Angular dependence of dose sensitivity of nanoDot optically stimulated luminescent dosimeters in different radiation geometries.

Purpose: A type of in vivo dosimeter, an optically stimulated luminescent dosimeter, OSLD, may have dose sensitivity that depends on the angle of incidence of radiation. This work measures how angular dependence of a nanoDot changes with the geometry of the phantom in which irradiation occurs and with the intrinsic structure of the nanoDot.

Methods: The OSLDs used in this work were nanoDot dosimeters (Landauer, Inc.

Kytococcus schroeteri Bacteremia in a Patient with Hairy Cell Leukemia: A Case Report and Review of the Literature.

The Kytococcus genus formerly belonged to Micrococcus. The first report of a Kytococcus schroeteri infection was in 2002 in a patient diagnosed with endocarditis. We report a case of central line associated Kytococcus schroeteri bacteremia in a patient with underlying Hairy Cell Leukemia.

Quality assurance measurements for high-dose-rate brachytherapy without film.

The purpose of this study was to develop new and modified tools that allow HDR brachytherapy quality assurance tests to be carried out efficiently without film, video cameras, stopwatches, and mechanical rulers; and to devise methods that use these new tools for daily and quarterly check procedures, which are efficient and provide increased accuracy compared to previous methods. The HDR brachytherapy system tested was the GammaMedplus iX, Ir-192 HDR. Various catheters and treatment applicators designed for this system were tested.

In vivo measurements for high dose rate brachytherapy with optically stimulated luminescent dosimeters.

Purpose: To show the feasibility of clinical implementation of OSLDs for high dose-rate (HDR) in vivo dosimetry for gynecological and breast patients. To discuss how the OSLDs were characterized for an Ir-192 source, taking into account low gamma energy and high dose gradients. To describe differences caused by the dose calculation formalism of treatment planning systems.

Dependence of diode sensitivity on the pulse rate of delivered radiation.

Purpose: It has been reported that diode sensitivity decreases by as much as 2% when the average dose rate set at the accelerator console was decreased from 600 to 40 MU∕min. No explanation was given for this effect in earlier publications. This work is a detailed investigation of this phenomenon: the change of diode sensitivity versus the rate of delivery of dose pulses in the milliseconds and seconds range.

Development by a Large Integrated Health Care System of an Objective Methodology for Evaluation of Medical Oncology Service Sites.

Purpose: Aurora Health Care (AHC) is the largest health care system in Wisconsin, with 14 acute care hospitals. In early 2010, a group of 18 medical oncologists became affiliated with AHC. This affiliation added 13 medical oncology infusion clinics to our existing 12 sites.

In vivo dosimetry with optically stimulated luminescent dosimeters, OSLDs, compared to diodes; the effects of buildup cap thickness and fabrication material.

Purpose: For external beam in vivo measurements, the dosimeter is normally placed on the patient's skin, and the dose to a point of interest inside the patient is derived from surface measurements. In order to obtain accurate and reliable measurements, which correlate with the dose values predicted by a treatment planning system, a dosimeter needs to be at a point of electronic equilibrium. This equilibrium is accomplished by adding material (buildup) above the detector.

An unusual case of autoimmune pancreatitis presenting as pancreatic mass and obstructive jaundice: a case report and review of the literature.

Background: Autoimmune pancreatitis is a rare chronic inflammatory pancreatic disease that is increasingly being diagnosed worldwide. As a result of overlap in clinical and radiological features, it is often misdiagnosed as pancreatic cancer. We report the case of a patient with autoimmune pancreatitis that was initially misdiagnosed as pancreatic cancer.

Acquired factor VIII inhibitor (acquired hemophilia A) presenting as spontaneous blood-filled scrotum.

Acquired hemophilia A, also known as acquired factor VIII deficiency, is an exceedingly rare bleeding diathesis that does not require any personal or family history of bleeding or clotting disorder. Because treatment is available, misdiagnosing or completely missing this diagnosis can be life threatening for patients. Clinicians should be aware that acquired forms of hemophilia do exist and are associated with high morbidity and mortality in elderly adults.

MapCHECK used for rotational IMRT measurements: step-and-shoot, TomoTherapy, RapidArc.

Purpose: To measure patient-specific-QA dose distributions with a 2D array of diodes, the MapCHECK, for the dose delivered, with step-and-shoot and rotational IMRT.

Methods: Two MapCHECKs were used that had different styles of diode connection. These MapCHECKs were used in their original manufactured configuration and in a modified configuration.

Changes in optically stimulated luminescent dosimeter (OSLD) dosimetric characteristics with accumulated dose.

Purpose: A new type of in vivo dosimeter, an optically stimulated luminescent dosimeter (OSLD), has now become commercially available for clinical use. The OSLD is a plastic disk infused with aluminum oxide doped with carbon (Al2O3:C). Crystals of Al2O3:C, when exposed to ionizing radiation, store energy that is released as luminescence (420 nm) when the OSLD is illuminated with stimulation light (540 nm).

Angular dependence of dose sensitivity of surface diodes.

Commercially available surface diodes are found to have as great as +/-12% change in sensitivity with the angle of incidence of radiation. This work is a study of the cause of angular dependence in diode sensitivity and how it can be decreased. A number of different surface diodes were used in these measurements: A commercially available diode and four prototype diodes.

Characterization of optically stimulated luminescent dosimeters, OSLDs, for clinical dosimetric measurements.

Optically stimulated luminescent dosimeters, OSLDs, are plastic disks infused with aluminum oxide doped with carbon (Al2O3 : C). These disks are encased in a light-tight plastic holder. Crystals of Al2O3 : C when exposed to ionizing radiation store energy that is released as luminescence (420 nm) when the OSLD is illuminated with stimulation light (540 nm).

Measurement of head scatter factors of linear accelerators with columnar miniphantoms.

The measurement of linear accelerator head scatter factors or in-air output factors, Sc, with columnar miniphantoms is refined in this work. Columnar miniphantoms are constructed from water equivalent materials: solid water and M3, and materials with higher mass density and atomic number: copper and lead. The change in the value of Sc from a 4-cm X 4-cm to a 40-cm X 40-cm field is different by 22% +/- 3%, 18% +/- 2%, and 10% +/- 3% for 6, 15, and 23 MV x rays, respectively, when measured with water equivalent or lead miniphantoms of 10 gm/cm2 depth.

Protocols for managing chemotherapy-induced neutropenia in clinical oncology practices.

Chemotherapy-induced neutropenia is managed in different ways in clinical practice. Chemotherapy dose reductions and delays are used more often than proactive, first-cycle use of colony-stimulating factors, but such dose modifications can result in suboptimal treatment outcomes. This article reviews how 3 oncology practices have used practice pattern studies to assess and improve their quality of care, particularly in the management of neutropenia.

Immune hemolytic anemia caused by sensitivity to a metabolite of etodolac, a nonsteroidal anti-inflammatory drug.

Background: Immune hemolytic anemia can be caused by sensitivity to many different drugs. In some instances, the sensitizing compound can be identified by in vitro testing, but results are often negative. One reason for this is that a drug metabolite formed in vivo can be the sensitizing agent, but the responsible metabolites have rarely been identified at a chemical level.

The advanced practice nurse: meeting the information needs of the rural cancer patient.

Background: The goal of the Rural Cancer Care Project is to assist patients and families residing in rural areas to receive the highest-quality cancer care in their own communities.

Methods: An advanced practice nursing clinic, serving as an adjunct service to specialty cancer care, is the core of the intervention model demonstrated by the "Rural Partnership Linkage for Cancer Care", a National Cancer Institute grant awarded to Michigan State University in 1990. The nursing intervention is directed to meeting patient and family needs.