Radioiodine therapy: care of the helpless patient and handling of the radioactive corpse.

Nurses caring for a helpless patient following a nominal 800 MBq administration of radioiodine were concerned about their radiation dose. Using published data, a nurse could receive an estimated 650 microSv per shift. A regime to restrict their dose was planned using a 500 microSv dose constraint. Thermoluminescent dosimeters indicated a maximum whole-body effective dose of 250 microSv. Three days post 131I administration the patient died (estimated activity in the body 400 MBq). A minimum delay of two weeks was advised prior to a post-mortem. Special precautions were issued to minimise contamination. Dose rates (microSv h(-1)), measured one day after the patient died, at the level of the thyroid, chest and bladder at 0.01 m from the corpse were 1800, 290 and 73 respectively. At 1.0 m the dose rate was 26 microSv h(-1) at all levels. The pathologist was estimated to have received a maximum whole-body dose of 400 microSv during the post-mortem. Contamination measurements (Bq cm(-2)) made following the post-mortem were as follows: pathologist's hands 5, clothes 0, towels 1.8, saw 5, instruments 0.5, plastic sheet 0.8, scales 0.4 and floors/walls 1.1. These data indicate that with appropriate radiation protection guidelines, staff can be reassured that their doses in these circumstances are very low.     

RP-HPLC法测定家兔血浆中甲苯喹哌浓度和药代动力学参数

本文建立了以紫外230nm波长检测的反相高效液相色谱法(RP-HPLC)测定家兔血浆中甲苯喹派浓度。填料使用LiChrosorb RP-C18,流动相为甲醇—水—三乙胺—磷酸(63:37:1:0.8 v/v),血样(或尿样)经碱化后用乙醚提取,再以0.2 mol/L硫酸回提,进样。方法回收率为99.84±3.10(SD)%;天内、天间精密度平均CV为4.12%及3.95%(n=5);最低检测限3ng.经提取的标准线性浓度在25～2000 ng/ml范围内,Y=0.002865X-0.01346,r=0.9999,内源性物质及可能的合并用药不干扰色谱测定。文内用质谱法鉴定血样中甲苯喹哌色谱峰纯度,并由尿样分析对其主要代谢物予以初步验证。本法可应用于药代动力学参数测定。家兔按8mg/kg静注后,药—时曲线符合二室模型T_1/2=4.8008±1.1522(SD)h。     

Utility of DRG and ICD-9-CM classification codes for the study of transfusion issues. Transfusions in patients with digestive diseases

Red cell transfusions in all patients within specific medical or surgical diagnosis-related groups (DRGs) and International Classification of Diseases (ICD-9-CM) classes were analyzed by a unique body of data that combined abstracted patient discharge records with the numbers of red cell units transfused. Informative measures of transfusion practice within an ICD-9-CM class were the proportion of patients transfused, the mean units transfused per patient, and the ratio of standard deviation to the mean of units transfused. Transfusion frequency plots (percentage of patients against units of red cells transfused per patient) revealed the existence of a modal transfusion frequency, as well as an asymmetric tail on the high frequency side. These and other features make it possible to characterize transfusion practice in specific ICD-9-CM classes. The mean units of red cells transfused for all patients in a DRG is a measure of blood resource utilization and should be useful in planning to meet future needs.