Search

In Africa, the incidence of cancer is increasing rapidly and efforts to establish minimum services for the prevention and treatment of the disease still meet with enormous difficulties. The basic components of cancer control are especially inadequate in sub-Saharan Africa, where survival remains lower than in all other low-income countries. The main challenges stem from the scarcity or absence of cancer control programmes, qualified staff, diagnostic and treatment capacity, cancer care funding, and political commitment. Policies devised to overcome these problems include capacity building in health planning, provision of technical and fi nancial support to create sustainable national cancer control programmes, promotion of horizontal integration of cancer control programmes with other health services, establishment of regional referral centres, creation of telemedicine infrastructures, support of drug donation initiatives world wide, and establishment of international partnerships between national govern ments, non-governmental organisations, foundations, higher education institutions, associations of health-care professionals, and industry. In the past few years, these principles have been integrated into comprehensive strategic plans designed

Background: Telemedicine has been posited as a potential means of bolstering radiation therapy delivery in developing nations. World Aid Exchange (WaidX) is an innovative intercontinental telemedicine platform oriented to oncology specialties. This platform, devoted to reducing the digital divide on health practice, provides telecommunication services between health care facilities in developed and developing countries. It conveys the ability to safely share radiologic images and patient medical records for diagnostic and care purposes. It was successfully piloted in Mwanza, Tanzania in 2015. Since then, it has been implemented in varied settings such as Ethiopia, Djibouti and Brazil. After conducting a site visit and a focused needs assessment, we recognized the need for teleconferencing with the Radiation Department of National Center of Oncology, Yerevan, Armenia, to share expertises in general patient management and contouring and planning for radiotherapy. Aim: To develop a TeleRadiotherapy platform that enables: 1: Conference calling for tumor boards to review radiotherapy plans, discuss disease management and conduct remote quality control 2: Real-time sharing of diagnostic images to guide clinical decision making 3: E-contouring activity performed by parties in Yerevan and New York on radiographic images, with minimization of time lag in contouring 4: Generation of a database for clinical data (i.e., radiation dose, toxicity, disease stage) that serves as a departmental registry and a tool for future research use 5: Access to lectures delivered by physicians, nurses, therapists and physicists both in Yerevan and New York on varied aspects of radiotherapy Methods: The initiative was funded through a competitive grant established within the Department of Radiation Oncology at Cornell. The TeleRadiotherapy system is comprised of 2 physical units, equipped to support networking and telephony integration. An application was used to establish a simplified direct connection between mobile phones in New York and fixed phone extensions in Yerevan. A customized version of Veyon was used for remote connection to a contouring station. Zoom was used to establish the teleconference. Remote operators in Weill Cornell Medicine were trained for using the system. Results: The first teleradiotherapy interaction between Yerevan and New York occurred on February 7th, 2018. Demonstration of contouring on the Oncentra treatment planning system in Yerevan revealed ease of use. The brush tool displayed less drag time than the point-by-point contouring tools. Diagnostic images were easily shared without compromise of the image resolution. Conference call quality was high. This conference has opened a series of biweekly chart rounds, between the two institutions. Conclusion: Teleradiotherapy is feasible with excellent voice quality, image sharing capability and real-time contouring. The database is under construction. We are developing a new model for learning, training and collaboration in radiotherapy using WaidX, to enable rapid knowledge and technology transfer for a more equitable access to high-quality cancer care worldwide.

The imbalance between vastus medialis oblique (VMO) and vastus lateralis (VL) strength is one of the main factor for patellofemoral pain syndrome (PFPS) onset, related to improper alignment of the patella. The aim of this paper is to investigate the effects of knee flexion, knee rotation and ankle flexion attitudes on the activity of the VMO and VL muscles during unilateral maximal voluntary isometric contraction (MIVC) of the quadriceps femoris. Eighteen healthy subjects volunteered for the study. Five conditions for two different knee flexion angles (90°; 30°) were tested using leg extension machine: Neutral (N) condition, maximal knee medial rotation (MR), maximal knee lateral rotation (LR), maximal ankle plantarflexion (PF) and maximal ankle dorsiflexion (DF). Data were normalized in order to calculate the normalized VMO/VL ratio. The normalized VMO/VL ratio for all the conditions occurred at 90° of knee flexion was higher than the same conditions at 30° of knee flexion (p = 0.02). No statistical differences between conditions at the same knee angle and for angle x condition interaction were observed (p > 0.05). These findings suggest that knee flexion should be the first variable to be managed during isometric knee extension movement performed by leg extension machine, in order to increase VMO/VL ratio.

In some medical applications, the simultaneous acquisition of signals corresponding to physiological parameters and video recording allows a more accurate analysis of the problem and a more complete diagnosis. In rehabilitation, the correlation between parameters of interest (angles, speed, power, EMG) and images of the patient's movements is important to devise an adequate training protocol. In neurology, some pathologies need to be investigated by a comparison of images and EEG signals. Nowadays, commonly used systems are made up of two different apparatuses: one for signals acquisition and one for video recording. They are separate pieces of equipment, and the integration between data and video is possible only to the detriment of information and the possibility to make quantitative analysis. This paper describes a new digital system for the concomitant acquisition of signals and video. It is a low cost instrumentation, PC based and easy-to-use. Data and video are recorded in standard formats and can be analyzed in a post-acquisition stage. The time resolution of the system is given by the video frame rate (25 fps), although an A/D conversion system allows frequencies up to 8000 Hz. The prototype was tested to verify synchronism between data and frames, and differences smaller than the resolution (40 ms) were found. The feasibility of the system was checked in two different applications: rehabilitation training with an isotonic Leg Extension and a daily EEG examination of one patient at the Neurological Institute of Bologna University. Both the applications gave good results in terms of time resolution, synchronism and user-friendliness.

According to the World Health Organisation (WHO), deaths from non-communicable diseases (NCDs) will increase globally, with the largest increase being on the African continent. On our continent, projections have indicated that deaths from NCDs will exceed all combined communicable, maternal, perinatal and nutritional diseases as the most common causes of death by 2030. Hence, the importance of a functional and improved pathology system in the diagnosis of cancer cannot be debated. Recently, the African Organization for Research and Training in Cancer (AORTIC) organised its East African regional meeting in Mwanza, Tanzania on 25–26 June 2015, with the focus being ‘Pathology and oncology: Education and training for the future in cancer research’. The main themes of the workshop were around improving cancer care and the role of twinning in Eastern Africa, in particular the Mwanza cancer project, telepathology, e-health and biobanking. The outcomes of a 2 day strategic meeting were developing an efficient and effective plan to guide the improvement in pathology training and cancer research in Africa.