Questionnaire d’une évaluation nationale de la qualité des centres de physiothérapie: étude pilote au liban

Background: Lebanon still lacks a unified platform upon which private physiotherapy practitioners can base and apply their knowledge and practice. Accreditation of physiotherapy centres would promote collaboration, boost consistency and enhance quality of services. The Order of Physiotherapists in Lebanon is called on to provide a high quality of service by focusing on standards. Aims: The aim of this study was to assess the feasibility and applicability of a standard for the quality assessment of physiotherapy centres, and to assess the current status of a sample of centres in Lebanon. Methods: A questionnaire was developed by a panel of experts based on a review of international and national requirements in physiotherapy centres. A set of 14 items was generated covering 3 categories: qualifications of the team, facility and environmental status, and data collection and analysis. A pilot study was conducted from December 2013 to February 2014 in 6 Lebanese physiotherapy centres. Descriptive statistics are reported. Results: The highest median score and compliance score for the 6 centres were reported for the “Facility and environmental status” category (median = 8.0) and the lowest were reported in the “Data collection and analysis” category (median = 5.0). Conclusions: Further studies are needed to validate the quality assessment in physiotherapy centres questionnaire, and to implement it as a primary tool for assessing quality standards and for accreditation of physiotherapy centres.SCOPUS: ar.jDecretOANoAutActifinfo:eu-repo/semantics/publishe

Replacement Computational Phantoms to Estimate Dose in Out-Of-Field Organs and Tissues

Purpose: To estimate the absorbed dose in organs and tissues at risk for radiogenic cancer for children receiving photon radiotherapy for localized brain tumors (LBTs) by supplementing their missing body anatomies with those of replacement computational phantoms. Applied beyond the extent of the RT Images collected by computed tomography simulation, these phantoms included RT Image and RT Structure Set objects that encompassed sufficient extents and contours for dosimetric calculations. Method: Nine children, aged 2 to 14 years, who received three‐dimensional conformal radiotherapy for low‐grade LBTs, were randomly selected for this study under Institutional‐Review‐Board protocol. Because the extents of their RT Images were cranial only, they were matched for size and sex with patients from a previous study with larger extents and for whom contours of organs at risk for radiogenic cancer had already been delineated. Rigid fusion was performed between the patients’ data and those of the replacement computational phantoms using commercial software. In‐field dose was calculated with a clinically‐commissioned treatment planning system, and out‐of‐field dose was estimated with an analytical model. Results: Averaged over all nine children and normalized for a therapeutic dose of 54 Gy prescribed to the PTV, where the PTV is the GTV, the highest mean organ doses were 3.27, 2.41, 1.07, 1.02, 0.24, and 0.24 Gy in the non‐tumor remainder, red bone marrow, thyroid, skin, breasts, and lungs, respectively. The mean organ doses ranged by a factor of 3 between the smallest and largest children. Conclusion: For children receiving photon radiotherapy for LBTs, we found their doses in organs at risk for second cancer to be non‐negligible, especially in the non‐tumor remainder, red bone marrow, thyroid, skin, breasts, and lungs. This study demonstrated the feasibility for patient dosimetry studies to augment missing patient anatomy by applying size‐ and sex‐matched replacement computational phantoms with pre‐contoured organs.status: Published onlin

Selective Photothermolysis to target Sebaceous Glands: Theoretical Estimation of Parameters and Preliminary Results Using a Free Electron Laser

The success of permanent laser hair removal suggests that selective photothermolysis (SP) of sebaceous glands, another part of hair follicles, may also have merit. About 30% of sebum consists of fats with copious CH2 bond content. SP was studied in vitro, using free electron laser (FEL) pulses at an infrared CH2 vibrational absorption wavelength band. Absorption spectra of natural and artificially prepared sebum were measured from 200 nm to 3000 nm, to determine wavelengths potentially able to target sebaceous glands. The Jefferson National Accelerator superconducting FEL was used to measure photothermal excitation of aqueous gels, artificial sebum, pig skin, human scalp and forehead skin (sebaceous sites). In vitro skin samples were exposed to FEL pulses from 1620 to 1720 nm, spot diameter 7-9.5 mm with exposure through a cold 4C sapphire window in contact with the skin. Exposed and control tissue samples were stained using H and E, and nitroblue tetrazolium chloride staining (NBTC) was used to detect thermal denaturation. Natural and artificial sebum both had absorption peaks near 1210, 1728, 1760, 2306 and 2346 nm. Laser-induced heating of artificial sebum was approximately twice that of water at 1710 and 1720 nm, and about 1.5x higher in human sebaceous glands than in water. Thermal camera imaging showed transient focal heating near sebaceous hair follicles. Histologically, skin samples exposed to {approx}1700 nm, {approx}100-125 ms pulses showed evidence of selective thermal damage to sebaceous glands. Sebaceous glands were positive for NBTC staining, without evidence of selective loss in samples exposed to the laser. Epidermis was undamaged in all samples. Conclusions: SP of sebaceous glands appears to be feasible. Potentially, optical pulses at {approx}1720 nm or {approx}1210 nm delivered with large beam diameter and appropriate skin cooling in approximately 0.1 s may provide an alternative treatment for acne