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.

Hiroshima and Nagasaki: Have the long-term effects been exaggerated?

A paper published this week re-analyzes data from the ongoing study of Nagasaki and Hiroshima's survivors. The author argues that the long-term health effects of the atomic bomb are not as dire as many believe them to be and asks why public perception does not match the facts.

In August 1945, during the final throes of World War II, America, backed by the Allies, dropped two atom bombs on Japan.

The immediate effects of the attacks were devastating.

First to be dropped was a uranium-based weapon dubbed Little Boy; it hit the city of Hiroshima, killing 90,000-146,000 people in the first few days.

Three days later, a plutonium-based bomb, called Fat Man, was dropped on Nagasaki. Within the first few days of the explosion, an estimated 39,000-80,000 people were dead.

The majority of the immediate deaths were due to the explosion blast itself, acute radiation poisoning, and the ensuing firestorm.

Hiroshima and Nagasaki's gigantic detonations were the first and only time that nuclear weapons have been used during warfare.

Documenting the fallout

These events, unique in their destruction and horror, sparked a thorough scientific investigation into the long-term effects of surviving such weapons. From 1947 onward, the Japanese government set out to measure and understand the ongoing health implications of nuclear war.

A group, called the Radiation Effects Research Foundation (RERF), collates this information; they are funded by the Japanese and American governments. RERF followed roughly 100,000 survivors, 77,000 of their offspring, and, as a control, 20,000 people who were not exposed to radiation.

Data provided by these studies have been invaluable in quantifying the risks of radiation poisoning. Because each survivor knew where they were when the detonation occurred, it has been possible to measure each person's radiation exposure precisely. The findings of RERF have helped set safety standards for people who work in the nuclear industry and the public.

This week in the journal Genetics, Bertrand Jordan, a molecular geneticist, published his findings from an analysis of the data collected by RERF. Rather than providing new data, he aimed to "summarize the results of the studies undertaken to date, which have been published in more than 100 papers."

Using over 60 years worth of information, Jordan looked at the effects of Hiroshima and Nagasaki on survivors and their children. He found a large discrepancy between people's general understanding of the atom bomb's effects and the reality.

It is commonly believed that the survivors of Hiroshima and Nagasaki have a high cancer burden, a significantly shortened lifespan, and children with high rates of mutations and abnormalities. After a careful examination of the data, the author found this to be an incorrect assumption.

Jordan summarizes his findings: "There's an enormous gap between that belief and what has actually been found by researchers."

Hiroshima and Nagasaki cancer rates

Cancer rates were indeed found to be higher in individuals who had survived the bombs, when compared with residents who had been out of town at the time of the explosions. Risk of cancer increased depending on proximity to the site, age (younger people had a larger lifetime risk), and gender (women had a greater risk).

However, the majority of survivors did not develop cancer. Because most people only had a modest exposure to radiation, the overall risk of developing solid cancers between 1958 and 1998 increased by 10 percent. This represents 848 additional cancer cases among 44,635 survivors.

But the picture was much worse for those who received higher doses. Individuals who received 1 Gray fared less well. A Gray is a unit of measurement defined as the absorption of one joule of radiation energy per kilogram of matter, equivalent to 1,000 times the normal safety limit for the public. These individuals had a 42 percent increase in cancer risk.

Even in those who received the highest doses of radiation, although cancer risk was greater, their lifespan was reduced by just 1.3 years.

Effects on the children of survivors

RERF also follow the health of the children of survivors. So far, no negative health effects or mutations have been found in the offspring. Jordan believes that in the future, as genetic tools become ever finer, subtle differences might be seen in their genomes. But what is clear, is that if there are negative health consequences for the children of survivors, they are very small.

In his paper, Jordan discusses the reasons for the mismatch between public perception and the the facts.

"People are always more afraid of new dangers than familiar ones. For example, people tend to disregard the dangers of coal, both to people who mine it and to the public exposed to atmospheric pollution.

Radiation is also much easier to detect than many chemical hazards. With a hand-held Geiger counter, you can sensitively detect tiny amounts of radiation that pose no health risk at all."

Bertrand Jordan

Jordan is careful to ensure that he is not seen as a pro-nuclear lobbyist. That is not his stance at all. For instance, he says, "I used to support nuclear power until Fukushima happened." He realized that even in a country as technologically advanced and well-regulated as Japan, disasters with the potential to spill out across the world were still possible.

The thrust of Jordan's argument is that any debate should be carried out in a rational way. He says, "I would prefer that people look at the scientific data, rather than gross exaggerations of the danger."

Learn about the long-term health effects of Fukushima.



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Boron carrier for targeted tumour therapy

Scientists at Tokyo Institute of Technology have developed a boron carrier for use in targeted radiation treatment for cancerous tumours. The carrier is based on a common blood plasma protein, meaning it can be tailored to individual patients thus lessening the chances of blood contamination.

Targeted radiation-based therapies for treating cancerous tumours such as 'boron neutron capture therapy' (BNCT), rely on the efficient and effective delivery of the capture agent (in this case, boron) to the tumour. The agent must collect in the tumour in high enough concentrations to trigger an effective reaction during thermal neutron irradiation.

Delivering the agent to tumours safely, while limiting the chances of it being distributed in the bloodstream and major organs, is a major challenge. Hiroyuki Nakamura and co-workers at the Tokyo Institute of Technology, in collaboration with researchers across Japan, decided to test the ability of a common blood plasma protein known as albumin to carry boron to tumours during BNCT.

Albumin flows readily to and accumulates in malignant tissues; in fact, it is a major source of nutrition for growing tumours. Tumours therefore attract albumin, making the protein an ideal candidate for carrying drugs - it has already been used as a drug carrier for breast, lung and pancreatic cancers. However, its ability to transport boron for BNCT remains untested.

Nakamura's team developed a tiny capsule, made from maleimide-functionalized closo-dodecaborate (MID), and trialled its ability to bind with albumin and to carry boron. They found that MID successfully binds with both cysteine and lysine residues in albumin, creating a stable carrier for boron that the team called MID-AC.

They tested MID-AC on 26 tumour-bearing mice. The team found that the boron concentrated highly and efficiently in tumours; the active uptake of boron by the albumin led to double the concentration of boron reaching tumours than previous systems. Levels of boron in the bloodstream and organs were very low, indicating a viable targeted delivery system. Thermal irradiation was then carried out on the mice, and led to the significant suppression of tumour growth even at low boron levels.

This technique could limit existing problems of using blood-based products in cancer treatment. Albumin could be taken from patients in hospital prior to treatment, then used in MID-AC to carry boron to tumours in the patients' own bodies. This will limit contamination and encourage the acceptance of the system by the patients' immune systems.

Background

Boron therapy

Boron neutron capture therapy (BNCT) is a non-invasive method for the targeted destruction of cancer cells in tumours. The two-step technique firstly relies on the effective delivery of boron - a non-radioactive isotope capable of capturing neutrons to trigger a nuclear reaction - to tumours. The patient is injected with boron carriers which make their way through the bloodstream to the tumour. Creating carriers that target tumours specifically without discharging boron in healthy tissues has been a significant challenge for scientists.

Once the boron has accumulated in sufficient levels in the tumour, the patient undergoes thermal neutron irradiation - the resulting miniature nuclear reaction inside the tumour blasts the cancer cells and destroys them. So far, two small boron molecules, such as mercaptoundecahydrododecaborate (BSH) and L-p-boronophenylalanine (L-BPA), have been used as boron carriers for clinical treatment of brain tumors, melanoma, head and neck cancers, and other cancers in BNCT.

Implications of the current study

The MID-AC system is based on a common blood protein called albumin, which is found in abundant levels in blood plasma. Nakamura's team developed a boron carrier which uses albumin to transport the agent to the tumour. As a result, the system could greatly enhance current BNCT delivery, because if patients' own albumin is used to carry the boron to the tumour, there is a far smaller chance of blood contamination - a risk when using blood products from other people.

Further, the success of the system lies in the fact that it makes use of albumin's natural propensity to gather in tumours. This means that boron levels in surrounding healthy cells and organs is limited, reducing the risk of side effects during radiation-based cancer therapy.

Article: Maleimide-functionalized closo-dodecaborate albumin conjugates (MID-AC): Unique ligation at cysteine and lysine residues enables efficient boron delivery to tumor for neutron capture therapy, Shunsuke Kikuchia, Daisuke Kanohb, Shinichi Satoa, Yoshinori Sakuraic, Minoru Suzukid, Hiroyuki Nakamura, Journal of Controlled Release, doi:10.1016/j.jconrel.2016.07.017, published online 12 July 2016.



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Radical treatment and examination combined can halve mortality from prostate cancer

Men with very high-risk prostate cancer, who are treated at hospitals with a high proportion of administered radical local treatment (radiotherapy or prostatectomy), only have half of the mortality risk of men who are treated at hospitals with the lowest proportion. This is according to a new study conducted by researchers at Umeå University in Sweden and published in European Urology.

"The results suggest that the combination of thorough examination and subsequent radical local therapy can prolong life for men with very high-risk prostate cancer," says Pär Stattin, a researcher at the Department of Surgical and Perioperative Sciences who led the study.

Using patient data from the National Prostate Cancer Register (NPCR) of Sweden, the researchers investigated the link between prostatectomy or full-dose radiotherapy and mortality in men with deadly high-risk prostate cancer. Differences in treatment selection were analysed on a group basis whereas mortality from prostate cancer and other causes was analysed on an individual basis.

Results show that men with a very high-risk prostate cancer, who were treated at hospitals with the highest proportion of radical treatment, were only half as likely (mortality rate ratio; MRR 0.51) to die from prostate cancer compared to men treated at hospitals where radical local therapy was administered the least. However, since this was an observational study, the potential effects of high-intensity in diagnostic activity and work-up cannot be isolated from therapeutic activity.

"Our data suggests that there are benefits of radical local therapy for men with very advanced forms of prostate cancer. However, these men most often only receive hormonal treatment. To confirm our findings and hopefully to improve treatment praxis, there is a need for a randomized study of the effects of local radical therapy on patients with very high-risk prostate cancer," says Pär Stattin

Article: Association of Radical Local Treatment with Mortality in Men with Very High-risk Prostate Cancer: A Semiecologic, Nationwide, Population-based Study, Pär Stattin et al., European Urology, doi:10.1016/j.eururo.2016.07.023, published online 5 August 2016.



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