Tennantclarke5134

nefit, especially in vital clinical indications.The security of medical radioactive sources, both open and sealed, is an important consideration for reducing the risk of an intentional or inadvertent additional radiation dose to the public, according to the principle of keeping any additional radiation dose as low as reasonably achievable. The detection and following radiological investigation of the misuse of iodine-125 (I), a medically used radionuclide, in Germany is described in detail with the aim of sharing experience and raising awareness. The misuse of I shows that the security of I is not guaranteed completely at the present time.Low alanine aminotransferase (ALT) blood levels prior to rehabilitation are associated with poor rehabilitation outcomes in terms of low mobility and function in older adults following hip fracture. We have hypothesized that low ALT blood levels prior to rehabilitation are also associated with one-year mortality in this population. Included were 456 older adults (age ≥ 60 years, median age 83 years, 82.5% women) admitted for rehabilitation following hip fracture. ALT blood levels were documented between one and six months prior to rehabilitation. Excluded were patients with ALT blood levels over 40 IU/L possibly consistent with liver injury. The study group included patients with low (≤10 IU/L) ALT blood levels, and the control group included patients with high-normal (11-40 IU/L) ALT blood levels. The main outcome was all-cause mortality one year following rehabilitation admission. The study group included 142 (31.1%) patients with low ALT blood levels, and the control group included 314 (68.9%) patients witation are not available.The use of the Nintendo Wii system has become a common tool for balance rehabilitation in patients with multiple sclerosis, but few studies verified the effectiveness of such an approach using quantitative measures of postural control. We aimed to evaluate the impact of rehabilitation treatment using the Nintendo Wii Fit Plus balance program on objective stabilometric parameters in multiple sclerosis patients. We enrolled 36 multiple sclerosis patients, with mild-moderate disability, referring to the multiple sclerosis Centre of the University of Catania from September 2013 to June 2014. Twenty participants underwent 20 individual sessions of balance exercise using the Nintendo Wii Fit Plus. GSK-3 activity They were assessed at baseline (T0) and at the end of rehabilitation program (T1) by Neurocom Balance Manager. Functional independence measure, Barthel index, and Berg balance scale were also administered. At T1, we found a significant improvement in total path length-open eyes, sway area-open eyes, and mean sway velocity-open eyes. Patients showed significant improvement in functional independence measure motor score, Barthel index, and in Berg balance scale. No significant differences between T0 and T1 in closed eyes trials were found. A significant correlation between delta values between T0 and T1 of sway area-open eyes and the Berg balance scale (r = -0.76; P less then 0.0001) was found. This study confirmed that balance rehabilitation training performed using the Nintendo Wii with balance board significantly reduced some postural sway parameters in multiple sclerosis patients. It could be a good support to standard rehabilitation program in multiple sclerosis patients.Smartphone-based measurement could represent a portable and cheap solution to assess the Nordic Hamstring break-point angle (BPA). We investigated the following (1) the reproducibility of the DrGoniometer app, (2) its agreement with a computerized video analysis software used as a reference method, and (3) the effects of raters' experience. Fifty recordings were processed by four independent raters. Intraclass correlation coefficient (ICC), SEM, and minimum detectable change (MDC) were calculated. Bland-Altman plots verified the limits of agreement (LoA) with the reference method. The effect of raters' clinical experience was investigated by unpaired t-tests. The app showed excellent intra-rater (ICC = 0.89, 95% CI, 0.84-0.92) and inter-rater reliability (ICC = 0.82, 95% CI, 0.74-0.89), low error (SEM = 2°; MDC = 5.5°), and substantial agreement with video analysis [95% LoA = ±6.7°; mean difference = 1.0°]. Rater experience did not affect results (P > 0.05). The smartphone-based app offers a reliable, valid, quick, and portable method for measuring the BPA in Nordic Hamstring exercise.Because of the high demand of organs, the usage of marginal grafts has increased. These marginal organs have a higher risk of developing ischemia-reperfusion injuries, which can lead to post-transplant complications. Ex-situ machine perfusion, compared to the traditional static cold storage, may better protect these organs from ischemia-reperfusion injuries. In addition, machine perfusion can also act as a platform for dynamic administration of pharmacological agents or gene therapy to further improve transplant outcomes. Numerous therapeutic agents have been studied under both hypothermic (1-8°C) and normothermic (35.5-37.5°C) settings. Here we review all the therapeutics used during machine perfusion in different organ systems. The major categories of therapeutics include vasodilators, mesenchymal stem cells, anti-inflammatory agents, anti-infection agents, siRNA and defatting agents. Numerous animal and clinical studies have examined machine perfusion therapeutic agents (MPTAs), some of which have even led to the successful reconditioning of discarded lung grafts. More clinical studies, especially randomized controlled trials, will need to be conducted in the future to solidify these promising results and to define the role of MPTA in solid organ transplantation.BACKGROUND Normothermic machine perfusion (NMP) bears the potential for significant prolongation of liver preservation prior to transplantation. Although safety and feasibility have been recently published, not data are available describing the significant challenges of establishing NMP programs outside clinical studies. We herein present our experience and propose a multidisciplinary approach for liver NMP in the clinical routine. METHODS AND RESULTS In February 2018, liver NMP was introduced for routine use in marginal organs, logistical challenges and complex recipients at our institution. In a multidisciplinary effort between transplant coordinators, perfusionists, transplant surgeons, anesthesia, nurses, blood bank as well as laboratory staff, a clinical routine was established and 34 NMP cases were performed without critical incidents or organ loss. Nine livers were discarded due to poor organ quality and function observed during NMP. Twenty-five livers were successfully transplanted after preservation of up to 38 hours.