The development of patient information leaflets incorporating patient diversity considerations: Varicocele embolisation and fluoroscopy guided joint injection examinations.

PURPOSE: The production of patient information leaflets (PILs) for diverse patient cohorts is challenging. This study developed varicocele and fluoroscopy guided joint injection (FLGJI) procedural PILs. METHODOLOGY: Evidence-based PILs were developed, providing radiological procedural information - preparation, explanation of interventional procedures and aftercare. PIL readability was tested via validated readability programs: Flesch Kincaid and Flesch ease reading score methods. Radiology approval of PIL(s) content was confirmed. PILs were distributed with appointment information. Patient interviews were conducted just prior to examination and by telephone, 7 days post procedure. RESULTS: Participants were purposely sampled (6 months): varicocele embolisation (n = 17) and FLGJI (n = 47). Overall 78.1% of all participants preferred Maltese leaflets. Varicocele embolisation patients were generally younger and a greater percentage educated to tertiary level compared to FLGJI patients. Education and age were found to be recurrent significant variables in the patient demographics and responses for both patient cohorts. Age versus education for the FLGJI cohort proved to be significant for several responses. Readability statistics identified the FLGJI leaflet as a plain English rating, the varicocele embolisation leaflet was more difficult. Patient feedback identified 'what is a varicocele?' as important to varicocele embolisation patients whereas FLGJI patients chose, 'advice about aftercare' and 'advice about pain management', highlighting differences in patients' priorities between procedures. CONCLUSION: PILs provided tangible, accurate information pre and post examination. Patient involvement in achieving appropriate information informed the PILs development, which were adopted clinically. The development of tailored PILs to meet the diversity of other interventional radiology procedures is recommended.

Interleukin 2-mediated events in gamma-interferon production are calcium dependent at more than one site.

Both leukotrienes and dibutyryl cyclic GMP can replace the interleukin 2 (IL 2) requirement for gamma-interferon (gamma-IFN) production. In this study, the Ca dependence of the IL 2 help was demonstrated by blockage of gamma-IFN production by the Ca blocker Mn, and the competitive reversal of this block by Ca. Neither leukotriene C4 nor dibutyryl cyclic GMP could reverse the Mn block, which suggests that arachidonic acid release from phospholipids is not the only Ca-dependent event in IL 2 help for gamma-IFN production. A role for calmodulin or protein kinase C in the IL 2-mediated events was suggested by the blockage of gamma-IFN production by chlorpromazine. Relatively high concentrations of Ca were able to replace the IL 2 helper effects. Consistent with this were Ca influx experiments that showed that IL 2 helper signals for gamma-IFN production involved activation of a Ca channel.