teleconsult

Teleradiology

Designing and delivering teleradiology services which meet your specific requirements is our forte. Our Board Certified radiologists offer preliminary, final and subspecialty reports 24/7/365. Turnaround times are set to match your needs. Our technical support center provides state of the art PACS/RIS and communication technology, which securely integrates with your current Information Systems.

Telepathology

Teleconsult pathologists offer services ranging from remote reporting of cyto- and histological cases, to lab design and quality assurance programs. We support the most basic lab set ups with second opinions and on-line consultations, and connect more advanced labs to our web based telepathology platform for routine reporting of diverse cases.

Telemicrobiology

Our telemicrobiology services are offered by Dutch and UK Board Certified clinical microbiologists with sub-specialties in the fields of general microbiology, bacteriology, virology, parasitology, mycology, molecular diagnostics and epidemiology. Our clinical microbiologists are mainly active in clinical hospital settings, keeping them closely connected and in tune with daily clinical situations and challenges. This creates affinity with remote cases and ensures the up-to-date knowledge our customers require.

Locum Placement

Our recruitment division recruits certified radiologists, pathologists and micro biologists for part time and full time positions. In our 15 year history we successfully recruited and placed medical specialists in over 60 hospitals and clinics across the globe

Screening & Trials

From its worldwide network of Board Certified medical specialists, TeleConsult creates subspecialty teams for specific screening and clinical trial assignments. In 2012 TeleConsult’s dedicated breast radiologists were selected by the Dutch Breast Cancer Screening program to interpret its screening mammography studies.

We are hiring

We recruit, select and place sub-specialty, EU educated and certified radiologists, pathologists and microbiologists for short and long term positions. Our reputation has been built on a foundation of providing highly skilled doctors and the following core values: Professionalism, Value for money, Quality, Reliability and Integrity. Interested in joining our team? Register now!

Specialist care at your fingertips

Whether you are a hospital  department, diagnostic center or laboratory, Teleconsult doctors and IT experts bring optimal efficiency to your  workflow. A thorough analysis of your current situation, needs and requirements results in a balanced work flow management plan.

Teleconsult does not have any volume requirement and you are in full control to decide when to outsource studies to a Teleconsult doctor. To find out how your clinic or department will benefit from working with Teleconsult Europe, please contact us.

  • INCREASE YOUR SUBSPECIALTY OFFERINGS

  • Balance on- and off site tasks

  • INCREASE PRODUCTIVITY AND PROFITABILITY

  • MAXIMUM USE OF RADIOLOGY AND LABORATORY EQUIPMENT

  • 24/7/365 AVAILABILITY OF EXPERTISE

About Teleconsult

Founded in 2007 by Dutch radiologists, TeleConsult Europe (TCE) offers radiology services to hospitals, clinics, diagnostic centers, laboratories, medical services companies and the Dutch Government.

TCE’s mission is to provide its customers with tailored telemedicine solutions. Since its inception, TCE carefully listened to wishes and needs of its clients. This resulted in an array of interchangeable services providing radiology and pathology departments with high quality, cost efficient, flexible on- and off-site solutions.

Today TCE’s solutions consist of a combination of an on-site physician workforce, teleradiology, telepathology, and IT services. Our Western Board certified radiologists and pathologists perform reading services for a broad array of institutions varying from a 24/7 emergency reading service for hospitals and clinics, to screening services for the famous Dutch Breast Cancer Screening Program.

The primary objective of our highly trained physicians and staff is to enable our clients to provide optimal patient care and diagnostic services by placing quality and value first. Our synergetic modules provide tailored services to hospitals, clinics and imaging centers at any location on the globe. Whether you need an on-site physician, reports through telemedicine or a combination of both, we help you to realize an optimal and cost efficient workflow.

Apollo astronauts more prone to cardiovascular problems

Astronauts who flew in deep space on the Apollo program have a higher chance of developing cardiovascular disease, possibly because of exposure to radiation. These are the findings of research published in Scientific Reports.

Astronauts traveled into deep space as part of the Apollo lunar missions. These men were exposed to high levels of galactic cosmic radiation. Astronauts and cosmonauts on other missions did not face such high levels of radiation.

Previous studies have suggested that space travel can lead to stiffening of the arteries. The near-zero gravity experienced during space travel affects blood circulation.

The human circulatory system is designed to pump liquids upward, to counter the Earth's gravitational force. In space, the face becomes puffy as liquids are not pulled toward the feet.

Past research has indicated that 10 percent of all astronauts who died between 1959-1991 had cardiovascular problems, 5 percent had cancer, 80 percent died in accidents, and 5 percent died of other causes. However, most of these did not fly in deep space.

High levels of cardiovascular disease

A team led by Prof. Michael Delp, of Florida State University, wanted to know whether exposure to deep space radiation, weightlessness, or both, would be likely to trigger the cardiovascular problems seen in Apollo astronauts.

The Apollo program operated from 1961-1972. Apollo astronauts included Neil Armstrong, Buzz Aldrin, and Michael Collins. They flew to the moon in 1969 on Apollo 11.

Between 1968-1972, there were 11 manned Apollo flights. Nine of those flew beyond Earth's orbit into deep space.

In total, 24 men flew into deep space on the Apollo missions. Eight of them have already died. The researchers looked at data for seven of those men. An eighth, Edgar Mitchell, passed on after the analysis of the data was carried out.

Results showed that 43 percent of the Apollo astronauts who died had a cardiovascular problem. In comparison, astronauts who did not fly had a 9 percent chance of dying of a similar problem. Among the astronauts who flew in low Earth orbit only, the odds of having cardiovascular disease were 11 percent.

The Apollo astronauts were four to five times more likely to die of cardiovascular issues than astronauts who either did not fly or who flew in low Earth orbit.

Those who flew in low orbit experienced weightlessness, and their chance of dying of cardiovascular problems was slightly higher than in those who did not fly. But for those who flew in deep space, exposed to both weightlessness and radiation, the risk was far higher.

This suggests that radiation, rather than weightlessness, is the main factor contributing to cardiovascular disease.

Mouse studies support findings

The scientists gave mice similar exposure to the type of radiation that the Apollo astronauts would have faced.

Six months later, which is the mouse equivalent of 20 human years, the mice showed signs of cardiovascular disease.

Their arteries sustained the kind of damage that, in humans, typically leads to atherosclerotic cardiovascular disease. Results suggest that irradiation from deep space leads to a sustained dysfunction in the vascular endothelial cells. This type of dysfunction is known to lead to occlusive artery disease.

According to Prof. Delp, this suggests that deep space radiation can damage vascular health.

"We know very little about the effects of deep space radiation on human health, particularly on the cardiovascular system. This gives us the first glimpse into its adverse effects on humans."

Prof. Michael Delp

Astronauts normally have better healthcare outcomes than most people, as they are highly educated and have access to top medical care.

However, when the Apollo astronauts traveled into deep space, they did something that nobody else has ever done; they are the only people ever to have experienced these particular conditions.

Space travel: Into the future

This type of information will no doubt be of interest to government and private organizations that are currently making plans for deep space travel and tourism.

The National Aeronautics and Space Administration (NASA) are planning orbital missions around the moon from 2020-2030, and a manned flight to Mars is a future possibility.

The authors note that a limitation of their study was the small sample size. Now, together with NASA, they are planning further studies into the cardiovascular health of the Apollo astronauts.

Find out more about the health risks associated with space travel.



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Combining ipilimumab with local treatments improved survival for patients with melanoma

Among patients with melanoma, those who received both ipilimumab (Yervoy) and local peripheral treatments such as radiotherapy or electrochemotherapy had significantly prolonged overall survival compared with those who received only ipilimumab, according to a retrospective clinical study.

Ipilimumab is an immunotherapy that has revolutionized the treatment of malignant melanoma, a very aggressive type of skin cancer, according to Theurich. About 20 percent of patients who receive ipilimumab achieve durable responses, which is a major advance compared with historic outcomes, but physician-scientists are looking for ways to increase the percentage of patients who gain long-term benefit from this immunotherapy, he added.

Currently, local peripheral treatments are not used to try and cure patients with malignant melanoma; rather, they are used to provide relief from symptoms caused by the melanoma tumors, explained Theurich.

Theurich and his colleagues analyzed data from 127 patients with malignant melanoma who were treated consecutively at four cancer centers in Germany and Switzerland. Eighty-two patients received ipilimumab only and 45 received ipilimumab and local peripheral treatment to relieve tumor-related symptoms.

Median overall survival for patients receiving ipilimumab and local peripheral treatment was 93 weeks, compared with 42 weeks for those receiving only ipilimumab.

After excluding patients with brain metastases from the analysis, because these patients were not distributed equally among the two treatment groups, the median overall survival benefit for those receiving ipilimumab and local peripheral treatment remained - 117 weeks compared with 46 weeks for those receiving only ipilimumab.

"We found that adding local peripheral treatments, including external radiotherapy, electrochemotherapy, or internal radiotherapy, to systemic ipilimumab treatment doubled survival chances in our patient cohort and did not increase immune-related side effects," said Theurich. "Importantly, this survival advantage seemed to overcome even traditional risk factors of poor outcomes. This suggests that this combination could be an option for all patients with malignant melanoma, and this is being tested in ongoing prospective clinical trials.

"Our results are concordant with those previously reported for 29 patients treated in the United States with ipilimumab and local radiotherapy," continued Theurich. "Having data from different parts of the world improves the validity of the results, especially if you deal with retrospective analyses. Moreover, all our patients were treated with the same dose of ipilimumab, whereas those in the previous study received varying doses because they were being treated in a dose- escalation clinical trial.

"We were also able to begin to investigate the potential immunologic mechanism underlying the benefit of adding local peripheral treatment to ipilimumab," added Theurich. "It seems that local peripheral treatments activate immune cells, which are then able to attack tumors at sites away from the local treatment site. However, we are investigating this further in prospective studies."

According to Theurich, the main limitations of the study are that the data were not collected prospectively and in a randomized fashion, but the validity of the results is now being tested in prospective clinical trials.

The study was in part funded by the University of Cologne (Physician Scientist Program, "Gerok-Rotationsstelle") and the Freie Akademische Gesellschaft Basel, Switzerland. Theurich declares no conflicts of interest.

Article: Local Tumor Treatment in Combination with Systemic Ipilimumab Immunotherapy Prolongs Overall Survival in Patients with Advanced Malignant Melanoma, Sebastian Theurich et al., Cancer Immunology Research, doi: 10.1158/2326-6066.CIR-15-0156, published online 27 July 2016.



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Markers that cause toxic radiotherapy side-effects in prostate cancer identified

A new study involving researchers from The University of Manchester looked at the genetic information of more than 1,500 prostate cancer patients and identified two variants linked to increased risk of radiotherapy side-effects.

Nearly 50% of the 1.1 million men a year worldwide diagnosed with prostate cancer undergo radiotherapy. It is an effective treatment, but between 10 and 50 percent of men suffer from radiotherapy side-effects which can cause long-term problems with urinating or rectal bleeding.

It is not known why some men are more susceptible to side-effects and as a result doses are kept low to minimise the risk in all patients - reducing the effectiveness of treatment. The new Radiogenomics Consortium study coordinated from Manchester aimed to identify if there were any genetic markers which could explain this.

Genetic profiling was carried out on 1,564 patients from four centres based in Europe and North America. It examined genetic variants described as single nucleotide polymorphisms (SNPs) which form part of the subunits of DNA.

Two years after the radiotherapy, 17.8% of the group had suffered from rectal bleeding, 15% an increase in urinary frequency and 8.1% a decrease in urine stream.

Professor of Radiation Biology, Catharine West from The University of Manchester's Institute of Cancer Sciences led the research. She said: "The first studies into SNPs were smaller. We needed to show we could combine them to increase the number of patients investigated and improve our ability to identify genetic variants. Centres give radiotherapy in different ways and we needed to show this variability was not a problem."

The two variants found were associated with an increased frequency of urinating and a decreased flow of urine.

The causes for the associations are unclear, but the two SNPs identified are located in the regions of genes that are expressed in tissues exposed to radiation.

The results show radiotherapy cohorts can be combined and larger studies should identify enough variants to develop a test to predict a cancer patient's risk of radiotherapy side-effects.

Professor West added: "There are currently more than 32 million people alive five years after having cancer, so the side-effects of their treatment are an important issue for them. If we can develop a test that means people can reduce the risk of these problems that will be of huge benefit to this group."

Article: Meta-analysis of Genome Wide Association Studies Identifies Genetic Markers of Late Toxicity Following Radiotherapy for Prostate Cancer, Kerns SL, Dorling L, Fachal L et al., EBioMedicine, doi:10.1016/j.ebiom.2016.07.022, published online 20 July 2016.



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