Australian Speech-Language Pathologists’ Knowledge and Practice of Radiation Protection While Performing Videofluoroscopic Swallowing Studies

During a videofluoroscopic swallowing study (VFSS), speech and language pathologists (SLPs) are potentially exposed to radiation. To effectively limit unnecessary exposure, SLPs performing VFSS are encouraged to actively shield themselves and to be monitored by radiation-monitoring badges. The aim of this research was to assess the level of current knowledge and practice of radiation protection among SLPs performing this procedure. A questionnaire was distributed via Speech Pathology Australia (SPA) and the Australasian Dysphagia Newsletter (ADN). Sixty-nine questionnaires were returned. The results revealed that participants had received some radiation protection training, which provided them with general knowledge on radiation protection. Participants indicated a lack of formal education and were unsure of the adequacy of the information provided. Ninety-seven percent of participants always wore lead aprons, 76% always wore thyroid shields, and 36% wore radiation-monitoring badges. The researchers recommend that education on radiation protection and safety be provided for SLPs at university level to educate them before they enter the workplace. It is also recommended that SLPs always wear lead aprons, thyroid shields, and radiation-monitoring badges.

Surgical Prevention of Arm Lymphedema After Breast Cancer Treatment

Purpose  

To prospectively assess the efficacy of the lymphatic microsurgical preventive healing approach (LYMPHA) to prevent lymphedema after axillary dissection (AD) for breast cancer treatment.     

Diagnostic and prognostic value of electrophysiologic study in patients with nondocumented palpitations

The 12-lead electrocardiogram helps to define the arrhythmic mechanism in patients with palpitations. However, in the setting of nondocumented palpitations the value of the electrophysiologic study (EPS) needs additional investigation. We investigated the utility of the EPS in patients with nondocumented palpitations. A total of 172 patients with normal electrocardiographic findings and nondocumented palpitations underwent an EPS. The clinical and electrophysiologic characteristics were assessed. The symptoms were long-lasting (>5 minutes) in 56%. Sudden onset was present in 99%, and termination was rapid in 65%. Neck palpitations were reported in 36%. The EPS findings were normal in 86 patients (50%); atrioventricular nodal reentrant tachycardia was induced in 43, orthodromic reentrant tachycardia in 9, and nonsustained atrial tachycardia/fibrillation (AT/AF) in 34. Long-lasting episodes, sudden termination, and neck palpitations predicted positive EPS findings and were associated with reentrant supraventricular tachycardia (p<0.001). The induction of AT/AF was associated with age >50 years and structural heart disease (p<0.001). After 53 ± 36 months of follow-up, 92% of patients with negative EPS findings were symptom free. Only 32% of patients with induced AT/AF remained free of symptoms (p<0.001). The recurrence of palpitations was more prevalent among patients with structural heart disease and aged >50 years (p<0.001). In conclusion, 50% of patients with nondocumented palpitations had positive EPS findings. A long duration, sudden termination, and neck palpitations, together with structural heart disease and age >50 years, predicted tachycardia inducibility and recurrence and could help in selecting patients suitable for EPS and ablation.     

Circulating levels of beta2-glycoprotein I in thrombotic disorders and in inflammation

Beta2-glycoprotein I (beta2GPI) is a plasma protein suspected to have a role in inhibition of thrombosis. This suspicion is reinforced by the observation that beta2GPI is the major target for autoantibodies in the antiphospholipid syndrome. However, little is known about its circulating levels in common thrombotic diseases or inflammation. We measured beta2GPI levels in 344 healthy controls, 58 normal pregnancies, 102 patients with non-haemorrhagic stroke, 121 patients with acute coronary syndrome and 200 patients with elevated C-reactive protein (CRP). In healthy individuals, we found a strong positive correlation between age and beta2GPI concentration (r = 0.274, P < 0.001) and that beta2GPI levels fall significantly after the eighth week of pregnancy (P = 0.002). We also found significantly reduced levels of beta2GPI in patients with stroke and in elderly patients with myocardial syndrome (P = 0.013 and 0.043). However, in neither group did beta2GPI levels change in the following six months, suggesting that the reduced levels were not a transient post-event phenomenon. In patients with inflammation, beta2GPI levels showed a significant negative correlation with CRP (r = -0.284, P < 0.001) and positively correlated with albumin and transferrin (r = 0.372 and 0.453, respectively with P < 0.001 for both). Furthermore, the largest reduction in beta2GPI levels occurred in patients with the highest CRP values (P < 0.001).