By E. Yespas. New Mexico State University.
Cordero Ramírez Issues on patient safety during radiation therapy — Concerns of regulatory authority P order female cialis 20mg. Dubner Organ and effective doses from verification techniques in image-guided radiotherapy V female cialis 10mg line. Dufek Application of the risk matrix approach in radiotherapy: An Ibero-American experience C purchase 10mg female cialis visa. Duménigo Neutron contamination in radiotherapy treatments — Evaluation of dose and secondary cancer risk in patients M order female cialis 20 mg with amex. Gershkevitsh Direct calibration of Australian hospital reference chambers in linac beams P. Harty Prevention and management of accidental exposures in radiotherapy in the Czech Republic I. Ismail Determination of entrance and exit doses in vivo in radiotherapy photon beams — A simple approach A. Malicki Dose from secondary radiation outside the treatment fields at different treatment distances with the use of multi-leaf collimators, physical and enhanced dynamic wedges R. Melchor Operational health physics during the commissioning phase of the West German Proton Therapy Centre Essen B. Niemeyer Comparison of the energy dependence of two homemade ionization chambers in relation to a standard ionization chamber in low-energy kilovoltage X ray beams, therapy level F. Nyakodzwe Radioprotection of workers with head and neck cancer during radiotherapy L. Pylypenko Doses to critical organs following radiotherapy treatment of lung, larynx and pelvis M. Rahman Radioprotection of paediatric patients in the Department of Radiotherapy of Prof. Ribeiro da Rosa Implementation of safety culture in radiotherapy centers in Brazil L. Teixeira The Australian Clinical Dosimetry Service: A national audit in the Australian context I. Alnaaimi Pearls and pitfalls of the nuclear medicine radioprotection programme in Argentina M. Gil Stamati Dosimetric evaluation of extravasated activity in nuclear medicine scans J. Namías Radiation protection in diagnostic nuclear medicine in Argentina — Current status and recommendations for the future M. Namías Radiation doses to staff in the Nuclear Medicine Department (Szczecin, Poland) in years 2008-2011 H. Piwowarska-Bilska A 10-year retrospective study of radiation exposure of the staff at nuclear medicine department J. Ptáček Evaluation of effective doses for occupational staff and patients in examinations with Mo99-Tc-99m in nuclear medicine in Albania L. Qafmolla Optimization of cardiologic protocols in nuclear medicine examinations S. Desai Thermoluminescent in vivo dosimetry for patient protection in intraoperative radiotherapy — Applications in breast cancer treatment D. Menezes Radiobiological evaluation of Bi-213 and Tb-149 radioisotopes for targeted alpha therapy by computational methods S. Natouh Safety in brachytherapy: Source position indicator as a quality assurance tool in stepping source technology E. Oyekunle Prostate cancer and radiation protection — A future health and radiation protection issue in developing countries A. Pellizzon Monte Carlo treatment planning in nuclear medicine: Application in Y-90 microspheres therapy of liver cancer A. Petitguillaume A general view of radioisotope therapy and associated safety management D. Sarti Patient’s safety in the application of high dose rate superficial brachytherapy on the skin tumor and keloids — A retrospective study S.
However purchase female cialis 20mg amex, given the existence of marked inter- and intraspecies differences in cholesterol metabolism and athero- genic mechanisms order female cialis 20mg line, it is not possible to extrapolate these data directly to humans purchase female cialis 10 mg fast delivery. A significant relative risk was also observed in the Western Electric Study order female cialis 10mg mastercard, which remained significant after adjustment for a number of covariates, including dietary fat and serum cholesterol concentration (Stamler and Shekelle, 1988). More recently, in a study of 10,802 health- conscious men and women in the United Kingdom, a univariate relation- ship of cholesterol intake to ischemic heart disease mortality was observed (Mann et al. This finding was corroborated in a European study, but after multivariate analysis adjust- ing for fiber intake, the association was no longer significant (Toeller et al. Measures of atherosclerosis using imaging techniques have also been assessed in relation to diet. Angiographically assessed coronary artery disease progression over 39 months in 50 men was weakly related to cholesterol intake in univariate, but not multivariate, analysis (Watts et al. In 13,148 male and female participants in the Atherosclerosis Risk in Commu- nities Study, carotid artery wall thickness, an index of early atherosclerosis, was significantly related to dietary cholesterol intake by univariate analyses; multivariate analysis was not performed (Tell et al. Another uncertainty relates to interpreting the effects of dietary cholesterol on blood cholesterol concentrations. Finally, the considerable interindividual variation in lipid response to dietary cholesterol may result in differing outcomes in differ- ent populations or population subgroups. Cancer As shown in Tables 9-5 through 9-8, no consistent significant associa- tions have been established between dietary cholesterol intake and cancer, including lung, breast, colon, and prostate. Several case-control studies have suggested that a high consumption of cholesterol may be associated with an increased risk of lung cancer (Alavanja et al. As reviewed above, on average, an increase of 100 mg/d of dietary cholesterol is predicted to result in a 0. This effect of added cholesterol is highly variable among individuals and is considerably attenuated at higher baseline cholesterol intakes. Epidemiological studies have limited power to detect effects of such magnitude and thus do not provide a meaningful basis for establishing adverse effects of dietary cholesterol. However, no studies have examined the effects of very small increments of dietary cholesterol in numbers of subjects suffi- ciently large enough to permit statistical treatment of the data. Because cholesterol is unavoidable in ordinary, nonvegan diets, eliminating choles- terol in the diet would require significant changes in patterns of dietary intake. Independence of the effects of cholesterol and degree of saturation of the fat in the diet on serum cholesterol in man. Andersson S-O, Wolk A, Bergström R, Giovannucci E, Lindgren C, Baron J, Adami H-O. Energy, nutrient intake and prostate cancer risk: A population- based case-control study in Sweden. Dietary fat and risk of coronary heart disease in men: Cohort follow up study in the United States. Influence of formula versus breast milk on cholesterol synthesis rates in four-month-old infants. Effect of egg yolk feeding on the concentration and composition of serum lipoproteins in man. Reproducibility of the variations between humans in the response of serum cholesterol to cessation of egg consumption. Comparison of the lipid composition of breast milk from mothers of term and preterm infants. Dependence of the effects of dietary cholesterol and experimental conditions on serum lipids in man. Dependence of the effects of dietary cholesterol and experimental conditions on serum lipids in man. A proteolytic pathway that controls the cholesterol content of membranes, cells, and blood. Dietary lipids and blood cholesterol: Quantitative meta-analysis of metabolic ward studies. Body fat distribution is a determinant of the high-density lipoprotein response to dietary fat and cholesterol in women. The interrelated effects of dietary choles- terol and fat upon human serum lipid levels.
Medicine is not taking into consideration the following critically important aspects of a healthy human organism: (a) stress and how it adversely affects the immune system and life processes discount female cialis 20 mg amex; (b) insufficient exercise purchase female cialis 20mg visa; (c) excessive caloric intake buy discount female cialis 20 mg; (d) highly processed and denatured foods grown in denatured and chemically damaged soil generic 10 mg female cialis mastercard; and (e) exposure to tens of thousands of environmental toxins. Instead of minimizing these disease-causing factors, we cause more illness through medical technology, diagnostic testing, overuse of medical and surgical procedures, and overuse of pharmaceutical drugs. The huge disservice of this therapeutic strategy is the result of little effort or money being spent on preventing disease. Underreporting of Iatrogenic Events As few as 5% and no more than 20% of iatrogenic acts are ever reported. In 1994, Leape said his figure of 180,000 medical mistakes resulting in death annually was equivalent to three jumbo-jet crashes every two days. What we must deduce from this report is that medicine is in need of complete and total reform—from the curriculum in medical schools to protecting patients from excessive medical intervention. It is obvious that we cannot change anything if we are not honest about what needs to be changed. We are fully aware of what stands in the way of change: powerful pharmaceutical and medical technology companies, along with other powerful groups with enormous vested interests in the business of medicine. They fund medical research, support medical schools and hospitals, and advertise in medical journals. Such funding can sway the balance of opinion from professional caution to uncritical acceptance of new therapies and drugs. You have only to look at the people who make up the hospital, medical, and government health advisory boards to see conflicts of interest. Erik Campbell, the lead author, said, "Our previous research with faculty has shown us that ties to industry can affect scientific behavior, leading to such things as trade secrecy and delays in publishing research. Marcia Angell struggled to bring greater attention to the problem of commercializing scientific research. In June 2002, the New England Journal of Medicine announced that it would accept journalists who accept money from drug companies because it was too difficult to find ones who have no ties. Jerome Kassirer, said that was not the case and that plenty of researchers are available who do not work for drug companies. Cynthia Crossen, a staffer for the Wall Street Journal, i n 1996 published Tainted Truth : The Manipulation of Fact in America , a book about the widespread practice of lying with statistics. In 1981 Steel reported that 36% of hospitalized patients experienced iatrogenesis with a 25% fatality rate, and adverse drug reactions were involved in 50% of the injuries. In 1991, Bedell reported that 64% of acute heart attacks in one hospital were preventable and were mostly due to adverse drug reactions. Leape focused on the “Harvard Medical Practice Study” published in 1991, (16a) which found a 4% iatrogenic injury rate for patients, with a 14% fatality rate, in 1984 in New York State. From the 98,609 patients injured and the 14% fatality rate, he estimated that in the entire U. Why Leape chose to use the much lower figure of 4% injury for his analysis remains in question. Using instead the average of the rates found in the three studies he cites (36%, 20%, and 4%) would have produced a 20% medical error rate. The number of iatrogenic deaths using an average rate of injury and his 14% fatality rate would be 1,189,576. Leape acknowledged that the literature on medical errors is sparse and represents only the tip of the iceberg, noting that when errors are specifically sought out, reported rates are “distressingly high. First, he found that each patient had an average of 178 “activities” (staff/procedure/medical interactions) a day, of which 1. This may not seem like much, but Leape cited industry standards showing that in aviation, a 0. In trying to determine why there are so many medical errors, Leape acknowledged the lack of reporting of medical errors. Medical errors occur in thousands of different locations and are perceived as isolated and unusual events. But the most important reason that the problem of medical errors is unrecognized and growing, according to Leape, is that doctors and nurses are unequipped to deal with human error because of the culture of medical training and practice. Medical mistakes are therefore viewed as a failure of character and any error equals negligence.
It is expedient for a woman giving birth with difficulty that she be bathed in water in which mallow effective female cialis 10mg, fenugreek female cialis 10mg with visa, linseed generic female cialis 20mg fast delivery, and barley have been cooked generic female cialis 10mg otc. Let her sides, belly, hips, and vagina be anointed with oil of violets or rose oil. Let her be rubbed vigorously and let oxizaccara35 be given in a drink and some powder of mint and wormwood, and let one ounce be given. This whole mixture, having been ground and given in wine, is good [for this condition], or [when it is given] with water in which lupins have been cooked. Fiat lexiuia de cinere facto de fraxino et puluerisa seminis malueb commisceanturc drachma. Book on the Conditions of Women [] But if birth is up to now still delayed or if the fetus is dead inside her and she is not delivered of it, let her drink ‘‘a. Let them be ground with some oil and a little sugar and place this upon the pubic area or upon the navel, and it works even better. There- fore, let sneezing be provoked, and let this be done with the mouth and nose closed. On the Signs of Pregnancy [] In order to know whether a woman is carrying a male or a female, take water from a spring and let the woman extract two or three drops of blood or illius mulieris incontinenti B. Prouideat sibia mulier in tribus ultimis mensibus ita ut in dieta utatur leuibus cibis [va] et digestibilibus, ut per hec membra dilatentur,b ut sunt uitella ouorum, carnes etc uisculad pullorum et minorum auium, scilicet perdicum, fasianorum, et piscium squamosorum cum bono condimento. Fugiat balneumf aerium et stupham, et cum de balneo exierit, inungaturg unguentis calidis, ut oleo laurish et de oleo seminisi lini et auxungia anserisj uel anatis uel galline, et hec inunctiok fiat ab umbilico inferius cum predictis unguentis calidis. Deinde detur eig de- coctio fenugreci, muscillago, linih et psillii, ueli parum cyriace uel dyatessaron cum decoctione arthimesie in ui[vb]no. Ad hoc ualent species odorifere, ut muscus, ambra, lignum aloes, et similia, et herbe odorifere, ut menta, fenicu- lus, origanum, et similia. Book on the Conditions of Women milk from her right side and let these be dropped in the water. And if they fall to the bottom, she is carrying a male; if they float on top, a female. Let the woman herself see to it that in the last three months [of pregnancy] her diet consists of light and digestible foods, so that by means of these the organs are dilated. Such foods are the yolks of eggs, the flesh and innards of young fowl and small birds, that is, partridges and pheasants, and scaly fish with good sauces. And if softening herbs are added to the bath, such as marsh mallowand the like, so much the better. Let her avoid open-air baths and steambaths, and when she comes out of the bath, let her be anointed with hot unguents, such as oil of lau- rel and oil of linseed and goose or duck or hen’s grease. And let this anointing be done from the navel down with the above-mentioned hot unguents. On the Regimen for a Woman Giving Birth [] When the time of birth arrives, let the woman prepare herself as is cus- tomary, and likewise the midwife should do the same with great care. And let sneezing be induced with the nose and mouth constricted, so that the greatest part of her strength and spirit tends toward the womb. Then let her be given a decoction of fenugreek, spurge laurel, flax and fleawort, or a little theriac or diathessaron43 with a decoction of mugwort in wine. Above all, let her be- ware of the cold, and let there not be any aromatic fumigation to the nose. But this can be applied more safely to the orifice of the womb, because the womb follows sweet-smelling substances and flees foul-smelling ones. For this, odor- iferous spices are good, such as musk, ambergris, aloewood, and similar things, and also odoriferous herbs, such as mint, fennel, oregano, and similar things. Et ut cicius loquatur, unge palatum cum melle et naresc cum aqua calida, et unctionibus semper mun- dificetur,d et muscillagines semper emunganture et emundentur. Puer itaque semper est fricandus et quelibet eius membra in unaquaquef parteg fascia sunt retinenda et iungenda,h et rectificanda sunt eius membra, scilicet caput, frons, ¶a. On the Mode of Generation of the Embryo *[] In the first month, there is purgation of the blood. In the eighth month, Nature moves and the infant is made complete in the blessing of [all] its parts.