). All patients received BoNT type A injections. Results: A total of 858 injections of BoNT were administered to 128 patients. Seventy (54.7%) patients with hemifacial spasm...

  14. Clinical experience with hyperthermia in cancer radiotherapy: Special reference to in vivo thermometry

    International Nuclear Information System (INIS)

    Combined use of heat and ionizing radiation is a promising treatment of radioresistant tumors, because the two modalities act complementary for cell killing in vitro. Cells in S phase and chronically hypoxic cells, which as a consequence have a low pH, are vulnerable to heat. This chapter describes the authors' clinical experiences of combined localized hypethermia in cancer radiotherapy and discusses mainly problems associated with temperature measurement and its evaluation, including the effects of electromagnetic waves on the thermometer system, the difference of temperature distribution in static phantom and in vivo, and the method for evaluating the heat dose, administered under conditions of various temperatures

  15. Clinical case reviews in multiple sclerosis spasticity: experiences from around Europe.

    Science.gov (United States)

    Koehler, Jürgen; Amato, Maria P; Oreja-Guevara, Celia; Lycke, Jan

    2013-12-01

    Spasticity is one of the main symptoms associated with multiple sclerosis (MS). Epidemiological studies indicate that approximately two-thirds of MS patients experience spasticity and, in a relevant proportion of this group, spasticity is moderate to severe. Yet, spasticity remains largely undertreated. The most commonly used oral antispasticity agents (e.g., baclofen, tizanidine, gabapentin) generally do not reduce spasticity adequately at dosages that are well tolerated by patients. This review of MS spasticity cases from around Europe presents current knowledge of considerations for administration of a new agent (tetrahydrocannabinol/cannabidiol-based nabiximols [Sativex®] oromucosal spray) for management of MS spasticity, with the aim of ensuring appropriate and optimal use for best outcomes. Assessment of the European clinical experience is intended to provide a better understanding of the prescribing regulations for MS spasticity treatments, facilitate identification of suitable candidate patients for Sativex and increase awareness of alternative management approaches for MS-related spasticity. PMID:24289846

  16. Clinical Experience in Using the Water Jet in Burn Wound Debridement

    Science.gov (United States)

    Yang, J.-Y.; Hwuang, J.-Y.; Chuang, S.-S.

    2007-01-01

    Summary Water jets have been used in many areas of surgery. Recently a new surgical debridement device was launched onto the market - VersajetTM. VersajetTM is a unique hydrosurgical device that uses a precise jet of water to simultaneously hold, cut, and remove devitalized or necrotic tissue. This paper describes our experience with ten patients comparing Weck knives with the newly designed hydrosurgical device when debriding burn wounds. The patients' age ranged from 27 to 60 yr (average, 37.8 yr) and the burn wounds treated were between 3 and 7% total body surface area, involving the face, abdomen, and limbs. The hydrosurgical system is a very useful tool for irregular and complex burn wound debridement. This paper represents the first written clinical experience utilizing hydrosurgery in the burn wound management in an Eastern country. PMID:21991073

  17. IAEA advisory group meeting on nuclear and atomic data for radiotherapy and related radiobiology in co-operation with the Radiobiological Institute of the Division for Health Research TNO, 16-20 September 1985, Rijswijk, the Netherlands

    International Nuclear Information System (INIS)

    The IAEA Advisory Group Meeting on ''Nuclear and Atomic Data for Radiotherapy and Related Radiobiology'' was held at Rijswijk, the Netherlands, from 16 to 20 September 1985, in co-operation with the Radiobiological Institute TNO. The meeting participants reviewed the current and future requirements on nuclear and atomic data for radiotherapy and radiobiology, identified data requirements and their priorities, and issued a number of specific recommendations for future technical work in nuclear and atomic data required to establish a more solid nuclear physics foundation of radiotherapy and related radiobiology. The recommendations in this report are directed to three areas, namely beam production and field description, dosimetry, and interpretation and optimization of biological effects. The final proceedings will be issued as an IAEA publication in 1986. (author)

  18. A critical evaluation of student radiographers' experience of the transition from the classroom to their first clinical placement

    International Nuclear Information System (INIS)

    Introduction: Students studying for qualifications which enable them to apply for registration as health care professionals are expected to undertake a large amount of clinical placement to support their learning. The BSc Hons Diagnostic Radiography at one post-1992 UK University is no exception. It was identified in a previous study by this researcher that a relatively large number of first year student radiographers were unsure, or nervous, about some aspects of the transition to their first clinical placement. It was felt that further investigation into the student experience of the transition to the first clinical placement was warranted. Methodology: A mixed-methods survey approach was used to elicit quantitative and qualitative data from current radiography students, academic staff and clinical staff about student experience of the transition to the first clinical placement. Results: In general, most students enjoyed their first clinical placement, and the opportunity to put theory into practice. However, three key themes emerged from the data that caused students difficulty in the first clinical placement; working with clinical staff, working with very ill patients, and moving around the department each week. Key Conclusions: This study has identified that some aspects of the transition into the first clinical placement need to be improved. Recommendations have been made for curriculum development in the academic block prior to the first clinical placement, and to improve student support during clinical placement. The implementation of these recommendations is crucial to reduce the dissonance between theory and practice, and improve student experience of the transition to the first clinical placement. - Highlights: • Issues for student radiographers during their first clinical placement are identified. • Recommendations made for curriculum development to improve preparation for clinical placement. • Recommendations made to improve student support in

  19. Estimation of a Self-Consistent Set of Radiobiological Parameters From Hypofractionated Versus Standard Radiation Therapy of Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pedicini, Piernicola, E-mail: ppiern@libero.it [Service of Medical Physics, Istituto di Ricovero e Cura a Carattere Scientifico Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture (Italy); Strigari, Lidia [Laboratory of Medical Physics and Expert Systems, Istituto Nazionale Tumori Regina Elena, Rome (Italy); Benassi, Marcello [Service of Medical Physics, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (Italy)

    2013-04-01

    Purpose: To determine a self-consistent set of radiobiological parameters in prostate cancer. Methods and Materials: A method to estimate intrinsic radiosensitivity (α), fractionation sensitivity (α/β), repopulation doubling time, number of clonogens, and kick-off time for accelerated repopulation of prostate cancer has been developed. Based on the generalized linear-quadratic model and without assuming the isoeffective hypothesis, the potential applications of the method were investigated using the clinical outcome of biochemical relapse-free survival recently reviewed in the literature. The strengths and limitations of the method, regarding the fitted parameters and 95% confidence intervals (CIs), are also discussed. Results: Our best estimate of α/β is 2.96 Gy (95% CI 2.41-3.53 Gy). The corresponding α value is 0.16 Gy{sup −1} (95% CI 0.14-0.18 Gy{sup −1}), which is compatible with a realistic number of clonogens: 6.5 × 10{sup 6} (95% CI 1.5 × 10{sup 6}-2.1 × 10{sup 7}). The estimated cell doubling time is 5.1 days (95% CI 4.2-7.2 days), very low if compared with that reported in the literature. This corresponds to the dose required to offset the repopulation occurring in 1 day of 0.52 Gy/d (95% CI 0.32-0.68 Gy/d). However, a long kick-off time of 31 days (95% CI 22-41 days) from the start of radiation therapy was found. Conclusion: The proposed analytic/graphic method has allowed the fitting of clinical data, providing a self-consistent set of radiobiological parameters for prostate cancer. With our analysis we confirm a low value for α/β with a correspondingly high value of intrinsic radiosensitivity, a realistic average number of clonogens, a long kick-off time for accelerated repopulation, and a surprisingly fast repopulation that suggests the involvement of subpopulations of specifically tumorigenic stem cells during continuing radiation therapy.

  20. Estimation of a Self-Consistent Set of Radiobiological Parameters From Hypofractionated Versus Standard Radiation Therapy of Prostate Cancer

    International Nuclear Information System (INIS)

    Purpose: To determine a self-consistent set of radiobiological parameters in prostate cancer. Methods and Materials: A method to estimate intrinsic radiosensitivity (α), fractionation sensitivity (α/β), repopulation doubling time, number of clonogens, and kick-off time for accelerated repopulation of prostate cancer has been developed. Based on the generalized linear-quadratic model and without assuming the isoeffective hypothesis, the potential applications of the method were investigated using the clinical outcome of biochemical relapse-free survival recently reviewed in the literature. The strengths and limitations of the method, regarding the fitted parameters and 95% confidence intervals (CIs), are also discussed. Results: Our best estimate of α/β is 2.96 Gy (95% CI 2.41-3.53 Gy). The corresponding α value is 0.16 Gy−1 (95% CI 0.14-0.18 Gy−1), which is compatible with a realistic number of clonogens: 6.5 × 106 (95% CI 1.5 × 106-2.1 × 107). The estimated cell doubling time is 5.1 days (95% CI 4.2-7.2 days), very low if compared with that reported in the literature. This corresponds to the dose required to offset the repopulation occurring in 1 day of 0.52 Gy/d (95% CI 0.32-0.68 Gy/d). However, a long kick-off time of 31 days (95% CI 22-41 days) from the start of radiation therapy was found. Conclusion: The proposed analytic/graphic method has allowed the fitting of clinical data, providing a self-consistent set of radiobiological parameters for prostate cancer. With our analysis we confirm a low value for α/β with a correspondingly high value of intrinsic radiosensitivity, a realistic average number of clonogens, a long kick-off time for accelerated repopulation, and a surprisingly fast repopulation that suggests the involvement of subpopulations of specifically tumorigenic stem cells during continuing radiation therapy

  1. Experiences by student nurses during clinical placement in psychiatric units in a hospital

    Directory of Open Access Journals (Sweden)

    W.J.C. Van Rhyn

    2004-09-01

    Full Text Available An exploratory study was conducted with the aim of discovering and describing experiences of psychiatric nursing students during clinical placement in a psychiatric unit. For the purpose of the study an unstructured interview was conducted with each participant during their first placement in a psychiatric unit to identify the factors experienced as stressful. The results indicated that all eight participants experienced average to high stress. Sources of stress identified included, among others, ineffective teaching and learning programmes, poor managerial governance of the service, detachment of professional nurses from their teaching role, poor relationships among staff, overreliance on the medical model of care and patient neglect. Psychiatric nursing students sampled indicated universal support for in-service education and training for professional nurses, attitude change of professional nurses towards students, support for student initiatives, student involvement in patient care and adequate allocation of resources for patient care and nurse training. The exploration and description of experiences of the psychiatric nursing students will help nurse educators plan clinical learning opportunities in such a way that they are less stressful, thus ensuring that psychiatric nursing students are equipped to utilise themselves as therapeutic instruments.

  2. Three clinical experiences with SNP array results consistent with parental incest: a narrative with lessons learned.

    Science.gov (United States)

    Helm, Benjamin M; Langley, Katherine; Spangler, Brooke; Vergano, Samantha

    2014-08-01

    Single nucleotide polymorphism microarrays have the ability to reveal parental consanguinity which may or may not be known to healthcare providers. Consanguinity can have significant implications for the health of patients and for individual and family psychosocial well-being. These results often present ethical and legal dilemmas that can have important ramifications. Unexpected consanguinity can be confounding to healthcare professionals who may be unprepared to handle these results or to communicate them to families or other appropriate representatives. There are few published accounts of experiences with consanguinity and SNP arrays. In this paper we discuss three cases where molecular evidence of parental incest was identified by SNP microarray. We hope to further highlight consanguinity as a potential incidental finding, how the cases were handled by the clinical team, and what resources were found to be most helpful. This paper aims to contribute further to professional discourse on incidental findings with genomic technology and how they were addressed clinically. These experiences may provide some guidance on how others can prepare for these findings and help improve practice. As genetic and genomic testing is utilized more by non-genetics providers, we also hope to inform about the importance of engaging with geneticists and genetic counselors when addressing these findings. PMID:24222483

  3. Explaining the Learning Experiences of Clinical Procedures of the Internal Medicine Residents at Department of Gastroenterology

    Directory of Open Access Journals (Sweden)

    Mansoureh Taghavinia

    2012-07-01

    Full Text Available Introduction: the method and way of learning and teaching are effective in acquiring clinical skills, and identifying the shortcomings of learning and teaching will lead to better planning. The purpose of this study was to explain the experiences of the learning clinical procedures of the internal medicine residents in gastroenterology department. Methods: qualitative study using content thematic analysis was done. Six fourth-year residents were selected and interviewed considering purposive sampling. The data of the interviews were transcribed and analyzed after rereading. Results: the collected data are divided into three categories: learning and experience with the following four categories (learning time and experiencing, leaning and experiencing times, learning and experiencing opportunities, training and the lack of the training of some procedures. These categories are explained by using some quotes derived from the data. Conclusion: the results of this study suggest that the administrative management of internal residency is poor and should get seriously in implementation and application of intended instructions existing in the prepared program of Medical Education and Specialized Council of internal residency period. The attending physicians and residents must be aware of the content of education program at the beginning of the residency periods and the trainers must try to supervise the residents’ education.

  4. Animal experiments and clinical application of olfactory ensheathing cell transplantation for treatment of spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    Nan Liu; Wei Liu; Baiyu Zhou; Jing Wang; Bing Li

    2008-01-01

    BACKGROUND: The olfactory epithelium can still generate new neurons after arresting its growth and development in the human body. Axons can still be generated and pass through peripheral tissue to reach the olfactory bulb. Thus, olfactory cells have been widely used in the repair of spinal cord injury.OBJECTIVE: Using animal experiments in conjunction with a clinical study of olfactory ensheathing cells, this paper was designed to clarify the function and application prospects of olfactory ensheathing cells, as well as the existing problems with their application. RETRIEVAL STRATEGY: Using the terms "olfactory ensheathing cells, spinal cord injury", we retrieved manuscripts published from January 1990 to June 2007. The languages were limited to English and Chinese. Inclusion criteria: studies addressing the characteristics, basic study, clinical application and prospects of olfactory ensheathing cells; studies that were recently published or were published in high-impact journals. Exclusion criteria: repetitive studies.LITERATURE EVALUATION: The included 29 manuscripts were primarily clinical or basic experimental studies. DATA SYNTHESIS: Following spinal cord injury, spinal neurons die, neurotrophic factors are lacking, and the existing glial scar and cavities hinder axonal growth. One method to repair spinal cord injury is to interfere with the above-mentioned factors based on animal experiments. Myelination and axonal regeneration are the keys to spinal cord injury therapy. Olfactory ensheathing cells can secrete several neurotrophic factors, inhibit horizontal cell reactions, have noticeable neuroprotective effects, and possess a very strong reproductive activity, so they have many advantages in the fields of cell transplantation and gene therapy. However, there still exist many questions and uncertainties, such as the best time window and dose, as well as complications of olfactory ensheathing cell transplantation; precise mechanism of action after olfactory

  5. Who benefits most from THC:CBD spray? Learning from clinical experience.

    Science.gov (United States)

    Koehler, Jürgen

    2014-01-01

    Patients with multiple sclerosis (MS) represent a diverse and heterogeneous population varying in terms of disease type, its severity and variable progression/time-course, and with regard to the wide range of presenting symptoms. Consequently, detailed experience with individual patients is important to provide examples of therapy to specific patient types. In this article, real-life data from clinical practice showing specific aspects relating to use of 9-delta-tetrahydocannabinol and cannabidiol (THC:CBD) oromucosal spray (Sativex®) in patients with moderate to severe spasticity resistant to usual therapy will be presented. Three common clinical scenarios will be considered: MS patients with resistance to usual spasticity therapies; patients with impairment in MS spasticity symptoms; MS patients with relevant impairment in quality of life/activities of daily living (QoL/ADL). These case reports highlight the diverse nature of the MS spasticity population and they show the possible usefulness of THC:CBD oromucosal spray in individual patients with moderate to severe spasticity resistant to existing therapies, within the frame of use approved after large clinical trial results. Perhaps the most important finding is the possibility of obtaining relevant improvements in QoL/ADL in some patients with resistant MS spasticity, allowing them to engage back in physical and social activities. PMID:24457847

  6. Paul Scherrer Institut annual report 1995. Annex II: PSI life sciences and institute for medical radiobiology newsletter 1995

    International Nuclear Information System (INIS)

    The newsletter presents the 1995 progress report of PSI F2-Department and of the Institute for Medical Radiobiology in the fields of radiation medicine, radiopharmacy and radiation hygiene. figs., tabs., refs

  7. Paul Scherrer Institut annual report 1995. Annex II: PSI life sciences and institute for medical radiobiology newsletter 1995

    Energy Technology Data Exchange (ETDEWEB)

    Blaeuenstein, P.; Gschwend, B. [eds.

    1996-09-01

    The newsletter presents the 1995 progress report of PSI F2-Department and of the Institute for Medical Radiobiology in the fields of radiation medicine, radiopharmacy and radiation hygiene. figs., tabs., refs.

  8. Paul Scherrer Institut annual report 1996. Annex II: PSI life sciences and Institute for Medical Radiobiology Newsletter 1996

    International Nuclear Information System (INIS)

    This annex to the PSI Annual Report 1996 reports on the progress achieved by the PSI Department II during 1996 in the fields of radiation medicine, radiopharmacy, radiation hygiene, positron emission tomography and medical radiobiology. figs., tab., refs

  9. Activities of the radiobiological institute, the institute for experimental gerontology, and the primate center. Annual report, 1976

    International Nuclear Information System (INIS)

    Activities, presented by way of concise articles, cover the following subjects: radiation physics, radiobiology, experimental tumor therapy, tumor induction and tumor biology, immunology, transplantation and immunogenetics, hematology, gerontology, ethology, microbiology and quotobiology, techniques, and animals

  10. New insights into the clinical evaluation of hereditary transthyretin amyloidosis patients: a single center's experience

    Directory of Open Access Journals (Sweden)

    Suhr OB

    2012-08-01

    Full Text Available Ole B Suhr,1 Sandra Gustavsson,1 Victoria Heldestad,2 Rolf Hörnsten,3 Per Lindqvist,1 Erik Nordh,2 Urban Wiklund41Department of Public Health and Clinical Medicine, 2Department of Pharmacology and Clinical Neuroscience, 3Department of Surgical and Perioperative Sciences, Clinical Physiology, Heart Centre, 4Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, SwedenAbstract: Over the last decade, new medical treatment modalities have emerged based on increased insights into amyloid formation. With the increased possibilities for treatment of amyloidosis caused by transthyretin (TTR amyloid deposits comes the need for diagnostic procedures for early diagnosis and better tools to follow disease progression. This is of particular importance in clinical trials evaluating the efficacy of new treatments. Until recently, the treatment of TTR amyloidosis (ATTR was based solely on liver transplantation, a procedure that has halted disease progression in many patients. Liver transplantation has been especially effective in patients under the age of 50 years carrying the TTR V30M mutation, whereas the outcome of the procedure has been variable for others, particularly elderly male patients and those carrying a non-V30M mutation. This review concentrates on new insights derived from our center's experience with liver transplantation, how to implement this experience in evaluation of new treatment modalities for ATTR, and how to facilitate early diagnosis of neuropathy with easily available diagnostic tools. Attention has focused on manifestations of the disease that involve the heart and the peripheral nervous system; change in peripheral nerve function has been the primary endpoint in two controlled clinical trials, one finished and one ongoing. New insights into the amyloid formation process and the lessons learned from liver transplantation give the opportunity to design potentially effective treatment modalities for ATTR

  11. Clinical experiences during preclinical training: the function of modeled behavior and the evidence of professionalism principles

    Directory of Open Access Journals (Sweden)

    Barret Michalec

    2012-03-01

    Full Text Available Objectives: Following the fundamental tenets of Bandura's social learning theory, this study examines the functions of modeled behavior during clinical experiences in the first two years of medical training from the students' perspective, and explores the potential presence of professionalism principles in students' narratives. Methods: Data were gathered through in-depth interviews with ten first year and ten second year medical students. Data were analyzed utilizing a subset of deductive codes extracted from previous literature, as well as inductive codes and particular categories and themes that followed from subsequent analysis procedures. Results: Although not explicitly prompted during inter-views, students offered basic principles of professionalism through their descriptions of behaviors and attributes exhibited by shadowed physicians and preceptors as characteristics that they found appealing and desirable to emulate. Also, students not only actively distinguish between role models and anti-models, but the data suggests that antimodels may even serve as effective mechanisms of social learning processes during these early clinical experiences. Furthermore, the data point to the probable influence of anticipatory socialization processes prior to medical training in that students present, as early as their first week of training, conceptions of how a doctor should act towards patients and other health care professionals. Conclusions: Students actively engage in the social learning process, and early clinical exposure provides opportunities for students to refine their understandings and perceptions of their future role through analysis of the attitudes and behaviors displayed by physicians they deem as positive and negative models of the physician role.

  12. Patients' experiences of dental implant placement for treatment of partial edentulism in a student clinic setting.

    Science.gov (United States)

    Seferli, Jotta; Michelin, Mattias; Klinge, Björn; Wettergren, Lena

    2014-01-01

    The aim of this study was to evaluate patients' experiences of oral implant surgery when performed in a student clinic setting and the potential impact on patients'daily life. Patient selection was carried out during a round, to which undergraduate students in semester 9 and 10 could bring patients that they considered eligible for one or two implants. Partial edentulous patients that fulfilled the inclusion criteria for implant installation at the student's clinic were consequently enrolled to implant surgery with either Astra Tech or 3i implants. The same surgeon accomplished all implant installations and the students were involved in the treatment, initially by assisting during the surgery and subsequently by performing the prosthetic restoration. After the surgery, a study-specific questionnaire was sent to patients for evaluation of discomfort, pain during the surgical procedure and postoperative symptoms. Thirty-six patients were included in the study, 30 patients answered the questionnaire (response rate 83%). When retrospectively assessed, more than half of the patients (60%) perceived discomfort in the course of the implant surgery and 29% reported pain during the surgical procedure. Impact on daily living and postoperative symptoms were rarely reported (most common were pain, swelling and difficulties with chewing) and had a short duration when they occurred. Based on the results of this study conducted at a student's clinic, the impact of implant surgery on daily living appears to be small. However, it is noteworthy that the perception of discomfort and pain during the surgical procedure was frequently reported. Continued research is recommended to expose the patient's experiences of implant surgery in an educational context as well as in general dental practice. PMID:25102718

  13. SU-E-T-344: Validation and Clinical Experience of Eclipse Electron Monte Carlo Algorithm (EMC)

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study is to validate Eclipse Electron Monte Carlo (Algorithm for routine clinical uses. Methods: The PTW inhomogeneity phantom (T40037) with different combination of heterogeneous slabs has been CT-scanned with Philips Brilliance 16 slice scanner. The phantom contains blocks of Rando Alderson materials mimicking lung, Polystyrene (Tissue), PTFE (Bone) and PMAA. The phantom has 30×30×2.5 cm base plate with 2cm recesses to insert inhomogeneity. The detector systems used in this study are diode, tlds and Gafchromic EBT2 films. The diode and tlds were included in CT scans. The CT sets are transferred to Eclipse treatment planning system. Several plans have been created with Eclipse Monte Carlo (EMC) algorithm 11.0.21. Measurements have been carried out in Varian TrueBeam machine for energy from 6–22mev. Results: The measured and calculated doses agreed very well for tissue like media. The agreement was reasonably okay for the presence of lung inhomogeneity. The point dose agreement was within 3.5% and Gamma passing rate at 3%/3mm was greater than 93% except for 6Mev(85%). The disagreement can reach as high as 10% in the presence of bone inhomogeneity. This is due to eclipse reporting dose to the medium as opposed to the dose to the water as in conventional calculation engines. Conclusion: Care must be taken when using Varian Eclipse EMC algorithm for dose calculation for routine clinical uses. The algorithm dose not report dose to water in which most of the clinical experiences are based on rather it just reports dose to medium directly. In the presence of inhomogeneity such as bone, the dose discrepancy can be as high as 10% or even more depending on the location of normalization point or volume. As Radiation oncology as an empirical science, care must be taken before using EMC reported monitor units for clinical uses

  14. Developing a new mid-level health worker: lessons from South Africa's experience with clinical associates

    Directory of Open Access Journals (Sweden)

    Sharon Fonn

    2013-01-01

    Full Text Available Background: Mid-level medical workers play an important role in health systems and hold great potential for addressing the human resource shortage, especially in low- and middle-income countries. South Africa began the production of its first mid-level medical workers – known as clinical associates – in small numbers in 2008. Objective: We describe the way in which scopes of practice and course design were negotiated and assess progress during the early years. We derive lessons for other countries wishing to introduce new types of mid-level worker. Methods: We conducted a rapid assessment in 2010 consisting of a review of 19 documents and 11 semi-structured interviews with a variety of stakeholders. A thematic analysis was performed. Results: Central to the success of the clinical associate training programme was a clear definition and understanding of the interests of various stakeholders. Stakeholder sensitivities were taken into account in the conceptualisation of the role and scope of practice of the clinical associate. This was achieved by dealing with quality of care concerns through service-based training and doctor supervision, and using a national curriculum framework to set uniform standards. Conclusions: This new mid-level medical worker can contribute to the quality of district hospital care and address human resource shortages. However, a number of significant challenges lie ahead. To sustain and expand on early achievements, clinical associates must be produced in greater numbers and the required funding, training capacity, public sector posts, and supervision must be made available. Retaining the new cadre will depend on the public system becoming an employer of choice. Nonetheless, the South African experience yields positive lessons that could be of use to other countries contemplating similar initiatives.

  15. The association between demographic factors, user reported experiences and user satisfaction: results from three casualty clinics in Norway

    OpenAIRE

    Forland Oddvar; Garratt Andrew; Bjertnaes Oyvind A; Danielsen Kirsten; Iversen Hilde; Hunskaar Steinar

    2010-01-01

    Abstract Background User reported experiences and satisfaction are increasingly used as basis for quality indicators in the health sector. However, there is limited understanding of factors associated with user reported experiences and satisfaction with casualty clinics. Methods A random sample of 542 patients that had contacted any of three casualty clinics from mid April to mid May 2008 was mailed a questionnaire. A reminder was sent to non-respondents after six weeks. Descriptive statistic...

  16. Integration of the clinical engineering specialist at a high complexity children's hospital. Our professional experience at a surgical center

    International Nuclear Information System (INIS)

    This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center

  17. Learning Experience of Student Nurses through Reflection on Clinical Practice: A Case Study in Pediatric Nursing, Southern Thailand

    OpenAIRE

    Charuai SUWANBAMRUNG

    2015-01-01

    This article aims to describe student nurse experiences of clinical practice through their reflections. Forty reflections on clinical practice in a pediatric department were conducted at a tertiary hospital. Student nurses wrote reflections which were then thematically analyzed. Analysis was founded on the following: First, situations of nursing care in medical and surgical pediatrics; Second, clinical practice with nursing care as procedurals; Third, results after student’s activities; and F...

  18. Clinical medical students’ experiences of unprofessional behaviour and how these should inform approaches to teaching of professionalism

    LENUS (Irish Health Repository)

    Abu, Ozotu Rosemary

    2016-08-01

    This mixed method research explores unprofessional behaviour experienced by clinical Medical students, during clinical training in Ireland; with a view to obtaining learning points that inform future design of modules on Professionalism. It also looks at the impact of these on students and the relationship between gender\\/ethnicity and students’ experiences of these behaviours.

  19. Learning pathways during clinical placement of physiotherapy students: a Malaysian experience of using learning contracts and reflective diaries

    Directory of Open Access Journals (Sweden)

    Ayiesah Ramli

    2013-07-01

    These learning themes reflected the views of the students about what they have considered to be important learning pathways during their clinical placements. They give valuable insights into the experiences and opinions of students during their clinical education process, which should be useful for enhancing teaching and learning methods in physiotherapy education.

  20. Dental Students' Perceived Value of Peer-Mentoring Clinical Leadership Experiences.

    Science.gov (United States)

    Sheridan, Rachel A; Hammaker, Daniel J; de Peralta, Tracy L; Fitzgerald, Mark

    2016-03-01

    This pilot study compared second- and fourth-year dental students' perceived values of newly implemented clinical leadership experiences (CLEs) at one U.S. dental school during the 2012-13 academic year. In the CLEs, fourth-year (D4) students mentored second-year (D2) dental students during faculty-supervised patient treatment. The two cohorts' perceived value of the experiences was measured with questionnaires consisting of five-point Likert scale questions and open text responses. Out of a total of 114 D2 and 109 D4 students, 46 D2 students and 35 D4 students participated (response rates of 40.4% and 32.1%, respectively). While responses from both cohorts showed they highly valued the CLEs, the D2s perceived greater value: 4.07 (0.53) v. 3.51 (0.95), pmanagement, leadership, and collaborative work experience. Theme analysis also highlighted student concerns about a lack of program structure. Overall, the majority of both groups valued CLEs in their dental education. Particular advantages they perceived were increased comfort, guidance, and attention. Further program development should address student concerns. These results suggest that similar programs should be considered and/or expanded in other dental schools' curricula. PMID:26933106

  1. Clinical audits in a postgraduate general practice training program: an evaluation of 8 years' experience.

    Directory of Open Access Journals (Sweden)

    Abeer Al-Baho

    Full Text Available BACKGROUND: Clinical audit can be of valuable assistance to any program which aims to improve the quality of health care and its delivery. Yet without a coherent strategy aimed at evaluating audits' effectiveness, valuable opportunities will be overlooked. Clinical audit projects are required as a part of the formative assessment of trainees in the Family Medicine Residency Program (FMRP in Kuwait. This study was undertaken to draw a picture of trainees' understanding of the audit project with attention to the knowledge of audit theory and its educational significance and scrutinize the difficulties confronted during the experience. METHODOLOGY/PRINCIPAL FINDINGS: The materials included the records of 133 audits carried out by trainees and 165 post course questionnaires carried out between 2004 and 2011. They were reviewed and analyzed. The majority of audit projects were performed on diabetic (44.4% and hypertensive (38.3% care. Regarding audits done on diabetic care, they were carried out to assess doctors' awareness about screening for smoking status (8.6%, microalbuminuria (19.3%, hemoglobin A1c (15.5%, retinopathy (10.3%, dyslipidemia (15.8%, peripheral neuropathy (8.8%, and other problems (21.7%. As for audits concerning hypertensive care, they were carried out to assess doctors' awareness about screening for smoking status (38.0%, obesity (26.0%, dyslipidemia (12.0%, microalbuminuria (10.0% and other problems (14.0%. More than half the participants (68.48% who attended the audit course stated that they 'definitely agreed' about understanding the meaning of clinical audit. Most of them (75.8% 'definitely agreed' about realizing the importance of clinical audit in improving patients' care. About half (49.7% of them 'agreed' that they can distinguish between 'criteria' and 'standards'. CONCLUSION: The eight years of experience were beneficial. Trainees showed a good understanding of the idea behind auditing the services provided. They

  2. VI Congress on radiation research (radiobiology, radioecology, radiation safety). Abstracts. Volume 1 (sections I-VII)

    International Nuclear Information System (INIS)

    The collection contains abstracts at the VI Congress on radiation studies, a program that included various aspects of the action of ionizing and non-ionizing radiation on living organisms, problems of radioecology and radiation safety of human health and environment. Congress is confined to the 25th anniversary of the accident at the Chernobyl NPP. Several reports have summarized the 25-years studying the effects of the accident, articulated forecasts and the main directions of further research. The first volume contains the plenary reports, presentations on the sections of radiation biochemistry and molecular radiobiology, radiation genetics, radiation immunology and hematology, medical and biological aspects of radiation effect, mechanisms of low dose and low intensity radiation effects, long-term effects of radiation. Radiation protection and modification of radiation effects, radiobiology of tumors, problems of radiation therapy are under consideration

  3. Radiobiological effects in small mammals populations dwelled at radioactive waste disposal sites

    International Nuclear Information System (INIS)

    A major issue in evaluating the ecological acceptability of a disposal system for radioactive waste is in preventing the ecological risk that may arise from exposures in the distant future. There is uncertainty surrounding any estimate of these doses or risks due to lack of knowledge about future conditions. Therefore, the adequate estimation of the ecological acceptability of a radioactive waste disposal system required a complex radioecological and radiobiological approach. Environmental surveillance at the Sergievo-Posadsky radioactive waste disposal system of the Scientific and Industrial Association Radon in additional to a standard complex radiological testing includes also the study of the radiobiological effects in different biological objects sampled from the contaminated areas. In present report the results obtained on small rodents (mice and voles) sampled from the strict mode and fence zones of this disposal system are displayed and discussed. (author)

  4. Ill-posed problem and regularization in reconstruction of radiobiological parameters from serial tumor imaging data

    International Nuclear Information System (INIS)

    The main objective of this article is to improve the stability of reconstruction algorithms for estimation of radiobiological parameters using serial tumor imaging data acquired during radiation therapy. Serial images of tumor response to radiation therapy represent a complex summation of several exponential processes as treatment induced cell inactivation, tumor growth rates, and the rate of cell loss. Accurate assessment of treatment response would require separation of these processes because they define radiobiological determinants of treatment response and, correspondingly, tumor control probability. However, the estimation of radiobiological parameters using imaging data can be considered an inverse ill-posed problem because a sum of several exponentials would produce the Fredholm integral equation of the first kind which is ill posed. Therefore, the stability of reconstruction of radiobiological parameters presents a problem even for the simplest models of tumor response. To study stability of the parameter reconstruction problem, we used a set of serial CT imaging data for head and neck cancer and a simplest case of a two-level cell population model of tumor response. Inverse reconstruction was performed using a simulated annealing algorithm to minimize a least squared objective function. Results show that the reconstructed values of cell surviving fractions and cell doubling time exhibit significant nonphysical fluctuations if no stabilization algorithms are applied. However, after applying a stabilization algorithm based on variational regularization, the reconstruction produces statistical distributions for survival fractions and doubling time that are comparable to published in vitro data. This algorithm is an advance over our previous work where only cell surviving fractions were reconstructed. We conclude that variational regularization allows for an increase in the number of free parameters in our model which enables development of more

  5. Radiobiological investigations of the accelerators at the Joint Institute for Nuclear Research

    International Nuclear Information System (INIS)

    Full text: The Joint Institute for Nuclear Research (JINR) has the different accelerators of heavy charged particles for various energies. The radiobiological investigations at these machines have been commenced some tens years ago. The main task of scientific research at the Laboratory of Radiation Biology of JINR is connected with investigations of genetic effects of accelerated charged particles with wide spectrum of energies. Using accelerated heavy ions with low energy, the following directions of researches in radiobiology and radiation genetics were performed: study of RBE problem in connection with DNA repair processes; investigation of the molecular mechanisms of point and structural mutation induction in prokaryotic cells and the influence of the repair systems on the mutagenic processes after irradiation in a wide range of linear energy transfer (LET); study of the SOS-response of bacterial cells by using SOS-chromo test, SOS-lux test and by criteria of α-prophage induction in lysogenic bacteria after irradiation by heavy ions; study of the regularities of gene mutation inductions in yeast cells under action of ionizing radiation with different LET; investigations of the regularities of unstable and stable chromosomal aberrations (translocations) in human cells under action of ionizing radiation with wide LET range; study of mutagenic (HPRT gene) effects in mammalian cells in culture after heavy charged particle irradiation and chromosomal instability in HPRT-mutant clones after irradiation; study of the cytogenetic effects in mammalian cells irradiated by heavy ions in low doses. The radiobiological investigations with high energy are carried out at the Nuclotron - the new JINR accelerator. The programme involves the most vital tasks of modern radiobiology: study of the regularities and mechanisms of stable and unstable chromosome aberration induction in human cells; genetic control of check-point regulation in low eukaryotic cells; study of the

  6. Radiobiological impact of dose calculation algorithms on biologically optimized IMRT lung stereotactic body radiation therapy plans

    OpenAIRE

    Liang, X.; Penagaricano, J.; Zheng, D.; Morrill, S.; Zhang, X; Corry, P.; Griffin, R. J.; Han, E. Y.; Hardee, M.; Ratanatharathom, V.

    2016-01-01

    Background The aim of this study is to evaluate the radiobiological impact of Acuros XB (AXB) vs. Anisotropic Analytic Algorithm (AAA) dose calculation algorithms in combined dose-volume and biological optimized IMRT plans of SBRT treatments for non-small-cell lung cancer (NSCLC) patients. Methods Twenty eight patients with NSCLC previously treated SBRT were re-planned using Varian Eclipse (V11) with combined dose-volume and biological optimization IMRT sliding window technique. The total dos...

  7. Installation of a flow cytometry facility and some applications in radiobiology

    International Nuclear Information System (INIS)

    Flow cytometry has enormous potential in many areas of experimental pathology. Details of the installation and commissioning of a flow cytometer at the Harwell Laboratory are described. Following an explanation of the principles of flow cytometry, several applications to specific problems in radiobiology are discussed. Also included are results of some preliminary studies with the Harwell flow cytometer on samples such as blood, bone marrow, macrophages and cell cultures, and a discussion of future applications. (author)

  8. A community call for a dedicated radiobiological research facility to support particle beam cancer therapy

    DEFF Research Database (Denmark)

    Holzscheiter, Michael H.; Bassler, Niels; Dosanjh, Manjit;

    2012-01-01

    Recently more than one hundred researchers followed an invitation to a brainstorming meeting on the topic of a future dedicated radio-biological and radio-physical research center. 100 more joint the meeting via webcast. After a day of presentations and discussions it was clear, that an urgent ne...... for such a development exists, resulting in a community call for the construction of a dedicated laboratory. Below we comment on the essential points....

  9. [From microdosimetry to nanodosimetry--the link between radiobiology and radiation physics].

    Science.gov (United States)

    Fu, Yuchuan; Li, Ping

    2014-06-01

    The link between micro- and macro-parameters for radiation interactions that take place in living biological systems is described in this paper. Meanwhile recent progress and development in microdosimetry and nanodosimetry are introduced, including the methods to measure and calculate these micro- or nano-parameters. The relationship between radiobiology and physical quantities in microdosimetry and nanodosimetry was presented. Both the current problems on their applications in radiation protection and radiotherapy and the future development direction are proposed. PMID:25219261

  10. The impact of modeling nuclear fragmentation on delivered dose and radiobiology in ion therapy

    International Nuclear Information System (INIS)

    The importance of nuclear interactions for ion therapy arises from the influence of the particle spectrum on, first, radiobiology and therefore also on treatment planning, second, the accuracy of measuring dose and, third, the delivered dose distribution. This study tries to determine the qualitative as well as the quantitative influence of the modeling of inelastic nuclear interactions on ion therapy. Thereby, three key disciplines are investigated, namely dose delivery, dose assessment and radiobiology. In order to perform a quantitative analysis, a relative comparison between six different descriptions of nuclear interactions is carried out for carbon ions. The particle transport is simulated with the Monte Carlo code SHIELD-HIT10A while dose planning and radiobiology are covered by the analytic treatment planning program for particles TRiP, which determines the relative biological effectiveness (RBE) with the local effect model. The obtained results show that the physical dose distribution can in principle be significantly influenced by the modeling of fragmentation (about 10% for a 20% change in all inelastic nuclear cross sections for a target volume ranging from 15 to 25 cm). While the impact of nuclear fragmentation on stopping power ratios can be neglected, the fluence correction factor may be influenced by the applied nuclear models. In contrast to the results for the physical dose, the variation of the RBE is only small (about 1% for a 20% change in all inelastic nuclear cross sections) suggesting a relatively weak dependence of radiobiology on the detailed composition of the particle energy spectrum of the mixed radiation field. Also, no significant change (about 0.2 mm) of the lateral penumbra of the RBE-weighted dose is observed. (paper)

  11. Ill-posed problem and regularization in reconstruction of radiobiological parameters from serial tumor imaging data

    Science.gov (United States)

    Chvetsov, Alevei V.; Sandison, George A.; Schwartz, Jeffrey L.; Rengan, Ramesh

    2015-11-01

    The main objective of this article is to improve the stability of reconstruction algorithms for estimation of radiobiological parameters using serial tumor imaging data acquired during radiation therapy. Serial images of tumor response to radiation therapy represent a complex summation of several exponential processes as treatment induced cell inactivation, tumor growth rates, and the rate of cell loss. Accurate assessment of treatment response would require separation of these processes because they define radiobiological determinants of treatment response and, correspondingly, tumor control probability. However, the estimation of radiobiological parameters using imaging data can be considered an inverse ill-posed problem because a sum of several exponentials would produce the Fredholm integral equation of the first kind which is ill posed. Therefore, the stability of reconstruction of radiobiological parameters presents a problem even for the simplest models of tumor response. To study stability of the parameter reconstruction problem, we used a set of serial CT imaging data for head and neck cancer and a simplest case of a two-level cell population model of tumor response. Inverse reconstruction was performed using a simulated annealing algorithm to minimize a least squared objective function. Results show that the reconstructed values of cell surviving fractions and cell doubling time exhibit significant nonphysical fluctuations if no stabilization algorithms are applied. However, after applying a stabilization algorithm based on variational regularization, the reconstruction produces statistical distributions for survival fractions and doubling time that are comparable to published in vitro data. This algorithm is an advance over our previous work where only cell surviving fractions were reconstructed. We conclude that variational regularization allows for an increase in the number of free parameters in our model which enables development of more

  12. Clinical trends and outcomes of male breast cancer: Experience of a tertiary oncology centre in India

    Directory of Open Access Journals (Sweden)

    Anindya Mukherjee

    2014-08-01

    Full Text Available Purpose: Because of its rarity in any oncology centre, the clinical trends of male breast cancer specific to its geographical distribution have remained relatively unexplored. This study was done to analyze the clinico-pathological data, treatment given and survival patterns of male breast cancer patients visiting our tertiary medical centre and compare our results with available literature. Methods: All male breast cancer patients registered at our clinic from 2003 to 2009 were included. Frequency distribution analysis of the demographic and clinico-pathological data and treatment variables was done. Treatment outcome was examined from Kaplan-Meir survival estimates. Results: Thirty-three male breast cancer patients were encountered. The median age of presentation was sixty years. Mostly (87.9% they presented with lump in breast or axilla and were clinically staged to be ‘3’ (57.6%.Obesity and alcohol were the commonest risk factors identified. Modified radical mastectomy was the commonest (69.6% definitive therapy rendered with (only for clinically staged 3 patients or without neo-adjuvant chemotherapy. Infiltrating ductal carcinoma was identified in most cases. Twenty-two patients received adjuvant chemotherapy and twenty-four received adjuvant radiotherapy. Eighteen (54.5% patients were hormone-receptor positive and received tamoxifen. The median Overall survival (OS and Progression-free survival (PFS came out to be 14.3 months (standard error, SE of 1.185; 95% confidence interval, CI 12-16.6 and 15.7 (SE 5.35, 95% CI 5.2-26.19 months respectively.Conclusion: Male breast cancers usually carry a poor prognosis due to presentation at later stages. Most of our results correlate with previous literature. Multi-centric prospective studies are required to validate the etiological factors and prognostic determinants of survival.-----------------------------Cite this article as: Mukherjee A, Saha A, Chattopadhyay S, Sur P. Clinical trends and

  13. An exploration of the experience of compassion fatigue in clinical oncology nurses.

    Science.gov (United States)

    Perry, Beth; Toffner, Greg; Merrick, Trish; Dalton, Janice

    2011-01-01

    Compassion fatigue (CF) is "debilitating weariness brought about by repetitive, empathic responses to the pain and suffering of others" (LaRowe, 2005, p. 21). The work performed by oncology nurses, and the experiences of the people they care for, place oncology nurses at high risk for CF (Pierce et al., 2007; Ferrell & Coyle, 2008). Thus oncology nurses were chosen as the study focus. This paper details a descriptive exploratory qualitative research study that investigated the experience of CF in Canadian clinical oncology registered nurses (RNs). A conceptual stress process model by Aneshensel, Pearlin, Mullan, Zarit, and Whitlatch (1995) that considers caregivers' stress in four domains provided the study framework (see Figure 1). Nineteen study participants were recruited through an advertisement in the Canadian Oncology Nursing Journal (CONJ). The advertisement directed potential participants to a university-based online website developed for this study. Participants completed a questionnaire and wrote a narrative describing an experience with CF and submitted these through the secure research website. Data were analyzed thematically. Five themes include: defining CF, causes of CF, factors that worsen CF, factors that lessen CF, and outcomes of CF. Participants had limited knowledge about CF, about lack of external support, and that insufficient time to provide high quality, care may precipitate CF. The gap between quality of care nurses wanted to provide and what they were able to do, compounded by coexisting physical and emotional stress, worsened CF. CF was lessened by colleague support, work-life balance, connecting with others, acknowledgement, and maturity and experience. Outcomes of CF included profound fatigue of mind and body, negative effects on personal relationships, and considering leaving the specialty. Recommendations that may enhance oncology nurse well-being are provided. PMID:21661623

  14. Crossing Over: The Lived Experiences of Clinical Laboratory Science Education Teachers as They Transition from Traditional to Online Instruction

    Science.gov (United States)

    Veldkamp, Ruth B.

    2013-01-01

    A phenomenological study was undertaken to understand and describe the nature and meaning of the live experiences of faculty transition from traditional to teaching online clinical laboratory science courses. In order to gain insight into the lived experiences of faculty, in-depth interviews were conducted with 10 faculty members. The task of the…

  15. Fast neutrons set the pace. [Radiobiological investigations with fast neutrons at the CSIR cyclotron in Pretoria

    Energy Technology Data Exchange (ETDEWEB)

    Hough, J.H.; Slabbert, J.P. (Council for Scientific and Industrial Research, Pretoria (South Africa). National Accelerator Centre)

    1985-01-01

    Radiobiological investigations with fast neutrons have been initiated at the CSIR cyclotron in Pretoria. It was proposed some years ago to create a neutron therapy facility using the CSIR cyclotron. Neutrons are classified as high linear energy transfer (LET) particles. Biological damage occurring in tissue is a direct function of the LET of the incident radiation. To quantify the biological effects of different types of radiation on mammalian cells, several procedures and concepts have evolved from radiobiological research. Probably the most significant laboratory techniques developed, were the derivation of cell survival curves which are obtained by determining the number of cell colonies that have survived a certain radiation dose. A semi-logarithmic plot of surviving fraction versus the absorbed dose yields the survival curve. Dose modifying factors such as the relative biological effectiveness (RBE) of the radiation can be quantified in terms of this relationship. A radiobiological programme has to be undertaken before patients can receive neutron therapy at the CSIR cyclotron. The article is a discussion of this programme.

  16. Clinical and human resource planning for the downsizing of psychiatric hospitals: the British Columbia experience.

    Science.gov (United States)

    Macfarlane, D; Fortin, P; Fox, J; Gundry, S; Oshry, J; Warren, E

    1997-01-01

    Riverview Hospital, B.C.'s only and Canada's largest remaining provincial psychiatric hospital began a formal planned "downsizing" process in 1992. This initiative was an important element in the Province's strategic plan to shift to a more community-focused mental health system and to bring tertiary psychiatric services "closer to home" by redeveloping Riverview Hospital on three sites. The paper summarizes the literature pertaining to the "downsizing" of psychiatric hospital services in relation both to clinical and human resource planning. It describes the mental health system in B.C. and the service system context in which this exercise is occurring. It is based on the first three years of experience in identifying the major challenges and the strategies developed to meet these challenges. It draws some conclusions about the effectiveness of these strategies and it speculates about the likely future challenges as the "downsizing" process continues. PMID:9021839

  17. The Influence of Clinical Experience and Photographic Presentation on Age Assessment of Women

    DEFF Research Database (Denmark)

    Nielsen, Barbara Rubek; Linneberg, Allan; Christensen, Kaare;

    2016-01-01

    BACKGROUND: Epidemiological studies have reported that a higher perceived age is associated with poor health and higher mortality. However, the method used for the assessment of perceived age differs between studies with regard to age, gender, the number and occupation of assessors as well as the...... presentation of participants. OBJECTIVE: It is not known whether the clinical experience of the assessor or photographic presentation have an influence on the assessment of perceived age, which the present study aimed to investigate. METHODS: In a cross-sectional study of 460 women aged 25-93 years, 10...... inter-class correlation coefficient within each assessor group and photographic presentation varied from 0.66 to 0.75. Limits of agreement were in a broad range but were similar in the two assessor groups. The best inter-assessor agreement was obtained from photographs of both the face and the whole...

  18. Family Nursing Therapeutic Conversations in Heart Failure Outpatient Clinics in Denmark: Nurses’ Experiences

    DEFF Research Database (Denmark)

    Voltelen, Barbara; Konradsen, Hanne; Østergaard, Birte

    2016-01-01

    conducted. Content analysis was performed using a combined deductive and inductive process. Nurses reported developing a distinct, closer, and more constructive relationship with the patients and their families and reported FNTC increased family bonding and strengthened family relationships. The nurses......As part of the Heart Failure Family Trial presently being conducted in Denmark, this qualitative process evaluation explored the perceptions of seven practicing cardiac nurses who offered family nursing therapeutic conversations (FNTC) to families in three heart failure outpatient clinics. FNTC...... were guided by the Calgary Family Assessment and Intervention Models. Data consisted of 34 case reports written by the nurses which documented the use of FNTC, including family responses to the FNTC. A focus group interview with the six of the nurses about their experience of offering FNTC was also...

  19. [FlU Zhonghua's clinical experience of Fu's subcutaneous needling for cervical spondylosis].

    Science.gov (United States)

    Zhong, Minying; Zhang, Xiyu

    2015-08-01

    Professor FU Zhonghua's unique clinical experience of Fu's subcutaneous needling (FSN) for cervical spondylosis (CS) is discussed in this paper, which is analyzed from the aspects of recognition of CS pathogenesis, treatment mechanism of FSN, advantage indications of FSN for CS and examples of medical cases. Professor FU introduced the theory of myofascial trigger points (MTrP) into the field of the management of CS. The site of neck MTrP should be carefully examined, and FSN needles for single use are used to sweep the affected area or subcutaneous layer of adjacent upper limb. This method can rapidly improve ischemia and hypoxia state of the relevant muscles and prompt the self-recovery of neck muscles. During FSN treatment, reperfusion approach is recommended to adopt to improve the qi and blood circulation and recovery of neck function. PMID:26571902

  20. Monte Carlo application based on GEANT4 toolkit to simulate a laser–plasma electron beam line for radiobiological studies

    Energy Technology Data Exchange (ETDEWEB)

    Lamia, D., E-mail: debora.lamia@ibfm.cnr.it [Institute of Molecular Bioimaging and Physiology IBFM CNR – LATO, Cefalù (Italy); Russo, G., E-mail: giorgio.russo@ibfm.cnr.it [Institute of Molecular Bioimaging and Physiology IBFM CNR – LATO, Cefalù (Italy); Casarino, C.; Gagliano, L.; Candiano, G.C. [Institute of Molecular Bioimaging and Physiology IBFM CNR – LATO, Cefalù (Italy); Labate, L. [Intense Laser Irradiation Laboratory (ILIL) – National Institute of Optics INO CNR, Pisa (Italy); National Institute for Nuclear Physics INFN, Pisa Section and Frascati National Laboratories LNF (Italy); Baffigi, F.; Fulgentini, L.; Giulietti, A.; Koester, P.; Palla, D. [Intense Laser Irradiation Laboratory (ILIL) – National Institute of Optics INO CNR, Pisa (Italy); Gizzi, L.A. [Intense Laser Irradiation Laboratory (ILIL) – National Institute of Optics INO CNR, Pisa (Italy); National Institute for Nuclear Physics INFN, Pisa Section and Frascati National Laboratories LNF (Italy); Gilardi, M.C. [Institute of Molecular Bioimaging and Physiology IBFM CNR, Segrate (Italy); University of Milano-Bicocca, Milano (Italy)

    2015-06-21

    We report on the development of a Monte Carlo application, based on the GEANT4 toolkit, for the characterization and optimization of electron beams for clinical applications produced by a laser-driven plasma source. The GEANT4 application is conceived so as to represent in the most general way the physical and geometrical features of a typical laser-driven accelerator. It is designed to provide standard dosimetric figures such as percentage dose depth curves, two-dimensional dose distributions and 3D dose profiles at different positions both inside and outside the interaction chamber. The application was validated by comparing its predictions to experimental measurements carried out on a real laser-driven accelerator. The work is aimed at optimizing the source, by using this novel application, for radiobiological studies and, in perspective, for medical applications. - Highlights: • Development of a Monte Carlo application based on GEANT4 toolkit. • Experimental measurements carried out with a laser-driven acceleration system. • Validation of Geant4 application comparing experimental data with the simulated ones. • Dosimetric characterization of the acceleration system.

  1. Monte Carlo application based on GEANT4 toolkit to simulate a laser–plasma electron beam line for radiobiological studies

    International Nuclear Information System (INIS)

    We report on the development of a Monte Carlo application, based on the GEANT4 toolkit, for the characterization and optimization of electron beams for clinical applications produced by a laser-driven plasma source. The GEANT4 application is conceived so as to represent in the most general way the physical and geometrical features of a typical laser-driven accelerator. It is designed to provide standard dosimetric figures such as percentage dose depth curves, two-dimensional dose distributions and 3D dose profiles at different positions both inside and outside the interaction chamber. The application was validated by comparing its predictions to experimental measurements carried out on a real laser-driven accelerator. The work is aimed at optimizing the source, by using this novel application, for radiobiological studies and, in perspective, for medical applications. - Highlights: • Development of a Monte Carlo application based on GEANT4 toolkit. • Experimental measurements carried out with a laser-driven acceleration system. • Validation of Geant4 application comparing experimental data with the simulated ones. • Dosimetric characterization of the acceleration system

  2. Use of antidepressants in the treatment of depression in Asia: guidelines, clinical evidence, and experience revisited.

    Science.gov (United States)

    Treuer, Tamás; Liu, Chia-Yih; Salazar, Gerardo; Kongsakon, Ronnachai; Jia, Fujun; Habil, Hussain; Lee, Min-Soo; Lowry, Amanda; Dueñas, Héctor

    2013-12-01

    Major depressive disorder is prevalent worldwide, and only about half of those affected will experience no further episodes or symptoms. Additionally, depressive symptoms can be challenging to identify, with many patients going undiagnosed despite a wide variety of available treatment options. Antidepressants are the cornerstone of depression treatment; however, a large number of factors must be considered in selecting the treatment best suited to the individual. To help support physicians in this process, international and national treatment guidelines have been developed. This review evaluates the current use of antidepressant treatment for major depressive disorder in six Asian countries (China, Korea, Malaysia, Philippines, Taiwan, and Thailand). No remarkable differences were noted between Asian and international treatment guidelines or among those from within Asia as these are adapted from western guidelines, although there were some local variations. Importantly, a shortage of evidence-based information at a country level is the primary problem in developing guidelines appropriate for Asia, so most of the guidelines are consensus opinions derived from western research data utilized in western guidelines. Treatment guidelines need to evolve from being consensus based to evidence based when evidence is available, taking into consideration cost/effectiveness or cost/benefit with an evidence-based approach that more accurately reflects clinical experience as well as the attributes of each antidepressant. In everyday practice, physicians must tailor their treatment to the patient's clinical needs while considering associated external factors; better tools are needed to help them reach the best possible prescribing decisions which are of maximum benefit to patients. PMID:23857712

  3. Heidelberg Ion Therapy Center (HIT): Initial clinical experience in the first 80 patients

    International Nuclear Information System (INIS)

    The Heidelberg Ion Therapy Center (HIT) started clinical operation in November 2009. In this report we present the first 80 patients treated with proton and carbon ion radiotherapy and describe patient selection, treatment planning and daily treatment for different indications. Patients and methods. Between November 15, 2009 and April 15, 2010, 80 patients were treated at the Heidelberg Ion Therapy Center (HIT) with carbon ion and proton radiotherapy. Main treated indications consisted of skull base chordoma (n = 9) and chondrosarcoma (n = 18), malignant salivary gland tumors (n=29), chordomas of the sacrum (n = 5), low grade glioma (n=3), primary and recurrent malignant astrocytoma and glioblastoma (n=7) and well as osteosarcoma (n = 3). Of these patients, four pediatric patients aged under 18 years were treated. Results. All patients were treated using the intensity-modulated rasterscanning technique. Seventy-six patients were treated with carbon ions (95%), and four patients were treated with protons. In all patients x-ray imaging was performed prior to each fraction. Treatment concepts were based on the initial experiences with carbon ion therapy at the Gesellschaft fuer Schwerionenforschung (GSI) including carbon-only treatments and carbon-boost treatments with photon-IMRT. The average time per fraction in the treatment room per patient was 29 minutes; for irradiation only, the mean time including all patients was 16 minutes. Position verification was performed prior to every treatment fraction with orthogonal x-ray imaging. Conclusion. Particle therapy could be included successfully into the clinical routine at the Dept. of Radiation Oncology in Heidelberg. Numerous clinical trials will subsequently be initiated to precisely define the role of proton and carbon ion radiotherapy in radiation oncology.

  4. Heidelberg Ion Therapy Center (HIT): Initial clinical experience in the first 80 patients

    Energy Technology Data Exchange (ETDEWEB)

    Combs, Stephanie E. (Univ. Hospital of Heidelberg, Dept. of Radiation Oncology, Heidelberg (Germany)), E-mail: Stephanie.Combs@med.uni-heidelberg.de; Ellerbrock, Malte; Haberer, Thomas (Heidelberger Ionenstrahl Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120 Heidelberg (Germany)) (and others)

    2010-10-15

    The Heidelberg Ion Therapy Center (HIT) started clinical operation in November 2009. In this report we present the first 80 patients treated with proton and carbon ion radiotherapy and describe patient selection, treatment planning and daily treatment for different indications. Patients and methods. Between November 15, 2009 and April 15, 2010, 80 patients were treated at the Heidelberg Ion Therapy Center (HIT) with carbon ion and proton radiotherapy. Main treated indications consisted of skull base chordoma (n = 9) and chondrosarcoma (n = 18), malignant salivary gland tumors (n=29), chordomas of the sacrum (n = 5), low grade glioma (n=3), primary and recurrent malignant astrocytoma and glioblastoma (n=7) and well as osteosarcoma (n = 3). Of these patients, four pediatric patients aged under 18 years were treated. Results. All patients were treated using the intensity-modulated rasterscanning technique. Seventy-six patients were treated with carbon ions (95%), and four patients were treated with protons. In all patients x-ray imaging was performed prior to each fraction. Treatment concepts were based on the initial experiences with carbon ion therapy at the Gesellschaft fuer Schwerionenforschung (GSI) including carbon-only treatments and carbon-boost treatments with photon-IMRT. The average time per fraction in the treatment room per patient was 29 minutes; for irradiation only, the mean time including all patients was 16 minutes. Position verification was performed prior to every treatment fraction with orthogonal x-ray imaging. Conclusion. Particle therapy could be included successfully into the clinical routine at the Dept. of Radiation Oncology in Heidelberg. Numerous clinical trials will subsequently be initiated to precisely define the role of proton and carbon ion radiotherapy in radiation oncology.

  5. Clinical experience with infliximab biosimilar Remsima (CT-P13) in inflammatory bowel disease patients.

    Science.gov (United States)

    Jahnsen, Jørgen

    2016-05-01

    Many reference biological therapies have now reached or are near to patent expiry, and therefore a number of biosimilars have been or will be developed. The term biosimilar can be defined as a biotherapeutic product that is similar in efficacy, safety and quality to the licensed reference product. Biosimilars may lead to a reduced price and significant cost savings for the health community and hopefully more patients globally will have easier access to biological therapy when indicated. CT-P13, which is a TNF-alfa inhibitor, is the first monoclonal antibody biosimilar being used in clinical practice. The drug is approved for all indications as an innovator product although clinical efficacy has only been demonstrated in rheumatic diseases. Until now the number of patients with inflammatory bowel disease (IBD) treated with CT-P13 is confined, but experience is continuously growing. Based on current data, CT-P13 seems to be efficacious and generally well tolerated in IBD especially in patients who are naïve to biological therapy. Knowledge with regard to interchangeability between CT-P13 and the originator infliximab is however, still rather sparse and more data are desired. Immunogenicity and long-term safety related to CT-P13 are other areas of great importance and good and reliable postmarketing pharmacovigilance is therefore required in the coming years. PMID:27134662

  6. Pre-clinical Experience with a Multi-Chordal Patch for Mitral Valve Repair.

    Science.gov (United States)

    Chawla, Surendra K; Shi, Weiwei; McIver, Bryant V; Vinten-Johansen, Jakob; Frater, Robert W M; Padala, Muralidhar

    2016-04-01

    Surgical repair of flail mitral valve leaflets with neochordoplasty has good outcomes, but implementing it in anterior and bi-leaflet leaflet repair is challenging. Placing and sizing individual neochordae is time consuming and error prone, with persistent localized flail if performed incorrectly. In this study, we report our pre-clinical experience with a novel multi-chordal patch for mitral valve repair. The device was designed based on human cadaver hearts, and laser cut from expanded polytetrafluoroethylene. The prototypes were tested in: (stage 1) ex vivo hearts with leaflet flail (N = 6), (stage 2) acute swine induced with flail (N = 6), and (stage 3) two chronic swine survived to 23 and 120 days (N = 2). A2 and P2 prolapse were successfully repaired with coaptation length restored to 8.1 ± 2.2mm after posterior repair and to 10.2 ± 1.3mm after anterior repair in ex vivo hearts. In vivo, trace regurgitation was seen after repair with excellent patch durability, healing, and endothelialization at euthanasia. A new device for easier mitral repair is reported, with good early pre-clinical outcomes. PMID:26801477

  7. Clinical experience with the new oral anticoagulants for treatment of venous thromboembolism.

    Science.gov (United States)

    Bacchus, Farzana; Schulman, Sam

    2015-03-01

    Four non-vitamin K antagonist oral anticoagulants, apixaban, dabigatran, edoxaban, and rivaroxaban, have been evaluated in phase III clinical trials for the treatment of acute venous thromboembolism, and all except edoxaban have also been studied for extended secondary prophylaxis after venous thromboembolism. Rivaroxaban, and recently also dabigatran, has been approved for this indication, and it is therefore timely to review the characteristics, efficacy, and safety of these drugs with emphasis on patients with venous thromboembolism. This review focuses on the clinical results from the phase III trials, separately for each of the drugs as compared with vitamin K antagonists. We also address the results from meta-analyses that were published recently. Finally, the results in some special groups of interest-renal impairment, elderly patients, and patients with cancer-are reviewed, although they only comprised small minorities of the study populations. All 4 drugs demonstrated noninferiority against vitamin K antagonists in the acute treatment and clear superiority against placebo in the extended treatment (not performed with edoxaban). The risk of bleeding was generally lower with non-vitamin K antagonist oral anticoagulants, and the reduction of risk of intracranial hemorrhage seems to mirror the experience from atrial fibrillation trials. In conclusion, during the past 30 years we have moved from a week of hospitalization and intravenous heparin therapy, via low-molecular-weight heparin injections subcutaneously and early discharge from the hospital, to the possibility of only oral outpatient therapy without coagulation monitoring, yet safe for patients with acute venous thromboembolism. PMID:25717178

  8. Clinical experience of anidulafungin for the treatment of patients with documented candidemia.

    Science.gov (United States)

    Falcone, M; Russo, A; De Rosa, F G; Pasero, D; Toma, L; Raponi, G; Ghezzi, M C; Venditti, M

    2010-12-01

    Candida species are the most common causes of invasive fungal infections in humans, producing infections that range from mucocutaneous disorders to invasive disease that can involve any organ. Here we present our clinical experience with anidulafungin for the treatment of documented nosocomial candidaemia. From february 2009 through January 2010 all patients with documented candidemia treated with anidulafungin in three medical centers in italy were reviewed. Demographics, clinical and microbiological data, and outcome were collected for each patient. Twenty-four patients were included in the study. most patients had a central venous catheter (CVC) or a port-a-cath (100%), had a history of recent surgery (87.5%), or were receiving total parenteral nutrition (79%), broad spectrum antibiotics (83%), steroids or chemotherapy (45.8%). C. albicans (54%) was the most commonly isolated pathogen. CVC was the source of candidemia in 79% of cases. Six patients (25%) developed severe sepsis or septic shock, and five patients had unfavorable outcomes, with an overall mortality rate of 20%. No patients experienced side effects related to anidulafungin therapy. Anidulafungin was effective in the treatment of patients with documented candidemia arising from different sites, and no significant side effects were observed. PMID:21303747

  9. Intensity-modulated radiotherapy for pituitary adenomas: The preliminary report of Cleveland Clinic experience

    International Nuclear Information System (INIS)

    Purpose: Intensity-modulated radiotherapy (IMRT) is being increasingly used for the treatment of pituitary adenomas. However, there have been few published data on the short- and long-term outcomes of this treatment. This is the initial report of Cleveland Clinic's experience. Methods and Materials: Between February 1998 and December 2003, 34 patients with pituitary adenomas were treated with IMRT. A retrospective chart review was conducted for data analysis. Results: With a median follow-up of 42.5 months, the treatment has proven to be well tolerated, with performance status remaining stable in 90% of patients. Radiographic local control was 89%, and among patients with secretory tumors, 100% had a biochemical response. Only 1 patient required salvage surgery for progressive disease, giving a clinical progression free survival of 97%. The only patient who received more than 46 Gy experienced optic neuropathy 8 months after radiation. Smaller tumor volume significantly correlated with subjective improvements in nonvisual neurologic complaints (p = 0.03), and larger tumor volume significantly correlated with subjective worsening of visual symptoms (p = 0.05). New hormonal supplementation was required for 40% of patients. Younger patients were significantly more likely to require hormonal supplementation (p 0.03). Conclusions: Intensity-modulated radiation therapy is a safe and effective treatment for pituitary adenomas over the short term. Longer follow-up is necessary to determine if IMRT confers any advantage with respect to either tumor control or toxicity over conventional radiation modalities

  10. Isavuconazole: Pharmacology, Pharmacodynamics, and Current Clinical Experience with a New Triazole Antifungal Agent.

    Science.gov (United States)

    Rybak, Jeffrey M; Marx, Kayleigh R; Nishimoto, Andrew T; Rogers, P David

    2015-11-01

    Coinciding with the continually increasing population of immunocompromised patients worldwide, the incidence of invasive fungal infections has grown over the past 4 decades. Unfortunately, infections caused by both yeasts such as Candida and molds such as Aspergillus or Mucorales remain associated with unacceptably high morbidity and mortality. In addition, the available antifungals with proven efficacy in the treatment of these infections remain severely limited. Although previously available second-generation triazole antifungals have significantly expanded the spectrum of the triazole antifungal class, these agents are laden with shortcomings in their safety profiles as well as formulation and pharmacokinetic challenges. Isavuconazole, administered as the prodrug isavuconazonium, is the latest second-generation triazole antifungal to receive U.S. Food and Drug Administration approval. Approved for the treatment of both invasive aspergillosis and invasive mucormycosis, and currently under investigation for the treatment of candidemia and invasive candidiasis, isavuconazole may have therapeutic advantages over its predecessors. With clinically relevant antifungal potency against a broad range of yeasts, dimorphic fungi, and molds, isavuconazole has a spectrum of activity reminiscent of the polyene amphotericin B. Moreover, clinical experience thus far has revealed isavuconazole to be associated with fewer toxicities than voriconazole, even when administered without therapeutic drug monitoring. These characteristics, in an agent available in both a highly bioavailable oral and a β-cyclodextrin-free intravenous formulation, will likely make isavuconazole a welcome addition to the triazole class of antifungals. PMID:26598096

  11. Results of 1 year of clinical experience with independent dose calculation software for VMAT fields

    Directory of Open Access Journals (Sweden)

    Juan Fernando Mata Colodro

    2014-01-01

    Full Text Available It is widely accepted that a redundant independent dose calculation (RIDC must be included in any treatment planning verification procedure. Specifically, volumetric modulated arc therapy (VMAT technique implies a comprehensive quality assurance (QA program in which RIDC should be included. In this paper, the results obtained in 1 year of clinical experience are presented. Eclipse from Varian is the treatment planning system (TPS, here in use. RIDC were performed with the commercial software; Diamond ® (PTW which is capable of calculating VMAT fields. Once the plan is clinically accepted, it is exported via Digital Imaging and Communications in Medicine (DICOM to RIDC, together with the body contour, and then a point dose calculation is performed, usually at the isocenter. A total of 459 plans were evaluated. The total average deviation was -0.3 ± 1.8% (one standard deviation (1SD. For higher clearance the plans were grouped by location in: Prostate, pelvis, abdomen, chest, head and neck, brain, stereotactic radiosurgery, lung stereotactic body radiation therapy, and miscellaneous. The highest absolute deviation was -0.8 ± 1.5% corresponding to the prostate. A linear fit between doses calculated by RIDC and by TPS produced a correlation coefficient of 0.9991 and a slope of 1.0023. These results are very close to those obtained in the validation process. This agreement led us to consider this RIDC software as a valuable tool for QA in VMAT plans.

  12. Clinical Experience With A High Resolution Digital Imaging System For Gastro-Intestinal Radiology

    Science.gov (United States)

    Edmonds, E. W.; Rowlands, J. A.; Hynes, D. M.; Toth, B. D.; Porter, A. J.

    1987-01-01

    In our department, it is planned that the gastro-intestinal fluoroscopic area will be equipped entirely with digital imaging systems. The use of the 1024 X 1024 pixel frame store, backed by a hard disc for rapid image transfer, and the production of hard copy on a laser imager has reached the point where clinical efficacy and acceptance are assured. The further addition of facilities for annotation and the application of digital post-processing techniques are being explored both at the clinical site and at the research laboratorieS. The use of laser imaging has produced a further improvement in image quality and some of the practical problems related to this apparatus will be described. The availability of larger capacity laser disc image storage enables the local area network or "mini-PACS" system for fluoroscopy areas to become a concept worthy of investigation. We present our experience over a number of years with these systems, together with our latest investigations into potential applications of laser technology to the practice of radiology in a busy imaging centre.

  13. Clinical experience with a high resolution digital imaging system for gastro-intestinal radiology

    International Nuclear Information System (INIS)

    In the authors' department, it is planned that the gastro-intestinal fluoroscopic area will be equipped entirely with digital imaging systems. The use of the 1024 x 1024 pixel frame store, backed by a hard disc for rapid image transfer, and the production of hard copy on a laser imager has reached the point where clinical efficacy and acceptance are assured. The further addition of facilities for annotation and the application of digital post-processing techniques are being explored both at the clinical site and at the research laboratories. The use of laser imaging has produced a further improvement in image quality and some of the practical problems related to this apparatus will be described. The availability of larger capacity laser disc image storage enables the local area network or ''mini-PACS'' system for fluoroscopy areas to become a concept worthy of investigation. The authors present their experience over a number of years with these systems, together with their latest investigations into potential applications of laser technology to the practice of radiology in a busy imaging centre

  14. Clinical and Neuroradiological Spectrum of Metronidazole Induced Encephalopathy: Our Experience and the Review of Literature.

    Science.gov (United States)

    Roy, Ujjawal; Panwar, Ajay; Pandit, Alak; Das, Susanta Kumar; Joshi, Bhushan

    2016-06-01

    Metronidazole is an antimicrobial agent mainly used in the treatment of several protozoal and anaerobic infections, additionally, is often used in hepatic encephalopathy and Crohn disease. Apart from peripheral neuropathy, metronidazole can also cause symptoms of central nervous system dysfunction like ataxic gait, dysarthria, seizures, and encephalopathy which may result from both short term and chronic use of this drug and is collectively termed as "metronidazole induced encephalopathy"(MIE). Neuroimaging forms the backbone in clinching the diagnosis of this uncommon entity, especially in cases where there is high index of suspicion of intoxication. Although typical sites of involvement include cerebellum, brain stem and corpus callosum, however, lesions of other sites have also been reported. Once diagnosed, resolution of findings on Magnetic Resonance Imaging (MRI) of the Brain along with clinical improvement remains the mainstay of monitoring. Here we review the key clinical features and MRI findings of MIE as reported in medical literature. We also analyze implication of use of this drug in special situations like hepatic encephalopathy and brain abscess and discuss our experience regarding this entity. PMID:27504340

  15. Clinical routine operation of a filmless radiology department: three years experience

    Science.gov (United States)

    Mosser, Hans M.; Paertan, Gerald; Hruby, Walter

    1995-05-01

    This paper communicates the operational implementation of filmless digital radiology in clinical routine, its feasibility and its effect on the radiology profession, based on the three years clinical experience from the filmless digital radiology department of the Danube Hospital, a major teaching hospital in Vienna, Austria, with currently 850 acute-care beds. Since April 1992 all radiological modalities are reported from the monitors of 16 reporting consoles in the radiology department. Images and reports are distributed by the hospital-wide network (Sienet, Siemens Medical Systems, Erlangen), and can be viewed on 60 display consoles throughout the hospital. Filmless radiology primarily is an efficient hospital-wide infrastructure to deliver radiological services along with other medical information, providing safe and fast access to this information anytime and anywhere, necessary for the conduct of the diagnostic and therapeutic task of patient care. In a comparative study of the Danube Hospital with the film based Rudolfstiftung Hospital in Vienna, we found a significant decrease of the mean patient length of hospital stay (1.99 to 3.72 days) that partially might be attributed to the implementation of filmless radiology.

  16. Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice

    Directory of Open Access Journals (Sweden)

    Megan Doerr

    2014-03-01

    Full Text Available Family health history is a leading predictor of disease risk. Nonetheless, it is underutilized to guide care and, therefore, is ripe for health information technology intervention. To fill the family health history practice gap, Cleveland Clinic has developed a family health history collection and clinical decision support tool, MyFamily. This report describes the impact and process of implementing MyFamily into primary care, cancer survivorship and cancer genetics clinics. Ten providers participated in semi-structured interviews that were analyzed to identify opportunities for process improvement. Participants universally noted positive effects on patient care, including increases in quality, personalization of care and patient engagement. The impact on clinical workflow varied by practice setting, with differences observed in the ease of integration and the use of specific report elements. Tension between the length of the report and desired detail was appreciated. Barriers and facilitators to the process of implementation were noted, dominated by the theme of increased integration with the electronic medical record. These results fed real-time improvement cycles to reinforce clinician use. This model will be applied in future institutional efforts to integrate clinical genomic applications into practice and may be useful for other institutions considering the implementation of tools for personalizing medical management.

  17. Clinical experiences with a chemical radioprotector in tumor radiotherapy: WR-2721

    International Nuclear Information System (INIS)

    Since cysteine was found to protect lethally irradiated rats, sulfhydryl compounds that provide protection of laboratory animals against lethal doses of ionizing radiations have also been given much attention. The SH compounds have been the most extensively investigated, and β-aminoethylisothiouronium (AET) and cysteamine have been selected as being representative of those drugs that are highly protective. However, clinical application is limited, as the toxicity of these compounds is high. In a series of experiments to reevaluate radioprotective agents with low toxicity, the authors found that 2-mercaptopropionylglycine (MPG) and adrenochrome monoguangylhydrazone methanesulfonate (AMM) have a potent radioprotector effect in a dose far below their toxic doses in both mice and humans. Recently, the development of effective thiophosphate derivatives of cysteamine, namely WR-2721 [S-2-(3-amino-propylaminoethyl)phosphorothioate] by the U.S. Army Medical Research and Development Commands, led to a reevaluation of these compounds and their potential in radiotherapy. Initial investigations indicated that WR-2721 provided a considerable degree of radioprotection to normal tissues. This compound provided excellent protection for normal tissues (DMF = 2-2.5) but little protection for the transplanted tumor. Thus this drug may have a differential protection in vivo and may be useful for improving the therapeutic ratio in cancer radiotherapy. The results of animal and chemical experiments in Japan are summarized herein

  18. Advances in the management of multiple sclerosis spasticity: experiences from recent studies and everyday clinical practice.

    Science.gov (United States)

    Pozzilli, Carlo

    2013-12-01

    Although spasticity of varying severity affects up to 80% of patients with multiple sclerosis (MS) during the course of their disease, the symptom is often overlooked and undertreated. Despite the availability of oral antispasticity treatments (baclofen, tizanidine and others), approximately one-third of MS patients in Europe and the USA experience moderate or severe nonfocalized spasticity. At present, a thorough clinical evaluation of MS-related spasticity that takes into account the patient's own perception of spasms, spasticity-related pain and other associated symptoms is not common in daily neurological practice. Some of the usual spasticity scales, such as the Ashworth and modified Ashworth scales, reflect the observer's measurement of spasticity at a particular point in time. Herbal (smoked) cannabis has long been recognized as a possible option for relief of spasticity and neuropathic pain, but pertinent concerns about psychoactive effects and addiction risk have prevented its common use. An innovative method of benefiting from the mode of action of cannabinoids while limiting their drawbacks is to reduce peak plasma levels of 9-delta-tetrahydrocannabinol and counteract psychoactivity with higher than naturally occurring proportions of a second cannabinoid, cannabidiol. Sativex® oromucosal spray (1:1 ratio of 9-delta-tetrahydrocannabinol/cannabidiol) has recently been approved in a number of EU countries and elsewhere for use in patients with MS-related spasticity who are resistant to treatment with other antispasticity medications. In clinical trials, Sativex provided initial relief of spasticity symptoms within the first 4 weeks of treatment (trial period) in up to about half of patients resistant to other available oral antispasticity medications and demonstrated clinically significant improvement in spasticity (30% or higher reduction from baseline) in three-quarters of the initial responders. Adverse events were limited mainly to mild or moderate

  19. Dissociative experiences in obsessive-compulsive disorder and trichotillomania: clinical and genetic findings.

    Science.gov (United States)

    Lochner, Christine; Seedat, Soraya; Hemmings, Sian M J; Kinnear, Craig J; Corfield, Valerie A; Niehaus, Dana J H; Moolman-Smook, Johanna C; Stein, Dan J

    2004-01-01

    A link between dissociation proneness in adulthood and self-reports of childhood traumatic events (including familial loss in childhood, sexual/physical abuse and neglect) has been documented. Several studies have also provided evidence for an association between dissociative experiences and trauma in patients with various psychiatric disorders, including post-traumatic stress disorder, borderline personality, dissociative identity and eating disorders. Based on the relative paucity of data on dissociation and trauma in obsessive-compulsive disorder (OCD) and trichotillomania (TTM), the primary objective of this study was to examine the relationship between trauma and dissociative experiences (DE) in these two diagnostic groups. Furthermore, the availability of clinical and genetic data on this sample allowed us to explore clinical and genetic factors relevant to this association. A total of 110 OCD and 32 TTM patients were compared with respect to the degree of dissociation (using the Dissociative Experiences Scale [DES]) and childhood trauma (using the Childhood Trauma Questionnaire [CTQ]). Patients were classified on the DES as either "high" (mean DES score >/= 30) or "low" (mean DES score sexual abuse, and physical neglect. In the OCD group, high dissociators were significantly younger than low dissociators, and significantly more high dissociators than low dissociators reported a lifetime (current and past) history of tics (P disorder (P =.027). In the TTM group, significantly more high dissociators than low dissociators reported (lifetime) kleptomania (P =.005) and depersonalisation disorder (P =.005). In the Caucasian OCD patients (n = 114), investigation of genetic polymorphisms involved in monoamine function revealed no significant differences between high and low dissociator groups. This study demonstrates a link between childhood trauma and DE in patients with OCD and TTM. High dissociative symptomatology may be present in a substantial proportion of

  20. Hypo-fractionated treatment in radiotherapy: radio-biological models Tcp and NTCP; Tratamiento hipofraccionado en radioterapia: modelos radiobiologicos TCP y NTCP

    Energy Technology Data Exchange (ETDEWEB)

    Astudillo V, A. J.; Mitsoura, E. [Universidad Autonoma del Estado de Mexico, Facultad de Medicina, Paseo Tollocan s/n, 50180 Toluca, Estado de Mexico (Mexico); Paredes G, L. [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico); Resendiz G, G., E-mail: lydia.paredes@inin.gob.mx [Hospital Medica Sur, Departamento de Radioterapia, Puente de Piedra 150, Col. Toriello Guerra, 14050 Mexico D. F. (Mexico)

    2014-08-15

    At the present time the breast cancer in Mexico has the first place of incidence of the malignant neoplasia s in the women, and represents 11.34% of all the cancer cases. On the other hand, the treatments for cancer by means of ionizing radiations have been dominated under the approaches of the medical radio-oncologists which have been based on test and error by many years. The radio-biological models, as the Tcp, NTCP and dosimetric variables, for their clinical application in the conventional radiotherapy with hypo-fractionation have as purpose predicting personalized treatment plans that they present most probability of tumor control and minor probability of late reactions, becoming this way support tools in the decisions taking for the patient treatments planning of Medical Physicists and Radio-oncologists. (Author)