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Biomedical subjects

D Doughty

Publications and source records attributed to D Doughty.

18 recordsLinked to original sources
PubMed1992

Role of the enterostomal therapy nurse in ostomy patient rehabilitation.

Enterostomal therapy (ET) nurses specialize in the management of patients with urinary and fecal diversions, draining wounds and fistulas, fecal and urinary incontinence, and chronic wounds such as pressure ulcers and vascular ulcers. ET nurses have much to offer in the management of patients with cancer. Such nurses play a major role in the rehabilitation of patients undergoing fecal or urinary diversions. Preoperative services include: counseling regarding planned surgical procedure, the impact of an ostomy on the patient's life, and the basics of ostomy management; sexual counseling; and stoma site selection. Postoperatively, the ET nurse instructs the patient and family in ostomy care, dietary and fluid alterations, and ways to incorporate ostomy management into the patient's life. The ET nurse also provides long-term follow-up care in outpatient settings; such care includes ongoing counseling, education, and surveillance for complications requiring medical intervention. ET nurses can recommend appropriate measures to prevent and manage skin breakdown that is related to immobility, friable skin, incontinence, and/or radiation therapy. They also can assist in correcting or containing fecal or urinary incontinence and in cost-effective management of draining wounds and fistulas.

Counseling↗
PubMed1992

Intracranial germ cell tumours: II. The application of a partial transmission block technique to reduce late morbidity.

Craniospinal axis (CSA) irradiation may be associated with significant late sequelae. The recognition of the influence of dose per fraction on late sequelae and the radiosensitivity of germ cell tumours (GCT) led to the adoption of a partial transmission block (PTB) technique for patients with intracranial GCTs. The PTB allows a dose differential between the whole cranium (prophylactic area) and the primary site (high-dose area) throughout the CSA prescription. The PTB technique has been used in four patients, two with germinoma and two with non-germinomatous germ cell tumours (NGGCT). All patients received two courses of primary chemotherapy with at least a partial response prior to CSA irradiation with the PTB and a three-field boost to the primary site. There was no prolongation in the overall treatment time. The use of this 'CNS friendly' radiotherapy technique was straightforward and the potential benefit in reducing late sequelae is discussed using two isoeffect methods.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

An innovative method for neuraxis radiotherapy using partial transmission block technique.

Whole CNS (neuraxis) radiotherapy is an important part of therapy for certain CNS tumours which seed via the CSF. Many, if not the majority, of these predominantly young patients are cured but the neuropsychometric, neuroendocrine and growth morbidity of neuraxis radiotherapy on children by conventional methods may be considerable; patients receiving such therapy at an early age often are eventually in the educationally subnormal category. Recent radiobiological data support the concept that all aspects of CNS radiation tolerance are heavily dependent on daily fraction size. We describe a new radiotherapy technique that allows lower daily fraction sizes to be delivered to the neuraxis without prejudicing the total dose to the neuraxis or primary area and without prolonging the overall treatment time. Published radiobiological data support the concept that all the major morbidities attributed to conventional neuraxis radiotherapy will be reduced by the currently described technique without reducing tumour control rates.

Brain Neoplasms↗
PubMed1990

Stereotactic multiple arc radiotherapy.

A radiotherapy technique is presented for delivering a concentrated pattern of absorbed dose to intracranial lesions. Treatment takes place on a conventional, isocentrically mounted linear accelerator, rotated in several planes around a single target site. A new, relocatable stereotactic frame is used which enables fractionated radiotherapy to be administered if required. Calculations of the absorbed dose distribution in three orthogonal planes are performed using specially prepared software on a computer used for standard treatment planning. In this way, the need for excessive computing power is avoided.

Brain Diseases↗
PubMed1988

Radiotherapy in benign orbital disease. II: Ophthalmic Graves' disease and orbital histiocytosis X.

Ophthalmic Graves' disease and histiocytosis X involving the orbit are occasionally refractory to treatment, so that vision may be threatened. In these situations megavoltage external beam radiotherapy should be employed, and the indications for this treatment are discussed. A highly accurate technique is described, using precise planning with information obtained from high definition CT scans, a complete patient head shell for immobilisation, and modern megavoltage radiotherapy treatment machines. As a result the dose to the lens is minimised (to a maximum of 10% of the prescribed dose), and late morbidity will be small. Two cases are described to illustrate this procedure and the response to treatment.

Adult↗
PubMed1987

Improved total-body irradiation dosimetry.

The total-body irradiation (TBI) technique at St Bartholomew's Hospital has been developed to improve dose homogeneity within the patient. Using a standard 6 MV linear accelerator in an orthodox-sized treatment room, the midpoint doses in head, neck, shoulders, mid-mediastinum, pelvis, knees and ankles are +/- 5% of that of the umbilicus in our current technique. This homogeneity has been achieved by a four-field technique, a reproducible patient set-up, careful use of a new bolus material and an additional beam-flattening filter mounted near the machine head. In addition, thermoluminescent dosimetric data collected at a test irradiation before TBI are used to influence field weightings and further improve dosimetry. This individualised and empirical TBI technique has dosimetric advantages over theoretical TBI dosimetric considerations in reducing dose gradients within the patient. These advantages are discussed.

Data Collection↗
PubMed1985

Combining backscattered electrons and low energy photons to improve the dose distribution to an eyelid.

In electron beam therapy, backscattered electrons from metal shields result in a high dose to tissue in the vicinity of the shield. Data are now available which enable both the magnitude of the dose enhancement at the interface and the fall off in dose 'up stream' to be determined. With the aid of these data, a combined modality therapy (5 MeV electrons, 1.1 mm A1 HVL X rays) was given to an eyelid during which the lens was protected with a superficial X ray lead eye shield. The eyelid was treated to a mid lid dose of 45 Gy in 28 days, and the dose gradient on the beam central axis was more uniform (+/- 3%) than that obtainable with superficial X rays alone. The lens dose from the combined therapy was estimated to be less than 0.25 Gy.

Aged↗
PubMedDate not supplied

Fecal incontinence.

Explore the source record for details and available documents.

Education, Nursing, Continuing↗
PubMedDate not supplied

New publication.

Explore the source record for details and available documents.

Curriculum↗
PubMedDate not supplied

Charging for services: efficiently, effectively, and easily.

In summary, fiscal awareness and involvement are critical in maintaining one's position as an ET nurse and in supporting both quality care and institutional survival. The authors challenge all ET nurses to work toward the establishment of equitable and reimbursable charging systems, and to share the knowledge gained in the process.

Enterostomy↗