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.

Radiation and immunotherapy combination can destroy both primary and secondary tumours

Radiation therapy not only kills cancer cells, but also helps to activate the immune system against their future proliferation. However, this immune response is often not strong enough to be able to cure tumours, and even when it is, its effect is limited to the area that has been irradiated. Now, however, research to be presented to the ESTRO 35 conference today (Sunday) has shown that the addition of an immune system-strengthening compound can extend the radiation therapy-induced immune response against the tumour sites and that this response even has an effect on tumours outside the radiation field.

Ms Nicolle Rekers, MSc, from the Department of Radiation Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands, will describe to the conference how a combination of radiation therapy and L19-IL2, an immunotherapy agent 1, can increase significantly the immune response when given to mice with primary colorectal tumours. L19-IL2 is a combination of an antibody that targets the tumour blood vessels and a cytokine, a small protein important in cell signalling in the immune system.

The researchers found not only that the mice were tumour-free following treatment, but also that when re-injected with cancer cells 150 days after cure, they did not form new tumours. There was also an increase in the number of cells with an immunological memory.

"Radiation therapy damages the tumour creating a sort of tumour-specific vaccine," Ms Rekers will say. "It feeds the immune system and ensures that it notices that something is wrong. What is unique about our latest experiments is that we have been able to create a so-called abscopal effect, where a localised radiation treatment has also had an effect on other tumour sites outside this radiation field."

The lifespan of mice is quite short - about two years - so 150 days is a relatively long time. "Of course, these mice are models of human disease and can never be 100% comparable with a patient, but the fact that the cured mice never formed new tumours, compared with a 100% tumour formation in untreated mice of the same age, is significant. We will know more after analysing results from the Phase I/II clinical study in human patients that we started recently," says Ms Rekers 2.

L19-IL2 is known to be safe in patients, with only mild side effects limited to injection site reactions. The new trial will look at the combination treatment in patients with oligometastatic 3 solid tumours. "Our ultimate aim is to increase the time during which the disease does not progress by using this combination to bring about an immune response that will attack both the primary tumour and its metastases," says Ms Rekers.

Although reprogramming the immune system has only been feasible relatively recently, research to date seems to indicate that it is without damaging long-term effects. "We believe that the risk/benefit equation is likely to come down firmly on the side of benefit. We hope that this treatment will not only destroy tumours, but also enable the immune system to develop a memory that allows it to annihilate them in the future as well," Ms Rekers will conclude.

ESTRO President Professor Philip Poortmans commented: "A couple of years after the first breakthrough of immunotherapy in medical oncology, we are now on the verge of an exciting new era that combines this novel approach with radiation therapy. This could open the door to shorter treatment durations, thereby reducing side effects and costs compared to common palliative approaches in mono-immunotherapy, as well as to potentially new curative options where we had none before. It is time to join forces with all partners, including industry, to explore these capabilities."



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Massive failure to publish trial results exposes patients to risks without providing benefits for others

Although the publication of results of clinical trials carried out in the US within 12 months of their completion has been mandatory since 2007, an astoundingly high number of Phase III radiotherapy trials did not do so, according to new research to be presented at the ESTRO 35 conference today (Saturday). An analysis of 802 trials with a primary completion date of before 1 January 2013 showed that 655, or 81.7%, did not publish even a summary result.

Jaime Pérez-Alija and his colleague Pedro Gallego, medical physicists from the radiotherapy and oncology department, Hospital Plató, Barcelona, Spain, also looked at radiotherapy trials that began before the 2007 Act was passed, and found little difference; 422 out of 552, or 76.4%, did not deposit their results with the ClinicalTrials.gov database.

"These findings came as a surprise for many reasons, not least of which was that many of the trials had been funded by the US National Institutes of Health. Since we know that clinical trials produce the best data for decision-making in modern evidenced-based medicine, it is particularly worrying that the law is being ignored on such a wide scale," Mr Pérez-Alija will tell the conference.

One possible reason for non-publication, say the researchers, is that some of the trials may have been granted a deadline extension. But, if this is the case, it is not publicly known. "Therefore, our first problem is that we do not know with any certainty whether a trial is truly overdue. The registry says clearly that all dates must be updated if an extension has been allowed, but it seems likely that this is not happening in many cases," says Mr Pérez-Alija.

The researchers are investigating the issue further to see, for example, how many of the trials registered in ClinicalTrials.gov or in other databases are being published in medical journals. They will also analyse bias, in the knowledge that it is easier and more usual to publish positive rather than negative findings. They intend to email principal investigators to ask why the mandatory deposition of results did not take place, and to enquire about the reasons for non-publication in medical journals of those trials where there is a published deposition.

"Interestingly, we found that company-funded trials are far better at complying with the rules than academic trials - 55% and 30% respectively. However, only one-third of all the trials we studied were company trials," Mr Pérez-Alija will say.

The researchers broke down their results further by cancer sub-type. The only sub-type where more than half the trial results were published was eye cancer, with 47% unpublished, whereas in testicular and anal cancer the percentage of unpublished trial results was 100% for both categories. Even common cancers such as breast and lung fared badly, with 78% and 73.7% of results unpublished respectively.

"We have shown that a large number of study participants are routinely exposed to the risks of trial participation without the benefits that sharing and publishing results would have for patients in the future. This ethical issue should be at the heart of our current medical practice, and our leaders should be made aware that withholding these data poses a significant threat to public health. Both the US and, more recently, EU laws have made important steps to correct this situation. But if most trials - even those funded by public institutions - do not comply with these requirements, further measures need to be taken," says Mr Pérez-Alija.

The US Act allows for economic sanctions to be taken against trial sponsors who do not comply with regulations. But the danger here, the researchers say, is that some investigators might decide not to begin a new trial if sanctions are a possibility. Having fewer trials could be damaging to the health system as a whole as well as to future patients.

A potential solution would be to institute a system whereby if clinical investigators apply for public funding, they would have to disclose results of all previously-conducted trials. And for privately-funded trials, results from all previous studies would have to be made available before the new trial could be registered.

"Millions of volunteers have participated in clinical trials to help find out more about the effects of treatments on disease, yet the important ethical issue of reporting results has been ignored widely. Information about what was done, and what was found in these trials could be lost forever, leading to bad treatment decisions, missed opportunities for good medicine, and trials being repeated unnecessarily. This situation should not be allowed to continue," Mr Pérez-Alija will conclude.

ESTRO President Professor Philip Poortmans commented: "Patients who agree to participate in trials do so for the unselfish reason that they want to help others to have the best possible treatment in the future. Not to publish results is unfair to them, to future patients, and to medicine as a whole."



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Study links residential radon exposure to hematologic cancers in women

A new report finds a statistically-significant, positive association between high levels of residential radon and the risk of hematologic cancer (lymphoma, myeloma, and leukemia) in women. The study is the first prospective, population-based study of residential radon exposure and hematologic cancer risk, leading the authors to caution that it requires replication to better understand the association and whether it truly differs by sex. It appears early online in Environmental Research.

Radon is a naturally occurring byproduct of the decay of radium, and is a known human lung carcinogen, the second-leading cause of lung cancer in the United States. Modeling studies show that radon delivers a non-negligible dose of alpha radiation to the bone marrow and therefore could be related to risk of hematologic cancers. Studies to date, however, have produced inconsistent results.

More than 171,000 new cases of hematologic cancer and more than 58,000 deaths are expected in the United States in 2016. Hematologic cancers are the most expensive cancers to treat per quality-adjusted life year gained.

For the current study, researchers led by Lauren Teras, Ph.D. of the American Cancer Society used data from the American Cancer Society Cancer Prevention Study-II Nutrition Cohort established in 1992, to examine the association between county-level residential radon exposure and risk of hematologic cancer. The analysis included 140,652 participants among whom there were 3,019 hematologic cancers during 19 years of follow-up.

They found women living in counties with the highest mean radon concentration had a statistically significant 63% higher risk of hematologic cancer compared to those living in counties with the lowest radon levels. They also found evidence of a dose-response relationship. There was no such association among men.

The authors say men may have a higher baseline risk, possibly because of more exposure to occupational or other risk factors for hematologic cancer, reducing the impact of any additional risk from residential radon. In women, who have a smaller baseline risk, residential radon exposure might be a larger contributor to overall risk. Another reason may be that the women of this generation spent more time in their homes, so had more residential exposure than men.

"The overall lifetime risk of hematological cancers in the United States is about 2%, so even a 60% relative increase would still mean a relatively small absolute risk," said Dr. Teras. "Nonetheless, radon is already associated with lung cancer, and if other studies confirm the link to blood cancers, we think it would warrant strengthened public health efforts to mitigate residential radon risks."

Residential radon exposure and risk of incident hematologic malignancies in the Cancer Prevention Study-II Nutrition Cohort. Lauren R. Teras, W. Ryan Diver, Michelle C. Turner, Daniel Krewski, Liora Sahar, Elizabeth Ward, Susan M. Gapstur. Environmental Research. DOI:10.1016/j.envres.2016.03.002. Published online 23 March 2016.



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