Quality assurance for the optimization of patient dose in interventional radiology

Drie maatregelen kunnen de dosis straling optimaliseren die patienten ontvangen tijdens radiologische interventies. Ten eerste moderne apparatuur gebruiken die speciaal geschikt is voor interventies. Ten tweede extra aandacht schenken aan stralingsbescherming tijdens opleidingen op het gebied van de interventieradiologie. En tot slot complicaties van straling opnemen in het complicatieregister van de sectie Interventieradiologie van de Nederlandse Vereniging voor Radiologie. Dit blijkt uit onderzoek dat het RIVM in opdracht van de Inspectie voor de Gezondheidszorg heeft uitgevoerd naar de kwaliteitsborging van de interventieradiologie in Nederland. De opdracht is ingegeven door de relatief hoge stralingsdosis waaraan patienten kunnen worden blootgesteld tijdens radiologische interventies. Bij interventieradiologie worden medische behandelingen uitgevoerd via een kleine opening in de huid, terwijl die ingreep in beeld wordt gebracht met behulp van rontgen, CT, MRI of echografie. Bij gebruik van rontgen of CT kan de stralingsdosis leiden tot nadelige effecten voor de gezondheid, zoals roodheid, verbranding van de huid, (tijdelijke) ontharing of op de lange termijn kanker.Three measures may optimize the radiation dose that patients receive during interventional radiology procedures. The first is by using modern equipment that is appropriate for interventional radiology procedures, while the second involves paying extra attention to radiation protection in courses in the field of interventional radiology. A final measure is to incorporate radiation-related complications into the complication register of the Interventional Radiology section of the Dutch Association for Radiology. This was found in an investigation of quality assurance in interventional radiology in the Netherlands that was assigned to RIVM by the Dutch Health Inspectorate. The investigation was motivated by the relatively high radiation dose that patients undergoing an interventional radiology procedure may be exposed to. In interventional radiology, medical treatment is applied through a small opening in the skin, while the procedure is monitored using medical imaging such as X-ray, CT, MRI or ultrasound. In the case of X-ray or CT, the radiation dose may cause adverse health effects such as erythema, burnt skin, (temporary) epilation or, in the long term, cancer.Inspectie voor de Gezondheidszor

Naar een grutto-mozaïekmodel : definitie van een model voor evaluatie vooraf van de effectiviteit van mozaïekbeheer, stand van zaken juni 2005

Weidevogels gaan sterk achteruit in Nederland. Agrarisch natuurbeheer en weidevogelreservaten moeten deze achteruitgang stoppen, maar lijken daarin niet effectief te zijn. Een oorzaak zou kunnen zijn dat onvoldoende wordt gelet op de ruimtelijke samenhang in de maatregelen ten behoeve van weidevogels. Op diverse fronten wordt daarom gewerkt aan Grutto-mozaïek-beheer, waarbij de habitateisen van de Grutto leidraad zijn. Doel van dit project in opdracht van het EU-interregproject Farmers for Nature is het ontwikkelen en uittesten van een kennissysteem in de vorm van een computermodel om de effectiviteit van graslandbeheer voor weidevogels vast te stellen. Het model wordt operationeel via Internet. Behalve voor evaluatie wordt het model ook door boeren gebruikt voor planning en optimalisatie van het weidevogelbeheer. Dit rapport beschrijft het ontwikkelingstraject en de stand van zaken. In Midden-Delfland is een ArcvView-prototype uitgeprobeer

Regionatuurplan: etalage voor groene diensten door agrarische natuurverenigingen : aanzet tot een kennis- en beheersysteem voor agrarisch natuurbeheer, pilot Midden-Delfland

Een prototype van een evaluatiesysteem is ontwikkeld voor de ruimtelijk evaluatie van weidevogel- en slootkantenbeheer. Proefgebied is Midden-Delfland. Gebruik is gemaakt van het beheer zoals dat in bedrijfsnatuurplannen is opgenomen. Door toepassing van een aantal vuistregels tav de ligging van beheer, o.m. ontleend aan mozaïekbeheer, wordt inzichtelijk in hoeverre dit voor weidevogels effectief is. Voor slootkantbeheer is mn gelet op ontwateringsdiepte, grondsoort en nabijheid van gewenste soorten. De evaluatie wordt op regioniveau uitgevoerd. Toepassing van GIS-techniek speelt een belangrijke rol. De methode levert bruikbare resultaten op voor de evaluatie beheer en voor verbeteringen daarvan. Het systeem kan worden toegepast bij de uitwerking van Groene Diensten, omdat het de mogelijkheid biedt vraag en aanbod aan natuur inzichtelijk te maken. Bij verdere ontwikkeling kan worden gewerkt aan de gebruikers¬vriendelijkheid: toegang via internet is daarvoor een veelbelovende optie

Informants' ratings of activity level in infancy predict ADHD symptoms and diagnoses in childhood

We tested the hypothesis that high activity levels in infancy would predict self-regulatory problems and later symptoms of ADHD in a longitudinal study of British families (N = 321). Infants’ activity levels were assessed at 6 months, using three informants’ reports from the Infant Behaviour Questionnaire (IBQ) and Actigraphs during baseline, attention and restraint tasks. At a mean of 33 months, the children were assessed on self-regulatory tasks and at a mean of 36 months three informants reported symptoms of ADHD. At a mean of 7.0 years, the children were assessed on executive function tasks; three informants reported on the child’s symptoms of ADHD; and diagnoses of disorder were obtained using the Preschool Age Psychiatric Assessment (PAPA). Informants’ reports of high activity levels at 6 months predicted ADHD symptoms in early childhood and diagnoses of ADHD with clinical impairment at age 7. The IBQ activity scale was also associated with the children’s later performance on self-regulation tasks in early and middle childhood. Activity level in infancy reflects normal variation and is not a sign of psychopathology. However, these findings suggest that further study of the correlates of high activity level in infancy may help identify those children most at risk for disorder

Effectiveness of dementia follow-up care by memory clinics or general practitioners: randomised controlled trial

Objective To examine the effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared with general practitioners

Aberrant iPSC-derived human astrocytes in Alzheimer's disease

The pathological potential of human astroglia in Alzheimer's disease (AD) was analysed in vitro using induced pluripotent stem cell (iPSC) technology. Here, we report development of a human iPSC-derived astrocyte model created from healthy individuals and patients with either early-onset familial AD (FAD) or the late-onset sporadic form of AD (SAD). Our chemically-defined and highly efficient model provides >95% homogeneous populations of human astrocytes within 30 days of differentiation from cortical neural progenitor cells (NPCs). All astrocytes expressed functional markers including; glial fibrillary acidic protein (GFAP), excitatory amino acid transporter 1 (EAAT1), S100B and glutamine synthetase (GS) comparable to that of adult astrocytes in vivo. However, induced astrocytes derived from both SAD and FAD patients exhibit a pronounced pathological phenotype, with a significantly less complex morphological appearance, overall atrophic profiles, and abnormal localisation of key functional astroglial markers. Furthermore, NPCs derived from identical patients did not show any differences, therefore, validating that remodelled astroglia are not as a result of defective neuronal intermediates. This work not only presents a novel model to study the mechanisms of human astrocytes in vitro, but also provides an ideal platform for further interrogation of early astroglial cell-autonomous events in AD and the possibility of identification of novel therapeutic targets for the treatment of AD

Balancing the immune response in the brain: IL-10 and its regulation

Background: The inflammatory response is critical to fight insults, such as pathogen invasion or tissue damage, but if not resolved often becomes detrimental to the host. A growing body of evidence places non-resolved inflammation at the core of various pathologies, from cancer to neurodegenerative diseases. It is therefore not surprising that the immune system has evolved several regulatory mechanisms to achieve maximum protection in the absence of pathology. Main body: The production of the anti-inflammatory cytokine interleukin (IL)-10 is one of the most important mechanisms evolved by many immune cells to counteract damage driven by excessive inflammation. Innate immune cells of the central nervous system, notably microglia, are no exception and produce IL-10 downstream of pattern recognition receptors activation. However, whereas the molecular mechanisms regulating IL-10 expression by innate and acquired immune cells of the periphery have been extensively addressed, our knowledge on the modulation of IL-10 expression by central nervous cells is much scattered. This review addresses the current understanding on the molecular mechanisms regulating IL-10 expression by innate immune cells of the brain and the implications of IL-10 modulation in neurodegenerative disorders. Conclusion: The regulation of IL-10 production by central nervous cells remains a challenging field. Answering the many remaining outstanding questions will contribute to the design of targeted approaches aiming at controlling deleterious inflammation in the brain.We acknowledge the Portuguese Foundation for Science and Technology (FCT) for providing a PhD grant to DLS (SFRH/BD/88081/2012) and a post-doctoral fellowship to SR (SFRH/BPD/72710/2010). DS, AGC and SR were funded by FEDER through the Competitiveness Factors Operational Programme (COMPETE) and National Funds through FCT under the scope of the project POCI-01-0145-FEDER007038; and by the project NORTE-01-0145-FEDER-000013, supported by Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF). The MS lab was financed by Fundo Europeu de Desenvolvimento Regional (FEDER) funds through the COMPETE 2020—Operacional Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, and by Portuguese funds through FCT in the framework of the project “Institute for Research and Innovation in Health Sciences ” (POCI-01-0145-FEDER-007274). MS is a FCT Associate Investigator. The funding body had no role in the design of the study and collection, analysis, and interpretation of the data and in writing the manuscript

Theories of schizophrenia: a genetic-inflammatory-vascular synthesis

BACKGROUND: Schizophrenia, a relatively common psychiatric syndrome, affects virtually all brain functions yet has eluded explanation for more than 100 years. Whether by developmental and/or degenerative processes, abnormalities of neurons and their synaptic connections have been the recent focus of attention. However, our inability to fathom the pathophysiology of schizophrenia forces us to challenge our theoretical models and beliefs. A search for a more satisfying model to explain aspects of schizophrenia uncovers clues pointing to genetically mediated CNS microvascular inflammatory disease. DISCUSSION: A vascular component to a theory of schizophrenia posits that the physiologic abnormalities leading to illness involve disruption of the exquisitely precise regulation of the delivery of energy and oxygen required for normal brain function. The theory further proposes that abnormalities of CNS metabolism arise because genetically modulated inflammatory reactions damage the microvascular system of the brain in reaction to environmental agents, including infections, hypoxia, and physical trauma. Damage may accumulate with repeated exposure to triggering agents resulting in exacerbation and deterioration, or healing with their removal. There are clear examples of genetic polymorphisms in inflammatory regulators leading to exaggerated inflammatory responses. There is also ample evidence that inflammatory vascular disease of the brain can lead to psychosis, often waxing and waning, and exhibiting a fluctuating course, as seen in schizophrenia. Disturbances of CNS blood flow have repeatedly been observed in people with schizophrenia using old and new technologies. To account for the myriad of behavioral and other curious findings in schizophrenia such as minor physical anomalies, or reported decreased rates of rheumatoid arthritis and highly visible nail fold capillaries, we would have to evoke a process that is systemic such as the vascular and immune/inflammatory systems. SUMMARY: A vascular-inflammatory theory of schizophrenia brings together environmental and genetic factors in a way that can explain the diversity of symptoms and outcomes observed. If these ideas are confirmed, they would lead in new directions for treatments or preventions by avoiding inducers of inflammation or by way of inflammatory modulating agents, thus preventing exaggerated inflammation and consequent triggering of a psychotic episode in genetically predisposed persons

ISSN exercise & sport nutrition review: research & recommendations

Sports nutrition is a constantly evolving field with hundreds of research papers published annually. For this reason, keeping up to date with the literature is often difficult. This paper is a five year update of the sports nutrition review article published as the lead paper to launch the JISSN in 2004 and presents a well-referenced overview of the current state of the science related to how to optimize training and athletic performance through nutrition. More specifically, this paper provides an overview of: 1.) The definitional category of ergogenic aids and dietary supplements; 2.) How dietary supplements are legally regulated; 3.) How to evaluate the scientific merit of nutritional supplements; 4.) General nutritional strategies to optimize performance and enhance recovery; and, 5.) An overview of our current understanding of the ergogenic value of nutrition and dietary supplementation in regards to weight gain, weight loss, and performance enhancement. Our hope is that ISSN members and individuals interested in sports nutrition find this review useful in their daily practice and consultation with their clients