Keloids treated with postoperative Iridium 192* brachytherapy: a retrospective study

Background   Post-excisional brachytherapy with Iridium 192 is a treatment of keloids scars (KS). Its indications and its parameters are not subject to any consensus.
Objective   We wanted to assess the effectiveness and satisfaction of patients treated in our centre.
Patients and Methods   This was a retrospective study conducted from November 2006 to November 2007. Patients with clinically and histologically proven KS treated between 1990 and 2005, were convened in consultation between September and October 2007. Clinical data and parameters of the brachytherapy have been collected.
Results   Eighty-seven patients (138 KS) were treated. Eighty-two KS (46 patients) met the criteria for inclusion. Thirty-two patients (55 KS) have been seen in consultation. The average time between the onset of KS and treatment was 63.5 months. The brachytherapy has begun after a maximum of 7 hours posterior to surgery for all KS. The average dose was 17.9 Gy calculated at 5 mm. We observed 23.6% of recurrence after treatment. Seventy-nine per cent of itching and 87.5% of pain have totally disappeared. The phototypes 5 and 6 had an increased risk of reccurence.
Discussion   This is the most important series of KS treated with Post-excisional brachytherapy presented so far. The technique is efficient in preventing keloid reccurence and in treating the functional signs, but at the expense of an unaesthetic result, of wich patient must be warned about. A follow-up of at least two years after treatment is recommended.

Conflicts of interest

None declared     

Acupuncture for insomnia

Sun JL, Sung MS, Huang MY, Cheng GC, Lin CC. Effectiveness of acupressure for residents of long‐term care facilities with insomnia: a randomized controlled trial. Int J Nurs Stud 2010; 47: 798–805.     

应用组织型纤溶酶原激活物行静脉溶栓治疗急性缺血性卒中的时间窗延长——美国心脏协会／美国卒中协会的科学建议

美国心脏协会卒中委员会发布了关于急性缺血性卒中的现行治疗指南,其中包括应用重组组织型纤溶酶原激活物（rt—PA）行静脉溶栓的建议。尽管该药对改善神经功能预后有一定的疗效,但由于患者通常在发病3h后方能到达医院,往往已经超过了用药的时间窗。因此,大部分缺血性卒中患者未能接受rt—PA治疗。目前研究认为,增加rt—PA治疗例数的最可能方法就是延长治疗时间窗。     

Involving users in the design of a randomised controlled trial of an intervention to promote early presentation in breast cancer: qualitative study

Background  

The purpose of this study was to explore women's views of the design of a large pragmatic cost-effectiveness randomised controlled trial of the policy of offering a health professional-delivered intervention to promote early presentation with breast symptoms in older women and thereby improve survival, with a view to informing protocol development. The trial will recruit over 100,000 healthy women aged 67+, and outcome data will be collected on those who develop breast cancer. The scale of the trial and the need for long-term follow-up presented a number of design challenges in relation to obtaining consent, ascertaining and contacting participants who developed breast cancer, and collecting outcome data.     

孕早期阴道B超引导下多胎妊娠胚胎抽吸减胎术5例

1临床资料唐都医院妇产科在2003-09/2005-02间接受辅助生殖技术助孕后发生多胎妊娠的不孕症患者5例,年龄24～34岁,在孕6～8 wk进行减胎术.术前夫妇双方签署知情同意书.     

Metrizamide myelography: blood and cerebrospinal fluid response

Cerebrospinal fluid and blood were examined for immunologic factors before and after metrizamide myelography in 13 patients who underwent lumbar myelography and seven patients who underwent thoracic myelography. Clinical symptoms were also recorded. The results were consistent with a toxic reaction to the contrast medium, rather than an immunologic one.