Search

Virtual mono-energetic images (VMI) using dual-layer computed tomography (DLCT) enable substantial contrast medium (CM) reductions. However, the combined impact of patient size, tube voltage, and heart rate (HR) on VMI of coronary CT angiography (CCTA) remains unknown. This phantom study aimed to assess VMI levels achieving comparable contrast-to-noise ratio (CNR) in CCTA at 50% CM dose across varying tube voltages, patient sizes, and HR, compared to the reference protocol (100% CM dose, conventional at 120 kVp). A 5 mm artificial coronary artery with 100% (400 HU) and 50% (200 HU) iodine CM-dose was positioned centrally in an anthropomorphic thorax phantom. Horizontal coronary movement was matched to HR (at 0, < 60, 60–75, > 75 bpm), with varying patient sizes simulated using phantom extension rings. Raw data was acquired using a clinical CCTA protocol at 120 and 140 kVp (five repetitions). VMI images (40–70 keV, 5 keV steps) were then reconstructed; non-overlapping 95% CNR confidence intervals indicated significant differences from the reference. Higher CM-dose, reduced VMI, slower HR, higher tube voltage, and smaller patient sizes demonstrated a trend of higher CNR. Regardless of HR, patient size, and tube voltage, no significant CNR differences were found compared to the reference, with 100% CM dose at 60 keV, or 50% CM dose at 40 keV. DLCT reconstructions at 40 keV from 120 to 140 kVp acquisitions facilitate 50% CM dose reduction for various patient sizes and HR with equivalent CNR to conventional CCTA at 100% CM dose, although clinical validation is needed. [ABSTRACT FROM AUTHOR]

The article informs that the Initial experiences with hippocampus-sparing whole-brain radiotherapy for lung cancer patients. Topics discussed include chemo-radiotherapy, depending on the histology, disease stage, and patient performance status and comorbidities; determine if the metastases were situated in or near the hippocampal sparring low-dose volume; and patients were retreated with intracranial stereotactic radiotherapy.

Objective: To explore physical health problems and their causes in patients with severe mental illness, as well as possibilities for prevention and treatment from the patients' and staff's perspectives. Method: We conducted six focus groups with patients and staff separately, from three out-patient clinics treating patients with schizophrenia or substance-use disorder comorbid to another psychiatric disorder. Focus groups were audio-recorded, transcribed verbatim and analysed using a template approach. Results: Paramount physical health problems are weight issues, cardiovascular diseases and poor physical shape. Main causes are lifestyle, the mental disorder and organisational issues. Patients and staff expressed similar opinions regarding physical health problems and their causes. Possibilities for prevention and treatment includes a case manager and binding communities with like-minded, as well as management support and implementation of physical health into daily psychiatric practice. Although patients and staff suggested different possibilities for prevention and treatment, they support one strategy: less fragmentation of the treatment system and cooperation between psychiatric and somatic healthcare. Conclusion: To prevent and treat physical health problems in patients with severe mental illness, support in daily structure and lifestyle changes is needed. Management support is needed to change daily practice and implement routines regarding physical health. [ABSTRACT FROM AUTHOR]

Objective: The time span between knowledge becoming available and its integration into daily clinical routine is lengthy. This phenomenon is explored in this study. Method: We used the outcomes of our activities for investigating and strengthening the research-based activities to improve physical health in the routines of clinical psychiatric wards as examples for our analyses. Results: The time span between new knowledge becoming available and its implementation into general clinical treatment is very long. However, a shortening of this time span is seen through active leadership backup and clinical research experience among psychiatrists and staff in the wards. In particular, the involvement of medical students interested in clinical research activities seems to have a positive impact. Conclusion: Academia needs to be re-implemented into clinical psychiatry. Staff with research experience is needed in all professions to increase evidence-based practice. Leaders must take responsibility for implementing new knowledge into the routines of the department and must support staff in these activities on a daily basis. [ABSTRACT FROM AUTHOR]

Aims The Associazione Medici Diabetologi-annals initiative is a physician-led quality-of-care improvement scheme that has been shown to improve HbA1c concentration, blood pressure, lipid profiles and BMI in enrolled people with Type 2 diabetes. The present analysis investigated the long-term cost-effectiveness of enrolling people with Type 2 diabetes in the Associazione Medici Diabetologi-annals initiative compared with conventional management. Methods Long-term projections of clinical outcomes and direct costs (in 2010 Euros) were made using a published and validated model of Type 2 diabetes in people with Type 2 diabetes who were either enrolled in the Associazione Medici Diabetologi-annals initiative or who were receiving conventional management. Treatment effects were based on mean changes from baseline seen at 5 years after enrolment in the scheme. Costs and clinical outcomes were discounted at 3% per annum. Results The Associazione Medici Diabetologi-annals initiative was associated with improvements in mean discounted life expectancy and quality-adjusted life expectancy of 0.55 years (95% CI 0.54-0.57) years and 0.48 quality-adjusted life years (95% CI 0.46-0.49), respectively, compared with conventional management. Whilst treatment costs were higher in the Associazione Medici Diabetologi-annals arm, this was offset by savings as a result of the reduced incidence and treatment of diabetes-related complications. The Associazione Medici Diabetologi-annals initiative was found to be cost-saving over patient lifetimes compared with conventional management [€ 37,289 (95% CI 37,205-37,372) vs € 41,075 (95% CI 40,956-41,155)]. Conclusions Long-term projections indicate that the physician-led Associazione Medici Diabetologi-annals initiative represents a cost-saving method of improving long-term clinical outcomes compared with conventional management of people with Type 2 diabetes in Italy. [ABSTRACT FROM AUTHOR]

The article presents a study concerning the secular trends in examining the physical health of patients with mental illness. Information about the application of Medical Subject Headings (MESH) terms in research of schizophrenia and cardiovascular diseases, is provided. Also emphasized is conducted log-transformed and linear regression in the comparison of coefficients.

The problem with the stability of a smectic A liquid crystal (LC) mixture in a display based on the electrically reversible memory effect is discussed. The degradation of the LC mixture is initiated by the electric field and consists of electrochemical decomposition of one of the mixture components accompanied by gas bubbles arising on the electrodes of the display. The electrochemical degradation was successfully prevented by the introduction of different passivation layers and by the modification of problematic LC mixture component. The obtained results are used for improving the lifetime of a display based on the electrically reversible memory effect. [ABSTRACT FROM AUTHOR]

The author discusses the development of training for student writers in research and scientific writing, organized by the Psychiatric Research Academy, a group of medical students with dedication to psychiatric research, in Aarhus University Hospital. Topics include the mentoring of clinical professor Povl Munk-Jørgensen, contributions of medical students in administering the training, the leadership workshop of professor Norman Sartorius, in mental health programs.

The article discusses a research on the reputation of psychiatry. It highlights the high rate of stigma and negative attitudes toward psychiatrists, psychiatric patients, and psychiatry in a medical sector. It states the increased number of initiatives within the psychiatric field. Also emphasized is the role of trained psychiatrists and local authorities in the teaching medical students.