Clin Exp Emerg Med 2016;3(2):105-108http://dx.doi.org/10.15441/ceem.15.103 Intravenous lidocaine for the treatment eISSN: 2383-4625 of acute pain in the emergency departmentBrendan Michael Fitzpatrick, Michael Eugene MullinsDivision of Emergency Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
Tdl manual.Prostate Awareness Road Shows Event Guidance Manual Guidance Manual !Contents How To Get Started How To Run A Road Show Post Road Show Activities Appendices !!!!!!!!!! Introduction !This manual has been developed as a guide to groups putting on Prostate Health Awareness road shows including PSA tests using the TDL TINIES. !Background The Graham Fulford Charitable Trust was formed by Graham Fulford late 2004 having had a very dear friend and a close relative diagnosed with prostate cancer. Sadly both lost their fight against this insidious disease having, like many, been diagnosed too late. Over the last 10 years the Trust has, working closely with David Baxter Smith M.A,M.Sc.,B.A.O.,F.R.C.S. Consultant Urological Surgeon and the Kidderminster Prostate Cancer Support Group, carried out over 34,000 PSA tests all over the country and have found approaching 700 prostate cancers at the time of writing. The great advantage of using the TDL TINIES is not only the speed of response of getting the result (could be as soon as 48hrs) but also the flexibility it gives in enabling regular events to be held in local communities. It is essential to understand all such groups will have the full support of TGFCT (with the experience gained in holding in excess of 325 events all over the country) and David Baxter Smith. Please feel free to contact them at any time. ! How To Get Started !Get together a group of like-minded individuals who would "like to make a difference" in this vital area of men's healthcare. Prostate cancer support groups are a perfect example. Visit www.tdlpathology.com to see their brief film about how using TDL TINIES to PSA testing has to offer. Discuss this matter via phone, email or post with any or all of the following: Graham Fulford of TGFCT on: T: 07831 156071, E: [email protected] 3 Mill Street, Warwick, CV34 4HB Annette Wilkinson of The Doctors Laboratory (TDL) T: 020 7307 7373: E: [email protected] David Baxter Smith Consultant Urologist Keepings, 36 Middlefield Lane, Hagley, Worcestershire, DY9 0PX Consider holding a "pilot" session in a suitable venue in your locality. Please note GFCT and DBS will provide full ongoing support and follow up of any "abnormal" letters resulting from this pilot. After the "pilot" session consider setting up an ongoing regular awareness programme. As a guide each test costs £12 to £15 depending whether the extra test of ‘Free to total' is required. Local charities such as Freemasons, Rotary and Lions are just 3 of the many organisations who may be able to help financially. Just ask around-you may be pleasantly surprised by the results! Moreover, you can have voluntary collections at awareness events to help fund future road shows. ! !How To Run a Road show Locate and book a suitable venue and time. Please note the emphasis is now on checking the "Health" of your prostate. This should help alleviate some of the worries. Advertise it – bearing in mind each test takes 3 to 4 minutes. Organise a pool of helpers and trained operatives. You may have to at least reimburse expenses for the latter. Liaise with TDL and GFCT to ensure you have sufficient Tinies Psa kits and literature stock to cover the session Organise fund raising before, during and after the event to cover the cost of that and future sessions. Give your helpers specific roles on the night (it may be worth swapping roles on an event by event basis so helpers become "multi taskers"). These tasks will include; Greeting men as they arrive and explaining how it all works. Giving them leaflets about PSA testing and any supporting organisations (GFCT/Rotary/Lions etc). Getting them to read the ‘A guide for men considering a PSA Test' leaflet giving them the Pro's and Con's of the test then if happy to go ahead to complete a PSA test consent form, ensuring its been completed legibly and signed. Results will be analysed by TDL who will email the results to DBS. He will then email (or post if no email address available) the relevant "Green"(normal result-but look out for any symptoms); "Amber"(close to the upper "normal" level for a man of that age-recommended to have a follow up test in 3/6 months); or "Red"(abnormal-not necessarily meaning anything seriously wrong-but should certainly be followed up by a GP). All men are given the telephone number of Consultant Urologist David Baxter Smith, who will be available to offer advice or deal with any concerns the recipient may have. At the end of the event collect up the samples and either post them in any Royal Mail post box, using the post-paid self addressed envelopes or, arrange with TDL for the samples to be collected by their couriers. This will depend very much on location and timing. Also collect up the completed consent forms and send via recorded next day delivery to David Baxter Smith for his analysing. Please note David Baxter Smith (and possibly other experienced urologists) will be following up the "red" letters after approximately 6 months and "amber" letters after approximately 12 months. This procedure has been very well received in the past. Post Road show Activities Ensure consent forms have been sent to David Baxter Smith and samples to TDL. Have a "debrief" meeting to discuss how the event went/how it might be improved etc. This is a new approach for us all. Feedback will be welcome. Plan future events with a mindful eye-as ever-on fund raising to cover them! You should expect each event to cost £12 to £15 per person. If those who can contribute £12 - £15 do so, this means that the fund-raising can go much further! Keep in touch with TDL and GFCT about how things are going on this initiative. Working together we will drive up the number of cancer finds and equally importantly improve the quality of life of lots of men suffering from benign conditions which it is equally important to find and treat. APPENDIX A – INCIDENTALS NEEDED TO RUN AN EVENT GUIDE TO PSA TEST LEAFLETS (PCRMP) GFCT CONSENT FORMS LARGE ENVELOPE ADDRESSED TO DBS FOR CONSENT FORMS RECEPTION DESK AND TDL OPERATIVE INFORMATION SHEETS PROSTATE HEALTH INFORMATION LEAFLETS (CAN BE SOURCED FROM PROSTATE UK) TISSUES, DISPOSABLE GLOVES, ANTISEPTIC HAND GEL COLLECTION BUCKETS AND GIFT AID FORM Please Read Carefully Before Commencing !On Arrival Men Are Given A Pack Containing PSA Guide Information (Pcrmp) Gift Aid Form (If Using One) TGFCT Consent Form Please Ask Them To Read The ‘A Guide For Men Considering A Psa Test' (Pcrmp) And If Happy To Proceed Fill In The Consent Form Top Tips: Warm Hands Make It Easier To Collect A Good Sample So If They Would Wash Their Hands In Warm Water And Keep Their Hands Warm. Stand Up When Collecting Your Sample – Hands Lower Than Heart Level Help Speed Up The Sample Collection Process Too. They Are Then Shown To The Waiting Area Please Read Carefully Before Commencing Please Visit The Tdl Psa Link To Watch The Short Film On How To Take A Sample When Ready Call Men Over Check Consent Form Is Signed, And Legible Take Sample And Follow Instructions As Per The Leaflet On The Tinies Filling In The Label And The Tdl Form To Go With The Sample Please Make Sure All Writing Is Legible Put Sample In The Pre-Paid Envelope With The Tdl Form. Inform The Man He Will Receive His Result As Soon As We Can – Hopefully Within A Week Though This Is Dependant On The Urologists Work Load! A GUIDE FOR MEN CONSIDERING A PSA TEST The Psa Test Is A Simple Blood Test Used To Help Detect Prostate Cancer In Its Early Stages Pc Generally Produces No Symptoms, So It Is Important To Diagnose The Disease Before Symptoms Arise And While It Is Still Potentially Curable. A Recent Trial Suggests That Treating Pc May Significantly Prolong A Man'S Life. A High Level Of Psa (Usually 10Ng/Ml & Above) Is Likely To Be An Indication Of Prostate Cancer And Should Therefore Prompt Further Investigation. A Moderately Raised Psa Level (Usually 4Ng/Ml & Above) (Dependant On Age) Means That Other Factors, Including Digital Rectal Examination, Ethnicity Family History, Prostate Volume, Psa History, And Free To Total Psa Ratio, Should Be Considered In Determining Whether To Send A Man For Further Tests Such As Biopsy. However, In Three Quarters Of Such Cases, Further Tests Do Not Detect Cancer. There Can Be Other Reasons For A Moderately Elevated Psa¸ E.G. Urinary Infection, Enlarged Prostate Etc. And These May Need Treatment. Prostate Cancer Is Not Always Aggressive Or Life Threatening. Even If Further Tests Do Detect Early-Stage Prostate Cancer, A Specialist May Not Be Able To Tell Whether The Condition Is Life Threatening Or Harmless. This May Make Treatment Choices Difficult For Both Patient & Clinician. All These Factors Have Led To The Current Controversy Over The Value Of The Psa Test. However, The Uncertainties May Be Reduced By Men Having A Regular Test, Ideally On An Annual Basis. Regular Monitoring Of Psa Levels Can Highlight Any Significant Or Gradual Increase, So That Even When The Psa Is Within The 'Normal' Range, One Maybe Alerted To The Need For Further Investigation. ! CONSENT FORM FOR TDL TEST PLEASE PRINT IN BLOCK CAPITALS You Are Reminded That By Definition This Test Is Only An Indicative One. We Strongly Urge You To Follow The Matter Up With Your Gp If Advised To Do So. !Name: Date Of Birth: …………………………………… Age ……………………………… White – European: White Other: Asian: Afro Caribbean: Mixed Race: Other: Family History Of Prostate Cancer: Father Brother Uncle Grandfather Family History Of Breast Cancer: Mother Sister Aunt Grandmother You Have Had Sexual Intercourse Or Ejaculated In The Last Twenty Four Hours You Are Currently Taking The Drug: Proscar /Propecia (Finasteride) You Are Currently Taking The Drug: Avodart (Dutasteride) Yes Or No You Are Currently Taking The Drug: Combodart ( Dutasteride) Yes Or No You Have Taken Vigorous Exercise In The Last 24Hrs (Cycle Riding Especially) PLEASE TURN PAGE OVER ! Do You Consent To The Transfer Of Your Details To Our Research Collaborators To Contact You Again For The Collection Of Further Data Related To The Investigation Of The Causes Of Cancer And Other Diseases? !Yes / No !!I Would Like To Have A Blood Test By Which The Level Of Prostate Specific Antigen (Psa) And Other Markers May Be Measured. I Understand That This Could Give A Doctor Some Indication Of Any Abnormality Within My Prostate Gland But That I May Also Need A Simple Clinical Examination Carried Out By My Doctor. I Understand That I Will Be Notified Of The Result And Advised Of Any Further Action That May Need To Be Taken. I Understand That Very Occasionally The Result Could Be Normal Even If My Prostate Gland Is Abnormal And That If I Have Trouble Passing Urine I Should Still Arrange To See My Doctor. Please Tick This Box And Add Your Email Address Clearly If You Would Be Happy To Receive Your Result By Email !Email Address …………………………………………………………………………. !!!Signature: . Date: .
Please cite this article in press as: Tachibana et al., Human Embryonic Stem Cells Derived by Somatic Cell Nuclear Transfer, Cell (2013),http://dx.doi.org/10.1016/j.cell.2013.05.006 Human Embryonic Stem Cells Derivedby Somatic Cell Nuclear Transfer Masahito Tachibana,Paula Michelle Sparman,Nuria Marti Rebecca Tippner-Hedges,Hong Eunju Alimujiang Fulati,Hyo-Sang Lee,Hathaitip Keith Masterson,Janine Larson,Deborah Karen David David Diana Jeffrey Jensen,Phillip Patton,Sumita Gokhale,Richard L. Stouffer,Don Wolf,and Shoukhrat 1Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, 505NW 185th Avenue, Beaverton, OR 97006, USA2Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Oregon Health & Science University, 3181 SW SamJackson Park Road, Portland, OR 97239, USA3Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand4Women's Health Research Unit, Oregon Health & Science University, 3303 SW Bond Avenue, Portland, OR 79239, USA5Boston University School of Medicine, 72 East Concord Street, Boston, MA 02118, USA6Present address: Laboratory Animal Center, Osong Medical Innovation Foundation, Chungbuk 363-951, Republic of Korea*Correspondence: