Britt Ottesen (rockboat48)
Phaeochromocytomas and paragangliomas (PPGL) are rare neuroendocrine tumours with a hereditary background in over one third of patients. Mutations in succinate dehydrogenase (SDH) genes increase the risk for PPGLs and several other tumours. Mutations in subunit B (SDHB) in particular are a risk factor for metastatic disease, further highlighting the importance of identifying SDH mutations for patient management. Genetic variants of unknown significance, where implications for the patient and family members are unclear, are a problem for interpretation. For such cases, reliable methods for evaluating protein functionality are required. Immunohistochemistry for SDHB (SDHB-IHC) is the method of choice but does not assess functionality at the enzymatic level. Liquid chromatography mass spectrometry-based measurements of metabolite precursors and products of enzymatic reactions provides an alternative method. Here, we compare SDHB-IHC with metabolite profiling in 189 tumours from 187 PPGL patients. Besides evaluatnt management. This article is protected by copyright. All rights reserved.Objective To assess the potential impact of the Shetty test over Ottawa ankle foot rules (OAFR) on plain imaging utilisation in the ED. Methods Nursing and medical staff assessed both Shetty test and OAFR in ED. All patients received ankle and foot radiographs. Results Fifty-four participants were assessed. Shetty test specificity at triage was 0.40 (95% CI 0.25-0.57), compared to OAFR 0.10 (95% CI 0.03-0.24), McNemar's P less then 0.01. Shetty test and OAFR sensitivity at triage was 0.92 (95% CI 0.64-0.99), McNemar's P = 1.00. Conclusion Shetty test may safely reduce unneeded radiographs in ED. Further research is warranted.Purpose To develop a practical method for predicting patient-specific collision during the treatment planning process. Materials and method Based on geometry information of the accelerator gantry and the location of plan isocenter, the collision-free space region could be determined. In this study, collision-free space region was simplified as a cylinder. Radius of cylinder was equal to the distance from isocenter to the collimator cover. The collision-free space was converted and imported into treatment planning system (TPS) in the form of region of interest (ROI) which was named as ROISS. Collision was viewed and evaluated on the fusion images of patient's CT and ROIs in TPS. If any points of patient's body or couch fell beyond the safety space, collision would occur. This method was implemented in the Pinnacle TPS. The impact of safety margin on accuracy was also discussed. Sixty-five plans of clinical patients were chosen for the clinical validation. Results When the angle of couch is zero, the ROISS displays as a series of circles on the cross section of the patient's CT. When the couch angle is not zero, ROISS is a series of ellipses in the transverse view of patient's CT. The ROISS can be generated quickly within five seconds after a single mouse click in TPS. Adding safety margin is an effective measure in preventing collisions from being undetected. Safety margin could increase negative predictive value (NPV) of test cases. Accuracy obtained was 96.3% with the 3 cm safety margin with 100% true positive collision detection. Conclusion This study provides a reliable, accurate, and fast collision prediction during the treatment planning process. Potential collisions can be discovered and prevented early before delivering. This method can integrate with the current clinical workflow without any additional required resources, and contribute to improvement in the safety and efficiency of the clinic.Objective In Australia, the current ED burden related to COVID-19 is from 'suspected' rather than 'confirmed' cases. The initial aim of the Registry for Emergency Care (REC) Project is to determine the impact of isolation processes on the emergency care of all patients. Methods The REC Project builds on the COVID-19 Emergency Dep