Strengthening medical radiation technologist recognition through advanced practice in Canada: A narrative review

BackgroundLack of professional recognition from the public and other healthcare professionals has been a long-standing issue for medical radiation technologists (MRTs) in Canada. This situation was further highlighted by the pandemic when several provinces refused to recognize MRTs as essential workers. In addition to continued advocacy to develop interprofessional awareness of the MRT discipline, prioritizing the creation of advanced practice opportunities will increase the perceived value of MRTs to healthcare.MethodsLiterature for this review was found by searching the electronic databases of PubMed, CINAHL, Google Scholar, and Athabasca University. Relevant reports from credible Canadian organizations, global MRT professional association websites, frameworks for advanced practice, and one dissertation were also reviewed.DiscussionThe implementation of advanced practice radiography roles present a tremendous opportunity to increase the visibility and recognition of the MRT profession in both clinical and research domains. In Canada, role extension in radiography has underscored the significance and need for advanced practice.ConclusionTo keep pace with growing demand for medical imaging, the use of human health resources must be re-evaluated to optimize care delivery and capitalize on the full skill set of MRTs.     

Antioxidation,anti-inflammation and anti-apoptosis by paeonol in LPS/d-GalN-induced acute liver failure in mice

To evaluate the hepatoprotective effects and potential mechanisms of paeonol (Pae) against acute liver failure (ALF) induced by lipopolysaccharide (LPS)/d-galactosamine (d-GalN) in mice, we examined anti-oxidative, anti-inflammatory and anti-apoptotic activities of Pae. We found that Pae pretreatment markedly reduced the activities of alanine transaminase and aspartate transaminase as well as the histopathological changes induced by LPS/d-GalN. Catalase, glutathione and superoxide dismutase activities increased and reactive oxygen species activity decreased after Pae treatment compared with LPS/d-GalN treatment. Pretreatment with Pae also significantly inhibited the expression levels of iNOS, nitric oxide (NO), COX-2 and prostaglandin E₂ (PGE₂). In addition, Pae administration prevented the phosphorylated expression of IκB kinase, inhibitor kappa B in the nuclear factor-kappa B (NF-κB) signaling pathway, and suppressed the phosphorylated expression of extracellular signal-regulated kinase (ERK), c-jun-N-terminal kinase and p38 in the MAPK signaling pathway. Pretreatment with Pae also inhibited hepatocyte apoptosis by reducing the expression of caspases 3, 8, 9, and Bax, and increasing Bcl-2. In total, protective effects of Pae against LPS/d-GalN-induced ALF in mice are attributed to its antioxidative effect, inflammatory suppression in NF-κB and MARK signaling pathways, and inhibition of hepatocyte apoptosis inhibition. Therefore, Pae can be a potential therapeutic agent in attenuating LPS/d-GalN-induced ALF in the future.     

The 100 most influential publications pertaining to intracranial aneurysms and aneurysmal subarachnoid hemorrhage

The study of intracranial aneurysms has grown at an astounding rate since Sir Charles Symond’s association of hemorrhage within the subarachnoid space to intracranial aneurysms in 1923. These associations led to the first surgical treatment of an intracranial aneurysm with wrapping by Norman Dott in 1931, and shortly thereafter, clip ligation by Walter Dandy in 1938. Surgical outcomes were improved by the introduction of the operative microscope in the 1960s and perioperative care utilizing induced hypertension, hypovolemia, and hemodilution (“HHH therapy”). Recent monumental advancements, such as coil embolization in 1990 by Guglielmi, have continued to advance the field forward. The authors hope to highlight some of the most seminal and influential works. Herein, we utilize the technique of citation analysis to assemble a list of the 100 most influential works pertaining to aneurysmal subarachnoid hemorrhage published between the years 1900 and 2015 to honor these individuals and to provide guidance to current and future researchers in the field. We additionally calculate the effects of author, journal, topic, and study design on the overall influence of publications in this field.     

Association of plasma dipeptidyl peptidase-4 activity with non-alcoholic fatty liver disease in nondiabetic Chinese population

ObjectiveThe pathogenesis of non-alcoholic fatty liver disease (NAFLD) is attributed to a “multi-hits hypothesis” involving insulin resistance, oxidative stress and inflammation. Dipeptidyl peptidase-4 (DPP4) was identified as a novel adipokine capable of enhancing the“multi-hits”. Hence, we investigated the association between plasma DPP4 activity and NAFLD in nondiabetic Chinese population.Design and methodsWe performed a cross-sectional study using data from 1105 subjects (36–79 years) in Guilin between 2015 and 2016. Plasma DPP4 activity, homeostatic model assessment of insulin resistance (HOMA-IR), oxidative stress parameters, and inflammatory markers were measured in all participants. NAFLD and its severity were diagnosed by ultrasound after the exclusion of alcohol abuse and other liver diseases.ResultsParticipants in the highest quartile of DPP4 activity had higher HOMA-IR, nitrotyrosine, 8-iso-PGF2a, interleukin-6, CRP, alanine aminotransferase, aspartate aminotransferase and γ-glutamyltransferase compared with those in the lowest quartile (all P < 0.05). Plasma DPP4 activity gradually increased across the groups according to the ultrasonographic severity of steatosis (P < 0.001 for the trend). In the highest DPP4 quartile, NAFLD risk was higher (odds ratio 1.88; 95% CI 1.04–3.37) than in the lowest quartile after adjustment for confounders. The risk for NAFLD increased more with higher levels of DPP4 activity, HOMA-IR, nitrotyrosine, 8-iso-PGF2a, interleukin-6 and CRP.ConclusionsPlasma DPP4 activity is significantly associated with NAFLD. The underlying mechanisms may be partly attributed to the interactions between insulin resistance, oxidative stress, inflammation, and DPP4.     

Potential impact of Helicobacter pylori-related metabolic syndrome on upper and lower gastrointestinal tract oncogenesis

Both Helicobacter pylori infection and metabolic syndrome present significant global public health burdens. Metabolic syndrome is closely related to insulin resistance, the major underlying mechanism responsible for metabolic abnormalities, and Helicobacter pylori infection has been proposed to be a contributing factor. There is growing evidence for a potential association between Helicobacter pylori infection and insulin resistance, metabolic syndrome and related morbidity, including abdominal obesity, type 2 diabetes mellitus, dyslipidemia, hypertension, all of which increase mortality related to cardio-cerebrovascular disease, neurodegenerative disorders, nonalcoholic fatty liver disease and malignancies. More specifically, insulin resistance, metabolic syndrome and hyperinsulinemia have been associated with upper and lower gastrointestinal tract oncogenesis. Apart from cardio-cerebrovascular, degenerative diseases and nonalcoholic fatty liver disease, a number of studies claim that Helicobacter pylori infection is implicated in metabolic syndrome-related Barrett's esophagus and esophageal adenocarcinoma development, gastric and duodenal ulcers and gastric oncogenesis as well as lower gastrointestinal tract oncogenesis. This review summarizes evidence on the potential impact of Helicobacter pylori-related metabolic syndrome on gastroesophageal reflux disease-Barrett's esophagus-esophageal adenocarcinoma, gastric atrophy-intestinal metaplasia-dysplasia-gastric cancer and colorectal adenoma-dysplasia-colorectal cancer sequences. Helicobacter pylori eradication might inhibit these oncogenic processes, and thus further studies are warranted.     

Soft tissue thickness in young north eastern Brazilian individuals with different skeletal classes

The aim of this study was to evaluate the variation in facial soft tissue thickness in young north eastern Brazilian individuals according to gender and skeletal class. Measurements were obtained from digitized teleradiographs of 300 children, aged from 8 to 12 years, using the Sidexis Xg program. Data of mean, standard deviation, maximum and minimum soft tissue thickness values of the faces of Angle's Class I, II and III individuals, were evaluated. The results demonstrated that there was no difference in soft tissue thickness among the skeletal classes for most of anthropological points. For the Class I, statistical differences were found (P < 0.05) between the genders in the rhinion point, subnasal and upper lip. It was concluded that there was no difference in soft tissue thickness among the skeletal classes, except between Class II and III for the points: Stomion, Bottom lip and Pogonion, allowing definition of parameters of this population for the purpose of facial reconstruction.     

预防和控制流感在养老院暴发管理的最佳证据总结

背景　目前我国流感疫苗覆盖率较低，一旦暴发将加剧医疗压力。目的　总结预防和控制流感在养老院暴发的最佳证据，以强化养老院管理者以及工作人员对流感的重视。方法　计算机检索万方数据知识服务平台（Wanfang Data）、维普网（VIP）、中国知网（CNKI）、中国生物医学文献数据库（CBM）、中华人民共和国民政部官网、Cochrane Library、PubMed、Medline、Joanna Briggs Institute（JBI）循证卫生保健中心图书馆、Up to Date、Ovid数据库及美国疾病控制与预防中心（CDC）官网关于预防和控制养老院流感暴发的临床指南、系统评价、专家共识、队列研究、随机对照试验、横断面研究。检索时间为建库至2020-02-12。分别采用AGREE Ⅱ、AMSTAR、JBI循证卫生保健中心专家共识评价标准（2017年澳大利亚版本）、2016版JBI循证卫生保健中心队列研究评价标准、Jadad评分量表、2017版JBI循证卫生保健中心横断面研究质量评价工具进行质量评价。最后采用2014年澳大利亚版本JBI循证卫生保健中心证据分级及证据推荐级别系统进行证据汇总、评价和等级划分。结果　本研究最终纳入文献17篇，其中临床指南5篇、系统评价2篇、专家共识3篇、队列研究2篇、随机对照试验4篇、横断面研究1篇。5篇临床指南中各领域≥60%的数目为6的有3篇，推荐级别为A级的有5篇。2篇系统评价的质量评价结果均为准予纳入。3篇专家共识的质量评价结果均为准予纳入。2篇队列研究的质量评价结果显示文献质量均较高，允许纳入。4篇随机对照试验的质量评价结果均为准予纳入。1篇横断面研究的质量评价结果为文献属于高质量文献，允许纳入。证据汇总最终得出27条预防和控制养老院流感暴发的最佳证据，包含环境、人员管理、预防措施以及疫苗接种影响因素4个方面。结论　总结和分析国内外养老院流感暴发预防与控制的相关文献得出接种流感疫苗仍是目前控制流感的最佳方法，养老院管理者及工作人员应当提高对流感重视程度，优化流感预防管理模式。     

Single versus double burr hole drainage of chronic subdural hematomas. A study of 267 cases

A spectrum of surgical techniques has been used in the management of chronic subdural hematomas. Single burr hole and double burr hole drainage are among the commonest techniques. A retrospective analysis of 267 patients with chronic subdural hematomas treated surgically by either single or double burr holes was performed. Recurrence rates of subdural hematomas treated either with single or double burr holes were not significantly different (χ²; p > 0.05). Thus, the number of burr holes does not affect the post-operative recurrence rate of chronic subdural hematomas. Both techniques are equally effective treatments.     

围手术期综合护理对CT引导下碘125粒子植入治疗后患者疼痛及生活质量的影响

目的探讨围手术期综合护理对碘125粒子植入治疗后患者疼痛及生活质量的影响。方法以2009年5月~2013年4月收治的肿瘤患者作为研究对象,并对符合标准的入组患者92例采用简单随机抽样法分为观察组及对照组各46例,对照组在治疗过程中给予常规护理,而观察组则给予围手术期综合护理。结果干预前,两组患者疼痛及生活质量差异无统计学意义(P>0.05),经护理干预后,两组患者疼痛情况均有改善(P<0.05),而观察组在干预后48h和72h的疼痛改善程度明显优于对照组(P<0.05)。两组患者的生活质量经干预后也都有明显改善(P<0.05),但观察组的改善程度要优于对照组(P<0.05)。结论围手术期综合护理对碘125粒子植入治疗后患者疼痛情况改善明显,并且能有效提高患者术后的生存质量。     

Vitamin K2 (Menaquinone-7) supplementation does not affect vitamin K-dependent coagulation factors activity in healthy individuals

Background:Vitamin K has long been regarded as a procoagulant drug by physicians, and concerns have been raised with regard to its effects on hemostasis. Although many studies have shown that vitamin K supplementation is safe for thrombotic events, the effect of vitamin K supplementation on the activities of vitamin K dependent procoagulation factors in healthy individuals is not available.Objectives:This study aimed to investigate whether vitamin K2 supplementation at recommended doses affects the activity of vitamin K dependent procoagulation factors in healthy individuals without any anticoagulation treatment.Design:Forty healthy volunteers between 25 and 40 years of age were recruited. Menaquinone-7 (MK-7) was administrated at 90 μg for 30 days. Prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and blood coagulation factors II, VII, IX, and X activities and Protein induced by vitamin K absence or antagonist-II (PIVKA-II) were measured on days 0 and 30 after MK-7 administration.Results:PT, APTT, and TT showed no significant differences on day 30 when compared with baseline. The activities of coagulation factors II, VII, IX, and X on day 30 showed no significant differences with those at baseline. PIVKA-II levels were unchanged after 30 days of MK-7 supplementation.Conclusions:MK-7 supplementation at recommended dosage does not affect vitamin K-dependent coagulation factors’ coagulation activity, and does not enhance the carboxylation of prothrombin in healthy individuals. This indicated that MK-7 administration does not alter hemostatic balance in healthy populations without anticoagulation treatment.