Gordonbusch9982

PURPOSE Accurate administration of radiotracer dose is essential to positron emission tomography (PET) image quality and quantification. Misadministration (infiltration) of the dose can affect PET/computed tomography results and lead to unnecessary or inappropriate treatments and procedures. Quality control efforts ensure accuracy of the administered dose; however, they fail to ensure complete delivery of the dose into the patient's circulation. We used new technology to assess and improve infiltration rates and evaluate sustainability. METHODS Injection quality was measured, improved, and sustained during our participation in a multicenter quality improvement project using Define, Measure, Analyze, Improve, Control methodology. Five technologists monitored injection quality in the Measure and Improve phases. After seven new technologists joined the team in the Control phase, infiltration rates were recalculated, controlling for technologist- and patient-level correlations, and comparisons were made between these two groups of technologists. RESULTS In the Measure phase, five technologists monitored 263 injections (13.3% infiltration rate). Nonantecubital fossa injections had a higher probability of infiltration than antecubital fossa injections. After implementing a quality improvement plan (QIP), the same technologists monitored 278 injections in the Improve phase (2.9% infiltration rate). The 78% decrease in infiltration rate was significant (P less then .001) as was the decrease in nonantecubital fossa infiltrations (P = .0025). In the Control phase, 12 technologists monitored 1,240 injections (3.1% infiltration rate). The seven new technologists had significantly higher rates of infiltration (P = .017). CONCLUSION A QIP can significantly improve and sustain injection quality; however, ongoing monitoring is needed as new technologists join the team.Background Hip precautions are routinely provided to reduce the risk of dislocation following total hip replacement despite evidence suggesting they provide no additional benefit and may, actually, impede recovery. Our aim was to report the views of patients who had been recruited into a trial comparing outcomes in participants who were prescribed hip precautions with those who were not.Methods Semi-structured interviews were conducted. Topics explored included experiences and opinions of the service (either hip precautions or no hip precautions), information offered, and equipment provided. Thematic analysis was used to identify and report themes.Results Six themes were identified perceived justification, and advantages and disadvantages for the postoperative recovery regime prescribed, perceived risk, and fear of dislocation, adherence to the postoperative regime prescribed, and experiences of adaptive equipment.Conclusions Participants who received hip precautions had mixed views about their use some felt they were restrictive whilst others believed they provided reassurance. Participants who did not receive hip precautions were less anxious about dislocating their hip but were unsure how to progress their rehabilitation. The discontinuation of precautions may decrease patients' fears about dislocation but more guidance from rehabilitation staff about how to move safely during recovery is required.Implications for rehabilitationHip precautions may unnecessarily exacerbate patients' anxieties and fear about dislocation following total hip replacement.Hip precautions impact on patients' recovery both physically and psychologically.Patients should be advised about moving and returning to activities following total hip replacement, whether they receive hip precautions or not.Introduction The 6-Minute Walking Test (6MWT) is a safe, standardized and well utilized method to assess the functional capacity. Recently, it was reported that the published prediction equations cannot accurately predict a valid maximal oxygen consumption ([Formula see text]O2 peak) value in cancer survivors. Thus, the aim of this study was to establish and to validate a new equation based on the 6MWT to predict [Formula see text]O2 peak in childhood acute lymphoblastic leukemia (ALL) survivors.Methods A total of 200 childhood ALL survivors were enrolled in this study, among which 168 participants underwent a cardiopulmonary exercise test and a 6MWT to assess their functional capacity and their cardiorespiratory fitness. In addition, participants completed a physical activity questionnaire. Participants were randomly divided in two groups to establish the equations (n = 118 (70%)) and to validate it (n = 50 (30%)). Multiple linear regression analyses were used to determine a new prediction equation for [Formability of these newly established [Formula see text]O2 peak equations makes them an accurate tool to provide a better follow-up and better adapted physical training for survivors. We invite researchers to use our assessment procedures for their further studies.IMPLICATIONS FOR REHABILITATIONIt is critical to understand the cardiorespiratory fitness of the childhood ALL survivorsThe maximal oxygen consumption (i.e., [Formula see text]O2 peak) is recognized as the gold standard to measure the patient's cardiorespiratory fitness in the field of exercise physiologyThis study is novel and reports the validation of two new VO2 peak equations, from 6MWT, by using clinical and disease-specific variables of childhood ALL survivorsThe availability of such validated equations can better facilitate the follow-up of survivors' cardiorespiratory fitness, by relevant health care professionals and exercise physiologists.Immunotherapy with programmed cell death-1 (PD-1) receptor and programmed death ligand 1 (PD-L1) inhibitors has improved outcomes for certain patients with advanced lung cancer. As use of these therapies has expanded in first-line settings, in patients with different histologies, and in combinations with chemotherapeutic and targeted agents, more patients with lung cancer may benefit from these therapies. However, with expanded use comes greater potential exposure to the immune-related adverse events (irAEs) associated with these immune checkpoint inhibitors (ICIs). This article uses two case examples to illustrate the presentation, evaluation, and management of pulmonary and neurologic symptoms in two patients receiving PD-1-based therapy for non-small-cell lung cancer. These cases illustrate the challenges associated with recognizing pneumonitis and neuropathy in patients receiving ICIs for lung cancer. Oprozomib mouse Although pneumonitis and neuropathy are relatively rare irAEs, they can have devastating or even fatal outcomes if not promptly recognized and managed appropriately.