Repeated hyperthermia exposure increases circulating Brain Derived Neurotrophic Factor levels which is associated with improved quality of life,and reduced anxiety: A randomized controlled trial

ContextHyperthermia is known to be beneficial to patients affected by various diseases. Brain Derived Neurotrophic Factor (BDNF) is a marker of neuroplasticity usually increased as response to acute exposure to human body stressors. Little is known about BDNF changes after repeated exposure to hyperthermia.ObjectiveTo investigate the effect of a repeated hyperthermia exposure programme (HTC) on serum BDNF in healthy humans.Design, setting, participantsRandomized, single-blind, controlled trial in healthy humans conducted at Sechenov University Physiology Laboratory between December 2016 and November 2018. The treatment period was 10 weeks. Researchers analysing serum BDNF and questionnaires data were blinded to participants allocation.ParticipantsWere 34 healthy male (age 20.2 ± 1.6 years).InterventionRepeated Hyperthermia exposure programme, HTC, versus Light Intermittent Exercise, LIE, programme as control (10 weeks).Main outcome measureChange in BDNF from baseline to final visit three days after treatment completion.Results25 participants were analyzed. One participant withdrew before signing the informed consent and 8 participants (n = 3 in HTC and n = 5 in LIE) could not undertake the first assessment and were excluded. Mean change in BDNF was higher in HTC group vs LIE after both time points (after 12 and after 24 sessions). After 24 sessions BDNF was 30170 (SD 5268) pg/ml in HTC group a value that was significantly higher than 24104 (SD 2876) pg/ml measured in LIE group. BDNF concentrations were significantly higher than baseline values in HTC group only, 30170 (SD 5268) vs 26710 (SD 5437) pg/ml.ConclusionA 10-week programme consisting of repeated exposure to hyperthermia resulted in a significantly higher increase of circulating BDNF compared to a programme consisting of intermittent light intensity exercise.     

Determination of the surface dose of a water phantom using a semiconductor detector for diagnostic kilovoltage x-ray beams

PurposeTo determine the surface dose of a water phantom using a semiconductor detector for diagnostic kilovoltage x-ray beams.MethodsAn AGMS-DM+ semiconductor detector was calibrated in terms of air kerma measured with an ionization chamber. Air kerma was measured for 20 x-ray beams with tube voltages of 50–140 kVp and a half-value layer (HVL) of 2.2–9.7 mm Al for given quality index (QI) values of 0.4, 0.5, and 0.6, and converted to the surface dose. Finally, the air kerma and HVL measured by the AGMS-DM+ detector were expressed as a ratio of the surface dose for 10 × 10 and 20 × 20 cm² fields. The ratio of both was represented as a function of HVL for the given QI values and verified by comparing it with that calculated using the Monte Carlo method.ResultsThe air kerma calibration factor, CF, for the AGMS-DM+ detector ranged from 0.986 to 1.016 (0.9% in k = 1). The CF values were almost independent of the x-ray fluence spectra for the given QI values. The ratio of the surface dose to the air kerma determined by the PTW 30,013 chamber and the AGMS-DM+ detector was less than 1.8% for the values calculated using the Monte Carlo method, and showed a good correlation with the HVL for the given QI values.ConclusionIt is possible to determine the surface dose of a water phantom from the air kerma and HVL measured by a semiconductor detector for given QI values.     

热疗联合奥沙利铂对SW480细胞增殖和凋亡的影响

目的:观察奥沙利铂联合热疗对人结肠癌细胞SW480增殖及凋亡的影响,确定联合用药的效果,为临床方案提供参考。方法:采用MTT(四唑盐)法检测热疗、奥沙利铂及联合用药对细胞增殖的影响;瑞士吉姆萨染色法观察细胞形态;流式细胞仪检测细胞凋亡和周期;Western blot检测Bax、Bcl-2以及Caspase8蛋白表达量变化;q PCR检测Bax、Bcl-2以及Caspase8 m RNA的积累。结果:热疗联合奥沙利铂可以显著抑制细胞增殖,与对照组相比,热疗组、化疗组、联合组细胞凋亡率分别为16.2%、20.5%和36.1%,具有显著性差异(P0.01);细胞学形态中,热疗组细胞发生皱缩,化疗组细胞膜破裂;化疗将细胞阻滞在G2/M期,热疗和联合组将细胞阻滞S期;Western blot和qPCR显示Bax/Bcl-2比值上升,Caspase8表达量增加,联合组三种蛋白的表达量均与对照组具有显著性差异(P0.01)。结论:热疗联合奥沙利铂可以显著促进细胞凋亡,提高治疗效果,为结肠癌的治疗提供参考。     

Lack of protection of prior heat shock against UV-induced oxidative stress in human skin fibroblasts

Abstract

The effect of prior hyperthermia on UV-induced oxidative stress was studied in human skin fibroblasts. UV radiation alone induced an increased release of superoxide anions and increased lipid peroxidation in skin fibroblasts accompanied by a rise in catalase and superoxide dismutase activities. Hyperthermia was found to induce a significant rise in the cell content of heat-shock proteins, HSP60 and HSP70, but this treatment prior to UV radiation did not influence any indicators of oxidative stress in the fibroblasts. In contrast, the combination of heat shock prior to UV-exposure reduced fibroblast cell viability compared with UV radiation-exposure alone.     

Determination of backscatter factors based on the quality index for diagnostic kilovoltage x-ray beams

PurposeThis study aims to investigate the relationship between backscatter factors and Al-half-value-layers (Al-HVL) by making the quality index (QI) a parameter for diagnostic kilovoltage x-ray beams.MethodsBackscatter factors, B_w, for x-ray fluence spectra were calculated from the weighted average of B_w for monoenergetic photons of between 8 and 140 keV with field sizes of 10 cm × 10 cm to 40 cm × 40 cm. The value of B_w for monoenergetic photons was calculated from the ratio of the water kerma at the surface of a water phantom and that at the same point free-in-air using the EGSnrc/cavity code. The weighted averaged backscatter factors were validated by comparing them with those of direct Monte Carlo calculations for the x-ray fluence spectra. The B_w for the x-ray fluence spectra were classified by a QI of 0.35, 0.4, 0.5, 0.6, and 0.7 specified by the ratio of the effective energy and maximum energy. The relationship between B_w and Al-HVL was evaluated for the given QI values. The x-ray fluence spectra were generated for tube voltages of 40–140 kVp with Al-HVLs of 0.5–13.2 mm using the SpekCalc program.ResultsThe weighted averaged backscatter factors for x-ray fluence spectra agreed within 0.7% with those of the direct Monte Carlo calculations. The backscatter factors were represented by the fitting curves of R² > 0.99 with Al-HVL for the given QI values.ConclusionsIt is possible to obtain B_w more accurately by using QI specified by the measured Al-HVL.     

First proposal of quality indicators and standards and recommendations to improve the healthcare in the Spanish National Registry of Hip Fracture

BackgroundThe Spanish National Hip Fracture Registry (or Registro Nacional de Fractura de Cadera, RNFC) is a database of hip fracture patients admitted to Spanish hospitals. Its goals include assessment and continuous improvement of the care process.ObjectivesTo (1) establish a series of indicators, (2) evaluate their initial fulfillment, (3) propose quality standards, (4) suggest recommendations to facilitate standards compliance, and (5) monitor the indicators.MethodThe indicators fulfilled the criteria of (1) evaluating the process or outcome, (2) being clinically relevant for patients, (3) being modifiable through changes in healthcare practice, and (4) being considered important by the RNFC participants. The first quartile obtained by the group of hospitals in each of the respective variables was proposed as the standard. The Indicators Advisory Committee (IAC) elaborated a list of recommendations for each indicator, based on the available evidence.ResultsSeven indicators were chosen. These indicators (its baseline compliance vs. the standard to be reached, respectively) were: the proportion of patients receiving surgery within 48 h (44% vs. 63%), mobilized the first postoperative day (56% vs. 86%), with antiosteoporotic medication at discharge (32% vs. 61%), with calcium supplements at discharge (46% vs. 77%), with vitamin D supplements at discharge (67% vs. 92%), who developed pressure ulcers during hospitalization (7.2% vs. 2.1%) and with independent mobility at 30 days (58% vs. 70%). The IAC has established 25 recommendations for improving care.ConclusionThe indicators and standards chosen are presented, as well as the list of recommendations. This process completes the first step to improve quality of care. The results will be evaluated 6 months after implementing the recommendations.     

A Systematic Review of the Amount of Water per Person per Day Needed to Prevent Morbidity and Mortality in (Post-)Disaster Settings

BackgroundIn order to improve the effectiveness and efficiency of humanitarian efforts, minimum standards for humanitarian assistance and key indicators, showing whether a standard has been attained, have been developed. However, many of these standards and indicators are based on a consensus on best practices and experiences in humanitarian response, because relevant evidence on the impact of humanitarian interventions is often lacking.ObjectivesOne important example of a standard in humanitarian aid in a disaster setting is “water quantity.” The accompanying indicator states how many litres of water are needed per person per day in a disaster setting. It was our objective to determine the evidence base behind this indicator, in order to improve health outcomes such as morbidity (e.g., diarrhoea) and mortality.MethodsA systematic review was performed searching The Cochrane Library, Medline and Embase. We included studies performed during disasters and in refugee camps that reported a specific water amount and health-related outcomes related to water shortages, including diarrhoea, cholera, and mortality. We used GRADE to determine the quality of evidence.ResultsOut of 3,630 articles, 111 references relevant to our question were selected. Based on our selection criteria, we finally retained 6 observational studies, including 1 study that was performed during the disaster and 5 studies in a post-disaster phase. From two studies there is conclusive evidence on the relationship between the amount of water received and diarrhoea or mortality rates in refugee camps. However, overall, these studies do not contain enough data with relevance to a specific amount of water, and the level of evidence is very low.ConclusionsMore primary research on water amounts in a disaster setting is necessary, so that the humanitarian sector can further professionalise its water-related standards, indicators and interventions.     

Evaluating outcomes in planning: Indicators and reference values for Swiss landscapes

Evaluation of achievement of set targets is a necessary step in landscape planning in order to learn from the past, reassess implemented measures and enhance trust in public managers and institutions. Though it is commonly accepted that indicators play a major role in such evaluations, so far no accepted framework for evaluating planning outcomes exists. Furthermore, the selection of appropriate indicators and reference values to effectively assess conditions of landscapes and determine whether observed developments can be considered positive or negative remains challenging. Our study contributes to much-needed research on this topic with a proposed evaluation framework built on goals, indicators and reference values. We analyzed the landscape section of eight Swiss cantonal comprehensive plans to specifically address (1) whether currently tracked indicators suffice to evaluate landscape-planning goals; (2) what a minimal set of landscape indicators for regional planning might look like; and (3) how the ratified value approach could be operationalized to develop reference values for landscape indicators. All eight plans have a similar hierarchical goal system with six major landscape goals, up to 18 themes and 21–33 subordinate goals. The studied cantons track from 29 to 84 indicators. We found a considerable imbalance in the ratio between subordinate goals and indicators, with comparatively few indicators being tracked to assess visual and recreational landscape quality. Our proposed minimal indicator set is well balanced since it lists 5–7 indicators for each theme. The general procedure for modeling reference values is based on the assumption that the protection status of a landscape is a proxy for high societal appreciation of a place. Consequently, indicator values for these areas would reflect reference values (ratified values). We illustrate the procedure with the exemplary indicator impervious surface. The proposed indicators and maps are powerful tools for outcome evaluation and also facilitate benchmarking, i.e. interregional comparisons of landscape qualities, which could be very useful for landscape planning in Europe.     

Hyperthermia in cervical cancer – current status

BackgroundThis article reviews the salient features of recent results of clinical studies. It puts a special emphasis on technical aspects, mechanisms of action together with radiotherapy and chemotherapy and points out areas for additional investigation.AimTo present the current state of knowledge on hyperthermia (HT) and to highlight its role in the treatment of cervical cancer.Materials and methodsThe literature on the clinical use of combined hyperthermia for cervical cancer was analyzed. Clinical outcomes together with the technical aspects and the role of HT were also evaluated.ResultsClinically randomized trials have demonstrated benefit including survival with the addition of hyperthermia to radiation or chemotherapy in the treatment of cervical cancer without significant acute or late morbidities. The technological advances have led to an effective and safer treatment delivery, thermal treatment planning, thermal dose monitoring and online adaptive temperature modulation.ConclusionsDue to rapid development over the last decade of hyperthermia systems and new studies at the basic science and clinical level, the perception of hyperthermia as a part of multimodality treatment in cervical cancer has been changed. However, there is still a need for multicentre randomized clinical trials.     

Cancer cells resist hyperthermia due to its obstructed activation of caspase 3

AimIt is well known that inducing hyperthermia is a type of cancer treatment but some research groups indicate that this treatment is not effective. This article finds and explains the mechanism of this treatment and its possible problems.BackgroundHyperthermia is commonly known as a state when the temperature of the body rises to a level that can threaten one’s health. Hyperthermia is a type of cancer treatment in which body tissue is exposed to high temperatures (up to 45 °C). Research has shown that high temperatures can damage and kill cancer cells, usually with minimal injury to normal tissues. However, this mechanism is not known.Materials and MethodsWe recently treated cancer cells with different temperatures ranging from 37 °C to 47 °C and further measured their caspase 3 secretion by ELISA, western blot and cell survival rate by microscope.ResultsWe found that most cancer cells are able to resist hyperthermia more than normal cells most likely via non-activation of caspase3. We also found that hyperthermia-treated (≥41°) cancer cells extend a long pseudopod-like extension in comparison to the same cancer cells under normal conditions.ConclusionOur data here indicates that cancer cells have resistance to higher temperatures compared to normal cells via non-activation of caspase 3. This is a significant issue that needs to be brought to attention as the medical community has always believed that a high temperature treatment can selectively kill cancer/tumor cells. Additionally, we believe that the pseudopod-like extensions of hyperthermia-treated cancer cells must be related to its resistance to hyperthermia.     

Hysteresis losses and specific absorption rate measurements in magnetic nanoparticles for hyperthermia applications

BackgroundMagnetic hysteresis loops areas and hyperthermia on magnetic nanoparticles have been studied with the aim of providing reliable and reproducible methods of measuring the specific absorption rate (SAR).MethodsThe SAR of Fe₃O₄ nanoparticles with two different mean sizes, and Ni_1 −xZn_xFe₂O₄ ferrites with 0 ≤ x ≤ 0.8 has been measured with three approaches: static hysteresis loops areas, dynamic hysteresis loops areas and hyperthermia of a water solution. For dynamic loops and thermometric measurements, specific experimental setups have been developed, that operate at comparable frequencies (≈ 69 kHz and ≈ 100 kHz respectively) and rf magnetic field peak values (up to 100 mT). The hyperthermia setup has been fully modelled to provide a direct measurement of the SAR of the magnetic nanoparticles by taking into account the heat exchange with the surrounding environment in non-adiabatic conditions and the parasitic heating of the water due to ionic currents.ResultsDynamic hysteresis loops are shown to provide an accurate determination of the SAR except for superparamagnetic samples, where the boundary with a blocked regime could be crossed in dynamic conditions. Static hysteresis loops consistently underestimate the specific absorption rate but can be used to select the most promising samples.ConclusionsA means of reliably measure SAR of magnetic nanoparticles by different approaches for hyperthermia applications is presented and its validity discussed by comparing different methods.General significanceThis work fits within the general subject of metrological traceability in medicine with a specific focus on magnetic hyperthermia. This article is part of a Special Issue entitled "Recent Advances in Bionanomaterials" Guest Editor: Dr. Marie-Louise Saboungi and Dr. Samuel D. Bader.     

Energy response of radiophotoluminescent glass dosimeter for diagnostic kilovoltage x-ray beams

PurposeThis study aimed to investigate the energy response of a radiophotoluminescent glass dosimeter (RGD) for diagnostic kilovoltage x-ray beams by Monte Carlo (MC) calculations and measurements.MethodsThe uniformity and reproducibility of GD-352M (with Sn filter) and GD-302M (no filter) were tested with 45 RGDs in free air. Subsequently, the RGD response was obtained as a function of an Al-HVL using the parameter, quality index (QI), which is defined as the ratio of the effective energy (keV) to the maximum energy (keV) of the photons. The x-ray fluence spectra with QI of 0.4, 0.5, and 0.6 were set for tube voltages of 50 ~ 137.6 kVp. The RGD response was calculated in free air using the MC method and verified by the air kerma, K_air, measured using an ionization chamber.ResultsThe uniformity and reproducibility of the 45 RGDs were ± 2.3% and ± 2.7% for GD-352M and ± 0.7% and ± 1.6% for GD-302M at the one standard deviation level, respectively. The calculated RGD response was 0.965 to 1.062 at Al-HVL 2.73 mm or more for GD-352M and varied from 3.9 to 2.8 for GD-302M. Both RGD responses exhibited a good correlation with the Al-HVL for the given QI. K_air measured by RGDs for each beam quality with a QI of 0.5 was in the range of −5%~0.8% for GD-352M and −1.8%~3% for GD-302M, relative to the chamber measurements.ConclusionsThe RGD response was indicated as a function of the Al-HVL for the given QI, and it presented a good correlation with the Al-HVL.     

Influence of repeated hyperthermia on the early development of carcinogen-induced rat mammary cancers; Refinement of a technique for hyperthermia research

• 1.1.|Hyperthermia (c. 41°C) occurs in mammals (e.g. humans) during normal life-history events such as fever and vigorous exercise. The effects of such episodic hyperthermia on early developmental stages of cancer are of potential importance, yet have been investigated hardly at all.
• 2.2.|We injected female Sprague-Dawley rats with the mammary-gland carcinogen 7,12-dimethylbenzathracene and, over a 4-week period before cancer onset, subjected them to 20 1-h episodes of whole-body hyperthermia (41.2°C colonic) to determine effects on subsequent appearance of carcinomas.
• 3.3.|Hyperthermia did not have significant effects on the development of clinical disease in this system, indicating that precancerous or incipient cancerous cells are not susceptible to damage by the levels of hyperthermia associated with normal life-history events.
• 4.4.|For repeated induction of hyperthermia with minimal confounding effects of stress, we refined a technique in which hyperthermia-treated animals, as well as controls, were anesthetized with sodium pentabarbital during thermal treatments, thus suppressing thermoregulation and higher brain functions.

     

Preoperative treatment of rectal cancer with radiation, chemotherapy and hyperthermia: analysis of treatment efficacy and heat-shock response

Preoperative treatment of locally advanced rectal cancer with radiation, chemotherapy and hyperthermia is analyzed with regard to heat-shock response. In 23 patients with locally advanced rectal cancer (uT3/uT4), hyperthermia was administered in combination with radiotherapy and chemotherapy. In parallel, the effect of the treatment on levels of the heat-shock proteins HSP27 and inducible HSP70 in tumors and surrounding tissues was investigated by Western blotting. The patients' sera were also examined for autoantibodies against HSPs. HSP27 and inducible HSP70 were detected in most rectal tumors and surrounding tissues before and after treatment. HSP27 and inducible HSP70 levels had changed in 10 tumors after treatment. However, prior to treatment, there existed an unexpected diversity in HSP levels in the tumors and surrounding tissue. Hyperthermia doses in cumulative minutes for which 90% of the tumor is above the reference temperature (cum min T90 > or = 15 min) led to increased survival and response compared to that of a control group of patients treated without or with low-dose hyperthermia (cum min T90 < 15 min). However, there was no correlation to different expression of the HSPs. Hyperthermia as used in this setting does not lead to any sustained expression of HSPs in either the tumor or the surrounding tissue.     

磁流体肿瘤热疗技术的研究进展

热疗在近年来已经成为肿瘤治疗最为重要的手段之一,但存在一定的局限性。磁流体热疗技术作为新兴发展起来的热疗手段,克服了常规热疗的缺陷,可以辅助治疗,甚至发展成独立治疗手段。本文综述了国内外近年来有关磁流体热疗基础研究及试验领域的最近进展,首先对磁流体特性、常见磁流体材料和交变磁场装置等方面进行了介绍,最后介绍了磁流体肿瘤热疗技术在体外试验、动物试验和临床研究方面的进展状况。虽然磁流体热疗逐步进入临床阶段,但仍存在不足,需要进一步的完善提高治疗效果。     

A validation of SpekPy: A software toolkit for modelling X-ray tube spectra

PurposeTo validate the SpekPy software toolkit that has been developed to estimate the spectra emitted from tungsten anode X-ray tubes. The model underlying the toolkit introduces improvements upon a well-known semi-empirical model of X-ray emission.Materials and methodsUsing the same theoretical framework as the widely-used SpekCalc software, new electron penetration data was simulated using the Monte Carlo (MC) method, alternative bremsstrahlung cross-sections were applied, L-line characteristic emissions were included, and improvements to numerical methods implemented. The SpekPy toolkit was developed with the Python programming language. The toolkit was validated against other popular X-ray spectrum models (50 to 120 kVp), X-ray spectra estimated with MC (30 to 150 kVp) as well as reference half value layers (HVL) associated with numerous radiation qualities from standard laboratories (20 to 300 kVp).ResultsThe toolkit can be used to estimate X-ray spectra that agree with other popular X-ray spectrum models for typical configurations in diagnostic radiology as well as with MC spectra over a wider range of conditions. The improvements over SpekCalc are most evident at lower incident electron energies for lightly and moderately filtered radiation qualities. Using the toolkit, estimations of the HVL over a large range of standard radiation qualities closely match reference values.ConclusionsA toolkit to estimate X-ray spectra has been developed and extensively validated for central-axis spectra. This toolkit can provide those working in Medical Physics and beyond with a powerful and user-friendly way of estimating spectra from X-ray tubes.     

纳米铁氧化物磁热疗相关机制研究进展

热疗作为继手术、放疗和化疗后的肿瘤治疗的重要方法之一,自其诞生之初便受到研究人员和产业部门的关注.磁热疗目前已经应用到前列腺癌、脑部肿瘤等临床实验或治疗中,并取得较好的疗效.本文主要介绍基于磁性纳米颗粒的磁热疗产热物理机制与影响因素,以及磁热的亚细胞水平生物学效应.     

An application case of ecological indicator values (Zeigerwerte) calculated with a simple algorithmic approach

Abstract

The vegetation of the study site near Rome (Castelporziano Estate), where different woodland types occur, was analysed on the basis of ecological indicator values (Zeigerwerte) for light, temperature, continentality of climate, soil moisture, soil pH and nitrogen. Indicator values were estimated with Hill's reprediction algorithm for the flora of Central-Southern Italy relying on a database of 4,207 original relevés representing a balanced survey of the vegetation of this and surrounding areas. It was possible to obtain indicator values for an important fraction of the Italian Mediterranean flora. Results are ecologically reasonable, and it was possible to find strong correlation between the recalculated values and a few environmental variables. These correlations were not significant in an analogous test with subjectively derived scores of Ellenberg indicator values.     

Prostaglandin involvement in hyperthermia induced by sleep deprivation: A pharmacological and autoradiographic study

AimsHyperthermia is a characteristic functional effect of sleep deprivation (SD). We hypothesize here that prostaglandin E2 (PGE2) could be involved in hyperthermia induced by sleep deprivation.Main methodsTo address this issue we examined the effects of a selective cyclo-oxygenase-2 inhibitor (COX-2) agent on hyperthermia induced by SD in rats. We also investigated binding to PGE2 receptors in hypothalamic brain areas of sleep-deprived rats using in vitro autoradiography. Male Wistar rats were deprived of sleep for 96 h using the platform technique. Sleep deprived and control groups received saline or Celecoxib (20, 30 and 40 mg/kg; p.o.) daily during the SD period. Colonic temperature was measured daily.Key findingsResults indicated that core temperature of sleep-deprived rats that receiving saline increased from the first to the fourth day of SD compared to baseline and to the respective control group. However, the hyperthermia induced by SD was not blocked by COX-2 inhibitor at any dose. [³H]PGE2 binding did not differ significantly among the groups in any of a number of hypothalamic areas examined.SignificanceAlthough SD rats showed no response to the COX-2 inhibitor and no alterations in [³H]PGE2 binding, the possibility remains that other prostaglandin system and/or receptor subtypes may be altered by SD.     

Quantification Methodology of “Health Human Resources” Related to “Health Technologies” Based on Indicators “RhSan”, “TechSan” and “RhTech”: Application to Senegal

ObjectivesAfter a century of spectacular advances, healthcare systems are facing unprecedented crisis, linked to shortage of health human resources and health technologies. In fact, availability of care depends on both technological and human resources of health. The objective of this study is to develop indicators that can measure qualitatively human resources and technologies of health in healthcare facilities, in order to assess availability of care in sub-Saharan African countries.Materials and MethodsRegarding “health technology” related to “medical devices”, an indicator called “TechSan” for “Technologies de Santé” was previously developed and published (Ndione FB et al. (2019) [6]). To address the deficiencies in usual indicators related to health human resources, a second indicator called “RhSan” for “Ressources humaines de santé” in French is proposed. This indicator assigns a weight to each health worker taking into account his specific “level of medical knowledge” and “experience”. In order to correlate “RhSan” with “TechSan”, a third indicator called “RhTech” is also developed to assess matches between “health technologies” and “health human resources” and establish realistic availability of care. These indicators have the advantage to be consolidated by specialty such as laboratory, imaging, surgery, and “mother and child care”.ResultsThe application of TechSan, RhSan and RhTech to data collected in Senegal in 2016, enabled to assess the distribution of “health technology” and “health human resources” in this country. They also permit the mapping of care availability per specialty in Senegal. The results show a strong oversupply of Dakar in terms of both human resources and technologies of health compared to other Senegalese regions. Oppositely, Sedhiou, Kaffrine, Matam and Kédougou are poorly endowed showing limits of the Senegalese health pyramid system.ConclusionTechSan, RhSan and RhTech can provide reliable decision-making tools in order to elaborate health policies in sub-Saharan African countries on more rigorous basis.