Importance of dose settings in the x-ray systems used for interventional radiology: a national survey.

The purpose of this work was to investigate the differences in dose settings among the X-ray units involved in a national survey of patient doses in interventional radiology (IR). The survey was promoted by the National Society of IR and involved 10 centers. As part of the agreed quality control for the survey, entrance doses were measured in a 20-cm-thick acrylic phantom simulating a medium-sized patient. A standard digital subtraction angiography (DSA) imaging protocol for the abdomen was used at the different centers. The center of the phantom was placed at the isocenter of the C-arm system during the measurements to simulate clinical conditions. Units with image intensifiers and flat detectors were involved in the survey. Entrance doses for low, medium, and high fluoroscopy modes and DSA acquisitions were measured for a field of view of 20 cm (or closest). A widespread range of entrance dose values was obtained: 4.5-18.6, 9.2-28.4, and 15.4-51.5 mGy/min in low, medium, and high fluoroscopy mode, respectively, and 0.7-5.0 mGy/DSA image. The ratios between the maximum and the minimum values measured (3-4 for fluoroscopy and 7 for DSA) suggest an important margin for optimization. The calibration factor for the dose-area product meter was also included in the survey and resulted in a mean value of 0.73, with a standard deviation of 0.07. It seems clear that the dose setting for the X-ray systems used in IR requires better criteria and approaches.

Intellectual capacity measurement in schizophrenia.

INTRODUCTION: The measurement of the intellectual capacity (IC) in schizophrenic patients has been found to be of clinical relevance. A user-friendly tool such as the Cattell's intelligence test might facilitate this measurement in daily clinical practice. METHOD: In this study, we measured the intelligence quotient (IQ) using Cattell's test in 35 schizophrenic patients before and after treatment with risperidone. RESULTS: At baseline, the sample showed an average intelligence of 78.3 points (standard deviation [SD]: 14.3), in the low-medium range. After 1 year on risperidone, the IQ significantly improved (mean: 84.8; SD: 17.0; p = 0.028). This IQ elevation was positively correlated with the improvement in the psychotic symptoms rated with the PANSS. CONCLUSIONS: Cattell's intelligence test could be a valid instrument to measure cognitive performance in schizophrenic patients. Antipsychotic therapy with risperidone could be effective to improve cognitive functioning in these subjects.

A pilot experience launching a national dose protocol for vascular and interventional radiology.

The design of a national dose protocol for interventional radiology has been one of the tasks during the European SENTINEL Coordination Action. The present paper describes the pilot experience carried out in cooperation with the Spanish Society on Vascular and Interventional Radiology (SERVEI). A prospective sample of procedures was initially agreed. A common quality control of the X-ray systems was carried out, including calibration of the air kerma area product (KAP) meters. Occupational doses of the radiologists involved in the survey were also included in the survey. A total of 10 Spanish hospitals with interventional X-ray units were involved. Six hundred and sixty-four patient dose data were collected from 397 diagnostic and 267 therapeutic procedures. Occupational doses were evaluated in a sample of 635 values. The obtained KAP median/mean values (Gy.cm2) for the gathered procedures were: biliary drainage (30.6/68.9), fistulography (4.5/9.8), lower limb arteriography (52.2/60.7), hepatic chemoembolisation (175.8/218.3), iliac stent (45.9/73.2) and renal arteriography (39.1/59.8). Occupational doses (mean monthly values, in mSv) were 1.9 (over apron); 0.3 (under apron) and 4.5 (on hands). With this National experience, a protocol was agreed among the SENTINEL partners to conduct future similar surveys in other European countries.

Medición de la capacidad intelectual en pacientes esquizofrénicos / Intellectual capacity measurement in schizophrenia

Introducción. La medición del conciente intelectual (CI) del paciente esquizofrénico resulta relevante para la intervención clínica con estos enfermos. Poder disponer de un instrumento de manejo sencillo como el test de inteligencia de Cattell permitiría realizar esta medición en la práctica clínica habitual. Método. En este estudio se presentan los hallazgos de la medición del nivel de CI en un grupo de 35 pacientes esquizofrénicos utilizando el test de Cattell antes y después del tratamiento con risperidona. Resultados. Al inicio del estudio se observó una inteligencia media de 78,3 puntos (desviación estándar [DE]: 14,3), que puede considerarse en el rango medio-bajo. Tras 1 año de tratamiento con risperidona se produjo una mejoría estadísticamente significativa del CI (media: 84,8; DE: 170; p=0,028). Esta elevación en el CI se correlacionó positivamente con la mejoría de la sintomatología psicótica medida mediante la PANSS. Conclusiones. El test de inteligencia de Cattell podría ser un instrumento válido para medir el rendimiento cognitivo de los pacientes esquizofrénicos. El tratamiento antipsicótico con risperidona podría ser efectivo para mejorar la función cognitiva en estos enfermos (AU)

Introduction. The measurement of the intellectual capacity (IC) in schizophrenic patients has been found to be of clinical relevance. A user-friendly tool such as the Cattell's intelligence test might facilitate this measurement in daily clinical practice. Method. In this study, we measured the intelligence quotient (IQ) using Cattell's test in 35 schizophrenic patients before and after treatment with risperidone. Results. At baseline, the sample showed an average intelligence of 78.3 points (standard desviation [SD]:14.3), in the low-medium range. After 1 year on risperidone, the IQ significantly improved (mean: 84.8; SD:17.0; p = 0.028). This IQ elevation was positively correlated with the improvement in the psychotic symptoms rated with the PANSS. Conclusions. Cattell's intelligence test could be a valid instrument to measure cognitive performance in schizophrenic patients. Antipsychotic therapy with risperidone could be effective to improve cognitive functioningin these subjects (AU)

Estudio de la prescripción analgésica en el servicio quirúrgico de ginecología / Study of analgesic prescriptions in the gynecological surgery department

El objetivo del presente trabajo fue evaluar la prescripción analgésica en el servicio quirúrgico de ginecología como paso previo a la elaboración de protocolos orientados a mejorar su prescripción. Para ello se realizó un estudio prospectivo durante sesenta días, seleccionándose a partir del sistema de distribución de medicamentos en dosis unitarias los pacientes que iniciaban tratamiento analgésico. De los tratamientos analgésicos se registraron el fármaco prescrito, dosis pautada, asociación analgésica, vía de administración e intervalo posológico utilizado. Se analizaron 3.600 prescripciones médicas de las que un 39.22 por ciento fueron tratamientos analgésicos. Los resultados más sobresalientes fueron la alta utilización de metamizol magnésico, la infradosificación de la mayoría de los analgésicos analizados, la gran prescripción de tratamientos a demanda, así como un importante porcentaje de combinaciones analgésicas incorrectas. Por todo ello parece necesario la implantación de protocolos analgésicos en el servicio a estudio (AU)

[Alternatives to solid pharmacutical forms usually given by enteral nutrition tubes]. / Alternativas a las formas farmacéuticas sólidas administradas habitualmente por sondas de nutrición enteral.

We analyze which drugs of those administered through an enteral nutrition tube, present problems which are inherent to the pharmaceutical forms. The study is conducted with a sample of 40 patients who have a feeding tube, who received a total of 48 different medications. 38 (78.3%) were in a solid pharmaceutical form, and 10 (21.7%) were liquid. Among the most used medications, ranitidine stands out in 12 patients, paracetamol in 8, and phenytoin in 7. We note the use of the solid forms of phenytoin, nifedipine, and controlled release morphine, as having the greatest interest due to their contraindication. For all the studied cases, we propose alternatives and we note those drugs for which we did not find any. The hospitalary pharmaceutical guides should include liquid pharmaceutical forms of those drugs which should not be ground up. There is little information on the wards about the administration of drugs through feeding tubes.