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Purpose: The goal of this study is to evaluate the dosimetric impact on a pretreatment planning of prostatic volume and shape variations occurring between the moment of the volume study (preplanning) and just before a transperineal permanent seed implant procedure. Such variations could be an obvious source of misplacement of the seeds relative to the prostate gland and organs at risk. Other sources of dosimetric uncertainties, such as misplacement due to the procedure itself or edema, are eliminated by looking at these variations before the implant procedure., Methods and Materials: For 35 clinical cases, prostate contours were taken at preplanning time as well as in the operating room (OR) minutes before the procedure. Comparison of shape and volume between the two sets was made. The impact on V100 was evaluated by placing the seeds in their planned positions in the new volume (clinical situation) and also by performing a new plan with the second set of contours to simulate an intraoperative approach., Results: The volume taken in the OR remained unchanged compared to the pretreatment planning volume in only 37% of the cases. While on average the dose coverage loss from pretreatment planning due to a combination of variations of volume and shape was small at 5.7%, a V100 degradation of up to 20.9% was observed in extreme cases. Even in cases in which no changes in volume were observed, changes in shape occurred and strongly affected implant dosimetry., Conclusions: Variations of volume and shape between pretreatment planning and the implant procedure can have a strong impact on the dosimetry if the planning and the implant procedure are not performed on the same day. This is an argument in favor of performing implant dosimetry in the OR.

Background: Computer-based teaching may allow effective teaching of important psychiatric knowledge and skills., Aims: To investigate the effectiveness and acceptability of computer-based teaching., Method: A single-blind, randomized, controlled study of 166 undergraduate medical students at the University of Leeds, involving an educational intervention of either a structured lecture or a computer-based teaching package (both of equal duration)., Results: There was no difference in knowledge between the groups at baseline or immediately after teaching. Both groups made significant gains in knowledge after teaching. Students who attended the lecture rated their subjective knowledge and skills at a statistically significantly higher level than students who had used the computers. Students who had used the computer package scored higher on an objective measure of assessment skills. Students did not perceive the computer package to be as useful as the traditional lecture format, despite finding it easy to use and recommending its use to other students., Conclusions: Medical students rate themselves subjectively as learning less from computer-based as compared with lecture-based teaching. Objective measures suggest equivalence in knowledge acquisition and significantly greater skills acquisition for computer-based teaching.

Benzo[b]fluoranthene (B[b]F) was used in relative abundance ratios (RARs), a parameter obtained by dividing the concentration of individual polycyclic aromatic hydrocarbons (PAHs) found in a given sample by the concentration of B[b]F in the same sample. The B[b]F RARs were derived for PAH concentrations measured at stacks and sampling stations in the vicinity of two Söderberg aluminum horizontal stud smelters (HSSs). The samples collected were analyzed by high-performance liquid chromatography using UV and fluorescence detection. A total of 15 PAHs were analyzed, but, due to the inefficiency of the sampling method used in collecting gaseous PAHs, only particulate PAHs were considered. Comparisons between the B[b]F RARs obtained simultaneously at the source (stack) and those obtained at sampling stations at the two smelters showed that B[b]F degrades more slowly than or at the same rate as most other particulate PAHs monitored. Twenty-three months of urban sampling in the vicinity of one of the aluminum HSSs are also presented, and the results indicate that B[b]F is more stable than all other particulate PAHs investigated. Sampling conducted during a smelter shutdown period confirmed that B[b]F was a much better marker of this source than was benzo[a]pyrene (B[a]P), the usual indicator. The remarkable stability of the benzo[k]fluoranthene (B[k]F)/B[b]F ratio is also discussed.

We report a case of acute intoxication due to a massive overdose of isotretinoin. A 29-year-old male patient ingested 900 mg of isotretinoin corresponding to 12.5 mg (kg/day) or 30 times the prescribed dosage and 1 day later the patient experienced mild headache. Forty-eight hours later, cheilitis, diffuse cutaneous xerosis and desquamation of the forehead and of the external auditory meatus occurred; cutaneous xerosis and cheilitis resolved spontaneously, We determined the serum level of isotretinoin and of 4-oxo-isotretinoin, its natural metabolite in sera taken 4, 5, 6 and 11 days following ingestion. The side-effects were mild and represented only exacerbations of some common isotretinoin side-effects. To date, three other cases of isotretinoin overdosage have been reported. There was a low toxicity of isotretinoin overdose.

In this article, the author proposes a behavioral evaluation model. The model takes into consideration both the resources and the limits of the person. This approach is employed with elderly persons who are considered to be <>. Their integration in reception centers poses many problems for helpers in those settings. In this project attention was paid to, among other subjects, attitudes toward the <> elderly person, the physical and human environment, and the training of personnel. The initial results show that it is possible to better integrate these persons and to improve their behavioral ability.