scholarly journals Common sources of radiations in a medical environment

2021 ◽  
Vol 9 (11) ◽  
pp. 3485
Author(s):  
Harshvardhan Sharma ◽  
Pradeep Gaur ◽  
Devesh Gupta ◽  
Vikas Rajpurohit
Keyword(s):  
Tertiary Care ◽  
Treatment Strategies ◽  
Mitigation Strategies ◽  
Therapeutic Interventions ◽  
Radiation Risks ◽  
Medical Environment ◽  
Radiation Worker ◽  
Safe Limits ◽  
Radiation Workers ◽  
Harmful Radiation

Use of radiation is now a days so common in most of the tertiary care hospitals for diagnostic and therapeutic purpose. The ionizing radiation provides many benefits in both diagnostic as well as therapeutic interventions, but they are also potential harmful. Radiation risks, exposure and mitigation strategies should always be in mind while using to an individual (public, radiation worker, and patient) and the environment should not exceed the prescribed safe limits. Regular monitoring of hospital area and radiation workers is mandatory to assess the quality of radiation safety. This review article emphasis on radiation risks, exposure and prevention and treatment strategies.

scholarly journals B Cells and Antibodies as Targets of Therapeutic Intervention in Neuromyelitis Optica Spectrum Disorders

2021 ◽  
Vol 14 (1) ◽  
pp. 37
Author(s):  
Jan Traub ◽  
Leila Husseini ◽  
Martin S. Weber
Keyword(s):  
B Cells ◽  
Neuromyelitis Optica ◽  
Plasma Cells ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Therapeutic Interventions ◽  
Complement Factor ◽  
Major Subset ◽  
Spectrum Disorders

The first description of neuromyelitis optica by Eugène Devic and Fernand Gault dates back to the 19th century, but only the discovery of aquaporin-4 autoantibodies in a major subset of affected patients in 2004 led to a fundamentally revised disease concept: Neuromyelits optica spectrum disorders (NMOSD) are now considered autoantibody-mediated autoimmune diseases, bringing the pivotal pathogenetic role of B cells and plasma cells into focus. Not long ago, there was no approved medication for this deleterious disease and off-label therapies were the only treatment options for affected patients. Within the last years, there has been a tremendous development of novel therapies with diverse treatment strategies: immunosuppression, B cell depletion, complement factor antagonism and interleukin-6 receptor blockage were shown to be effective and promising therapeutic interventions. This has led to the long-expected official approval of eculizumab in 2019 and inebilizumab in 2020. In this article, we review current pathogenetic concepts in NMOSD with a focus on the role of B cells and autoantibodies as major contributors to the propagation of these diseases. Lastly, by highlighting promising experimental and future treatment options, we aim to round up the current state of knowledge on the therapeutic arsenal in NMOSD.

scholarly journals Risk of Developing Postoperative Deficits Based on Tumor Location after Surgical Resection of an Intracranial Meningioma

2018 ◽  
Vol 80 (01) ◽  
pp. 059-066 ◽  
Author(s):  
Jeff Ehresman ◽  
Tomas Garzon-Muvdi ◽  
Davis Rogers ◽  
Michael Lim ◽  
Gary Gallia ◽  
...  
Keyword(s):  
Cognitive Deficits ◽  
Tertiary Care ◽  
Treatment Strategies ◽  
Tumor Location ◽  
Radiation Hazard ◽  
Motor Deficits ◽  
Intracranial Meningioma ◽  
Preoperative Radiation ◽  
Simpson Grade ◽  
Vision Deficits

Object Meningiomas occur in various intracranial locations. Each location is associated with a unique set of surgical nuances and risk profiles. The incidence and risk factors that predispose patients to certain deficits based on tumor locations are unclear. This study aimed to determine which preoperative factors increase the risk of patients having new deficits after surgery based on tumor location for patients undergoing intracranial meningioma surgery. Methods Adult patients who underwent primary, nonbiopsy resection of a meningioma at a tertiary care institution between 2007 and 2015 were retrospectively reviewed. Stepwise multivariate logistic regression analyses were used to identify associations with postoperative deficits based on tumor location. Results Postoperatively, from the 761 included patients, there were 39 motor deficits (5.1%), 23 vision deficits (3.0%), 19 language deficits (2.5%), 27 seizures (3.5%), and 26 cognitive deficits (3.4%). The factors independently associated with any postoperative deficits were preoperative radiation (hazard ratio [HR] [95% confidence interval, CI] 3.000 [1.346–6.338], p = 0.008), cerebellopontine angle tumors (HR [95% CI] 2.126 [1.094–3.947], p = 0.03), Simpson grade 4 resections (HR [95% CI] 2.000 [1.271–3.127], p = 0.003), preoperative motor deficits (HR [95% CI] 1.738 [1.005–2.923], p = 0.048), preoperative cognitive deficits (HR [95% CI] 2.033 [1.144–3.504], p = 0.02), and perioperative pulmonary embolisms (HR [95% CI] 11.741 [2.803–59.314], p = 0.0009). Conclusion Consideration of the factors associated with postoperative deficits in this study may help guide treatment strategies for patients with meningiomas.

Synergistic Apoptotic Effect of Naringenin on enhancing the Anti-Glioma Efficacy of Temozolomide in an in vitro Experimental Model

2021 ◽  
Vol 16 (10) ◽  
pp. 43-49
Author(s):  
Precilla S. Daisy ◽  
S. Kuduvalli Shreyas ◽  
R. Sathish ◽  
T.S. Anitha
Keyword(s):  
Drug Treatment ◽  
Caspase 3 ◽  
Treatment Strategies ◽  
Glioma Cells ◽  
C6 Glioma ◽  
Mitigation Strategies ◽  
Treatment Modalities ◽  
C6 Glioma Cells ◽  
Dependent Manner

Glioma is one of the most devastating and difficult-totreat brain tumors with a very poor prognosis. Despite the current treatment modalities, the overall survival rate is only 5% contributing to a high mortality rate. Nevertheless, of emerging treatment strategies, there is still a rising need for novel mitigation strategies to counteract glioma aggressiveness. One attempt towards this long-term goal was made in this study to reveal the combined efficacy of naringenin, a bioactive flavonoid on enhancing the anti-glioma potency of temozolomide in C6 glioma cells. The cytotoxic effect of temozolomide and naringenin, both individually and in combination was assessed by employing MTT assay. The synergistic effect of the drugs temozolomide and naringenin was determined by calculating the combination index. To confirm the presence of apoptotic changes in the cells at morphological level, acridine orange/ethidium bromide staining was performed. Further, the modulatory effects of the drugs on apoptotic genes, caspase-3 and BCL-2 were evaluated using quantitative real time-PCR. Interestingly, we found that the combinatorial drug treatment was in consensus and effectively inhibited the growth of C6 glioma cells in a dose-dependent manner. Furthermore, this combinatorial drug treatment significantly up-regulated the expression of the proapoptotic gene, caspase-3 and down-regulated the anti-apoptotic gene BCL-2 suggesting a shift of equilibrium towards apoptosis. Our findings suggest that naringenin can be employed as a potent drug to enhance the anti-glioma efficacy of temozolomide and could be therapeutically exploited for the management of glioma.

Studi Paparan Radiasi pada Pekerja Radiasi Cathlab dengan Menggunakan My Dose Mini sebagai Upaya Keselamatan Radiasi di RSUP Adam Malik Medan

2021 ◽  
Vol 1 (1) ◽  
pp. 41-46
Author(s):  
Martua Damanik ◽  
◽  
Josepa ND Simanjuntak ◽  
Elvita Rahmi Daulay
Keyword(s):  
Radiation Exposure ◽  
Biological Effects ◽  
Exposure Dose ◽  
Radiological Protection ◽  
Safe Level ◽  
Radiation Sources ◽  
Radiation Worker ◽  
Radiation Workers ◽  
Effects Of Radiation ◽  
Radiation Exposure Dose

Cathlab radiation workers, when performing interventional procedures, are at high risk of the effects of radiation exposure. The risk of radiation exposure is deterministic and stochastic biological effects. Therefore, radiation exposure studies of radiation workers at the cath lab were conducted to determine the value of radiation exposure received. This radiation exposure study was conducted by measuring and recording radiation exposure doses received by radiation workers. Measurements are made when the radiation officer performs the intervention procedure. The research was carried out for one month in the cath lab room of the Adam Malik General Hospital, Medan. The modalities used are GE Medical System Interventional Fluoroscopy and Phillips Allura Xper FD20. The dosimeter used is “my dose mini”, which is placed inside a shield or apron worn by radiation workers. The size of the apron shield used is 0.50 mm Pb at the front and 0.25 mm Pb at the rear. Radiation officers whose radiation exposure dose was measured consisted of 10 doctors, 11 nurses, and one radiographer. Each inspection procedure of each radiation worker has a different distance, time, and shield from the radiation source. The measurement of radiation exposure dose is (1-59 μSv) for doctors, (1-58 μSv) for nurses, and 1 μSv for radiographers. To protect against radiation must pay attention to the factors of time, distance, and shielding. Ways that can do are to avoid being close to radiation sources for too long, keep a space at a safe level from radiation, and use shields such as Pb-coated aprons, use Pb gloves, Pb goggles, and thyroid protectors. The amount of radiation exposure dose received by each radiation worker at the time of measurement is still within the tolerance limit. The Nuclear Energy Regulatory Agency (BAPETEN) regulation, which the International Commission recommends on Radiological Protection (ICRP), is 20 mSv/year. The results of this study are expected to be used as input for improving the quality of service for monitoring radiation exposure doses in the Cathlab and as reference material for further research.

Missing links — epigenetic regulators of the pancreatic cancer–associated inflammation

2021 ◽  
Vol 135 (10) ◽  
pp. 1289-1293
Author(s):  
Gregor Werba ◽  
Tamas A. Gonda
Keyword(s):  
Pancreatic Cancer ◽  
Noncoding Rna ◽  
Current Knowledge ◽  
Treatment Strategies ◽  
Therapeutic Interventions ◽  
Ductal Adenocarcinoma ◽  
Gastrointestinal Cancers ◽  
Novel Treatment ◽  
Epigenetic Regulator ◽  
Novel Treatment Strategies

Abstract Pancreatic ductal adenocarcinoma (PDAC) features a hostile tumor microenvironment (TME) that renders it remarkably resistant to most therapeutic interventions. Consequently, survival remains among the poorest compared with other gastrointestinal cancers. Concerted efforts are underway to decipher the complex PDAC TME, break down barriers to efficacious therapies and identify novel treatment strategies. In the recent Clinical Science, Li and colleagues identify the long noncoding RNA KLHDC7B-DT as a crucial epigenetic regulator of IL-6 transcription in PDAC and illustrate its potent influences on the pancreatic TME. In this commentary, we introduce epigenetics in pancreatic cancer and put the findings by Li et al. in context with current knowledge.

scholarly journals Clinical presentation and treatment in patients with acute coronary syndrome in a tertiary care general hospital in Bangladesh

2018 ◽  
Vol 4 (1) ◽  
pp. 117-122
Author(s):  
Monalisa Monwar ◽  
Ambia Khatun ◽  
Masud Parvez ◽  
Tarannum Naz ◽  
Mir Imam Ibne Wahed ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
General Hospital ◽  
Troponin I ◽  
Tertiary Care ◽  
Treatment Strategies ◽  
Acute Chest Pain ◽  
Average Hospital ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Depression

Acute coronary syndrome (ACS) is a leading cause of death among people in Bangladesh. The aim of the study was to analyze the clinical course and treatment strategies in patients with ACS and to determine to what extent management of ACS in a tertiary care general hospital in Bangladesh adhered to current guidelines. This study was carried out in the coronary care unit (CCU) of a tertiary care general hospital, Rajshahi, for a period of 3-months. A total number of 240 patients presenting with ACS were included in our study and the most common symptoms were acute chest pain (90%) and dyspnea (49%). The study group comprised of 27% female and 73% male patients with varying risk factors including hypertension (45%), hyperlipidemia (43%), family records of coronary artery disease (CAD) (20%), diabetes (17%) and smoking (15%). The most frequent ECG finding in patients was T wave change (71%), pathological Q wave (67%), ST segment elevation (33%), ST depression (9%), whereas, 12% patients with ACS reported to have normal ECG. Patients with ACS had elevated levels of SGOT and CK-MB. Troponin I level was positive in 100% of the patients with a mean peak troponin level of 1.5± 0.15ng/ml. In clinical setting, the patients were immediately managed with isosorbidedinitrate (58%), streptokinase (40%) and intravenous heparin (LMWH) followed by (46%) and (54%) of aspirin and aspirin-clopidogrel combinations respectively. In addition, long-term management with antihypertensive included β-blocker (58%), calcium channel blocker (29%), ACE-I (25%) and diuretics (12%). Anti-diabetic (18%) drugs were also prescribed in patients with co-existing diabetes and CAD. Adherence to guidelines is limited by lack of funds and resources in the hospital; however, attention must be paid to improve patient outcome. The average hospital stay ranges 2-3 days and hospital mortality was 10%.Asian J. Med. Biol. Res. March 2018, 4(1): 117-122

scholarly journals Treatment Strategies Based on Histological Targets against Invasive and Resistant Glioblastoma

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Akira Hara ◽  
Tomohiro Kanayama ◽  
Kei Noguchi ◽  
Ayumi Niwa ◽  
Masafumi Miyai ◽  
...  
Keyword(s):  
Glioma Cell ◽  
Treatment Strategies ◽  
Secondary Structures ◽  
Primary Brain Tumor ◽  
Therapeutic Interventions ◽  
High Recurrence Rate ◽  
Normal Brain ◽  
Biological Targets ◽  
Glioma Cell Migration ◽  
Histopathological Evidence

Glioblastoma (GBM) is the most common and the most malignant primary brain tumor and is characterized by rapid proliferation, invasion into surrounding normal brain tissues, and consequent aberrant vascularization. In these characteristics of GBM, invasive properties are responsible for its recurrence after various therapies. The histomorphological patterns of glioma cell invasion have often been referred to as the “secondary structures of Scherer.” The “secondary structures of Scherer” can be classified mainly into four histological types as (i) perineuronal satellitosis, (ii) perivascular satellitosis, (iii) subpial spread, and (iv) invasion along the white matter tracts. In order to develop therapeutic interventions to mitigate glioma cell migration, it is important to understand the biological mechanism underlying the formation of these secondary structures. The main focus of this review is to examine new molecular pathways based on the histopathological evidence of GBM invasion as major prognostic factors for the high recurrence rate for GBMs. The histopathology-based pharmacological and biological targets for treatment strategies may improve the management of invasive and resistant GBMs.

scholarly journals Acute kidney injury requiring dialysis in obstetric patients: management and clinical outcome in case series of 30 patients in a tertiary care centre

2017 ◽  
Vol 6 (7) ◽  
pp. 2997
Author(s):  
Molina U. Patel ◽  
Yuvraj Jadeja ◽  
Niket Patel ◽  
Nayana Patel ◽  
Smruti Vaishnav ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Tertiary Care ◽  
Case Series ◽  
Kidney Injury ◽  
Therapeutic Interventions ◽  
Risk Category ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Significant Difference ◽  
The Impact

Background: Acute Kidney Injury is a common medical problem affecting approximately 5% of all hospitalized and 30% of critically ill patients. The incidence in obstetric patients ranges from 1 in 2000 to 1 in 25000 pregnancies. In India till date, the impact of AKI on fetomaternal outcome and pertaining therapeutic interventions is only sparsely studied.Methods: It is a retrospective cross-sectional study. All obstetric patients with AKI on dialysis, admitted to Shree Krishna Hospital, a tertiary care hospital in Karamsad village in Gujarat from January 2013 to August 2015. Multivariate statistical analysis of clinical and laboratory parameters was performed using SPSS program to obtain the results.Results: The incidence of dialysis was 1.6%. HELLP syndrome and pre-eclampsia (80%) was found to be the most common etiology of AKI followed by Congestive cardiac failure (34.5%), hemorrhage and sepsis in 30% resp. All patients were admitted to ICU care. No significant difference was found between SAP II and SOFA monitoring system. Mechanical ventilation was done to support 53.3% and inotropic support was needed by 56.7% patients. According to the RIFLE criteria, majority of the patients fall under risk category followed by injury. 18% of the patients developed End Stage Renal Disease.Conclusions: In view of the multifaceted etiologies and complexity of management of AKI, a multi-disciplinary approach involving nephrologist, intensivists, obstetricians and neonatologists is extremely important.

scholarly journals Risk of bias and reporting completeness of randomised controlled trials in burn care: protocol for a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033472
Author(s):  
Amber Young ◽  
Barnaby C Reeves ◽  
Hung-Yuan Cheng ◽  
Jason Wasiak ◽  
Duncan Muir ◽  
...  
Keyword(s):  
Randomised Controlled Trials ◽  
Treatment Strategies ◽  
Risk Of Bias ◽  
Therapeutic Interventions ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Free Text ◽  
Burn Care ◽  
Care Protocol ◽  
Randomised Controlled

IntroductionBurn care represents a healthcare and economic burden to patients internationally. Choice of the most clinically effective treatment strategies requires evidence which is best obtained through high-quality randomised controlled trials (RCT). The number of published RCTs of burn care is increasing. However, trial quality and reporting standards are unclear. This study will assess the risk of bias and adequacy of reporting in recent burn care RCTs using tools endorsed by the Cochrane Collaboration.Methods and analysisA systematic literature review will be undertaken, assessing parallel group RCTs evaluating therapeutic interventions for patients with cutaneous burns. Literature searches will use Ovid Medline, Ovid Embase, Web of Science and the Cochrane Library. Separate searches for each database will include medical subject heading and free text terms including ‘burn’, ‘scald’, ‘thermal injury’ and ‘RCT’. Two reviewers will independently assess each study for inclusion. Risk of bias (RoB) will be assessed with the revised tool (RoB 2) and reporting completeness with the CONsolidated Standards of Reporting Trials (CONSORT) 2010 guidelines. We will report a narrative synthesis of all studies, including domain specific, and overall risk of bias for the primary outcome of each trial. Inter-rater agreement for RoB 2 will be reported using Fleiss’s Kappa. For adherence to the CONSORT guidelines, we will generate a completeness of reporting index for the five domains.Ethics and disseminationNo ethics approval is required because published documents will be used. Findings of the study will be disseminated in a peer-reviewed journal and presented at conferences.PROSPERO registration numberCRD42018111020.

scholarly journals Sociocultural Factors That Potentially Affect the Institution of Prevention and Treatment Strategies for Hepatitis B in Chinese Canadians

2009 ◽  
Vol 23 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Harry Wu ◽  
Colina Yim ◽  
Alex Chan ◽  
Michael Ho ◽  
Jenny Heathcote
Keyword(s):  
Health Care ◽  
Hepatitis B ◽  
Access To Health Care ◽  
Severe Disease ◽  
Tertiary Care ◽  
Treatment Strategies ◽  
Chinese Patients ◽  
Medical Attention ◽  
Sociocultural Factors ◽  
Tertiary Care Centre

BACKGROUND: Despite the availability of screening for chronic hepatitis B (CHB) infection and effective treatments now available, many at-risk individuals fail to seek appropriate medical attention.OBJECTIVE: To identify the barriers to care for CHB infection in a Chinese Canadian community.METHODS: A survey conducted in English or Chinese collected information from individuals with CHB infection that evaluated the level of understanding and identified the barriers that may prevent Chinese patients from undergoing monitoring, screening and/or treatment for CHB infection.RESULTS: Among the 204 patients enrolled, common misconceptions were that sharing food transmits hepatitis B and that patients with severe disease are always symptomatic. Patients with a better understanding of hepatitis B were better educated, younger and were being followed at a tertiary care centre (P<0.01 for all). Prominent barriers to health care were time, inconvenience and language difficulties. Patients under the care of family physicians who had extended office hours were less likely to cite time (P=0.06) and distance (P=0.05) as barriers.CONCLUSION: Patient misconceptions that severe liver disease due to hepatitis B infection is symptomatic may factor into the unwillingness to spare the time and undergo the inconvenience associated with regular medical follow-up. Implementation of programs that increase awareness of the silent progression of CHB infection and provide culturally responsive clinics, better able to work within patients’ time constraints may improve Chinese patients’ access to health care.

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