Intrapleural instillation of drugs (chemical pleurodesis) was performed in 57 patients with malignant pleural effusions or recurrent pneumothorax. Agents used included mechlorethamine hydrochloride (nitrogen mustard), quinacrine hydrochloride (Atabrine), tetracycline, and others. The most frequent finding on chest radiographs (56%) was multiple loculated air-fluid levels, an appearance simulating an empyema. Resolution of these changes occurred in one to three weeks. Late sequelae included pleural thickening (63%) or the development of a severe fibrothorax. In the majority of the six patients treated for recurrent pneumothoraces, the radiographic appearance returned to normal. The appearance of a new air-fluid level following withdrawal of the chest tube in one patient indicated a complicating empyema.

No abstract

A number of Radiotherapy Departments have extended the working day on linear accelerators, as a method of increasing treatment capacity. However, reports from the Royal College of Radiologists predict a rate of increase in requirements for radiotherapy, significantly in excess of the rate at which radiographers will become available to run the necessary equipment.Based on the premise that radiographers are the most difficult staff group to recruit, a number of different patterns of radiotherapy linear accelerator use has been investigated, with an aim of seeing which delivers the greatest return on radiographer time. The requirement for radiographers per linac-hour has been examined for a number of lengths of day and utilising various staffing assumptions.Given current patterns of work, the greatest manpower efficiency in use of trained radiographers is achieved if machines are run for a 7-h-day or for an 8-h-day if part-time radiographers are available. This working pattern relies on all ancillary tasks being removed from the treatment unit, many of which can be performed by other appropriately trained, non-radiographer, staff groups.With linac-hour demand projected to rise faster than the rate at which new trained radiographers become available, extended working days are not sustainable without significant change to current work patterns.

No abstract

No abstract