Systematic review of interventions for the prevention and treatment of postoperative urinary retention.

Background: Postoperative urinary retention (PO-UR) is an acute and painful inability to void after surgery that can lead to complications and delayed hospital discharge. Standard treatment with a urinary catheter is associated with a risk of infection and can be distressing, undignified and uncomfortable. This systematic review aimed to identify effective interventions for the prevention and treatment of PO-UR that might be alternatives to urinary catheterization. Methods: Electronic databases were searched from inception to September 2017. Randomized trials of interventions for the prevention or treatment of PO-UR were eligible for inclusion. Studies were assessed for risk of bias using the Cochrane (2.0) tool. Two reviewers were involved at all review stages. Where possible, data were pooled using random-effects meta-analysis. The overall quality of the body of evidence was rated using the GRADE approach. Results: Some 48 studies involving 5644 participants were included. Most interventions were pharmacological strategies to prevent PO-UR. Based on GRADE, there was high-certainty evidence to support replacing morphine in a regional anaesthetic regimen, using alpha-blockers (number needed to treat to prevent one case of PO-UR (NNT) 5, 95 per cent c.i. 5 to 7), the antispasmodic drug drotaverine (NNT 9, 7 to 30) and early postoperative mobilization (NNT 5, 4 to 8) for prevention, and employing hot packs or gauze soaked in warm water for treatment (NNT 2, 2 to 4). Very few studies reported on secondary outcomes of pain, incidence of urinary tract infection or duration of hospital stay. Conclusion: Promising interventions exist for PO-UR, but they need to be evaluated in randomized trials investigating comparative clinical and cost effectiveness, and acceptability to patients.

An integrating thermoluminescent Rn daughter personal dosimeter.

An integrating Rn daughter dosimeter using conventional Dy-doped CaSO4 thermoluminescent (TL) material has been developed for use as a personal monitor. The dosimeter was found to have a linear response over the range 0.5 WL-h to 25 WL-h and to be insensitive to the state of equilibrium of the Rn daughters. The use of the dosimeter to monitor both 222Rn and 220Rn daughters is described. The limiting sensitivity of the dosimeter, at a sampling rate of 1 L min-1, was determined to be 0.1 WL-h for 222Rn daughters and 0.5 WL-h for 220Rn daughters. The application of the thermoluminescent dosimeter (TLD) to occupational monitoring of 222Rn and 220Rn daughters is discussed.

A study of radiation parameters in an open-pit mine.

Radiation parameters associated with the open pit mining of a small (10,000 tonnes), but high grade (2%) uranium deposit at Nabarlek, N.T., have been investigated in detail. External radiation levels, radon emanation rates and radon daughter levels were measured systematically during the development of the mine, and are correlated with ore grade, properties of the host rock and atmospheric conditions. Significant radon daughter concentrations were observed only under stable atmospheric conditions, usually during the might and were invariably associated with thermal inversions. The mean cumulative exposure to radon daughters was estimated from the measured levels to be 0.065 Working Level Months for employees working in the pit for the entire four and a half months of mining. The mean cumulative external gamma ray exposure for the same employee group was measured using thermoluminescent dosimeters to be 2.3 mSv (230 mrem). For most other employees, however, exposures were much lower. Data on long lived radionuclides in dust and on particle size distribution are also presented.