Radiobiologically based assessments of the net costs of fractionated radiotherapy.

Purpose: To examine how the long-term costs of radiation therapy may be influenced by modifications to fractionation schemes, and how any improvements in tumor control might, in principle, be translated into a potential cost saving for the responsible healthcare organization.

Methods And Materials: Standard radiobiological modeling based on the linear-quadratic (LQ) model is combined with financial parameters relating to the estimated costs of different aspects of radiotherapy treatment delivery. The cost model includes provision for the long-term costs of treatment failure and enables the extra costs of near optimal radiotherapy to be balanced against suboptimal alternatives, which are more likely to be associated with further radiotherapy, salvage surgery, and continuing care.

Dose-rate effects in targeted radiotherapy.

The physical dose delivered in radio-immunotherapy (RIT) may not, by itself, be a reliable indicator of the likely effectiveness of the treatment. Radiobiological considerations, in particular those relating to the dose-rate, are also very relevant. Dose-rate effects are important in conventional radiotherapy because of their ability to produce differential sparing effects between normal and malignant tissue.

Pregnancy after uterine artery embolization to control haemorrhage from gestational trophoblastic tumour.

Gestational trophoblastic tumour (GTT) of the uterus can cause severe and even life threatening haemorrhage in patients who may be contemplating future pregnancy. Three cases of successful pregnancy after uterine artery embolization to control severe haemorrhage from uterine GTT are reported. Both uterine arteries had been selectively catheterized and embolized in these patients.

Recent advances in speech and language therapy.

Speech and language therapists are involved in the care of a wide range of pathogies. Recent changes have been marked by an increased involvement in feeding and swallowing work with premature babies, and oropharyngeal cancer sufferers. Changes have also occurred in assessment and management of communication problems resulting from acquired neurological pathologies such as stroke, Parkinson's disease and dementia.

Critically ill parturient women and admission to intensive care: a 5-year review.

Thirty-nine parturient women were admitted to a general intensive care unit (ICU) from April 1989 to March 1994 and of these four were readmitted (total 43 admissions). Twelve women were admitted to the obstetric unit from peripheral hospitals in different regions, but no requirement for intensive care was perceived on referral. Six women were transfered directly into the intensive care unit from different hospitals in the region.

One-to-one midwifery.

Key elements: Problems of One-to-One midwifery developing a caseload relationships with other staff--perceived 'elitism' boundaries of care for high-risk mothers long hours isolation women's unrealistic expectations of midwife, including overdependence Solutions maintain dialogue with other professionals hospital midwives invited to join OTO midwives on community visits clarify roles and responsibilities direct referral to on-call registrar partnerships with teams peer support weekly group meeting empowering women, reducing overdependence

New aspects in the histological diagnosis of breast carcinoma.

The wide use of mammographic screening and breast conservation surgery, as well as the introduction of a variety of new morphological and immunohistological assessment methods, has markedly changed the practice of breast histopathology. These changes have led to the emergence of new macroscopic and microscopic interpretation demands and difficulties. It is hoped that in the future the role played by diagnostic histopathology in the management of breast cancer will continue to be refined, so that it can provide more detailed information about individual tumors that will help in deciding the most likely approach to obtain the best treatment results.

Experience with the Memotherm permanently implanted prostatic stent.

Objective: To evaluate the Memotherm (Angiomed) permanently implantable prostatic stent.

Patients And Methods: Forty-eight men (mean age 70.3 years, range 57-86) with symptoms and urodynamics suggestive of bladder outflow obstruction had a Memotherm stent inserted into the prostatic urethra.