Eye lens radiation exposure in paediatric interventional treatment of retinoblastoma.

Retinoblastoma represents 3% of cancers in children under fifteen years of age. The standard paediatric treatment for saving the affected eye is supraselective intra-arterial chemotherapy performed in interventional rooms. In order to address the radiation toxicity due to the angiography, the aim of this study was to determine the typical dose value corresponding to the procedure, estimate the paediatric patients' eye lens dose and study the relationship between dose indicators and dose to the lens. An automatic dose management software was installed in two interventional rooms to obtain the distribution of the dose indicators kerma-area product and reference-point air kerma, getting a typical value 16 Gy·cm2 and 130 mGy, respectively (n = 35). The eye lens dose estimates were obtained with photoluminescent dosimeters placed on the patient's eyelids. In the left eye, the entrance surface air kerma was 44.23 ± 2.66 mGy, and 12.72 ± 0.89 mGy in the right eye (n = 10). There was a positive correlation between dose to the lens per procedure and dose indicators, with R2 > 0.65 for both eyes. Based on this information, the threshold for the onset of radiation-induce cataracts (500 mGy) will be exceeded if the treatment is performed for more than 8 sessions.

La automonitorización glucémica en los pacientes con diabetes tipo 2 no tratados con insulina, ¿es una técnica apropiada para todos los pacientes? / Capillary blood glucose monitoring in non-insulin treated patients with type 2 diabetes. Is that technique appropriate for all patients?

No hay un criterio unánime en la literatura médica acerca del beneficioque aporta el autoanálisis glucémico en el control metabólico(valorado por la HbA1c) en los pacientes diabéticos no tratados coninsulina. Nuestra experiencia en el seguimiento de un grupo pequeñode pacientes que, tras sufrir un episodio coronario, se incorporana un programa educativo parece que se decanta a favor del autoanálisis,observándose una mejoría más importante en la HbA1c deaquellos pacientes que lo realizan. Sin embargo, entre los profesionalessí existe unanimidad respecto a la necesidad de sistematizarmétodos de enseñanza adaptados a programas concretos que demuestrenempíricamente su eficacia.Los programas de educación terapéutica en diabetes incorporan el autoanálisisglucémico como una herramienta de apoyo para el aprendizaje,pues permite a las personas comprender, asumir y, sobre todo,experimentar la relación directa entre sus hábitos de vida y sus glucemias.De esta manera, desarrollan habilidades y estrategias que les permitenel autocontrol del tratamiento, tanto en alimentación como en larealización de ejercicio físico, o en los cambios en la medicación oral

There is no unanimous consensus in medical literature regarding the benefits of glucose self-monitoring in the metabolic control (evaluatedaccording to the HbA1c) in patients with non-insulin treated diabetes.Our experience in the follow-up of a small group of patients that, aftersuffering a coronary episode, joined an educational programme wouldappear to support the process of self-monitoring, fi nding a more significant improvement in the HbA1c of those patients who followed theprogramme. Nevertheless, there is unanimous consensus among professionalsregarding the need to systematise teaching methods adaptedto specifi c programmes that empirically prove its effectiveness.The therapeutic education programmes on diabetes include glucoseself-monitoring as a support tool for patient education, since it helpspeople to understand, to come to terms with and, above all, to experience,the direct relationship between their lifestyle habits and theirblood sugar levels. Like that, they develop skills and strategies thatmake it possible for them to self-monitor the treatment, both in termsof diet as well as physical exercise, or in terms of changes in the oral medication (AU)