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Technical Innovations & Patient Support... Dec 2022Radiation therapy has become increasingly complex over time and is rapidly evolving. Radiation therapists play a key role within the interdisciplinary team and their...
Radiation therapy has become increasingly complex over time and is rapidly evolving. Radiation therapists play a key role within the interdisciplinary team and their education must prepare them to function effectively in the future in order to ensure a safe, high quality radiation therapy service. The aim of this research was to evaluate the current status of radiation therapist education to establish the duration of education programs, the percentage of radiation therapy-specific content and the professional title on graduation. A survey was developed, based on the questionnaire used for the ESTRO 3rd Revision of the Core Curriculum for Radiation Therapists. This was piloted by colleagues to verify the validity of the survey and also its use outside of the European context. The final survey was distributed purposively through Survey Monkey via a local gatekeeper to key radiation therapy personnel covering all of Europe and Australia, New Zealand, USA and South Korea in January 2021 who distributed it to educational institutes and clinical departments in their respective countries. 101 responses were received of which 58 were fully complete and available for analysis representing 30 countries, 26 European and 4 beyond Europe. The duration and radiation therapy-specific content of education programs varied considerably with dedicated radiation therapy programs from the respondents offered only in Ireland, Australia, New Zealand, and the U.S.A. 17 countries in the survey offer 'combined' programs with the majority dedicating less than 20% of their content to radiation therapy. Of note is that several respondents were unable to state the percentage of content related to radiation therapy and there was a variation in content and duration of programs, even within a single country. This survey has demonstrated that there remains a significant deficit in the educational programs of radiation therapists in many regions.
PubMed: 36238200
DOI: 10.1016/j.tipsro.2022.09.006 -
The Archives of Bone and Joint Surgery Mar 2022The use of free cutaneous or myocutaneous flaps in some surgeries, especially in reconstructive surgeries, is routine and imperative; nevertheless, it is controversial... (Review)
Review
The use of free cutaneous or myocutaneous flaps in some surgeries, especially in reconstructive surgeries, is routine and imperative; nevertheless, it is controversial because of fear of flap loss due to tissue congestion and partial or complete necrosis. Different mechanisms are discussed in this process, and based on the involved mechanisms, various agents and approaches are suggested for flap salvage. Among these agents and strategies, leech therapy (hirudotherapy) can be a valuable complementary treatment; however, in this way, full attention should be given to all beneficial and harmful aspects to reach the best results. This study included a literature review of the essential complications following free tissue transfer and explained the effects of leech therapy for the respective complications. Based on the review of the literature, the essential complications following free tissue transfer were (I) venous obstruction and congestion, (II) delay in blood flow reestablishment, (III) ischemia/reperfusion injuries, and (IV) thrombus formation. Leech therapy can protect free flaps against the mentioned complications as a complementary treatment. Leech therapy is an appropriate complement, however, not a definite approach for flap salvage. Therefore, in some patients, other alternative methods or even flap removal may be a better option.
PubMed: 35514759
DOI: 10.22038/ABJS.2022.55013.2736 -
Biomedicines Apr 2020Before the advent of modern medicine, natural resources were widely used by indigenous populations for the prevention and treatment of diseases. The associated... (Review)
Review
Before the advent of modern medicine, natural resources were widely used by indigenous populations for the prevention and treatment of diseases. The associated knowledge, collectively described as folk medicine or traditional medicine, was largely based on trial-and-error testing of plant extracts (herbal remedies) and the use of invertebrates, particularly medicinal maggots of the blowfly and blood-sucking leeches. The widespread use of traditional medicine in the West declined as scientific advances allowed reproducible testing under controlled conditions and gave rise to the modern fields of biomedical research and pharmacology. However, many drugs are still derived from natural resources, and interest in traditional medicine has been renewed by the ability of researchers to investigate the medical potential of diverse species by high-throughput screening. Likewise, researchers are starting to look again at the benefits of maggot and leech therapy, based on the hypothesis that the use of such animals in traditional medicine is likely to reflect the presence of specific bioactive molecules that can be developed as drug leads. In this review, we consider the modern medical benefits of European medicinal leeches based on the systematic screening of their salivary proteins.
PubMed: 32349294
DOI: 10.3390/biomedicines8050099 -
Journal of Ayurveda and Integrative... 2020Hirudotherapy, also known as medicinal leech therapy, has been used to treat a wide range of disorders for thousands of years since Ancient Egypt. Leech therapy is also...
BACKGROUND
Hirudotherapy, also known as medicinal leech therapy, has been used to treat a wide range of disorders for thousands of years since Ancient Egypt. Leech therapy is also mentioned as a minimal invasive technique called Jalaukavacharana in the Sushruta Samhita, an ancient Sanskrit text of Ayurvedic medicine. Although hirudotherapy has become a popular component of complementary medicine in the last decade, scientometric studies investigating the articles published in this field, do not exist.
OBJECTIVE
In this study, we aimed to perform a detailed scientometric analysis of hirudotherapy literature.
MATERIALS AND METHODS
We collected data by using four databases provided by Web of Science using the keywords "hirudotherapy", "leech therapy", "medicinal leech" and "medicinal leech therapy".
RESULTS
A total of 834 articles were found of which 89.8% were original articles. USA was the leading country with 280 publications, followed by UK, Germany and France (128, 101 and 41 items, respectively). The most productive countries regarding hirudotherapy were the UK (1.93), Slovenia (1.44), and Israel (1.32). The peak publication year for hirudotherapy literature was 2011 with 41 papers.
CONCLUSION
To the best of our knowledge, our study was the first bibliometric and scientometric analysis in this field and we believe that multicenter studies and further searches from developing and least-developed countries are needed in hirudotherapy literature.
PubMed: 31289001
DOI: 10.1016/j.jaim.2018.11.006 -
Ear, Nose, & Throat Journal Nov 2021To determine the surgical outcomes of free tissue transfer surgery following head and neck tumor extirpation in a low-volume medical center.
OBJECTIVE
To determine the surgical outcomes of free tissue transfer surgery following head and neck tumor extirpation in a low-volume medical center.
METHODS
Retrospective chart review of patients who underwent free tissue transfer surgery for head and neck cancer at Moanalua Medical Center from 2015 to 2018.
MAIN OUTCOME OF MEASURE
Free flap failure rate and free flap-related complications.
RESULTS
From 2015 to 2018, there were 27 free tissue transfer surgery (mean 6.75 flap surgery/year). There were 2 events of partial flap necrosis, and no cases of total flap loss. One patient required leech therapy for venous congestion. One patient required additional free flap surgery. Two patients developed orocutaneous fistula that resolved with local wound care. One patient developed malocclusion following mandible reconstruction using fibular free flap. Overall free flap success rate was 96%.
CONCLUSION
This study supports the ability of small-volume centers to produce positive outcomes with few complications in head and neck cancer free flap reconstructive surgery. While the data are limited to a single surgical team in one care center, it provides additional support for the idea that there are factors beyond the surgical volume that determine outcome.
Topics: Free Tissue Flaps; Head and Neck Neoplasms; Hospitals, Low-Volume; Humans; Postoperative Complications; Plastic Surgery Procedures; Retrospective Studies; Treatment Outcome
PubMed: 32364445
DOI: 10.1177/0145561320923835 -
Biomedicine & Pharmacotherapy =... May 2022Medicinal leeches have been used in health care since before written history, with widely varying popularity over the centuries. Nowadays, medicinal leech therapy is... (Review)
Review
Medicinal leeches have been used in health care since before written history, with widely varying popularity over the centuries. Nowadays, medicinal leech therapy is mainly used in plastic and reconstructive microsurgery, with new interesting potential therapeutic applications in many other diseases. The leech's best-known salivary product, hirudin - one of the most powerful natural anticoagulants - was the only remedy to prevent blood clotting until the discovery of heparin. Starting from hirudin, pharmacological research succeeded in developing new anticoagulants, which represent a cornerstone of prevention and treatment of thromboembolic disease. While we are perhaps on the threshold of a new era of anticoagulation, with the development of FXI and XII inhibitors and direct reversible covalent thrombin inhibitors, which promise to achieve effective anticoagulation without bleeding risk. This review retraces the intriguing journey of these drugs in cardiovascular disease, highlighting the fil rouge that links the ancient leech to the current and oncoming antithrombotic therapy. We think that knowledge of the past is key to understanding and appreciating the present and to seize future opportunities.
Topics: Animals; Anticoagulants; Antithrombins; Fibrinolytic Agents; Hirudins; Leeches; Thrombin
PubMed: 35364378
DOI: 10.1016/j.biopha.2022.112878 -
Journal of Traditional and... Mar 2020The use of medicinal leech therapy (MLT) is the subject of many articles describing basic pharmacological principles, application procedures, or efficacy and safety of... (Review)
Review
The use of medicinal leech therapy (MLT) is the subject of many articles describing basic pharmacological principles, application procedures, or efficacy and safety of the broad range of therapeutic indications. This review is focused on the information gap between Eastern and Western medicine when medicinal leech therapy is used in wound healing. Impaired wound healing has serious consequences for patients' health in a variety of clinical conditions. Western, Persian and Indian medicine seem to apply different therapeutic approaches when using medicinal leech therapy for healing wounds. A range of review articles, single case reports and case series on the use of medicinal leech therapy in wound healing have been inspected. The various reports indicate that medicinal leech therapy has potential benefits for patients experiencing venous congestion of the skin and tissues, as well as varied types of ulcers. Such therapy is proven to have thrombolytic, anti-coagulant, blood and lymph enhancing, anti-inflammatory and pain-relieving effects. The specifics of these approaches are expected to stimulate further research on the use of medicinal leech therapy in wound healing. Although the use of medicinal leech therapy to relieve venous congestion following reconstructive and plastic surgery is well-known in Western medicine, its use in promoting wound healing in various ulcer forms, in the context of Ayurveda/Unani/Persian medicine, seems largely restricted to Asian- and Arabic spheres. The true value of medicinal leech therapy in wound healing should be elucidated by further investigations applying modern, evidence-based research methods.
PubMed: 32257872
DOI: 10.1016/j.jtcme.2019.08.003 -
Turkiye Parazitolojii Dergisi Jun 2021Lichen planus is a traumatic (koebner positive), chronic, inflammatory and autoimmune disease affecting the oral and genital mucosa, scalp and nails. The Food and Drug...
Lichen planus is a traumatic (koebner positive), chronic, inflammatory and autoimmune disease affecting the oral and genital mucosa, scalp and nails. The Food and Drug Administration approved the use of medical leeches for therapeutic purposes (hirudotherapy) in 2004 to ensure flap nutrition in plastic surgery. A 34-year-old male patient was admitted to our dermatology outpatient clinic with a swollen, itchy and purple-coloured rash on legs and back for a month, and white and reticulated plaques in the mouth. It was learned that a week earlier, eight leeches was applied to both knees and ankles to alleviate knee and leg pain. The patient had no history of drug use. A punch biopsy was taken from the patient with a preliminary diagnosis of lichen planus and lichenoid drug reaction. The histopathological examination showed hyperkeratosis, irregular acanthosis and hypergranulosis. Systemic methylprednisolone, levocetrizine and topical methylprednisolone aceponate were planned for the therapy. To the best of our knowledge, the appearance of lichen planus after hirudotherapy was never reported in literature. Hence, physicians should keep in mind that lichen planus and similar dermatoses could be triggered due to hirudotherapy. The fact that lichen planus appeared a week after hirudotherapy does not necessarily mean that leeches were the cause of this phenomenon. Accordingly, it could be deduced that lichen planus was probably developed as a result of leech therapy.
Topics: Adult; Anti-Inflammatory Agents; Biopsy; Humans; Leeching; Lichen Planus; Male; Skin
PubMed: 34103294
DOI: 10.4274/tpd.galenos.2020.7066 -
Medical Anthropology Quarterly Mar 2021This article offers vascularity as a multi-dimensional imaginary for the interspecies entanglements constituting Ayurvedic leech therapy. Whether, when, where, and how a...
This article offers vascularity as a multi-dimensional imaginary for the interspecies entanglements constituting Ayurvedic leech therapy. Whether, when, where, and how a leech decides to bite, suck, and release comprise pivotal junctures in leech therapy as practiced in southern Kerala, India. In the course of leech-human intra-actions, leeches translate matter, providing sensory mediation, relief, and amusement. Enmeshed in social and ecological relations inflected by gender, religion, class, and caste, this analysis of Ayurvedic leech therapy reframes questions of agencies starting with and from the viewpoint of the vascular capacities of leeches in their interactions with humans. This image of vascularity provides an analytic for the emergent agencies of humans and leeches constituted by sensory intra-actions at branching points in this multispecies clinical practice.
Topics: Aged; Animals; Anthropology, Medical; Blood Vessels; Female; Humans; India; Leeches; Leeching; Male; Medicine, Ayurvedic; Middle Aged; Varicose Ulcer
PubMed: 32779247
DOI: 10.1111/maq.12595 -
Current Research in Neurobiology 2023Future neuroscience and biomedical projects involving non-human primates (NHPs) remain essential in our endeavors to understand the complexities and functioning of the... (Review)
Review
Future neuroscience and biomedical projects involving non-human primates (NHPs) remain essential in our endeavors to understand the complexities and functioning of the mammalian central nervous system. In so doing, the NHP neuroscience researcher must be allowed to incorporate state-of-the-art technologies, including the use of novel viral vectors, gene therapy and transgenic approaches to answer continuing and emerging research questions that can only be addressed in NHP research models. This perspective piece captures these emerging technologies and some specific research questions they can address. At the same time, we highlight some current caveats to global NHP research and collaborations including the lack of common ethical and regulatory frameworks for NHP research, the limitations involving animal transportation and exports, and the ongoing influence of activist groups opposed to NHP research.
PubMed: 36582401
DOI: 10.1016/j.crneur.2022.100064