Commissioning of MRI-guided gynaecological brachytherapy using an MR-linac.

Purpose. To evaluate the feasibility of use of an 1.5 T magnetic resonance (MR)-linear accelerator MR-linac for imaging in gynaecologic high-dose-rate (HDR) brachytherapy.Method. Commissioning measurements for MR images quality control, geometric distortion, dwell position accuracy, applicator reconstruction and end-to-end test for a tandem-and-ring applicator were performed following the recommendations of American Brachytherapy Society, International Commission on Radiation Units and Measurements and Report of the Brachytherapy Working Group of the Spanish Society of Medical Physics. The values for MR-based IGABT were compared to the corresponding values with computed tomography (CT).Results. Measured distorsions for the MR images were less than 0.50 mm compared to the CT images. The differences between 3D displacements for all dwell positions were 0.66 mm and 0.62 mm for the tandem and ring, respectively. The maximum difference is 0.64 mm for the distances from the applicator tip obtained using the films. The CT and MR dose differences for the right and left 'A' points were 0.9% and -0.7%, respectively. Similar results were observed in terms of dose distribution for CT and Mr The gamma passing rate was 99.3% and 99.5%, respectively.Conclusion. The use of MR images from an MR-linac used in a radiotherapy service for gynaecological brachytherapy was proved to be feasible, safe and precise as the geometrical differences were less than 1 mm, and the dosimetric differences were less than 1% when comparing to the use of CT images for the same purpose.

Ion-Imprinted Polymer Structurally Preorganized Using a Phenanthroline-Divinylbenzoate Complex with the Cu(II) Ion as Template and Some Adsorption Results.

The novel [Cuphen(VBA)2H2O] complex (phen: phenanthroline, VBA: vinylbenzoate) was prepared and used as a functional monomer to preorganize a new ion-imprinted polymer (IIP). By leaching the Cu(II) from the molecular imprinted polymer (MIP), [Cuphen(VBA)2H2O-co-EGDMA]n (EGDMA: ethylene glycol dimethacrylate), the IIP was obtained. A non-ion-imprinted polymer (NIIP) was also prepared. The crystal structure of the complex and some physicochemical, spectrophotometric techniques were also used for the MIP, IIP, and NIIP characterization. The results showed that the materials are nonsoluble in water and polar solvents, which are the main features of polymers. The surface area of the IIP is higher than the NIIP demonstrated by the blue methylene method. The SEM images show monoliths and particles smoothly packed together on spherical and prismatic-spherical surfaces in the morphology of MIP and IIP, respectively. Moreover, the MIP and IIP could be considered as mesoporous and microporous materials, shown by the size of the pores determined by the BET and BJH methods. Furthermore, the adsorption performance of the IIP was studied using copper(II) as a contaminant heavy metal. The maximum adsorption capacity of IIP was 287.45 mg/g at 1600 mg/L Cu2+ ions with 0.1 g of IIP at room temperature. The Freundlich model was found to best describe the equilibrium isotherm of the adsorption process. The competitive results indicate that the stability of the Cu-IIP complex is higher than the Ni-IIP complex with a selectivity coefficient of 1.61.

Alcohol, drugs, and road traffic injuries in an emergency department in Mexico City.

There have been no studies reporting on the use of biological specimens in Mexico to analyze the prevalence of alcohol and drug use among Emergency Department (ED) patients with a road traffic injury (RTI). We report here on a sample of 304 adult patients, admitted to the ED of a public hospital in Mexico City from January to April 2022, after being involved in an RTI. Patients gave informed consent for a breath test measuring breath alcohol concentration (BAC) and a saliva screening test for six classes of drugs (amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, and methamphetamine). We found that at least one in every four patients (27.6%) had traces of alcohol or drugs in their body upon arrival in the ED. The breath test found a positive BAC in 16.1% of the sample; the most common substances detected in saliva were amphetamines or methamphetamine (8.6%), followed by cocaine (7.0%) and cannabis (6.9%). Only a few variables differentiated those with positive BAC from those with negative BAC (male, arriving on a weekend day or night, and arriving by ambulance), and even fewer variables differentiated those testing positives for drugs than those testing negative (less than 13 years of education and drivers of cars, bicycles, or other vehicles). While alcohol continues to be the single most used substance, our findings indicate that stimulants are of great concern. Since those testing positives for alcohol or drugs are so similar in their demographic pattern to those testing negative, the introduction of biological testing as a routine practice in the ED is highly recommended. Routine testing makes it possible to provide the patient with the best treatment and is also the best way to assess substance use.

Atención domiciliaria a adultos mayores crónicos: acercando la atención a los más necesitados / Home nursing for chronic aging patients: approaching care for the most needed

Este proyecto surge al observar la necesidad de ortorgar una atención a adultos mayores crónicos. Ellos, por deterioro en el estado de su salud, comprometen su autonomía y funcionalidad física y les imposibilita asistir a los controles médicos correspondientes. El estudio se realizó en el Consultorio Eduardo de Geyter de Rancagua. Se optó por este Centro de Atención Primaria porque es aquí donde se encuentra el m s alto número de población Adulto Mayor de la comuna. De tipo Experimental-Descriptivo, longitudinal, prospectivo, este an lisis combina los métodos cuantitativos y cualitativos. Consta de dos etapas: en la primera, se indentificó a los usuarios y las razones de su ausencia a los controles. Se consideró el total de los inasistentes al momento del censo de Julio de 1999. Se trataba de 102 pacientes. De ellos, un 10 porciento presentaba un deterioro físico-cognitivo importante; un 20 porciento de ellos postrados (los que ingresaron al programa). A partir de ahí, se inicia la segunda fase. Allí se realizaron visitas periódicas para controlar y evaluar su patología crónica. Adem s se desarrolló un proceso de educación al paciente y su familia; este proceso buscaba prevenir complicaciones y fortalecer el autocuidado para mantenerlos compensados en su patología. Por último, se pretendía alcanzar una mejor calidad de vida. La totalidad de los ancianos intervenidos se sintieron tomados en cuenta, volvieron a sentirse seguros. Por su parte, la familia expresa sentirse respaldada y contar con el apoyo de los profesionales para lograr una atención integral para su ser querido. Este entorno fortaleció el vínculo paciente-familia-enfermera