WorldWideScience

Sample records for diagnostic medical exposures

  1. Medical radiation exposure and usage for diagnostic radiology in Malaysia

    International Nuclear Information System (INIS)

    Ng, Kwan-Hoong; Rassiah, Premavathy; Abdullah, B.J.J.; Wang, Hwee-Beng; Shariff Hambali, Ahmad; Muthuvelu, Pirunthavany; Sivalingam, S.

    2001-01-01

    A national dose survey of routine X-ray examinations in Malaysia (a Level II country) from 1993 to 1995 had established baseline data for seven common types of x-ray examinations. A total of 12 randomly selected public hospitals and 867 patients were included in this survey. Survey results are generally comparable with those reported in the UK, USA and IAEA. The findings support the importance of the ongoing national quality assurance programme to ensure doses are kept to a level consistent with optimum image quality. The data was useful in the formulation of national guidance levels as recommended by the IAEA. The medical radiation exposure and usage for diagnostic radiology (1990-1994) enabled a comparison to be made for the first time with the UNSCEAR 2000 Report. In 1994, the number of physicians, radiologists, x-ray units and x-ray examinations per 1000 population was 0.45, 0.005, 0.065 and 183, respectively; 3.6 million x-ray examinations were performed; the annual effective dose per capita was 0.05 mSv and collective dose was 1000 person-Sv. Chest examinations contributed 63% of the total. Almost all examinations experienced increasing frequency except for barium studies, cholecystography, and intravenous urography (-23%, -36%, -51%). Notable increases were observed in computed tomography (161%), cardiac procedures (190%), and mammography (240%). (author)

  2. Diagnostic medical exposures. Advice on exposure to ionising radiation during pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Sharp, C.; Shrimpton, J.; Bury, R

    1998-07-01

    The main objective of NRPB advice concerning in utero exposures to ionising radiations is 'to prevent unnecessary exposure of the fetus when medical diagnostic procedures involving ionising radiations are indicated during pregnancy'. In addition, advice is meant to help to avoid unnecessary concern or action if an exposure does occur. NRPB issued ASP8 (Exposure to ionising radiation of pregnant women: advice on the diagnostic exposure of women who are, or who may be, pregnant) in 1985. This advice suggested that there would be no risks to the concepts following irradiation during the first 10 days of the menstrual cycle and that subsequent risks in the remainder of the first 4 week period would be likely to be so small that no special limitation on exposure was required - sometimes known as 'the 28-day rule'. In 1993, NRPB published further advice to replace ASP8 in the Documents of the NRPB series, in Volume 4, No 4 - henceforth referred to as Doc NRPB 4(4){sup 2} - which drew upon data published since 1985. The more recent data suggest that risks in the interval between 10 days and the date at which the next menstrual period is due, although still small for most diagnostic procedures, may be significant for higher dose procedures. Consequently, it is considered there is a need to operate a modified policy for such higher dose procedures. This pocket publication has been produced to present in a concise and user-friendly format the basis of the most recent NRPB advice and to provide a guide for the implementation of that advice in the everyday practice of diagnostic radiology. The opportunity has also been taken to provide the most up to date data on doses in the UK. This publication is split into three parts: an introduction to the terms used in the document, a practical guide to implementation of the advice, and the scientific background to the advice.

  3. Diagnostic medical exposures. Advice on exposure to ionising radiation during pregnancy

    International Nuclear Information System (INIS)

    Sharp, C.; Shrimpton, J.; Bury, R.

    1998-01-01

    The main objective of NRPB advice concerning in utero exposures to ionising radiations is 'to prevent unnecessary exposure of the fetus when medical diagnostic procedures involving ionising radiations are indicated during pregnancy'. In addition, advice is meant to help to avoid unnecessary concern or action if an exposure does occur. NRPB issued ASP8 (Exposure to ionising radiation of pregnant women: advice on the diagnostic exposure of women who are, or who may be, pregnant) in 1985. This advice suggested that there would be no risks to the concepts following irradiation during the first 10 days of the menstrual cycle and that subsequent risks in the remainder of the first 4 week period would be likely to be so small that no special limitation on exposure was required - sometimes known as 'the 28-day rule'. In 1993, NRPB published further advice to replace ASP8 in the Documents of the NRPB series, in Volume 4, No 4 - henceforth referred to as Doc NRPB 4(4) 2 - which drew upon data published since 1985. The more recent data suggest that risks in the interval between 10 days and the date at which the next menstrual period is due, although still small for most diagnostic procedures, may be significant for higher dose procedures. Consequently, it is considered there is a need to operate a modified policy for such higher dose procedures. This pocket publication has been produced to present in a concise and user-friendly format the basis of the most recent NRPB advice and to provide a guide for the implementation of that advice in the everyday practice of diagnostic radiology. The opportunity has also been taken to provide the most up to date data on doses in the UK. This publication is split into three parts: an introduction to the terms used in the document, a practical guide to implementation of the advice, and the scientific background to the advice

  4. General Principles of Radiation Protection in Fields of Diagnostic Medical Exposure.

    Science.gov (United States)

    Do, Kyung-Hyun

    2016-02-01

    After the rapid development of medical equipment including CT or PET-CT, radiation doses from medical exposure are now the largest source of man-made radiation exposure. General principles of radiation protection from the hazard of ionizing radiation are summarized as three key words; justification, optimization, and dose limit. Because medical exposure of radiation has unique considerations, diagnostic reference level is generally used as a reference value, instead of dose limits. In Korea, medical radiation exposure has increased rapidly. For medical radiation exposure control, Korea has two separate control systems. Regulation is essential to control medical radiation exposure. Physicians and radiologists must be aware of the radiation risks and benefits associated with medical exposure, and understand and implement the principles of radiation protection for patients. The education of the referring physicians and radiologists is also important.

  5. The report of medical exposures in diagnostic radiology. Pt. 1. The questionnaire of medical exposure and standard radiation exposure

    International Nuclear Information System (INIS)

    Sasakawa, Yasuhiro; Matsumura, Yoshitaka; Iwasaki, Takanobu; Segawa, Hiroo; Yasuda, Sadatoshi; Kusuhara, Toshiaki

    1997-01-01

    We had made reports of patient radiation exposure for doctors to judge adaptation of medical radiation rightly. By these reports the doctors can be offered data of exposure dose and somatic effect. First, we sent out questionnaires so that we grasped the doctor's understanding about radiation exposure. Consequently we understood that the doctors had demanded data of exposure dose and somatic effect. Secondly, by the result of questionnaires we made the tables of exposure dose about radiological examination. As a result we have be able to presume exposure dose about high radiation sensitive organization as concrete figures. (author)

  6. Children's exposure to diagnostic medical radiation and cancer risk: epidemiologic and dosimetric considerations

    Energy Technology Data Exchange (ETDEWEB)

    Linet, Martha S.; Rajaraman, Preetha [National Cancer Institute, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Kim, Kwang pyo [National Cancer Institute, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Kyung Hee University, Department of Nuclear Engineering, Yongin-si, Gyeonggi (Korea)

    2009-02-15

    While the etiology of most childhood cancers is largely unknown, epidemiologic studies have consistently found an association between exposure to medical radiation during pregnancy and risk of childhood cancer in offspring. The relation between early life diagnostic radiation exposure and occurrence of pediatric cancer risks is less clear. This review summarizes current and historical estimated doses for common diagnostic radiologic procedures as well as the epidemiologic literature on the role of maternal prenatal, children's postnatal and parental preconception diagnostic radiologic procedures on subsequent risk of childhood malignancies. Risk estimates are presented according to factors such as the year of birth of the child, trimester and medical indication for the procedure, and the number of films taken. The paper also discusses limitations of the methods employed in epidemiologic studies to assess pediatric cancer risks, the effects on clinical practice of the results reported from the epidemiologic studies, and clinical and public health policy implications of the findings. Gaps in understanding and additional research needs are identified. Important research priorities include nationwide surveys to estimate fetal and childhood radiation doses from common diagnostic procedures, and epidemiologic studies to quantify pediatric and lifetime cancer risks from prenatal and early childhood exposures to diagnostic radiography, CT, and fluoroscopically guided procedures. (orig.)

  7. Children's exposure to diagnostic medical radiation and cancer risk: epidemiologic and dosimetric considerations

    International Nuclear Information System (INIS)

    Linet, Martha S.; Rajaraman, Preetha; Kim, Kwang pyo

    2009-01-01

    While the etiology of most childhood cancers is largely unknown, epidemiologic studies have consistently found an association between exposure to medical radiation during pregnancy and risk of childhood cancer in offspring. The relation between early life diagnostic radiation exposure and occurrence of pediatric cancer risks is less clear. This review summarizes current and historical estimated doses for common diagnostic radiologic procedures as well as the epidemiologic literature on the role of maternal prenatal, children's postnatal and parental preconception diagnostic radiologic procedures on subsequent risk of childhood malignancies. Risk estimates are presented according to factors such as the year of birth of the child, trimester and medical indication for the procedure, and the number of films taken. The paper also discusses limitations of the methods employed in epidemiologic studies to assess pediatric cancer risks, the effects on clinical practice of the results reported from the epidemiologic studies, and clinical and public health policy implications of the findings. Gaps in understanding and additional research needs are identified. Important research priorities include nationwide surveys to estimate fetal and childhood radiation doses from common diagnostic procedures, and epidemiologic studies to quantify pediatric and lifetime cancer risks from prenatal and early childhood exposures to diagnostic radiography, CT, and fluoroscopically guided procedures. (orig.)

  8. Occupational exposure of medical staff due to diagnostic X-ray examinations in veterinary medicine

    International Nuclear Information System (INIS)

    Mergel, E.; Feige, S.; Haeusler, U.

    2007-01-01

    The implementation of the Council directive 96/29 EURATOM and the corresponding national Radiation Protection Ordinance and the X-ray Protection Ordinance coming subsequently into effect led to a changed situation regarding the occupational radiation protection in the medical sector. To reduce the occupational exposure of veterinarians and assisting staff in veterinary radiography is particularly challenging as, in opposite to human radiological examination, the presence of staff is indispensable to restrain the patient. Beyond that the relevant literature reports about too high and/or about unnecessary radiation exposures. To gain a comprehensive knowledge upon the possible exposure of involved staff, the variety of typical examination methods in veterinary clinics and at practitioners had been investigated during the daily routine. Dose measurements were performed for different employees during the examinations taking into account several places of exposure (lens, thyroid, chest, hand, gonad, and feet). Veterinary X-ray diagnostic examinations for pets as well as in equine radiography had been accounted for this study. In total, 101 examination methods, 4.484 accompanied examinations and 53.892 single dose readings resulted in a reliable statistical base to set up a 'Job-Exposure-Matrix' allowing the dose assessment for a variable number and kind of examinations. The 'Job-Exposure-Matrix' is believed to be a useful tool for optimization of occupational radiation exposure of veterinarians by appraising the height of a possible dose, forcing a review of the status quo and triggering the improvement of personal protection by establishing adequate measures. (orig.)

  9. Cost Benefit Optimization of the Israeli Medical Diagnostic X-Ray Exposure

    International Nuclear Information System (INIS)

    Ben-Shlomo, A.; Shlesinger, T.; Shani, G.; Kushilevsky, A.

    1999-01-01

    Diagnostic and therapeutic radiology is playing a major role in modern medicine. A preliminary survey was carried out during 1997 on 3 major Israeli hospitals in order to assess the extent of exposure of the population to medical x-rays (1). The survey has found that the annual collective dose of the Israeli population to x-ray medical imaging procedures (excluding radio-therapy) is about 7,500 Man-Sv. The results of the survey were analyzed in order to. 1. Carry out a cost-benefit optimization procedure related to the means that should be used to reduce the exposure of the Israeli patients under x-ray procedures. 2. Establish a set of practical recommendations to reduce the x-ray radiation exposure of patients and to increase the image quality. . Establish a number of basic rules to be utilized by health policy makers in Israel. Based on the ICRP-60 linear model risk assessments (2), the extent of the annual risk arising A.om the 7,500 Man-Sv medical x-ray collective dose in Israel has been found to be the potential addition of 567 cancer cases per year, 244 of which to be fatal, and a potential additional birth of 3-4 children with severe genetic damage per year. This assessment take into account the differential risk and the collective dose according to the age distribution in the Israeli exposed population, and excludes patients with chronic diseases

  10. Update of diagnostic medical and dental x-ray exposures in Romania

    Energy Technology Data Exchange (ETDEWEB)

    Sorop, Ioana; Mossang, Daniela; Dadulescu, Elena [Radiation Hygiene Laboratory of Public Health Authority Dolj, 2, Constantin Lecca Street, Craiova (Romania); Iacob, Mihai Radu [University ' Alexandru Ioan Cuza' , 11, Carol I Street, 700506, Iasi (Romania); Iacob, Olga [Institute of Public Health, 14, Victor Babes Street, 700465 Iasi (Romania)], E-mail: danamossang@sanpubdj.ro

    2008-12-15

    This national study, the third in the last 15 years, updates the magnitude of medical radiation exposure from conventional x-ray examinations, in order to optimise the radiological protection to the population in a cost-effective manner. Effective doses from diagnostic radiology were estimated for adult and paediatric patients undergoing the 20 most important types of x-ray examination. Data were collected from 179 x-ray departments, selected by their annual workload, throughout the country. Estimates were made using two dosimetric quantities: entrance surface dose, derived from the absorbed dose in air measured by simulation of radiographic examinations, and dose-area product, measured during fluoroscopic examinations performed on adult and paediatric patients. Conversion coefficients to effective dose of the UK National Radiological Protection Board (NRPB) have been used in all calculations. The effective dose per patient from all medical x-ray examinations was 0.74 mSv and the resulting annual collective effective dose was 6930 man Sv, with annual effective dose per caput of 0.33 mSv. The current size of population exposure from diagnostic radiology is lower than the previous one by 40%, but could be about 30% higher by taking into account the estimated contribution from computed tomography (CT) procedures.

  11. Childhood leukaemia following medical diagnostic exposure to ionizing radiation in utero or after birth

    International Nuclear Information System (INIS)

    Wakeford, R.

    2008-01-01

    A statistical association between childhood leukaemia and an abdominal X-ray examination of the pregnant mother was first reported in 1956 from a case-control study of childhood cancer mortality conducted in Great Britain. This study, later called the Oxford Survey of Childhood Cancers (OSCC), was continued and eventually showed a highly statistically significant ∼50% proportional increase in the risk of childhood leukaemia associated with antenatal diagnostic radiography. The association has been confirmed by many case-control studies carried out around the world, the appropriately combined results of which show a highly statistically significant increase in risk that is compatible with the OSCC finding. There is no doubt about the reality of the statistical association, but a causal interpretation has been questioned. On balance, however, the evidence points to low-level irradiation of the fetus increasing the risk of leukaemia in childhood, with an excess relative risk coefficient of around 50 Gy -1 (equivalent to an excess absolute risk coefficient of about 3% Gy -1 ), although the uncertainty associated with these coefficients is considerable and they are likely to be overestimates. In contrast to exposure in utero, the evidence from case-control studies for an association between childhood leukaemia and postnatal exposure to medical diagnostic irradiation is equivocal and sometimes conflicting. Since standard radiation risk models predict that low-level exposure in the early years of life should produce an increased risk of childhood leukaemia that is roughly similar to that arising from fetal exposure, this absence of persuasive evidence is likely to be due to various problems with the studies. This is unfortunate given the rise in relatively high dose diagnostic procedures (e.g. paediatric CT scans) that would be predicted to materially increase the relative risk of childhood leukaemia. (authors)

  12. Exposure of the French paediatric population to ionising radiation from diagnostic medical procedures in 2010

    Energy Technology Data Exchange (ETDEWEB)

    Etard, Cecile; Aubert, Bernard [Institut de Radioprotection et de Surete Nucleaire, Medical Expertise Unit, Fontenay-aux-Roses (France); Mezzarobba, Myriam [Institut de Radioprotection et de Surete Nucleaire, Laboratory of Epidemiology, Fontenay-aux-Roses (France); Bernier, Marie-Odile [Institut de Radioprotection et de Surete Nucleaire, Laboratory of Epidemiology, Fontenay-aux-Roses (France); Institut de Radioprotection et de Surete Nucleaire, IRSN/PRP-HOM/SRBE/LEPID, Laboratoire d' Epidemiologie, Fontenay-aux-Roses (France)

    2014-12-15

    Medical examination is the main source of artificial radiation exposure. Because children present an increased sensitivity to ionising radiation, radiology practices at a national level in paediatrics should be monitored. This study describes the ionising radiation exposure from diagnostic medical examinations of the French paediatric population in 2010. Data on frequency of examinations were provided by the French National Health Insurance through a representative sample including 107,627 children ages 0-15 years. Effective doses for each type of procedure were obtained from the published French literature. Median and mean effective doses were calculated for the studied population. About a third of the children were exposed to at least one examination using ionising radiation in 2010. Conventional radiology, dental exams, CT scans and nuclear medicine and interventional radiology represent respectively 55.3%, 42.3%, 2.1% and 0.3% of the procedures. Children 10-15 years old and babies from birth to 1 year are the most exposed populations, with respectively 1,098 and 734 examinations per 1,000 children per year. Before 1 year of age, chest and pelvis radiographs are the most common imaging tests, 54% and 32%, respectively. Only 1% of the studied population is exposed to CT scan, with 62% of these children exposed to a head-and-neck procedure. The annual median and mean effective doses were respectively 0.03 mSv and 0.7 mSv for the exposed children. This study gives updated reference data on French paediatric exposure to medical ionising radiation that can be used for public health or epidemiological purposes. Paediatric diagnostic use appears much lower than that of the whole French population as estimated in a previous study. (orig.)

  13. Exposure of the French paediatric population to ionising radiation from diagnostic medical procedures in 2010

    International Nuclear Information System (INIS)

    Etard, Cecile; Aubert, Bernard; Mezzarobba, Myriam; Bernier, Marie-Odile

    2014-01-01

    Medical examination is the main source of artificial radiation exposure. Because children present an increased sensitivity to ionising radiation, radiology practices at a national level in paediatrics should be monitored. This study describes the ionising radiation exposure from diagnostic medical examinations of the French paediatric population in 2010. Data on frequency of examinations were provided by the French National Health Insurance through a representative sample including 107,627 children ages 0-15 years. Effective doses for each type of procedure were obtained from the published French literature. Median and mean effective doses were calculated for the studied population. About a third of the children were exposed to at least one examination using ionising radiation in 2010. Conventional radiology, dental exams, CT scans and nuclear medicine and interventional radiology represent respectively 55.3%, 42.3%, 2.1% and 0.3% of the procedures. Children 10-15 years old and babies from birth to 1 year are the most exposed populations, with respectively 1,098 and 734 examinations per 1,000 children per year. Before 1 year of age, chest and pelvis radiographs are the most common imaging tests, 54% and 32%, respectively. Only 1% of the studied population is exposed to CT scan, with 62% of these children exposed to a head-and-neck procedure. The annual median and mean effective doses were respectively 0.03 mSv and 0.7 mSv for the exposed children. This study gives updated reference data on French paediatric exposure to medical ionising radiation that can be used for public health or epidemiological purposes. Paediatric diagnostic use appears much lower than that of the whole French population as estimated in a previous study. (orig.)

  14. Assessment of medical radiation exposure to patients and ambient doses in several diagnostic radiology departments

    Science.gov (United States)

    Sulieman, A.; Elhadi, T.; Babikir, E.; Alkhorayef, M.; Alnaaimi, M.; Alduaij, M.; Bradley, D. A.

    2017-11-01

    In many countries diagnostic medical exposures typically account for a very large fraction of the collective effective dose that can be assigned to anthropological sources and activities. This in part flags up the question of whether sufficient steps are being taken in regard to potential dose saving from such medical services. As a first step, one needs to survey doses to compare against those of best practice. The present study has sought evaluation of the radiation protection status and patient doses for certain key radiological procedures in four film-based radiology departments within Sudan. The radiation exposure survey, carried out using a survey meter and quality control test tools, involved a total of 299 patients their examinations being carried out at one or other of these four departments. The entrance surface air kerma (ESAK) was determined from exposure settings using DosCal software and an Unfors -Xi-meter. The mean ESAK for x-ray examination of the chest was 0.30±0.1 mGy, for the skull it was 0.96±0.7 mGy, for the abdomen 0.85±0.01 mGy, for spinal procedures 1.30±0.6 mGy and for procedures involving the limbs it was 0.43±0.3 mGy. Ambient dose-rates in the reception area, at the closed door of the x-ray room, recorded instantaneous values of up to 100 μSv/h. In regard to protection, the associated levels were found to be acceptable in three of the four departments, corrective action being required for one department, regular quality control also being recommended.

  15. PROLARM: Cancer risk from medical diagnostic exposures is strongly dependent upon patients' prognosis

    International Nuclear Information System (INIS)

    Eschner, Wolfgang; Schmidt, Matthias; Dietlein, Markus; Schicha, Harald

    2008-01-01

    when the associated survival is known. Conclusion: Calculations of cancer risk from diagnostic medical exposures must take into account the patient's prognosis. LAR will be significantly lower when patients are severely ill at exposure. (author)

  16. Diagnostic medical exposures: advice on exposure to ionising radiation during pregnancy

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    The NRPB offers advice on exposure to ionizing radiation during pregnancy, based on data published since 1985. In providing this advice the Board has considered risks to the developing embryo and fetus of death, malformation, mental impairment, cancer (solid tumours and leukaemias) and genetic damage from irradiation after the first missed menstrual period. The possible risks from irradiation of the early (up to 3-4 weeks) conceptus and from gonodal irradiation of patients is also covered in the present advice. (Author)

  17. Unintentional exposure to radiation during pregnancy from nuclear medical diagnostic procedures; Unabsichtliche Strahlenexposition in der Schwangerschaft durch nuklearmedizinische Diagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Moka, D. [Gemeinschaftspraxis fuer Radiologie und Nuklearmedizin, Essen (Germany)

    2005-12-01

    The administration of radiopharmaceuticals during pregnancy is contraindicated due to a lack of vital indications. However, if prenatal exposure to radiation should occur in the framework of a nuclear medical diagnostic procedure then fortunately no longterm side-effects would normally be expected. Radiation damage in the preimplantation phase leads to early abortion. However, if the further course of pregnancy remains uncomplicated then no subsequent side-effects need be expected. On a conservative estimate, it would require doses exceeding 50 mGy to cause radiation damage within the uterus after the preimplantation phase. However, the standard radioactivities applied for diagnostic purposes in nuclear medicine, can be obtained with doses of less than 20 mGy. On the basis of current knowledge, therefore, there is no reason to terminate pregnancy on medical grounds after diagnostic exposure to radiopharmaceuticals. (orig.)

  18. Exposure of the U.S. population from diagnostic medical radiation

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    This publication includes a short introduction and overview, followed by a brief section on concepts, units, and quantities. Data sources, equipment availability and film usage, number and trends of examinations, demographics, differential trends, exposure and absorbed dose, quality assurance and dose reduction, gonadal and genetically significant doses, mean active bone marrow dose, somatic doses and effective dose equivalents, and future trends in diagnostic radiology are discussed. A summary is then presented

  19. Radiation exposure of population due to medical diagnostic procedures in the USSR

    International Nuclear Information System (INIS)

    Vorob'ev, E.I.; Stavitskij, R.V.; Knizhnikov, V.A.; Barkhudarov, R.M.; Korsunskij, V.N.; Popov, V.I.; Tarasenko, Yu.I.; Postnikov, V.A.; Frolov, N.V.; Sidorin, V.P.

    1984-01-01

    The evaluation of radiation doses to population in the ussr on the basis of the data on frequency of 12 main forms of X-ray examinations and the results of measuring absorbed doses on tissue-kquivalent main's phantom are given. The evaluation of radiation exposure due to radiopharmaceutical preparations is based on consumption of 26 types of compounds in 320 national laboratories and i is performed by the methods developed in the framework of the mird committee (usa). In thhe active bone marrow, lungs mammary, glands thyroid and other organs (stomach, liver, spleen, etc.) the equivalent doses are determined and on their base the effective equivalent doses (eed). The average eed from x ray diagnostic examinations is 1.4 mSv per year (140 mrem per year) of which 55.4% falls on X-ray examination, 26.9% on radiography, 17.7% on mass miniature radiography (fluorography). Radionuclide diagnostics contribution is 3.2x10 -2 mSv per year (3.8 mrem per year). Medicinal radiation exposure approximately doubles the natural background, it is comparable with exposure in premises and essentially exceeds the radiation doses to population from other sources

  20. Radiation exposure of the Italian population due to medical diagnostic examinations in 1975

    International Nuclear Information System (INIS)

    Benassai, S.; Curatolo, M.; Dobici, F.; Indovina, P.L.; Pugliani, L.; Salvadori, P.

    1977-01-01

    The genetically significant dose received by the Italian population in 1975 due to the diagnostic X-ray examinations and radiopharmaceuticals was investigated and the results are presented. Concerning the diagnostic X-ray examinations the data were obtained by a representative sample and extrapolated over the whole population with reference to the over-all X-ray film consumption. From the reported data it can be concluded that about 50% of population was subjected to X-ray examinations and the genetically significant dose amounts to about 30 mrem. With reference to diagnostic use of radiopharmaceuticals the number of collected data was so large to be considered as representative of the situation. From the collected data it can be concluded that about 10% of population was subjected to these examinations and that the genetically significant dose is less than 2 mrem. Both for diagnostic X-ray examinations and use of radiopharmaceuticals results are here presented for the distribution of different uses and examinations. The genetically significant dose to which the Italian population was exposed in 1975 can be said to be of the order of 30 mrem. In view of lowering this dose some indications are presented with reference both to the legislative and technical measures

  1. Radiation exposure in diagnostic medicine

    International Nuclear Information System (INIS)

    Haehnel, S.; Michalczak, H.; Reinoehl-Kompa, S.

    1995-01-01

    This volume includes the manuscripts of the papers read at the conference as well as a summary and assessment of its results. The scientific discussions were centred upon the following issues: - International surveys and comparisons of rdiation exposures in diagnostic radiology and nuclear medicine, frequency of the individual diagnostic procedures and age distribution of patients examined; - policies and regulations for the radiation protection of patients, charcteristic dosimetric values and practical usefulness of the effective dose concept during medical examinations; - assessments of the relative benefits and risks and measures to reduce the radiation exposure in the light of quality assurance aspects. The main objective of this conference not only was to evaluate the risks from diagnostic radiology and nuclear medicine but also to encourgage a critical analysis and adjustment of examination routines followed in everyday practice. Among the measures recommended were quality assurance, maintenace of international standards, development of guidelines, introduction of standard doses, improved training and professional education of personnel as well as surveys and analyses of certain examination procedures associated with substantial radiation exposure. (orig./MG) [de

  2. Effective doses and standardised risk factors from paediatric diagnostic medical radiation exposures: Information for radiation risk communication

    International Nuclear Information System (INIS)

    Bibbo, Giovanni

    2018-01-01

    In the paediatric medical radiation setting, there is no consistency on the radiation risk information conveyed to the consumer (patient/carer). Each communicator may convey different information about the level of risk for the same radiation procedure, leaving the consumer confused and frustrated. There is a need to standardise risks resulting from medical radiation exposures. In this study, paediatric radiographic, fluoroscopic, CT and nuclear medicine examination data have been analysed to provide (i) effective doses and radiation induced cancer risk factors from common radiological and nuclear medicine diagnostic procedures in standardised formats, (II) awareness of the difficulties that may be encountered in communicating risks to the layperson, and (iii) an overview of the deleterious effects of ionising radiation so that the risk communicator can convey with confidence the risks resulting from medical radiation exposures. Paediatric patient dose data from general radiographic, computed tomography, fluoroscopic and nuclear medicine databases have been analysed in age groups 0 to <5 years, 5 to <10 years, 10 to <15 years and 15 to <18 years to determine standardised risk factors. Mean, minimum and maximum effective doses and the corresponding mean lifetime risks for general radiographic, fluoroscopic, CT and nuclear medicine examinations for different age groups have been calculated. For all examinations, the mean lifetime cancer induction risk is provided in three formats: statistical, fraction and category. Standardised risk factors for different radiological and nuclear medicine examinations and an overview of the deleterious effects of ionising radiation and the difficulties encountered in communicating the risks should facilitate risk communication to the patient/carer.

  3. Dose assessment and radioprotective medical evaluation of prenatal radiation exposures to diagnostic X-rays

    International Nuclear Information System (INIS)

    Bruening, L.; Haehnel, S.; Arndt, D.

    1989-01-01

    The 2nd to 15th weeks after conception are assessed to be the critical time period for the induction of teratogenic radiation damage. In the GDR, women having incurred fetal doses in excess of 100 mGy are recommended to interrupt pregnancy. Of 275 patients advised in the National Board for Atomic Safety and Radiation Protection between 1978 and 1988, approximately 90% were found to have received fetal doses below 20 mGy. Only 4 women had been exposed to doses above 100 mGy. Exposure data were given in the form of tables, and discussed. (author)

  4. Medical exposures, challenge and impacts

    International Nuclear Information System (INIS)

    Cardenas H, J.; Molina P, D.; Martinez G, A.

    2006-01-01

    The medical exposures have a significant contribution to the doses received by the population, reasons for what has not been considered during time its risks. In such sense in the last years the scientific community and international organizations have defined requirements for contribute to that the doses to those patients are the minimum ones necessary to achieve its diagnostic objective. The work exposes the radiological contribution, risks, uses and the actions for to improve the safety of the medical exposures. (Author)

  5. Exposure from diagnostic nuclear medicine procedures

    International Nuclear Information System (INIS)

    Iacob, O.; Diaconescu, C.; Isac, R.

    2002-01-01

    According to our last national study on population exposures from natural and artificial sources of ionizing radiation, 16% of overall annual collective effective dose represent the contribution of diagnostic medical exposures. Of this value, 92% is due to diagnostic X-ray examinations and only 8% arise from diagnostic nuclear medicine procedures. This small contribution to collective dose is mainly the result of their lower frequency compared to that of the X-ray examinations, doses delivered to patients being, on average, ten times higher. The purpose of this review was to reassess the population exposure from in vivo diagnostic nuclear medicine procedures and to evaluate the temporal trends of diagnostic usage of radiopharmaceuticals in Romania. The current survey is the third one conducted in the last decade. As in the previous ones (1990 and 1995), the contribution of the Radiation Hygiene Laboratories Network of the Ministry of Health and Family in collecting data from nuclear medicine departments in hospitals was very important

  6. Ionizing radiation used in medical diagnostics as a source of radiation exposure of the patient with occupational diseases. Analysis and problems

    International Nuclear Information System (INIS)

    Apostolova, D.B.; Paskalev, Z.D.

    2001-01-01

    X-rays in medical diagnostic are the major source of Bulgarian population exposure to ionizing radiations. Diagnostic X-ray is the most diagnostic application and is used in a wide variety of examinations. The modern concept for radiation protection of patients in diagnostic radiology is based on two main principles: justification of the examinations and radiation protection optimization. It is pointed out that the collective effective dose of radiation may be considerably reduced by decreasing the number of clinically unwarranted X-ray examination of storage and delivery of diagnostic information and adopting a system for physical and technical quality control of the X-ray equipment. The aim of this investigation is assessment of the collective effective doses for the patients with occupational diseases exposed to ionizing radiation by radiological diagnostics. The study covers the period of 1990 through 1999. A total of 3293 patients, treated in the Department of Occupational Toxicology, Clinic of Occupational Diseases, Medical University - Sofia, were examined with X-ray and KT (cervical and lumbar spine, chest, skull, stomach, extremities, pelvis, brain). Most of the observed patients were with predominantlyheavy metals poisonings and a few with other chemical agents poisonings. Number of patients with radiological examinations was 1938, number of examination per capita was 0,59 and the total number of radiological examinations was 2536. The average number of radiological examination for one patient was 1,36, the most number of radiological examinations for one patient was 4. The collective effective dose for an examined patient was 1803 man.mSv. Our results shown the essential of the raising ensure that the medical exposure of patients be the minimum necessary to achieve the required diagnostic objective. (author)

  7. Fetal exposure in diagnostic radiology

    International Nuclear Information System (INIS)

    Baker, M.L.; Vandergrift, J.F.; Dalrymple, G.V.

    1979-01-01

    The problem of possible radiation damage to the fetus or embryo as a result of diagnostic radiography during pregnancy, particularly in the early stages, is discussed. Recommendations of therapeutic abortion after fetal exposure require an adequate knowledge of the doses involved. In the absence of actual dose measurements or estimates, approximate exposure levels may be determined from the literature. A summary of published values for radiography involving the lower abdomen is given. Data is also presented from a series of fetal exposures resulting mostly from routine diagnostic radiography when pregnancy was not known at the time but was established later. Results of actual dose measurements using a phantom and of dose calculations based on published values are in reasonable agreement indicating that literature values of dose provide a satisfactory alternative to measurement. These data suggest that diagnostic radiography rarely, if ever, results in fetal exposures high enough to justify therapeutic abortion. (author)

  8. Medical exposures. Annex G

    International Nuclear Information System (INIS)

    1982-01-01

    This Annex examines medical irradiation of the human body done in the course of diagnostic x ray procedures, in diagnostic nuclear medicine by internally administered radionuclides, and in radiation therapy. Doses to patients from various medical procedures have been assessed, both in order to follow trends and to make it possible to see which procedures are most significant with regard to possible radiation risks. This Annex also presents data on the distribution of doses among irradiated persons.

  9. Closing Remarks [International Workshop on Justification of Medical Exposure in Diagnostic Imaging, Brussels (Belgium), 2-4 September 2009

    International Nuclear Information System (INIS)

    Ristori, D.

    2011-01-01

    Ladies and Gentlemen, I am very delighted to be with you this afternoon on the occasion of the closing session of this very interesting seminar. First of all, I would like to express my thanks to all organizations involved in the preparation and conduct of this meeting and especially to the International Atomic Energy Agency, in particular Ms. Renate Czarwinski, and also to our services in the European Commission in charge of this matter, under the responsibility of Mr. A. Janssens, the Head of the Unit for Radiation Protection. I would like to present to you some comments regarding the global nuclear context and then, more specifically, regarding medical exposure. Today the world is going through important changes in the use of nuclear energy and ionizing radiation. We see more and more a new interest in the development of nuclear energy everywhere in the world, including in the European Union - this is the case not only in France or Finland but also today in the United Kingdom, in Italy, in Sweden and in the great majority of the new Member States from Central and Eastern Europe. We also note the rapid developments regarding the use of ionizing radiation in medicine. All these changes have the potential to contribute to a better life for European citizens, providing a cleaner environment, sustainable economic development and improved health care. However, developments in the nuclear arena also create safety and non-proliferation challenges that need to be tackled on national, regional and international levels. We have seen in the context of the last G8 summit new proposals, in particular the proposal from the new President of the United States of America to organize a Global Summit on nuclear security in Washington in April next year. We will also have in 2010, in the context of the United Nations, a review of the Non-Proliferation Treaty. And we, as Europeans, have a special responsibility because we have the largest number of nuclear power plants (over 140 in

  10. The Medical Exposure to Ionizing Radiation and Protection of the Patient in Medical Imaging Procedures for Diagnostic and Therapeutic Purposes (Excluding Radiotherapy) using X-Rays in Israel - Risk - Cost and Benefit

    International Nuclear Information System (INIS)

    Ben-Shlomo, A.

    1998-10-01

    Diagnostic and therapeutic radiology is playing a major role in modern medicine. The utilization of devices emitting ionizing radiation for medical diagnostic and therapeutic purposes is classified into three categories: a. Radiotherapy procedures for the treatment of malignant and benign tumors. b. Nuclear medicine procedures using radiopharmaceuticals that are introduced into the patient's body for diagnostic and therapeutic purposes. c. Diagnostic and therapeutic x-ray imaging procedures. This group includes conventional radiography, conventional fluoroscopy, cardiac catheterization, angiography, CT, mammography, dental, and fluoroscopy operation procedures. A survey was carried out on a sample of three major Israeli hospitals in order to: 1. Determine the status of radiation protection of patients in Israel with regard to the use of x-rays in medical imaging and interventional radiology. 2. Assess the extent of exposure of the population to medical x-rays, and assess the collective risk in Israel in this relation (based on Icr-60). 3. Carry out a cost-benefit optimization procedure related to the means that should be used to reduce the exposure of Israeli patients under x-ray procedures. 4. Establish a of practical recommendations to reduce the x-ray radiation exposure of patients and to increase the image quality. 5. Establish a number of basic rules to be utilized by health policy makers in Israel

  11. Guidelines on the implementation of radiation protection measures during diagnostic medical exposures of female patients of reproductive capacity

    International Nuclear Information System (INIS)

    2000-08-01

    These guidelines were produced in response to a perceived need for clear guidance concerning the implementation of the 10-day and 28-day rules regarding radiological radiation protection practices. At the outset it is important to emphasise that, in all cases, the seriousness of the clinical situation must be taken into account as being of paramount importance and an overriding consideration to the guidelines. Radiographs of the chest, skull and extremities may be done at any time, provided that best practices are adhered to. All requests for radiological examinations of female patients, which place the uterus in or near the primary X-ray beam, i.e. irradiation between the diaphragm and pubis, or nuclear medicine examinations which are likely to result in a dose to the unborn child up to 10 mGy, should include the date of the last menstrual period. The prescriber and practitioner or radiographer should ask a patient beyond day 10 of the menstrual cycle whether she might be pregnant. This enquiry and the patient's answer should be recorded in writing. If the answer is no, the examination may proceed. If the answer is yes or uncertain, the examination should not proceed. In cases of medical emergency, the practitioner or the prescriber, if necessary following discussion with the practitioner or radiographer and taking justification into account, may decide to proceed with the examination. The practitioner or prescriber must record this decision in writing and sign it. The 10-day rule is recommended for certain high dose examinations where the dose to the uterus is likely to exceed 10 mGy. These include a small number of diagnostic X-ray and nuclear medicine procedures. (author)

  12. Guidelines on the implementation of radiation protection measures during diagnostic medical exposures of female patients of reproductive capacity

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-08-01

    These guidelines were produced in response to a perceived need for clear guidance concerning the implementation of the 10-day and 28-day rules regarding radiological radiation protection practices. At the outset it is important to emphasise that, in all cases, the seriousness of the clinical situation must be taken into account as being of paramount importance and an overriding consideration to the guidelines. Radiographs of the chest, skull and extremities may be done at any time, provided that best practices are adhered to. All requests for radiological examinations of female patients, which place the uterus in or near the primary X-ray beam, i.e. irradiation between the diaphragm and pubis, or nuclear medicine examinations which are likely to result in a dose to the unborn child up to 10 mGy, should include the date of the last menstrual period. The prescriber and practitioner or radiographer should ask a patient beyond day 10 of the menstrual cycle whether she might be pregnant. This enquiry and the patient's answer should be recorded in writing. If the answer is no, the examination may proceed. If the answer is yes or uncertain, the examination should not proceed. In cases of medical emergency, the practitioner or the prescriber, if necessary following discussion with the practitioner or radiographer and taking justification into account, may decide to proceed with the examination. The practitioner or prescriber must record this decision in writing and sign it. The 10-day rule is recommended for certain high dose examinations where the dose to the uterus is likely to exceed 10 mGy. These include a small number of diagnostic X-ray and nuclear medicine procedures. (author)

  13. Medical exposure in Russia

    International Nuclear Information System (INIS)

    Kalnisky, S.A.; Bazukin, A.B.; Ivanov, E.V.; Jakubovskiy-Lipsky, Y.O.; Vlasova, M.M.; Gontsov, A.A.; Ivanov, S.I.

    2001-01-01

    Recently there have been considerable changes in radiology, which is because of coming to a new form of property, reforms of health services and crisis in the society. Big area, bad means of communication and low density of population in most regions of the country should be also mentioned among the factors influencing the level of both health protection and radiology services. All these factors don't allow to create an effective radiology system in a short time. Meanwhile the main nearest task of radiology is the integration and optimization of all means of visualization on the basis of solving fundamental problems of health protection according to the Federal program, normative acts and decrees of the government. In this connection it seemed to be an urgent task to estimate various aspects of radiology activity of Russian health in the dynamics for the recent period of time. The data of the state statistics are to be used to cope with this task. These data on the basis of the computer program 'Region', the quantity indices of various visualization methods used in Russia and the doses of exposure of the population have been estimated and the reference book 'Medical irradiation of the population in Russia. 1980-1997 years' has been published. It turned out that the average annual number of X-ray examinations per thousand population in Russia before 1988 year was constantly up to 1600. And only then because of Chernobyl accident its increase stopped and its gradual decline began (table 1). Such high frequency of the examinations was caused mainly by the large scales of mass preventive photofluorography (more than 40%), held for early tuberculosis exposure. It was as a result of reorganization of fluorographic examination system started in the late 80s and early 90s that this pernicious tendency was overcome and the number of fluorography was reduced almost twice from 90 to 56 millions a year, which considerably contributed to reducing the exposure. Unfortunately as

  14. Medical exposures requirements, present situation and prospects

    International Nuclear Information System (INIS)

    Cardenas Herrera, Juan

    2012-01-01

    Scope of medical exposures is studied, these include: exposure to patients as part of their diagnosis or treatment, exposures to persons who knowingly have assisted patients, exposures volunteers included in biomedical research programs. Medical exposures have contributed their benefits for human health improvement: possess a necessary character that people have to be exposed to radiation doses to achieve their goals, convergence of risk and benefit in the same individual is presented, variability is implicated in dose given to patients in terms of size and distribution, have contributed significantly to the doses received by the world population. Despite the above attributes and generally contribute to the direct benefit of the patient, long has been given less attention than other forms of exposure, there still potential for dose reduction to patients as a result of the applications of ionizing radiation. Currently have used for nuclear medicine diagnostic x-ray procedures, exams MN, radiotherapy, tomography, both medical and dental radiology. (author) [es

  15. Optoelectronic tweezers for medical diagnostics

    Science.gov (United States)

    Kremer, Clemens; Neale, Steven; Menachery, Anoop; Barrett, Mike; Cooper, Jonathan M.

    2012-01-01

    Optoelectronic tweezers (OET) allows the spatial patterning of electric fields through selected illumination of a photoconductive surface. This enables the manipulation of micro particles and cells by creating non-uniform electrical fields that then produce dielectrophoretic (DEP) forces. The DEP responses of cells differ and can produce negative or positive (repelled or attracted to areas of high electric field) forces. Therefore OET can be used to manipulate individual cells and separate different cell types from each other. Thus OET has many applications for medical diagnostics, demonstrated here with work towards diagnosing Human African Trypanosomiasis, also known as sleeping sickness.

  16. Safety of Medical Diagnostic Ultrasound

    International Nuclear Information System (INIS)

    Breyer, B.

    1998-01-01

    Large numbers of people (both sick and healthy) are routinely exposed to ultrasound waves. We shall discuss wave parameters and scanner properties that are relevant to the safety aspect. This includes central pulse frequency, pulse length, intensity (ISPTA and others), focusing, pulse repetition frequency, pulse pressure, etc. Since the transmitted ultrasound power has steadily been increasing during the last two decades, the problems are becoming more serious with time. Doppler methods have gained importance and 'popularity, which additionally increases ultrasound power requirements since the reflectivity of red blood cells is so small that the backscattered pressure is about 100 times less than that from soft tissue structures in the body. Main mechanisms that can potentially present hazard are heating and cavitation. The basic parameter used to assess thermal hazard is ISPTA and the optimal predictor of cavitation hazard is the peak rarefractional pressure. The hazard of heating-up can be summarized in saying that temperatures up to 38.5 o C are safe, while temperatures above 41 o C are definitely not. Care must be taken to stay within the safe zone. However, there does not exist a confirmed report of any type of hazardous effects on humans using intensities presently applied in diagnostic ultrasound scanners. Taking this into account, various international bodies have put limits to the application of ultrasound, which is best summarized in the FDA (USA) regulation that diagnostic apparatus may have an output of maximally 720 mW/cm 2 (derated) provided thermal and mechanical properties are indicated (onscreen) by properly defined Thermal Indices (TI) and Mechanical Index (MI). These aspects shall be discussed in some detail. We shall give the rules for the operator to apply ultrasound with minimal hazard. The general conclusion is that diagnostic ultrasound, as presently known, may be used whenever a qualified expert expects essential medical benefit for the

  17. Non-medical exposures - Ethical concerns

    International Nuclear Information System (INIS)

    O'Reilly, G.

    2009-01-01

    The scope of the Medical Exposure Directive (MED), 97/43/Euratom (Council Directive 97/43/EURATOM, on the health protection of individuals against the dangers of ionising radiation in relation to medical exposures. OJ L 180 of 09.07.1997), is such that it includes not only those exposures which are part of the normal diagnosis and treatment of patients but also exposures for occupational health surveillance, health-screening programmes, research and medico-legal exposures. This is the first time that radiation protection legislation has tried to deal explicitly with the issue of medico-legal exposures in a European Directive. However, it has done so in the context of a Directive whose primary focus is the protection of patients undergoing diagnostic or therapeutic medical exposures. This may not be an appropriate framework for medico-legal exposures. In considering medico-legal exposures, a significant number of ethical considerations arise. The MED may not adequately take account of these matters and in fact may not be a suitable legal instrument for dealing with them. This paper looks specifically at the issues surrounding medico-legal exposures and considers whether or not the current system provides adequate protection for the individuals exposed. (authors)

  18. Medical exposure: guidance on the 1990 Recommendations of ICRP

    International Nuclear Information System (INIS)

    Shrimpton, P.C.

    1993-01-01

    The Board's guidance relating to medical exposures develops the general advice given in the Statement and the supporting recommendations. The Board's guidance covers justification, optimisation of protection and dosimetry for the medical exposure of patients from diagnostic radiology, nuclear medicine and radiotherapy. Recommendations are also given relating to the optimisation of protection for medical exposures incurred by individuals other than as part of their own medical diagnosis or treatment. (author)

  19. CURRENT LEVELS OF MEDICAL EXPOSURE IN RUSSIA

    Directory of Open Access Journals (Sweden)

    M. I. Balonov

    2015-01-01

    Full Text Available We considered conditions of patients’ medical radiation exposure in Russian diagnostic radiology and nuclear medicine basing on the data of our own research, of the Unified system of individual dose control and of some relevant literature. We analyzed the data on the number of diagnostic examinations, patients’ individual and collective doses and their distribution by examination types. Time trends of the studied parameters are presented for the period between 1999 and 2013. Current level of Russian patients’ medical exposure is the lowest over the whole observation period and one of the lowest among the developed countries. The annual number of X-ray diagnostic examinations is 1.8 per capita. In 2013 median effective dose of medical exposure per capita in Russia was 0.45 mSv and median dose per procedure was 0.25 mSv. The major contribution to collective dose of medical exposure was from computed tomography and radiography; the largest individual doses were caused by interventional radiology, computed X-Ray and nuclear medicine tomographic examinations. The range of median doses comprises about four orders of magnitude, i.e. from several microSv in dental X-ray examinations up to several tens of milliSv in interventional and multistage tomographic examinations. The median effective dose of adult patients increases by about an order of magnitude with each transition from dental X-ray examinations to conventional radiology and further to computed tomography and interventional radiology examinations. During interventional X-Ray examinations, absorbed skin doses at radiation beam entrance site may reach several Gray, which may lead to deterministic radiation effects in skin and subcutaneous tissues. Due to replacement of low-dose ‘functional’ nuclear medicine examinations with more informative modern scintigraphy and tomography examination, patient doses substantially increased over the last decade. With current trend for re-equipment of

  20. Intelligent systems in technical and medical diagnostics

    CERN Document Server

    Korbicz, Jozef

    2013-01-01

    For many years technical and medical diagnostics has been the area of intensive scientific research. It covers well-established topics as well as emerging developments in control engineering, artificial intelligence, applied mathematics, pattern recognition and statistics. At the same time, a growing number of applications of different fault diagnosis methods, especially in electrical, mechanical, chemical and medical engineering, is being observed. This monograph contains a collection of 44 carefully selected papers contributed by experts in technical and medical diagnostics, and constitutes

  1. Staff radiation exposure in radiation diagnostics

    International Nuclear Information System (INIS)

    Khakimova, N.U.; Malisheva, E.Yu.; Shosafarova, Sh.G.

    2010-01-01

    Present article is devoted to staff radiation exposure in radiation diagnostics. Data on staff radiation exposure obtained during 2005-2008 years was analyzed. It was found that average individual doses of staff of various occupations in Dushanbe city for 2008 year are at 0.29-2.16 mSv range. They are higher than the average health indicators but lower than maximum permissible dose. It was defined that paramedical personnel receives the highest doses among the various categories of staff.

  2. Role of MRI in Medical Diagnostics

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 20; Issue 11. Role of MRI in Medical Diagnostics. Rashmi Rao Ramesh Venkatesan Sairam Geethanath. General Article Volume 20 Issue 11 November 2015 pp 1003-1011 ...

  3. DEVELOPMENT OF DIAGNOSTIC REFERENCE LEVELS (DRL OF PATIENTS X-RAY EXPOSURE IN DIAGNOSTIC RADIOLOGY

    Directory of Open Access Journals (Sweden)

    A. V. Vodovatov

    2013-01-01

    Full Text Available We introduce a system of Diagnostic Reference Levels (DRLs for patients medical exposure for national health care practice implementation. DRLs are an effective way of the patient radiation protection through the optimization of the medical exposure. The paper discusses and compares different methods of determining the DRLs based on measured and/or calculated quantities of patient’s dose: dose area product (DAP, entrance surface dose (ESD and an effective dose. Distributions of different dose quantities in different Saint-Petersburg clinics are shown on the example of chest PA examinations. The results are compared with the data from other sources. Regional DRLs for Saint-Petersburg are proposed.

  4. Medical exposure. Guidance on the 1990 Recommendations of ICRP

    International Nuclear Information System (INIS)

    Shrimpton, P.C.; Wall, B.F.; Croft, J.R.; Webb, G.A.M.

    1993-01-01

    The Board has been directed by the Health Ministers to advise the appropriate government departments and statutory bodies on the acceptability and applicability for the UK of recommendations of the International Commission on Radiological Protection (ICRP). The Board has given its response to the broad issues raised by the new ICRP recommendations and is providing more specific advice on the three categories of exposure considered by ICRP, namely occupational, medical and public, as well as on dose quantities. This document presents advice on medical exposure of patients from diagnostic radiology, nuclear medicine and radiotherapy, and on exposures (other than occupational) incurred by those helping in the support and comfort of such patients. The report contains recommendations concerning the justification of medical exposures both at the broad level of practice and for individual procedures. It discusses the importance of optimisation of protection and, in the context of diagnostic medical exposures, recommends the use of reference dose levels to give a quantitative guide to optimisation. Reference values of entrance surface dose per radiograph and dose-area product per examination are presented for some common types of X-ray procedure. Consideration is given to the suitability of effective dose for assessing detriment from diagnostic medical exposures. Dose constraints are proposed for medical exposures incurred by individuals other than as part of their own medical diagnosis or treatment and some issues regarding public exposure from medical radiology are discussed. (Author)

  5. Advances in medical diagnostic technology

    CERN Document Server

    Lai, Khin Wee; Mohamad Salim, Maheza Irna; Ong, Sang-Bing; Utama, Nugraha Priya; Myint, Yin Mon; Mohd Noor, Norliza; Supriyanto, Eko

    2014-01-01

    This book provides the most recent findings and knowledge in advanced diagnostics technology, covering a wide spectrum including brain activity analysis, breast and lung cancer detection, echocardiography, computer aided skeletal assessment to mitochondrial biology imaging at the cellular level. The authors explored magneto acoustic approaches and tissue elasticity imaging for the purpose of breast cancer detection. Perspectives in fetal echocardiography from an image processing angle are included. Diagnostic imaging in the field of mitochondrial diseases as well as the use of Computer-Aided System (CAD) are also discussed in the book. This book will be useful for students, lecturers or professional researchers in the field of biomedical sciences and image processing.

  6. Compliance to Diagnostic Reference Levels for radiation exposure in common radiological procedures in Dutch hospitals: A nation-wide survey carried out by medical imaging students.

    Science.gov (United States)

    Bijwaard, H; de Vries, G; Scheurleer, J; Roding, T; Erenstein, H; Ravensbergen, W; Haarmans-Jonkman, S; van Welie, F

    2017-08-01

    In the Netherlands, hospitals have difficulty in implementing the formal procedure of comparing radiation dose values to Diagnostic Reference Levels (DRLs). To support the hospitals, train radiography students, and carry out a nationwide dose survey, diagnostic radiography students performed 125 DRL comparisons for nine different procedures in 29 radiology departments. Students were instructed at three Dutch Universities of Applied Sciences with a radiography programme and supervised by medical physicists from the participating hospitals. After a pilot study in the western part of the country in eight hospitals, this study was enlarged to involve 21 hospitals from all over the Netherlands. The 86 obtained dose comparisons fall below the DRLs in 97% of all cases. This very high compliance may have been enhanced by the voluntary participation of hospitals that are confident about their performance. The results indicate that the current DRLs that were not based on a national survey, may need to be updated, sometimes to half their current value. For chest and pelvis examinations the DRLs could be lowered from 12 and 300 μGy·m 2 to the 75-percentile values found in this study of 5,9 and 188 μGy·m 2 , respectively. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

  7. Diagnostic Medical Imaging in Pediatric Patients and Subsequent Cancer Risk.

    Science.gov (United States)

    Mulvihill, David J; Jhawar, Sachin; Kostis, John B; Goyal, Sharad

    2017-11-01

    The use of diagnostic medical imaging is becoming increasingly more commonplace in the pediatric setting. However, many medical imaging modalities expose pediatric patients to ionizing radiation, which has been shown to increase the risk of cancer development in later life. This review article provides a comprehensive overview of the available data regarding the risk of cancer development following exposure to ionizing radiation from diagnostic medical imaging. Attention is paid to modalities such as computed tomography scans and fluoroscopic procedures that can expose children to radiation doses orders of magnitude higher than standard diagnostic x-rays. Ongoing studies that seek to more precisely determine the relationship of diagnostic medical radiation in children and subsequent cancer development are discussed, as well as modern strategies to better quantify this risk. Finally, as cardiovascular imaging and intervention contribute substantially to medical radiation exposure, we discuss strategies to enhance radiation safety in these areas. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  8. A recommender system for medical imaging diagnostic.

    Science.gov (United States)

    Monteiro, Eriksson; Valente, Frederico; Costa, Carlos; Oliveira, José Luís

    2015-01-01

    The large volume of data captured daily in healthcare institutions is opening new and great perspectives about the best ways to use it towards improving clinical practice. In this paper we present a context-based recommender system to support medical imaging diagnostic. The system relies on data mining and context-based retrieval techniques to automatically lookup for relevant information that may help physicians in the diagnostic decision.

  9. BIOANALYTICAL STANDARDIZING FOR SEROLOGICAL DIAGNOSTIC MEDICAL DEVICES

    Directory of Open Access Journals (Sweden)

    A. Yu. Galkin

    2015-04-01

    Full Text Available In article we analyzed national and international regulations concerning the quality and safety of medical devices for in vitro diagnostics. We discussed the possibility of a partial application of the recommendations of the State Pharmacopoeia of Ukraine to this type of product. The main guiding regulatory documents establishing requirements for quality and safety tools for the serological diagnosis products are The technical regulation on medical devices for the diagnosis in vitro, DSTU ISO 13485 “Medical devices. Quality management system. Regulatory requirements”, and DSTU ISO/IEC 17025 “General requirements for the competence of testing and calibration laboratories”. Similar requirements of the State Pharmacopoeia of Ukraine which are used for drug standardization can not be directly applied to the medical devises for in vitro diagnostics due to a number of features, namely, the serological diagnosis products pre-designed to determine the unknown concentration of a particular analyte in a biological material, the diagnostic kits has to include the control samples (internal standard systems that need to be calibrated. It was determined following parameters of bioanalytical standardization and validation characterization for of qualitative (semi quantitative test-kits for serological diagnosis: precision (convergence, intralaboratory precision and reproducibility, diagnostic and analytical specificity, diagnostic sensitivity. It’s necessary to inspect additional parameters for quantitative test-kits such as accuracy (precision, linearity, analytical sensitivity and range.

  10. Medical exposures: challenges and impacts

    International Nuclear Information System (INIS)

    Cardenas Herrera, Juan; Fernandez Gomez, Isis Maria

    2008-01-01

    Good medical care that is practiced in the safety and welfare of the patient with the medical radiation is analyzed. The attention to patients includes: exposures to patients as part of their diagnosis or treatment, exposures to people that consciously help to the patients and exposures to volunteers included in biomedical research programs. The good medical treatment allows the improvement of the human health, the necessary doses of radiation are benefits for the patients. 2000 million are performed annually in radiodiagnosis, 32 million of nuclear medicine studies and 5.5 million of radiotherapy treatment. Ionizing medical radiations have increased considerably by reports of Unsa in 2000, since 1988 the radiation has been used to provide diagnoses and therapies in patients. The radiation is used both in children and adults to prevent and control different diseases, for example the cancer. In this report, the Cuban experience in relation to the subject is told, their progress, rights and wrongs. Finally, there are surprising data about how radiation has damaged human health and in some cases the doctors have been using the wrong dose and the wrong drug in patients [es

  11. Diagnostic reference levels in medical imaging

    International Nuclear Information System (INIS)

    Rosenstein, M.

    2001-01-01

    The paper proposes additional advice to national or local authorities and the clinical community on the application of diagnostic reference levels as a practical tool to manage radiation doses to patients in diagnostic radiology and nuclear medicine. A survey was made of the various approaches that have been taken by authoritative bodies to establish diagnostic reference levels for medical imaging tasks. There are a variety of ways to implement the idea of diagnostic reference levels, depending on the medical imaging task of interest, the national or local state of practice and the national or local preferences for technical implementation. The existing International Commission on Radiological Protection (ICRP) guidance is reviewed, the survey information is summarized, a set of unifying principles is espoused and a statement of additional advice that has been proposed to ICRP Committee 3 is presented. The proposed advice would meet a need for a unifying set of principles to provide a framework for diagnostic reference levels but would allow flexibility in their selection and use. While some illustrative examples are given, the proposed advice does not specify the specific quantities to be used, the numerical values to be set for the quantities or the technical details of how national or local authorities should implement diagnostic reference levels. (author)

  12. Medical exposures, challenge and impacts; Exposiciones medicas, retos e impactos

    Energy Technology Data Exchange (ETDEWEB)

    Cardenas H, J.; Molina P, D.; Martinez G, A. [Centro de Proteccion e Higiene de las Radiaciones, Calle 20 No. 4113 e/41 y 47 Playa, 11300 La Habana, Direccion Postal A.P. 6195, C.P. 10600 (Cuba)

    2006-07-01

    The medical exposures have a significant contribution to the doses received by the population, reasons for what has not been considered during time its risks. In such sense in the last years the scientific community and international organizations have defined requirements for contribute to that the doses to those patients are the minimum ones necessary to achieve its diagnostic objective. The work exposes the radiological contribution, risks, uses and the actions for to improve the safety of the medical exposures. (Author)

  13. Overview of dosimetry methods used in medical exposure

    International Nuclear Information System (INIS)

    Ninsiima, Lynn

    2016-04-01

    Medical exposure is the highest means of contribution of ionizing radiation to humans. The different modalities in medical exposure present a high risk to the human body as a result of the dose associated with them. However, with the knowledge of the available dosimetry techniques, medical exposure can be highly beneficial to the patients involved. This project provides an overview of the available dosimetry methods in all the medical exposure modalities and the dosimetric quantities required in order to estimate the dose received by the patients in a bid to keep it as low as reasonably achievable yet with the required diagnostic image quality and treatment being availed. With the knowledge about the dosimetric techniques, required qualification and appropriate training of the workers in the medical field together with the principles of justification and optimization of the procedures, both the medical practitioners and the patients are able to achieve the required goal, diagnosis and treatment at the end of the day. (au)

  14. Nano structures for Medical Diagnostics Md

    International Nuclear Information System (INIS)

    Bellah, M.; Iqbal, S.M.; Bellah, M.; Iqbal, S.M.; Christensen, S.M.; Iqbal, S.M.; Iqbal, S.M.

    2012-01-01

    Nano technology is the art of manipulating materials on atomic or molecular scales especially to build nano scale structures and devices. The field is expanding quickly, and a lot of work is ongoing in the design, characterization, synthesis, and application of materials, structures, devices, and systems by controlling shape and size at nanometer scale. In the last few years, much work has been focused on the use of nano structures toward problems of biology and medicine. In this paper, we focus on the application of various nano structures and nano devices in clinical diagnostics and detection of important biological molecules. The discussion starts by introducing some basic techniques of micro-/nano scale fabrication that have enabled reproducible production of nano structures. The prospects, benefits, and limitations of using these novel techniques in the fields of bio detection and medical diagnostics are then discussed. Finally, the challenges of mass production and acceptance of nano technology by the medical community are considered.

  15. The impact of education on occupational radiation exposure reduction in a diagnostic radiology department

    International Nuclear Information System (INIS)

    Vetter, R.J.; Gray, J.E.

    1987-01-01

    Patient load, number of radiographic exams, complexity of some exams, and associated potential occupational radiation exposure of medical personnel have increased significantly in the past decade. Efforts to reduce exposure through employee education and awareness have resulted in significant reduction in occupational exposure for most diagnostic radiographic areas at Mayo Clinic. This paper reviews trends in occupational radiation exposure from diagnostic x- rays at Mayo Clinic over the past ten years. Changes in employee radiation dose equivalents are correlated with patient workload, complexity of exams, increased interventional radiology and cardiology, and efforts to reduce employee radiation exposure

  16. Fitness of equipment used for medical exposures to ionising radiation

    International Nuclear Information System (INIS)

    1998-01-01

    The advice in this guidance note is aimed at employers in control of equipment used for medical exposures to ionising radiation and ancillary equipment. This includes NHS trusts, health authorities or boards, private hospitals, clinics, surgeries, medical X-ray facilities in industry, dentists and chiropractors. The guidance should also be useful to radiation protection advisers appointed by such employers. The guidance provides advice on the requirements of regulation 33 of the Ionising Radiations Regulations 1985 (IRR85). In particular, it covers: (a) the selection, installation, maintenance, calibration and replacement of equipment to ensure that it is capable of restricting, so far as reasonably practicable, the medical exposure of any person to the extent that this is compatible with the intended diagnostic or therapeutic purpose; (b) recommended procedures for the definitive calibration of radiotherapy treatment; and (c) the need to investigate incidents involving a malfunction or defect in any 'radiation equipment' which result in medical exposures much greater than intended and to notify the Health and Safety Executive (HSE). 'Medical exposure' is defined in IRR85 as exposure of a person to ionising radiation for the purpose of his or her medical or dental examination or treatment which is conducted under the direction of a suitably qualified person and includes any such examination or treatment conducted for the purposes of research. For convenience, people undergoing medical exposure will be referred to as 'patients' in this guidance. Nothing in this publication is intended to indicate whether or not patients should be informed of any incident resulting from malfunction or defect in equipment used for medical exposure and the possible consequences of that exposure. As stated above, this guidance concerns medical exposures much greater than intended and although exposures much lower than intended can also have serious consequences, the incident would not

  17. Radiation exposure from medical field in France

    International Nuclear Information System (INIS)

    Scanff, P.; Aubert, B.; Donadieu, J.; Pirard, P.

    2006-01-01

    Full text of publication follows: The only nationwide survey on medical X-ray practices in France was carried out more than fifteen years ago and recent updated information about the nature and frequency of X-ray diagnostic procedures and associated doses is lacking. However, with the implementation of the European Directive 97/43, the knowledge of medical practices is necessary and the question of the population dose resulting from medical X-ray examinations is raised again. In order to provide French data concerning the medical exposure to ionizing radiation, the Institute for Radiation Protection and Nuclear Safety (I.R.S.N.) and the National Institute for Public Health Surveillance (I.n.V.S.) have created an observatory of medical exposure to ionizing radiation. A first study was carried out in order to evaluate the nature and frequency of X-ray diagnostic procedures in conventional radiology and computed tomography. Information about annual frequencies was collected from two main sources: the main health insurance company (C.N.A.M.-T.S. - private radiologists) and the national statistics of the health establishments (S.A.E. examinations realized in public and private hospitals) from the ministry of health. Relevant data concerning examinations in conventional radiology (C.R.) with dental radiology and computed tomography (CT) were collected for the year 2002. As these two main sources of data may overlap, two hypotheses were retained, named low hypothesis (l.h.) and high hypothesis (h.h.). Dose contribution of these exams per inhabitant was calculated from French values of dose from the diagnostic reference level (D.R.L.) campaign completed with data from the European Commission publication 118 and from the health protection agency (H.P.A.). In this study, 82 different examination types were identified for C.R., according to the new French nomenclature for medical examinations (C.C.A.M.). The first five examinations (in number) are respectively chest

  18. Radiation exposure from medical field in France

    Energy Technology Data Exchange (ETDEWEB)

    Scanff, P.; Aubert, B. [Institut de Radioprotection et de Surete Nucleaire (IRSN), 92 - Fontenay-aux-Roses (France); Donadieu, J.; Pirard, P. [Institut de Veille Sanitaire, St Maurice (France)

    2006-07-01

    Full text of publication follows: The only nationwide survey on medical X-ray practices in France was carried out more than fifteen years ago and recent updated information about the nature and frequency of X-ray diagnostic procedures and associated doses is lacking. However, with the implementation of the European Directive 97/43, the knowledge of medical practices is necessary and the question of the population dose resulting from medical X-ray examinations is raised again. In order to provide French data concerning the medical exposure to ionizing radiation, the Institute for Radiation Protection and Nuclear Safety (I.R.S.N.) and the National Institute for Public Health Surveillance (I.n.V.S.) have created an observatory of medical exposure to ionizing radiation. A first study was carried out in order to evaluate the nature and frequency of X-ray diagnostic procedures in conventional radiology and computed tomography. Information about annual frequencies was collected from two main sources: the main health insurance company (C.N.A.M.-T.S. - private radiologists) and the national statistics of the health establishments (S.A.E. examinations realized in public and private hospitals) from the ministry of health. Relevant data concerning examinations in conventional radiology (C.R.) with dental radiology and computed tomography (CT) were collected for the year 2002. As these two main sources of data may overlap, two hypotheses were retained, named low hypothesis (l.h.) and high hypothesis (h.h.). Dose contribution of these exams per inhabitant was calculated from French values of dose from the diagnostic reference level (D.R.L.) campaign completed with data from the European Commission publication 118 and from the health protection agency (H.P.A.). In this study, 82 different examination types were identified for C.R., according to the new French nomenclature for medical examinations (C.C.A.M.). The first five examinations (in number) are respectively chest

  19. The ionising radiation (medical exposure) regulations - IR (ME) R, Malta

    International Nuclear Information System (INIS)

    Desai, R.; Brejza, P.; Cremona, J.

    2004-01-01

    framework of procedures for medical exposures. Asole practitioner is required to establish and follow his own procedures. The employer's guidelines must cover the matters set out in regulations 9.1.1 to 9.1.12. It also requires the employer to establish written protocols for standard radiological practices, recommendations concerning referral criteria, quality assurance programmes for standard operating procedures, diagnostic reference levels, appropriate guidance and dose constrains for helpers and medical research programmes. It also requires investigations of incidents suspecting that a patient may have received a radiation dose much greater than intended. 10. Regulation 10 requires the practitioner and operator to comply with the employer's procedures. 11. Regulation 11 provides list of duties of practitioner, referrer and operator. 12. Regulation 12 provides optimisation of procedures so as to ensure that exposure is kept as low as reasonably practicable. The practitioner and the operator are responsible for the optimisation of medical exposures as specified in this regulation. This regulation provides that special attention be given to exposure in (i) medico-legal procedures (ii) health screening or voluntary participation in research where no direct medical benefit is expected from the exposure or where exposure involves high doses, (iii) pregnant or potentially pregnant women (iv) breast-feeding females (v) children. This regulation also provides that certain written instruction and information be given where radioactive medicinal products are administered. 13. Regulation 13 provides for medical physics experts to be consulted where appropriate. 14. Regulation 14 prohibits a practitioner or operator from carrying out a medical procedure without having been adequately trained and requires the employer to keep a record of training qualifications of all practitioners and operators engaged by him. 15. Regulation 15 requires the employer to maintain an inventory of

  20. Unjustified prenatal radiation exposure in medical applications

    International Nuclear Information System (INIS)

    Cardenas Herrera, J.; Lamadrid, A.I.; Garcia Lima, O.; Diaz Bernal, E.; Freixas, V.; Lopez Bejerano, G.; Sanchez, R.

    2001-01-01

    The exposure to the radiation ionising of pregnant women, frequently constitutes motive of preoccupation for the expectant mother and the medical professionals taken the responsibility with its attention. The protection of the embryo-fetus against the ionising radiation is of singular importance due to its special vulnerability to this agent. On the other hand the diagnosis or treatment with radiations ionising beneficial for the expectant mother, are only indirectly for the embryo-fetus that is exposed to a hazard without perceiving anything. The present paper presents the experience obtained in the clinical and dosimetric evaluation from twenty-one pregnant patients subjected to diverse radiodiagnostic procedures or nuclear medicine during the years 1999-2000. The obtained results evidence that 24% of the patients was subjected to procedures of nuclear medicine with diagnostic purposes. While the period of pregnancy of the patients ranged between 4 and 12 weeks, it could be concluded that in all the cases the doses received by the patients in the whole body did not exceed 2 mSv. When conjugating the period of pregnancy of the patients with the doses received, there is no evidence of significant risk for the embryo-fetus. Paradoxically the physicians of assistance suggested to their patients in all the cases to carry out the interruption of the pregnancy, demonstrating with this decision ignorance on the biological effects of the ionizing radiations during the prenatal exposures. (author)

  1. Diagnostic Reasoning across the Medical Education Continuum

    Directory of Open Access Journals (Sweden)

    C. Scott Smith

    2014-07-01

    Full Text Available We aimed to study linguistic and non-linguistic elements of diagnostic reasoning across the continuum of medical education. We performed semi-structured interviews of premedical students, first year medical students, third year medical students, second year internal medicine residents, and experienced faculty (ten each as they diagnosed three common causes of dyspnea. A second observer recorded emotional tone. All interviews were digitally recorded and blinded transcripts were created. Propositional analysis and concept mapping were performed. Grounded theory was used to identify salient categories and transcripts were scored with these categories. Transcripts were then unblinded. Systematic differences in propositional structure, number of concept connections, distribution of grounded theory categories, episodic and semantic memories, and emotional tone were identified. Summary concept maps were created and grounded theory concepts were explored for each learning level. We identified three major findings: (1 The “apprentice effect” in novices (high stress and low narrative competence; (2 logistic concept growth in intermediates; and (3 a cognitive state transition (between analytical and intuitive approaches in experts. These findings warrant further study and comparison.

  2. Dealing of embryo/fetal exposures in a medical setting

    International Nuclear Information System (INIS)

    Miller, K.L.

    1991-01-01

    The medical environment presents two uniquely different situations involving potential radiation exposure to the embryo or fetus. On the one hand we have the potential for radiation exposure to the embryo of fetus of the occupationally exposed employee where the recommendations are well defined. On the other hand we have the pregnant or potentially pregnant patient requiring diagnostic radiological examinations or therapeutic procedures where the recommendations are not as well defined. This paper provides an overview of both situations, a discussion of potential exposures and a review of methods for estimating fetal doses when the exposed individual is the patient

  3. An Idea of a Computer Knowledge Bank on Medical Diagnostics

    OpenAIRE

    Chernyakhovskaya, Mery; Kleschev, Alexander; Moskalenko, Filip

    2008-01-01

    The paper is a description of information and software content of a computer knowledge bank on medical diagnostics. The classes of its users and the tasks which they can solve are described. The information content of the bank contains three ontologies: an ontology of observations in the field of medical diagnostics, an ontology of knowledge base (diseases) in medical diagnostics and an ontology of case records, and also it contains three classes of information resources for e...

  4. Exposure to Indian population from diagnostic radiology

    International Nuclear Information System (INIS)

    Supe, S.J.; Venkataraman, G.; Sasane, J.B.; Sawant, S.G.; Shirva, V.K.; Iyer, P.S.

    1993-01-01

    Many national and international agencies are actively engaged in taking stock of radiation safety status of radiation procedures which add to the population dose significantly. National survey is being conducted to collect data from various diagnostic X-ray institutions to assess radiation safety status and population dose arising from such practices in India. For this purpose 11 centres are collecting information on annual number of patients examined site wise and on their age and sex distribution. Patient doses are also measured for various diagnostic X-ray examinations in a few hospitals using CaSO 4 :Dy TLD dosimeters. Preliminary results of earlier study indicate that the country has about 50000 diagnostic X-ray units. The annual number of X-ray examinations is estimated to be 9x10 7 . Mean entrance skin dose for diagnostic X-rays are between 0.2 to 50 mGy depending on the type of examination. On the basis of experience gained in the earlier survey an exhaustive survey is undertaken for 1992-93 for improving the assessment of population dose. (author). 3 refs

  5. Calibration of diagnostic x-ray machines using radiation exposure and radiographic parameters

    International Nuclear Information System (INIS)

    Agba, E.H.; Uloko, P. I.; Tyovenda, A. A.

    2011-01-01

    Calibration of diagnostic x-ray machines using radiation exposure and radiographic parameters of the x-ray machines has been carried out. Three phase diagnostic x-ray machines situated at Federal Medical Centre, Makurdi, General Hospital, Otukpo and Christian Hospital, Mkar were used for the calibration work. The radiation meter was used to measure x-ray radiation exposure. The result of this work demonstrates mR/mAs=C(KV p ) that there exist a power law relation of the form between the radiation exposure and the radiographic parameters of diagnostic x-ray machines, which can be used to estimate patient exposure during routine x-ray diagnostic examinations for wide range of operating parameters. The values of the power exponent n, constant c and total filtrations of the diagnostic x-ray machines have been estimated. These values for the diagnostic x-ray machines at the Federal Medical Centre, Makurdi are: 2.14, 0.88 and 2.77 respectively, for the one at the General Hospital, Otukpo are: 2.07, 0.76 and 2.68 respectively and that of the Christian Hospital, Mkar are: 2.01,0.69 and 2.61 respectively.

  6. Cyclotrons for therapeutic and medical diagnostic applications

    International Nuclear Information System (INIS)

    Dey, Malay Kanti; Dutta, Atanu; Mallik, C.; Bhandari, R.K.

    2009-01-01

    Cyclotron has got its most successful application in the production of radionuclide. More than hundred cyclotron installations worldwide are engaged in the production of PET and SPECT isotopes ( 11 C, 13 N, 15 O, 18 F, 123 I, 203 Tl, 67 Ga) used in medical diagnostics, including isotopes for therapeutic applications ( 64 Cu, l03 Pd, 186 Re etc.). Keeping pace with the world trend of exploding number of medical cyclotrons, VECC is also setting up a high current (∼350 μA), 30 MeV proton cyclotron facility, which will be mostly dedicated for radioisotope production, besides its R and D utilization in material science. Besides, to bring down the operating cost, we are exploring the possibility of using permanent magnet, instead of copper coils, in a 10 MeV PET cyclotron. During last decade, the cyclotron has got potential application in particle therapy. About fifteen particle therapy facilities are under construction world-wide and about half of them will be using cyclotrons. Specifically, the development of 250 MeV proton superconducting cyclotron has fulfilled nicely most of the requirements for a hospital based machine. Based on experience accrued in developing the K500 superconducting cyclotron, VECC has proposed a project in XI-th five year plan on design and development of 250 MeV proton superconducting cyclotron for therapy. Our activities in these fields will be briefly presented here. The preliminary design calculations for the proposed 250 MeV proton superconducting cyclotron will be discussed specifically. (author)

  7. Effects of radiation exposure from radiopharmaceuticals used in diagnostic studies

    International Nuclear Information System (INIS)

    Witcofski, R.L.

    1981-01-01

    In the United States about 90 percent of man-made radiation exposure to the general population is from the use of radiation in diagnostic medicine. Although the doses of radiation from these procedures to individuals are generally quite small, large numbers of people are exposed. Estimates of the radiation doses associated with such use in the healing arts are approximately 15 million person-rem to the general population from diagnostic x ray and 3.3 million person-rem from the diagnostic use of radiopharmaceuticals. The purpose of this paper is to present what is known about the possible effects of radiation from diagnostic radiopharmaceuticals

  8. Overview of the use of dose constraints in medical exposures

    International Nuclear Information System (INIS)

    Tuyisenge, J. D.

    2014-01-01

    The project overviewed the use of dose constraints in medical exposure in literature. Different documents on the establishment, the development and the application of this concept are reviewed with regard to the use of medical exposure of patients, including their comforters and carers or helpers, and volunteers in biomedical research. It has been showed that the concept of Dose Constraints along with many other concepts of radiation protection is widely applied in the optimisation of exposure to radiation. These concepts include Dose Limits, Dose References levels and Guidance levels among others. With regard to medical exposure of patients, it is not appropriate to apply dose limits or dose constraints, because such limits would often do more harm than good as far as benefits from such an exposure is concerned. Dose constraints do not apply with regard to any exposure of patient for his/her diagnostic or therapeutic purposes. With regard to patient comforters, carers or helpers, and volunteers in biomedical research, the benefits of such an exposure are not direct to the exposed individuals; therefore dose constraints will be appropriately applied. From the beginning of the establishment of Dose Constraints as a concept in radiation protection, the International Commission of Radiological Protection (ICRP) has published a number of documents that provide detailed application related to radiological protection and safety in the medical applications of ionising radiation. Each of these publications addresses a specific topic defined by the type of radiation source and the medical discipline in which the source is applied. This is done in the intention of communicating directly to the relevant medical radiation users, competent radiation authorities and health related institutions concerns with radiation protection and safe use of radiation sources in medical applications. This project provides an overview of such publications and related documents. (author)

  9. Radiation doses from medical diagnostic procedures in Canada

    International Nuclear Information System (INIS)

    Aldrich, J.E.; Lentle, B.C.; Vo, C.

    1997-03-01

    This document sets out to record and analyze the doses incurred in Canada from medical procedures involving the use of ionizing radiation in a typical year. Excluded are those doses incurred during therapeutic irradiation, since they differ in scale to such a large degree and because they are used almost exclusively in treating cancer. In this we are following a precedent set by the United Nations Scientific Committee on the Effects of Ionizing Radiation. Although the International Commission on Radiological Protection (ICRP) notes that dose limits should not be applied to medical exposures, it also observes that doses in different settings for the same procedure may vary by as much as two orders of magnitude, and that there are considerable opportunities for dose reductions in diagnostic radiology. Because these data do not stand in isolation the report also encompasses a review of the relevant literature and some background comment on the evolving technology of the radiological sciences. Because there is a somewhat incomplete perception of the changes taking place in diagnostic methods we have also provided some introductory explanations of the relevant technologies. In addition, there is an analysis of at least some of the limitations on the completeness of the data which are reported here. (author)

  10. Fluorescence spectroscopy for medical and environmental diagnostics

    International Nuclear Information System (INIS)

    Johansson, Jonas.

    1993-09-01

    Fluorescence spectroscopy can be used for diagnostics in medical and environmental applications. The many aspects of fluorescence emission are utilized to enhance the accuracy of the diagnosis. A fluorescence detection system, based on nitrogen laser or dye laser excitation and optical multichannel detection, was constructed, and fluorescence spectra from human malignant tumours of various origins, were recorded. Tumour demarcation was observed using exogenous chromophores, as well as the endogenous tissue fluorescence. In particular, δ-amino levulinic acid was found to provide very good tumour demarcation. A multi-colour imaging system capable of simultaneous recording of four fluorescence images at selected wavelengths, was developed. Examples of processed images, based on the four sub-images, are shown for malignant tumours. In addition, data from photodynamic treatment of human malignant tumours are presented. Autofluorescence spectra from excised pieces of human atherosclerotic aorta and atherosclerotic coronary segment were found to be different from those of non-diseased vessels. Furthermore, fluorescence decay curves from atherosclerotic samples were found to differ from those of non-diseased samples. It is concluded that both spectral and temporal information should be utilized to enhance the demarcation. Methods for obtaining fluorescence data free from interference from blood, with applications to in vivo laser angioplasty of atherosclerosis, are discussed. The optical multichannel system and the multi-colour imaging system were integrated with a remote sensing system, originally used for environmental measurements, to obtain fluorescence spectra as well as fluorescence images of plants at a distance of up to 100 m. The fluorescence data from plants subject to environmental stress or senescent plants were found to differ from those obtained from healthy vegetation. 359 refs

  11. Radiation exposure and image quality in x-Ray diagnostic radiology physical principles and clinical applications

    CERN Document Server

    Aichinger, Horst; Joite-Barfuß, Sigrid; Säbel, Manfred

    2012-01-01

    The largest contribution to radiation exposure to the population as a whole arises from diagnostic X-rays. Protecting the patient from radiation is a major aim of modern health policy, and an understanding of the relationship between radiation dose and image quality is of pivotal importance in optimising medical diagnostic radiology. In this volume the data provided for exploring these concerns are partly based on X-ray spectra, measured on diagnostic X-ray tube assemblies, and are supplemented by the results of measurements on phantoms and simulation calculations.

  12. Exposure to Environmental Air Manganese and Medication ...

    Science.gov (United States)

    Manganese (Mn) is an essential element with natural low levels found in water, food, and air, but due to industrialized processes, both workplace and the environmental exposures to Mn have increased. Recently, environmental studies have reported physical and mental health problems associated with air-Mn exposure, but medical record reviews for exposed residents are rare in the literature. When medical records and clinical testing are unavailable, examination of residents’ prescribed medication use may be used as a surrogate of health effects associated with Mn. We examined medication use among adult Ohio residents in two towns with elevated air-Mn (n=185) and one unexposed control town (n=90). Study participants recorded medication use in a health questionnaire and brought their currently prescribed medication, over-the-counter and supplement lists to their interview. Two physicians (family and psychiatric medicine) reviewed the provided medication list and developed medical categories associated with the medications used. The exposed (E) and control (C) groups were compared on the established 12 medication and 1 supplement categories using chi-square tests. The significant medication categories were further analyzed using hierarchical binomial logistic regression adjusting for education, personal income, and years of residency. The two groups were primarily white (E:94.6%; C:96.7%) but differed on education (E:13.8; C:15.2 years), residence length in their re

  13. Calculation of radiation exposure in diagnostic radiology. Method and surveys

    International Nuclear Information System (INIS)

    Duvauferrier, R.; Ramee, A.; Ezzeldin, K.; Guibert, J.L.

    1984-01-01

    A computerized method for evaluating the radiation exposure of the main target organs during various diagnostic radiologic procedures is described. This technique was used for educational purposes: study of exposure variations according to the technical modalities of a given procedure, and study of exposure variations according to various technical protocols (IVU, EGD barium study, etc.). This method was also used for studying exposure of patients during hospitalization in the Rennes Regional Hospital Center (France) in 1982, according to departments (urology, neurology, etc.). This method and results of these three studies are discussed [fr

  14. Collective dose estimation in Portuguese population due to medical exams of diagnostic radiology and nuclear medicine

    International Nuclear Information System (INIS)

    Teles, Pedro; Vaz, Pedro; Paulo, Graciano; Santos, Joana; Pascoal, Ana; Lanca, Isabel; Matela, Nuno; Sousa, Patrick; Carvoeiras, Pedro; Parafita, Rui; Simaozinho, Paula

    2013-01-01

    In order to assess the exposure of the Portuguese population to ionizing radiation due to medical examinations of diagnostic radiology and nuclear medicine, a working group, consisting of 40 institutions, public and private, was created to evaluation the coletive dose in the Portuguese population in 2010. This work was conducted in collaboration with the Dose Datamed European consortium, which aims to assess the exposure of the European population to ionizing radiation due to 20 diagnostic radiology examinations most frequent in Europe (the 'TOP 20') and nuclear medicine examinations. We obtained an average value of collective dose of ≈ 1 mSv/caput, which puts Portugal in the category of countries medium to high exposure to Europe. We hope that this work can be a starting point to bridge the persistent lack of studies in the areas referred to in Portugal, and to enable the characterization periodic exposure of the Portuguese population to ionizing radiation in the context of medical applications

  15. Medical exposure and effective dose

    International Nuclear Information System (INIS)

    Maruyama, Takashi

    1995-01-01

    The frequency of radiological diagnosis in Japan and individual population effective dose are reported. Questionnaire on radiological practice was delivered to selected medical facilities. The total number of X-ray diagnosis performed in 1991 was 180,000,000, being age-dependent in both men and women. The chest was the most common site to be examined. The number of X-ray films per examination was the highest for the stomach. The spread of ultrasound has decreased radiological practice in the obstetric field (approximately one sixth between 1979 and 1986). There was an 8-fold increase in the number of X-ray CT as of 1989 during the past decade. The total number of CT scanning in 1989 reached nearly 14,850,000 (about 16 times as much as that of 1979). The number of stomach X-ray screening increased to 7,800,000 which is twice as much as that in 1975. In the dental field, panoramic method brought about a 7-fold increase between 1974 and 1985. The frequency of nuclear medicine diagnosis has slightly increased, reaching 1,400,000 cases in 1992, and 99m Tc was the most common nuclide. The total population effective dose of radiography and fluoroscopy was 179,000 mSv. The highest effective dose was associated with gastric X-ray. The effective dose equivalent per diagnosis was estimated to be 1.02 mSv (the total population/total number of radiological diagnosis). The population effective dose per person was 2.3 mSv (population effective dose equivalent/national population), which was equal to the world average of yearly effective dose equivalent of natural radiation. (S.Y.)

  16. Medical exposure and effective dose

    Energy Technology Data Exchange (ETDEWEB)

    Maruyama, Takashi [Association of Radiation Effects, Chiba (Japan)

    1995-09-01

    The frequency of radiological diagnosis in Japan and individual population effective dose are reported. Questionnaire on radiological practice was delivered to selected medical facilities. The total number of X-ray diagnosis performed in 1991 was 180,000,000, being age-dependent in both men and women. The chest was the most common site to be examined. The number of X-ray films per examination was the highest for the stomach. The spread of ultrasound has decreased radiological practice in the obstetric field (approximately one sixth between 1979 and 1986). There was an 8-fold increase in the number of X-ray CT as of 1989 during the past decade. The total number of CT scanning in 1989 reached nearly 14,850,000 (about 16 times as much as that of 1979). The number of stomach X-ray screening increased to 7,800,000 which is twice as much as that in 1975. In the dental field, panoramic method brought about a 7-fold increase between 1974 and 1985. The frequency of nuclear medicine diagnosis has slightly increased, reaching 1,400,000 cases in 1992, and {sup 99m}Tc was the most common nuclide. The total population effective dose of radiography and fluoroscopy was 179,000 mSv. The highest effective dose was associated with gastric X-ray. The effective dose equivalent per diagnosis was estimated to be 1.02 mSv (the total population/total number of radiological diagnosis). The population effective dose per person was 2.3 mSv (population effective dose equivalent/national population), which was equal to the world average of yearly effective dose equivalent of natural radiation. (S.Y.).

  17. Radiation exposure from diagnostic imaging among patients with gastrointestinal disorders.

    LENUS (Irish Health Repository)

    Desmond, Alan N

    2012-03-01

    There are concerns about levels of radiation exposure among patients who undergo diagnostic imaging for inflammatory bowel disease (IBD), compared with other gastrointestinal (GI) disorders. We quantified imaging studies and estimated the cumulative effective dose (CED) of radiation received by patients with organic and functional GI disorders. We also identified factors and diagnoses associated with high CEDs.

  18. Methodology for quantitative evaluation of diagnostic medical imaging

    International Nuclear Information System (INIS)

    Metz, C.

    1980-01-01

    This report deals with the evaluation of the performance of diagnostic medical imaging procedures using the Receiver Operating Characteristic or ROC analysis. The development of new tests for the statistical significance of apparent differences between ROC curves is discussed

  19. Physician Knowledge of Radiation Exposure and Risk in Medical Imaging.

    Science.gov (United States)

    Hobbs, Jason B; Goldstein, Noah; Lind, Kimberly E; Elder, Deirdre; Dodd, Gerald D; Borgstede, James P

    2018-01-01

    Medical imaging is an increasingly important source of radiation exposure for the general population, and there are risks associated with such exposure; however, recent studies have demonstrated poor understanding of medical radiation among various groups of health care providers. This study had two aims: (1) analyze physicians' knowledge of radiation exposure and risk in diagnostic imaging across multiple specialties and levels of training, and (2) assess the effectiveness of a brief educational presentation on improving physicians' knowledge. From 2014 to 2016, 232 health care providers from multiple departments participated in an educational presentation and pre- and postpresentation tests evaluating knowledge of radiation exposure and risk at a large academic institution. Knowledge of radiation exposure and risk was relatively low on the prepresentation test, including particularly poor understanding of different imaging modalities, with 26% of participants unable to correctly identify which modalities expose patients to ionizing radiation. Test scores significantly increased after the educational presentation. Radiologists had higher prepresentation test scores than other specialties, and therefore less opportunity for improvement, but also demonstrated improvement in radiation safety knowledge after education. Aside from radiology, there was no significant difference in initial knowledge of radiation exposure and risk among the other specialties. Providers' knowledge of radiation exposure and risk was low at baseline but significantly increased after a brief educational presentation. Efforts to educate ordering providers about radiation exposure and risk are needed to ensure that providers are appropriately weighing the risks and benefits of medical imaging and to ensure high-quality, patient-centered care. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  20. Medical diagnostic through image: Whose field?

    International Nuclear Information System (INIS)

    Plaja, G.V.

    1997-01-01

    This article refers the process to be carried out, to obtain an integral diagnostic with the help of x rays, mammography, axial computerized mammography and ultrasonic. It includes information of the academic preparation of doctors in Costa Rica, and the need of more specialization in the radiologic field. (S. Grainger) [es

  1. The future of medical diagnostics : review paper

    NARCIS (Netherlands)

    Jerjes, Waseem K.; Upile, Tahwinder; Wong, Brian J.; Betz, Christian S.; Sterenborg, Henricus J.; Witjes, Max J.; Berg, Kristian; van Veen, Robert; Biel, Merrill A.; El-Naggar, Adel K.; Mosse, Charles A.; Olivo, Malini; Richards-Kortum, Rebecca; Robinson, Dominic J.; Rosen, Jennifer; Yodh, Arjun G.; Kendall, Catherine; Ilgner, Justus F.; Amelink, Arjen; Bagnato, Vanderlei; Barr, Hugh; Bolotine, Lina; Bigio, Irving; Chen, Zhongping; Choo-Smith, Lin-Ping; D'Cruz, Anil K.; Gillenwater, Ann; Leunig, Andreas; MacRobert, Alexander J.; McKenzie, Gordon; Sandison, Ann; Soo, Khee C.; Stepp, Herbert; Stone, Nicholas; Svanberg, Katarina; Tan, I. Bing; Wilson, Brian C.; Wolfsen, Herbert; Hopper, Colin

    2011-01-01

    While histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple optical

  2. The future of medical diagnostics: Review paper

    NARCIS (Netherlands)

    W.K. Jerjes (Waseem K.); T. Upile (Tahwinder); B.J. Wong (Brian J.); C.S. Betz (Christian S.); H.J.C.M. Sterenborg (Dick); M.J.H. Witjes (Max); K. Svanberg (Katarina); R. van Veen (Robert); M.A. Biel (Merrill A.); A.K. El-Naggar (Adel K.); C.A. Mosse (Charles A.); M. Olivo (Malini); R. Richards-Kortum (Rebecca); D.J. Robinson (Dominic); P.J. Rosen (Peter J.); A.G. Yodh (Arjun G.); C. Kendall (Catherine); J.F. Ilgner (Justus F.); A. Amelink (Arjen); V. Bagnato (Vanderlei); H. Barr (Hugh); L. Bolotine (Lina); I. Bigio (Irving); Z. Chen (Zhiyi); L.P. Choo-Smith; A.K. D'Cruz (Anil K.); A. Gillenwater (Ann); A. Leunig (Andreas); A.J. MacRobert (Alexander J.); G. McKenzie (Gordon); A. Sandison (Ann); K.C. Soo (Khee Chee); H. Stepp (Herbert); J.R.N. Stone; I.B. Tan (I. Bing); B.C. Wilson (Brian C.); H. Wolfsen (Herbert); C. Hopper (Colin)

    2011-01-01

    textabstractWhile histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple

  3. The future of medical diagnostics: review paper

    NARCIS (Netherlands)

    Jerjes, Waseem K.; Upile, Tahwinder; Wong, Brian J.; Betz, Christian S.; Sterenborg, Henricus J.; Witjes, Max J.; Berg, Kristian; van Veen, Robert; Biel, Merrill A.; El-Naggar, Adel K.; Mosse, Charles A.; Olivo, Malini; Richards-Kortum, Rebecca; Robinson, Dominic J.; Rosen, Jennifer; Yodh, Arjun G.; Kendall, Catherine; Ilgner, Justus F.; Amelink, Arjen; Bagnato, Vanderlei; Barr, Hugh; Bolotine, Lina; Bigio, Irving; Chen, Zhongping; Choo-Smith, Lin-Ping; D'Cruz, Anil K.; Gillenwater, Ann; Leunig, Andreas; MacRobert, Alexander J.; McKenzie, Gordon; Sandison, Ann; Soo, Khee C.; Stepp, Herbert; Stone, Nicholas; Svanberg, Katarina; Tan, I. Bing; Wilson, Brian C.; Wolfsen, Herbert; Hopper, Colin

    2011-01-01

    While histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple optical

  4. Ordering of diagnostic information in encoded medical images. Accuracy progression

    Science.gov (United States)

    Przelaskowski, A.; Jóźwiak, R.; Krzyżewski, T.; Wróblewska, A.

    2008-03-01

    A concept of diagnostic accuracy progression for embedded coding of medical images was presented. Implementation of JPEG2000 encoder with a modified PCRD optimization algorithm was realized and initially verified as a tool for accurate medical image streaming. Mean square error as a distortion measure was replaced by other numerical measures to revise quality progression according to diagnostic importance of successively encoded image information. A faster increment of image diagnostic importance during reconstruction of initial packets of code stream was reached. Modified Jasper code was initially tested on a set of mammograms containing clusters of microcalcifications and malignant masses, and other radiograms. Teleradiologic applications were considered as the first area of interests.

  5. Diagnostic imaging in undergraduate medical education: an expanding role

    International Nuclear Information System (INIS)

    Miles, K.A.

    2005-01-01

    Radiologists have been involved in anatomy instruction for medical students for decades. However, recent technical advances in radiology, such as multiplanar imaging, 'virtual endoscopy', functional and molecular imaging, and spectroscopy, offer new ways in which to use imaging for teaching basic sciences to medical students. The broad dissemination of picture archiving and communications systems is making such images readily available to medical schools, providing new opportunities for the incorporation of diagnostic imaging into the undergraduate medical curriculum. Current reforms in the medical curriculum and the establishment of new medical schools in the UK further underline the prospects for an expanding role for imaging in medical education. This article reviews the methods by which diagnostic imaging can be used to support the learning of anatomy and other basic sciences

  6. The future of medical diagnostics: review paper

    LENUS (Irish Health Repository)

    Jerjes, Waseem K

    2011-08-23

    Abstract While histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple optical techniques of tissue interrogation. Their accuracy, expressed as sensitivity and specificity, are reported in a number of studies suggests that they have a potential for cost effective, real-time, in situ diagnosis. We review the Third Scientific Meeting of the Head and Neck Optical Diagnostics Society held in Congress Innsbruck, Innsbruck, Austria on the 11th May 2011. For the first time the HNODS Annual Scientific Meeting was held in association with the International Photodynamic Association (IPA) and the European Platform for Photodynamic Medicine (EPPM). The aim was to enhance the interdisciplinary aspects of optical diagnostics and other photodynamic applications. The meeting included 2 sections: oral communication sessions running in parallel to the IPA programme and poster presentation sessions combined with the IPA and EPPM posters sessions.

  7. A survey of medical diagnostic imaging technologies

    International Nuclear Information System (INIS)

    Heese, V.; Gmuer, N.; Thomlinson, W.

    1991-10-01

    The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today's more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities

  8. A survey of medical diagnostic imaging technologies

    Energy Technology Data Exchange (ETDEWEB)

    Heese, V.; Gmuer, N.; Thomlinson, W.

    1991-10-01

    The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today`s more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities.

  9. A survey of medical diagnostic imaging technologies

    Energy Technology Data Exchange (ETDEWEB)

    Heese, V.; Gmuer, N.; Thomlinson, W.

    1991-10-01

    The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today's more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities.

  10. Exposure of the bulgarian population from diagnostic radiology during 2001/2006 y

    International Nuclear Information System (INIS)

    Kostova-Lefterova, D.; Ingilizova, K.

    2008-01-01

    Each Member State of the European Union is currently committed to produce national legislation, demonstrating conformity with the European Directive on medical exposures. According to the Directive, each country shall estimate the medical exposure of its population. For this purpose it is necessary to calculate the individual effective dose from each type of diagnostic radiology examination and the frequency of the examinations. The collective effective dose (CED) is disputable indicator for the medical exposures but it is a criterion for the level of the country on the radiation protection of persons undergoing medical exposure. The individual effective doses from each type of diagnostic radiology examination will depend on the patient's age, sex, weight, the number and type of images, the screening time and also the equipment used. Some mean values can be obtained through surveys of patient dose and compared with the national or European reference doses for 'standard sized' patients. The aim of this investigation is to assess the exposure of Bulgarian population undergoing diagnostic radiology examinations. The diagnostic radiology procedures are in 30 positions, distributed in 3 age groups: 0 - 17 y., 17 - 45 y. and over 45 y. For the assessment of the CED the generally accepted formula has been applied. The individual effective doses have been established on the basis of standard tablegrams for the radiographic diagnostic examinations and the results from the national research project 'Phare' in 2002. Presented data are: average number of examinations 3848.92x10 3 , frequency in thousands 500, annual effective individual dose 0.89 mSv/y and average annual collective effective dose - 3314.59 man.Sv/y. The mean effective dose per caput of population for medical exposures can then be compared with that of other countries having similar levels of health care. Comparisons can also be made with exposure of the population from other sources of radiation. The dynamics

  11. Nuclear medical diagnostic with ventricular aneurysm

    International Nuclear Information System (INIS)

    Litter, H.

    1987-01-01

    In the diagnostic of ventricular aneurysms myocardial scintigraphy and above all radionuclide ventriculography (RNV) have special importance. Because of the non-invasive method and the as a result safe and easy use even with stress studies, RNV can provide a very valuable aid with aneurysm patients in early diagnosis, evaluation of the operability and as well as in the prognosis. It must be noted, however, that the differentiation of multivascular diseases and sometimes ventricular aneurysms can be difficult and the inclusion of an angiocardiograph as a radiological invasive examination procedure seems fitting. (orig./MG) [de

  12. Exposure of Medical Staff during Interventional Procedures

    International Nuclear Information System (INIS)

    Osvay, M.; Turak, O.

    2013-01-01

    The medical staff during interventional procedures receives significant doses on their hands, or parts of their body not covered with protective shielding equipment, as they are close to X-rays field. It can be stated, that interventional radiology and cardiology have one of the highest doses among the X-ray diagnostic procedures. The radiologist use X-ray machine directly in the interventional procedures. The occupational dose is measured only by one Kodak film badge worn under the lead apron for the estimation of the effective dose in Hungary. Our lecture presents the results of dose measurements on eye lens, hands, knees using LiF thermoluminescent dosemeters on the medical staff of two Hungarian hospitals. Results suggest that wearing only one film badge (or other dosemeter system) under the lead apron does not provide proper information on the real occupational dose of medical staff.(author)

  13. Towards a Diagnostic Toolbox for Medical Communication

    OpenAIRE

    Billingsley, William; Gallois, Cindy; Smith, Andrew; Marks, Timothy; Bernal, Fernando; Watson, Marcus

    2010-01-01

    International audience; Poor communication is a major cause of adverse patient events in hospitals. Although sophisticated simulators are in use for performing medical operations, there is comparatively little technology support being used for improving communication skills including patient history taking. Artificial Intelligence and Natural Language Processing researchers have developed sophisticated algorithms for analysing conversations. We are experimentally developing software that can ...

  14. Medical X-ray techniques in diagnostic radiography. 4. ed.

    International Nuclear Information System (INIS)

    Plaats, G.J. van der; Vijlbrief, P.

    1980-01-01

    A step by step account is given of every aspect of the technical factors involved in the production of X-ray images. Chapter titles include, methods of image formation and laws of projection, sharpness and unsharpness, contrast, perceptibility of detail in the radiographic image-image quality, properties of fluoroscopic screens, radiographic films, intensifying screens and cassettes, image intensification and X-ray television, processing technique, fluoroscopy and radiographic technique in general, special radiographic techniques, radiographic examinations using contrast media, exposure and exposure tables and automatic density control, diagnostic X-ray apparatus, and diagnostic stands and accessories. (C.F.)

  15. Laser-induced fluorescence for medical diagnostics

    International Nuclear Information System (INIS)

    Andersson Engels, S.

    1989-12-01

    Laser-induced fluorescence as a tool for tissue diagnostics is discussed. Both spectrally and time-resolved fluorescence signals are studied to optimize the demarcation of diseased lesions from normal tissue. The presentation is focused on two fields of application: the identification of malignant tumours and atherosclerotic plaques. Tissue autofluorescence as well as fluorescence from administered drugs have been utilized in diseased tissue diagnosis. The fluorescence criterion for tissue diagnosis is, as far as possible, chosen to be independent of unknown fluorescence parameters, which are not correlated to the type of tissue investigated. Both a dependence on biological parameters, such as light absorption in blood, and instrumental characteristics, such as excitation pulse fluctuations and detection geometry, can be minimized. Several chemical compounds have been studied in animal experiments after intraveneous injection to verify their capacity as malignant tumour marking drugs under laser excitation and fluorescence detection. Another objective of these studies was to improve our understanding of the mechanism and chemistry behind the retention of the various drugs in tissue. The properties of a chemical which maximize its selective retention in tumours are discussed. In order to utilize this diagnostic modality, three different clinically adapted sets of instrumentation have been developed and are presented. Two of the systems are nitrogen-laser-based fluorosensors; one is a point-monitoring system with full spectral resolution and the other one is an imaging system with up to four simultaneously recorded images in different spectral bands. The third system is a low-cost point-monitoring mercury-lamp-based fluoroscence emission as well as reflection characteristics of tissue. (author)

  16. Communicating risks and benefits of medical exposures to patients

    International Nuclear Information System (INIS)

    Wall, B.F.

    2001-01-01

    An information leaflet for concerned patients is in preparation, which attempts to explain the risks and benefits of diagnostic medical exposures in terms suitable for the layman. In view of the wide variability in patient doses for the same examination and the considerable uncertainties in radiation risk coefficients, x-ray examinations have been divided into just four broad categories each spanning a factor of 10 in risk. The doses are put into perspective by comparison with those from natural background radiation. Sufficient quantitative information on the approximate level of the risks for some common diagnostic procedures is provided to allow patients to make an informed decision on whether the benefits, as described by the referring clinician, outweigh the radiation risks. (author)

  17. Radiation protection programme for planned medical exposure situation

    International Nuclear Information System (INIS)

    Hanciles, Milford

    2016-04-01

    Radiation protection programme for planned medical exposure situation which involved diagnostic and interventional radiology was discussed. The radiation protection programme (RPP) should reflect the management’s commitment to radiation protection and safety through the management structure, policies, procedures and organizational arrangement commensurate with the nature and extent of the risk. Registrants and licensees should use the RPP as a tool for the development of a safety culture in diagnostic and interventional radiology departments .Recommendations are provided which when implemented in the education and training of radiographers, referral physician and all those involved in the use of ionizing radiation for diagnosis purposes will improve protection and safety of the occupationally exposed worker, the patient, the public and the environment. (au)

  18. Cancer risks following diagnostic and therapeutic radiation exposure in children

    Energy Technology Data Exchange (ETDEWEB)

    Kleinerman, Ruth A. [National Institutes of Health, Division of Cancer Epidemiology and Genetics, National Cancer Institute, EPS 7044, Rockville, MD (United States)

    2006-09-15

    The growing use of interventional and fluoroscopic imaging in children represents a tremendous benefit for the diagnosis and treatment of benign conditions. Along with the increasing use and complexity of these procedures comes concern about the cancer risk associated with ionizing radiation exposure to children. Children are considerably more sensitive to the carcinogenic effects of ionizing radiation than adults, and children have a longer life expectancy in which to express risk. Numerous epidemiologic cohort studies of childhood exposure to radiation for treatment of benign diseases have demonstrated radiation-related risks of cancer of the thyroid, breast, brain and skin, as well as leukemia. Many fewer studies have evaluated cancer risk following diagnostic radiation exposure in children. Although radiation dose for a single procedure might be low, pediatric patients often receive repeated examinations over time to evaluate their conditions, which could result in relatively high cumulative doses. Several cohort studies of girls and young women subjected to multiple diagnostic radiation exposures have been informative about increased mortality from breast cancer with increasing radiation dose, and case-control studies of childhood leukemia and postnatal diagnostic radiation exposure have suggested increased risks with an increasing number of examinations. Only two long-term follow-up studies of cancer following cardiac catheterization in childhood have been conducted, and neither reported an overall increased risk of cancer. Most cancers can be induced by radiation, and a linear dose-response has been noted for most solid cancers. Risks of radiation-related cancer are greatest for those exposed early in life, and these risks appear to persist throughout life. (orig.)

  19. [Perspective technologies and researches in the areaof medical laboratory diagnostics].

    Science.gov (United States)

    Ivanov, A M; Zhdanov, K V; Krivoruchko, A A; Ivoĭlov, O O

    2013-06-01

    The main principles of organisation of medical laboratory diagnostics are efficiency of analysis, mobility of laboratory services and quality of researches. These goals can be achieved by the use of portative laboratory analizers, by automation and computerization of the laboratorial service, by development and adoption of new laboratory technologies, integrating different methods and types of research. It is necessary to pay attention to the problem of NPT and indication of pathogenic germs. Priority areas of medical laboratory diagnostics development are: development and use of portative laboratory analyzers; development of chemical, that help to speed up and cheapen researches, improve effectiveness of laboratory diagnostics of infections and indications of pathogenic and other germ; development of new, more sensitive, specific, but simple methods of laboratory analysis; development of complex methods and types of researches, further implementation of methods and researches with different principles of action; development and implementation of new methods of NPT results recording; automation and computerization of the laboratorial diagnostics.

  20. Understanding the medical and nonmedical value of diagnostic testing.

    Science.gov (United States)

    Lee, David W; Neumann, Peter J; Rizzo, John A

    2010-01-01

    To develop a framework for defining the potential value of diagnostic testing, and discuss its implications for the health-care delivery system. We reviewed the conceptual and empirical literature related to the valuing of diagnostic tests, and used this information to create a framework for characterizing their value. We then made inferences about the impact of this framework on health insurance coverage, health technology assessment, physician-patient relationships, and public health policy. Three dimensions can effectively classify the potential value created by diagnostic tests: 1) medical value (impact on treatment decisions); 2) planning value (affect on patients' ability to make better life decisions); and 3) psychic value (how test information affects patients' sense of self). This comprehensive framework for valuing diagnostics suggests that existing health technology assessments may systematically under- or overvalue diagnostics, leading to potentially incorrect conclusions about cost-effectiveness. Further, failure to account for all value dimensions may lead to distorted payments under a value-based health-care system. The potential value created by medical diagnostics incorporates medical value as well as value associated with well-being and planning. Consideration of all three dimensions has important implications for technology assessment and value-based payment.

  1. Exposure of the french population to ionizing radiation link to medical diagnosis act in 2007

    International Nuclear Information System (INIS)

    Etard, C.; Aubert, B.; Sinno-Tellier, S.

    2010-01-01

    The objective of this report is to update and complete the data relative to the medical exposure of the French population to diagnostic imaging examinations for the year 2007. The last published data correspond to the year 2002. The information supplied by this report precise: the medical exposure to diagnostic imaging examinations by imaging modality (conventional radiology, scanner, nuclear medicine, and diagnostic interventional imaging), by anatomical area, by age, and according to the sex of the patient and it also the part of the French population (strength, age, sex) who actually benefited of diagnostic acts using ionizing radiation in 2007. In 2007, 74.6 millions of diagnostic acts using ionizing radiation have been realised in france. These acts induce for the year 2007 to an efficient average dose of 1.3 MSv. (N.C.)

  2. Radically Reducing Radiation Exposure during Routine Medical Imaging

    Science.gov (United States)

    Exposure to radiation from medical imaging in the United States has increased dramatically. NCI and several partner organizations sponsored a 2011 summit to promote efforts to reduce radiation exposure from medical imaging.

  3. Case-control study of leukemia and diagnostic radiation exposure

    International Nuclear Information System (INIS)

    Yuasa, Hidemichi; Hamajima, Nobuyuki; Ueda, Ryuzo

    1997-01-01

    A case-control study of leukemia and diagnostic X-ray exposure was conducted by a multi-institution co-operative study group. The subjects were 134 patients with acute myelogenous leukemia, 57 with chronic myelogenous leukemia, 56 with acute lymphocytic leukemia and 50 with myelodysplasia syndrome, who were between 15 and 79 years old, and diagnosed at one of 27 hospitals between September 1993 and August 1995. The controls were 479 first-visit patients seen at eight of these 27 hospitals. History of diagnostic X-ray tests between 1982 and 1991 was determined by an anonymous self-administered questionnaire. The total relative dose of radiation exposure was calculated by summing the products of given weights and frequencies of each test. The relative risk was 0.83 (95% confidence interval (C.I.), 0.58-1.19) for relative dose of 10-30 (equivalent to 4-11 times of UGI series), 0.76 (0.48-1.20) for relative dose of 30 or more (more than 12 times of UGI series), when compared with relative dose of 0-10 (0-3 times of UGI series). Analysis according to type of leukemia revealed that only acute myelogenous leukemia had an estimated relative risk above unity (1.08, 95%, C.I. 0.69-1.69, for relative dose 10-30). This study did not support the hypothesis that diagnostic X-ray tests increases leukemia risk. (author)

  4. Chapter 7: pregnancy and medical exposure

    International Nuclear Information System (INIS)

    Cordoliani, Y.S.; Foehrenbach, H.

    2003-01-01

    The situations of child exposure in utero in the frame of medical practice are different according to the type of practice. For the diagnosis, in radiology as well in nuclear medicine, the malformation risk is null. The justification and optimization of exposures stand out, nevertheless to take into account the delayed carcinogenesis risk. In brachytherapy by iodine, the hypothyroidism risk for the fetus and secondary cancer can be prevented by the practice of a pregnancy test or the carried forward of the therapy after the birth. For the radiotherapy, where the fetal doses can be strong, the carcinogenesis risks are confirmed and the risk of bad cerebral development is not null but the development of the child depends on the mother health. There is a rational choice to do, where the ethic and family questions have to take place. (N.C.)

  5. 78 FR 32612 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Science.gov (United States)

    2013-05-31

    ... translation (CART) web streaming link will be posted on the Access Board's Medical Diagnostic Equipment Web..., Office of Technical and Information Services, Architectural and Transportation Barriers Compliance Board... disabilities. Communication Access Realtime Translation (CART) will be provided via a web link. Also, persons...

  6. An audit of diagnostic tests performed in medical microbiology, and ...

    African Journals Online (AJOL)

    Clinical audit is an important tool for reviewing and improving the quality of service in clinical laboratories. This is a three year audit of diagnostic test carried out in Medical Microbiology and Immunology laboratories of University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. The objectives were to document and ...

  7. Osseous Metastase of Occult Paraganglioma: A Diagnostic Medical Error

    Directory of Open Access Journals (Sweden)

    Ghasemi TA

    2013-10-01

    Full Text Available Introduction: Diagnostic errors have a natural complexity. Medical diagnoses make up a large proportion of all medical errors and cause much suffering and harm. Compared to other types of error, diagnostic errors receive little attention-a major factor in continuity of unacceptable rates of diagnostic error. Case: A 55-year-old woman presented to the emergency department (ED complaining of bone pain which has been started a month ago and increased gradually in the upper right thigh. Following the emergency evaluation she was sent home with pain medication. On the second visit, a femur neck fracture was seen in the x-ray. She underwent hemiarthroplasty and was discharged. Over several weeks she was reevaluated by many Physicians, because of her worsening pain .In the third visit after the surgery, her x-ray showed bone destruction and following bone biopsy, malignant paraganglioma was diagnosed. Discussion and solution: In all cases in which patient comes to us with skeletal pain, getting a comprehensive history and a full physical examination are prior to lab tests and x-rays. Bone metastasis which can develop severe pain and pathological fractures, is common in patients with malignant paraganglioma. Effective steps for diagnostic error prevention are: Considering the diagnostic error in the normal range of quality assurance surveillance and review, identifying the elements leading to diagnostic errors and getting feedback on the diagnoses Physicians make, in order to improve their skills. Conclusion: It is an every health system priority to identify, analyze, and prevent diagnostic errors in order to improve patient safety

  8. Constancy of radiation output during diagnostic X-ray exposures

    International Nuclear Information System (INIS)

    Ardran, G.M.; Crooks, H.E.; Birch, R.

    1978-01-01

    Variation in X-ray output and quality during a diagnostic exposure can be undesirable and may result in unnecessary dose to the patient. When significant build-up or decay periods are present errors will arise if factors obtained under steady-state conditions are employed to estimate the exposure. These parameters must be taken into account when calibrating X-ray generators. A variable speed spinning film device and a spectrometry system have been used to measure the variations under fluoroscopic and radiographic conditions for a number of generators. Variations in output due to filament heating, voltage supply and rectification, cable capacity and target pitting have been demonstrated. At low fluoroscopic currents, large surges and long decays have been observed; the significance of these effects is considered. (author)

  9. Representation scaffolds improve diagnostic efficiency in medical students.

    Science.gov (United States)

    Braun, Leah T; Zottmann, Jan M; Adolf, Christian; Lottspeich, Christian; Then, Cornelia; Wirth, Stefan; Fischer, Martin R; Schmidmaier, Ralf

    2017-11-01

    Diagnostic efficiency is important in daily clinical practice as doctors have to face problems within a limited time frame. To foster the clinical reasoning of students is a major challenge in medical education research. Little is known about students' diagnostic efficiency. On the basis of current theories, scaffolds for case representation (statement of the case as far as it is summarised in the mind) could be a promising approach to make the diagnostic reasoning of intermediate medical students more efficient. Clinical case processing of 88 medical students in their fourth and fifth years was analysed in a randomised, controlled laboratory study. Cases dealing with dyspnoea were provided in an electronic learning environment (CASUS). Students could freely choose the time, amount and sequence of clinical information. During the learning phase the intervention group was asked to write down case representation summaries while working on the cases. In the assessment phase diagnostic efficiency was operationalised as the number of correct diagnoses divided by the time spent on diagnosing. Diagnostic efficiency was significantly improved by the representation scaffolding (M = 0.12 [SD = 0.07], M = 0.09 [SD = 0.06] correct cases/time, p = 0.045), whereas accuracy remained unchanged (M = 2.28 [SD = 1.10], M = 2.09 [SD = 1.08], p = 0.52). Both groups screened the same amount of clinical information, but the scaffolding group did this faster (M = 20.8 minutes [SD = 7.15], M = 24.6 minutes [SD = 7.42], p = 0.01; Cohen's d = 0.5). Diagnostic efficiency is an important outcome variable in clinical reasoning research as it corresponds to workplace challenges. Scaffolding for case representations significantly improved the diagnostic efficiency of fourth and fifth-year medical students, most likely because of a more targeted screening of the available information. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical

  10. Prenatal radiation exposures at diagnostic procedures: methods to identify exposed pregnant patients

    International Nuclear Information System (INIS)

    Pettersson, H.; Sandborg, M.; Nilsson, J.; Olsson, S.

    2002-01-01

    Knowledge about frequency and doses to embryo/foetus from diagnostic radiology is of great importance both in the sense of estimating the radiation risks but also for optimizing the diagnostic procedures and making decisions regarding alternative procedures. In addition, the pregnant patient has the right to know the magnitude and type of radiation risks expected as a result of foetus exposure. From a risk perspective epidemiological data have shown that the embryo/foetus together with children experience higher radiation sensitivity in terms of induced leukemia and cancer compared to an adult population. Recent estimates give cancer excess lifetime mortality risks for whole body exposures of children and foetus (0-15 y age) of 0.06% (ICRP84, 2000) up to 0.14% per 10 mSv (BEIR-V 1990). In addition to the risk of cancer induction effects of cell killing, e.g. CNS abnormalities, cataracts, malformations, growth retardation, may occur. However, these effects are believed to have a threshold, about 100-200 mGy (ICRP84, 2000), and such foetus doses are rarely reached in diagnostic radiology procedures. There are 2 principal situations where foetus exposures may occur in diagnostic radiology; 1. The pregnancy of the patient is known at the time of examination, but due to the medical indications the examination can not be postponed or put forward in time, and there are no suitable alternative non-radiological procedures. 2. The pregnancy of the patient is not known at the time of examination, either due to the fact that the patient is unaware of her pregnancy or the medical personnel failed to obtain this information. The former situation may occur during the first few weeks from conception, whereas the latter situation may cover a greater gestation period

  11. The global assessment of medical radiation exposures

    International Nuclear Information System (INIS)

    Shannoun, F.

    2010-01-01

    World Health Organization (WHO) is the United Nations specialized agency which acts as a coordinating authority on international public health. It was established in 1948. It has 147 Country Offices, 6 Regional Offices and 193 Member States Ministries of Health Its headquarters is in Geneva. The World Health Assembly (WHA) requested WHO to s tudy the optimum use of ionizing radiation in medicine and the risks to health of excessive or improper use . (WHA, 1971) International Basic Safety Standards BSS) The (BSS) mark the culmination of efforts towards global harmonization of radiation safety requirements. However, the involvement of the health sector in the BSS implementation is still weak and scant. There is a need to mobilize the health sector towards safer and effective use of radiation in medicine. Radiation in Health Care The use of radiation in health care is by far the largest contributor to the exposure of the general population from artificial sources. Annually worldwide there are 3,600 million X-ray exams (> 300 million in children), 37 million nuclear medicine procedures and 7.5 million radiation oncology treatments [UNSCEAR Report 2008]. WHO Global Initiative on Radiation Safety in Health Care Settings Was launched in December 2008 It involved the following:- There was involvement of international organizations and professionals bodies, national health and radiation protection authorities, etc. Its aim is to improve the protection of patients and health care workers through better implementation of the BSS. It complements the International Action Plan for Radiological Protection of Patients established by the IAEA 7 UNSCEAR's medical exposure survey Objectives of UNSCEAR's survey were to facilitate evaluation of: - Global estimates of frequency and levels of exposures, with break-downs by medical procedure, age, sex, health care level, and country; - Trends in practice (including those relatively fast-changing); with supporting contextual

  12. Computational Diagnostic: A Novel Approach to View Medical Data.

    Energy Technology Data Exchange (ETDEWEB)

    Mane, K. K. (Ketan Kirtiraj); Börner, K. (Katy)

    2007-01-01

    A transition from traditional paper-based medical records to electronic health record is largely underway. The use of electronic records offers tremendous potential to personalize patient diagnosis and treatment. In this paper, we discuss a computational diagnostic tool that uses digital medical records to help doctors gain better insight about a patient's medical condition. The paper details different interactive features of the tool which offer potential to practice evidence-based medicine and advance patient diagnosis practices. The healthcare industry is a constantly evolving domain. Research from this domain is often translated into better understanding of different medical conditions. This new knowledge often contributes towards improved diagnosis and treatment solutions for patients. But the healthcare industry lags behind to seek immediate benefits of the new knowledge as it still adheres to the traditional paper-based approach to keep track of medical records. However recently we notice a drive that promotes a transition towards electronic health record (EHR). An EHR stores patient medical records in digital format and offers potential to replace the paper health records. Earlier attempts of an EHR replicated the paper layout on the screen, representation of medical history of a patient in a graphical time-series format, interactive visualization with 2D/3D generated images from an imaging device. But an EHR can be much more than just an 'electronic view' of the paper record or a collection of images from an imaging device. In this paper, we present an EHR called 'Computational Diagnostic Tool', that provides a novel computational approach to look at patient medical data. The developed EHR system is knowledge driven and acts as clinical decision support tool. The EHR tool provides two visual views of the medical data. Dynamic interaction with data is supported to help doctors practice evidence-based decisions and make judicious

  13. Synthesis and Development of Diagnostic Tools for Medical Imaging

    DEFF Research Database (Denmark)

    Schaarup-Jensen, Henrik

    The need for novel diagnostic tools in medical imaging is increasing since they can improve the positive therapeutic outcome as well as patient compliance. In this thesis different diagnostic tools were developed within an interdisciplinary project, whereas the main work reported in this thesis...... of injectable fiducial tissue markers for surgical guidance of non-palpable tumors and brachytherapy. As radioactive tracer, radioiodinated SAIB-derivatives were developed based on the regioselective ipso-iodination of aryl-TMS moieties. Radioiodination was conducted under carrier free conditions in high...... was synthesized. Remote loading of one candidate was successful; however, the proper contrast level was not sufficient to be visible by CT-imaging. Another diagnostic tool for blood pool imaging is DOTA-modified pluronic/cyclodextrin (CD)-based polyrotaxanes (PRs). With the previously reported chelation of Gd and...

  14. The impact of data mining techniques on medical diagnostics

    Directory of Open Access Journals (Sweden)

    Siri Krishan Wasan

    2006-11-01

    Full Text Available Medical data mining has great potential for exploring the hidden patterns in the data sets of the medical domain. These patterns can be utilized for clinical diagnosis. However, the available raw medical data are widely distributed, heterogeneous in nature, and voluminous. These data need to be collected in an organized form. This collected data can be then integrated to form a hospital information system. Data mining technology provides a user-oriented approach to novel and hidden patterns in the data. Data mining and statistics both strive towards discovering patterns and structures in data. Statistics deals with heterogeneous numbers only, whereas data mining deals with heterogeneous fields. We identify a few areas of healthcare where these techniques can be applied to healthcare databases for knowledge discovery. In this paper we briefly examine the impact of data mining techniques, including artificial neural networks, on medical diagnostics.

  15. Analysis of medical exposures in digital mammography

    International Nuclear Information System (INIS)

    Oliveira, Sergio R.; Mantuano, Natalia O.; Albrecht, Afonso S.

    2014-01-01

    Currently, the use of digital mammography in the early diagnosis of breast cancer is increasingly common due to the production of high definition image that allows to detect subtle changes in breast images profiles. However it is necessary to be an improvement of the technique used since some devices offer minimization parameters of entrance dose to the skin. Thus, this study seeks to examine how the qualification of technical professionals in radiology interferes with the use of the techniques applied in mammography. For this, survey was carried out in a hospital in the city of Rio de Janeiro, which evaluated the scans of 1190 patients undergoing routine mammography (It is considered routinely the 4 basic exhibitions: with 2 flow skull and 2 medium oblique side, excluding repeats and supplements) in 2013. The medical exposures analyzed obtained from a single full digital equipment, model Senographe DS were compared with three different procedures performed by professionals in mammography techniques. The images were classified according to exposure techniques available in the equipment: Standard (STD), contrast (CNT) and dose (dose), and to be selected as breast density of the patient. Comparing the variation of the radiographic technique in relation to the professional who made the exhibition, what is observed is that the professional B presented the best conduct in relation to radiological protection, because she considered breast density in the choice of technical equipment parameter. The professional A, which is newly formed, and C, which has more service time, almost did not perform variations in the pattern of exposure, even for different breast densities. Thus, we can conclude that there is a need to update the professionals so that the tools available of dose limitation and mamas variability to digital mammography are efficiently employed in the service routine and thus meet the requirements of current legislation

  16. The patient exposure from chest examination in diagnostic radiology

    International Nuclear Information System (INIS)

    Igna, L.; Burkhardt, R.; Fulea, D.

    2003-01-01

    The survey was carried out in the three representative units in Cluj city for chest examination (two hospitals and one ambulatory centre). The purpose of the study is to verify the most technical parameters of radiological system which influence the image quality and patient exposures. Values found for entrance surface dose (ESD) and effective doses are above diagnostic reference level in all three units included in our study, especially because the high value of mAs. Despite the same protocols applied for PhilipsDuodiagnost and Eltex X-ray system, the variation in doses is due to the inaccurate kVp. This high values of ratio patient effective dose / guidance level require an investigation and optimisation of X-ray system or protocols. (authors)

  17. Pediatric radiation exposure from diagnostic nuclear medicine examinations in Tehran

    International Nuclear Information System (INIS)

    Neshandar Asli, I.; Tabeie, F.

    2005-01-01

    As a part of a nationwide survey to estimate population exposure to radiation from diagnostic nuclear medicine in Iran, this paper presents the pediatric population radiation exposure due to nuclear medicine examinations in Tehran. Patients and methods: the effective dose equivalent, H E , was used to calculate the collective effective dose in pediatric patients undergoing nuclear medicine procedures, and the corresponding data were obtained from thirty out of thirty seven active nuclear medicine departments in Tehran. Results: annually about 5.26% of nuclear medicine examinations were performed on patients under 15 years of age in Tehran. The most frequent was renal examinations (38.2%), followed y thyroid (27.4%) and bone (26.7%). The annual collective H E for patients under 15 was 19.03 human-Sv, which contributed 3.96% to the collective H E for all patients. The contribution of renal, bone and thyroid examinations to the pediatric collective H E were 24.6% 48.8% and 13.5% respectively. The mean effective dose equivalent per pediatric patient was 3.75 mSv.Conclusion: Among the three most frequent examinations, the bone with a relative frequency of 27.4% constituted 48.8% of the collective H E , which was the highest absorbed dose per examination. The mean effective dose per examination for patients younger than 15 years was 67.9% of the adults

  18. Prenatal Radiation exposures at diagnostic procedures: methods to identify exposed pregnant patients

    Energy Technology Data Exchange (ETDEWEB)

    Pettersson, H.; Sandborg, M.; Nilsson, J.; Olsson, S.; Hellman, S. [Dept of Radiation Physics, Faculty of Health Sciences, Linkoeping University, Linkoeping(Sweden); Helmrot, E. [Radiology Dept, County Hospital Ryhov, Joenkoeping (Sweden); Persliden, J. [Dept of Medical Physics, Oerebro Univ Hospital, Oerebro (Sweden); Cederlund, T. [Swedish Radiation Protection Authority, Stockholm (Sweden)

    2003-06-01

    Knowledge about frequency and doses to embryo/foetus from diagnostic radiology is of great importance both in the sense of estimating the radiation risks but also for optimizing the diagnostic procedures and making decisions regarding alternative procedures. In addition, the pregnant patient has a right to know the magnitude and type of radiation risks expected as a result of foetus exposure. From a risk perspective epidemiological data has shown that the embryo/foetus together with children experience higher radiation sensitivity in terms of induced leukemia and cancer compared to an adult population. Recent estimates give cancer excess lifetime mortality risks for whole body exposures of children and foetus (0-15 y age) of 0.06% up to 0.14% per 10 mSv. In addition to the risk of cancer induction effects of cell killing, e.g. CNS abnormalities, cataracts, malformations, growth retardation, may occur. However, these effects are believed to have a threshold, about 100-200 mGy, and such foetus doses are rarely reached in diagnostic radiology procedures. There are 2 principal situations where foetus exposures may occur in diagnostic radiology; The pregnancy of the patient is known at the time of examination, but due to the medical indications the examination can not be postponed or put forward in time, and there are no suitable alternative non-radiological procedures. The pregnancy of the patient is not known at the time of examination, either due to the fact that the patient is unaware of her pregnancy or the medical personnel failed to obtain this information. The former situation may occur during the first few weeks from conception, whereas the latter situation may cover a greater gestation period. The frequency of foetus exposure is not well documented. In Sweden, there are well-established routines to track down pregnant patients before examinations are being performed. However, there are no general obligations or routines to document the cases either (i) when

  19. Diagnostic hepatic haemodynamic techniques: safety and radiation exposure.

    Science.gov (United States)

    Hari, Andrej; Nair, Hari Kumar; De Gottardi, Andrea; Baumgartner, Iris; Dufour, Jean-François; Berzigotti, Annalisa

    2017-01-01

    Hepatic venous pressure gradient (HVPG) and transjugular liver biopsy (TJLB) are increasingly used in the management of patients with liver disease. We aimed to describe the safety profile of these procedures, providing data on the intra- and periprocedure complications, radiation exposure and amount of iodinated contrast material used. In 106 consecutive patients undergoing HVPG and TJLB data on fluoroscopy time (FT), absorbed radiation dose, equivalent effective dose (mSv) and volume of iodinated contrast material (ICM) were prospectively collected and reviewed, together with clinical and laboratory data. Incidence and severity of procedure-related complications were assessed. In 28 hospitalised patients, creatinine values after 72 hours of the procedure were reviewed to identify contrast-induced nephropathy (CIN). Median effective radiation dose was 5.4 mSv (IQR 10 mSv). A total 28.3% of patients exceeded an effective exposure of 10 mSv and 9.4% exceeded 20 mSv. Only age and BMI correlated with radiation dose (R = .327, P=.001 and R = .410, Pexposure over 20 mSv. Procedure-related complications occurred in eight patients (7.5%), and were minor in six cases. Median ICM volume was 12.5 mL. 6/28 patients met the diagnostic criteria for CIN. Hepatic venous pressure gradient and Transjugular liver biopsy show a good safety profile and radiation exposure associated with these procedures is in most of the cases low. In hepatic haemodynamic procedures, efforts should be made to reduce the radiation dose in patients with overweight/obesity and to use the minimal possible ICM volume in patients with acute-on-chronic liver failure. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Clinical Training of Medical Physicists Specializing in Diagnostic Radiology

    International Nuclear Information System (INIS)

    2010-01-01

    The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for diagnostic radiology. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists based in the clinical setting. However, an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement (RCA) for Research, Development and Training related to Nuclear Sciences for Asia and the Pacific. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia-Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specializing in diagnostic radiology started in 2007 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experiences of clinical training programmes in Australia and New Zealand, the UK and the USA, and was moderated by physicists working in the Asian region. This publication follows the approach of the IAEA publication Training Course Series No. 37, Clinical Training of Medical Physicists specializing in Radiation Oncology. This approach to clinical training has been successfully tested

  1. Medical UV exposures and HIV activation

    Energy Technology Data Exchange (ETDEWEB)

    Zmudzka, B.Z.; Miller, S.A.; Jacobs, M.E.; Beer, J.Z. [Food and Drug Administration, Rockville, MD (United States). Center for Devices and Radiological Health

    1996-08-01

    This paper presents the first attempt to evaluate the potential of clinical UV exposures to induce the human immunodeficiency (HIV) promoter and, thus, to upregulate HIV growth in those skin cells that are directly affected by the exposure. Using the data for HIV promoter activation in vitro, we computed UVB and psoralen plus UVA (PUVA) doses that produce 50% of the maximal promoter activation (AD{sub 50}). Then, using (a) literature data for UV transmittance in the human skin, (b) a composite action spectrum for HIV promoter and pyrimidine dimer induction by UVB and (c) an action spectrum for DNA synthesis inhibition by PUVA, we estimated the distribution of medical UVB and PUVA doses in the skin. This allowed us to estimate how deep into the skin the HIV-activating doses might penetrate in an initial and an advanced stge of UVB and PUVA therapy. Such analysis was done for normal type II skin and for single exposures. For UVB we found that, when the incident dose on the surface of the skin is 500 J/m{sup 2} (290-320 nm) (initial stage of the therapy), the dose producing 50% of the maximal HIV promoter activation (AD{sub 50}{sup UVB}) is limited to the stratum corneum. For PUVA we found that, when the incident UVA doses are 25 or 100 kJ/m{sup 2} (320-400 nm) (an initial and an advanced stage of therapy, respectively), and the 8-methoxypsoralen concentration in the blood is 0.1 {mu}g/mL (the desired level), the combined doses to the mid epidermis (and some areas of the upper dermis) are well below the 50% HIV promoter-activating PUVA dose (AD{sub 50}{sup PUVA}). These results suggest that the probability of HIV activation in the epidermis by direct mechanisms is higher for UVB than for PUVA treatment. However, complexities of the UV-inducible HIV activation and immunomodulatory phenomena are such that our results by themselves should not be taken as an indication that UVB therapy carries a high risk than PUVA therapy when administered to HIV-infected patients.

  2. Medical UV exposures and HIV activation

    International Nuclear Information System (INIS)

    Zmudzka, B.Z.; Miller, S.A.; Jacobs, M.E.; Beer, J.Z.

    1996-01-01

    This paper presents the first attempt to evaluate the potential of clinical UV exposures to induce the human immunodeficiency (HIV) promoter and, thus, to upregulate HIV growth in those skin cells that are directly affected by the exposure. Using the data for HIV promoter activation in vitro, we computed UVB and psoralen plus UVA (PUVA) doses that produce 50% of the maximal promoter activation (AD 50 ). Then, using (a) literature data for UV transmittance in the human skin, (b) a composite action spectrum for HIV promoter and pyrimidine dimer induction by UVB and (c) an action spectrum for DNA synthesis inhibition by PUVA, we estimated the distribution of medical UVB and PUVA doses in the skin. This allowed us to estimate how deep into the skin the HIV-activating doses might penetrate in an initial and an advanced stge of UVB and PUVA therapy. Such analysis was done for normal type II skin and for single exposures. For UVB we found that, when the incident dose on the surface of the skin is 500 J/m 2 (290-320 nm) (initial stage of the therapy), the dose producing 50% of the maximal HIV promoter activation (AD 50 UVB ) is limited to the stratum corneum. For PUVA we found that, when the incident UVA doses are 25 or 100 kJ/m 2 (320-400 nm) (an initial and an advanced stage of therapy, respectively), and the 8-methoxypsoralen concentration in the blood is 0.1 μg/mL (the desired level), the combined doses to the mid epidermis (and some areas of the upper dermis) are well below the 50% HIV promoter-activating PUVA dose (AD 50 PUVA ). These results suggest that the probability of HIV activation in the epidermis by direct mechanisms is higher for UVB than for PUVA treatment. However, complexities of the UV-inducible HIV activation and immunomodulatory phenomena are such that our results by themselves should not be taken as an indication that UVB therapy carries a high risk than PUVA therapy when administered to HIV-infected patients. (Author)

  3. High precision instrumentation for measuring the true exposure time in diagnostic X-ray examinations

    International Nuclear Information System (INIS)

    Silva, Danubia B.; Santos, Marcus A.P.; Barros, Fabio R.; Santos, Luiz A.P.

    2013-01-01

    One of the most important physical quantities to be evaluated in diagnostic radiology is the radiation exposure time experimented by the patient during the X-ray examination. IAEA and WHO organizations have suggested that any country must create a quality surveillance program to verify if each type of ionizing radiation equipment used in the hospitals and medical clinics are in conformity with the accepted uncertainties following the international standards. The purpose of this work is to present a new high precision methodology for measuring true exposure time in diagnostic X-ray examinations: pulsed, continuous or digital one. An electronic system named CronoX, which will be soon registered at the Brazilian Patent Office (INPI), is the equipment that provides such a high precision measurement. The principle of measurement is based on the electrical signal captured by a sensor that enters in a regeneration amplifier to transform it in a digital signal, which is treated by a microprocessor (uP). The signal treatment results in a two measured times: 1) T rx , the true X-ray exposure time; 2) T nx , the time in which the X-ray machine is repeatedly cut off during the pulsed irradiation and there is no delivery dose to the patient. Conventional Polymat X-ray equipment and dental X-ray machines were used to generate X-ray photons and take the measurements with the electronic systems. The results show that such a high precision instrumentation displays the true exposure time in diagnostic X-ray examinations and indicates a new method to be purposed for the quality surveillance programs in radiology. (author)

  4. Tacit knowledge and visual expertise in medical diagnostic reasoning: implications for medical education

    DEFF Research Database (Denmark)

    Heiberg Engel, Peter Johan

    2008-01-01

    focused on the specialty of intern medicine, while specialties with other skills, i.e. perceptive skills within pathology and radiology, have been ignored. AIMS: To show that the concept of tacit knowledge is important in medical education-at all levels and in medical diagnostic reasoning. METHODS......: Describing how tacit knowledge according to Michael Polany, is experienced and expressed in day-to-day life, it is shown that there is a tacit dimension to all knowledge. Reviewing recent literature on medical diagnostic reasoning, it is shown that tacit knowledge is recognized in connection with concepts...... such as "non-analytical reasoning" and "dual process of reasoning." CONCLUSION: It is important that educators are trained in how explicit and implicit knowledge is attained and that tacit knowledge is included in educational programmes of all medical specialties....

  5. A Prospective Study of Medical Diagnostic Radiography and Risk of Thyroid Cancer

    Science.gov (United States)

    Neta, Gila; Rajaraman, Preetha; Berrington de Gonzalez, Amy; Doody, Michele M.; Alexander, Bruce H.; Preston, Dale; Simon, Steven L.; Melo, Dunstana; Miller, Jeremy; Freedman, D. Michal; Linet, Martha S.; Sigurdson, Alice J.

    2013-01-01

    Although diagnostic x-ray procedures provide important medical benefits, cancer risks associated with their exposure are also possible, but not well characterized. The US Radiologic Technologists Study (1983–2006) is a nationwide, prospective cohort study with extensive questionnaire data on history of personal diagnostic imaging procedures collected prior to cancer diagnosis. We used Cox proportional hazard regressions to estimate thyroid cancer risks related to the number and type of selected procedures. We assessed potential modifying effects of age and calendar year of the first x-ray procedure in each category of procedures. Incident thyroid cancers (n = 251) were diagnosed among 75,494 technologists (1.3 million person-years; mean follow-up = 17 years). Overall, there was no clear evidence of thyroid cancer risk associated with diagnostic x-rays except for dental x-rays. We observed a 13% increase in thyroid cancer risk for every 10 reported dental radiographs (hazard ratio = 1.13, 95% confidence interval: 1.01, 1.26), which was driven by dental x-rays first received before 1970, but we found no evidence that the relationship between dental x-rays and thyroid cancer was associated with childhood or adolescent exposures as would have been anticipated. The lack of association of thyroid cancer with x-ray procedures that expose the thyroid to higher radiation doses than do dental x-rays underscores the need to conduct a detailed radiation exposure assessment to enable quantitative evaluation of risk. PMID:23529772

  6. Exhaled breath analysis: physical methods, instruments, and medical diagnostics

    International Nuclear Information System (INIS)

    Vaks, V L; Domracheva, E G; Sobakinskaya, E A; Chernyaeva, M B

    2014-01-01

    This paper reviews the analysis of exhaled breath, a rapidly growing field in noninvasive medical diagnostics that lies at the intersection of physics, chemistry, and medicine. Current data are presented on gas markers in human breath and their relation to human diseases. Various physical methods for breath analysis are described. It is shown how measurement precision and data volume requirements have stimulated technological developments and identified the problems that have to be solved to put this method into clinical practice. (instruments and methods of investigation)

  7. Medical students' attitudes towards early clinical exposure in Iran.

    Science.gov (United States)

    Khabaz Mafinejad, Mahboobeh; Mirzazadeh, Azim; Peiman, Soheil; Khajavirad, Nasim; Mirabdolhagh Hazaveh, Mojgan; Edalatifard, Maryam; Allameh, Seyed-Farshad; Naderi, Neda; Foroumandi, Morteza; Afshari, Ali; Asghari, Fariba

    2016-06-19

    This study was carried out to investigate the medical students' attitudes towards early clinical exposure at Tehran University of Medical Sciences. A cross-sectional study was conducted during 2012-2015. A convenience sample of 298 first- and second-year students, enrolled in the undergraduate medical curriculum, participated in an early clinical exposure program. To collect data from medical students, a questionnaire consisting of open-ended questions and structured questions, rated on a five-point Likert scale, was used to investigate students' attitudes toward early clinical exposure. Of the 298 medical students, 216 (72%) completed the questionnaires. The results demonstrated that medical students had a positive attitude toward early clinical exposure. Most students (80.1%) stated that early clinical exposure could familiarize them with the role of basic sciences knowledge in medicine and how to apply this knowledge in clinical settings. Moreover, 84.5% of them believed that early clinical exposure increased their interest in medicine and encouraged them to read more. Furthermore, content analysis of the students' responses uncovered three main themes of early clinical exposure, were considered helpful to improve learning: "integration of theory and practice", "interaction with others and professional development" and "desire and motivation for learning medicine". Medical students found their first experience with clinical setting valuable. Providing clinical exposure in the initial years of medical curricula and teaching the application of basic sciences knowledge in clinical practice can enhance students' understanding of the role they will play in the future as a physician.

  8. Design and implementation of medical diagnostic X-ray machine's tube current testing system

    International Nuclear Information System (INIS)

    Huang Ping; Fang Fang; Liu Zhihong

    2011-01-01

    As an important parameter, Medical X-ray tube current control the X-ray intensity, which has been included in the JJG 744-2004 'Medical Diagnostic X-ray radiation sources' in the state verification procedures. With the continuous development of the digital diagnosis and treatment, traditional ammeter is not able to measure the X-ray tube current and exposure time accurately, in order to ensure safety and reliable operation of Medical X-ray machine, improve the corresponding level of digital detection, so designing a verification of non-intrusive system of tube current, which include FPGA combination of high speed ADC digital sampling technology, current transformers and Bluetooth technology. The system has obvious advantages on the diversification of measured parameters and the accuracy of data analysing, has more in line with the characteristics of tube current. At the same time with high accuracy and good repeatability, the system meet national requirements of testing procedures. (authors)

  9. Visualizing and measuring the temperature field produced by medical diagnostic ultrasound using thermography

    International Nuclear Information System (INIS)

    Vachutka, J; Grec, P; Mornstein, V; Caruana, C J

    2008-01-01

    The heating of tissues by diagnostic ultrasound can pose a significant hazard particularly in the imaging of the unborn child. The demonstration of the temperature field in tissue is therefore an important objective in the teaching of biomedical physics to healthcare professionals. The temperature field in a soft tissue model was made visible and measured using thermography. Temperature data from the images were used to investigate the dependence of temperature increase within the model on ultrasound exposure time and distance from the transducer. The experiment will be used within a multi-professional biomedical physics teaching laboratory for enhancing learning regarding the principles of thermography and the thermal effects of ultrasound to medical and healthcare students and also for demonstrating the quantitative use of thermographic imaging to students of biophysics, medical physics and medical technology

  10. Medical and occupational radiation exposure reported by self-administered questionnaire

    International Nuclear Information System (INIS)

    Yamamoto, Osamu; Fujita, Shoichiro

    1977-01-01

    Affirmative response rates for diagnostic, therapeutic, and occupational ionizing radiation exposure were ascertained by surveying Hiroshima and Nagasaki aBCC-JNIH Adult Health Study subjects. Half reported diagnostic exposure since last visiting ABCC; 20%, within 3 months of interview. Rates were higher for A-bomb exposed than those not-in-city; possibly because of a higher disease rate or concern therefore among the A-bomb exposed group and/or A-bomb Survivors Medical Treatment Law handbooks' facilitating more examinations of the exposed. The rates did not differ among the A-bomb exposed groups. The respective Hiroshima and Nagasaki rates were 2.6%, and 1.6% for radiation therapy; and 0.5% and 0.2% for occupational exposure. Neither radiation therapy nor occupational exposure rates differed by A-bomb dose. (auth.)

  11. How 3D immersive visualization is changing medical diagnostics

    Science.gov (United States)

    Koning, Anton H. J.

    2011-03-01

    Originally the only way to look inside the human body without opening it up was by means of two dimensional (2D) images obtained using X-ray equipment. The fact that human anatomy is inherently three dimensional leads to ambiguities in interpretation and problems of occlusion. Three dimensional (3D) imaging modalities such as CT, MRI and 3D ultrasound remove these drawbacks and are now part of routine medical care. While most hospitals 'have gone digital', meaning that the images are no longer printed on film, they are still being viewed on 2D screens. However, this way valuable depth information is lost, and some interactions become unnecessarily complex or even unfeasible. Using a virtual reality (VR) system to present volumetric data means that depth information is presented to the viewer and 3D interaction is made possible. At the Erasmus MC we have developed V-Scope, an immersive volume visualization system for visualizing a variety of (bio-)medical volumetric datasets, ranging from 3D ultrasound, via CT and MRI, to confocal microscopy, OPT and 3D electron-microscopy data. In this talk we will address the advantages of such a system for both medical diagnostics as well as for (bio)medical research.

  12. Are diagnostic criteria for eating disorders markers of medical severity?

    Science.gov (United States)

    Peebles, Rebecka; Hardy, Kristina K; Wilson, Jenny L; Lock, James D

    2010-05-01

    The objective of this study was to compare the medical severity of adolescents who had eating disorders not otherwise specified (EDNOS) with those who had anorexia nervosa (AN) and bulimia nervosa (BN). Medical records of 1310 females aged 8 through 19 years and treated for AN, BN, or EDNOS were retrospectively reviewed. Patients with EDNOS were subcategorized into partial AN (pAN) and partial BN (pBN) when they met all Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria but 1 for AN or BN, respectively. Primary outcome variables were heart rate, systolic blood pressure, temperature, and QTc interval on electrocardiogram. Additional physiologically significant medical complications were also reviewed. A total of 25.2% of females had AN, 12.4% had BN, and 62.4% had EDNOS. The medical severity of patients with EDNOS was intermediate to that of patients with AN and BN in all primary outcomes. Patients with pAN had significantly higher heart rates, systolic blood pressures, and temperatures than those with AN; patients with pBN did not differ significantly from those with BN in any primary outcome variable; however, patients with pAN and pBN differed significantly from each other in all outcome variables. Patients with pBN and BN had longer QTc intervals and higher rates of additional medical complications reported at presentation than other groups. EDNOS is a medically heterogeneous category with serious physiologic sequelae in children and adolescents. Broadening AN and BN criteria in pediatric patients to include pAN and pBN may prove to be clinically useful.

  13. Biorisk assessment of medical diagnostic laboratories in Nigeria.

    Science.gov (United States)

    Oladeinde, Bankole Henry; Omoregie, Richard; Odia, Ikponmwonsa; Osakue, Eguagie Osareniro; Imade, Odaro Stanley

    2013-06-01

    The aim of this study was to assess public and private medical diagnostic laboratories in Nigeria for the presence of biosafety equipment, devices, and measures. A total of 80 diagnostic laboratories in biosafety level 3 were assessed for the presence of biosafety equipment, devices, and compliance rate with biosafety practices. A detailed questionnaire and checklist was used to obtain the relevant information from enlisted laboratories. The results showed the presence of an isolated unit for microbiological work, leak-proof working benches, self-closing doors, emergency exits, fire extinguisher(s), autoclaves, and hand washing sinks in 21.3%, 71.3%, 15.0%, 1.3%, 11.3%, 82.5%, and 67.5%, respectively, of all laboratories surveyed. It was observed that public diagnostic laboratories were significantly more likely to have an isolated unit for microbiological work (p = 0.001), hand washing sink (p = 0.003), and an autoclave (p ≤ 0.001) than private ones. Routine use of hand gloves, biosafety cabinet, and a first aid box was observed in 35.0%, 20.0%, and 2.5%, respectively, of all laboratories examined. Written standard operating procedures, biosafety manuals, and biohazard signs on door entrances were observed in 6.3%, 1.3%, and 3.8%, respectively, of all audited laboratories. No biosafety officer(s) or records of previous spills, or injuries and accidents, were observed in all diagnostic laboratories studied. In all laboratories (public and private) surveyed, marked deficiencies were observed in the area of administrative control responsible for implementing biosafety. Increased emphasis on provision of biosafety devices and compliance with standard codes of practices issued by relevant authorities is strongly advocated.

  14. Tacit knowledge and visual expertise in medical diagnostic reasoning: implications for medical education.

    Science.gov (United States)

    Heiberg Engel, Peter Johan

    2008-01-01

    Much education--especially at the university level--has been criticized for having primarily dealt with explicit knowledge, i.e. those aspects of mental activities, which are verbal and conscious. Furthermore, research in medical diagnostic reasoning has been criticized for having focused on the specialty of intern medicine, while specialties with other skills, i.e. perceptive skills within pathology and radiology, have been ignored. To show that the concept of tacit knowledge is important in medical education-at all levels and in medical diagnostic reasoning. Describing how tacit knowledge according to Michael Polany, is experienced and expressed in day-to-day life, it is shown that there is a tacit dimension to all knowledge. Reviewing recent literature on medical diagnostic reasoning, it is shown that tacit knowledge is recognized in connection with concepts such as "non-analytical reasoning" and "dual process of reasoning." It is important that educators are trained in how explicit and implicit knowledge is attained and that tacit knowledge is included in educational programmes of all medical specialties.

  15. Advanced synchronous luminescence imaging for chemical and medical diagnostics

    Science.gov (United States)

    Vo-Dinh, Tuan

    2006-09-05

    A diagnostic method and associated system includes the steps of exposing at least one sample location with excitation radiation through a single optical waveguide or a single optical waveguide bundle, wherein the sample emits emission radiation in response to the excitation radiation. The same single optical waveguide or the single optical waveguide bundle receives at least a portion of the emission radiation from the sample, thus providing co-registration of the excitation radiation and the emission radiation. The wavelength of the excitation radiation and emission radiation is synchronously scanned to produce a spectrum upon which an image can be formed. An increased emission signal is generated by the enhanced overlap of the excitation and emission focal volumes provided by co-registration of the excitation and emission signals thus increasing the sensitivity as well as decreasing the exposure time necessary to obtain an image.

  16. Medical diagnostics by laser-based analysis of exhaled breath

    Science.gov (United States)

    Giubileo, Gianfranco

    2002-08-01

    IMany trace gases can be found in the exhaled breath, some of them giving the possibility of a non invasive diagnosis of related diseases or allowing the monitoring of the disease in the course of its therapy. In the present lecture the principle of medical diagnosis based on the breath analysis will be introduced and the detection of trace gases in exhaled breath by high- resolution molecular spectroscopy in the IR spectral region will be discussed. A number of substrates and the optical systems for their laser detection will be reported. The following laser based experimental systems has been realised in the Molecular Spectroscopy Laboratory in ENEA in Frascati for the analysis of specific substances in the exhaled breath. A tuneable diode laser absorption spectroscopy (TDLAS) appartus for the measurement of 13C/12C isotopic ratio in carbon dioxide, a TDLAS apparatus for the detection of CH4 and a CO2 laser based photoacoustic system to detect trace ethylene at atmospheric pressure. The experimental set-up for each one of the a.m. optical systems will be shown and the related medical applications will be illustrated. The concluding remarks will be focuses on chemical species that are of major interest for medical people today and their diagnostic ability.

  17. Design And Measurement Of Radiation Exposure Rates At An X-Ray Diagnostic Radiological Unit

    International Nuclear Information System (INIS)

    Tito-Sutjipto

    2003-01-01

    Every radiation employees suffers radiation exposure risk while doing his job. It is important therefore to investigate the occupational health and safety of radiation employees on its relationship with the design and measurement of radiation exposure rates at an X-ray diagnostic radiological unit in this work, a case study was held on the radiological unit at BP-4 Yogyakarta for patient diagnostics, This research armed to investigate the relationship between the design of radiological unit for X-ray diagnostics and the location of the X-ray machine, based on the distance variable and radiation exposure rate during patient diagnostics. This was performed using radiological unit design data for X-ray diagnostics and the measurement of radiation exposure rates throughout patient diagnostics. The design data can then be used for determining the requirement of primary and secondary shielding materials for radiological unit as well as a calculation basis of radiation exposure rates during patient diagnostics. From the result of the research, it can be concluded that from the occupational health and safety point of view, radiation exposure around the X-ray machines are fairly good, both for the shielding materials in each X-ray room and the radiation exposures received by the workers, because they are far beyond the maximum permittable average limit (16.67 m R/days). (author)

  18. In-phantom spectrometry of medical diagnostic x rays

    Energy Technology Data Exchange (ETDEWEB)

    Stansbury, P. S.

    1977-10-01

    A program of measurements was made to determine the spectral fluence distributions at locations of significance in a heterogeneous, hominoid phantom exposed to x rays in a manner simulating medical diagnostic radiology. The measurements were made with a specially constructed NaI(Tl) scintillation detector. The detector had a spherically shaped active volume 0.6 cm in diameter. The resolution of this detector was five times worse than that of a more conventional NaI(Tl) spectrometer. Resolution broadening and other distortions were removed from the observed pulse height spectra with a computer-coded, iterative unfolding technique. The performance of the spectrometer and the unfolding scheme was assessed by comparing, in a few cases, the unfolded NaI(Tl) spectra with spectra determined with a high resolution Ge(Li) spectrometer. The measurements were made in a physical model of an idealized representation of an average adult patient.

  19. In-phantom spectrometry of medical diagnostic x rays

    International Nuclear Information System (INIS)

    Stansbury, P.S.

    1977-10-01

    A program of measurements was made to determine the spectral fluence distributions at locations of significance in a heterogeneous, hominoid phantom exposed to x rays in a manner simulating medical diagnostic radiology. The measurements were made with a specially constructed NaI(Tl) scintillation detector. The detector had a spherically shaped active volume 0.6 cm in diameter. The resolution of this detector was five times worse than that of a more conventional NaI(Tl) spectrometer. Resolution broadening and other distortions were removed from the observed pulse height spectra with a computer-coded, iterative unfolding technique. The performance of the spectrometer and the unfolding scheme was assessed by comparing, in a few cases, the unfolded NaI(Tl) spectra with spectra determined with a high resolution Ge(Li) spectrometer. The measurements were made in a physical model of an idealized representation of an average adult patient

  20. The Use of Nanomaterials and Microfluidics in Medical Diagnostics

    DEFF Research Database (Denmark)

    Ashley, Jon; Sun, Yi

    2018-01-01

    and manipulation of materials, systems, and devices at the nanometer scale. The development of nanomaterials and nano-devices can be classified into two general approaches. The top down approach deals exclusively with developing nanostructures through machining, templating and lithographic techniques and refers...... to the fabrication and development of microfluidic and nanofluidic devices. The bottom-up approach focuses on the synthesis of nanomaterials from a single atom or molecule and relies on self-assembly or self-organization to produce particles with uniform size and shape. These micro/nanofluidic devices...... and nanomaterials display extraordinary physical and chemical properties which have been exploited for a large number of different novel nanodiagnostic applications. In this chapter, a general overview of nanotechnology for medical diagnostic applications will be given. The chapter will firstly define...

  1. Analysis of errors during medical and computerized diagnostics of spherical lung neoplasms

    International Nuclear Information System (INIS)

    Pozmogov, A.I.; Petruk, D.A.

    1985-01-01

    Reasons for errors in medical and computerized diagnostics of spherical lung neoplasms are studied based on material of 212 case records and clinicoroentgenological data; it should promote improvement of their diagnostics

  2. Application of diagnostic reference levels in medical practice

    Energy Technology Data Exchange (ETDEWEB)

    Bourguignon, Michel [Faculty of Medicine of Paris, Deputy Director General, Nuclear Safety Authority (ASN), Paris (France)

    2006-07-01

    Diagnosis reference levels (D.R.L.) are defined in the Council Directive 97/43 EURATOM as 'Dose levels in medical radio diagnosis practices or in the case of radiopharmaceuticals, levels of activity, for typical examinations for groups of standards-sized patients or standards phantoms for broadly defined types of equipment. These levels are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied'. Thus D.R.L. apply only to diagnostic procedures and does not apply to radiotherapy. Radiation protection of patients is based on the application of 2 major radiation protection principles, justification and optimization. The justification principle must be respected first because the best way to protect the patient is not to carry a useless test. Radiation protection of the patient is a continuous process and local dose indicator values in the good range should not prevent the radiologist or nuclear medicine physician to continue to optimize their practice. (N.C.)

  3. The future of novel diagnostics in medical mycology.

    Science.gov (United States)

    Teles, Fernando; Seixas, Jorge

    2015-04-01

    Several fungal diseases have become serious threats to human health and life, especially upon the advent of human immunodeficiency virus/AIDS epidemics and of other typical immunosuppressive conditions of modern life. Accordingly, the burden posed by these diseases and, concurrently, by intensive therapeutic regimens against these diseases has increased worldwide. Existing and available rapid tests for point-of-care diagnosis of important fungal diseases could enable the limitations of current laboratory methods for detection and identification of medically important fungi to be surpassed, both in low-income countries and for first-line diagnosis (screening) in richer countries. As with conventional diagnostic methods and devices, former immunodiagnostics have been challenged by molecular biology-based platforms, as a way to enhance the sensitivity and shorten the assay time, thus enabling early and more accurate diagnosis. Most of these tests have been developed in-house, without adequate validation and standardization. Another challenge has been the DNA extraction step, which is especially critical when dealing with fungi. In this paper, we have identified three major research trends in this field: (1) the application of newer biorecognition techniques, often applied in analytical chemistry; (2) the development of new materials with improved physico-chemical properties; and (3) novel bioanalytical platforms, allowing fully automated testing. Keeping up to date with the fast technological advances registered in this field, primarily at the proof-of-concept level, is essential for wise assessment of those that are likely to be more cost effective and, as already observed for bacterial and viral pathogens, may provide leverage to the current tepid developmental status of novel and improved diagnostics for medical mycology. © 2015 The Authors.

  4. Cari Kitahara Explores Medical Radiation Exposures and Thyroid Cancer Etiology

    Science.gov (United States)

    Dr. Cari Kitahara has built a multidisciplinary research program to explore cancer risks from occupational and medical radiation exposures, and to investigate the etiology of radiosensitive tumors, including thyroid cancer.

  5. Medical records and radiation exposure cards

    International Nuclear Information System (INIS)

    Vigan, C.

    1975-01-01

    Some ideas concerning medical records at the Ispra Centre are exposed. The approved medical practitioner has two main tasks: he must gather enough relevant information to decide on the worker's suitability and also to determine his physical condition, normal or otherwise, and he must record it with enough detail to permit comparison with findings at later examinations. for the purposes of medical records, clinical examinations and complementary investigations, a large proportion of the measurements are of course made on the critical organs. The problems of the container or physical medium receiving the information to be recorded is considered. The possibilities offered by computer techniques are discussed

  6. Radiation Exposure from Medical Exams and Procedures

    Science.gov (United States)

    ... replacement, less time- consuming and invasive. Physicians and technologists performing these procedures are trained to use the ... dose from Do magnetic resonance imaging (MRI) and ultrasound medical exams? use radiation? Ask your doctor to ...

  7. Senior medical students' awareness of radiation risks from common diagnostic imaging examinations.

    Science.gov (United States)

    Scali, Elena; Mayo, John; Nicolaou, Savvas; Kozoriz, Michael; Chang, Silvia

    2017-12-01

    Senior medical students represent future physicians who commonly refer patients for diagnostic imaging studies that may involve ionizing radiation. The radiology curriculum at the University of British Columbia provides students with broad-based knowledge about common imaging examinations. The purpose of this study was to investigate students' awareness of radiation exposures and risks. An anonymous multiple-choice cross-sectional questionnaire was distributed to final year medical students to assess knowledge of radiation from common diagnostic examinations and radiation-related risks following completion of the longitudinal radiology curriculum, carried out over the four years of medical training. Sixty-three of 192 eligible students participated (33% response rate). The majority felt that knowledge of radiation doses of common imaging examinations is somewhat or very important; however, only 12% (N = 8) routinely discuss radiation-related risks with patients. While all respondents recognized children as most sensitive to the effects of radiation, only 24% (N = 15) correctly identified gonads as the most radiation-sensitive tissue. Almost all respondents recognized ultrasound and MRI as radiation free modalities. Respondents who correctly identified the relative dose of common imaging examinations in chest x-ray equivalents varied from 3-77% (N = 2 - 49); the remaining responses were largely underestimates. Finally, 44% (N = 28) correctly identified the excess risk of a fatal cancer from an abdominal CT in an adult, while the remainder underestimated this risk. Medical students acknowledge the importance of radiation-related issues to patient care. While almost all students are familiar with radiation-free modalities, many are not familiar with, and commonly underestimate, the relative doses and risks of common imaging studies. This may expose patients to increasing imaging investigations and exposure to radiation hazards.

  8. Photoionization sensors for non-invasive medical diagnostics

    Science.gov (United States)

    Mustafaev, Aleksandr; Rastvorova, Iuliia; Khobnya, Kristina; Podenko, Sofia

    2016-09-01

    The analysis of biomarkers can help to identify the significant number of diseases: lung cancer, tuberculosis, diabetes, high levels of stress, psychosomatic disorders etc. To implement continuous monitoring of the state of human health, compact VUV photoionization detector with current-voltage measurement is designed by Saint-Petersburg Mining University Plasma Research Group. This sensor is based on the patented method of stabilization of electric parameters - CES (Collisional Electron Spectroscopy). During the operation at atmospheric pressure VUV photoionization sensor measures the energy of electrons, produced in the ionization with the resonance photons, whose wavelength situated in the vacuum ultraviolet (VUV). A special software was developed to obtain the second-order derivative of the I-U characteristics, taken by the VUV sensor, to construct the energy spectra of the characteristic electrons. VUV photoionization detector has an unique set of parameters: small size (10*10*1 mm), low cost, wide range of recognizable molecules, as well as accuracy, sufficient for using this instrument for the medical purposes. This device can be used for non-invasive medical diagnostics without compromising the quality of life, for control of environment and human life. Work supported by Foundation for Assistance to Small Innovative Enterprises in Science and Technology.

  9. Diagnostic delay in malignant pleural mesothelioma due to physicians fixation on history with non-exposure to asbestos

    DEFF Research Database (Denmark)

    Madsen, Poul Henning; Laursen, Christian B.; Davidsen, Jesper Rømhild

    2013-01-01

    assessment of all available information is of utmost importance, as fixation on single details can be misguiding with inappropriate consequences in both the diagnostic and therapeutic approach. This case report presents how an atypical medical history led to a delay in the diagnosis of malignant pleural......To establish the diagnosis of virtually any disease, the clinician must combine a variety of information. Often emphasised in this context is thorough medical history-taking including information on exposure to factors leading to or being associated with the disease in question. Continuous...

  10. Medications as a source of paraben exposure.

    Science.gov (United States)

    Dodge, Laura E; Kelley, Katherine E; Williams, Paige L; Williams, Michelle A; Hernández-Díaz, Sonia; Missmer, Stacey A; Hauser, Russ

    2015-04-01

    Parabens are used as antimicrobial excipients in some pharmaceuticals. Parabens may adversely affect reproduction. Determine whether paraben-containing medication contributes to high urinary paraben concentrations. Individuals at a fertility clinic provided multiple urine samples during evaluation/treatment and reported 24-h use of medications and personal care products (PCP). Repeated measures models compared specific gravity-adjusted urinary methyl, propyl, and butyl paraben concentrations between samples "exposed" and "unexposed" to paraben-containing medication. Eleven participants contributed 12 exposed and 45 unexposed samples, among which paraben concentrations did not differ. Use within 7h was associated with 8.7-fold and 7.5-fold increases in mean methyl (P=0.11) and propyl (P=0.10) paraben concentrations, respectively, after adjusting for PCP use. However, these associations decreased to 1.3-fold (P=0.76) and 2.6-fold (P=0.34), respectively, after removal of one influential individual. Paraben-containing medications contributed to higher urinary paraben concentrations within hours of use. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Energy and rate dependence of diagnostic x-ray exposure meters

    International Nuclear Information System (INIS)

    Wagner, L.K.; Cerra, F.; Conway, B.; Fewell, T.R.; Ohlhaber, T.R.

    1988-01-01

    Variations in x-ray exposure measurements among a variety of contemporary diagnostic exposure meters are investigated. Variations may result from systematic errors due to calibration, beam-quality dependence and exposure-rate dependence. It is concluded that the majority of general purpose diagnostic meters will agree to within 10% of each other if exposure rates are below 1.3 mC kg-1S-1 of air (5 R s-1) and beam qualities are typical for general purpose radiology, excluding mammography. For exposure rates comparable to those in barium enema radiography the variations can range up to 25% or more. Variations up to 40% were observed among general purpose exposure meters at mammographic beam qualities. In the mammographic range, mammographic (thin window) exposure meters varied by no more than 2%

  12. Medical diagnostic system based on image receivers of various spectral ranges

    Science.gov (United States)

    Siniakova, Olga G.; Ishmuhametov, Airat I.

    1996-04-01

    The medical diagnostics is one of the most important spheres of application of measuring and diagnostic systems based on introscopy methods. The modern medical introscopy diagnostics has in its arsenal many various devices using x-ray radiation with energy from 10 to 100 keV (roentgenological diagnostics, x-ray computer tomography), gamma radiation of radionuclides with energy 10 - 300 keV (radionuclide diagnostics), infrared radiation of human body (thermovision), optical radiation range (endoscopic diagnostics). The application of high- frequency sound fluctuations (ultrasonography) is also effective for tasks of medical diagnostics. The microwave sources based on nuclear magnetic resonance (magnetic resonance imaging) are used for reception the images of internal structures of human body. The prompt development of modern medical introscopy diagnostics observable in last years is connected first of all with wide application of computer facilities for receiving, processing, restoration and analysis of images. It gives the additional opportunity to increase the reliability, accuracy, sensitivity and timeliness of diagnostic decisions. The images received both by scintillation gamma camera and by specialized x-ray or gamma radiation video camera based on charge- coupled devices can be used for evaluation of structural and functional state of vital organs and systems. One of the main tasks at development of medical diagnostic systems is the reduction of optical image to form that maximally facilitates its analysis to the doctor. The article considers the diagnostic system oriented on receiving, processing and evaluating data of radionuclide imaging studies.

  13. Diagnostic image quality of mammograms in German outpatient medical care

    International Nuclear Information System (INIS)

    Pfandzelter, R.; Wuelfing, U.; Boedeker, B.

    2010-01-01

    Purpose: A total of 79 115 mammograms from statutory health insurance (SHI) physicians within German outpatient care were evaluated with respect to the diagnostic image quality. Materials and Methods: Mammograms were randomly selected between 2006 and 2008 by the regional Associations of Statutory Health Insurance Physicians and submitted to regional boards of experts for external evaluation. The mammogram quality was evaluated using a 3-point scale (adequate, borderline, failure) and documented using a nationally standardized protocol. Results: 87.6 % of the mammograms were classified as adequate, 11.0 % as borderline and 1.4 % as failure. Mediolateral oblique mammograms (mlo) had worse ratings than craniocaudal mammograms (cc). Main reasons for classifying the mammograms as borderline or failure were 'inframammary fold not adequately visualized' (mlo), 'pectoral muscle not in the correct angle or not to the level with the nipple' (mlo), 'the nipple not in profile' (mlo, cc) and 'breast not completely or not adequately visualized' (cc). Conclusion: The results show a good overall quality of mammograms in German outpatient medical care. Failures can be associated predominantly with incorrect positioning of the breast. More precisely defined quality criteria using objective measures are recommended, especially for craniocaudal mammograms (cc). (orig.)

  14. Children's exposure to ionizing radiations linked with diagnostic procedures in 2010 in France

    International Nuclear Information System (INIS)

    2013-01-01

    The objective of this study was to characterize the medical exposure of the French pediatric population to ionizing radiations (IR) in 2010. It only includes diagnostic procedures. Data are mainly provided by the French Health Insurance (CNAM-TS), through a representative sample of about 1% of the French population (the so-called 'EGB' sample). In 2010, more than 100,000 children from 0 to 15 years old were included in this sample. About 600 examinations per 1000 children were performed: 55% are radiological examinations and 42% dental. CT examinations are rather rare (about 2%). Nuclear medicine and interventional radiology represent less than 1% of the examinations. Children from 10 to 15 years old and babies from new born to 1 year old are the most examined. Exposure of girls and boys are rather similar. From 10 to 15 years old, dental and limbs examinations are the most frequent. Chest and pelvic examinations are the most frequent examinations performed on babies. CT pediatric examinations concern mainly the head and the neck. In 2010, a third of the French children has been exposed to at least one examination using IR. The mean and median effective doses were respectively equal to 0.65 mSv and 0.025 mSv. These values were respectively 5.7 mSv and 1.7 mSv for the children exposed to at least one CT examination (about 1% of the studied population). This study brings reference data on pediatric exposure to IR, and makes them available for public health and epidemiological purposes. This analysis should be periodically carried out to assess the evolution of the pediatric exposure. (authors)

  15. Risk factors of coronary heart disease among medical diagnostic X-ray workers

    International Nuclear Information System (INIS)

    Zhang Wei; Wang Jixian; Zhao Yongcheng; Li Benxiao; Fan Tiqiang; Zhao Zhigang; Lin Zhidong

    2002-01-01

    Objective: To investigate risk factors of coronary heart disease (CHD) in medical diagnostic X-ray workers in China, especially the relationship of CHD with occupational irradiation. Methods: A 1:2 matched case-control study was carried out. The study subjects consisted of 112 pair-matched cases and controls coming from different hospitals in China. Information about occupational and non-occupational risk factors obtained by interviewing every subjects personally. Individual doses were estimated by normalized work load method. SAS 6.12 software conditional Logistic regression method was applied to data analysis. Results: Variables such as family history of CHD (OR=17.298, P = 0.0001), history of hypertension (OR = 6.172, P = 0.0003), overweight (OR = 2.679, P = 0.0150), physical exercises (OR = 0.421, P0.0333), diabetes (OR = 7.823, P = 0.0200), radiation protection condition (OR = 3.992, P 0.0027), and accumulated radiation dose (OR = 1.612, P 0.0454) were included in the last model. Conclusions: For the medical diagnostic X-ray workers, family history of coronary heart disease, history of hypertension, diabetes, etc. are the main risk factors of CHD, and occupational exposure may be a potential risk factor. As for the mechanism, further studies are needed

  16. National Programme for Radiological Protection in Medical Exposures

    International Nuclear Information System (INIS)

    2013-07-01

    radiation protection and safety in medical exposure

  17. Factors impacting public acceptance of medical radiation exposure

    International Nuclear Information System (INIS)

    Tsuji, Satsuki; Kanda, Reiko

    2009-01-01

    We undertook a survey to determine the public acceptance of medical radiation exposure throughout Japan, and 1,357 responses (67.9% response rate) were obtained using a two-stage systematic stratified random sampling method. The acceptance of exposure of children was generally similar to that of adults. For each of the attributes, 45-60% of the participants were accepting of exposure for cancer treatment and diagnosis, but only 30% were accepting of exposure for X-ray diagnoses of bone fractures and dental caries. In general, the presence of a child did not markedly affect women's acceptance of exposure. Factor analyses identified 3 factors influencing the acceptance of child exposure: symptomatic diseases to determine treatment, the possibility of high-risk diseases (or major organ diseases), and the association with cancer. Cluster analysis showed 4 clusters: a positive group regarding children's exposure for the diagnosis of bone fractures and dental caries (12.9% of all participants), a positive group for major organ disease and cancer (15.5%), a negative group excluding cancer (55.2%), and a positive group for all cases (16.4%). The cluster distributions revealed that mothers with 10- to 18-year-old firstborn children showed a tendency to accept the medical radiation exposure of their children in all cases. (author)

  18. Fitness of equipment used for medical exposure to ionising radiation

    International Nuclear Information System (INIS)

    1992-01-01

    The purpose of this note is to provide guidance to those who have duties under the Health and Safety at Work Act and other relevant legislation. It gives guidance on the practical application of legislation, concerning radiotherapy equipment. Two particular issues arise out of the requirements of Regulation 33 of the Ionising Radiations Regulations 1985 (IRR85) in relation to equipment which is used for medical exposures. These are the requirement to select, install and maintain this type of equipment in such a way that it is capable of restricting, so far as reasonably practicable, the medical exposure of any person where this is compatible with the intended clinical purpose, including the need to ensure that equipment used for radiotherapy is properly calibrated, and the requirement to notify the Health and Safety Executive (HSE) when an incident occurs involving a malfunction or defect in any 'radiation equipment' which gives rise to a medical exposure that is much greater than intended. (author)

  19. Fitness of equipment used for medical exposure to ionising radiation

    International Nuclear Information System (INIS)

    1992-01-01

    This document provides advice on two particular issues arising out of the requirements of Regulation 33 of the Ionising Radiations Regulations 1985 (IRR85) in relation to equipment which is used for medical exposures. These issues are: (a) the requirement to select, install and maintain this type of equipment in such a way that it is capable of restricting, so far as reasonably practicable, the medical exposure of any person to the extent that this is compatible with the intended clinical purpose, including the need to ensure that equipment used for radiotherapy is properly calibrated; and (b) the requirement to notify the Health and Safety Executive (HSE) when an incident occurs involving a malfunction or defect in any 'radiation equipment' which gives rise to a medical exposure that is much greater then intended. (author)

  20. Medical radiation exposure and genetic risks

    International Nuclear Information System (INIS)

    Baker, D.G.

    1980-01-01

    Everyone is exposed to background radiation throughout life (100 mrem/year to the gonads or 4 to 5 rem during the reproductive years). A lumbosacral series might deliver 2500 mrem to the male or 400 mrem to the female gonads. A radiologic procedure is a cost/benefit decision, and genetic risk is a part of the cost. Although cost is usually very low compared to benefit, if the procedure is unnecessary then the cost may be unacceptable. On the basis of current estimates, the doubling dose is assumed to be 40 rem (range 20 to 200) for an acute dose, and 100 rem for protracted exposure. Although there is no satisfactory way to predict the size of the risk for an individual exposed, any risk should be incentive to avoid unnecessary radiation to the gonads. Conception should be delayed for at least ten months for women and three or four months for men after irradiation of the gonads. The current incidence of genetically related diseases in the United States population is 60,000 per million live births. Based on the most conservative set of assumptions, an average gonadal dose of 1000 mrem to the whole population would increase the incidence of genetically related diseases by 0.2%

  1. A comparison of the millon behavioral medical diagnostic and millon behavioral health inventory with medical populations.

    Science.gov (United States)

    Wise, Edward A; Streiner, David L

    2010-12-01

    There is a lack of normative data on broadband omnibus types of personality tests with medical populations. In fact, the only two tests normed on medical populations are the Millon Behavioral Medicine Diagnostic (MBMD) and the Millon Behavioral Health Inventory (MBHI). The internal consistency, test-retest reliabilities, and validity studies of these instruments are reviewed and compared in an effort to aid clinicians in discerning their relative psychometric strengths and weaknesses. Due to the lack of validity studies with the MBMD and the fact that reliability limits the ceiling of validity coefficients, the MBMD has yet to meet the challenges it was designed to meet. Implications for practice are addressed. © 2010 Wiley Periodicals, Inc.

  2. Can occupational exposure be optimized for medical workers?

    International Nuclear Information System (INIS)

    Aubert, B.; Lefaure, C.

    1998-01-01

    Implementation of the principle of optimization (ALARA), an essential radiation protection regulations, remains very limited in the medical field, even though 80 % of workers whose exposure exceeds 50 mSv are to be found in this domain. The doses measured by legal dosimetry sometimes underestimate the real exposure of workers. It is therefore necessary to optimize the protection of occupational exposure in the medical field. This paper reviews the steps of the optimization procedure with emphasis on specificity of its application in this domain. Operating dosimetry as well as information on the residual risk due to low exposures and a better estimation of the risk/benefit factor for the patient are needed for satisfactory implementation. (author)

  3. Abnormal medical exposure in pregnant patients

    International Nuclear Information System (INIS)

    Cardenas Herrera, J.; Lopez Bejerano, G.; Lamadrid, A.I.; Garcia Lima, O.; Diaz Bernal, E.; Freixas, V.; Sanchez, R.

    2001-01-01

    The exhibition to the ionizing radiations of women, during the gestational period constitutes, with some frequency, the reason for preoccupation for the future mother and the medical professionals in charge to take care of them. The protection of the embryo-fetus against the ionizing radiations is from singular importance, given its special vulnerability to this physical agent, whereas on the other hand the processing or diagnosis with ionizing radiations is beneficial for the mother, only is it indirectly for the embryo-fetus, that exposes itself to a risk in exchange for anything. This work gathers the experience obtained in the dosimetric clinical evaluation of twenty one pregnant patients submitted to diverse procedures of radiation diagnosis or nuclear medicine during years 1999-2000. The main results obtained demonstrate that 25% of the patients were put under nuclear medicine procedures with aims therapeutic or diagnoses. The gestational age of the patients oscillated between 4 and 12 weeks. It can be conclude that in all the case the dose receive by the patient in all the body not surpass the 2 mSv, reason why to, conjugated with the gestational age, not exist evidence of risk for the embryo-fetus paradoxically in all cases his doctors have indicated to the patients to make the interruption of his pregnancy, what demonstrate the ignorance of some of the professional of the health on the biological effect of the ionizing radiation during the prenatal exhibition

  4. Stochastic risk estimation from medical x-ray diagnostic examinations, 2

    International Nuclear Information System (INIS)

    Hashizume, Tadashi; Maruyama, Takashi; Noda, Yutaka; Iwai, Kazuo; Tateno, Y.; Nishizawa, Kanae.

    1981-01-01

    The risks of genetic, leukemia and malignant diseases from medical X-ray diagnostic examinations were estimated using the frequency of radiographic and fluoroscopic exposures per diagnostic examination, child expectancy, leukemia and malignancy significant factors, and using a weighting factor determined on the basis of data concerning the cancer mortality among atomic bomb survivors in Nagasaki and of a recommendation of International Commission of Radiological Protection. The organ or tissue doses with respect to the stochastic risks were determined with ionization chambers and thermoluminescent dosimeters placed at the positions of the organs or tissues in a RANDO woman phantom which was exposed to diagnostic X-rays according to technical factors of typical radiographic and fluoroscopic examinations obtained from a nationwide survey. The resultant risks by age-group and type of radiographic and fluoroscopic examination are tabulated in terms of risk level of 10 -6 . In general, the total risk defined as the sum of genetic, leukemia and malignant risks was a high value for the X-ray diagnosis of digestive organs involving barium meal and barium enema. For example, the total risk for young age-group was 100 to 200 x 10 -6 for the X-ray diagnosis of digestive organs. The total risk from the chest radiography was lower value as compared with the risk from the X-ray diagnosis of other organs or tissues. On the contrary, the risk from the chest tomography was comparable to the risk from the diagnosis of digestive organs. The total risk decreased with increasing of age for every X-ray diagnostic examination. (author)

  5. Molecular diagnostics: the changing culture of medical microbiology.

    Science.gov (United States)

    Bullman, Susan; Lucey, Brigid; Sleator, Roy D

    2012-01-01

    Diagnostic molecular biology is arguably the fastest growing area in current laboratory-based medicine. Growth of the so called 'omics' technologies has, over the last decade, led to a gradual migration away from the 'one test, one pathogen' paradigm, toward multiplex approaches to infectious disease diagnosis, which have led to significant improvements in clinical diagnostics and ultimately improved patient care.

  6. Radiation exposure and image quality in X-ray diagnostic radiology. Physical principles and clinical applications. 2. ed.

    International Nuclear Information System (INIS)

    Saebel, Manfred; Aichinger, Horst; Dierker, Joachim; Joite-Barfuss, Sigrid

    2012-01-01

    Diagnostic X-rays are the largest contributor to radiation exposure to the general population, and protecting the patient from radiation damage is a major aim of modern health policy. Once the decision has been taken to use ionising radiation for imaging in a particular patient, it is necessary to optimize the image acquisition process taking into account the diagnostic quality of the images and the radiation dose to the patient. Both image quality and radiation dose are affected by a number of parameters, knowledge of which permits scientifically based decision making. The authors of this second edition of Radiation Exposure and Image Quality in X-ray Diagnostic Radiology have spent many years studying the optimization of radiological imaging. In this book they present in detail the basic physical principles of diagnostic radiology and their application to clinical problems. Particular attention is devoted to evaluation of the dose to the patient, the influence of scattered radiation on image quality, the use of antiscatter grids, and optimization of image quality and dose. The final section is a supplement containing tables of data and graphical depictions of X-ray spectra, interaction coefficients, characteristics of X-ray beams, and other aspects relevant to patient dose calculations. In addition, a complementary CD-ROM contains a user-friendly Excel file database covering these aspects that can be used in the reader's own programs. Since the first edition, the text, figures, tables, and references have all been thoroughly updated, and more detailed attention is now paid to image quality and radiation exposure when using digital imaging and computed tomography. This book will be an invaluable aid to medical physicists when performing calculations relating to patient dose and image quality, and will also prove useful for diagnostic radiologists and engineers. (orig.)

  7. A study of radiological protection for women of reproductive age in diagnostic radiology. Questionnaire for medical radiation technologists

    International Nuclear Information System (INIS)

    Tsubone, Chie; Ban, Nobuhiko; Kai, Michiaki

    2005-01-01

    There has been great concern regarding the radiation protection for women of reproductive age when exposed to diagnostic radiation. The 10-day-rule proposed by the ICRP has not been recommended since 1983 because the risk to embryo and fetus within four weeks after menstruation may be small. However, some expects see that incomplete abandon of the 10-day-rule might cause confusion among the medical doctors and patients, and consequently unwarranted abortion happens. This paper surveyed the views of radiation technologies in hospitals and discussed how radiation exposure of women of reproductive age in medicine should be controlled. We found that the views to be 10-day-rule were spilt 50:50 and that radiation technologists do not necessarily think the 10-day-rule should be abandoned. Even the radiation technologists who are supposed to be able to explain to the patients the health risk following diagnostic exposure do not fully understand the risk involved. In conclusion, although a low-dose risk of diagnostic exposure should be sufficiently educated in order to obtain an exact understanding, the 10-day-rule may be useful in order to actually avoid any trouble in diagnostic radiology. (author)

  8. Protein Changes in Sulfur Mustard Exposure: Diagnostic and Therapeutic Implications

    International Nuclear Information System (INIS)

    Ray, P.; Jin, X.; Ray, R.

    2007-01-01

    Laminin-5, a heterotrimer of laminin α3, β3, and γ2 subunits, is a component of the skin basal epithelium. Laminin-5 functions as a ligand of the α3β1 and α6β4 integrins in epidermal keratinocytes to regulate cell adhesion, migration, morphogenesis, and assembly of basement membranes; thus it is essential for a stable attachment of the epidermis to the dermis and recovery of damaged skin. Sulfur mustard (SM), also known as mustard gas, is a vesicant chemical warfare and terrorism agent. Skin exposure to SM results in fluid-filled blisters; proposed mechanisms are inflammation, protease stimulation, basal cell death, and separation of the epidermis from the dermis apparently due to the degradation of attachment proteins like laminin-5. Therefore, we investigated the effects of SM exposure on the degradation of laminin-5 by exposing normal human epidermal keratinocytes (NHEK) to SM (0-300 μM, 1-24 hours). We found that SM degraded laminin-5 and its two subunits β3 and γ2, but not α3. Preincubation of cells with a serine protease inhibitor (PMSF), or a metalloprotease inhibitor (1, 10-phenanthroline) prior to SM exposure partially prevented SM-induced degradation of laminin-5 subunits, β3 and γ2. Regarding specificity, laminin-5 γ2 was degraded due to a bifunctional mustard compound like SM, but not due to the other alkylating agents tested. Our results support that laminin-5 degradation is an important mechanism of SM injury as well as a useful biomarker of SM exposure. This knowledge of the mechanism of laminin-5 degradation due to SM has potential application in developing cutaneous therapeutics against SM.(author)

  9. Mapping the different methods adopted for diagnostic imaging instruction at medical schools in Brazil

    Directory of Open Access Journals (Sweden)

    Rubens Chojniak

    Full Text Available Abstract Objective: To map the different methods for diagnostic imaging instruction at medical schools in Brazil. Materials and Methods: In this cross-sectional study, a questionnaire was sent to each of the coordinators of 178 Brazilian medical schools. The following characteristics were assessed: teaching model; total course hours; infrastructure; numbers of students and professionals involved; themes addressed; diagnostic imaging modalities covered; and education policies related to diagnostic imaging. Results: Of the 178 questionnaires sent, 45 (25.3% were completed and returned. Of those 45 responses, 17 (37.8% were from public medical schools, whereas 28 (62.2% were from private medical schools. Among the 45 medical schools evaluated, the method of diagnostic imaging instruction was modular at 21 (46.7%, classic (independent discipline at 13 (28.9%, hybrid (classical and modular at 9 (20.0%, and none of the preceding at 3 (6.7%. Diagnostic imaging is part of the formal curriculum at 36 (80.0% of the schools, an elective course at 3 (6.7%, and included within another modality at 6 (13.3%. Professors involved in diagnostic imaging teaching are radiologists at 43 (95.5% of the institutions. Conclusion: The survey showed that medical courses in Brazil tend to offer diagnostic imaging instruction in courses that include other content and at different time points during the course. Radiologists are extensively involved in undergraduate medical education, regardless of the teaching methodology employed at the institution.

  10. Mapping the different methods adopted for diagnostic imaging instruction at medical schools in Brazil.

    Science.gov (United States)

    Chojniak, Rubens; Carneiro, Dominique Piacenti; Moterani, Gustavo Simonetto Peres; Duarte, Ivone da Silva; Bitencourt, Almir Galvão Vieira; Muglia, Valdair Francisco; D'Ippolito, Giuseppe

    2017-01-01

    To map the different methods for diagnostic imaging instruction at medical schools in Brazil. In this cross-sectional study, a questionnaire was sent to each of the coordinators of 178 Brazilian medical schools. The following characteristics were assessed: teaching model; total course hours; infrastructure; numbers of students and professionals involved; themes addressed; diagnostic imaging modalities covered; and education policies related to diagnostic imaging. Of the 178 questionnaires sent, 45 (25.3%) were completed and returned. Of those 45 responses, 17 (37.8%) were from public medical schools, whereas 28 (62.2%) were from private medical schools. Among the 45 medical schools evaluated, the method of diagnostic imaging instruction was modular at 21 (46.7%), classic (independent discipline) at 13 (28.9%), hybrid (classical and modular) at 9 (20.0%), and none of the preceding at 3 (6.7%). Diagnostic imaging is part of the formal curriculum at 36 (80.0%) of the schools, an elective course at 3 (6.7%), and included within another modality at 6 (13.3%). Professors involved in diagnostic imaging teaching are radiologists at 43 (95.5%) of the institutions. The survey showed that medical courses in Brazil tend to offer diagnostic imaging instruction in courses that include other content and at different time points during the course. Radiologists are extensively involved in undergraduate medical education, regardless of the teaching methodology employed at the institution.

  11. Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP).

    Science.gov (United States)

    Davis, Robert L

    2010-01-01

    Knowledge about safe medication use during pregnancy is limited, yet about two of every three women take at least one prescription medication during pregnancy, furthermore, there is a lack of rigorous studies evaluating birth outcomes associated with in utero exposure to medications. The Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP) is intended to provide a mechanism for collaborative pharmacoepidemiological research to address the safety of pharmaceutical product exposure during pregnancy, through the development of standardized data requirements and of the necessary data linkages of mother-infant pairs to conduct multi-site investigations. This presentation will describe the program, the types of data collected, and progress to date. The current MEPREP population includes female health plan members of 11 distinct health management entities within three research centres who have delivered an infant between January 1, 2001 and December 31, 2007, along with the administrative and birth certificate data on over one million children linked to mothers. There is information on all the medications those mothers took, as well as most of the outcomes of the babies. One of the benefits of this dataset is the information that could be investigated, such as birth weight, fetal growth, congenital anomalies, perinatal conditions, etc., against various demographics of the women in the dataset. The population size within the dataset suggests that various parameters could be studied with at least a modest degree of power.

  12. SU-E-P-01: An Informative Review On the Role of Diagnostic Medical Physicist in the Academic and Private Medical Centers

    International Nuclear Information System (INIS)

    Weir, V; Zhang, J

    2014-01-01

    Purpose: The role of physicist in the academic and private hospital environment continues to evolve and expand. This becomes more obvious with the newly revised requirements of the Joint Commission (JC) on imaging modalities and the continued updated requirements of ACR accreditation for medical physics (i.e., starting in June 2014, a physicists test will be needed before US accreditation). We provide an informative review on the role of diagnostic medical physicist and hope that our experience will expedite junior physicists in understanding their role in medical centers, and be ready to more opportunities. Methods: Based on our experience, diagnostic medical physicists in both academic and private medical centers perform several clinical functions. These include providing clinical service and physics support, ensuring that all ionizing radiation devices are tested and operated in compliance with the State and Federal laws, regulations and guidelines. We also discuss the training and education required to ensure that the radiation exposure to patients and staff is as low as reasonably achievable. We review the overlapping roles of medical and health physicist in some institutions. Results: A detailed scheme on the new requirements (effective 7/1/2014) of the JC is provided. In 2015, new standards for fluoroscopy, cone beam CT and the qualifications of staff will be phased in. A summary of new ACR requirements for different modalities is presented. Medical physicist have other duties such as sitting on CT and fluoroscopy committees for protocols design, training of non-radiologists to meet the new fluoroscopy rules, as well as helping with special therapies such as Yittrium 90 cases. Conclusion: Medical physicists in both academic and private hospitals are positioned to be more involved and prominent. Diagnostic physicists need to be more proactive to involve themselves in the day to day activities of the radiology department

  13. Exploring the Case for a Global Alliance for Medical Diagnostics Initiative

    Directory of Open Access Journals (Sweden)

    Melissa L. Mugambi

    2017-01-01

    Full Text Available In recent years, the private and public sectors have increased investments in medical diagnostics for low- and middle-income countries (LMICs. Despite these investments, numerous barriers prevent the adoption of existing diagnostics and discourage the development and introduction of new diagnostics in LMICs. In the late 1990s, the global vaccine community had similar challenges, as vaccine coverage rates stagnated and the introduction of new vaccines was viewed as a distraction to delivering existing vaccines. To address these challenges, the international community came together and formed the Global Alliance for Vaccines Initiative (GAVI. Sixteen years after the formation of GAVI, we see evidence of a healthier global vaccine landscape. We discuss how GAVI’s four guiding principles (product, health systems strengthening, financing and market shaping might apply to the advancement of medical diagnostics in LMICs. We present arguments for the international community and existing organizations to establish a Global Alliance for Medical Diagnostics Initiative (GAMDI.

  14. A national survey of occupational radiation exposure among diagnostic radiologic technologists in South Korea

    International Nuclear Information System (INIS)

    Lee, Jeeyoung; Cha, Eun Shil; Jeong, Meeseon; Lee, Won Jin

    2015-01-01

    The objective of this study was to investigate representative occupational characteristics and radiation exposure for South Korean radiologic technologists. The authors conducted a national survey by stratified sampling of South Korean administrative districts and types of medical facilities. A total of 585 technologists were surveyed, and survey data were linked with dosimetry data from the National Dose Registry. A total of 73 % of radiologic technologists sampled were male, 62 % were younger than age 40 and 86.5 % began employment after 1990. The most frequent practices among radiologic technologists were diagnostic routine X-ray followed by computed tomography (CT) and portable X-ray. Male workers were more frequently involved in CT, portable X-ray and interventional radiology whereas female workers carried out most mammography procedures. The average annual effective dose was 2.3 mSv for male and 1.3 mSv for female workers. The dose was significantly higher for workers in the provinces and those who had recently started work. (authors)

  15. Diagnostic Vacuum Curettage | Nelson | South African Medical Journal

    African Journals Online (AJOL)

    A trial of the Vabra aspirator, a sterile disposable suction curette, was carried out on 136 outpatients. The apparatus is designed to allow full curettage of the uterine cavity. Adequate specimens for diagnostic histology were obtained in' all but 10 cases. Of these, no specimen was obtained in 4 cases. The side-effects were ...

  16. The design of diagnostic medical facilities using ionizing radiation

    International Nuclear Information System (INIS)

    1988-03-01

    This Code, setting out the general principles of radiological protection as applied to diagnostic radiation facilities in hospitals and clinics, is intended as a guide to architects and to works departments concerned with their design and construction, and with the modification of existing units

  17. Diagnostic Error in Medical Education: Where Wrongs Can Make Rights

    Science.gov (United States)

    Eva, Kevin W.

    2009-01-01

    This paper examines diagnostic error from an educational perspective. Rather than addressing the question of how educators in the health professions can help learners avoid error, however, the literature reviewed leads to the conclusion that educators should be working to induce error in learners, leading them to short term pain for long term…

  18. Review of Safety of Diagnostic Ultrasound in Medical Practice ...

    African Journals Online (AJOL)

    In Nigeria, there is a dearth of scientific literature about the safety of ultrasound as a diagnostic modality. Because of its low cost, real-time image display and lack of evidence of bio-effects, ultrasound is a fast growing imaging modality. The impact of ultrasound in the care of women and children is most obvious. Information ...

  19. Statistical physics of medical diagnostics: Study of a probabilistic model

    Science.gov (United States)

    Mashaghi, Alireza; Ramezanpour, Abolfazl

    2018-03-01

    We study a diagnostic strategy which is based on the anticipation of the diagnostic process by simulation of the dynamical process starting from the initial findings. We show that such a strategy could result in more accurate diagnoses compared to a strategy that is solely based on the direct implications of the initial observations. We demonstrate this by employing the mean-field approximation of statistical physics to compute the posterior disease probabilities for a given subset of observed signs (symptoms) in a probabilistic model of signs and diseases. A Monte Carlo optimization algorithm is then used to maximize an objective function of the sequence of observations, which favors the more decisive observations resulting in more polarized disease probabilities. We see how the observed signs change the nature of the macroscopic (Gibbs) states of the sign and disease probability distributions. The structure of these macroscopic states in the configuration space of the variables affects the quality of any approximate inference algorithm (so the diagnostic performance) which tries to estimate the sign-disease marginal probabilities. In particular, we find that the simulation (or extrapolation) of the diagnostic process is helpful when the disease landscape is not trivial and the system undergoes a phase transition to an ordered phase.

  20. Diagnostic outcome of patients referred to psychiatry with medically ...

    African Journals Online (AJOL)

    Objective: Medically unexplained symptoms (MUS) are commonly encountered in medical practice. In psychiatry, they are classified mostly as Somatoform Disorders and are often associated with anxiety and depression. The literature suggests that, in some cases, MUS may be ascribed to Somatoform Disorders when, fact, ...

  1. Diagnostic outcome of patients referred to psychiatry with medically ...

    African Journals Online (AJOL)

    Keywords: Medically unexplained symptoms; Psychiatric disorders; Retrospective review; Somatoform disorders. Received: 19-10- .... 4% had an anxiety disorder and 2% had a psychotic illness. Seventy eight percent of referrals came from medical officers or registrars from within the hospital, 8% from hospital consultants ...

  2. The justification of a medical exposure - Who does it?

    International Nuclear Information System (INIS)

    Marsden, P.J.; Hardwick, J.; McHugh, K.

    2001-01-01

    It is widely acknowledged that the use of ionising radiation in medical exposures must be justified, but it has often been difficult to determine who makes that justification, and who is responsible for it. New legislation introduced in the UK following the European Union Medical Exposures Directive makes it necessary to ensure that justification takes place and to ensure that the individuals responsible for it are identified and are adequately trained. This paper presents an approach to justification which minimises the need for extra training by focussing responsibility for justification on professionals who have gained sufficient knowledge as part of their specialisation. By acknowledging the role of radiographers in the justification process and allowing them flexibility in their judgement, it is proposed that the justification process will become more robust and should screen out inappropriate referrals more effectively. (author)

  3. Obstetric and Neonatal Outcomes After Antipsychotic Medication Exposure in Pregnancy

    Science.gov (United States)

    Coughlin, Catherine G.; Blackwell, Katherine A.; Bartley, Christine; Hay, Madeleine; Yonkers, Kimberly A.; Bloch, Michael H.

    2015-01-01

    Objective Antipsychotic medications are used by increasing numbers of women of reproductive age. The safety of these medications during pregnancy has not been well-described. We undertook a systematic review and meta-analysis of the adverse obstetric and neonatal outcomes associated with exposure to antipsychotics during pregnancy. Data Sources PubMed, Reprotox, and ClinicalTrials.gov were searched to identify potential studies for inclusion. Methods of Study Selection Case-control or cohort studies estimating adverse birth outcomes associated with antipsychotic exposure during pregnancy were included. Pooled odds ratios (OR) were used for dichotomous outcomes and weighted mean differences (WMD) were used for infant birth weight and gestational age. Thirteen cohort studies, including 6,289 antipsychotic-exposed and 1,618,039 unexposed pregnancies were included. Tabulation, Integration, and Results Antipsychotic exposure was associated with an increased risk of major malformations (Absolute Risk Difference = 0.03, 95% confidence interval [CI] 0.00 – 0.05, p=0.04, Z = 2.06), heart defects (Absolute Risk Difference =0.01, 95% CI 0.00 – 0.01, pantipsychotic medications. Antipsychotic exposure was not associated with risk of large for gestational age births, stillbirth, and spontaneous abortion. Although antipsychotic exposure during pregnancy was associated with increased risk of adverse obstetric and neonatal outcomes, this association does not necessarily imply causation. This analysis was limited by the small number of included studies and limited adjustment in studies for possible confounders. Conclusion Women requiring antipsychotic treatment during pregnancy appear at higher risk of adverse birth outcomes, regardless of causation, and may benefit from close monitoring and minimization of other potential risk factors during pregnancy. PMID:25932852

  4. Pediatric marijuana exposures in a medical marijuana state.

    Science.gov (United States)

    Wang, George Sam; Roosevelt, Genie; Heard, Kennon

    2013-07-01

    An increasing number of states are decriminalizing the use of medical marijuana, and the effect on the pediatric population has not been evaluated. To compare the proportion of marijuana ingestions by young children who sought care at a children's hospital in Colorado before and after modification of drug enforcement laws in October 2009 regarding medical marijuana possession. Retrospective cohort study from January 1, 2005, through December 31, 2011. Tertiary-care children's hospital emergency department in Colorado. A total of 1378 patients younger than 12 years evaluated for unintentional ingestions: 790 patients before September 30, 2009, and 588 patients after October 1, 2009. Marijuana ingestion. Marijuana exposure visits, marijuana source, symptoms, and patient disposition. The proportion of ingestion visits in patients younger than 12 years (age range, 8 months to 12 years)that were related to marijuana exposure increased after September 30, 2009, from 0 of 790 (0%; 95% CI, 0%-0.6%) to 14 of 588 (2.4%; 95% CI, 1.4%-4.0%) (P marijuana, and 7 of these exposures were from food products. We found a new appearance of unintentional marijuana ingestions by young children after modification of drug enforcement laws for marijuana possession in Colorado. The consequences of unintentional marijuana exposure in children should be part of the ongoing debate on legalizing marijuana.

  5. Medical management of three workers following a radiation exposure incident

    International Nuclear Information System (INIS)

    House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L.

    1992-01-01

    The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms

  6. Medical management of three workers following a radiation exposure incident

    Energy Technology Data Exchange (ETDEWEB)

    House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L. (Department of Occupational and Environmental Health, St. Michael' s Hospital, Toronto, Ontario (Canada))

    1992-01-01

    The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms.

  7. Topical aspects of nuclear medical diagnostics in dermatology

    Energy Technology Data Exchange (ETDEWEB)

    Wehrenberg, O.

    1985-09-09

    The diagnostic value of soft tissue and bone scintigraphy in various dermatological diseases is discussed. We received new knowledge about frequency, dimension and validity of psoriatic osteoarthropathia by using scintigraphic methods. Bone scintigraphy is more sensitive than clinical and radiological investigation and there is an earlier detection of arthropathy in psoriasis. Whole body scintigraphy using bone seeking radiopharmaceuticals has proven to be a sensitive diagnostic tool in the detection of bone and joint involvement in collagen diseases. These methods can also be of great value in the evaluation and clinical management of diseases with possible generalized or multiple bone lesions (e. g. syphilis; dermatomyositis; sarcoidosis; malignant melanoma). Since the discovery of hybridoma technique for the production of monoclonal antibodies it became apparent that this new class of immunoglobulins may represent a new useful tool in the diagnosis and in the therapy of malignant diseases. In this paper we discuss the application of murine and human monoclonal antibodies in experimental and clinical oncology.

  8. Health effects assessment of staff involved in medical practices of radiation exposures

    Energy Technology Data Exchange (ETDEWEB)

    Popescu, I.A.; Lacob, O. [Institute of Public Health Iasi, Radiation Hygiene Lab. (Romania); Roman, I.; Havarneanu, D. [Institute of Public Health Iasi, Occupational Medicine Dept. (Romania)

    2006-07-01

    This study aimed, starting from new national recommendation appearance, to detect health effects of medical staff from six counties of Moldavia region involved in radiation practices and to create a national register data for radiation-induce cancer. Staff involved in medical ionizing radiation uses in Romania - health care level I are monitored on recent new recommendations for three years. The micro nuclei high levels and morphological lymphocytes changes vs. clinical diagnostic can be considered as early possible malignant signs. The micro nuclei test, although unspecific, as a new exam in our legislation can bring useful information on staff exposure and provides a guidance to occupational physician in making his medical recommendations. This cytogenetic test does not seem to correlate with smoking habit or length of exposure. Micro nuclei test both in oral mucous epithelial cells and peripheral culture lymphocytes can be considered of much specificity and correlates with a recent acute exposure level. The conclusions of individual health status surveillance and assessment of personal dose equivalent are very useful data for recording in the radiation cancer-induced register.

  9. Health effects assessment of staff involved in medical practices of radiation exposures

    International Nuclear Information System (INIS)

    Popescu, I.A.; Lacob, O.; Roman, I.; Havarneanu, D.

    2006-01-01

    This study aimed, starting from new national recommendation appearance, to detect health effects of medical staff from six counties of Moldavia region involved in radiation practices and to create a national register data for radiation-induce cancer. Staff involved in medical ionizing radiation uses in Romania - health care level I are monitored on recent new recommendations for three years. The micro nuclei high levels and morphological lymphocytes changes vs. clinical diagnostic can be considered as early possible malignant signs. The micro nuclei test, although unspecific, as a new exam in our legislation can bring useful information on staff exposure and provides a guidance to occupational physician in making his medical recommendations. This cytogenetic test does not seem to correlate with smoking habit or length of exposure. Micro nuclei test both in oral mucous epithelial cells and peripheral culture lymphocytes can be considered of much specificity and correlates with a recent acute exposure level. The conclusions of individual health status surveillance and assessment of personal dose equivalent are very useful data for recording in the radiation cancer-induced register

  10. Examination of occupational exposure to medical staff (primarily nurses) during 131I medical treatments

    International Nuclear Information System (INIS)

    Watanabe, Masayoshi; Ishikawa, Naofumi; Ito, Kunihiko; Ito, Koichi

    2004-01-01

    Recently, a new amendment to protect against radiation damage to humans has been enacted based on a 1990 recommendation by the International Commission on Radiological Protection (ICRP). Consequently, the dose limits of occupational exposure to medical staff were cut down sharply compared with conventional readjustments. This amended bill, however, may be triggering a reduction in the number of applicants, which hope to engage in radiotherapy. This being the case, we measured the dose levels of the occupational exposure to medical staff (doctor's group, nuclear medicine technologist's group, nurse's group and pharmacist's group) from 1999 to 2002. Moreover, we investigated what the main factor is in nurse's occupational exposure to 131 I. The highest doses of occupational exposure were 3.640 mSv to doctors, 7.060 mSv to nuclear medicine technologists, 1.486 mSv to nurses and 0.552 mSv to pharmacists. According to our results, it was clear that the highest doses in each group were far below the legally mandated upper limits of exposure doses. Although we investigated the correlations between the factors of nurse's occupational exposure to 131 I with the number of inpatients, the amount of 131 I and the number of servicing times for patients, there were no correlations found. Furthermore, to analyzing the factors in detail, it became clear that the main factor in the nurse's occupational exposure was due to the existence of patients who needed many more servicing times for their care than ordinary patients. (author)

  11. Advanced signal processing theory and implementation for sonar, radar, and non-invasive medical diagnostic systems

    CERN Document Server

    Stergiopoulos, Stergios

    2009-01-01

    Integrates topics of signal processing from sonar, radar, and medical system technologies by identifying their concept similarities. This book covers non-invasive medical diagnostic system applications, including intracranial ultrasound, a technology that attempts to address non-invasive detection on brain injuries and stroke.

  12. Slovak Government Regulation No. 340/2006 Coll. of 17 May 2006 on the protection of human health against adverse effects of ionizing radiation in medical exposure

    International Nuclear Information System (INIS)

    2006-01-01

    This Government Regulation establishes requirements for the implementation of activities leading to exposure and provides the basic requirements of radiation protection for persons using sources of ionizing radiation in medical exposure. This Government Regulation shall apply to medical exposure: (a) patients in determining their diagnosis or treatment; (b) individuals in connection with monitoring the health of employees; (c) individuals in connection with preventive health programs; (d) healthy individuals or patients voluntarily participating in medical, biomedical, diagnostic or therapeutic research programs (hereinafter referred to as 'volunteers'); (e) individuals in connection with examinations for the purpose of establishing a medical opinion. This Government Regulation shall also apply to the exposure of individuals outside the scope of their employment voluntarily and knowingly assisting persons undergoing medical exposure (hereinafter referred to as accompanying persons). This Regulation came into force on June 1, 2006.

  13. Course of radiological protection and safety in the medical diagnostic with X-rays

    International Nuclear Information System (INIS)

    Dominguez A, C.E.

    1997-01-01

    The obtention of images of human body to the medical diagnostic is one of the more old and generalized applications for X-ray. Therefore the design and performance of equipment and installations as well as the operation procedures must be oriented toward safety with the purpose to guarantee this radiological practice will bring a net positive benefit to the society. Given that in Mexico only exists the standardization related to source and equipment generators of ionizing radiation in the industrial area and medical therapy, but not so to the medical diagnostic area it is the purpose of this work to present those standards related with this application branch. Also it is presented the preparation of a manual for the course named Formation of teachers in radiological protection and safety in the X-ray medical diagnostic in 1997 which was imparted at ININ. (Author)

  14. Health Technology Assessment for Molecular Diagnostics: Practices, Challenges, and Recommendations from the Medical Devices and Diagnostics Special Interest Group.

    Science.gov (United States)

    Garfield, Susan; Polisena, Julie; S Spinner, Daryl; Postulka, Anne; Y Lu, Christine; Tiwana, Simrandeep K; Faulkner, Eric; Poulios, Nick; Zah, Vladimir; Longacre, Michael

    2016-01-01

    Health technology assessments (HTAs) are increasingly used to inform coverage, access, and utilization of medical technologies including molecular diagnostics (MDx). Although MDx are used to screen patients and inform disease management and treatment decisions, there is no uniform approach to their evaluation by HTA organizations. The International Society for Pharmacoeconomics and Outcomes Research Devices and Diagnostics Special Interest Group reviewed diagnostic-specific HTA programs and identified elements representing common and best practices. MDx-specific HTA programs in Europe, Australia, and North America were characterized by methodology, evaluation framework, and impact. Published MDx HTAs were reviewed, and five representative case studies of test evaluations were developed: United Kingdom (National Institute for Health and Care Excellence's Diagnostics Assessment Programme, epidermal growth factor receptor tyrosine kinase mutation), United States (Palmetto's Molecular Diagnostic Services Program, OncotypeDx prostate cancer test), Germany (Institute for Quality and Efficiency in Healthcare, human papillomavirus testing), Australia (Medical Services Advisory Committee, anaplastic lymphoma kinase testing for non-small cell lung cancer), and Canada (Canadian Agency for Drugs and Technologies in Health, Rapid Response: Non-invasive Prenatal Testing). Overall, the few HTA programs that have MDx-specific methods do not provide clear parameters of acceptability related to clinical and analytic performance, clinical utility, and economic impact. The case studies highlight similarities and differences in evaluation approaches across HTAs in the performance metrics used (analytic and clinical validity, clinical utility), evidence requirements, and how value is measured. Not all HTAs are directly linked to reimbursement outcomes. To improve MDx HTAs, organizations should provide greater transparency, better communication and collaboration between industry and HTA

  15. Medical Student Assessment of Videotape for Teaching in Diagnostic Radiology

    Science.gov (United States)

    Moss, J. R.; McLachlan, M. S. F.

    1976-01-01

    A series of six recordings that describe some aspects of the radiology of the chest, using only radiographs, were viewed by a small group of final year medical students. Their scores for factual questions immediately afterwards were compared with their attitudes to the learning experience; higher scores correlated with positive attitudes. (LBH)

  16. Medical image information system 2001. Development of the medical image information system to risk management- Medical exposure management

    International Nuclear Information System (INIS)

    Kuranishi, Makoto; Kumagai, Michitomo; Shintani, Mitsuo

    2000-01-01

    This paper discusses the methods and systems for optimizing the following supplements 10 and 17 for national health and medical care. The supplements 10 and 17 of DICOM (digital imaging and communications in medicine) system, which is now under progress for the purpose to keep compatibility within medical image information system as an international standard, are important for making the cooperation between HIS (hospital information system)/RIS (radiation information system) and modality (imaging instruments). Supplement 10 concerns the system to send the information of patients and their orders through HIS/RIS to modality and 17, the information of modality performed procedure step (MPPS) to HIS/RIS. The latter defines to document patients' exposure, a part of which has not been recognized in Japan. Thus the medical information system can be useful for risk-management of medical exposure in future. (K.H.)

  17. Medical image information system 2001. Development of the medical image information system to risk management- Medical exposure management

    Energy Technology Data Exchange (ETDEWEB)

    Kuranishi, Makoto; Kumagai, Michitomo; Shintani, Mitsuo [Toyama Medical and Pharmaceutical Univ. (Japan). Hospital

    2000-12-01

    This paper discusses the methods and systems for optimizing the following supplements 10 and 17 for national health and medical care. The supplements 10 and 17 of DICOM (digital imaging and communications in medicine) system, which is now under progress for the purpose to keep compatibility within medical image information system as an international standard, are important for making the cooperation between HIS (hospital information system)/RIS (radiation information system) and modality (imaging instruments). Supplement 10 concerns the system to send the information of patients and their orders through HIS/RIS to modality and 17, the information of modality performed procedure step (MPPS) to HIS/RIS. The latter defines to document patients' exposure, a part of which has not been recognized in Japan. Thus the medical information system can be useful for risk-management of medical exposure in future. (K.H.)

  18. MEDICAL AND DIAGNOSTIC APPLICATIONS OF SNAKE VENOM PROTEOMES

    Directory of Open Access Journals (Sweden)

    Ashis K. Mukherjee

    2011-06-01

    Full Text Available Snake venom is a highly toxic secretion produced and stored in specialized salivary glands of snakes which constitutes a vast array of biologically-active compounds, such as enzymes, proteins, peptides and low molecular weight compounds. These substances target an immense number of receptors and membrane proteins as well as coagulation proteins with high affinity, selectivity and potency, and can serve as potential drugs or scaffolds for drug design. During the recent years, much attention has been given to understand the mechanism of action of complex venom proteins for the development of novel drugs and therapeutic agents to treat life-threatening diseases such as cardiovascular diseases, cancer, thrombosis, arthritis, microbial infections and hypertension etc. Further, snake venom components have found uses in the diagnosis of haemostatic disorders. This paper reviews the various biomedical applications of snake venom proteins in terms of therapeutic and diagnostic values.

  19. Radiation exposure of fertile women in medical research studies

    International Nuclear Information System (INIS)

    Vetter, R.J.

    1988-01-01

    Fertile women may be exposed to ionizing radiation as human subjects in medical research studies. If the woman is pregnant, such exposures may result in risk to an embryo/fetus. Fertile women may be screened for pregnancy before exposure to ionizing radiation by interview, general examination, or pregnancy test. Use of the sensitive serum pregnancy test has become common because it offers concrete evidence that the woman is not pregnant (more specifically, that an embryo is not implanted). Evidence suggests that risk to the embryo from radiation exposure before organogenesis is extremely low or nonexistent. Further, demonstrated effects on organogenesis are rare or inconclusive at fetal doses below 50 mSv (5 rem). Therefore, there may be some level of radiation exposure below which risk to the fetus may be considered essentially zero, and a serum pregnancy test is unnecessary. This paper reviews the fetal risks and suggests that consideration be given to establishing a limit to the fetus of 0.5 mSv (50 mrem), below which pregnancy screening need not include the use of a serum pregnancy test

  20. Differential diagnostic value of procalcitonin in surgical and medical patients with septic shock.

    Science.gov (United States)

    Clec'h, Christophe; Fosse, Jean-Philippe; Karoubi, Philippe; Vincent, Francois; Chouahi, Imad; Hamza, Lilia; Cupa, Michel; Cohen, Yves

    2006-01-01

    To assess whether different diagnostic and prognostic cutoff values of procalcitonin should be considered in surgical and in medical patients with septic shock. Prospective observational study. Intensive care unit of the Avicenne teaching hospital, France. All patients with septic shock or noninfectious systemic inflammatory response syndrome within 48 hrs after admission. None. Patients were allocated to one of the following groups: group 1 (surgical patients with septic shock), group 2 (surgical patients with noninfectious systemic inflammatory response syndrome), group 3 (medical patients with septic shock), and group 4 (medical patients with noninfectious systemic inflammatory response syndrome). Procalcitonin at study entry was compared between group 1 and group 2 and between group 3 and group 4 to determine the diagnostic cutoff value in surgical and in medical patients, respectively. Procalcitonin was compared between survivors and nonsurvivors from group 1 and group 3 to determine its prognostic cutoff value. One hundred forty-three patients were included: 31 in group 1, 36 in group 2, 36 in group 3, and 40 in group 4. Median procalcitonin levels (ng/mL [interquartile range]) were higher in group 1 than in group 3 (34.00 [7.10-76.00] vs. 8.40 [3.63-24.70], p = .01). In surgical patients, the best diagnostic cutoff value was 9.70 ng/mL, with 91.7% sensitivity and 74.2% specificity. In medical patients, the best diagnostic cutoff value was 1.00 ng/mL, with 80% sensitivity and 94% specificity. Procalcitonin was a reliable early prognostic marker in medical but not in surgical patients with septic shock. A cutoff value of 6.00 ng/mL had 76% sensitivity and 72.7% specificity for separating survivors from nonsurvivors. The diagnostic cutoff value of procalcitonin was higher in surgical than in medical patients. Early procalcitonin was of prognostic interest in medical patients.

  1. Mamma diagnostics for MTRA (medical-radiological personnel)/RT (radiologists); Mammadiagnostik fuer MTRA/RT

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Uwe; Baum, Friedemann

    2014-07-01

    The text book on mamma diagnostics for MTRA (medical-radiological personnel)/RT (radiologists) covers the following issues: Anatomy, development and physiology of mammary glands; tumor development an breast cancer risk; pathology, non-imaging diagnostics; mammography: physical-technical fundamentals; mammography: analogue technique; mammography: digital technique; mammography: quality assurance; mammography: legal questions and radiation protection; mammography: new developments; mammography: setting technique; mammography: use and appraisal; mamma-sonography: technique and methodology; mamma-sonography: assignment and appraisal, mamma-NMR: technique and methodology; mamma-NMR: assignment and appraisal lymph node diagnostics; mamma interventions; biopsy; mamma interventions: marking examination concepts; therapeutic concepts; hygienic concepts; communication and interaction.

  2. Overview of quality assurance in diagnostic medical x-ray examinations

    International Nuclear Information System (INIS)

    Benson, J.S.

    1975-01-01

    Quality assurance is defined as reduction of patient exposure and improvement in film quality. The history of quality assurance programs is briefly reviewed. The Dental Exposure Normalization Technique for improving dental practices and dental equipment is discussed. Data on exposure of patients to medical radiation show wide variations. Some causes of poor film quality are inconsistent machine output, poor beam alignment, timer inaccuracy, improper film-screen combination, and poor film-screen contact

  3. Efficient medical image access in diagnostic environments with limited resources

    Directory of Open Access Journals (Sweden)

    José Eduardo Venson

    Full Text Available Abstract Introduction A medical application running outside the workstation environment has to deal with several constraints, such as reduced available memory and low network bandwidth. The aim of this paper is to present an approach to optimize the data flow for fast image transfer and visualization on mobile devices and remote stationary devices. Methods We use a combination of client- and server-side procedures to reduce the amount of information transferred by the application. Our approach was implemented on top of a commercial PACS and evaluated through user experiments with specialists in typical diagnosis tasks. The quality of the system outcome was measured in relation to the accumulated amount of network data transference and the amount of memory used in the host device. Besides, the system's quality of use (usability was measured through participants’ feedback. Results Contrarily to previous approaches, ours keeps the application within the memory constraints, minimizing data transferring whenever possible, allowing the application to run on a variety of devices. Moreover, it does that without sacrificing the user experience. Experimental data point that over 90% of the users did not notice any delays or degraded image quality, and when they did, they did not impact on the clinical decisions. Conclusion The combined activities and orchestration of our methods allow the image viewer to run on resource-constrained environments, such as those with low network bandwidth or little available memory. These results demonstrate the ability to explore the use of mobile devices as a support tool in the medical workflow.

  4. Teaching Critical Thinking in Graduate Medical Education: Lessons Learned in Diagnostic Radiology.

    Science.gov (United States)

    Morrissey, Benjamin; Heilbrun, Marta E

    2017-01-01

    The 2014 Institute of Medicine report, Graduate Medical Education that Meets the Nation's Health Needs , challenged the current graduate medical training process and encouraged new opportunities to redefine the fundamental skills and abilities of the physician workforce. This workforce should be skilled in critically evaluating the current systems to improve care delivery and health. To meet these goals, current challenges, motivations, and educational models at the medical school and graduate medical education levels related to formal training in nonclinical aspects of medicine, especially critical thinking, are reviewed. Our diagnostic radiology training program is presented as a "case study" to frame the review.

  5. Influence of patient medication on diagnostic accuracy in nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Sampson, C.B. [Addenbrooke`s Hospital, Cambridge (United Kingdom). Dept. of Nuclear Medicine

    1997-12-31

    Full text. In recently years many reports have published of unusual or unexpected changes in the biodistribution of radiopharmaceuticals which do not correlate with normality or disease. Whilst many extraneous factors can alter tracer kinetics it has become apparent that concomitant patient medication can be such a factor. If the clinician is unaware that patient is on drug therapy difficulties arise in making a accurate diagnosis. Most drug/radio pharmaceutical effects are those in which the functional status of the organ is altered as a result of the pharmacological action of the drug. Examples here are narcotic analgesics such as methadone, pethidine and morphine which cause spasm of the biliary tract due to contraction of the sphincter of Oddi and an altered transit time of the technetium labelled tracer. Cytotoxic drugs such as cyclophosphamide and vincristine can markedly affect tumour uptake of 67-gallium so that litter or no activity is taken up by the tumour. Nifedipine, because of its powerful calcium channel blocking activity is known to affect the radiolabelling of white cells and red cells and to affect uptake of Tc-99 m MDP into bones. Other important and confusing effects are caused by phenothiazines, cimetidine and oral contraceptives. In recent years it has been reported that drugs such as cyclosporin, azathioprine and heparin and derivatives of heparin can markedly interfere with cell labelling procedures. This review will consider some of the clinical effects of drugs and will also address the reporting of instances of drug/radio pharmaceutical interactions

  6. Photoionization sensor CES for non-invasive medical diagnostics

    Science.gov (United States)

    Mustafaev, Aleksandr; Rastvorova, Iuliia; Khobnya, Kristina; Podenko, Sofia

    2016-10-01

    Method CES (collisional electron spectroscopy), patented in Russia, the USA, Japan, China, Germany and Britain, allows to analyze the gaseous mixtures using electron spectroscopy under high pressures up to atmospheric without using vacuum. The design of VUV photoionization detector was developed based on this method. Such detector is used as a portable gas analyzer for continuous personal bio-medical monitoring. This detector measures energy of electrons produced in ionization with resonance photons, whose wavelength situated in the vacuum ultraviolet (VUV). Nowadays, micro plasma source of such photons on resonant line of Kr with energy of 10,6 eV is developed. Only impurities are ionized and detected by the VUV-emission, meanwhile the main components of air stay neutral that reduces background signal and increases the sensibility along with accuracy. The experimental facilities with VUV photoionization sensors CES are constructed with the overall sizes about 10*10*1 mm. The watt consumption may comprise less than 1W. Increase of electrometer amplifier's sensibility and more high-aperture construction are used today to increase the sensibility of CES-detectors. The wide range of detectable molecules and high sensitivity allow the development of portable device, which can become the base of the future preventive medicine. Work supported by Foundation for Assistance to Small Innovative Enterprises in Science and Technology.

  7. Formal art observation training improves medical students' visual diagnostic skills.

    Science.gov (United States)

    Naghshineh, Sheila; Hafler, Janet P; Miller, Alexa R; Blanco, Maria A; Lipsitz, Stuart R; Dubroff, Rachel P; Khoshbin, Shahram; Katz, Joel T

    2008-07-01

    Despite evidence of inadequate physical examination skills among medical students, teaching these skills has declined. One method of enhancing inspection skills is teaching "visual literacy," the ability to reason physiology and pathophysiology from careful and unbiased observation. To improve students' visual acumen through structured observation of artworks, understanding of fine arts concepts and applying these skills to patient care. Prospective, partially randomized pre- vs. post-course evaluation using mixed-methods data analysis. Twenty-four pre-clinical student participants were compared to 34 classmates at a similar stage of training. Training the Eye: Improving the Art of Physical Diagnosis consists of eight paired sessions of art observation exercises with didactics that integrate fine arts concepts with physical diagnosis topics and an elective life drawing session. The frequency of accurate observations on a 1-h visual skills examination was used to evaluate pre- vs. post-course descriptions of patient photographs and art imagery. Content analysis was used to identify thematic categories. All assessments were blinded to study group and pre- vs. post-course evaluation. Following the course, class participants increased their total mean number of observations compared to controls (5.41 +/- 0.63 vs. 0.36 +/- 0.53, p interdisciplinary course improved participants' capacity to make accurate observations of art and physical findings.

  8. X-ray diagnostics, X-ray therapy, diagnostics and therapy with radioactive materials in free medical practice

    International Nuclear Information System (INIS)

    Setzer, H.D.

    1976-01-01

    On the basis of the documents of the Kassenaerztliche Vereinigung Niederbayerns in Straubing, the work of the established general practicioners in the fields of X-ray and nuclear medicine was investigated for the 1st quarter of 1971, and the X-ray diagnostic services rendered were evaluated according to age and sex. 2/3 of all doctors participating in a health insurance plan in Lower Bavaria are general practitioners; all other fields are represented less often than in Munich. The values for the whole Federal Republic are in between. Internal specialists, radiologists, and urologists together carry out 85.7% of the ten examinations which contribute most to the total gonadal dose. An application of the data on the 1st quarter to the annual value is only possible by allowing for an error of 13.1%. All in all, 6% more X-ray services are administered to men than to women. For both sexes, the genetically most important group of 15-34 resp. 15-39 years of age is highly represented, although young men receive X-ray diagnostics more frequently. X-ray therapy makes up only about 0.5% of all services. Nuclear medical diagnostics is employed to the same extent by radiologists and internal specialists, while therapy with radioactive substances is almost exclusively provided by radiologists. Relative to the population density, radioactive substances are more often used in Lower Bavaria than in West Berlin. (orig.) [de

  9. Diagnostic Imaging in the Medical Support of the Future Missions to the Moon

    Science.gov (United States)

    Sargsyan, Ashot E.; Jones, Jeffrey A.; Hamilton, Douglas R.; Dulchavsky, Scott A.; Duncan, J. Michael

    2007-01-01

    This viewgraph presentation is a course that reviews the diagnostic imaging techniques available for medical support on the future moon missions. The educational objectives of the course are to: 1) Update the audience on the curreultrasound imaging in space flight; 2) Discuss the unique aspects of conducting ultrasound imaging on ISS, interplanetary transit, ultrasound imaging on ISS, interplanetary transit, and lunar surface operations; and 3) Review preliminary data obtained in simulations of medical imaging in lunar surface operations.

  10. Stochastic risk estimation from medical x-ray diagnostic examinations, 3

    International Nuclear Information System (INIS)

    Hashizume, Tadashi; Maruyama, Takashi; Noda, Yutaka; Iwai, Kazuo; Fukuhisa, Kenjiro

    1981-01-01

    The genetically significant dose (GSD), per Caput mean bone marrow dose (CMD), leukemia significant dose (LSD) and malignancy significant dose (MSD) from medical diagnostic X-ray examinations in Japan were estimated based on a 1979 nationwide survey of randomly sampled hospitals and clinics. The population risk estimates were carried out using the resultant values of GSD, LSD and MSD. In the risk estimates, the significant factors, namely, the relative child expectancy, the leukemia significant factor and the malignancy significant factor, for patients were assumed to be same as those of general population. The risk factors used were 185 x 10 -6 rad -1 for genetic risk of all generations, 20 x 10 -6 rad -1 for fatal leukemia and 165 x 10 -6 rad -1 for fatal malignant diseases, respectively. The resultant annual population doses per person were 15 mrad (0.15 mGy) for GSD, 107 mrad (1.07 mGy) for CMD, 86 mrad (0.86 mGy) for LSD and 43 mrad (0.43 mGy) for MSD, respectively. The present data other than the MSD were compared with the data in 1960, 1969 and 1974. For example, the GSD of 1979 was approximately same as that of 1974, although the annual number of examinations in 1979 increased by about 30 percent as compared with those of 1974. The population risks from X-ray diagnosis were estimated to be 260 persons per year for genetic risk of all generations, 192 person per year for fatal leukemic risk and 825 person per year for malignant risk, respectively, for the whole population in Japan, assuming that the X-ray diagnosis in 1979 will be performed continuously in the future. The average risks per one exposure for X-ray radiography were estimated using the weighted average of the significant factor and the organ or tissue dose with the number of radiographic exposures by age and by type of examination. The average risks per radiographic exposure were 176 x 10 -9 for genetic risk, 285 x 10 -9 for leukemic risk and 1.75 x 10 -6 for malignant risk respectively. (author)

  11. Comparison of radiation exposure during transradial diagnostic coronary angiography with single- or multi-catheters approach.

    Science.gov (United States)

    Plourde, Guillaume; Abdelaal, Eltigani; MacHaalany, Jimmy; Rimac, Goran; Poirier, Yann; Arsenault, Jean; Costerousse, Olivier; Bertrand, Olivier F

    2017-08-01

    To compare radiation exposure during transradial diagnostic coronary angiography (DCA) using standard single- or multi-catheters with different shapes. Transradial DCA can be performed using single- or multi-catheters to canulate left and right coronary ostia. To date, it remains unknown whether there are differences in radiation exposure between the two strategies. From November 2012 to June 2014, 3,410 consecutive patients who underwent transradial DCA were recruited. Groups were based on the initial diagnostic catheter used and were dichotomized between single- and multi-catheters approach. All crossovers were excluded. The multi-catheters approach (Multi) group consisted of Judkins left and right catheters, whereas the single-catheter (Single) group included Amplatz, Barbeau, or Multipurpose catheters. Fluoroscopy time (FT) as a surrogate end-point for total radiation exposure and kerma-area product (KAP; patient radiation exposure) were collected as radiation exposure parameters. A single-catheter strategy was used in 439 patients, while 2,971 patients had a multi-catheters approach. There was no significant difference in FT between groups (2.86 ± 1.48 min for Multi vs. 2.87 ± 1.72 min for Single, P = 0.13). The multi-catheters approach was associated with a significant 15% reduction in KAP (3,599 ± 2,214 cGy · cm 2 vs. 3,073 ± 1,785 cGy · cm 2 , P approach. When pooling all patients, mean FT was 2.86 ± 1.51 min. Mean KAP was 3,141 ± 1,854 cGy · cm 2 . Reference levels in our institution in both groups were below international diagnostic reference levels. Overall both FT and KAP decreased by 15% and 19%, respectively, over the 2-year study period. Compared to a single-catheter approach, a multi-catheters approach with standard Judkins catheters for DCA significantly reduced patient radiation exposure. Whether single catheter designed for DCA by radial approach can further reduce radiation exposure compared to

  12. Micronucleus induction by repeated exposure of diagnostic X-ray on oral buccal mucosa

    International Nuclear Information System (INIS)

    Lohith Tejashvi, K.; Suchetha Kumari, N.; Shetty, Shishir Ram

    2012-01-01

    Radiography is the important diagnostic tools essential for diagnosis and planning of orthodontic treatment. X-ray is ionizing radiation which showed various effects include breaking the bond of biological molecules, inducing loss of ability of cell death, increases nuclear alterations. Micronuclei - x000D - (MN) are small chromatin bodies that appear in the cytoplasm by the - x000D - condensation of acrocentric chromosomal fragments or by whole chromosomes. This - x000D - is a sensitive indicator of genetic damage. - x000D - x000D - . To evaluate micronucleus induction by repeated exposure of diagnostic X-ray on human buccal cell. Methods: 25 patients who visiting to ABSMIDS, Department of Oral medicine and Radiology for dental checkup exposed to diagnostic X-ray more than 4 times have been selected for this study. The buccal cell for analysis was collected from the cheek mucosa by means of gentle scraping of epithelial using ice-cream sticks and placed in Buffer saline. This sample was smeared on glass slide and then fixed in methanol:glacial acetic acid (3:1). Air dried and stained with Giemsa for 15-25 minutes. Then 250 cells in each slides were analyzed under microscope and frequency of micronucleus was scored (n=4). Repeated X-ray exposed cells showed micronucleus (1.25%) and nuclear alteration (2.3%) compare to the control. Repeated X-ray exposure leads to induces detectable number of micronucleus and nuclear alterations. (author)

  13. Radiation exposure from medical imaging in patients with chronic and recurrent conditions.

    Science.gov (United States)

    Stein, Evan G; Haramati, Linda B; Bellin, Eran; Ashton, Lori; Mitsopoulos, Gus; Schoenfeld, Alan; Amis, E Stephen

    2010-05-01

    Advances in medical imaging have been associated with increased utilization and increased radiation exposure, especially for patients with chronic and recurrent conditions. The authors estimated the cumulative radiation doses from medical imaging for specific cohorts with chronic and recurrent conditions. All patients diagnosed with hydrocephalus (n = 1,711), pulmonary thromboembolic disease (n = 3,220), renal colic (n = 5,855), and cardiac disease (n = 11,072) from January 1, 2000, to December 31, 2005, were retrospectively identified. Each imaging examination that used ionizing radiation from 2000 to 2008 was incorporated into an estimate of total effective dose and organ-specific doses. Patients with high levels of radiation exposure after 3 years (total effective dose > 50 mSv; dose to the ocular lens > 150 mSv) were identified. The mean estimated effective doses for the surviving diagnostic cohorts after 3 years were 12.3 mSv for patients with hydrocephalus, 21.7 mSv for those with pulmonary thromboembolic disease, 18.7 mSv for those with renal colic, and 14.0 mSv for those with cardiac disease. Among patients with hydrocephalus, 26.3% (339 of 1,291) had radiation doses > 150 mSv to the ocular lens within 3 years. In all cohorts, the proportion of patients with total effective doses > 50 mSv within 3 years was significantly higher for those diagnosed in 2004 and 2005 than for those diagnosed in 2000 and 2001. Patients with hydrocephalus, pulmonary thromboembolic disease, renal colic, and cardiac disease received radiation exposures that may put them at increased risk for cancer. Moreover, the proportion who received estimated total effective doses > 50 mSv within 3 years was significantly higher for those diagnosed most recently. It is the responsibility of institutions and physicians to critically evaluate their infrastructures, diagnostic strategies, and imaging techniques for each individual patient, with an eye toward minimizing cumulative medical

  14. Effects of job stress on hypertension among medical diagnostic X-ray workers in China

    International Nuclear Information System (INIS)

    Zhao Zhigang; Wang Jixian; Zhao Yongcheng; Zhang Wei

    2004-01-01

    Objective: To study the relation between job stress and hypertension among medical diagnostic x-ray workers in China. Methods: A total of 264 confirmed cases of hypertension were selected among medical diagnostic X-ray workers from 10 provinces and cities. A case-control study with 1:2 matched pair was conducted. Job stress was defined according to Siegrist effort-reward imbalance model. Results: High imbalance ,high overcommitment and severe work environment were associated with enhanced hypertension risk significantly. The OR was 1.848 (P=0.018), 2.058 (P=0.000) and 1.797 (P=0.008) for imbalance, overcommitment and severe work environment, respectively. After controlling other risk factors, the relation still remained significant. Conclusion: The main work-related risk factors causing hypertension among diagnostic X-ray workers are effort-reward imbalance, overcommitment and severe work environment. (authors)

  15. Predictive Modeling of Student Performances for Retention and Academic Support in a Diagnostic Medical Sonography Program

    Science.gov (United States)

    Borghese, Peter; Lacey, Sandi

    2014-01-01

    As part of a retention and academic support program, data was collected to develop a predictive model of student performances in core classes in a Diagnostic Medical Sonography (DMS) program. The research goal was to identify students likely to have difficulty with coursework and provide supplemental tutorial support. The focus was on the…

  16. Value of multi-criteria decision analysis in early assessment of medical diagnostic devices

    NARCIS (Netherlands)

    IJzerman, Maarten Joost; Hummel, J. Marjan

    2010-01-01

    OBJECTIVES: Multicriteria decision analytic (MCDA) techniques are a powerful tool in evaluating health care interventions where multiple, often competing, factors need to be considered. The analytic hierarchy process (AHP) is one such technique. We have applied AHP to evaluate medical diagnostic

  17. Crossing the Great Divide: Adoption of New Technologies, Therapeutics and Diagnostics at Academic Medical Centers

    Science.gov (United States)

    DeMonaco, Harold J.; Koski, Greg

    2007-01-01

    The role of new technology in healthcare continues to expand from both the clinical and financial perspectives. Despite the importance of innovation, most academic medical centers do not have a clearly defined process for technology assessment. Recognizing the importance of new drugs, diagnostics and procedures in the care of patients and in the…

  18. Order no. 286 on X-ray diagnostic equipment for medical use

    International Nuclear Information System (INIS)

    1988-05-01

    This Order amends the provisions on occupational radiation protection of the Order of 1977 on X-ray diagnostic equipment for medical use. The amendments concern X-ray examinations of women of childbearing age. In particular, it is provided that in case of pregnancy, alternate methods to X-ray examinations must be applied [fr

  19. Search of medical literature for indoor carbon monoxide exposure

    Energy Technology Data Exchange (ETDEWEB)

    Brennan, T.; Ivanovich, M.

    1995-12-01

    This report documents a literature search on carbon monoxide. The search was limited to the medical and toxicological databases at the National Library of Medicine (MEDLARS). The databases searched were Medline, Toxline and TOXNET. Searches were performed using a variety of strategies. Combinations of the following keywords were used: carbon, monoxide, accidental, residential, occult, diagnosis, misdiagnosis, heating, furnace, and indoor. The literature was searched from 1966 to the present. Over 1000 references were identified and summarized using the following abbreviations: The major findings of the search are: (1) Acute and subacute carbon monoxide exposures result in a large number of symptoms affecting the brain, kidneys, respiratory system, retina, and motor functions. (2) Acute and subacute carbon monoxide (CO) poisonings have been misdiagnosed on many occasions. (3) Very few systematic investigations have been made into the frequency and consequences of carbon monoxide poisonings.

  20. On-line integration of computer controlled diagnostic devices and medical information systems in undergraduate medical physics education for physicians.

    Science.gov (United States)

    Hanus, Josef; Nosek, Tomas; Zahora, Jiri; Bezrouk, Ales; Masin, Vladimir

    2013-01-01

    We designed and evaluated an innovative computer-aided-learning environment based on the on-line integration of computer controlled medical diagnostic devices and a medical information system for use in the preclinical medical physics education of medical students. Our learning system simulates the actual clinical environment in a hospital or primary care unit. It uses a commercial medical information system for on-line storage and processing of clinical type data acquired during physics laboratory classes. Every student adopts two roles, the role of 'patient' and the role of 'physician'. As a 'physician' the student operates the medical devices to clinically assess 'patient' colleagues and records all results in an electronic 'patient' record. We also introduced an innovative approach to the use of supportive education materials, based on the methods of adaptive e-learning. A survey of student feedback is included and statistically evaluated. The results from the student feedback confirm the positive response of the latter to this novel implementation of medical physics and informatics in preclinical education. This approach not only significantly improves learning of medical physics and informatics skills but has the added advantage that it facilitates students' transition from preclinical to clinical subjects. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  1. 75 FR 8375 - Device Improvements to Reduce Unnecessary Radiation Exposure From Medical Imaging; Public Meeting...

    Science.gov (United States)

    2010-02-24

    ...] Device Improvements to Reduce Unnecessary Radiation Exposure From Medical Imaging; Public Meeting... Improvements to Reduce Unnecessary Radiation Exposure From Medical Imaging.'' The purpose of this meeting is to... radiation from these medical imaging modalities. The deadline for submitting comments related to this public...

  2. Exposure of medical personnel to radiation during radionuclide therapy practices.

    Science.gov (United States)

    Lancelot, Sophie; Guillet, Benjamin; Sigrist, Sophie; Bourrelly, Marc; Waultier, Serge; Mundler, Oliver; Pisano, Pascale

    2008-04-01

    Radioisotopes that emit beta radiation are used for the treatment of hepatocellular carcinoma, of arthritic patients (radiosynovectomy) and treatment of bone metastases with, respectively, I-labelled lipiodol, colloidal citrate of Y or and Sm-labelled EDTMP. Radiation energy of these radioisotopes that emit beta or beta and gamma radiation (from 300 to 2000 keV) leads to an increase in radiation dose received by nuclear medicine staff. In this paper we focused on clinical and laboratory staff exposure during these types of metabolic radiation therapies. Cylindrical LiF thermoluminescence dosimeters were used to measure radiation-related whole-body doses (WBDs) and finger doses of the clinical staff. Exposure of the two radiopharmacists and three nurses taking part in I-labelled lipiodol, Y-colloid and Sm-EDTMP therapies, for 12 months in succession, were 146 microSv and 750 microSv, respectively, considering WBD, and 14.6 mSv and 6.5 mSv, respectively, considering finger doses. Extrapolated annual exposures (six radiosynovectomies per year) for the rheumatologists were estimated to be 21 microSv (WBD) and 13.2 mSv (finger dose). Extrapolated annual WBDs and finger doses (25 I-labelled lipiodol treatments per year) for radiologists were estimated to 165 microSv and 3.8 microSv, respectively. Fortunately, these doses were always lower than the limits reported in the European Directive EURATOM 96/29 05/13/1996 (WBD medical staff involved in all these clinical practices justifies dosimetry studies to validate protocols and radiation protection devices for each institution.

  3. Application of visually based, computerised diagnostic decision support system in dermatological medical education: a pilot study.

    Science.gov (United States)

    Chou, Wan-Yi; Tien, Peng-Tai; Lin, Fang-Yu; Chiu, Pin-Chi

    2017-05-01

    Medical education has shifted from memory-based practice to evidence-based decisions. The question arises: how can we ensure that all students get correct and systematic information? Visually based, computerised diagnostic decision support system (VCDDSS, VisualDx) may just fit our needs. A pilot study was conducted to investigate its role in medical education and clinical practice. This was a prospective study, including one consultant dermatologist, 51 medical students and 13 dermatology residents, conducted in the dermatology teaching clinic at China Medical University Hospital from 30 December 2014 to 21 April 2015. Clinical diagnoses of 13 patients were made before and after using VCDDSS. Questionnaires were filled out at the end. The consultant dermatologist's diagnosis was defined as the standard answer; the Sign test was used to analyse diagnostic accuracy and the Fisher exact test to analyse questionnaires. There was an 18.75% increase in diagnostic accuracy after use of VCDDSS (62.5-81.25%; p value system in clinical practice, medical education, residency training, and patient education in the future. Further large-scale studies should be planned to confirm its application. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Effect of medical x-ray exposure on subsequent reproductive outcomes in scoliosis patients

    International Nuclear Information System (INIS)

    Visscher, W.A.

    1987-01-01

    A retrospective cohort study was done which was designed to assess the effects of medical x-ray exposure on cancer incidence among scoliosis patients. Although the primary purpose of the study was to assess cancer incidence, a secondary goal was to investigate whether diagnostic x-ray exposure is related to adverse reproductive events in the female subjects. A series of case-control analyses were done which were designed to assess these effects. Radiation exposure was measured both by total films received and by an estimate of the number of films received and by an estimate of the number of films which involved ovarian irradiation. Radiation appeared to increase a woman's risk of any adverse event in the overall analysis and her risk of a premature or low birth weight infant in the separate analyses. Radiation did not appear to be related to spontaneous abortion, complications of pregnancy or delivery or birth defects, although the results of the pregnancy complications analysis was suggestive

  5. Quantifying Medical Student Education and Exposure to Otolaryngology.

    Science.gov (United States)

    Wong, Kevin; Jang, Minyoung; Gilad, Amir; Levi, Jessica R

    2017-06-01

    Evaluate the educational and exposure opportunities provided to students by national otolaryngology organizations. Twenty-four otolaryngology organizations and subspecialty societies were reviewed for medical student involvement opportunities, educational and enrichment opportunities, costs of involvement, and available research and travel scholarships. Nine organizations (37.5%) offered membership; 6 charged a membership fee, averaging $73 ± $30 (mean ± SD). Membership was limited to associate status for 7 organizations (77.8%; 7/9). Three organizations (12.5%) provided service opportunities, 4 (16.7%) allowed students to vote, and 1 (4.2%) allowed students to endorse others for membership. Most organizations allowed students to attend conferences (95.8%), and 19 (79.2%) allowed students to present research. Twenty-one (87.5%) organizations charged a conference registration fee ($366 ± $300). Seven organizations (29.2%) offered research scholarships, and 5 (20.8%) offered travel awards. Opportunities exist for medical students to attend conferences and present research; however, educational and enrichment activities in other areas were limited. Future efforts may be warranted to increase the number and type of opportunities for students.

  6. Impact of precision of Bayesian networks parameters on accuracy of medical diagnostic systems

    Science.gov (United States)

    Oniśko, Agnieszka; Druzdzel, Marek J.

    2014-01-01

    Objective One of the hardest technical tasks in employing Bayesian network models in practice is obtaining their numerical parameters. In the light of this difficulty, a pressing question, one that has immediate implications on the knowledge engineering effort, is whether precision of these parameters is important. In this paper, we address experimentally the question whether medical diagnostic systems based on Bayesian networks are sensitive to precision of their parameters. Methods and Materials The test networks include Hepar II, a sizeable Bayesian network model for diagnosis of liver disorders and six other medical diagnostic networks constructed from medical data sets available through the Irvine Machine Learning Repository. Assuming that the original model parameters are perfectly accurate, we lower systematically their precision by rounding them to progressively courser scales and check the impact of this rounding on the models' accuracy. Results Our main result, consistent across all tested networks, is that imprecision in numerical parameters has minimal impact on the diagnostic accuracy of models, as long as we avoid zeroes among parameters. Conclusion The experiments' results provide evidence that as long as we avoid zeroes among model parameters, diagnostic accuracy of Bayesian network models does not suffer from decreased precision of their parameters. PMID:23466438

  7. The diagnostic accuracy of three rapid diagnostic tests for typhoid fever at Chittagong Medical College Hospital, Chittagong, Bangladesh.

    Science.gov (United States)

    Maude, Rapeephan R; de Jong, Hanna K; Wijedoru, Lalith; Fukushima, Masako; Ghose, Aniruddha; Samad, Rasheda; Hossain, Mohammed Amir; Karim, Mohammed Rezaul; Faiz, Mohammed Abul; Parry, Christopher M

    2015-10-01

    To determine the diagnostic accuracy of three rapid diagnostic tests (RDTs) for typhoid fever in febrile hospitalised patients in Bangladesh. Febrile adults and children admitted to Chittagong Medical College Hospital, Bangladesh, were investigated with Bact/Alert(®) blood cultures and real-time PCR to detect Salmonella enterica Typhi and Paratyphi A and assays for Rickettsia, leptospirosis and dengue fever. Acute serum samples were examined with the LifeAssay (LA) Test-it™ Typhoid IgM lateral flow assay detecting IgM antibodies against S. Typhi O antigen, CTKBiotech Onsite Typhoid IgG/IgM Combo Rapid-test cassette lateral flow assay detecting IgG and IgM antibodies against S. Typhi O and H antigens and SD Bioline line assay for IgG and IgM antibodies against S. Typhi proteins. In 300 malaria smear-negative febrile patients [median (IQR) age of 13.5 (5-31) years], 34 (11.3%) had confirmed typhoid fever: 19 positive by blood culture for S. Typhi (three blood PCR positive) and 15 blood culture negative but PCR positive for S. Typhi in blood. The respective sensitivity and specificity of the three RDTs in patients using a composite reference standard of blood culture and/or PCR-confirmed typhoid fever were 59% and 61% for LifeAssay, 59% and 74% for the CTK IgM and/or IgG, and 24% and 96% for the SD Bioline RDT IgM and/or IgG. The LifeAssay RDT had a sensitivity of 63% and a specificity of 91% when modified with a positive cut-off of ≥2+ and analysed using a Bayesian latent class model. These typhoid RDTs demonstrated moderate diagnostic accuracies, and better tests are needed. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  8. Biomedical visual data analysis to build an intelligent diagnostic decision support system in medical genetics.

    Science.gov (United States)

    Kuru, Kaya; Niranjan, Mahesan; Tunca, Yusuf; Osvank, Erhan; Azim, Tayyaba

    2014-10-01

    In general, medical geneticists aim to pre-diagnose underlying syndromes based on facial features before performing cytological or molecular analyses where a genotype-phenotype interrelation is possible. However, determining correct genotype-phenotype interrelationships among many syndromes is tedious and labor-intensive, especially for extremely rare syndromes. Thus, a computer-aided system for pre-diagnosis can facilitate effective and efficient decision support, particularly when few similar cases are available, or in remote rural districts where diagnostic knowledge of syndromes is not readily available. The proposed methodology, visual diagnostic decision support system (visual diagnostic DSS), employs machine learning (ML) algorithms and digital image processing techniques in a hybrid approach for automated diagnosis in medical genetics. This approach uses facial features in reference images of disorders to identify visual genotype-phenotype interrelationships. Our statistical method describes facial image data as principal component features and diagnoses syndromes using these features. The proposed system was trained using a real dataset of previously published face images of subjects with syndromes, which provided accurate diagnostic information. The method was tested using a leave-one-out cross-validation scheme with 15 different syndromes, each of comprised 5-9 cases, i.e., 92 cases in total. An accuracy rate of 83% was achieved using this automated diagnosis technique, which was statistically significant (p<0.01). Furthermore, the sensitivity and specificity values were 0.857 and 0.870, respectively. Our results show that the accurate classification of syndromes is feasible using ML techniques. Thus, a large number of syndromes with characteristic facial anomaly patterns could be diagnosed with similar diagnostic DSSs to that described in the present study, i.e., visual diagnostic DSS, thereby demonstrating the benefits of using hybrid image processing

  9. Using simulation to identify sources of medical diagnostic error in child physical abuse.

    Science.gov (United States)

    Anderst, James; Nielsen-Parker, Monica; Moffatt, Mary; Frazier, Terra; Kennedy, Chris

    2016-02-01

    Little is known regarding sources of diagnostic error at the provider level in cases of possible child physical abuse. This study examines medical diagnosis as part of medical management and not as part of legal investigation. Simulation offers the opportunity to evaluate diagnostic accuracy and identify error sources. We aimed to identify sources of medical diagnostic error in cases of possible abuse by assessing diagnostic accuracy, identifying gaps in evaluation, and characterizing information used by medical providers to reach their diagnoses. Eight femur fracture simulation cases, half of which were abuse and half accident, were created. Providers from a tertiary pediatric emergency department participated in a simulation exercise involving 1 of the 8 cases. Performance was evaluated using structured scoring tools and debriefing, and qualitative analysis characterized participants' rationales for their diagnoses. Overall, 39% of the 43 participants made an incorrect diagnosis regarding abuse. An incorrect diagnosis was over 8 times more likely to occur in accident than in abuse cases (OR=8.8; 95% CI 2 to 39). Only 58% of participants correctly identified the fracture morphology, 60% correctly identified the mechanics necessary to generate the morphology, and 30% of ordered all appropriate tests for occult injury. In misdiagnoses, participants frequently falsely believed the injury did not match the proposed mechanism and the history provided by the caregiver had changed. Education programs targeting the identified error sources may result in fewer diagnostic errors and improve outcomes. The findings also support the need for referral to child abuse experts in many cases. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Diagnostics

    DEFF Research Database (Denmark)

    Donné, A.J.H.; Costley, A.E.; Barnsley, R.

    2007-01-01

    In order to support the operation of ITER and the planned experimental programme an extensive set of plasma and first wall measurements will be required. The number and type of required measurements will be similar to those made on the present-day large tokamaks while the specification...... of the measurements—time and spatial resolutions, etc—will in some cases be more stringent. Many of the measurements will be used in the real time control of the plasma driving a requirement for very high reliability in the systems (diagnostics) that provide the measurements. The implementation of diagnostic systems......&D is needed to prepare the systems. In some cases the environmental difficulties are so severe that new diagnostic techniques are required. The starting point in the development of diagnostics for ITER is to define the measurement requirements and develop their justification. It is necessary to include all...

  11. Justification of Individual Medical Exposures for Diagnosis: A HERCA Position Paper

    International Nuclear Information System (INIS)

    2014-01-01

    Improving the application of the justification principle in medical imaging is the responsibility of many stakeholders. This document is intended to provide clarity on the regulator's approach to the roles and responsibilities of the undertaking as well as a range of professionals involved in medical exposures. In doing so it considers the requirements of the new European Basic Safety Standards (BSS) Directive 2013/59/Euratom and discusses a number of emerging challenges associated with efficient, effective and rapidly changing health care systems. In summary, - the justification process should be completed prior to the exposure taking place and include consideration of the following: - adequate information regarding the clinical condition(s) of the patient, relevant to the imaging request -this must be available including known possible contraindications (e.g. pregnancy, breast feeding) - the diagnostic question(s) to be addressed - where practicable, information, with regard to possible previous/concurrent examinations - the decision on the appropriate imaging procedure including the option of one that does not involve ionising radiation - traceability of the above to the referrer and practitioner, - the role of the regulator is to provide, through regulations and associated guidance, a clear and unambiguous regulatory framework including requirements for the justification process and accountability within local procedures - these will be subject to inspection, - the role of the undertaking and the professionals involved is to demonstrate compliance with regulations through procedures and documentation associated with each individual exposure, showing beyond reasonable doubt that the elements of the justification process have been completed, and by whom, in accordance with the responsibilities laid down in procedures

  12. [Methodical features of the molding of diagnostic competences in medical parasitology workers].

    Science.gov (United States)

    Dovgalev, A S; Astanina, S Iu; Avdiukhina, T I; Serdiuk, A P; Imamkuliev, K D

    2015-01-01

    The paper provides a rationale for a procedure to mold diagnostic competences in medical workers of the laboratories of therapeutic-and-prophylactic institutions and hygiene and epidemiology centers, Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare. The methodical features of molding diagnostic competences in the above contingents are the design and organization of an educational process by applying systems integration and competence-based approaches; increased active self-directed learning of audience; a procedure to organize its unsupervised extracurricular activities. Professional habits and skills in laboratory specialists should be molded on the basis of didactic principles and in compliance with the found methodical patterns. The eventual result (molded competences) and its compliance with the practical health care requirements is assessed using all control types (incoming, running, intermediate, and ultimate ones). This ensures the stability and predictability of molding diagnostic competences in parasitology specialists.

  13. Diagnostic error in children presenting with acute medical illness to a community hospital.

    Science.gov (United States)

    Warrick, Catherine; Patel, Poonam; Hyer, Warren; Neale, Graham; Sevdalis, Nick; Inwald, David

    2014-10-01

    To determine incidence and aetiology of diagnostic errors in children presenting with acute medical illness to a community hospital. A three-stage study was conducted. Stage 1: retrospective case note review, comparing admission to discharge diagnoses of children admitted to hospital, to determine incidence of diagnostic error. Stage 2: cases of suspected misdiagnosis were examined in detail by two reviewers. Stage 3: structured interviews were conducted with clinicians involved in these cases to identify contributory factors. UK community (District General) hospital. All medical patients admitted to the paediatric ward and patients transferred from the Emergency Department to a different facility over a 90-day period were included. Incidence of diagnostic error, type of diagnostic error and content analysis of the structured interviews to determine frequency of emerging themes. Incidence of misdiagnosis in children presenting with acute illness was 5.0% (19/378, 95% confidence interval (CI) 2.8-7.2%). Diagnostic errors were multi-factorial in origin, commonly involving cognitive factors. Reviewers 1 and 2 identified a median of three and four errors per case, respectively. In 14 cases, structured interviews were possible; clinicians believed system-related errors (organizational flaws, e.g. inadequate policies, staffing or equipment) contributed more commonly to misdiagnoses, whereas reviewers found cognitive factors contributed more commonly to diagnostic error. Misdiagnoses occurred in 5% of children presenting with acute illness and were multi-factorial in aetiology. Multi-site longitudinal studies further exploring aetiology of errors and effect of educational interventions are required to generalize these findings and determine strategies for mitigation. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  14. Principles and applications of polymerase chain reaction in medical diagnostic fields: a review.

    Science.gov (United States)

    Valones, Marcela Agne Alves; Guimarães, Rafael Lima; Brandão, Lucas André Cavalcanti; de Souza, Paulo Roberto Eleutério; de Albuquerque Tavares Carvalho, Alessandra; Crovela, Sergio

    2009-01-01

    Recent developments in molecular methods have revolutionized the detection and characterization of microorganisms in a broad range of medical diagnostic fields, including virology, mycology, parasitology, microbiology and dentistry. Among these methods, Polymerase Chain Reaction (PCR) has generated great benefits and allowed scientific advancements. PCR is an excellent technique for the rapid detection of pathogens, including those difficult to culture. Along with conventional PCR techniques, Real-Time PCR has emerged as a technological innovation and is playing an ever-increasing role in clinical diagnostics and research laboratories. Due to its capacity to generate both qualitative and quantitative results, Real-Time PCR is considered a fast and accurate platform. The aim of the present literature review is to explore the clinical usefulness and potential of both conventional PCR and Real-Time PCR assays in diverse medical fields, addressing its main uses and advances.

  15. Radiation protection in medical diagnostic radiology in the city of Sobral, Brazil

    International Nuclear Information System (INIS)

    Menezes, F.L.; Paschoal, C.M.M.; Ferreira, F.C.L.; Alcantara, M.C.

    2015-01-01

    The objective of this study was to evaluate the suitability to radiation protection of four diagnostic radiology medical services in the city of Sobral-CE, Northeast of Brazil, and to analyze results of the literature for the cities of Rio Branco-AC, North of Brazil, and Rio de Janeiro-RJ, South-east of Brazil. In Sobral-CE, it was performed interviews and direct observations with reference to Brazilian law, the National Ordinance No.453/1998 of the Ministry of Health that regulates the operation of medical and odontological diagnostic radiology services. The results show the occurrence of many items in disagreement with the standard. The technical and operational infractions have basically due to unfamiliarity with the legislation, the lack of investment in training and/or professional development courses. (authors)

  16. [Regulations governing the training of diagnostic imaging residents: the residents' statute and the medical specialties law].

    Science.gov (United States)

    Morales Santos, A; del Cura Rodríguez, J L; Vieito Fuentes, X

    2010-01-01

    The current system for training medical specialists in Spain originated in 1963, and diagnostic radiology was one of the first specialties recognized. There are currently three types of regulations that govern the training of specialists: a) professional, The Health Professions Law; b) labor: The Residents' Statute; and c) educational, The New Medical Specialties Law and the Diagnostic Imaging Program This system consists of an exclusive contract with the training organization, a unified system of access, and a training program in accredited units that includes tutoring, evaluation, and progressive assignment of responsibilities. Residents have a right to be trained and evaluated, to participate in the teaching unit, and to their labor rights. In exchange, they must complete the tasks assigned in the program and abide by the institution's rules. Residents must be supervised directly in the first year and thereafter they should be given progressively more responsibility. Copyright 2009 SERAM. Published by Elsevier Espana. All rights reserved.

  17. MO-F-204-00: Preparing for the ABR Diagnostic and Nuclear Medical Physics Exams

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of all aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear

  18. [The challenges of standardization in clinical diagnostic laboratories of medical organizations].

    Science.gov (United States)

    Men'shikov, V V

    2013-04-01

    The generalized data concerning the conditions of application of regulations of national standards in clinical diagnostic laboratories of medical organizations is presented. The primary information was provided by 14 regions of 6 federal administrative okrugs of Russia. The causes of challenges of application of requirements of standards are presented. They are mostly related with insufficient financial support, lacking of manpower, difficulties with reagents supply, inadequate technical maintenance of devices and absence of support of administration of medical organizations. The recommendations are formulated concerning the necessity of publishing the document of Minzdrav of Russia to determine the need in application of standards in laboratory practice.

  19. MO-F-204-00: Preparing for the ABR Diagnostic and Nuclear Medical Physics Exams

    International Nuclear Information System (INIS)

    2016-01-01

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of all aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear

  20. Virtual reality aided visualization of fluid flow simulations with application in medical education and diagnostics.

    Science.gov (United States)

    Djukic, Tijana; Mandic, Vesna; Filipovic, Nenad

    2013-12-01

    Medical education, training and preoperative diagnostics can be drastically improved with advanced technologies, such as virtual reality. The method proposed in this paper enables medical doctors and students to visualize and manipulate three-dimensional models created from CT or MRI scans, and also to analyze the results of fluid flow simulations. Simulation of fluid flow using the finite element method is performed, in order to compute the shear stress on the artery walls. The simulation of motion through the artery is also enabled. The virtual reality system proposed here could shorten the length of training programs and make the education process more effective. © 2013 Published by Elsevier Ltd.

  1. Diagnostic screening of paroxysmal nocturnal hemoglobinuria: Prospective multicentric evaluation of the current medical indications.

    Science.gov (United States)

    Morado, Marta; Freire Sandes, Alex; Colado, Enrique; Subirá, Dolores; Isusi, Paloma; Soledad Noya, María; Belén Vidriales, María; Sempere, Amparo; Ángel Díaz, José; Minguela, Alfredo; Álvarez, Beatriz; Serrano, Cristina; Caballero, Teresa; Rey, Mercedes; Pérez Corral, Ana; Cristina Fernández Jiménez, María; Magro, Elena; Lemes, Angelina; Benavente, Celina; Bañas, Helena; Merino, Juana; Castejon, Celine; Gutierrez, Olivier; Rabasa, Pilar; Vescosi Gonçalves, Matheus; Perez-Andres, Martin; Orfao, Alberto

    2017-09-01

    Although consensus guidelines have been proposed in 2010 for the diagnostic screening of paroxysmal nocturnal hemoglobinuria (PNH) by flow cytometry (FCM), so far no study has investigated the efficiency of such medical indications in multicentric vs. reference laboratory settings. Here we evaluate the efficiency of consensus medical indications for PNH testing in 3,938 peripheral blood samples submitted to FCM testing in 24 laboratories in Spain and one reference center in Brazil. Overall, diagnostic screening based on consensus medical indications was highly efficient (14% of PNH + samples) both in the multicenter setting in Spain (10%) and the reference laboratory in Brazil (16%). The highest frequency of PNH + cases was observed among patients screened because of bone marrow (BM) failure syndrome (33%), particularly among those with aplastic anemia (AA; 45%) and to a less extent also a myelodysplastic syndrome (MDS; 10%). Among the other individuals studied, the most efficient medical indications for PNH screening included: hemolytic anemia (19%), hemoglobinuria (48%) and unexplained cytopenias (9%). In contrast, only a minor fraction of the patients who had been submitted for PNH testing because of unexplained thrombosis in the absence of cytopenia, were positive (0.4%). In summary, our results demonstrate that the current medical indications for PNH screening by FCM are highly efficient, although improved screening algorithms are needed for patients presenting with thrombosis and normal blood cell counts. © 2016 International Clinical Cytometry Society. © 2016 International Clinical Cytometry Society.

  2. Definitions and outlook targeting x-ray exposure of patients in diagnostic imaging

    Science.gov (United States)

    Regulla, Dieter F.

    2011-03-01

    Computer tomography (CT) is vital and currently irreplaceable in diagnostic radiology. But CT operates with ionizing radiation which may cause cancer or non-cancer diseases in humans. The degree of radiation impact depends on the dose administered by an investigation. And this is the core issue: Even CT exams executed lege artis, administer doses to patients which by magnitude are far beyond the level of hitherto known doses of conventional film-screen techniques. Patients undergoing one or multiple CT examinations, digital angiographies or interventions will be exposed to effective doses between roughly several mSv and several 100 mSv depending on type and frequency of the diagnostic investigations. From the radiation protection point of view, there is therefore the worldwide problem of formulating firm rules for the control of these high-dose investigations, as dose limits can not be established for reasons of the medical benefit. This makes the difference compared with radiation protection for occupationally exposed persons. What remains is "software", namely "justification" and "optimization". Justification requires balancing the interests between the health benefit and the potential harm of an exam which has to be responsibly executed by the physician himself; therefore the radiologists' associations are in the duty to prepare practicable rules for justification. Optimization again needs a cooperative solution, and that is the establishment of reference doses for diagnostic examinations, to be checked by the technical service of the producers' companies. Experts and authorities have been aware of the high-dose dilemma in diagnostic imaging since long. It is time for the reflection of active solutions and their implementation into practice.

  3. The quest for 'diagnostically lossless' medical image compression: a comparative study of objective quality metrics for compressed medical images

    Science.gov (United States)

    Kowalik-Urbaniak, Ilona; Brunet, Dominique; Wang, Jiheng; Koff, David; Smolarski-Koff, Nadine; Vrscay, Edward R.; Wallace, Bill; Wang, Zhou

    2014-03-01

    Our study, involving a collaboration with radiologists (DK,NSK) as well as a leading international developer of medical imaging software (AGFA), is primarily concerned with improved methods of assessing the diagnostic quality of compressed medical images and the investigation of compression artifacts resulting from JPEG and JPEG2000. In this work, we compare the performances of the Structural Similarity quality measure (SSIM), MSE/PSNR, compression ratio CR and JPEG quality factor Q, based on experimental data collected in two experiments involving radiologists. An ROC and Kolmogorov-Smirnov analysis indicates that compression ratio is not always a good indicator of visual quality. Moreover, SSIM demonstrates the best performance, i.e., it provides the closest match to the radiologists' assessments. We also show that a weighted Youden index1 and curve tting method can provide SSIM and MSE thresholds for acceptable compression ratios.

  4. Transition in occupational radiation exposure monitoring methods in diagnostic and interventional radiology

    International Nuclear Information System (INIS)

    Loennroth, N.; Hirvonen-Kari, M.; Timonen, M.; Savolainen, S.; Kortesniemi, M.

    2008-01-01

    Radiation exposure monitoring is a traditional keystone of occupational radiation safety measures in medical imaging. The aim of this study was to review the data on occupational exposures in a large central university hospital radiology organisation and propose changes in the radiation worker categories and methods of exposure monitoring. An additional objective was to evaluate the development of electronic personal dosimeters and their potential in the digitised radiology environment. The personal equivalent dose of 267 radiation workers (116 radiologists and 151 radiographers) was monitored using personal dosimeters during the years 2006-2010. Accumulated exposure monitoring results exceeding the registration threshold were observed in the personal dosimeters of 73 workers (59 radiologists' doses ranged from 0.1 to 45.1 mSv; 14 radiographers' doses ranged from 0.1 to 1.3 mSv). The accumulated personal equivalent doses are generally very small, only a few angiography radiologists have doses >10 mSv per 5 y. The typical effective doses are -1 and the highest value was 0.3 mSv (single interventional radiologist). A revised categorisation of radiation workers based on the working profile of the radiologist and observed accumulated doses is justified. Occupational monitoring can be implemented mostly with group dosimeters. An active real-time dosimetry system is warranted to support radiation protection strategy where optimisation aspects, including improving working methods, are essential. (authors)

  5. Occupational exposure from external radiation used in medical practices in Pakistan by film badge dosimetry

    International Nuclear Information System (INIS)

    Jabeen, A.; Munir, M.; Khalil, A.; Masood, M.; Akhter, P.

    2010-01-01

    Occupational exposure data of workers due to external sources of radiation in various medical practices such as nuclear medicine (NM), radiotherapy and diagnostic radiology (DR) in Pakistan were collected and analysed. Whole-body doses of workers were measured by film badge dosimetry technique during 2003-2007. Annual average effective dose in NM, radio-therapy and DR varied in the range of 1.39-1.80, 1.05-1.45 and 1.22-1.71 mSv, respectively, during 2003-2007. These values are quite low and well below the annual limit of 20 mSv averaged over a period of 5 consecutive years. Nobody received the radiation dose >50 mSv in any single year over a period of 5 consecutive years; therefore, no overexposure case has been detected. Decreasing trend of annual average dose values in aforementioned categories of work during 2003-2007 indicates the improvement of radiation protection status in medical field in Pakistan. (authors)

  6. Moving beyond quality control in diagnostic radiology and the role of the clinically qualified medical physicist.

    Science.gov (United States)

    Delis, H; Christaki, K; Healy, B; Loreti, G; Poli, G L; Toroi, P; Meghzifene, A

    2017-09-01

    Quality control (QC), according to ISO definitions, represents the most basic level of quality. It is considered to be the snapshot of the performance or the characteristics of a product or service, in order to verify that it complies with the requirements. Although it is usually believed that "the role of medical physicists in Diagnostic Radiology is QC", this, not only limits the contribution of medical physicists, but is also no longer adequate to meet the needs of Diagnostic Radiology in terms of Quality. In order to assure quality practices more organized activities and efforts are required in the modern era of diagnostic radiology. The complete system of QC is just one element of a comprehensive quality assurance (QA) program that aims at ensuring that the requirements of quality of a product or service will consistently be fulfilled. A comprehensive Quality system, starts even before the procurement of any equipment, as the need analysis and the development of specifications are important components under the QA framework. Further expanding this framework of QA, a comprehensive Quality Management System can provide additional benefits to a Diagnostic Radiology service. Harmonized policies and procedures and elements such as mission statement or job descriptions can provide clarity and consistency in the services provided, enhancing the outcome and representing a solid platform for quality improvement. The International Atomic Energy Agency (IAEA) promotes this comprehensive quality approach in diagnostic imaging and especially supports the field of comprehensive clinical audits as a tool for quality improvement. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  7. Retrospective study of cumulative diagnostic radiation exposure during childhood in patients with spina bifida.

    Science.gov (United States)

    Smookler, Gregory; Deavenport-Saman, Alexis

    2015-10-01

    The Biological Effects of Ionizing Radiation Committee of the National Academy of Sciences in 2005 and other expert panels have warned that risk of cancer increases with higher doses of radiation. Children with spina bifida and hydrocephalus have far greater exposure to radiation than the average person, starting almost directly after birth and continuing throughout their lifetimes. The purpose of this study was to estimate the amount of ionizing radiation that patients with spina bifida and hydrocephalus are exposed to during childhood from diagnostic imaging. Thirty patients, ages 18 years or older, with spina bifida and hydrocephalus were randomly selected from a spina bifida clinic and their radiology records were reviewed. Descriptive analyses were conducted. The total radiation exposure was then calculated for the study group, and the mean effective dose per patient was determined. In the study group, during their first 18 years, each patient had a mean of 55.1 studies and a median of 45 radiologic studies, a mean of 9.6 brain CT scans, and a mean cumulative effective dose of 81.9 mSv (2.6 mSv/patient/year over 18 years) and a median cumulative effective dose of 77.2 mSV of accumulated radiation exposure (4.5 mSv/patient/year over 18 years). Clinicians should recognize that increased radiation exposure puts patients with spina bifida and hydrocephalus at higher risk for cancer. The population of children and adults with spina bifida and hydrocephalus should be surveyed for incidence of cancer. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Cultivating Medical Intentionality: The Phenomenology of Diagnostic Virtuosity in East Asian Medicine.

    Science.gov (United States)

    Kim, Taewoo

    2017-03-01

    This study examines the perceptual basis of diagnostic virtuosity in East Asian medicine, combining Merleau-Ponty's phenomenology and an ethnographic investigation of Korean medicine in South Korea. A novice, being exposed to numerous clinical transactions during apprenticeship, organizes perceptual experience that occurs between him or herself and patients. In the process, the fledgling practitioner's body begins to set up a medically-tinged "intentionality" interconnecting his or her consciousness and medically significant qualities in patients. Diagnostic virtuosity is gained when the practitioner embodies a cultivated medical intentionality. In the process of becoming a practitioner imbued with virtuosity, this study focuses on the East Asian notion of "Image" that maximizes the body's perceptual capacity, and minimizes possible reductions by linguistic re-presentation. "Image" enables the practitioner to somatically conceptualize the core notions of East Asian medicine, such as Yin-Yang, and to use them as an embodied litmus as the practitioner's cultivated body instinctively conjures up medical notions at clinical encounters. In line with anthropological critiques of reductionist frameworks that congeal human existential and perceptual vitality within a "scientific" explanatory model, this article attempts to provide an example of various knowing and caring practices, institutionalized external to the culture of science.

  9. Medical radiation exposure and its impact on occupational practices in Korean radiologic technologists

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Seul Ki; Lee, Won Jin [Dept. of Preventive Medicine, Korea University College of Medicine, Seoul (Korea, Republic of)

    2016-12-15

    The use of radiology examinations in medicine has been growing worldwide. Annually an estimated 3.1 billion radiologic exams are performed. According to this expansion of medical radiation exposure, it has been hard to pay no attention to the effects of medical radiation exposures in the exposure from different types of radiation source. This study, therefore, was aimed to assess the association of medical and occupational radiation exposure in Korean radiologic technologists and evaluate necessity for its consideration in occupational studies. This study did not show the strong association between medical radiation exposure and occupational radiation exposure except several modalities with specific frequency. These results are preliminary but certainly meaningful for interpretation of epidemiologic finding, therefore, we need further evaluation specially for the repeatedly exposed imaging tests and high dose procedures that presented somewhat weak relationship in this study linked with health outcomes of radiation exposure. This study did not show the strong association between medical radiation exposure and occupational radiation exposure except several modalities with specific frequency. These results are preliminary but certainly meaningful for interpretation of epidemiologic finding, therefore, we need further evaluation specially for the repeatedly exposed imaging tests and high dose procedures that presented somewhat weak relationship in this study linked with health outcomes of radiation exposure.

  10. Clinical Training of Medical Physicists Specializing in Diagnostic Radiology (French Edition)

    International Nuclear Information System (INIS)

    2012-01-01

    The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for diagnostic radiology. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists based in the clinical setting. However, an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement (RCA) for Research, Development and Training related to Nuclear Sciences for Asia and the Pacific. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia-Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specializing in diagnostic radiology started in 2007 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experiences of clinical training programmes in Australia and New Zealand, the UK and the USA, and was moderated by physicists working in the Asian region. This publication follows the approach of the IAEA publication Training Course Series No. 37, Clinical Training of Medical Physicists specializing in Radiation Oncology. This approach to clinical training has been successfully tested

  11. Clinical Training of Medical Physicists Specializing in Diagnostic Radiology (Spanish Edition)

    International Nuclear Information System (INIS)

    2013-01-01

    The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for diagnostic radiology. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists based in the clinical setting. However, an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement (RCA) for Research, Development and Training related to Nuclear Sciences for Asia and the Pacific. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia-Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specializing in diagnostic radiology started in 2007 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experiences of clinical training programmes in Australia and New Zealand, the UK and the USA, and was moderated by physicists working in the Asian region. This publication follows the approach of the IAEA publication Training Course Series No. 37, Clinical Training of Medical Physicists specializing in Radiation Oncology. This approach to clinical training has been successfully tested

  12. [Diagnostic medical error as an overinterpretation of toxicology screening combined with inadequate clinical assessment].

    Science.gov (United States)

    Kłys, Małgorzata; Kowalski, Piotr

    2011-01-01

    Problems of patient safety within the system of health care are defined by prescriptive and ethical regulations; a breach of such regulations is associated with entering a complex category of situations covered by the term "medical error" or "appropriateness of medical management". In order to minimize the sources of diagnostic errors, with the knowledge on such errors largely originating from medico-legal practice, numerous initiatives emerge, according to which monitoring of adverse events and subjecting such events to a profound discussion is the most important element of prevention. The problem discussed in the paper is illustrated by the case of a 13-year old boy, in whom opioid poisoning was mistakenly diagnosed instead of a neurological condition in consequence of the physician disregarding significant symptoms of the disease and accepting his subjective suspicion of poisoning. The erroneous diagnosis was further compounded by lack of verification of the preliminary diagnosis and failure to perform further laboratory diagnostic management addressing the neurological status of the patient. The presented case supports data from publications found in the literature on the subject that describe a high risk of diagnostics errors in neurological conditions; such errors are often committed by emergency physicians other than neurologists.

  13. The Changing Landscape of Molecular Diagnostic Testing: Implications for Academic Medical Centers

    Directory of Open Access Journals (Sweden)

    Heidi L. Rehm

    2016-01-01

    Full Text Available Over the last decade, the field of molecular diagnostics has undergone tremendous transformation, catalyzed by the clinical implementation of next generation sequencing (NGS. As technical capabilities are enhanced and current limitations are addressed, NGS is increasingly capable of detecting most variant types and will therefore continue to consolidate and simplify diagnostic testing. It is likely that genome sequencing will eventually serve as a universal first line test for disorders with a suspected genetic origin. Academic Medical Centers (AMCs, which have been at the forefront of this paradigm shift are now presented with challenges to keep up with increasing technical, bioinformatic and interpretive complexity of NGS-based tests in a highly competitive market. Additional complexity may arise from altered regulatory oversight, also triggered by the unprecedented scope of NGS-based testing, which requires new approaches. However, these challenges are balanced by unique opportunities, particularly at the interface between clinical and research operations, where AMCs can capitalize on access to cutting edge research environments and establish collaborations to facilitate rapid diagnostic innovation. This article reviews present and future challenges and opportunities for AMC associated molecular diagnostic laboratories from the perspective of the Partners HealthCare Laboratory for Molecular Medicine (LMM.

  14. Radiation Exposure from Diagnostic Imaging in a Cohort of Pediatric Transplant Recipients.

    Directory of Open Access Journals (Sweden)

    Alexandra Seal

    Full Text Available Recipients of solid organ transplants (SOT have extensive diagnostic imaging (DI. The purpose of this study was to quantify this exposure. Children from northern Alberta with SOTs at Stollery Children's Hospital, Edmonton, Alberta January 1, 2006, to July 31, 2012, were included. Effective doses of radiation were estimated using published norms for DI performed post-transplant up to October 16, 2014. The 54 eligible children had 6215 DI studies (5628 plain films, 293 computerized tomography (CT scans, 149 positron emission topography (PET -CT scans, 47 nuclear medicine scans and 98 cardiac catheterizations. Children less than 5 years of age underwent more DI studies than did older children (median (IQR 140 (66-210 vs 49 (19-105, p = 0.010. Children with post-transplant lymphoproliferative disorder (N = 8 had more CT scans (median (IQR 13 (5.5-36 vs 1 (0-5, p100 mSv. In conclusion, a significant proportion of pediatric transplant recipients have sufficient radiation exposure post-transplant for DI to be at potential risk for radiation-induced malignancies.

  15. Exposure to rays and radiation hazards in connection with diagnostic X-ray procedures in children

    International Nuclear Information System (INIS)

    Protzer, K.

    1988-01-01

    In this study, figures and data about radiation exposures for diagnostic purposes are surveyed that were collected in connection with X-ray procedures in children. The data were sorted according to body regions and techniques required for their examination so as to permit separate analyses of procedures in the urogenital tract (intravenous urogramme, micturition cystourethrography), thorax (angiocardiogramme, thoractic aortogramme, examinations using cardiac catheters), gastrointestinal system (fluoroscopy and contrast-enhanced irrigoscopy), pelvis (survey radiography), skull (computed tomography) as well as in miscellaneous group of further origins. The second part of the report discusses the uncertainties surrounding the assessment of radiation hazards and indicated radiation doses. A formula is represented for the calculation of life-time reductions that can be applied to any type of cancer and embraces a number of factors like life expectancy at age X, the patient's age at the time of radiotherapy, the five-year-survival rate for the condition under investigation and the diseased organ. At the end of the study, some methods are pointed out that may be helpful in limiting radiation exposure. (KST) [de

  16. Research on radiation exposure from CT part of hybrid camera and diagnostic CT

    Science.gov (United States)

    Solný, Pavel; Zimák, Jaroslav

    2014-11-01

    Research on radiation exposure from CT part of hybrid camera in seven different Departments of Nuclear Medicine (DNM) was conducted. Processed data and effective dose (E) estimations led to the idea of phantom verification and comparison of absorbed doses and software estimation. Anonymous data from about 100 examinations from each DNM was gathered. Acquired data was processed and utilized by dose estimation programs (ExPACT, ImPACT, ImpactDose) with respect to the type of examination and examination procedures. Individual effective doses were calculated using enlisted programs. Preserving the same procedure in dose estimation process allows us to compare the resulting E. Some differences and disproportions during dose estimation led to the idea of estimated E verification. Consequently, two different sets of about 100 of TLD 100H detectors were calibrated for measurement inside the Aldersnon RANDO Anthropomorphic Phantom. Standard examination protocols were examined using a 2 Slice CT- part of hybrid SPECT/CT. Moreover, phantom exposure from body examining protocol for 32 Slice and 64 Slice diagnostic CT scanner was also verified. Absorbed dose (DT,R) measured using TLD detectors was compared with software estimation of equivalent dose HT values, computed by E estimation software. Though, only limited number of cavities for detectors enabled measurement within the regions of lung, liver, thyroid and spleen-pancreas region, some basic comparison is possible.

  17. Diagnostic accuracy of in vitro panoramic radiographs depending on the exposure.

    Science.gov (United States)

    Kaeppler, G; Dietz, K; Reinert, S

    2007-02-01

    The aim was to evaluate the effect of dose reduction on diagnostic accuracy in panoramic radiographs with increased tube potential and reduced milliampere settings. Panoramic radiographs of 12 dried human skulls prepared with lesions in the bone, teeth and peri-implant bone in ascending size were taken. Medium and regular film--screen combinations and a storage phosphor system were used for imaging. All systems were exposed at a low and a high tube potential level. To compare the dose at different tube potential settings, dose length product was measured at the secondary collimator. Five observers assessed the presence (response: 1) or absence (response: 0) of lesions. Sensitivity, specificity and diagnostic accuracy were evaluated and 36 000 ratings were made in all. All settings were repeated once. Intrarater agreement was expressed by Cohen's kappa coefficient. There was no significant difference in diagnostic accuracy between a medium and a regular film--screen combination at a low tube potential level (70 kV; 0.935 and 0.930) and the medium film--screen system at a high tube potential level (85 kV; 0.926). Compared with this group, the regular film-screen combinations at high tube potential level (85 kV, 0.906) and all digital radiographs were significantly different (0.886 and 0.866), irrespective of the tube potential level. The digital panoramic radiograph was only comparable with the best film--screen combinations with an exposure for a medium film-screen system and at a low tube potential level. Sensitivity was 89.9% and specificity 93.7%. The kappa coefficient for intrarater agreement was high (0.81). The medium intensifying screen can be used at high tube potential settings instead of low tube potential settings, or the regular intensifying screen can be used at low tube potential settings with the same diagnostic value. A dose reduction of about 40% is possible. The storage phosphor plates should be exposed at least like a regular film-screen system

  18. Physiologic changes associated with violence and abuse exposure: an examination of related medical conditions.

    Science.gov (United States)

    Keeshin, Brooks R; Cronholm, Peter F; Strawn, Jeffrey R

    2012-01-01

    Although the extant evidence is replete with data supporting linkages between exposure to violence or abuse and the subsequent development of medical illnesses, the underlying mechanisms of these relationships are poorly defined and understood. Physiologic changes occurring in violence- or abuse-exposed individuals point to potentially common biological pathways connecting traumatic exposures with medical outcomes. Herein, the evidence describing the long-term physiologic changes in abuse- and violence-exposed populations and associated medical illnesses are reviewed. Current data support that (a) specific neurobiochemical changes are associated with exposure to violence and abuse; (b) several biological pathways have the potential to lead to the development of future illness; and (c) common physiologic mechanisms may moderate the severity, phenomenology, or clinical course of medical illnesses in individuals with histories of exposure to violence or abuse. Importantly, additional work is needed to advance our emerging understanding of the biological mechanisms connecting exposure to violence and abuse and negative health outcomes.

  19. Relativity Screens for Misvalued Medical Services: Impact on Noninvasive Diagnostic Radiology.

    Science.gov (United States)

    Rosenkrantz, Andrew B; Silva, Ezequiel; Hawkins, C Matthew

    2017-11-01

    In 2006, the AMA/Specialty Society Relative Value Scale Update Committee (RUC) introduced ongoing relativity screens to identify potentially misvalued medical services for payment adjustments. We assess the impact of these screens upon the valuation of noninvasive diagnostic radiology services. Data regarding relativity screens and relative value unit (RVU) changes were obtained from the 2016 AMA Relativity Assessment Status Report. All global codes in the 2016 Medicare Physician Fee Schedule with associated work RVUs were classified as noninvasive diagnostic radiology services versus remaining services. The frequency of having ever undergone a screen was compared between the two groups. Screened radiology codes were further evaluated regarding the RVU impact of subsequent revaluation. Of noninvasive diagnostic radiology codes, 46.0% (201 of 437) were screened versus 22.2% (1,460 of 6,575) of remaining codes (P < .001). Most common screens for which radiology codes were identified as potentially misvalued were (1) high expenditures (27.5%) and (2) high utilization (25.6%). The modality and body region most likely to be identified in a screen were CT (82.1%) and breast (90.9%), respectively. Among screened radiology codes, work RVUs, practice expense RVUs, and nonfacility total RVUs decreased in 20.3%, 65.9%, and 75.3%, respectively. All screened CT, MRI, brain, and spine codes exhibited decreased total RVUs. Policymakers' ongoing search for potentially misvalued medical services has disproportionately impacted noninvasive diagnostic radiology services, risking the introduction of unintended or artificial shifts in physician practice. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  20. Three-Dimensional Visual Patient Based on Electronic Medical Diagnostic Records.

    Science.gov (United States)

    Shi, Liehang; Sun, Jianyong; Yang, Yuanyuan; Ling, Tonghui; Wang, Mingqing; Gu, Yiping; Yang, Zhiming; Hua, Yanqing; Zhang, Jianguo

    2018-01-01

    an innovative concept and method is introduced to use a 3-D anatomical graphic pattern called visual patient (VP) visually to index, represent, and render the medical diagnostic records (MDRs) of a patient, so that a doctor can quickly learn the current and historical medical status of the patient by manipulating VP. The MDRs can be imaging diagnostic reports and DICOM images, laboratory reports and clinical summaries which can have clinical information relating to medical status of human organs or body parts. the concept and method included three steps. First, a VP data model called visual index object (VIO) and a VP graphic model called visual anatomic object (VAO) were introduced. Second, a series of processing methods of parsing and extracting key information from MDRs were used to fill the attributes of the VIO model of a patient. Third, a VP system (VPS) was designed to map VIO to VAO, to create a VP instance for each patient. a prototype VPS has been implemented in a simulated hospital PACS/RIS integrated environment. Two evaluation results showed that more than 70% participating radiologists would like to use the VPS in their radiological imaging tasks, and the efficiency of using VPS to review the tested patients' MDRs was 2.24 times higher than that of using PACS/RIS, while the average accuracy by using PACS/RIS was better than that by using VPS; however, this difference was only about 4%. the developed VPS can show the medical status of patient organs/sub-organs with 3-D anatomical graphic pattern and will be welcomed by radiologists with better efficiency in reviewing the patients' MDRs and with acceptable accuracy. the VP introduces a new way for medical professionals to access and interact with a huge amount of patient records with better efficiency in the big data era.

  1. Ionizing diagnostic radiation exposure in patients with Crohn's disease: A retrospective study in a medium hospital and its predictive factors.

    Science.gov (United States)

    Merino Rodríguez, Esther; Carrera Alonso, Elisa; Torralba González de Suso, Miguel; Sánchez da Silva, Marta; Martínez López, María; Sánchez-Tembleque Zarandona, María Dolores

    2018-02-01

    It is estimated that diagnostic medical radiation exposure may be responsable for 0.5-2% of cancers worldwide. Because of the relapsing course of Crohn's disease (CD), these patients usually requiere multiple ionizing radiation test. Stimating the total cumulative effective dose received by our CD patients and identifying the risk factors associated with the exposure to a cumulative effective dose due to the disease (CEED) > 50mSv. Retrospective cohort study (2001-2014). patients with CD. Risk dose >50mSv. For calculating de cumulative effective dose and the CEED, all the ionizing test done were taken. For identifying predictive factors for receiving a CEDD >50mSv, an univariate and a multivariate logistic regression analyses were performed using a >50mSv dose as dependent variable. Of the 267 patients analyzed the 24.6% of them received a cumulative effective dose > 50mSv and the 15.2% a CEED>50mSv. In the multivariate analysis, the following variables were identified as independent predictors associated with a CEDD >50mSv: major surgery (OR= 2.1; IC 95% [1.1-3.8]; p=.019) and severity (OR= 20.6; IC 95% [4.5-94.8]; p<.01). Patients with CD are more at risk of receiving risk CEED, so it would be advisable to monitor the cumulative effective dose received to anticipate our intervention in order to avoid reaching that dose. The ultrasounds and abdominal resonance enterography are alternatives in these cases, although their accessibility is limited in some centers. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  2. CSIR research, development and innovation initiatives for the medical device and diagnostic industry

    CSIR Research Space (South Africa)

    Vilakazi, Busisiwe

    2017-10-01

    Full Text Available , subcellular and molecular level • The CSIR is well positioned to assist industry to design, develop and manufacture photonic-based point-of-care devices. • Advantages – Cost reduction per analysis – Portable device, possibly also equipment free – Low... devices and diagnostics lifecycle management platform – Examples of technology platforms ‹#› 3 Overview of SA medical device industry • ~30 multinationals companies • ~ 26 local manufacturers • Employ less than 50 people • Employs over 20 000 • 94...

  3. Radiation exposure of the population due to medical procedures

    International Nuclear Information System (INIS)

    Frischauf, H.

    1976-01-01

    The question of individual benefit-risk ratio in X-ray exposures is considered. The growth rate of the number of radiological examinations in New Zealand, Sweden, UK and USA is stated to be between 2 and 6 per cent per annum. The risks of internal radioisotope tests are emphasised and reductions of exposure are reported when 99Tc isotopes are used, counterbalanced by the increasing number of exposures made; the question of radiation-induced leukemia is raised in this respect. The problems of analysing delayed radiation effects are discussed, and the possibility of animal tests is suggested. (G.M.E.)

  4. Pregnancy outcomes after fetal exposure to antithyroid medications or levothyroxine

    DEFF Research Database (Denmark)

    Schurmann, Lene; Hansen, Anne Vinkel; Garne, Ester

    2016-01-01

    Aim: To investigate whether fetal exposure to antithyroid drugs (ATD) and levothyroxine affects gestational age (GA), birth weight, birth length, head circumference and prevalence of congenital anomalies. Methods: Cohort of all pregnancies from GA 12 weeks recorded in Danish registries from 1995......–2010. Exposure was having a prescription for ATD or levothyroxine from 91 days before to 91 days after pregnancy start (n = 8318). The reference group was pregnant women without exposure of ATD or levothyroxine (n = 969 303). A subpopulation was linked to the Danish EUROCAT congenital anomaly register. Results......: Overall 0.66% of the pregnant women had a prescription for levothyroxine and 0.19% had a prescription for ATD during the exposure period. There was no difference in proportion of live births compared to non-exposed pregnancies, but infants exposed to ATD were more often born very preterm (1.99% versus 0...

  5. Magnetic resonance imaging and spectroscopy- emerging trends in medical diagnostics and therapy

    International Nuclear Information System (INIS)

    Deshmukh, Sudha

    1997-01-01

    A dramatic acceleration in the application of magnetic resonance techniques in the field of medical sciences has been witnessed over the past decade. Magnetic Resonance Imaging (MRI) has been called the most significant development since the discovery of x-rays. As a method of visualizing cross-sectional anatomy, MRI is without peer. MRI images can now provide in-vivo anatomical details that were earlier available only with invasive procedures. Yet, despite its extraordinary potential, MRI has had limited success, if any, in tissue characterization using the three image parameters T 1 , T 2 and proton density ρ. MR spectroscopy has however bridged this gap to a large extent and opened up the possibility of studying in vivo chemistry. In the present article an attempt has been made to give a brief account of the application of magnetic resonance imaging and spectroscopy in medical diagnostics and therapy. The basic principles pertaining to MRI and MRS are also discussed in brief. (author)

  6. Lists I and II, nuclear medical diagnostics. As of January 18, 1983

    International Nuclear Information System (INIS)

    1983-01-01

    The information booklet presents the guidelines of the Federal Association of Panel Doctors, concerning the minimum equipment required for nuclear medical diagnostics practices (nuclear medical equipment guidelines), in the amended version of May 18, 1981; it also contains the list I (modern commercially available equipment) and the list II (older types of equipment). The devices specified in these lists are products of firms that are members of the ZVEI, and are in compliance with the guidelines of the Panel Doctors' Association. Combinations of older computer equipment/cameras with up-to-date equipment, also come up to the standards given in the guidelines if specifically mentioned therein. The list of manufacturers gives addresses of the manufacturers of the equipment stated in list I and II. An appendix up-dates the information to the date of October 1, 1986. (orig./HP) [de

  7. The role of radiology in diagnostic error: a medical malpractice claims review.

    Science.gov (United States)

    Siegal, Dana; Stratchko, Lindsay M; DeRoo, Courtney

    2017-09-26

    Just as radiologic studies allow us to see past the surface to the vulnerable and broken parts of the human body, medical malpractice claims help us see past the surface of medical errors to the deeper vulnerabilities and potentially broken aspects of our healthcare delivery system. And just as the insights we gain through radiologic studies provide focus for a treatment plan for healing, so too can the analysis of malpractice claims provide insights to improve the delivery of safe patient care. We review 1325 coded claims where Radiology was the primary service provider to better understand the problems leading to patient harm, and the opportunities most likely to improve diagnostic care in the future.

  8. Exposure to Fictional Medical Television and Health: A Systematic Review

    Science.gov (United States)

    Hoffman, Beth L.; Shensa, Ariel; Wessel, Charles; Hoffman, Robert; Primack, Brian A.

    2017-01-01

    Fictional medical television programs have long been a staple of television programming, and they remain popular today. We aimed to examine published literature assessing the influence of medical television programs on health outcomes. We conducted systematic literature searches in PubMed, PsychINFO and CINAHL. Selected studies had to be scholarly…

  9. Evaluation of medical radiation exposure in pediatric interventional radiology procedures

    Energy Technology Data Exchange (ETDEWEB)

    Navarro, Valeria Coelho Costa; Navarro, Marcus Vinicius Teixeira; Oliveira, Aline da Silva Pacheco, E-mail: vccnavarro@gmail.com [Instituto Federal de Educacao, Ciencia e Tecnologia da Bahia (IFBA), Salvador, BA (Brazil); Maia, Ana Figueiredo [Universidade Federal de Sergipe (UFS), Aracaju, SE (Brazil); Oliveira, Adriano Dias Dourado [Sociedade Brasileira de Hemodinamica e Cardiologia Intervencionista, Salvador, BA (Brazil)

    2012-07-15

    Objective: To evaluate pediatric radiation exposure in procedures of interventional radiology in two hospitals in the Bahia state, aiming at contributing to delineate the scenario at the state and national levels. The knowledge of exposure levels will allow an evaluation of the necessity of doses optimization, considering that peculiarities of radiology and pediatrics become even more significant in interventional radiology procedures which involve exposure to higher radiation doses. Materials and Methods: A total of 32 procedures were evaluated in four rooms of the two main hospitals performing pediatric interventional radiology procedures in the Bahia state. Air kerma rate and kerma-area product were evaluated in 27 interventional cardiac and 5 interventional brain procedures. Results: Maximum values for air kerma rate and kerma-area product and air kerma obtained in cardiac procedures were, respectively, 129.9 Gy.cm{sup 2} and 947.0 mGy; and, for brain procedures were 83.3 Gy.cm{sup 2} and 961.0 mGy. Conclusion: The present study results showed exposure values up to 14 times higher than those found in other foreign studies, and approximating those found for procedures in adults. Such results demonstrate excessive exposure to radiation, indicating the need for constant procedures optimization and evaluation of exposure rates. (author)

  10. Dose evaluation in medical staff during diagnostics procedures in interventional radiology; Avaliacao da dose na equipe medica durante procedimentos diagnoticos de radiologia intervencionista

    Energy Technology Data Exchange (ETDEWEB)

    Bacchim Neto, Fernando A.; Alves, Allan F.F.; Rosa, Maria E.D.; Miranda, Jose R.A. [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Instituto de Biociencias. Departamento de Fisica e Biofisica; Moura, Regina [Faculdade de Medicina de Botucatu, SP (Brazil). Departamento de Cirurgia e Ortopedia; Pina, Diana R., E-mail: bacchim@ibb.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Faculdade de Medicina. Departamento de Doencas Tropicais e Diagnostico por Imagem

    2014-08-15

    Studies show that personal dosimeters may underestimate the dose values in interventional physicians, especially in extremities and crystalline. The objective of this work was to study the radiation exposure levels of medical staff in diagnostic interventional radiology procedures. For this purpose LiF:Mg,Ti (TLD-100) dosimeters were placed in different regions of the physician body. When comparing with reference dose levels, the maximum numbers of annual procedures were found. This information is essential to ensure the radiological protection of those professionals. (author)

  11. Development of methodology for alternative testing strategies for the assessment of the toxicological profile of nanoparticles used in medical diagnostics. NanoTEST - EC FP7 project

    International Nuclear Information System (INIS)

    Dusinska, Maria; Fjellsbo, Lise Maria; Heimstad, Eldbjorg; Harju, Mikael; Bartonova, Alena; Tran, Lang; Juillerat-Jeanneret, Lucienne; Halamoda, Blanka; Marano, Francelyne; Boland, Sonja; Saunders, Margaret; Cartwright, Laura; Carreira, Sara; Thawley, Susan; Whelan, Maurice; Klein, Christoph; Housiadas, Christos; Volkovova, Katarina; Tulinska, Jana; Beno, Milan

    2009-01-01

    Nanoparticles (NPs) have unique, potentially beneficial properties, but their possible impact on human health is still not known. The area of nanomedicine brings humans into direct contact with NPs and it is essential for both public confidence and the nanotech companies that appropriate risk assessments are undertaken in relation to health and safety. There is a pressing need to understand how engineered NPs can interact with the human body following exposure. The FP7 project NanoTEST (www.nanotest-fp7.eu) addresses these requirements in relation to the toxicological profile of NPs used in medical diagnostics.

  12. Medical exposure to ionising radiation and the risk of brain tumours

    DEFF Research Database (Denmark)

    Blettner, Maria; Schlehofer, Brigitte; Samkange-Zeeb, Florence

    2007-01-01

    BACKGROUND: The role of exposure to low doses of ionising radiation in the aetiology of brain tumours has yet to be clarified. The objective of this study was to investigate the association between medically or occupationally related exposure to ionising radiation and brain tumours. METHODS: We...... used self-reported medical and occupational data collected during the German part of a multinational case-control study on mobile phone use and the risk of brain tumours (Interphone study) for the analyses. RESULTS: For any exposure to medical ionising radiation we found odds ratios (ORs) of 0.63 (95...... regions. CONCLUSION: We did not find any significant increased risk of brain tumours for exposure to medical ionising radiation....

  13. Medical capsule robots: A renaissance for diagnostics, drug delivery and surgical treatment.

    Science.gov (United States)

    Mapara, Sanyat S; Patravale, Vandana B

    2017-09-10

    The advancements in electronics and the progress in nanotechnology have resulted in path breaking development that will transform the way diagnosis and treatment are carried out currently. This development is Medical Capsule Robots, which has emerged from the science fiction idea of robots travelling inside the body to diagnose and cure disorders. The first marketed capsule robot was a capsule endoscope developed to capture images of the gastrointestinal tract. Today, varieties of capsule endoscopes are available in the market. They are slightly larger than regular oral capsules, made up of a biocompatible case and have electronic circuitry and mechanisms to capture and transmit images. In addition, robots with diagnostic features such as in vivo body temperature detection and pH monitoring have also been launched in the market. However, a multi-functional unit that will diagnose and cure diseases inside the body has not yet been realized. A remote controlled capsule that will undertake drug delivery and surgical treatment has not been successfully launched in the market. High cost, inadequate power supply, lack of control over drug release, limited space for drug storage on the capsule, inadequate safety and no mechanisms for active locomotion and anchoring have prevented their entry in the market. The capsule robots can revolutionize the current way of diagnosis and treatment. This paper discusses in detail the applications of medical capsule robots in diagnostics, drug delivery and surgical treatment. In diagnostics, detailed analysis has been presented on wireless capsule endoscopes, issues associated with the marketed versions and their corresponding solutions in literature. Moreover, an assessment has been made of the existing state of remote controlled capsules for targeted drug delivery and surgical treatment and their future impact is predicted. Besides the need for multi-functional capsule robots and the areas for further research have also been

  14. Radiological safety status and quality assurance audit of medical X-ray diagnostic installations in India

    Directory of Open Access Journals (Sweden)

    Sonawane A

    2010-01-01

    Full Text Available We conducted a radiological safety and quality assurance (QA audit of 118 medical X-ray diagnostic machines installed in 45 major hospitals in India. The main objective of the audit was to verify compliance with the regulatory requirements stipulated by the national regulatory body. The audit mainly covered accuracy check of accelerating potential (kVp, linearity of tube current (mA station and timer, congruence of radiation and optical field, and total filtration; in addition, we also reviewed medical X-ray diagnostic installations with reference to room layout of X-ray machines and conduct of radiological protection survey. A QA kit consisting of a kVp Test-O-Meter (ToM (Model RAD/FLU-9001, dose Test-O-Meter (ToM (Model 6001, ionization chamber-based radiation survey meter model Gun Monitor and other standard accessories were used for the required measurements. The important areas where there was noncompliance with the national safety code were: inaccuracy of kVp calibration (23%, lack of congruence of radiation and optical field (23%, nonlinearity of mA station (16% and timer (9%, improper collimator/diaphragm (19.6%, faulty adjustor knob for alignment of field size (4%, nonavailability of warning light (red light at the entrance of the X-ray room (29%, and use of mobile protective barriers without lead glass viewing window (14%. The present study on the radiological safety status of diagnostic X-ray installations may be a reasonably good representation of the situation in the country as a whole. The study contributes significantly to the improvement of radiological safety by the way of the steps already taken and by providing a vital feed back to the national regulatory body.

  15. The Design of Diagnostic Medical Facilities where Ionising Radiation is used

    International Nuclear Information System (INIS)

    Malone, J.; O'Reilly, G.; O'Connor, U.; Gallagher, A.; Sheahan, N.; Fennell, S.

    2009-06-01

    The original Code of Practice on The Design of Diagnostic Medical Facilities Using Ionising Radiation was first published by the Nuclear Energy Board in 1988. In the intervening years the 'Blue Book' as it became known has served the medical community well as the sector has expanded and modernised and the late Dr Noel Nowlan, then Chief Executive of the Nuclear Energy Board, deserves much credit for initiating this pioneering contribution to radiation safety in Ireland. There have been significant developments since its publication in terms of the underlying radiation protection legislation, regulatory practice as well as developments in new technologies that have given rise to the need for a revision of the Code. This revised Code is based on a comprehensive draft document produced by the Haughton Institute under contract to the RPII and was finalised following extensive consultations with the relevant stakeholders. The revised Code includes a brief review of the current legislative framework and its specific impact on the management of building projects (Chapters 1 and 2), a presentation of the main types of radiological (Chapter 3) and nuclear medicine (Chapter 4) facilities, a treatment of the technical aspects of shielding calculations (Chapter 5) and a discussion of the practical aspects of implementing shielding solutions in a building context (Chapter 6). The primary purpose of the Code is to assist in the design of diagnostic facilities to the highest radiation protection standards in order to ensure the safety of workers and members of the public and the delivery of a safe service to patients. Diagnostic radiology is a dynamic environment and the Code is intended to be used in consultation with the current literature, an experienced Radiation Protection Advisor and a multidisciplinary project team

  16. Isolated psychosis during exposure to very high and extreme altitude - characterisation of a new medical entity.

    Science.gov (United States)

    Hüfner, Katharina; Brugger, Hermann; Kuster, Eva; Dünsser, Franziska; Stawinoga, Agnieszka E; Turner, Rachel; Tomazin, Iztok; Sperner-Unterweger, Barbara

    2017-12-05

    Psychotic episodes during exposure to very high or extreme altitude have been frequently reported in mountain literature, but not systematically analysed and acknowledged as a distinct clinical entity. Episodes reported above 3500 m altitude with possible psychosis were collected from the lay literature and provide the basis for this observational study. Dimensional criteria of the Diagnostic and Statistical Manual of Mental Disorders were used for psychosis, and the Lake Louise Scoring criteria for acute mountain sickness and high-altitude cerebral oedema (HACE). Eighty-three of the episodes collected underwent a cluster analysis to identify similar groups. Ratings were done by two independent, trained researchers (κ values 0.6-1). Findings Cluster 1 included 51% (42/83) episodes without psychosis; cluster 2 22% (18/83) cases with psychosis, plus symptoms of HACE or mental status change from other origins; and cluster 3 28% (23/83) episodes with isolated psychosis. Possible risk factors of psychosis and associated somatic symptoms were analysed between the three clusters and revealed differences regarding the factors 'starvation' (χ2 test, p = 0.002), 'frostbite' (p = 0.024) and 'supplemental oxygen' (p = 0.046). Episodes with psychosis were reversible but associated with near accidents and accidents (p = 0.007, odds ratio 4.44). Episodes of psychosis during exposure to high altitude are frequently reported, but have not been specifically examined or assigned to medical diagnoses. In addition to the risk of suffering from somatic mountain illnesses, climbers and workers at high altitude should be aware of the potential occurrence of psychotic episodes, the associated risks and respective coping strategies.

  17. Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing.

    Directory of Open Access Journals (Sweden)

    Athanasios Tsalatsanis

    Full Text Available Dual Processing Theories (DPT assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive and type 2 (deliberative. Based on DPT we have derived a Dual Processing Model (DPM to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called "threshold probability" at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today's clinical practice.

  18. Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing.

    Science.gov (United States)

    Tsalatsanis, Athanasios; Hozo, Iztok; Kumar, Ambuj; Djulbegovic, Benjamin

    2015-01-01

    Dual Processing Theories (DPT) assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive) and type 2 (deliberative). Based on DPT we have derived a Dual Processing Model (DPM) to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called "threshold probability" at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT) and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today's clinical practice.

  19. Rabies Exposure: When Should I Seek Medical Attention?

    Science.gov (United States)

    ... Rabies and Kids! When should I seek medical attention? Language: English Spanish Recommend on Facebook Tweet Share ... with soap and water. See your doctor for attention for any trauma due to an animal attack ...

  20. Contribution of nuclear medicine to diagnosis medical exposure of the French population in 2007; Contribution de la medecine nucleaire a l'exposition medicale diagnostique de la population francaise en 2007

    Energy Technology Data Exchange (ETDEWEB)

    Etard, C.; Aubert, B. [Institut de radioprotection et de surete nucleaire (IRSN), 92 - Fontenay-aux-Roses (France); Sinno-Tellier, S. [Institut national de veille sanitaire, 94 - Saint-Maurice (France)

    2010-07-01

    Purpose: To characterize the distribution for 2007 of diagnostic nuclear medicine procedures and the effective dose associated with each type of procedure and anatomical areas explored. To study the variability between services of injected activities for the same type of act. Conclusions: the results of this study were associated to comparable data in order to update, for 2007, the data relative to diagnostic medical exposure of the french population in the framework of the I.R.S.N.-I.n.V.S. joint study (E.x.P.R.I. system, medical exposure of patients to ionizing radiation). (N.C.)

  1. Pregnancy outcomes after fetal exposure to antithyroid medications or levothyroxine.

    Science.gov (United States)

    Schurmann, Lene; Hansen, Anne Vinkel; Garne, Ester

    2016-10-01

    To investigate whether fetal exposure to antithyroid drugs (ATD) and levothyroxine affects gestational age (GA), birth weight, birth length, head circumference and prevalence of congenital anomalies. Cohort of all pregnancies from GA 12 weeks recorded in Danish registries from 1995-2010. Exposure was having a prescription for ATD or levothyroxine from 91 days before to 91 days after pregnancy start (n=8318). The reference group was pregnant women without exposure of ATD or levothyroxine (n=969303). A subpopulation was linked to the Danish EUROCAT congenital anomaly register. Overall 0.66% of the pregnant women had a prescription for levothyroxine and 0.19% had a prescription for ATD during the exposure period. There was no difference in proportion of live births compared to non-exposed pregnancies, but infants exposed to ATD were more often born very preterm (1.99% versus 0.94% Odds Ratio 2.04, 95% CI 1.46 - 2.86) and had higher infant mortality (Odds ratio 2.37, 95% CI 1.42 - 3.94). Infants exposed to ATD were more likely to have low birth weight and length for GA (Odds ratios 1.29 (1.12 - 1.50) and 1.40 (1.17 - 1.66). There was no difference in head circumference for the 3 exposure groups. Prevalence of congenital anomalies was the same for exposed and non-exposed pregnancies. Fetal exposure to ATD resulted in lower GA, birth weight, length and higher infant mortality. Treatment for hypothyroidism had no significant impact on these variables. There was no difference in prevalence of congenital anomalies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Non-medical exposure to radioiodines and thyroid cancer

    International Nuclear Information System (INIS)

    Hindie, Elif; Leenhardt, Laurence; Aurengo, Andre; Vitaux, Francoise; Colas-Linhart, Nicole; Bok, B.; Grosclaude, Pascale; Galle, Pierre

    2002-01-01

    The Chernobyl accident, which occurred 32 years after the accidental exposure of Marshall islanders, resulted in the exposure of neighbouring populations to a mixture of iodine isotopes and in an increased incidence of thyroid cancer. The highest thyroid doses were received by the youngest age groups. This review describes the existing evidence, and examines factors that may have increased the risk. It also stresses problems with contemporary thyroid measurements, and the lack of information on the sensitivity of the thyroid to short-lived iodine isotopes and iodine-131. Practical considerations for nuclear physicians, epidemiologists and thyroidologists are discussed in the light of this major accident. (orig.)

  3. Occupational Exposure to Alcohol-Based Hand Sanitizers: The Diagnostic Role of Alcohol Biomarkers in Hair.

    Science.gov (United States)

    Salomone, A; Bozzo, A; Di Corcia, D; Gerace, E; Vincenti, M

    2018-04-01

    Ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEEs) in hair are effective direct biomarkers of ethanol ingestion, whose analytical determination can be used to discriminate between chronic and occasional ethanol intake. Ethanol is a compound widely used in some workplaces (e.g., clinics, hospitals) and is present in considerable amounts in mouthwash for oral cleaning, medications, cosmetic products, hydro-alcoholic disinfectants and antiseptics for hands. This study examined the ethyl alcohol exposure derived from hand disinfectants (in gel form) by simulating the typical occupational situation of medical-health workers (healthcare workers, nurses, surgeons, etc.) who frequently wash their hands with antiseptic sanitizer. Two types of hand disinfectants with 62% w/w of ethanol content were daily applied to the hands of a teetotaler for 20 times a day, for 4 consecutive weeks, thus simulating a typical workplace situation and a cumulative dermal exposure to ethanol of ~1,100 g. Different matrices (head, chest and beard hair, urine) were regularly sampled and analyzed using a ultra high-performance liquid chromatography tandem massspectrometry validated method for EtG and a (HS)SPME-GC-MS validated technique for FAEEs. The data obtained showed that a significant dermal absorption and/or inhalation of ethanol occurred, and that the use of detergents produce urinary EtG concentrations both higher than the cut-offs normally used for clinical and forensic analyses (either 100 and 500 ng/mL, depending on the context). The concentrations of the ethanol metabolites in the keratin matrices were, respectively, below the cut-off of 7 pg/mg for EtG and below 0.5 ng/mg for FAAEs (0.35 ng/mg for ethyl palmitate). In conclusion, the regular use of alcohol-based hand sanitizers can affect the concentration of urinary EtG and lead to positive analytical results, particularly when specimens are obtained shortly after sustained use of ethanol-containing hand sanitizer. On the

  4. Exposure to Environmental Air Manganese and Medication Use

    Science.gov (United States)

    Manganese (Mn) is an essential element with natural low levels found in water, food, and air, but due to industrialized processes, both workplace and the environmental exposures to Mn have increased. Recently, environmental studies have reported physical and mental health problem...

  5. CEC quality criteria for diagnostic radiographic images and patient exposure trial

    International Nuclear Information System (INIS)

    Nahrstedt, U.; Wall, B.; Maccia, C.; Moores, B.M.; Padovani, R.

    1990-01-01

    The intention of this report has been to present the results of a multinational trial set up by a study group of the radiation protection programme of the CEC. In view of proceeding towards the harmonization and the optimization of the radiological techniques commonly used in different European countries, the relevance of quality criteria for radiographic images together with dose requirements were checked on about 900 examined patients. Due to the type of X-ray projections considered, more than 1 200 questionnaires concerning the real X-ray films were therefore collected and evaluated through a scoring system. Such an approach was relevant and contributed to providing practical considerations on how to reduce and optimize patient received dose while keeping the essential medical information imaged on the film. Indeed the results obtained allowed identification of technical modalities corresponding to that objective. Furthermore, analysis of results revealed two main areas which should be further taken into consideration: - personnel training in radiation protection (radiologists and radiographers), establishment of quality assurance programmes in diagnostic radiology (good usage of radiological equipment and reduction of wasted films)

  6. Diagnostic Accuracy of Lumbosacral Spine Magnetic Resonance Image Reading by Chiropractors, Chiropractic Radiologists, and Medical Radiologists.

    Science.gov (United States)

    de Zoete, Annemarie; Ostelo, Raymond; Knol, Dirk L; Algra, Paul R; Wilmink, Jan T; van Tulder, Maurits W

    2015-06-01

    A cross-sectional diagnostic accuracy study was conducted in 2 sessions. It is important to know whether it is possible to accurately detect "specific findings" on lumbosacral magnetic resonance (MR) images and whether the results of different observers are comparable. Health care providers frequently use magnetic resonance imaging in the diagnostic process of patients with low back pain. The use of MR scans is increasing. This leads to an increase in costs and to an increase in risk of inaccurately labeling patients with an anatomical diagnosis that might not be the actual cause of symptoms. A set of 300 blinded MR images was read by medical radiologists, chiropractors, and chiropractic radiologists in 2 sessions. Each assessor read 100 scans in round 1 and 50 scans in round 2. The reference test was an expert panel.For all analyses, the magnetic resonance imaging findings were dichotomized into "specific findings" or "no specific findings." For the agreement, percentage agreement and κ values were calculated and for validity, sensitivity, and specificity. Sensitivity analysis was done for classifications A and B (prevalence of 31% and 57%, respectively). The intraobserver κ values for chiropractors, chiropractic radiologists, and medical radiologists were 0.46, 0.49, and 0.69 for A and 0.55, 0.75, and 0.64 for B, respectively.The interobserver κ values were lowest for chiropractors (0.28 for A, 0.37 for B) and highest for chiropractic radiologists (0.50 for A, 0.49 for B).The sensitivities of the medical radiologists, chiropractors, and chiropractic radiologists were 0.62, 0.71, and 0.75 for A and 0.70, 0.74, 0.84 for B, respectively.The specificities of medical radiologists, chiropractic radiologists, and chiropractors were 0.82, 0.77, and 0.70 for A and 0.74, 0.52, and 0.61 for B, respectively. Agreement and validity of MR image readings of chiropractors and chiropractic and medical radiologists is modest at best. This study supports recommendations in

  7. Caring for medically unexplained physical symptoms after toxic environmental exposures: effects of contested causation.

    OpenAIRE

    Engel, Charles C; Adkins, Joyce A; Cowan, David N

    2002-01-01

    Medically unexplained physical symptoms (MUPS) are persistent idiopathic symptoms that drive patients to seek medical care. MUPS syndromes include chronic fatigue syndrome, fibromyalgia syndrome, and multiple chemical sensitivities. When MUPS occur after an environmental exposure or injury, an adversarial social context that we call "contested causation" may ensue. Contested causation may occur publicly and involve media controversy, scientific disagreement, political debate, and legal strugg...

  8. Diagnostic value and safety of medical thoracoscopy in tuberculous pleural effusion.

    Science.gov (United States)

    Wang, Zhen; Xu, Li-Li; Wu, Yan-Bing; Wang, Xiao-Juan; Yang, Yuan; Zhang, Jun; Tong, Zhao-Hui; Shi, Huan-Zhong

    2015-09-01

    Differentiating tuberculous pleural effusion from other lymphocytic pleural effusions is often challenging. This retrospective study aimed to assess the efficacy and safety of medical thoracoscopy in patients with suspected tuberculous pleural effusion. Between July 2005 and June 2014, patients with pleural effusions of unknown etiologies underwent medical thoracoscopy in our institute after less invasive means of diagnosis had failed. Demographic, radiographic, procedural, and histological data of patients with tuberculous pleural effusion were analyzed. During this 9-year study, 333 of 833 patients with pleural effusion were confirmed to have tuberculous pleurisy. Under thoracoscopy, we observed pleural nodules in 69.4%, pleural adhesion in 66.7%, hyperemia in 60.7%, plaque-like lesions in 6.0%, ulceration in 1.5% of patients with tuberculous pleurisy. Pleural biopsy revealed the presence of Mycobacterium tuberculosis in the pleural tissue or/and demonstration of caseating granulomas in 330 (99.1%) patients. No serious adverse events were recorded, and the most common minor complication was transient chest pain (43.2%) from the indwelling chest tube. Our data showed that medical thoracoscopy is a simple procedure with high diagnostic yield and excellent safety for the diagnosis of tuberculous pleural effusion. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Diagnostic x-ray in use in federal medical centre, case study Makurdi metropolis

    International Nuclear Information System (INIS)

    Onoja, R.A.; Fiase, J.O.

    2009-01-01

    Every year more than two thousand patients go for routine medical check-up at the Federal Medical Centre using diagnostic x-rays. This paper is based on a study to determine the entrance surface doses per radiograph of 108 patients that had diagnostic examinations at the Federal Medical Centre Makurdi. The examinations considered in this study are chest x-ray examinations, abdomen, skull and other extremities, for both adults and children. The results show that the mean entrance surface doses of PA chest x-ray for female range between 237-275μGy, for male is between 1183-297μGy, and for children range between 47-237μGy. The AP chest x-ray for female range between 1943-3440μGy, for male is between 1583-3484μGy and for children it ranges between 177-451μGy. The PA examination of the skull for adult female ranged between 117-787μGy, for male it ranged between 117-532μGy and children from 472-948μGy. Also for the AP examination for skull the adult female mean entrance surface doses range from 129-798μGy, for the male it range from 145-178μGy and for children 138-650μGy. The AP abdomen for adult female produces a mean entrance surface doses range between 620-682μGy, for the male is between 105-930μGy, and children it range between 144-398μGy. In the case of extremities AP examination are between the range of 173-468μGy for adult female, 300-595μGy for adult male and between 254-887μGy for the children. In the case of extremities PA examination mean entrance surface doses are between the range of 145-517μGy for adult female, 363-517μGy for adult male and between 130-566μGy for the children. The data shows that the entrance surface doses due to the x-ray examination for adult and children are within the ICRP guidance levels. These guidance levels of dose for diagnostic radiography for a typical adult patient are 10 mGy for AP abdomen, 0.4 mGy PA chest, 7 mGy for AP chest and 5 mGy for PA skull

  10. Assessments of medical exposures during interventional radiology procedures

    International Nuclear Information System (INIS)

    Navarro, V. C. C.; Navarro, M. V. T.; Maia, A. F.

    2013-01-01

    This study aims to contribute to the construction of a scenario regarding patient radiation exposure in Brazilian interventional radiology, aiming to provide data for the future drafting of specific legislation on interventional radiology because there is currently a lack of safety regulations for haemodynamics services in this country. Fourteen haemodynamics services in the states of Santa Catarina and Bahia were evaluated. The radiological devices were characterised through measurements of air kerma-area product, entrance surface air kerma (Ke), exposure time, spatial resolution (SR), low-contrast resolution and half value layer. During the evaluation of instrument parameters, several non-conformities were found according to current Brazilian regulations, with SR presenting the most critical situation. The results of the present study indicate the need for the optimisation of clinical practices in complex radiological procedures, although the overall results for the dose scenario in the present study revealed values similar to those reported in international publications. (authors)

  11. Occupational exposure to blood in medical students | Rabbitts ...

    African Journals Online (AJOL)

    Setting. Tygerberg Hospital, the Health Sciences Faculty of the University of Stellenbosch during a 15-week period from 4 February to 19 May 2002. Subjects. One hundred and thirty-six student interns (SIs), i.e. final-year medical students. Method. All SIs received a questionnaire and a letter motivating them to participate in ...

  12. THE ROLE AND PLACE OF LOGISTIC REGRESSION AND ROC ANALYSIS IN SOLVING MEDICAL DIAGNOSTIC TASK

    Directory of Open Access Journals (Sweden)

    S. G. Grigoryev

    2016-01-01

    Full Text Available Diagnostics, equally with  prevention and  treatment, is a basis of medical science and practice. For its history the medicine  has accumulated a great variety  of diagnostic methods for different diseases and  pathologic conditions. Nevertheless, new  tests,  methods and  tools are being  developed and recommended to application nowadays. Such  indicators as sensitivity and  specificity which  are defined on the basis  of fourfold contingency  tables   construction or  ROC-analysis method with  ROC  – curve  modelling (Receiver operating characteristic are used  as the  methods to estimate the  diagnostic capability. Fourfold  table  is used  with  the purpose to estimate the method which confirms or denies the diagnosis, i.e. a quality indicator. ROC-curve, being a graph, allows making the estimation of model  quality by subdivision of two classes  on the  basis  of identifying the  point  of cutting off a continuous or discrete quantitative attribute.The method of logistic regression technique is introduced as a tool to develop some  mathematical-statistical forecasting model  of probability of the event the researcher is interested in if there are two possible variants of the outcome. The method of ROC-analysis is chosen and described in detail as a tool to estimate the  model  quality. The capabilities of the named methods are demonstrated by a real example of creation  and  efficiency estimation (sensitivity and  specificity of a forecasting model  of probability of complication development in the form of pyodermatitis in children with  atopic dermatitis.

  13. The Value of In Vitro Diagnostic Testing in Medical Practice: A Status Report.

    Directory of Open Access Journals (Sweden)

    Ulrich-Peter Rohr

    Full Text Available In vitro diagnostic (IVD investigations are indispensable for routine patient management. Appropriate testing allows early-stage interventions, reducing late-stage healthcare expenditure (HCE.To investigate HCE on IVDs in two developed markets and to assess the perceived value of IVDs on clinical decision-making. Physician-perceived HCE on IVD was evaluated, as well as desired features of new diagnostic markers.Past and current HCE on IVD was calculated for the US and Germany. A total of 79 US/German oncologists and cardiologists were interviewed to assess the number of cases where: physicians ask for IVDs; IVDs are used for initial diagnosis, treatment monitoring, or post-treatment; and decision-making is based on an IVD test result. A sample of 201 US and German oncologists and cardiologists was questioned regarding the proportion of HCE they believed to be attributable to IVD testing. After disclosing the actual IVD HCE, the physician's perception of the appropriateness of the amount was captured. Finally, the association between physician-rated impact of IVD on decision-making and perceived contribution of IVD expenditure on overall HCE was assessed.IVD costs account for 2.3% and 1.4% of total HCE in the US and Germany. Most physicians (81% believed that the actual HCE on IVDs was >5%; 19% rated the spending correctly (0-4%, p<0.001. When informed of the actual amount, 64% of physicians rated this as appropriate (p<0.0001; 66% of decision-making was based on IVD. Significantly, more physicians asked for either additional clinical or combined clinical/health economic data than for the product (test/platform alone (p<0.0001.Our results indicate a poor awareness of actual HCE on IVD, but a high attributable value of diagnostic procedures for patient management. New markers should deliver actionable and medically relevant information, to guide decision-making and foster improved patient outcomes.

  14. ASIC design of a digital fuzzy system on chip for medical diagnostic applications.

    Science.gov (United States)

    Roy Chowdhury, Shubhajit; Roy, Aniruddha; Saha, Hiranmay

    2011-04-01

    The paper presents the ASIC design of a digital fuzzy logic circuit for medical diagnostic applications. The system on chip under consideration uses fuzzifier, memory and defuzzifier for fuzzifying the patient data, storing the membership function values and defuzzifying the membership function values to get the output decision. The proposed circuit uses triangular trapezoidal membership functions for fuzzification patients' data. For minimizing the transistor count, the proposed circuit uses 3T XOR gates and 8T adders for its design. The entire work has been carried out using TSMC 0.35 µm CMOS process. Post layout TSPICE simulation of the whole circuit indicates a delay of 31.27 ns and the average power dissipation of the system on chip is 123.49 mW which indicates a less delay and less power dissipation than the comparable embedded systems reported earlier.

  15. Effect of Accreditation on Accuracy of Diagnostic Tests in Medical Laboratories.

    Science.gov (United States)

    Jang, Mi Ae; Yoon, Young Ahn; Song, Junghan; Kim, Jeong Ho; Min, Won Ki; Lee, Ji Sung; Lee, Yong Wha; Lee, You Kyoung

    2017-05-01

    Medical laboratories play a central role in health care. Many laboratories are taking a more focused and stringent approach to quality system management. In Korea, laboratory standardization efforts undertaken by the Korean Laboratory Accreditation Program (KLAP) and the Korean External Quality Assessment Scheme (KEQAS) may have facilitated an improvement in laboratory performance, but there are no fundamental studies demonstrating that laboratory standardization is effective. We analyzed the results of the KEQAS to identify significant differences between laboratories with or without KLAP and to determine the impact of laboratory standardization on the accuracy of diagnostic tests. We analyzed KEQAS participant data on clinical chemistry tests such as albumin, ALT, AST, and glucose from 2010 to 2013. As a statistical parameter to assess performance bias between laboratories, we compared 4-yr variance index score (VIS) between the two groups with or without KLAP. Compared with the group without KLAP, the group with KLAP exhibited significantly lower geometric means of 4-yr VIS for all clinical chemistry tests (Plaboratories. Confidence intervals for the mean of each test in the two groups (accredited and non-accredited) did not overlap, suggesting that the means of the groups are significantly different. These results confirmed that practice standardization is strongly associated with the accuracy of test results. Our study emphasizes the necessity of establishing a system for standardization of diagnostic testing. © The Korean Society for Laboratory Medicine

  16. Risk factors of hypertension among medical diagnostic X-ray workers in China

    International Nuclear Information System (INIS)

    Zhang Wei; Wang Jixian; Zhao Yongcheng; Li Benxiao; Fan Tiqiang

    2002-01-01

    Objective: To investigate the risk factors of essential hypertension in medical diagnostic X- ray workers in China, especially for the relationship between essential hypertension and occupational irradiation. Methods: A 1:2 matched case-control study was carried out. The study subjects consisted of 288 pairs of matched cases and controls coming from different hospitals in China. Information about occupational and non-occupational risk factors were obtained through questionnaire. Individual doses were estimated by normalized workload method. Conditional Logistic regression method was applied to data analysis with SAS6.12 software. Results: Variables such as overweight (OR 3.087, P = 0.001), family history of hypertension ( OR = 3.140, P = 0.001), worrying about X-ray work as a health-damaging occupation (OR = 1.798, P=0.010) were three main risk factors in the ungrouped data. Dividing the study subjects into different subgroups according to sex and calendar period of entry, the highest level of accumulated dose ( > 300 mGy) as a risk factor had statistically reached significant level in the male X-ray workers of the earlier period of entry (OR= 5.672, P = 0.022). Conclusion: For medical diagnostic X-ray workers, overweight, family history of hypertension and occupational stress are the main risk factors of essential hypertension. For those accumulated doses over 300 mGy, indicating ionizing radiation may be a potential risk factor. As there is no reasonable biological mechanism to explain these findings, further studies are needed

  17. Effect of in utero exposure to diagnostic doses of X-rays on the growth and behaviour of mouse

    International Nuclear Information System (INIS)

    Prakash Hande, M.; Uma Devi, P.

    1992-01-01

    Intrauterine development, particularly the period of organogenesis is an especially radiosensitive phase in mammals. Teratogenic effect of low dose irradiation has been demonstrated in laboratory animals. Several studies have indicated the vulnerability of the developing human brain to radiation injury and demonstrated changes in postnatal behaviour following intrauterine animal irradiation. However, data are lacking on the comparative response of the different stages of prenatal development to low doses at levels that could result from diagnostic radiation exposure. This study attempts to empirically evaluate the differential response of critical stages in prenatal development of mouse to single low dose exposures to diagnostic X-rays. Data on growth and behaviour are briefly presented. (author). 22 refs., 2 figs., 1 tab

  18. Medical effects and risks of exposure to ionising radiation

    International Nuclear Information System (INIS)

    Mettler, Fred A

    2012-01-01

    Effects and risk from exposure to ionising radiation depend upon the absorbed dose, dose rate, quality of radiation, specifics of the tissue irradiated and other factors such as the age of the individual. Effects may be apparent almost immediately or may take decades to be manifest. Cancer is the most important stochastic effect at absorbed doses of less than 1 Gy. The risk of cancer induction varies widely across different tissues; however, the risk of fatal radiation-induced cancer for a general population following chronic exposure is about 5% Sv −1 . Quantification of cancer risk at doses of less than 0.1 Gy remains problematic. Hereditary risks from irradiation that might result in effects to offspring of humans appear to be much lower and any such potential risks can only be estimated from animal models. At high doses (over 1 Gy) cell killing and modification causes deterministic effects such as skin burns, and bone marrow depression, in which case immunosuppression becomes a critical issue. Acute whole body penetrating gamma irradiation at doses in excess of 2 Gy results in varying degrees of acute radiation sickness and doses over 10 Gy are usually lethal as a result of combined organ injury. (note)

  19. Radiation exposures of medical employes and its management

    International Nuclear Information System (INIS)

    Saegusa, Kenji; Arimizu, Noboru; Uchiyama, Akira.

    1982-01-01

    For the five years period from April, 1976, to March, 1981, the usage of film badges at the hospital of Chiba University is described as follows: the number of personnel using film badges, the distribution of radiation exposure dose, and the employes exposed beyond 500 mrem yearly in respective years, departments and professional types. The cumulative number of personnel was 2,476 (yearly average was 495). Professional types were physician, nurse, radiation technician, researcher, etc. The number of personnel using film badges has been increasing year after year; of which about 500, 70% are physicians. A cumulative total of the employes exposed exceeding 500 mrem yearly was 11, ten being physicians; the highest dose was 1,840 mrem. The average yearly exposure dose per person was the highest in radiation technicians (100 - 30 mrem/person/year), followed by physicians (50 - 24 mrem) and nurses (9 - 1 mrem). As a whole, the value was 45 - 20 mrem/person/year. (J.P.N.)

  20. Occupational Exposure to Antineoplastic Drugs: Identification of Job Categories Potentially Exposed throughout the Hospital Medication System.

    Science.gov (United States)

    Hon, Chun-Yip; Teschke, Kay; Chua, Prescillia; Venners, Scott; Nakashima, Lynne

    2011-09-01

    Studies examining healthcare workers' exposure to antineoplastic drugs have focused on the drug preparation or drug administration areas. However, such an approach has probably underestimated the overall exposure risk as the drugs need to be delivered to the facility, transported internally and then disposed. The objective of this study is to determine whether drug contamination occurs throughout a facility and, simultaneously, to identify those job categories that are potentially exposed. This was a multi-site study based in Vancouver, British Columbia. Interviews were conducted to determine the departments where the drugs travel. Subsequent site observations were performed to ascertain those surfaces which frequently came into contact with antineoplastic drugs and to determine the job categories which are likely to contact these surfaces. Wipe samples were collected to quantify surface contamination. Surface contamination was found in all six stages of the hospital medication system. Job categories consistently found to be at risk of exposure were nurses, pharmacists, pharmacy technicians, and pharmacy receivers. Up to 11 job categories per site may be at risk of exposure at some point during the hospital medication system. We found drug contamination on select surfaces at every stage of the medication system, which indicates the existence of an exposure potential throughout the facility. Our results suggest that a broader range of workers are potentially exposed than has been previously examined. These results will allow us to develop a more inclusive exposure assessment encompassing all healthcare workers that are at risk throughout the hospital medication system.

  1. Design of an affordable fluorescence confocal laser scanning microscope for medical diagnostics

    Science.gov (United States)

    Bechtel, Christin; Knobbe, Jens; Grüger, Heinrich; Lakner, Hubert

    2012-12-01

    Confocal fluorescence microscopes are a promising imaging tool in medical diagnostics due to their capability to selectively survey cross-sections of individual layers from `thick' samples. Non-invasive depth resolved investigation of neoplastic skin disorders is one example among other applications. However these microscopes are at present uncommon in medical practice. This is due to their main application area in research. The instruments dealt with here are generally complex, stationary units and are accordingly cost-intensive. It is for this reason, that we have designed a robust and portable MEMS based confocal fluorescence microscope with a field of view of 0.6mm x 0.6mm. This has been made possible by the integration of a 2D micro scanner mirror developed at Fraunhofer IPMS. A variable acquisition depth of cross-sectional images of the fluorescence specimen is enabled by an integrated z-shifter. With the use of commercially available optics an optical demonstrator set up has been realized. To characterize and to demonstrate the ability of this system test measurements were performed. The resolution of the microscope is better than 228 lp/mm determined by 1951 USAF resolution test target. Images of various biological samples are presented and optical sectioning capabilities are shown. A comparison of the measured with the predicted system performance will be given.

  2. Clinical Approach to the Standardization of Oriental Medical Diagnostic Pattern Identification in Stroke Patients

    Directory of Open Access Journals (Sweden)

    Han Jung Kim

    2011-01-01

    Full Text Available In Korea, many stroke patients receive oriental medical care, in which pattern-identification plays a major role. Pattern-identification is Oriental Medicine's unique diagnostic system. This study attempted to standardize oriental medical pattern-identification for stroke patients. This was a community-based multicenter study that enrolled stroke patients within 30 days after their ictus. We assessed the patients' general characteristics and symptoms related to pattern-identification. Each patient's pattern was determined when two doctors had the same opinion. To determine which variables affect the pattern-identification, binary logistic regression analysis was used with the backward method. A total of 806 stroke patients were enrolled. Among 480 patients who were identified as having a certain pattern, 100 patients exhibited the Fire Heat Pattern, 210 patients the Phlegm Dampness Pattern, nine patients the Blood Stasis Pattern, 110 patients the Qi Deficiency Pattern, and 51 patients the Yin Deficiency Pattern. After the regression analysis, the predictive logistic equations for the Fire Heat, Phlegm Dampness, Qi Deficiency, and Yin Deficiency patterns were determined. The Blood Stasis Pattern was omitted because the sample size was too small. Predictive logistic equations were suggested for four of the patterns. These criteria would be useful in determining each stroke patient's pattern in clinics. However, further studies with large samples are necessary to validate and confirm these criteria.

  3. Exposure and Knowledge of Sharps Injuries among Medical Students in Seven States of Mexico

    Directory of Open Access Journals (Sweden)

    Adrián Camacho-Ortiz

    2015-03-01

    Full Text Available Background: Medical students are vulnerable to accidental exposure to blood-borne pathogens when performing clinical activities. Knowle­dge of both the prevalence of exposure and necessary reporting procedures is important to minimize the risk of harm to medical students. Methods: A cross-sectional online survey of medical students from 19 universities from seven states in Mexico was utilized to determine the prevalence of needle stick injuries amongst medical students and the associated reporting procedures. Results: We included 312 res­pondents; of these, 52.24% were men and 47.76% were women, with a mean age of 23.19 years (SD ± 2.11 years. Nearly all of them (94.23% were medical students doing clerkships in public hospitals. Mean knowledge score of blood-borne pathogens was 3.6 (SD ± 1.16 on a scale of 0-10 designed specifically for this study. Thirty-five per cent of the respondents had sustained a needle stick injury at some point during their medical school training, and 33.97% reported some type of mucocutaneous exposure. Overall, the non-reporting rate of needle stick injury was 48.34%. Approximately 25% of the respondents were not familiar with reporting procedures in the event of a needle stick injury or mucocutaneous exposure; 61.50% had received information from their hospital about the standard protocol to follow after a blood or body fluid exposure. Conclusion: In this Mexican population of medical students, there is a high risk of suffering needle stick injuries during medical training. Furthermore, knowledge regarding prevention, evaluation, and reporting of needle stick injuries is suboptimal.

  4. Academic training of radiation protection human resources in the X-ray medical diagnostic

    International Nuclear Information System (INIS)

    Gaona, E.

    2008-12-01

    The current regulation, established by NOM-229-SSA1-2002 standard, T echnical requirements for facilities, health responsibilities, technical specifications for equipment and facilities for radiation protection in medical diagnosis with X-rays, t hat should be credited refresher courses, and training in radiation safety in accordance with current regulations, however, has been observed that the assistance and accreditation of courses is basically to cover administrative and regulatory requirements and therefore does not necessarily cover needs of the patient to radiation protection in the use of old and new technologies. David Brenner and Eric Hall claim that between 1.5 and 2% of all cancers in the USA may be attributable to exposure to X-ray computerized tomography techniques, given the intensive use of these techniques and the patient dose ranges in which incurred. While this is not debatable, if it is, the alternative does not seem to be abandoning the use of computerized tomography, because it gives them undoubted benefits with respect to invasive procedures. Deserves mention concerns the use of computerized tomography in children using scanning protocols designed for adults, in which case it incurs in 5 times higher dose. An additional warning about unwarranted use of computerized tomography is a procedure of this technique in abdomen resulting in an equivalent dose to 298 times that of a mammogram. Additional aspects such as biological effects (including deterministic) of both medical staff and patients of interventional procedures further reinforces the idea that there are education programs in radiation protection. Attention must put in the new generations, including in the curricula of medical residencies in radiology, endoscopy, cardiology and orthopedic, the education (no emerging courses) in radiation protection, radiobiology, radiology physics, and other topics, but previously must have medical physicists in radiology available to train new

  5. Evaluation of Dose Distribution and a Pilot Study of Population Doses for Diagnostic X Ray Exposure in Taiwan in 1997

    International Nuclear Information System (INIS)

    Yeh, H.; Hsu, J.; Yin, L.; Su, F.

    1999-01-01

    Evaluating medical radiation doses is very important because an estimated 80% of man-made radiation doses comes from medical applications. This study evaluated X ray doses from lung and abdomen examinations. An ionisation chamber was extensively used to standardise X ray doses. This investigation evaluated the deep equivalent dose, the shallow equivalent dose, the effective dose, and the effective dose equivalent, by using TLD LiF:Mg,Ti placed in a male RANDO phantom. The experiments were performed according to the parameters (kV p , mA.s) and procedures used in actual clinical examinations. In addition, this study estimated the population dose due to diagnostic X ray treatments using nationwide statistics for annual cases of X ray diagnostic examinations, in cooperation with the Central Health Insurance Agency in Taiwan. Finally, risk analyses were performed to elucidate the stochastic effects. (author)

  6. Current status of personnel exposure at nuclear power plants and other medical, industrial and educational facilities in JAPAN

    International Nuclear Information System (INIS)

    Sasaki, Fumiaki

    1991-01-01

    The state of radiation exposure of the workers engaging in radiation works in Japanese nuclear power stations, the factors of the radiation exposure of the workers engaging in radiation works, the countermeasures for reducing exposure in nuclear power stations, the state of radiation exposure of doctors, the workers engaging in radiation works, researchers and others in medical, industrial, research and educational and other facilities in Japan, the factors of their radiation exposure and the countermeasures for reducing the exposure, and the comparison of the exposure in nuclear power stations with that in medical, industrial, research and educational facilities are reported. (K.I.)

  7. Gestational Medication Use, Birth Conditions, and Early Postnatal Exposures for Childhood Asthma

    Directory of Open Access Journals (Sweden)

    Yang-Ching Chen

    2012-01-01

    Full Text Available Our aim is to explore (1 whether gestational medication use, mode of delivery, and early postnatal exposure correlate with childhood asthma, (2 the dose responsiveness of such exposure, and (3 their links to early- and late-onset asthma. We conducted a matched case-control study based on the Taiwan Children Health Study, which was a nationwide survey that recruited 12-to-14-year-old school children in 14 communities. 579 mothers of the participants were interviewed by telephone. Exclusive breastfeeding protected children from asthma. Notably, childhood asthma was significantly associated with maternal medication use during pregnancy, vacuum use during vaginal delivery, recurrent respiratory tract infections, hospitalization, main caregiver cared for other children, and early daycare attendance. Exposure to these factors led to dose responsiveness in relationships to asthma. Most of the exposures revealed a greater impact on early-onset asthma, except for vacuum use and daycare attendance.

  8. Lebanese medical students' exposure to domestic violence: does it affect helping survivors?

    Science.gov (United States)

    Usta, Jinan; Hlais, Sani; Farhat, Hala Abou; Romani, Maya; Bzeih, Hiba; Abdo, Lynn

    2014-02-01

    Our purpose was to assess medical students' willingness to help women survivors of intimate partner violence (IPV) and its relation to past exposure to violence. A cross-sectional study of medical students enrolled in three major universities in Beirut was carried out: 545 students filled out a self-administered questionnaire. The Inventory of Beliefs About Wife Beating, the Attitudes Toward Women's scale, the Marriage Role Expectations Inventory, the Conflict Tactics scale, and the Trauma Symptoms scale were used. The majority (93.6%) of medical students believed that battered wives should be helped by either social or governmental agencies, but only 48% showed readiness to provide help themselves. Female medical students were significantly more likely to be willing to help survivors of violence, whereas students exposed to domestic violence in childhood were significantly less likely to do so. Female medical students previously exposed to violence had significantly higher scores on the Briere and Runtz's Trauma Symptom Checklist, indicating more negative trauma-related symptoms. Multivariate analysis revealed that the students' exposure to verbal aggression, their marital role expectations, attitudes toward women, and parents' marital status accounted for 26% of the variability in the Helping Battered Wives score. The results of this study suggest that the medical students' past exposure to DV impacts their psychological well-being and their willingness to help abuse survivors. Given the multitude of stresses medical students are exposed to, careful attention and attendance to the effect of abuse on their well-being may be warranted.

  9. Development of polymer 'chips' used in medical diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Brush, Zachary G [Los Alamos National Laboratory; Schultz, Laura M [Los Alamos National Laboratory; Vanness, Justin W [Los Alamos National Laboratory; Farinholt, Kevin M [Los Alamos National Laboratory; Sarles, Stephen [VIRGINIA TECH; Leo, Donald [VIRGINIA TECH

    2010-11-03

    In recent years, there has been growing interest in creating bio-inspired devices that feature artificial bilayer lipid membranes (BLM), or lipid bilayers. These membranes can be tailored to mimic the structure and transport properties of cellular walls and can be used to selectively transport ions and other species between aqueous volumes. One application of this research is the formation of a standardized BLM contained within a portable and disposable housing for use in medical diagnostics. This concept utilizes a flexible polymer 'chip' that has internal compartments for housing both an organic solvent and an aqueous solution, which contains phospholipid molecules, proteins, and specific analyte molecules. The formation of a BLM within the chip enables integration of the chip into an electronic reader to perform diagnostic measurements of the sample. A key element of the bilayer formation process requires a single aqueous volume to first be separated into multiple volumes such that it can then be reattached to form a bilayer at the interface. This process, called the regulated attachment method, relies on the geometry of the deformable 'chip' to separate and reattach the aqueous contents held inside by opening and closing an aperture that divides adjacent compartments through the application of mechanical force. The purpose of this research is to develop an optimized chip that provides a controllable method for initially separating the aqueous phase via dynamic excitation. This study focuses on two specific aspects: designing an efficient excitation method for separating the aqueous volume, and optimizing the geometry of the chip to decrease the required input energy and better target the location and duration of the separation. Finite Element (FE) models are used to optimize the chip geometry and to identify suitable excitation signals. A series of experimental studies are also presented to validate the FE models.

  10. Assessment of medical students' knowledge retention in a diagnostic radiology course: lecture attendees versus absentees.

    Science.gov (United States)

    Chan, Wing Pong

    2009-03-01

    To compare class attendees versus absentees in their ability to retain knowledge during a diagnostic radiology course. This study recruited 146 fourth-year medical students who attended a diagnostic radiology course from February 2004 to June 2004. Eight unit tests were conducted. Questions for each test covered content taught in the prior class. Another examination (which students were not aware of beforehand) was conducted in June, and the questions for this examination included content from all lectures in the course. The class attendance rates were measured separately 6 times during the course. Students who were present on the last of these dates were categorised as attendees (group A students) and those who were absent were categorised as absentees (group B). The average class attendance was 76.8% and the lowest attendance was 56.8%. For the unit tests, the average score of group A students (80.7 +/- 7.3) was significantly higher than that of the group B students (76.2 +/- 8.8) (P = 0.001). However, in the unanticipated examination, there was no significant difference in the scores between group A (68.1 +/- 10.3; range, 36-92) and group B students (65.5 +/- 13.5; range, 28- 88) (P = 0.19). Self-learning time was related to the unit test scores (P = 0.001) but not to the unanticipated examination scores (P = 0.27). Students who frequently attend classes or study for longer can retain their knowledge over a short period of time, but there is no difference in knowledge retention between class attendees and absentees at the end of a 4-month course.

  11. Design of a Web-tool for diagnostic clinical trials handling medical imaging research.

    Science.gov (United States)

    Baltasar Sánchez, Alicia; González-Sistal, Angel

    2011-04-01

    New clinical studies in medicine are based on patients and controls using different imaging diagnostic modalities. Medical information systems are not designed for clinical trials employing clinical imaging. Although commercial software and communication systems focus on storage of image data, they are not suitable for storage and mining of new types of quantitative data. We sought to design a Web-tool to support diagnostic clinical trials involving different experts and hospitals or research centres. The image analysis of this project is based on skeletal X-ray imaging. It involves a computerised image method using quantitative analysis of regions of interest in healthy bone and skeletal metastases. The database is implemented with ASP.NET 3.5 and C# technologies for our Web-based application. For data storage, we chose MySQL v.5.0, one of the most popular open source databases. User logins were necessary, and access to patient data was logged for auditing. For security, all data transmissions were carried over encrypted connections. This Web-tool is available to users scattered at different locations; it allows an efficient organisation and storage of data (case report form) and images and allows each user to know precisely what his task is. The advantages of our Web-tool are as follows: (1) sustainability is guaranteed; (2) network locations for collection of data are secured; (3) all clinical information is stored together with the original images and the results derived from processed images and statistical analysis that enable us to perform retrospective studies; (4) changes are easily incorporated because of the modular architecture; and (5) assessment of trial data collected at different sites is centralised to reduce statistical variance.

  12. Concept of radiological, medical and social protection of the population of Russia affected by accidental exposure

    International Nuclear Information System (INIS)

    Osechinski, I.V.; Ivanov, E.V.; Ramzaev, P.V.; Balonov, M.I.; Tsyb, A.F.

    1997-01-01

    Main principles of population radiation protection from various accidental exposure, including the Chernobyl accident, have been implemented in officially approved Concept ''On radiological, medical, social protection and rehabilitation of the Russian Federation population affected by accidental radiation exposure''. The concept includes basic principles of radiation protection, designation of regional radionuclide contaminated territories, records and registers of exposed persons, health protection and rehabilitation, socio-economic and legal aspects

  13. The central registries of occupational and medical exposure in the Czech Republic

    International Nuclear Information System (INIS)

    Petrova, K.; Prouza, Z.

    1996-01-01

    This paper is intended to provide some insight into the recent situation in the Czech Republic concerning the registration and evaluation of occupational and medical radiation exposures. Since 1993 the creation of the Central (national) Registries of Occupational (CROE) and Medical Exposure (CRME) has been started. One of the main functions of these registries will be to provide statistics to guide policy making on a national basis. Authors give more detailed information on the structure of creating programs and discuss some actual arising problems. (author)

  14. The central registries of occupational and medical exposure in the Czech republic

    International Nuclear Information System (INIS)

    Petrova, K.; Prouza, Z.

    1995-01-01

    This paper is intended to provide some insight into the recent situation in the Czech Republic concerning the registration and evaluation of occupational and medical radiation exposures. Since 1993 the creation of the Central (national) Registries of Occupational (CROE) and Medical Exposure (CRME) has been started. One of the main functions of these registries will be to provide statistics to guide policy making on a national basis. Authors pick up their presentation in previous national conference in Jachymov last year and continue with further detailed information on the structure of creating programs and discuss some actual arising problems (author). 3 tabs., 5 refs

  15. Effective optimization of medical exposure: co-operation between radiation users and authorities

    International Nuclear Information System (INIS)

    Parkkinen, R.; Jarvinen, H.

    2006-01-01

    For the optimization of medical exposure in special radiological practices like in paediatric radiology, orthopaedics and cardiology, the Radiation and Nuclear Safety Authority (S.T.U.K.) in Finland has used a six step model to achieve the aims of the Medical Exposure Directive (97/43/EURATOM). The basis is to introduce the regulation and to meet the needs of the users for education and training. The aim is to educate some specialists to distribute information and good practices among their own professional groups. S.T.U.K. makes continuous verification on site visits and improves the process. (authors)

  16. FEATURES OF THE CHRONIC PAIN SYNDROME IN PATIENTS WITH RHEUMATOID ARTHRITIS AND MEDICAL DIAGNOSTIC TACTICS

    Directory of Open Access Journals (Sweden)

    M. A. Gromova

    2016-01-01

    medical tactics for rheumatoid arthritis patients with a chronic pain syndrome in therapeutic practice based on pain strength gradation, assessment of chronic pain syndrome variations, definition of anxiety and depression signs. All this allows to validate consultation of medical specialists and to differentiate treatment. Conclusions. The integrated approach to diagnostics of a chronic pain syndrome for rheumatoid arthritis allows to estimate pain strengths in dynamics of disease development, to reveal existence of pain variations, anxiety and depression. It enables usage of patient maintenance tactics and increases efficiency of treatment in therapeutic practice. 

  17. On Informatics Diagnostics and Informatics Therapeutics - Good Medical Informatics Research Is Needed Here.

    Science.gov (United States)

    Haux, Reinhold

    2017-01-01

    In the era of digitization some new procedures play an increasing role for diagnosis as well as for therapy: informatics diagnostics and informatics therapeutics. Challenges for such procedures are described. It is discussed, when research on such diagnostics and therapeutics can be regarded as good research. Examples are mentioned for informatics diagnostics and informatics therapeutics, which are based on health-enabling technologies.

  18. Recent Advances of Individual BODIPY and BODIPY-Based Functional Materials in Medical Diagnostics and Treatment.

    Science.gov (United States)

    Marfin, Yuriy S; Solomonov, Alexey V; Timin, Alexander S; Rumyantsev, Evgeniy V

    2017-01-01

    The group of fluorophores on boron dipyrrin platform (4,4- difluoro-4-bora3a,4a-diaza-s-indacene, also known as BODIPY) has attracted much attention in the field of molecular sensorics, including sensing of biomolecules and bioprocesses. Structural diversity of existing BODIPY with ample opportunities of directed modification of compounds makes this class of fluorophores attractive for medical and biological purposes. The recent progress in the design and functionalization of BODIPY allows using them for modification of drug micro- and nanocarriers in order to improve their therapeutic effect in cancer treatment. At the same time, integration of BODIPY into drug carriers provides the possibility of in vitro and in vivo real time imaging of used drug carriers. The high fluorescent intensity and low toxicity of BODIPY granted for conjugation with different biomolecules. The present review focuses on the recent advances for application of individual BODIPY in medical diagnostics, antimicrobial activity, as well as establishing the role of BODIPY in labeling of biomolecules (e.g. proteins, hormones and DNA). Also the review highlights the potential of BODIPY in functionalization of drug micro- and nanocarriers in order to achieve better therapeutic efficiency compared with non-modified materials. The advantages derived from the use of BODIPY for preparation and modification of drug carriers are critically evaluated and potential for future challenges, especially concerning the design of innovative multi-functional BODIPY-based nanocarriers, is discussed in detail using representative examples from literature. Our objective was to show that BODIPY are powerful tools for bioimaging, labeling of biomolecules and construction of new multifunctional drug carriers. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  19. Exposure to the field of renal transplantation during undergraduate medical education in the UK

    Directory of Open Access Journals (Sweden)

    Newman Alex

    2005-09-01

    Full Text Available Abstract Background There is a lack of surgeons in the field of renal transplantation, with a predicted shortage of over 20 consultants by the year 2005. Early positive exposure to the field, commencing at undergraduate level, has been identified as being vital to improving rates of recruitment. This study was performed to assess the exposure of undergraduates to the field of renal transplantation during medical education in the UK. Methods In October 2004 a questionnaire was sent to the clinical deans of all UK medical schools regarding undergraduate exposure to renal transplantation. Results Twenty-five replies were received, giving a response rate of 96%. All but one school had a centre for renal transplantation in their region. Three schools (12% gave no formal lecture or tutorial on the subject during the entire course. Of the remainder, between one to four formal sessions were provided, ranging from 15 minutes to 3 hours duration. Six medical schools (24% provided no compulsory clinical exposure to renal transplantation, with a further five (20% saying that students may receive exposure by chance. The average length of attachment was three weeks. Twenty-one medical schools (84% provided between 1–10% of students a choice to study renal transplantation, as part of electives and special study modules. Conclusion This study reveals a variation between, and within, medical schools in the levels of formal teaching. If the trends in recruitment to renal transplantation are to be reversed, we have an obligation to improve upon the medical education that students currently receive.

  20. Authentication and recovery of medical diagnostic image using dual reversible digital watermarking.

    Science.gov (United States)

    Deng, Xiaohong; Chen, Zhigang; Zeng, Feng; Zhang, Yaoping; Mao, Yimin

    2013-03-01

    This paper proposes a new region-based tampering detection and recovering method that utilizes both reversible digital watermarking and quad-tree decomposition for medical diagnostic image's authentication. Firstly, the quad-tree decomposition is used to divide the original image into blocks with high homogeneity, and then we computer pixels' linear interpolation as each block's recovery feature. Secondly, these recovery features as the first layer watermarking information is embedded by using simple invertible integer transformation. In order to enhance the proposed method's security, the logistic chaotic map is exploited to choose each block's reference pixel. The second layer watermark comprises by the quad-tree information and essential parameters for extraction are embedded by LSB replacement. In the authentication phase, the embedded watermark is extracted and the source image is recovered, and the similar linear interpolation technique is utilized to get each block's feature. Therefore, the tampering detection and localization can be achieved through comparing the extracted feature with the recomputed one, and the extracted feature can be used to recover those tampered regions with high similarity to their original state. Experimental results show that, compared with previous similar existing scheme, the proposed method not only achieves high embedding capacity and good visual quality of marked and restored image, but also has more accuracy for tampering detection.

  1. Malignant pleural mesothelioma: diagnostic value of medical thoracoscopy and long-term prognostic analysis.

    Science.gov (United States)

    Xu, Li-Li; Yang, Yuan; Wang, Zhen; Wang, Xiao-Juan; Tong, Zhao-Hui; Shi, Huan-Zhong

    2018-04-03

    Malignant pleural mesothelioma (MPM) is marked by its difficult diagnosis and poor prognosis. Medical thoracoscopy (MT) is an effective and safe procedure for the diagnosis of exudative pleural effusions and many factors associated with poor prognosis of MPM. We conducted this study to investigate the value of MT for diagnosing of MPM and to identify prognostic factors for MPM patients. From July 2005 through June 2014, a total of 833 patients with undiagnosed pleural effusions underwent MT and pleural biopsies were taken. Clinical data of all patients with MPM were retrospectively analyzed, and those with complete follow-up data were analyzed for prognostic factors. Eventually, MPM was the final diagnosis in 40 patients. Diagnostic efficiency of MT for MPM was 87.5%, since diagnosis of MPM failed to be established in 5 patients during the initial MT. Median survival was 17.1 mo (95% confidence interval: 13.6-20.7 mo). MT findings of pleural adhesion and plaques were adverse prognostic factors for MPM. In addition, old age, male gender, smoking history, histological type, poor staging, no treatment, low total protein level in pleural fluid, and computed tomographic findings such as pulmonary consolidation or infiltration, mediastinal lymphopathy, pulmonary mass or nodules, and pleural nodularity were also poor prognostic factors for MPM. MT is safe with a high positive rate in the diagnosis of MPM, and pleural adhesion and plaques seen under MT may be the adverse prognostic factors for MPM. Multiple clinical characteristics can affect the survival of MPM patients.

  2. Use of antihypertensive medications and diagnostic tests among privately-insured adolescents and young adults with primary vs. secondary hypertension

    Science.gov (United States)

    Yoon, Esther Y.; Cohn, Lisa; Freed, Gary; Rocchini, Albert; Kershaw, David; Ascione, Frank; Clark, Sarah

    2014-01-01

    Purpose To compare the use of antihypertensive medications and diagnostic tests among adolescents and young adults with primary vs. secondary hypertension Methods We conducted retrospective cohort analysis of claims data for adolescents and young adults (12–21 years) with ≥ 3 years of insurance coverage (≥ 11 months/year) in a large private managed care plan during 2003–2009 with diagnosis of primary hypertension or secondary hypertension. We examined their use of antihypertensive medications and identified demographic characteristics and presence of obesity-related comorbidities. For the subset receiving antihypertensive medications, we examined their diagnostic test use (echocardiograms, renal ultrasounds, and electrocardiograms (EKG)). Results Study sample included 1232 adolescents and young adults; 84% had primary hypertension and 16% had secondary hypertension. Overall prevalence rate of hypertension was 2.6%. One-quarter (28%) with primary hypertension had ≥1 antihypertensive medication whereas 65% with secondary hypertension had ≥1 antihypertensive medication. Leading prescribers of antihypertensives for subjects with primary hypertension were primary care physicians (PCP) (80%) whereas antihypertensive medications were equally prescribed by PCPs (43%) and subspecialists (37%) for subjects with secondary hypertension. Conclusions The predominant hypertension diagnosis among adolescents and young adults is primary hypertension. Antihypertensive medication use was higher among those with secondary hypertension compared to those with primary hypertension. Further study is needed to determine treatment effectiveness and patient outcomes associated with differential treatment patterns used for adolescents and young adults with primary vs. secondary hypertension. PMID:24492018

  3. Preliminary survey for communicating risk in medical exposure. Perception of risk among nurses working in radiology

    International Nuclear Information System (INIS)

    Kanda, Reiko; Tsuji, Satsuki; Shirakawa, Yoshiyuki; Yonehara, Hidenori

    2008-01-01

    A questionnaire survey was conducted on radiation risk and medical exposure, particularly in applications involving children. The survey was targeted at nurses (170 females) engaged in important roles in communicating risk regarding medical exposure. The questionnaire survey yielded the following findings. A significant number of respondents associated the word radiation' with 'cancer treatment,' 'exposure,' and 'X-ray pictures.' Perceptions about 'food exposure' differed between respondents with children and those without. Among the potential health problems posed by radiation, effects on children,' 'cancer and leukemia,' and 'genetic effects' were perceived as the most worrisome. Significant differences in perception were noted regarding infertility between respondents with children and those without. Concerning the effects of medical exposure on fetuses/children, only 10 percent of all respondents replied that they were not anxious about negative effects in either case. Among the respondents who felt uneasy about these aspects, most tended to assess exposed parts, doses, damage potentially suffered, timing of occurrence, and uncertainty, based on their professional experience and knowledge, to rationally distinguish acceptable risks from unacceptable ones and to limit concern to the unacceptable aspects. (author)

  4. Epidemiological studies on radiation carcinogenesis in human populations following acute exposure: nuclear explosions and medical radiation

    International Nuclear Information System (INIS)

    Fabrikant, J.I.

    1981-05-01

    The current knowledge of the carcinogenic effect of radiation in man is considered. The discussion is restricted to dose-incidence data in humans, particularly to certain of those epidemiological studies of human populations that are used most frequently for risk estimation for low-dose radiation carcinogenesis in man. Emphasis is placed solely on those surveys concerned with nuclear explosions and medical exposures

  5. Risk of congenital anomalies after exposure to asthma medication in the first trimester of pregnancy

    DEFF Research Database (Denmark)

    Garne, E.; Hansen, A. Vinkel; Morris, J.

    2016-01-01

    pregnancies in Norway (2004–2010), Wales (2000–2010) and Funen, Denmark (2000–2010). Methods: Exposure defined as having at least one prescription for asthma medications issued (Wales) or dispensed (Norway, Denmark) from 91 days before to 91 days after the pregnancy start date. Odds ratios (ORs) were...

  6. Effective Patient Education in Medical Imaging: Public Perceptions of Radiation Exposure Risk.

    Science.gov (United States)

    Ludwig, Rebecca L.; Turner, Lori W.

    2002-01-01

    In a cross-sectional survey of 200 adults, less than half agreed with experts on the risks of radiation exposure; 75-90% thought that medical imaging providers should be highly regulated; and less than one-quarter knew that most radiation damage is not permanent. (SK)

  7. Occupational radiation exposure of medical staff performing 90Y-loaded microsphere radioembolization

    International Nuclear Information System (INIS)

    Laffont, Sophie; Ardisson, Valerie; Lenoir, Laurence; Rolland, Yan; Rohou, Tanguy; Edeline, Julien; Pracht, Marc; Sourd, Samuel Le; Lepareur, Nicolas; Garin, Etienne

    2016-01-01

    Radioembolization of liver cancer with 90 Y-loaded microspheres is increasingly used but data regarding hospital staff exposure are scarce. We evaluated the radiation exposure of medical staff while preparing and injecting 90 Y-loaded glass and resin microspheres especially in view of the increasing use of these products. Exposure of the chest and finger of the radiopharmacist, nuclear medicine physician and interventional radiologist during preparation and injection of 78 glass microsphere preparations and 16 resin microsphere preparations was monitored. Electronic dosimeters were used to measure chest exposure and ring dosimeters were used to measure finger exposure. Chest exposure was very low for both products used (<10 μSv from preparation and injection). In our experience, finger exposure was significantly lower than the annual limit of 500 mSv for both products. With glass microspheres, the mean finger exposure was 13.7 ± 5.2 μSv/GBq for the radiopharmacist, and initially 17.9 ± 5.4 μSv/GBq for the nuclear medicine physician reducing to 13.97 ± 7.9 μSv/GBq with increasing experience. With resin microspheres, finger exposure was more significant: mean finger exposure for the radiopharmacist was 295.1 ± 271.9 μSv/GBq but with a reduction with increasing experience to 97.5 ± 35.2 μSv/GBq for the six most recent dose preparations. For administration of resin microspheres, the greatest mean finger exposure for the nuclear medicine physician (the most exposed operator) was 235.5 ± 156 μSv/GBq. Medical staff performing 90 Y-loaded microsphere radioembolization procedures are exposed to safe levels of radiation. Exposure is lower than that from treatments using 131 I-lipiodol. The lowest finger exposure is from glass microspheres. With resin microspheres finger exposure is acceptable but could be optimized in accordance with the ALARA principle, and especially in view of the increasing use of radioembolization. (orig.)

  8. Diagnostic radiography exposure increases the risk for thyroid microcarcinoma: a population-based case-control study.

    Science.gov (United States)

    Zhang, Yawei; Chen, Yingtai; Huang, Huang; Sandler, Jason; Dai, Min; Ma, Shuangge; Udelsman, Robert

    2015-09-01

    Thyroid cancer incidence and diagnostic radiography exposures, particularly computed tomography (CT) scanning and nuclear medicine examinations, have increased substantially in the USA. However, very few epidemiologic studies have directly investigated their associations. A population-based case-control study was conducted in Connecticut in 2010-2011, including 462 histologically confirmed incident thyroid cancer cases and 498 population-based controls. Multivariate unconditional logistic regression models were used to estimate the associations between diagnostic radiography and the risk of thyroid cancer, controlling for potential confounding factors. Exposure to any form of diagnostic radiography was associated with an increased risk of well-differentiated thyroid microcarcinoma [tumor size≤10 mm, odds ratio (OR)=2.76, 95% confidence interval (CI): 1.31-5.81]. The highest risk increase occurred with nuclear medicine examinations (excluding cardiology tests and thyroid uptake studies; OR=5.47, 95% CI: 2.10-14.23), followed by chest CT scanning (OR=4.30, 95% CI: 1.66-11.14), head and neck CT scanning (OR=3.88, 95% CI: 1.75-8.63), upper gastrointestinal series (OR=3.56, 95% CI: 1.54-8.21), lower gastrointestinal series (OR=3.29, 95% CI: 1.41-7.66), kidney radiography involving dye injection into a vein or artery (OR=3.21, 95% CI: 1.20-8.54), mammography (OR=2.95, 95% CI: 1.14-7.61), chest radiography (OR=2.93, 95% CI: 1.37-6.29), and abdomen CT scanning (OR=2.54, 95% CI: 1.02-6.30). No significant associations were found between these imaging modalities and thyroid tumors larger than 10 mm. This study provides the first direct evidence that CT scanning and nuclear medicine examinations are associated with an increased risk of thyroid cancer. The novel finding that an array of diagnostic radiography procedures are associated with thyroid microcarcinomas warrants further investigation.

  9. Diagnostic value of cone beam computed tomography and panoramic radiography in predicting mandibular nerve exposure during third molar surgery.

    Science.gov (United States)

    Hasani, A; Ahmadi Moshtaghin, F; Roohi, P; Rakhshan, V

    2017-02-01

    The aim of this study was to evaluate the diagnostic accuracies of cone beam computed tomography (CBCT) and panoramic techniques in predicting inferior alveolar nerve (IAN) exposure. The sample size was determined based on a pilot study. This prospective clinical series study included 59 third molar extraction sites with any of seven previously suggested panoramic signs of IAN exposure. The diagnosis of nerve exposure was done on panoramic and CBCT images. Molars were extracted and nerve exposure was evaluated clinically. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CBCT method, and sensitivity and PPV of panoramic method were estimated). The panoramic and CBCT methods correctly classified 67.7% and 93.3%, respectively, of 60 cases. This difference was statistically significant (χ 2 =13.333, P=0.000). The sensitivity, specificity, PPV, and NPV for CBCT were 97.4%, 85.7%, 92.7%, and 94.7%, respectively. The sensitivity and PPV of panoramic radiography were 67.8% and 97.6%, respectively. The signs with the highest sensitivity were interruption of the mandibular canal border and abrupt canal narrowing. None of the Pell and Gregory criteria, molar angulations, or three-dimensional canal-apex relationships was significantly associated with clinically confirmed IAN exposure. Panoramic radiography may miss about one-third of exposure cases, but a positive panoramic diagnosis is most likely to be a real exposure and should be taken seriously. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. HERCA WG Medical Applications / Sub WG 'Exposure of Asymptomatic Individuals in Health Care' - 'Position Paper on Screening'

    International Nuclear Information System (INIS)

    Griebel, Juergen; Ebdon-Jackson, Steve

    2012-05-01

    Over the course of several meetings the HERCA-Working Group (WG) 'Medical Applications' has discussed the exposure of asymptomatic individuals in health care. In particular, the discussions focused on the issue of the early detection of severe diseases, by use of X-rays, for those who do not present with symptoms. An important and established example is the use of X-ray mammography to detect early breast cancer and this has traditionally been referred to as screening. An emerging application is the use of computed tomography in a range of circumstances, some of which may be better described as a separate category of medical exposure as they are neither diagnostic nor screening in the accepted sense. The discussions have indicated that it is pivotal to clearly define the relevant terms generally applied and to clearly differentiate these terms from diagnostic examinations used in health care. In this context, it is important to note, that the revision of the Euratom Basic Safety Standards (Euratom BSS) Directive is under way and addresses in particular medical radiological procedures on asymptomatic individuals, intended to be performed for early detection of disease (Draft Proposal 29 September 2011 Article 54). Hereby, two types of examinations of asymptomatic individuals, (that in some cases have both been referred to as screening) are addressed: (1) exposures as part of screening programmes and (2) exposures associated with individual health assessment. On adoption, this directive will have significant implications for and a substantial impact on the work of the radiation protection authorities in Europe. In this position paper the WG 'Medical Applications' proposes a clear distinction between screening and radiological procedures as part of an individual health assessment and highlights special requirements for the latter. Finally, the impact on the work of radiation protection authorities in Europe is addressed

  11. Pre-Clinical Medical Students' Exposure to and Attitudes Toward Pharmaceutical Industry Marketing.

    Science.gov (United States)

    Fein, Eric H; Vermillion, Michelle L; Uijtdehaage, Sebastian H J

    2007-12-01

    Background - Recent studies have examined the exposures and attitudes of physicians and third- and fourth-year medical students toward pharmaceutical industry marketing, but fewer studies have addressed these topics among pre-clinical medical students. Thus, the purpose of this study was to assess pre-clinical students' level of exposure to the pharmaceutical industry and their attitudes toward marketing. Method - First and second-year medical students at UCLA completed a 40-item survey based on previous studies. Results - Over three quarters of pre-clinical students (78.5% or 226 of 288) responded to the survey. Exposure to pharmaceutical industry marketing started very early in medical school. Most second-year students (77%) had received gifts including drug samples after three semesters. Most felt that this would not affect their future prescribing behavior. Conclusions - These findings and findings from related studies, coupled with the students' desire to learn more about the issue, suggest that an early educational intervention addressing this topic may be warranted in American medical schools.

  12. TOPICAL REVIEW: Synthesis and applications of magnetic nanoparticles for biorecognition and point of care medical diagnostics

    Science.gov (United States)

    Sandhu, Adarsh; Handa, Hiroshi; Abe, Masanori

    2010-11-01

    Functionalized magnetic nanoparticles are important components in biorecognition and medical diagnostics. Here, we present a review of our contribution to this interdisciplinary research field. We start by describing a simple one-step process for the synthesis of highly uniform ferrite nanoparticles (d = 20-200 nm) and their functionalization with amino acids via carboxyl groups. For real-world applications, we used admicellar polymerization to produce 200 nm diameter 'FG beads', consisting of several 40 nm diameter ferrite nanoparticles encapsulated in a co-polymer of styrene and glycidyl methacrylate for high throughput molecular screening. The highly dispersive FG beads were functionalized with an ethylene glycol diglycidyl ether spacer and used for affinity purification of methotrexate—an anti-cancer agent. We synthesized sub-100 nm diameter magnetic nanocapsules by exploiting the self-assembly of viral capsid protein pentamers, where single 8, 20, and 27 nm nanoparticles were encapsulated with VP1 pentamers for applications including MRI contrast agents. The FG beads are now commercially available for use in fully automated bio-screening systems. We also incorporated europium complexes inside a polymer matrix to produce 140 nm diameter fluorescent-ferrite beads (FF beads), which emit at 618 nm. These FF beads were used for immunofluorescent staining for diagnosis of cancer metastases to lymph nodes during cancer resection surgery by labeling tumor cell epidermal growth factor receptor (EGFRs), and for the detection of brain natriuretic peptide (BNP)—a hormone secreted in excess amounts by the heart when stressed—to a level of 2.0 pg ml - 1. We also describe our work on Hall biosensors made using InSb and GaAs/InGaAs/AlGaAs 2DEG heterostructures integrated with gold current strips to reduce measurement times. Our approach for the detection of sub-200 nm magnetic bead is also described: we exploit the magnetically induced capture of micrometer sized 'probe

  13. Exposure to plastic surgery during undergraduate medical training: A single-institution review.

    Science.gov (United States)

    Austin, Ryan E; Wanzel, Kyle R

    2015-01-01

    Applications to surgical residency programs have declined over the past decade. Even highly competitive programs, such as plastic surgery, have begun to witness these effects. Studies have shown that early surgical exposure has a positive influence on career selection. To review plastic surgery application trends across Canada, and to further investigate medical student exposure to plastic surgery. To examine plastic surgery application trends, national data from the Canadian Resident Matching Service database were analyzed, comparing 2002 to 2007 with 2008 to 2013. To evaluate plastic surgery exposure, a survey of all undergraduate medical students at the University of Toronto (Toronto, Ontario) during the 2012/2013 academic year was conducted. Comparing 2002 to 2007 and 2008 to 2013, the average number of national plastic surgery training positions nearly doubled, while first-choice applicants decreased by 15.3%. The majority of Canadian academic institutions experienced a decrease in first-choice applicants; 84.7% of survey respondents indicated they had no exposure to plastic surgery during their medical education. Furthermore, 89.7% believed their education had not provided a basic understanding of issues commonly managed by plastic surgeons. The majority of students indicated they receive significantly less plastic surgery teaching than all other surgical subspecialties. More than 44% of students not considering plastic surgery as a career indicated they may be more likely to with increased exposure. If there is a desire to grow the specialty through future generations, recruiting tactics to foster greater interest in plastic surgery must be altered. The present study suggests increased and earlier exposure for medical students is a potential solution.

  14. Exposure to plastic surgery during undergraduate medical training: A single-institution review

    Science.gov (United States)

    Austin, Ryan E; Wanzel, Kyle R

    2015-01-01

    BACKGROUND: Applications to surgical residency programs have declined over the past decade. Even highly competitive programs, such as plastic surgery, have begun to witness these effects. Studies have shown that early surgical exposure has a positive influence on career selection. OBJECTIVE: To review plastic surgery application trends across Canada, and to further investigate medical student exposure to plastic surgery. METHODS: To examine plastic surgery application trends, national data from the Canadian Resident Matching Service database were analyzed, comparing 2002 to 2007 with 2008 to 2013. To evaluate plastic surgery exposure, a survey of all undergraduate medical students at the University of Toronto (Toronto, Ontario) during the 2012/2013 academic year was conducted. RESULTS: Comparing 2002 to 2007 and 2008 to 2013, the average number of national plastic surgery training positions nearly doubled, while first-choice applicants decreased by 15.3%. The majority of Canadian academic institutions experienced a decrease in first-choice applicants; 84.7% of survey respondents indicated they had no exposure to plastic surgery during their medical education. Furthermore, 89.7% believed their education had not provided a basic understanding of issues commonly managed by plastic surgeons. The majority of students indicated they receive significantly less plastic surgery teaching than all other surgical subspecialties. More than 44% of students not considering plastic surgery as a career indicated they may be more likely to with increased exposure. CONCLUSION: If there is a desire to grow the specialty through future generations, recruiting tactics to foster greater interest in plastic surgery must be altered. The present study suggests increased and earlier exposure for medical students is a potential solution. PMID:25821773

  15. Evaluation of the distribution of absorbed dose in child phantoms exposed to diagnostic medical x rays

    International Nuclear Information System (INIS)

    Chen, W.L.

    1977-01-01

    The purpose of the study was to determine, by theoretical calculation and experimental measurement, the absorbed dose distributions in two heterogeneous phantoms representing one-year- and five-year-old children from typical radiographic examinations for those ages. Theoretical work included the modification of an existing internal dose code which used Monte Carlo methods to determine doses within the Snyder-Fisher mathematical phantom. A Ge(Li) detector and a pinhole collimator were used to measure x-ray spectra which served as input (i.e., the source routine) to the modified Monte Carlo codes which were used to calculate organ doses in children. Experimental work included the fabrication of child phantoms to match the existing mathematical models. These phantoms were constructed of molded lucite shells filled with differing materials to simulate lung, skeletal, and soft-tissue regions. The skeleton regions of phantoms offered the opportunity to perform meaningful measurements of absorbed dose to bone marrow and bone. Thirteen to fourteen sites in various bones of the skeleton were chosen for placement of TLDs. These sites represented important regions in which active bone marrow is located. Sixteen typical radiographic examinations were performed representing common pediatric diagnostic procedures. The calculated and measured tissue-air values were compared for a number of organs. For most organs, the results of the calculated absorbed doses agreed with the measured absorbed doses within twice the coefficient of variation of the calculated value. The absorbed dose to specific organs for several selected radiological examinations are given for one-year-old, five-year-old, and adult phantoms. For selected radiological exposures, the risk factors of leukemia, thyroid cancer, and genetic death are estimated for one-year- and five-year-old children

  16. Occupational exposure of medical radiation workers in Lithuania, 1950-2003

    International Nuclear Information System (INIS)

    Samerdokiene, V.; Atkocius, V.; Kurtinaitis, J.; Valuckas, K.P.

    2008-01-01

    This study presents the summary of historical exposures, measurement practice and evolution of the recording of the individual doses of medical radiation workers during 1950-2003 in Lithuania. The aim of this study is to present occupational exposure of medical radiation workers in Lithuania since the earliest appearance period. Data from publications have been used for the earliest two periods prior to 1969; data from the archives of the largest hospitals, for the period 1970-1990 and data from Lithuanian Subdivision of Individual Dosimetry of Radiation Protection Center, for the period 1991-2003. The analysis of the data obtained from personal records allows to conclude that the average annual effective dose of Lithuanian medical radiation workers was greatly reduced in radiology, radiotherapy and nuclear medicine in all occupational categories from 1950 to 2003. During the last period 1991-2003 extremity doses clearly decreased and after 1994 were no longer present in Lithuania. (authors)

  17. The potential of high resolution melting analysis (hrma) to streamline, facilitate and enrich routine diagnostics in medical microbiology.

    Science.gov (United States)

    Ruskova, Lenka; Raclavsky, Vladislav

    2011-09-01

    Routine medical microbiology diagnostics relies on conventional cultivation followed by phenotypic techniques for identification of pathogenic bacteria and fungi. This is not only due to tradition and economy but also because it provides pure culture needed for antibiotic susceptibility testing. This review focuses on the potential of High Resolution Melting Analysis (HRMA) of double-stranded DNA for future routine medical microbiology. Search of MEDLINE database for publications showing the advantages of HRMA in routine medical microbiology for identification, strain typing and further characterization of pathogenic bacteria and fungi in particular. The results show increasing numbers of newly-developed and more tailor-made assays in this field. For microbiologists unfamiliar with technical aspects of HRMA, we also provide insight into the technique from the perspective of microbial characterization. We can anticipate that the routine availability of HRMA in medical microbiology laboratories will provide a strong stimulus to this field. This is already envisioned by the growing number of medical microbiology applications published recently. The speed, power, convenience and cost effectiveness of this technology virtually predestine that it will advance genetic characterization of microbes and streamline, facilitate and enrich diagnostics in routine medical microbiology without interfering with the proven advantages of conventional cultivation.

  18. The estimation of radiation effective dose from diagnostic medical procedures in general population of northern Iran

    International Nuclear Information System (INIS)

    Shabestani Monfared, A.; Abdi, R.

    2006-01-01

    The risks of low-dose Ionizing radiation from radiology and nuclear medicine are not clearly determined. Effective dose to population is a very important factor in risk estimation. The study aimed to determine the effective dose from diagnostic radiation medicine in a northern province of Iran. Materials and Methods: Data about various radiologic and nuclear medicine procedures were collected from all radiology and nuclear medicine departments In Mazandaran Province (population = 2,898,031); and using the standard dosimetry tables, the total dose, dose per examination, and annual effective dose per capita as well as the annual gonadal dose per capita were estimated. Results: 655,730 radiologic examinations in a year's period, lead to 1.45 mSv, 0.33 mSv and 0.31 mGy as average effective dose per examination, annual average effective dose to member of the public, and annual average gonadal dose per capita, respectively. The frequency of medical radiologic examinations was 2,262 examinations annually per 10,000 members of population. However, the total number of nuclear medicine examinations in the same period was 7074, with 4.37 mSv, 9.6 μSv and 9.8 μGy, as average effective dose per examination, annual average effective dose to member of the public and annual average gonadal dose per caput, respectively. The frequency of nuclear medicine examination was 24 examinations annually per 10,000 members of population. Conclusion: The average effective dose per examination was nearly similar to other studies. However, the average annual effective dose and annual average gonadal dose per capita were less than the similar values in other reports, which could be due to lesser number of radiation medicine examinations in the present study

  19. Clinically Unjustified Diagnostic Imaging – a Worrisome Tendency in Today’s Medical Practice

    Science.gov (United States)

    Sobiecka, Aleksandra; Bekiesińska-Figatowska, Monika; Rutkowska, Milena; Latos, Tomasz; Walecki, Jerzy

    2016-01-01

    Summary Background The purpose of the study was to evaluate the percentage of unjustified examinations among all the CT and MRI studies performed by two radiology departments and to determine the types of examinations which are most commonly carried out unnecessarily. Material/Methods Three radiologists assessed the justification of CT and MRI examinations performed during a period of 14 days based on the referrals. The radiologists assessed 799 referrals for CT scans (847 examinations of a particular part of the body) and 269 MRI referrals (269 examinations). The criteria for justification were: medical expertise and the guidelines. During the first stage radiologists divided the examinations into 3 groups: justified, unjustified and the examinations of questionable justification. The second step was to determine the reasons why the studies were considered as unjustified or of questionable justification. Results 73 of 1116 examinations (6.54%) were considered to be unjustified or of a questionable justification. There were 59 CT scans (59/847=6.97%) and 14 MRI studies (14/269=5.20%). The most common reasons to consider them as unjustified or of questionable justification were: inadequate method of diagnostic imaging chosen as a first-line tool and lacking or insufficient clinical details. Conclusions In our investigation 6.54% of both CT and MRI examinations were considered as unjustified or of questionable justification, which is lower than described in other studies (from 7% to 26%). The assessment was based only on referrals, therefore a total share of these examinations is likely to be higher. PMID:27471577

  20. Estimation of population doses from diagnostic medical examinations in Japan, 1974, (4)

    International Nuclear Information System (INIS)

    Hashizume, Tadashi; Maruyama, Takashi; Kumamoto, Yoshikazu

    1976-01-01

    In fetus exposed in utero to diagnostic x-rays for the medical examinations of the mother, the absorbed dose has been estimated on the basis of a 1974 nation wide radiological survey. The results of the survey showed that the number of radiographs per year connected with pregnant women was 0.32 million for chest examination excluding mass surveys. 0.29 million for obstetrical examinations including pelvimetry, and 0.21 million for abdominal and pelvic examinations with a total of 0.82 million. The dose absorbed in the fetus was measured with an ionization chamber placed at the hypothetical center of the fetus in an ''average woman'' Rando phantom in which a maternal body was simulated by adding MixDp materials. ''The collective dose'' to the fetus in the pregnant women receiving a given type of examination was calculated from the number of radiographs per year connected with the pregnant women and the fetal doses. The percapita mean marrow dose (CMD), the leukemia significant dose (LSD) and the genetically significant dose (GSD) for the fetus were determined from the collective dose, taking into account the birth expectancy, the child expectancy, life expectancy and significant factor for the fetus. The collective dose to the fetus was estimated to be 9.3 x 10 4 man rad per year. The resultant values of CMD, LSD and GSD were 0.81 mrad per year, 0.79 mrad per person per year and 1.44 mrad per person per year, respectively. (Evans, J.)

  1. Professional development and exposure to geriatrics: medical student perspectives from narrative journals.

    Science.gov (United States)

    Shield, Renée R; Farrell, Timothy W; Campbell, Susan E; Nanda, Aman; Wetle, Terrie

    2015-01-01

    Teaching professionalism is an important goal in American medical education. With the aging of the U.S. population, it is critical to understand how medical students develop professional behaviors when caring for older adults. Exposure to geriatrics and older patients can enhance students' professional development with patients of all ages and across different specialties. Medical students learn explicit and implicit messages during their education. In addition to helping to evaluate curricula, reflective journaling encourages individual development and helps in revealing how medical students become professionals. In this study, medical student volunteers described their responses to new geriatrics content in their curriculum, encounters with older patients in clinical settings, and their evolving physician identities. Multidisciplinary team analysis elicited 10 themes regarding: evaluation of geriatrics within the curriculum, recognition of geriatrics principles, and attitudes regarding aging and professional development over time. This article focuses on the impact of geriatrics exposure on students' professional development, revealing ways that students think about professionalism and older patients. Medical educators should consider journaling to help foster and gauge students' professional development.

  2. A strategy to optimize radiation exposure for non-contrast head CT: comparison with the Japanese diagnostic reference levels.

    Science.gov (United States)

    Kumamaru, Kanako K; Kogure, Yosuke; Suzuki, Michimasa; Hori, Masaaki; Nakanishi, Atsushi; Kamagata, Koji; Hagiwara, Akifumi; Andica, Christina; Ri, Keiken; Houshido, Naoyoshi; Aoki, Shigeki

    2016-06-01

    To describe how we performed a protocol review, analyzed data, identified opportunities to reduce radiation exposure, and then implemented a new imaging protocol for non-contrast adult head CT at our institution with reduced radiation exposure, using the Japanese diagnostic reference levels (DRLs) as the reference. After analyzing the CT dose index (CTDIvol) and dose length product (DLP) in all non-contrast adult head CT examinations performed during a 3-month period (September to November 2015) in order to identify a specific protocol that contributed to the above-DRL-level radiation exposure observed for non-contrast adult head CT at our institution, phantom studies with objective and subjective image quality analyses were performed to develop a new imaging protocol. After implementing the new protocol, its feasibility was evaluated in terms of radiation exposure, prevalence of significant disease detection, and subjective image quality. The review of 2040 examinations revealed that a helical protocol (CTDIvol = 93.4 mGy) with one of four CT scanners mainly contributed to the above-DRL-level radiation exposure (mean DLP at this scanner = 1401.2 mGy cm) in non-contrast adult head CT at our institution. To replace this protocol, the phantom study identified a wide-volume scan using 120 kVp, 350 mAs, a 4-cm detector, a slice thickness of 5 mm, and a CTDIvol of 69.8 mGy as a new protocol that yielded comparable image quality to the existing protocol. After the implementation of the new protocol, the overall mean DLP reduced to 1365 mGy cm without any apparent degradation of image quality. No significant decrease in the prevalence of significant findings after protocol revision was noted. We report the successful implementation of a new protocol with reduced radiation exposure for non-contrast head CT examinations.

  3. Medical students' exposure to and attitudes about the pharmaceutical industry: a systematic review.

    Science.gov (United States)

    Austad, Kirsten E; Avorn, Jerry; Kesselheim, Aaron S

    2011-05-01

    The relationship between health professionals and the pharmaceutical industry has become a source of controversy. Physicians' attitudes towards the industry can form early in their careers, but little is known about this key stage of development. We performed a systematic review reported according to PRISMA guidelines to determine the frequency and nature of medical students' exposure to the drug industry, as well as students' attitudes concerning pharmaceutical policy issues. We searched MEDLINE, EMBASE, Web of Science, and ERIC from the earliest available dates through May 2010, as well as bibliographies of selected studies. We sought original studies that reported quantitative or qualitative data about medical students' exposure to pharmaceutical marketing, their attitudes about marketing practices, relationships with industry, and related pharmaceutical policy issues. Studies were separated, where possible, into those that addressed preclinical versus clinical training, and were quality rated using a standard methodology. Thirty-two studies met inclusion criteria. We found that 40%-100% of medical students reported interacting with the pharmaceutical industry. A substantial proportion of students (13%-69%) were reported as believing that gifts from industry influence prescribing. Eight studies reported a correlation between frequency of contact and favorable attitudes toward industry interactions. Students were more approving of gifts to physicians or medical students than to government officials. Certain attitudes appeared to change during medical school, though a time trend was not performed; for example, clinical students (53%-71%) were more likely than preclinical students (29%-62%) to report that promotional information helps educate about new drugs. Undergraduate medical education provides substantial contact with pharmaceutical marketing, and the extent of such contact is associated with positive attitudes about marketing and skepticism about negative

  4. Medical students' exposure to and attitudes about the pharmaceutical industry: a systematic review.

    Directory of Open Access Journals (Sweden)

    Kirsten E Austad

    2011-05-01

    Full Text Available The relationship between health professionals and the pharmaceutical industry has become a source of controversy. Physicians' attitudes towards the industry can form early in their careers, but little is known about this key stage of development.We performed a systematic review reported according to PRISMA guidelines to determine the frequency and nature of medical students' exposure to the drug industry, as well as students' attitudes concerning pharmaceutical policy issues. We searched MEDLINE, EMBASE, Web of Science, and ERIC from the earliest available dates through May 2010, as well as bibliographies of selected studies. We sought original studies that reported quantitative or qualitative data about medical students' exposure to pharmaceutical marketing, their attitudes about marketing practices, relationships with industry, and related pharmaceutical policy issues. Studies were separated, where possible, into those that addressed preclinical versus clinical training, and were quality rated using a standard methodology. Thirty-two studies met inclusion criteria. We found that 40%-100% of medical students reported interacting with the pharmaceutical industry. A substantial proportion of students (13%-69% were reported as believing that gifts from industry influence prescribing. Eight studies reported a correlation between frequency of contact and favorable attitudes toward industry interactions. Students were more approving of gifts to physicians or medical students than to government officials. Certain attitudes appeared to change during medical school, though a time trend was not performed; for example, clinical students (53%-71% were more likely than preclinical students (29%-62% to report that promotional information helps educate about new drugs.Undergraduate medical education provides substantial contact with pharmaceutical marketing, and the extent of such contact is associated with positive attitudes about marketing and skepticism

  5. Traffic exposure in a population with high prevalence type 2 diabetes - Do medications influence concentrations of C-reactive protein?

    International Nuclear Information System (INIS)

    Rioux, Christine L.; Tucker, Katherine L.; Brugge, Doug; Gute, David M.; Mwamburi, Mkaya

    2011-01-01

    Type 2 Diabetes (T2D) and particulate air pollution are associated with inflammatory dysregulation. We assessed the modifying effects of diabetes medications on the association of C-reactive protein (CRP), a marker of inflammation, and traffic exposure in adults with T2D (n = 379). CRP concentrations were significantly positively associated with residence ≤100 m of a roadway, >100 m and ≤200 m of a roadway and increased traffic density for individuals using insulin. For individuals using oral hypoglycemic medications (OHAs), CRP was significantly negatively associated with residence >100 m - ≤200 m of a roadway and multiple roadway exposure in an interaction model. Among people with diabetes, individuals on insulin appear to be most vulnerable to the effects of traffic exposure. Disease severity among insulin users may promote the pro-inflammatory response to traffic exposure, though diabetes medications may also modify the response. Possible anti-inflammatory effects of OHAs with traffic exposure merit further evaluation. - Highlights: →We examine traffic exposure in a population with high rates of Type 2 Diabetes. →Differences in CRP were evaluated by traffic levels, medication use and type. →Those on insulin had significantly higher CRP with traffic exposure. →Interaction models demonstrated lower CRP with traffic exposure and OHA use. →Diabetes medications may modify the response to traffic exposure. - Among people with diabetes, individuals on insulin appear to be most vulnerable to the effects of traffic exposure. Diabetes medications may modify the response to traffic.

  6. Traffic exposure in a population with high prevalence type 2 diabetes - Do medications influence concentrations of C-reactive protein?

    Energy Technology Data Exchange (ETDEWEB)

    Rioux, Christine L., E-mail: christine.rioux@tufts.edu [Department of Public Health and Community Medicine, Tufts University, 136 Harrison Avenue, Boston, MA 02111 (United States); Tucker, Katherine L. [Department of Health Science, Northeastern University, Boston, MA (United States); Brugge, Doug [Department of Public Health and Community Medicine, Tufts University, 136 Harrison Avenue, Boston, MA 02111 (United States); Gute, David M. [Department of Civil and Environmental Engineering, Tufts University, Medford, MA (United States); Mwamburi, Mkaya [Department of Public Health and Community Medicine, Tufts University, 136 Harrison Avenue, Boston, MA 02111 (United States)

    2011-08-15

    Type 2 Diabetes (T2D) and particulate air pollution are associated with inflammatory dysregulation. We assessed the modifying effects of diabetes medications on the association of C-reactive protein (CRP), a marker of inflammation, and traffic exposure in adults with T2D (n = 379). CRP concentrations were significantly positively associated with residence {<=}100 m of a roadway, >100 m and {<=}200 m of a roadway and increased traffic density for individuals using insulin. For individuals using oral hypoglycemic medications (OHAs), CRP was significantly negatively associated with residence >100 m - {<=}200 m of a roadway and multiple roadway exposure in an interaction model. Among people with diabetes, individuals on insulin appear to be most vulnerable to the effects of traffic exposure. Disease severity among insulin users may promote the pro-inflammatory response to traffic exposure, though diabetes medications may also modify the response. Possible anti-inflammatory effects of OHAs with traffic exposure merit further evaluation. - Highlights: >We examine traffic exposure in a population with high rates of Type 2 Diabetes. >Differences in CRP were evaluated by traffic levels, medication use and type. >Those on insulin had significantly higher CRP with traffic exposure. >Interaction models demonstrated lower CRP with traffic exposure and OHA use. >Diabetes medications may modify the response to traffic exposure. - Among people with diabetes, individuals on insulin appear to be most vulnerable to the effects of traffic exposure. Diabetes medications may modify the response to traffic.

  7. Professional exposure of medical workers: radiation levels, radiation risk and personal dose monitoring

    International Nuclear Information System (INIS)

    Bai Guang

    2005-01-01

    The application of radiation in the field of medicine is the most active area. Due to the rapid and strong development of intervention radiology at present near 20 years, particularly, the medical workers become a popularize group which most rapid increasing and also receiving the must high of professional exposure dose. Because, inter alias, radiation protection management nag training have not fully follow up, the aware of radioactive protection and appropriate approach have tot fully meet the development and need, the professional exposure dose received by medical workers, especially those being engaged in intervention radiology, are more higher, as well as have not yet fully receiving the complete personal dose monitoring, the medical workers become the population group which should be paid the most attention to. The writer would advice in this paper that all medical workers who being received a professional radiation exposure should pay more attention to the safety and healthy they by is strengthening radiation protection and receiving complete personal dose monitoring. (authors)

  8. Modeled occupational exposures to gas-phase medical laser-generated air contaminants.

    Science.gov (United States)

    Lippert, Julia F; Lacey, Steven E; Jones, Rachael M

    2014-01-01

    Exposure monitoring data indicate the potential for substantive exposure to laser-generated air contaminants (LGAC); however the diversity of medical lasers and their applications limit generalization from direct workplace monitoring. Emission rates of seven previously reported gas-phase constituents of medical laser-generated air contaminants (LGAC) were determined experimentally and used in a semi-empirical two-zone model to estimate a range of plausible occupational exposures to health care staff. Single-source emission rates were generated in an emission chamber as a one-compartment mass balance model at steady-state. Clinical facility parameters such as room size and ventilation rate were based on standard ventilation and environmental conditions required for a laser surgical facility in compliance with regulatory agencies. All input variables in the model including point source emission rates were varied over an appropriate distribution in a Monte Carlo simulation to generate a range of time-weighted average (TWA) concentrations in the near and far field zones of the room in a conservative approach inclusive of all contributing factors to inform future predictive models. The concentrations were assessed for risk and the highest values were shown to be at least three orders of magnitude lower than the relevant occupational exposure limits (OELs). Estimated values do not appear to present a significant exposure hazard within the conditions of our emission rate estimates.

  9. Teaching surgical exposures to undergraduate medical students: an integration concept for anatomical and surgical education.

    Science.gov (United States)

    Hammer, Niels; Hepp, Pierre; Löffler, Sabine; Schleifenbaum, Stefan; Steinke, Hanno; Klima, Stefan

    2015-06-01

    Decreasing numbers of students are interested in starting a surgical career, posing substantial challenges to patient care in the next years. The anatomy course is one of the key subjects in medical training, especially in surgical disciplines. Innovative teaching concepts that integrate surgically relevant anatomy and manual dexterity might help boost student interest in surgery. A preclinical workshop entitled "Surgical exposures" was developed. A team of anatomists and surgeons introduced the surgical exposures, demonstrating the procedures on Thiel-fixed body donors. Following this introduction, students practiced the exposures in an operating room-like manner. A six-point Likert scale was used to evaluate the workshop and to compare it to the first-year dissection course. The overall evaluation result for the surgical exposures was excellent, proving to be a significantly better result when compared to the first-year dissection course. The students were more satisfied with the teaching time invested by the peers and regarded the workshop as clinically highly relevant. Furthermore, they felt that questions were addressed better and that the overall atmosphere was better than in the gross anatomy course. Subject to criticism was the course size and practicing time in both cases. The surgical exposures workshop provides preclinical students with clinically relevant anatomy and manual dexterity. It may positively influence the decision to follow a surgical career. This course, however, requires extensive teaching resources. The given concept may help implement practical medical skills in the preclinical curriculum, strengthening the professional identity of surgeons and anatomists.

  10. Current and Projected Modes of Delivery of Veterinary Medical Services to Animal Agriculture: Diagnostic Laboratory Services.

    Science.gov (United States)

    Seaton, Vaughn A.

    1980-01-01

    The veterinary diagnostic laboratory's prime role has been diagnosis and/or laboratory findings to assist a diagnosis. Interpretation and evaluation and more involvement with decision-making in monitoring groups of animals and their health status are seen as future roles for diagnostic laboratories. (MLW)

  11. Advance of the National Program of Radiological Protection and Safety for medical diagnostic with X-rays

    International Nuclear Information System (INIS)

    Verdejo S, M.

    1999-01-01

    The National Program of Radiological Protection and Safety for medical diagnostic with X-ray (Programa Nacional de Proteccion y Seguridad Radiologica para diagnostico medico con rayos X) was initiated in the General Direction of Environmental Health (Direccion General de Salud Ambiental) in 1995. Task coordinated with different dependences of the Public Sector in collaboration between the Secretary of Health (Secretaria de Salud), the National Commission of Nuclear Safety and Safeguards (Comision Nacional de Seguridad Nuclear y Salvaguardias) and, the National Institute of Nuclear Research (Instituto Nacional de Investigaciones Nucleares). The surveillance to the fulfilment of the standardization in matter of Radiological Protection and Safety in the medical diagnostic with X-rays has been obtained for an important advance in the Public sector and it has been arousing interest in the Private sector. (Author)

  12. Translating silicon nanowire BioFET sensor-technology to embedded point-of-care medical diagnostics

    DEFF Research Database (Denmark)

    Pfreundt, Andrea; Zulfiqar, Azeem; Patou, François

    2013-01-01

    Silicon nanowire and nanoribbon biosensors have shown great promise in the detection of biomarkers at very low concentrations. Their high sensitivity makes them ideal candidates for use in early-stage medical diagnostics and further disease monitoring where low amounts of biomarkers need to be de......Silicon nanowire and nanoribbon biosensors have shown great promise in the detection of biomarkers at very low concentrations. Their high sensitivity makes them ideal candidates for use in early-stage medical diagnostics and further disease monitoring where low amounts of biomarkers need...... rising fabrication costs. Also the translation of nano-scale sensor technology into daily-use point-of-care devices requires acknowledgement of the end-user requirements, making device portability and human-interfacing a focus point in device development. Sample handling or purification for instance...

  13. Trauma exposure and symptoms of post-traumatic stress disorder in emergency medical services personnel in Hawaii.

    Science.gov (United States)

    Mishra, Shalini; Goebert, Deborah; Char, Elizabeth; Dukes, Patricia; Ahmed, Iqbal

    2010-09-01

    Exposure to traumatic stressors is potentially an integral part of the job for emergency medical services (EMS) personnel, placing them at risk for psychological distress and mental health problems. The prevalence of post-traumatic stress disorder (PTSD) and post-traumatic stress symptoms was examined in a sample of EMS personnel in a multiethnic locality in Hawaii. Commonly encountered traumatic incidents at work were also assessed. The PTSD Check List-Civilian version was sent to 220 EMS personnel. The survey included questions on demographics, traumatic incidents at work, general stressors, coping methods and post-traumatic stress symptoms. 105 surveys were returned (48% response rate); 4% of respondents met clinical diagnostic criteria for PTSD, 1% met subclinical criteria for PTSD, 83% reported experiencing some symptoms but no PTSD and 12% had no symptoms. However, few had received treatment for these symptoms. Serious injury or death of a co-worker along with incidents involving children were considered very stressful. General work conditions also contributed to the overall stress levels. Most common coping strategies reported were positive reinterpretation (63%), seeking family and social support (59%) and awareness and venting of emotions (46%), with significant differences by ethnicity. EMS personnel are at high risk of experiencing post-traumatic stress symptoms. Early identification and treatment of potential stressors, psychiatric and medical problems is warranted and necessitates ongoing assessment and employee assistance programmes at the minimum.

  14. Occupational exposure to sharp injuries among medical and dental house officers in Nigeria

    Directory of Open Access Journals (Sweden)

    Nosayaba Osazuwa-Peters

    2013-04-01

    Full Text Available Objective: Sharp injuries constitute important occupational exposure in hospital environment, and perhaps the newly graduated medical and dental students, known as House Officers, in the first twelve months of their practice, are the most vulnerable of all health workers. This study was designed to examine the nature and prevalence of occupational injuries among medical and dental house officers and factors associated with reporting these injuries. Materials and Methods: A self-administered questionnaire was used to obtain information on demography, types of exposure, and barriers to official reporting of occupational injuries. One hundred and forty-four medical and dental house officers in 3 government owned hospitals in Edo State, Nigeria participated in the study, between April and May, 2010. Descriptive and multivariable analyses were performed. Results: The overall response rate was 96%. Out of all participants, 69.4% were male; 82.6% were medical house officers. Prevalence of percutaneous injury was 56.9%; where needlestick injury constituted one-third of all injuries. Mean frequency of injury was 1.86±2.24, with medicals having more injuries (p = 0.043. The ward was the most common location for the injury and 14.8% of exposures occurred as a result of lapse in concentration. At least 77.0% did not formally report their injury and perceived low injury risk was the most common reason given (51.67%. Conclusion: This study shows that a substantial number of House Officers are exposed to occupational injuries and that the majority of them does not formally report these. Safer work environment may be achieved by implementing adequate educational programs tailored specifically to house officers, and policies encouraging exposure reporting should be developed.

  15. Radiation doses to patients in medical diagnostic x-ray examinations in New Zealand: a 1983-84 survey

    International Nuclear Information System (INIS)

    Williamson, B.D.P.; Poletti, J.L.; Cartwright, P.H.; Le Heron, J.C.

    1993-06-01

    A survey of doses to patients undergoing diagnostic x-ray examinations was performed in 1983-84. Developments since 1983-84 were reviewed and estimates made of the frequency of x-ray examinations, and doses to patients, as at 1992. The collective effective dose from general medical diagnostic radiology in 1983-84 was estimated to have been about 443 μSv per capita per annum. The figure excluded computed tomography which was estimated to have contributed about 5.6 μSv per capita per annum and mammography gave 0.3 μSv per annum. The total per capital effective dose from all medical diag over the whole period from 1983-84 to 1992. The highest dose examinations in 1983-84 were the fluoroscopic procedures barium enema and meal. Over the whole period 1983-84 to 1992 the genetically significant dose (GSD) to the population of New Zealand from medical diagnostic radiology was estimated to have been in the range 200-250 μSv per capita per annum. The two opposing tendencies noted for effective dose, viz, the fall in frequency of some examination types and the rise of Computed tomography, acted also upon this dose index. 43 refs., tabs., figs., ills

  16. Exposure to systemic antibacterial medications during pregnancy and risk of childhood cancer.

    Science.gov (United States)

    Momen, Natalie C; Olsen, Jørn; Gissler, Mika; Kieler, Helle; Haglund, Bengt; Li, Jiong

    2015-08-01

    Up to one-third of women receive prescriptions for systemic antibacterial medications during pregnancy. This paper looks at the association between maternal use of systemic antibacterial medications during pregnancy and childhood cancer risk in the offspring using the prospective data on medication. A population-based follow-up study was carried out using Danish and Swedish register data. Exposure was maternal redemption of a prescription for a systemic antibacterial in the 3 months prior to pregnancy and during pregnancy (exposure window) documented in the national prescription registers, and offspring were followed up from birth to a cancer diagnosis, death, emigration, day before 15th birthday or end of follow-up, whichever came first. Timing, dosage, specific medication types and types of childhood cancer were also considered. Mothers of 35.1% (n = 506,194) of the children filled at least one prescription for systemic antibacterials during the exposure window. Exposed children had a hazard ratio of 1.08 (95% confidence interval: 0.97, 1.20) compared with unexposed children. Statistically significant results were found for some specific medications (for example, 'other antibacterials'/Anatomical Therapeutic Chemical code J01X) and combinations of cancer types and specific medications (leukaemia and other antibacterials, and hepatic cancers and tetracyclines). The results of this study indicate that most antibacterial drugs used during pregnancy were not related to childhood cancer risk in the offspring. However, some may be associated with the development of some specific types of childhood cancers. Our findings need to be replicated in an independent data source. Copyright © 2015 John Wiley & Sons, Ltd.

  17. Principles and practices for keeping occupational radiation exposures at medical institutions as low as reasonably achievable

    International Nuclear Information System (INIS)

    Brodsky, A.

    1977-10-01

    Some of the major considerations in establishing management policies, staff, facilities and equipment, and operational procedures to promote radiation safety in medical or hospital care programs using radioactive materials licensed by the U.S. Nuclear Regulatory Commission (NRC) are presented. It is a compendium of good practices for establishing adequate radiation safety programs in medical institutions. The information presented is intended to aid the NRC licensee in fulfilling the philosophy of maintaining radiation exposures of employees, patients, visitors, and the public as low as reasonably achievable (ALARA). Each subsection of this report is designed to include the major radiation safety considerations of interest to the specific type of activity

  18. Legal Rights of Asbestos Exposure Victims. A Practical Legal Guide for People With Breathing and Other Medical Problems, Possibly Resulting from Exposure to Asbestos.

    Science.gov (United States)

    Silberfeld, Roman M.; Hecht, Richard L.

    This practical legal guide for people with breathing and other medical problems, possibly resulting from exposure to asbestos, provides 19 questions and detailed answers about Asbestosis and other diseases resulting from asbestos exposure. Included is information concerning symptoms, difficulty of diagnosis, necessity of a detailed…

  19. Medical radiation exposure of pregnant and potentially pregnant women - approved 1977

    International Nuclear Information System (INIS)

    Anon.

    1978-01-01

    Sensitivity to ionizing radiation is greater during intrauterine stages of development than at other stages in the life of the mammalian organism. For this reason, the NCRP recommends special care in patient selection in certain cases of diagnostic radiology and nuclear medicine diagnostic procedures. For women of child-bearing capacity, the physician requesting a radiological or nuclear medicine examination involving the lower abdominal or pelvic region should ascertain whether the patient is, or could be, pregnant. Further, the NCRP recommends that physicians tell their premenopausal patients that, if they are likely to have nuclear medicine studies or x-ray examinations of the lower abdomen, it is generally advisable that they not run a risk of pregnancy until two months after the studies are carried out. Modification of an examination for dose reduction is warranted only if it reasonably can be done without significant jeopardy to the medical care of the patient and/or her unborn child

  20. A survey of medical students to assess their exposure to and knowledge of renal transplantation

    Directory of Open Access Journals (Sweden)

    Weale Andrew R

    2004-12-01

    Full Text Available Abstract Background Within the field of renal transplantation there is a lack of qualified and trainee surgeons and a shortage of donated organs. Any steps to tackle these issues should, in part, be aimed at future doctors. Methods A questionnaire was distributed to final year students at a single medical school in the UK to assess their exposure to and knowledge of renal transplantation. Results Although 46% of responding students had examined a transplant recipient, only 14% had ever witnessed the surgery. Worryingly, 9% of students believed that xenotransplantation commonly occurs in the UK and 35% were unable to name a single drug that a recipient may need to take. Conclusions This survey demonstrates a lack of exposure to, and knowledge of, the field of renal transplantation. Recommendations to address the problems with the recruitment of surgeons and donation of organs, by targeting medical students are made.

  1. Guidelines for the physician's behaviour after exposure of embryos or fetuses to ionizing radiation or after incorporation of radioactive substances for medical purposes

    International Nuclear Information System (INIS)

    Leppin, W.

    1980-01-01

    These guidelines intend to give the physician information on his further actions if radiation has been used in pregnant women for diagnostic purposes, and especially on the medical advice to be given to the woman. The guidelines deal mainly with radiation exposures up to a dose of 20 mGy (2 rd). The guidelines are to show that there is no indication in this dose range for the necessity of an abortion. If doses have been higher than 20 mGy (2 rd), which may be the fact in only a few cases, careful and complex diagnostic efforts are required for the decision on an abortion. The guidelines give some information also on the dose range above 20 mGy (2 rd). (orig.) [de

  2. A project report on medical exposure to the population around Jaitapur, due to diagnostic applications

    International Nuclear Information System (INIS)

    Khyalappa, R.J.; Sharma, S.D.

    2011-01-01

    The Entrance Skin Dose (ESD) values are calculated for the three districts of Maharashtra state viz. Ratnagiri, Sindhudurg and Kolhapur in India according to standard Dose Reference Values (DRL) given in the well known Indian study published by Sonawane et al. 2010. The DRL values for the type of X-rays that are not published in Sonawane et al., such as for cervical spine and for limb are taken from other studies in European countries, as very few studies have been calculated in India and other Asian countries. The highest numbers of X-ray examinations to which patients are exposed are chest, followed by hip, limb and then others. The numbers of CT examinations done are highest for head followed by abdomen, chest, lumbar spine, thorax and pelvis. The descending order for maximum number of X-ray examinations to which patients exposed is almost same in all the three districts mentioned as above with ESD measurements done for X-ray and CT data

  3. ANALYSIS OF PROPERTY STRUCTURE OF MEDICAL DIAGNOSTIC CONSULTATIVE CENTERS IN VARNA

    Directory of Open Access Journals (Sweden)

    Lyubomira Koeva-Dimitrova

    2016-06-01

    Full Text Available The production and financial performance of one company depend on the size of its assets and the aptness of the assets� proportion. The aim of this article is urged to make an external analysis of the asset structure of medical diagnostic and consultative centers (DCC in Varna and on this basis to draw conclusions regarding their property structure. Subject of the study is the annual financial statements, published in the Commercial Register, of all 9 in number DCCs that are registered in Varna. The names of DCC's are encoded with numbers from 1 to 9, with numbers from 1 to 7 are 6 DCCs, owned by the Municipality of Varna, one of them is a subsidiary of staterun hospital, with number 8 and 9 are private DCC's. Subject of the study are the assets and their proportion in the studied hospitals. The study covers 7 years - from year 2008 to year 2014. In the study are calculated and compared the indicators for intensity of the property as well as the relative share of the fixed assets obtained as an average value of the relative shares of all nine in number hospitals for the entire studied period. The following important conclusions have been made: 1 The average relative share of fixed assets of Varna DCCs for the period 2008 � 2014 is 56.85%. 2 The proportion of FA calculated only for municipal DCC's (average value is significantly higher - 72.75% compared to the overall average of 56.85%. 3 Private hospitals invest a lot less money in fixed assets than the municipal ones. 4 Since 2013 there is a slight increase of FA share in the private and the state-run DCC, and a slight decrease in the municipal ones (71.93. 5 The creation of an online database comprising of average indicators of the financial and property status of Bulgarian companies is essential and necessary condition for improving their competitiveness by providing reliable, accurate and usable information for comparison.

  4. X-ray diagnostics - benefits and risks

    International Nuclear Information System (INIS)

    Bartholomaeus, Melanie

    2016-01-01

    The brochure on benefits and risks of X-ray diagnostics discusses the following issues: X radiation - a pioneering discovery and medical sensation, fundamentals of X radiation, frequency of X-ray examinations in Germany in relation to CT imaging, radiation doses resulting from X-ray diagnostics, benefits of X-ray diagnostics - indication and examples, risks - measures for radiation exposure reductions, avoidance of unnecessary examinations.

  5. Report on recent over-exposure accidents with a medical linac in Japan

    International Nuclear Information System (INIS)

    Kudoh, Hisaaki

    2003-01-01

    On December 21, 2001, at a hospital in Tokyo, an engineer setting a medical-linac was over-exposed by the equipment due to lack of communication between workers. The exposed dose was initially reported as 1000 mSv (1 Sv), but later revised to 200 mSv at most. The outline of the accident and the statistical data on radiation exposure accidents in Japan and the world are briefly overlooked. (author)

  6. Medical management after contamination and incorporation of americium in occupational exposure

    International Nuclear Information System (INIS)

    Gensicke, F.; Stopp, G.; Scheler, R.; Klucke, H.; Czarwinski, R.; Naumann, M.; Hoelzer, F.; Ott, R.; Schmidt, I.

    1990-01-01

    In handling with an ampule of 241 Am-nitrate solution one person received an contamination of the body surface, especially the face and the hairs, and an internal contamination of americium. The paper presents the results obtained in medical management to reduced the contamination of the skin and of the incorporated radionuclide. The radioactivity of the body surface could be reduced up to small local areas. After treatment with DTPA (Ditripentat) the internal exposure decrease about 83%. (orig.) [de

  7. Use of antihypertensive medications and diagnostic tests among privately insured adolescents and young adults with primary versus secondary hypertension.

    Science.gov (United States)

    Yoon, Esther Y; Cohn, Lisa; Freed, Gary; Rocchini, Albert; Kershaw, David; Ascione, Frank; Clark, Sarah

    2014-07-01

    To compare the use of antihypertensive medications and diagnostic tests among adolescents and young adults with primary versus secondary hypertension. We conducted retrospective cohort analysis of claims data for adolescents and young adults (12-21 years of age) with ≥3 years of insurance coverage (≥11 months/year) in a large private managed care plan during 2003-2009 with diagnosis of primary hypertension or secondary hypertension. We examined their use of antihypertensive medications and identified demographic characteristics and the presence of obesity-related comorbidities. For the subset receiving antihypertensive medications, we examined their diagnostic test use (echocardiograms, renal ultrasounds, and electrocardiograms). The study sample included 1,232 adolescents and young adults; 84% had primary hypertension and 16% had secondary hypertension. The overall prevalence rate of hypertension was 2.6%. One quarter (28%) with primary hypertension had one or more antihypertensive medications, whereas 65% with secondary hypertension had one or more antihypertensive medications. Leading prescribers of antihypertensives for subjects with primary hypertension were primary care physicians (80%), whereas antihypertensive medications were equally prescribed by primary care physicians (43%) and sub-specialists (37%) for subjects with secondary hypertension. The predominant hypertension diagnosis among adolescents and young adults is primary hypertension. Antihypertensive medication use was higher among those with secondary hypertension compared with those with primary hypertension. Further study is needed to determine treatment effectiveness and patient outcomes associated with differential treatment patterns used for adolescents and young adults with primary versus secondary hypertension. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  8. Radiation exposure from diagnostic imaging in young patients with testicular cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sullivan, C.J.; Twomey, M.; O' Regan, K.N. [Cork and Mercy University Hospitals, Department of Radiology, Cork (Ireland); Murphy, K.P.; Maher, M.M.; O' Connor, O.J. [Cork and Mercy University Hospitals, Department of Radiology, Cork (Ireland); University College Cork, Department of Radiology, Cork (Ireland); McLaughlin, P.D. [Cork and Mercy University Hospitals, Department of Radiology, Cork (Ireland); Vancouver General Hospital, Department of Emergency and Trauma Radiology, Vancouver, British Columbia (Canada); Power, D.G. [Cork and Mercy University Hospitals, Department of Medical Oncology, Cork (Ireland)

    2015-04-01

    Risks associated with high cumulative effective dose (CED) from radiation are greater when imaging is performed on younger patients. Testicular cancer affects young patients and has a good prognosis. Regular imaging is standard for follow-up. This study quantifies CED from diagnostic imaging in these patients. Radiological imaging of patients aged 18-39 years, diagnosed with testicular cancer between 2001 and 2011 in two tertiary care centres was examined. Age at diagnosis, cancer type, dose-length product (DLP), imaging type, and frequency were recorded. CED was calculated from DLP using conversion factors. Statistical analysis was performed with SPSS. In total, 120 patients with a mean age of 30.7 ± 5.2 years at diagnosis had 1,410 radiological investigations. Median (IQR) surveillance was 4.37 years (2.0-5.5). Median (IQR) CED was 125.1 mSv (81.3-177.5). Computed tomography accounted for 65.3 % of imaging studies and 98.3 % of CED. We found that 77.5 % (93/120) of patients received high CED (>75 mSv). Surveillance time was associated with high CED (OR 2.1, CI 1.5-2.8). Survivors of testicular cancer frequently receive high CED from diagnostic imaging, mainly CT. Dose management software for accurate real-time monitoring of CED and low-dose CT protocols with maintained image quality should be used by specialist centres for surveillance imaging. (orig.)

  9. Collective dose estimation in Portuguese population due to medical exams of diagnostic radiology and nuclear medicine; Estimativa da dose coletiva na populacao portuguesa devido a exames medicos de radiologia de diagnostico e de medicina nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Teles, Pedro; Vaz, Pedro [Instituto Tecnologico e Nuclear, Sacavem (Portugal). Instituto Superior Tecnico; Sousa, M. Carmen de [Instituto Portugues de Oncologia de Coimbra (Portugal); Paulo, Graciano; Santos, Joana [Escola Superior de Tecnologia da Saude de Coimbra (Portugal); Pascoal, Ana [Kings College Hospital, London (United Kingdom). Kings Health Partners; Cardoso, Gabriela; Santos, Ana isabel [Hospital Garcia de Orta, Almada (Portugal); Lanca, Isabel [Administracao Regional de Saude, Coimbra (Portugal); Matela, Nuno [Universidade de Lisboa (Portugal). Fac. de Ciencias. Instituto de Biofisica e Engenharia Biomedica; Janeiro, Luis [Escola superior de Saude da Cruz Vermelha Portuguesa, Lisboa (Portugal); Sousa, Patrick [Laboratorio de Instrumentacao e Fisica Experimental de Particulas, Lisboa (Portugal); Carvoeiras, Pedro; Parafita, Rui [Medical Consult, SA, Lisboa (Portugal); Simaozinho, Paula [Administracao Regional de Saude, Faro (Portugal)

    2013-11-01

    In order to assess the exposure of the Portuguese population to ionizing radiation due to medical examinations of diagnostic radiology and nuclear medicine, a working group, consisting of 40 institutions, public and private, was created to evaluation the coletive dose in the Portuguese population in 2010. This work was conducted in collaboration with the Dose Datamed European consortium, which aims to assess the exposure of the European population to ionizing radiation due to 20 diagnostic radiology examinations most frequent in Europe (the 'TOP 20') and nuclear medicine examinations. We obtained an average value of collective dose of Almost-Equal-To 1 mSv/caput, which puts Portugal in the category of countries medium to high exposure to Europe. We hope that this work can be a starting point to bridge the persistent lack of studies in the areas referred to in Portugal, and to enable the characterization periodic exposure of the Portuguese population to ionizing radiation in the context of medical applications.

  10. A survey of medical exposure during X-ray diagnosis in Aomori

    International Nuclear Information System (INIS)

    Kon, Masanori; Fukushi, Shouji; Oota, Fumio; Kawamura, Kouji; Shinohe, Tetsuo; Suwa, Kouki; Fujii, Kiyosuke; Yamagami, Hirofumi

    2000-01-01

    The purpose of this project was to survey medical exposure doses in Aomori Prefecture and compare them with guidance levels for X-ray diagnosis. A questionnaire survey on X-ray diagnosis was conducted at the main medical institutions in the prefecture. The questionnaire asked about technical conditions, and replies were obtained from 72.2% of the 79 institutions. The medical exposure doses (entrance surface doses) were calculated from the results of the questionnaires by the modified numerical dose determination (NDD) method. The distribution of the entrance surface doses at each site was calculated as the 1st quartile, median, 3rd quartile, average, standard deviation, maximum value and minimum value, by the quartile method. The distribution of exposed doses at each site showed a similar pattern with that of the national distribution. Some institutions used higher doses than the Japanese proposed guidance levels and International Atomic Energy Agency (IAEA) guidance levels. Re-assessment of radiographic conditions and photosensitive materials is needed to reduce exposure doses. (K.H.)

  11. Diagnostic x-ray exposure increases the risk of thyroid microcarcinoma: a population-based case-control study

    Science.gov (United States)

    Zhang, Yawei; Chen, Yingtai; Huang, Huang; Sandler, Jason; Dai, Min; Ma, Shuangge; Udelsman, Robert

    2015-01-01

    Objective Thyroid cancer incidence and diagnostic x-ray exposures, particularly CT scans and nuclear medicine examinations have increased substantially in the United States. However, very few epidemiologic studies have directly investigated their associations. Methods A population-based case-control study was conducted in Connecticut in 2010–2011 including 462 histologically confirmed incident thyroid cancer cases and 498 population-based controls. Multivariate unconditional logistic regression models were used to estimate the associations between diagnostic x-rays and risk of thyroid cancer controlling for potential confounding factors. Results Exposure to any diagnostic x-rays was associated with an increased risk of well-differentiated thyroid microcarcinoma (tumor size ≤10 mm, OR=2.76, 95%CI: 1.31–5.81). The highest risk increase occurred with nuclear medicine examinations (excluding cardiology tests and thyroid uptake studies; OR=5.47, 95%CI: 2.10–14.23), followed by chest CT scans (OR=4.30, 95%CI: 1.66–11.14), head and neck CT scans (OR=3.88, 95%CI: 1.75–8.63), upper gastrointestinal series (OR=3.56, 95%CI: 1.54–8.21), lower gastrointestinal series (OR=3.29, 95%CI: 1.41–7.66), kidney x-rays involving dye injection into a vein or artery (OR=3.21, 95%CI: 1.20–8.54), mammograms (OR=2.95, 95%CI: 1.14–7.61), chest x-rays (OR=2.93, 95%CI: 1.37–6.29), and abdomen CT scans (OR=2.54, 95%CI: 1.02–6.30). No significant associations were found between these imaging modalities and thyroid tumors larger than 10 mm. Conclusions This study provides the first direct evidence that CT scans and nuclear medicine examinations are associated with an increased risk of thyroid cancer. The novel finding that an array of diagnostic x-ray procedures are associated thyroid microcarcinomas warrants further investigation. PMID:25932870

  12. Occupational health and safety assessment of exposure to jet fuel combustion products in air medical transport.

    Science.gov (United States)

    MacDonald, Russell D; Thomas, Laura; Rusk, Frederick C; Marques, Shauna D; McGuire, Dan

    2010-01-01

    Transport medicine personnel are potentially exposed to jet fuel combustion products. Setting-specific data are required to determine whether this poses a risk. This study assessed exposure to jet fuel combustion products, compared various engine ignition scenarios, and determined methods to minimize exposure. The Beechcraft King Air B200 turboprop aircraft equipped with twin turbine engines, using a kerosene-based jet fuel (Jet A-1), was used to measure products of combustion during boarding, engine startup, and flight in three separate engine start scenarios ("shielded": internal engine start, door closed; "exposed": ground power unit start, door open; and "minimized": ground power unit right engine start, door open). Real-time continuous monitoring equipment was used for oxygen, carbon dioxide, carbon monoxide, nitrogen dioxide, hydrogen sulfide, sulfur dioxide, volatile organic compounds, and particulate matter. Integrated methods were used for aldehydes, polycyclic aromatic hydrocarbons, volatile organic compounds, and aliphatic hydrocarbons. Samples were taken in the paramedic breathing zone for approximately 60 minutes, starting just before the paramedics boarded the aircraft. Data were compared against regulated time-weighted exposure thresholds to determine the presence of potentially harmful products of combustion. Polycyclic aromatic hydrocarbons, aldehydes, volatile organic compounds, and aliphatic hydrocarbons were found at very low concentrations or beneath the limits of detection. There were significant differences in exposures to particulates, carbon monoxide, and total volatile organic compound between the "exposed" and "minimized" scenarios. Elevated concentrations of carbon monoxide and total volatile organic compounds were present during the ground power unit-assisted dual-engine start. There were no appreciable exposures during the "minimized" or "shielded" scenarios. Air medical personnel exposures to jet fuel combustion products were

  13. An overview of measuring and modelling dose and risk from ionising radiation for medical exposures

    International Nuclear Information System (INIS)

    Tootell, Andrew; Szczepura, Katy; Hogg, Peter

    2014-01-01

    Purpose: This paper gives an overview of the methods that are used to calculate dose and risk from exposure to ionizing radiation as a support to other papers in this special issue. Background: The optimization of radiation dose is a legal requirement in medical exposures. This review paper aims to provide the reader with knowledge of dose by providing definitions and concepts of absorbed, effective and equivalent dose. Criticisms of the use of effective dose to infer the risk of an exposure to an individual will be discussed and an alternative approach considering the lifetime risks of cancer incidence will be considered. Prior to any dose or risk calculation, data concerning the dose absorbed by the patient needs to be collected. This paper will describe and discuss the main concepts and methods that can be utilised by a researcher in dose assessments. Concepts behind figures generated by imaging equipment such as dose-area-product, computed tomography dose index, dose length product and their use in effective dose calculations will be discussed. Processes, advantages and disadvantages in the simulation of exposures using the Monte Carlo method and direct measurement using digital dosimeters or thermoluminescent dosimeters will be considered. Beyond this special issue, it is proposed that this paper could serve as a teaching or CPD tool for personnel working or studying medical imaging

  14. Exposure of the French population to ionizing radiations related to medical diagnosis procedures in 2012

    International Nuclear Information System (INIS)

    2014-01-01

    This report updates (for 2012) data concerning the exposure of the French population related to diagnosis imagery tests using ionizing radiations. It notably outlines the characteristics of this medical exposure with respect to imagery modality (conventional radiology, scans, diagnosis interventional radiology, and nuclear medicine), to anatomic examined region, to age and to patient gender, and the share of the French population (quantity, age, gender) actually submitted to diagnosis procedures in 2012. The authors report the selection of procedure types, the determination of their frequency, the assessment of associated doses (choice of the efficient dose as indicator, assessment of efficient doses associated with each procedure type), the exposure of the French population in 2012 (general assessment, distribution of procedures and of the collective efficient dose, distribution in terms of age and gender), the characteristics of the actually exposed population. The representativeness of data is discussed, as well as the evolution of diagnosis medical exposure from 2007 to 2012. Data are compared with European and international data

  15. Medication type modifies inflammatory response to traffic exposure in a population with type 2 diabetes

    International Nuclear Information System (INIS)

    Rioux, Christine L.; Tucker, Katherine L.; Brugge, Doug; Mwamburi, Mkaya

    2015-01-01

    The association between residential traffic exposure and change in C-reactive protein over 2-years was evaluated using multivariate linear regression including interaction models for traffic and diabetes medication use/type (insulin vs. oral hypoglycemic agents (OHAs)). The study population was Puerto Rican adults (n = 356) residing in greater Boston with type 2 diabetes. Traffic was characterized as proximity to roads with >20,000 weekday traffic volumes, and multi-directional traffic density. Increases in CRP concentration were significantly associated with residence ≤100 m of a roadway (p = 0.009) or near multiple roadways (p < 0.001), vs. further away, for individuals using insulin in stratified models, with consistent results in interaction models (p = 0.071 and p = 0.002). CRP was significantly lower with highest traffic density exposure in stratified (p = 0.03) and interaction models (p = 0.024) for individuals using OHAs. Individuals on insulin experienced increased CRP concentrations with traffic exposure over a 2-year study period, while those using OHAs did not experience increases. - Highlights: • T2D medication effect on traffic exposure and CRP was examined longitudinally. • Participants were older Puerto Rican adults (n = 356) living in the Boston, MA area. • Major road proximity and traffic density were assessed for each residential address. • Those on insulin showed significantly increased CRP with increased traffic exposure. • Those on oral hypoglycemic agents did not show increased CRP with traffic exposure. - Individuals on insulin were most vulnerable to traffic-related increases in CRP, while those on OHAs did not experience increases

  16. Review on patients radiation dose and frequency of procedures during medical exposure in Sudan

    International Nuclear Information System (INIS)

    Abu Baker, Samah Mohamed Nasr

    2015-09-01

    The aim of this study was to estimate patient dose, the annual frequency and the number of staff and devices in the medical applications of ionizing radiation in Sudan. Survey was conducted on diagnostic radiology, nuclear medicine and radiotherapy. With respect to diagnostic radiology, only patient radiation dose was estimated. The data for diagnostic radiology was obtained from 24 peer reviewed scientific published literatures during the years ( 2006 - 2015). The collected publications included about 64 Sudanese hospitals covering different types of diagnostic exams. A values of the effective dose for pediatrics and adult patients were within the ranges of similar worldwide values published by UNSCEAR report in 2008 with exceptional to fluoroscopy hysterosalpingography for adult patients. For nuclear medicine procedures, questionnaires were distributed to five hospitals representing the whole existing NM department in Sudan at the time of of study. The estimated total annual frequency of diagnostic procedures was 0.2 per 1000 population. The estimated total annual collective and annual per caput effective dose from all NM procedures were 16.268 man Sv and 0.5 μSv, respectively. Comparing the annual per caput effective dose with UNSCEAR value our results was less than the worldwide value and greater than the value for heath care level 111-1 v countries. Questionnaires were also distributed to collect data on radiotherapy procedures performed in the two existing radioisotopes Sudanese hospitals. The prescribed dose and the number of fractions were comparable between the two hospitals. The minimum prescribed dose was 20 Gy with 5 fractions for nasopharynx (NPH) palliative and the maximum prescribed dose was 64 Gy with 32 fractions for prostate.(Author)

  17. Histological Knowledge as a Predictor of Medical Students' Performance in Diagnostic Pathology

    Science.gov (United States)

    Nivala, Markus; Lehtinen, Erno; Helle, Laura; Kronqvist, Pauliina; Paranko, Jorma; Säljö, Roger

    2013-01-01

    Over the years, the role and extent of the basic sciences in medical curricula have been challenged by research on clinical expertise, clinical teachers, and medical students, as well as by the development and diversification of the medical curricula themselves. The aim of this study was to examine how prior knowledge of basic histology and…

  18. Radiology Exposure in the Undergraduate Curriculum: A Medical Student Perspective on Quality and Opportunities for Positive Change.

    Science.gov (United States)

    Visscher, Kari L; Faden, Lisa; Nassrallah, Georges; Speer, Stacey; Wiseman, Daniele

    2017-08-01

    This article is a continuation of a qualitative study designed to explore how radiology exposures can impact medical student opinions and perceptions of radiology and radiologists. We focused on: 1) conducting a radiology exposure inventory from the perspective of the medical student; 2) student evaluation of the quality of the radiology exposures and suggestions for positive change; and 3) development of a framework to address the needs of medical students as it relates to radiology education in the undergraduate medical curriculum. Research methodology and design for this qualitative study were described in detail in a previous article by Visscher et al [1]. Participants included 28 medical students; 18 were in medical school years 1 and 2 (preclerkship), and 10 were in years 3 and 4 (clerkship). Specific to the focus of this article, the data revealed 3 major findings: 1) multiple exposures to radiology exist, and they are received and valued differently depending on the medical student's stage of professional development; 2) medical students value radiology education and want their radiology exposure to be comprehensive and high quality; 3) Medical students have constructive suggestions for improving the quality of both formal and informal radiology exposures. Performing a radiology exposure inventory from a medical student perspective is a useful way to explore how students receive and value radiology instruction. Medical students want a more comprehensive radiology education that can be summarized using the 5 C's of Radiology Education framework. The 5 C's (curriculum, coaching, collaborating, career and commitment) reflect medical students' desires to learn content that will support them in clinical practice, be supported in their professional development, and have the necessary information to make informed career decisions. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  19. Prevention of and response to inadvertent exposure of embryo/fetus to ionizing radiation, due to medical exposure of the mother. The Greek regulatory authority initiatives.

    Science.gov (United States)

    Economides, Sotirios; Boziari, Argiro; Vogiatzi, Stavroula; Hourdakis, Konstantinos J; Kamenopoulou, Vassiliki; Dimitriou, Panagiotis

    2014-03-01

    Embryo/fetus (E/F) irradiation as a result of medical exposure of the mother should be avoided, unless there are strong clinical indications. Medical practitioners are assigned the primary task and obligation of ensuring overall patient protection and safety in the prescription of and during the delivery of medical exposure. In cases of unintended exposure of embryo/fetus (E/F), the risk analysis and communication is conducted by or under the supervision of medical physicists at local level. National competent authorities can contribute to the prevention, risk analysis and communication of inadvertent E/F exposure to ionizing radiation by recording, analyzing and disseminating the relevant information. Since 2001, Greek Atomic Energy Commission has established a committee with the mandate to provide advice, to keep records, to analyze and disseminate the experience gained in cases of unintended E/F exposure. During the period 2001-2011, the committee was consulted by 269 pregnant women undergone medical exposures. The conclusions from the relevant data analysis, as well as the experience gained are herein presented and discussed. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  20. Evaluation of E.M.F. exposure from medical electrical equipment

    Energy Technology Data Exchange (ETDEWEB)

    Aniolczyk, H.; Mamrot, P.; Politanski, P. [Nofer Institute of Occupational Medicine, Lodz (Poland)

    2006-07-01

    he medical electric and electronic equipment, including electro surgical devices, short- and microwave diathermy units, and magnetic resonance imaging (MRI) systems, belong to the most hazardous sources of electromagnetic emissions. The electromagnetic emissions can interfere with emissions from other medical equipment located in the same facility (e.g. operation rooms) thus having impact on their work, but more importantly, they can be dangerous to patients, medical personnel operating them and other persons. In the present project, an assessment of E.M.F. intensity was performed for more than 2 000 electro surgical devices (330 khz, 440 khz and 1.76 MHz frequency ranges), 1 200 diathermy units and 45 MRI 0.2 - 1.5 T systems. E.M.F. exposure of medical staff was assessed based on respective national hygienic standards. The actual exposure levels were found to exceed the admissible values in Poland. The recorded E.M.F. intensities were compared with relevant Who and U E recommendations (e.g. I.C.N.I.R.P. guidelines, 1998, Directive 2004/40/E.C.). The findings revealed that for 18% of the devices examined, the E.M.F. was higher than the E.M.F. intensity values recommended by U E. (authors)

  1. Evaluation of E.M.F. exposure from medical electrical equipment

    International Nuclear Information System (INIS)

    Aniolczyk, H.; Mamrot, P.; Politanski, P.

    2006-01-01

    he medical electric and electronic equipment, including electro surgical devices, short- and microwave diathermy units, and magnetic resonance imaging (MRI) systems, belong to the most hazardous sources of electromagnetic emissions. The electromagnetic emissions can interfere with emissions from other medical equipment located in the same facility (e.g. operation rooms) thus having impact on their work, but more importantly, they can be dangerous to patients, medical personnel operating them and other persons. In the present project, an assessment of E.M.F. intensity was performed for more than 2 000 electro surgical devices (330 khz, 440 khz and 1.76 MHz frequency ranges), 1 200 diathermy units and 45 MRI 0.2 - 1.5 T systems. E.M.F. exposure of medical staff was assessed based on respective national hygienic standards. The actual exposure levels were found to exceed the admissible values in Poland. The recorded E.M.F. intensities were compared with relevant Who and U E recommendations (e.g. I.C.N.I.R.P. guidelines, 1998, Directive 2004/40/E.C.). The findings revealed that for 18% of the devices examined, the E.M.F. was higher than the E.M.F. intensity values recommended by U E. (authors)

  2. Upgrading the Medical Physics Calibration Laboratory Towards ISO/IEC 17025: Radiation Standards and Calibration in Diagnostic Radiology

    International Nuclear Information System (INIS)

    Asmaliza Hashim; Muhammad Jamal Md Isa; Abd Aziz Mhd Ramli; Wan Hazlinda Ismail; Norhayati Abdullah; Shahrul Azlan Azizan; Siti Sara Deraman; Nor Azlin Azraai; Md Khairusalih Md Zin

    2010-01-01

    Calibration of quality control (QC) test tools used in diagnostic radiology is legally required under the Ministry of Health (MOH) requirement. The Medical Physics Calibration Laboratory of the Malaysian Nuclear Agency is the national focal point for the calibration of quality control test tools used in diagnostic radiology. The Medical Physics Calibration Laboratory has measurement traceability to primary standard dosimetry laboratory (Physikalisch-Technische Bundesanstalt (PTB)), thus providing an interface between the primary standard dosimetry laboratory and Malaysian hospitals, clinics and license class H holder. The Medical Physics Calibration Laboratory facility is comprised of a constant potential x-ray system with a capability of 160 kV tube and a series of reference and working standard ion chambers. The stability of reference and working standard ion chambers was measured using strontium-90. Dosimetric instruments used in diagnostic radiology is calibrated in terms of air kerma to comply with an International Code of Practices of dosimetry for example IAEA's Technical Report Series number 457. The new series of standard radiation qualities was established based on ISO/IEC 61267. The measurement of beam homogeneity was measured using film and ion chamber to define the field size at certain distance and kV output was measured using the spectrometer and non-invasive kVp meter. The uncertainties measurement was determined with expended uncertainties to a level of confidence of approximately 95% (coverage factor k=2). This paper describes the available facility and the effort of the Medical Physics Calibration Laboratory to upgrade the laboratory towards ISO/IEC 17025. (author)

  3. Top 100 Cited articles on Radiation Exposure in Medical Imaging: A Bibliometric Analysis.

    Science.gov (United States)

    Kinnin, Jason; Hanna, Tarek N; Jutras, Marc; Hasan, Babar; Bhatia, Rick; Khosa, Faisal

    2018-03-20

    Bibliometric analyses by highest number of citations can help researchers and funding agencies in determining the most influential articles in a field. The main objective of this analysis was to identify the top 100 cited articles addressing radiation exposure from medical imaging and assess their characteristics. Relevant articles were extracted from the Scopus database after a systematic search by researchers using an iteratively defined Boolean search string. Subsequently, exclusion criteria were applied. A list of top 100 articles was prepared, and articles were ranked according to the citations they had received. No time restriction was applied. Descriptive statistics of the data were compiled. The top-cited articles were published from 1970-2013, with the most articles published in 2009 and 2010 (12 articles in each year). The citations ranged from 107-1888 with a median of 272. Manuscripts from our top-cited list originated from 20 different countries, with contributions made by 158 authors and 160 organizations. Eighty-eight percent of studies evaluated patient-related radiation exposure, 7% health care workers, and 5% both or were not specified. Thirty-two percent of studies examined adult populations, 14% pediatric, and 54% included both populations or did not specify. Seventy-two percent of studies were dedicated to Computed Tomography, 8% to radiography/fluoroscopy, 9% to interventional procedures, 4% to nuclear medicine, and 7% to a combination of 2 or more modalities. The top 100 cited articles in medical imaging related to radiation exposure are diverse, originating from many countries with numerous contributing authors. The most common topics covered involve CT and adult patients. The recent peak in the most-highly cited articles (2010) suggests that increased attention has been devoted to this field in recent years. Based on these results, it would appear that research on radiation exposure in medical imaging is poised to continue expanding

  4. Effects of Diagnostic Work-Up on Medical Decision-Making for Canine Urinary Tract Infection

    DEFF Research Database (Denmark)

    Sørensen, T M; Bjørnvad, C R; Cordoba, G

    2018-01-01

    dipstick (99%), microscopic examination of urine (80%) and bacterial culture (56%). Fifty-one percent of dogs had urinary tract infection (UTI) based on reference QBC. Appropriate DTT was made for 62% of the dogs, while 36% were over-prescribed and 2% under-prescribed. Inappropriate use of second......BACKGROUND: Clinical signs of urinary tract disease in dogs often lead to prescription of antibiotics. Appropriate diagnostic work-up could optimize treatment and reduce the risk of inappropriate use of antibiotics. HYPOTHESIS/OBJECTIVES: To describe and evaluate the impact of diagnostic work......-up on decision to treat (DTT) and choice of antibiotic treatment (COT) for dogs presenting with clinical signs of urinary tract disease. ANIMALS: One hundred and fifty-one dogs presenting to 52 Danish veterinary practices. METHODS: Prospective, observational study. Clinical signs, diagnostic work...

  5. CONGENITAL MALFORMATIONS: PRENATAL DIAGNOSTICS AND NOVEL CONCEPTION OF MEDICAL HELP TO NEWBORNS

    Directory of Open Access Journals (Sweden)

    Yu.F. Isakov

    2007-01-01

    Full Text Available Current views on basic prenatal diagnostics techniques, as ultrasound, maternal serum biochemical markers (alpha fetoprotein, human chorionic gonadotropin, and unconjugated estriol, and fetal biologic material (chorionic villus sampling, placenta, amniotic liquid, fetal blood, obtained with invasive techniques (chorion biopsy, amniocentesis, cordocentesis, its' efficacy and possible practical application are given in the article. These new conception announce to consolidate three branches providing maternal and children — welfare should consolidate maternal welfare outpatient clinics, maternal hospital and newborn surgery hospital — into one institute, thus allowing to success work of all stages, to avoid transportation and late surgical treatment, to reduce lethal outcomes following surgical treatment of congenital malformations. Primary results of implementation of this conception are presented in the article.Key words: prenatal diagnostics, newborns, congenital mal formations, prevention and prophylactics, diagnostics.

  6. Cumulative exposure to medical sources of ionizing radiation in the first year after pediatric heart transplantation.

    Science.gov (United States)

    McDonnell, Alicia; Downing, Tacy E; Zhu, Xiaowei; Ryan, Rachel; Rossano, Joseph W; Glatz, Andrew C

    2014-11-01

    Pediatric heart transplant recipients undergo a variety of radiologic tests with the attendant risk of exposure to ionizing radiation. We sought to quantify and describe the cumulative exposure to all forms of medical radiation during the first year after pediatric heart transplantation and identify factors associated with higher exposure. Pediatric patients who received a heart transplant between January 2009 and May 2012 with follow-up at our institution were retrospectively reviewed. Patients were included if they survived through 1 year and the first coronary angiography. All medical testing using ionizing radiation performed during follow-up was compiled, and exposures were converted to effective dose (mSv). Included were 31 patients who underwent heart transplantation at a median age of 13.6 years (range, 0.3-18.3 years). The median number of radiologic tests performed was 38 (range, 18-154), including 8 catheterizations (range, 2-12), and 28 X-ray images (range, 11-135). Median cumulative effective dose was 53.5 mSv (range, 10.6-153.5 mSv), of which 91% (range, 34%-98%) derived from catheterizations, 31% (range, 8%-89%) of the exposure occurred during the transplant admission, 59% (range, 11%-88%) during planned follow-up, and 3% (0%-56%) during unplanned follow-up. Older age at transplant was a risk factor for increased exposure (p = 0.006). When adjusted for age, a trend toward increased exposure was shown for congenital heart disease as the indication for transplant (p = 0.08), pre-sensitization (p = 0.12), and positive crossmatch (p = 0.09). Pediatric heart transplant patients are exposed to significant amounts of ionizing radiation during the first post-transplant year, most during scheduled catheterization. As survival improves, considering the long-term risks associated with these levels of exposure is important. Copyright © 2014 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  7. Abridged version of the AWMF guideline for the medical clinical diagnostics of indoor mould exposure: S2K Guideline of the German Society of Hygiene, Environmental Medicine and Preventive Medicine (GHUP) in collaboration with the German Association of Allergists (AeDA), the German Society of Dermatology (DDG), the German Society for Allergology and Clinical Immunology (DGAKI), the German Society for Occupational and Environmental Medicine (DGAUM), the German Society for Hospital Hygiene (DGKH), the German Society for Pneumology and Respiratory Medicine (DGP), the German Mycological Society (DMykG), the Society for Pediatric Allergology and Environmental Medicine (GPA), the German Federal Association of Pediatric Pneumology (BAPP), and the Austrian Society for Medical Mycology (ÖGMM).

    Science.gov (United States)

    Wiesmüller, Gerhard A; Heinzow, Birger; Aurbach, Ute; Bergmann, Karl-Christian; Bufe, Albrecht; Buzina, Walter; Cornely, Oliver A; Engelhart, Steffen; Fischer, Guido; Gabrio, Thomas; Heinz, Werner; Herr, Caroline E W; Kleine-Tebbe, Jörg; Klimek, Ludger; Köberle, Martin; Lichtnecker, Herbert; Lob-Corzilius, Thomas; Merget, Rolf; Mülleneisen, Norbert; Nowak, Dennis; Rabe, Uta; Raulf, Monika; Seidl, Hans Peter; Steiß, Jens-Oliver; Szewszyk, Regine; Thomas, Peter; Valtanen, Kerttu; Hurraß, Julia

    2017-01-01

    This article is an abridged version of the AWMF mould guideline "Medical clinical diagnostics of indoor mould exposure" presented in April 2016 by the German Society of Hygiene, Environmental Medicine and Preventive Medicine ( Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin, GHUP ), in collaboration with the above-mentioned scientific medical societies, German and Austrian societies, medical associations and experts. Indoor mould growth is a potential health risk, even if a quantitative and/or causal relationship between the occurrence of individual mould species and health problems has yet to be established. Apart from allergic bronchopulmonary aspergillosis (ABPA) and mould-caused mycoses, only sufficient evidence for an association between moisture/mould damage and the following health effects has been established: allergic respiratory disease, asthma (manifestation, progression and exacerbation), allergic rhinitis, hypersensitivity pneumonitis (extrinsic allergic alveolitis), and increased likelihood of respiratory infections/bronchitis. In this context the sensitizing potential of moulds is obviously low compared to other environmental allergens. Recent studies show a comparatively low sensitizing prevalence of 3-10% in the general population across Europe. Limited or suspected evidence for an association exist with respect to mucous membrane irritation and atopic eczema (manifestation, progression and exacerbation). Inadequate or insufficient evidence for an association exist for chronic obstructive pulmonary disease, acute idiopathic pulmonary hemorrhage in children, rheumatism/arthritis, sarcoidosis and cancer. The risk of infection posed by moulds regularly occurring indoors is low for healthy persons; most species are in risk group 1 and a few in risk group 2 ( Aspergillus fumigatus, A. flavus ) of the German Biological Agents Act ( Biostoffverordnung ). Only moulds that are potentially able to form toxins can be triggers of toxic

  8. Ante- and postmortem diagnostic techniques for anthrax: rethinking pathogen exposure and the geographic extent of the disease in wildlife.

    Science.gov (United States)

    Bagamian, Karoun H; Alexander, Kathleen A; Hadfield, Ted L; Blackburn, Jason K

    2013-10-01

    Although antemortem approaches in wildlife disease surveillance are common for most zoonoses, they have been used infrequently in anthrax surveillance. Classically, anthrax is considered a disease with extremely high mortality. This is because anthrax outbreaks are often detected ex post facto through wildlife or livestock fatalities or spillover transmission to humans. As a result, the natural prevalence of anthrax infection in animal populations is largely unknown. However, in the past 20 yr, antemortem serologic surveillance in wildlife has indicated that not all species exposed succumb to infection, and anthrax exposure may be more widespread than originally appreciated. These studies brought about a multitude of new questions, many of which can be addressed by increased antemortem serologic surveillance in wildlife populations. To fully understand anthrax transmission dynamics and geographic extent, it is important to identify exposure in wildlife hosts and associated factors and, in turn, understand how these influences may drive environmental reservoir dynamics and concurrent disease risk in livestock and humans. Here we review our current understanding of the serologic response to anthrax among wildlife hosts and serologic diagnostic assays used to augment traditional postmortem anthrax surveillance strategies. We also provide recommendations for the use of serology and sentinel species surveillance approaches in anthrax research and management.

  9. Medication Exposures and Subsequent Development of Ewing Sarcoma: A Review of FDA Adverse Event Reports

    Directory of Open Access Journals (Sweden)

    Judith U. Cope

    2015-01-01

    Full Text Available Background. Ewing sarcoma family of tumors (ESFT are rare but deadly cancers of unknown etiology. Few risk factors have been identified. This study was undertaken to ascertain any possible association between exposure to therapeutic drugs and ESFT. Methods. This is a retrospective, descriptive study. A query of the FDA Adverse Event Reporting System (FAERS was conducted for all reports of ESFT, January 1, 1998, through December 31, 2013. Report narratives were individually reviewed for patient characteristics, underlying conditions and drug exposures. Results. Over 16 years, 134 ESFT reports were identified, including 25 cases of ESFT following therapeutic drugs and biologics including immunosuppressive agents and hormones. Many cases were confounded by concomitant medications and other therapies. Conclusions. This study provides a closer look at medication use and underlying disorders in patients who later developed ESFT. While this study was not designed to demonstrate any clear causative association between ESFT and prior use of a single product or drug class, many drugs were used to treat immune-related disease and growth or hormonal disturbances. Further studies may be warranted to better understand possible immune or neuroendocrine abnormalities or exposure to specific classes of drugs that may predispose to the later development of ESFT.

  10. Diagnostic Accuracy of Lumbosacral Spine Magnetic Resonance Image Reading by Chiropractors, Chiropractic Radiologists, and Medical Radiologists

    NARCIS (Netherlands)

    de Zoete, A.; Ostelo, R.W.J.G.; Knol, D.L.; Algra, P.R.; Wilmink, J.T.; van Tulder, M.W.

    2015-01-01

    Study Design. A cross-sectional diagnostic accuracy study was conducted in 2 sessions. Objective. It is important to know whether it is possible to accurately detect "specific findings" on lumbosacral magnetic resonance (MR) images and whether the results of different observers are comparable.

  11. Digital gods: The making of a medical fact for rural diagnostic software

    NARCIS (Netherlands)

    P.A. Arora (Payal)

    2010-01-01

    textabstractThe chronic shortage of doctors in rural India seriously impacts the quality of health care available to villagers. In recent years, there has been considerable excitement in digital diagnostics as a possible answer to this situation by allowing non-doctors to diagnose and treat

  12. The benefits to medical undergraduates of exposure to community-based survey research.

    Science.gov (United States)

    Dongre, A R; Kalaiselvan, G; Mahalakshmy, T

    2011-12-01

    In India, there has been little effort to teach medical students about public health research. Few medical institutions in India and nearby Nepal formally offer exposure to field surveys or projects to medical undergraduates as a part of their training in community medicine. Little is known about the effect of such activity on students or how they apply what they learn. We implemented a systematic, hands-on experience in the public health research process with medical undergraduates in Puducherry, India to evaluate its effect on students. Two groups, each with 30 third-semester (second year) medical undergraduates, participated in a 15-day, two and one-half hours per day course on the public health research process. At the end of course, a retrospective post-then-pre self-assessment of students skills was obtained. One year later, we resurveyed students with open-ended questions to assess their impressions of what they had gained from learning about the field survey process. Out of the 60 students, 55 (91.6%) provided complete responses for analysis. The mean post-exposure Likert scores of students self-perceived skills and knowledge were significantly higher than their retrospective assessments of themselves prior to the course in areas such as being aware of the public health research process, their skills in interviewing and communicating with local villagers, and ability to collect, enter via computer and present gathered information (p undergraduates to the survey research process appears to help them be better clinicians, who are able to understand and use field level data.

  13. Modified Alvarado Scoring System as a diagnostic tool for Acute Appendicitis at Bugando Medical Centre, Mwanza, Tanzania

    Directory of Open Access Journals (Sweden)

    Rambau Peter

    2011-02-01

    Full Text Available Abstract Background Decision-making in patients with acute appendicitis poses a diagnostic challenge worldwide, despite much advancement in abdominal surgery. The Modified Alvarado Scoring System (MASS has been reported to be a cheap and quick diagnostic tool in patients with acute appendicitis. However, differences in diagnostic accuracy have been observed if the scores were applied to various populations and clinical settings. The purpose of this study was to evaluate the diagnostic value of Modified Alvarado Scoring System in patients with acute appendicitis in our setting. Methods A cross-sectional study involving all patients suspected to have acute appendicitis at Bugando Medical Centre over a six-month period between November 2008 and April 2009 was conducted. All patients who met the inclusion criteria were consecutively enrolled in the study. They were evaluated on admission using the MASS to determine whether they had acute appendicitis or not. All patients underwent appendicectomy according to the hospital protocol. The decision to operate was the prerogative of the surgeon or surgical resident based on overall clinical judgment and not the MASS. The diagnosis was confirmed by histopathological examination. Data was collected using a pre-tested coded questionnaire and analyzed using SPSS statistical computer software. Results A total number of 127 patients were studied. Their ages ranged from eight to 76 years (mean 29.64 ± 12.97. There were 37 (29.1% males and 90 (70.9% females (M: F = 1:2.4. All patients in this study underwent appendicectomy. The perforation rate was 9.4%. Histopathological examination confirmed appendicitis in 85 patients (66.9% and the remaining 42 patients had normal appendix giving a negative appendicectomy rate of 33.1% (26.8% for males and 38.3% for females. The sensitivity and specificity of MASS in this study were 94.1% (males 95.8% and females 88.3% and 90.4% (males 92.9% and females 89.7% respectively

  14. Evidence-based medical research on diagnostic criteria and screening technique of vascular mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Xia-wei LIU

    2015-07-01

    Full Text Available Background Vascular mild cognitive impairment (VaMCI is the prodromal syndrome of vascular dementia (VaD and key target for drug treatment. There is controversy over the diagnostic criteria and screening tools of VaMCI, which affects its clinical diagnosis. This paper aims to explore the clinical features, diagnostic criteria and screening technique of VaMCI.  Methods Taking "vascular mild cognitive impairment OR vascular cognitive impairment no dementia" as retrieval terms, search in PubMed database from January 1997 to March 2015 and screen relevant literatures concerning VaMCI. According to Guidance for the Preparation of Neurological Management Guidelines revised by European Federation of Neurological Societies (EFNS in 2004, evidence grading was performed on literatures. Results A total of 32 literatures in English were selected according to inclusion and exclusion criteria, including 3 guidelines and consensus and 29 clinical studies. Seven literatures (2 on Level Ⅰ, 5 on Level Ⅱ studied on neuropsychological features in VaMCI patients and found reduced processing speed and executive function impairment were main features. Two literatures reported the diagnostic criteria of VaMCI, including VaMCI criteria published by American Heart Association (AHA/American Stroke Association (ASA in 2011 and "Diagnostic Criteria for Vascular Cognitive Disorders" published by International Society for Vascular Behavioral and Cognitive Disorders (VASCOG in 2014. Fifteen literatures (4 on LevelⅠ, 11 on Level Ⅱ described the diagnostic criteria of VaMCI used in clinical research, from which 6 operational diagnostic items were extracted. Fourteen literatures (4 on Level Ⅰ, 10 on Level Ⅱ described neuropsychological assessment tools for VaMCI screening, and found the 5-minute protocol recommended by National Institute of Neurological Disorders and Stroke-Canadian Stroke Network (NINDS-CSN was being good consistency with other neuropsychological

  15. Evidence assessing the diagnostic performance of medical smartphone apps: a systematic review and exploratory meta-analysis.

    Science.gov (United States)

    Buechi, Rahel; Faes, Livia; Bachmann, Lucas M; Thiel, Michael A; Bodmer, Nicolas S; Schmid, Martin K; Job, Oliver; Lienhard, Kenny R

    2017-12-14

    The number of mobile applications addressing health topics is increasing. Whether these apps underwent scientific evaluation is unclear. We comprehensively assessed papers investigating the diagnostic value of available diagnostic health applications using inbuilt smartphone sensors. Systematic Review-MEDLINE, Scopus, Web of Science inclusive Medical Informatics and Business Source Premier (by citation of reference) were searched from inception until 15 December 2016. Checking of reference lists of review articles and of included articles complemented electronic searches. We included all studies investigating a health application that used inbuilt sensors of a smartphone for diagnosis of disease. The methodological quality of 11 studies used in an exploratory meta-analysis was assessed with the Quality Assessment of Diagnostic Accuracy Studies 2 tool and the reporting quality with the 'STAndards for the Reporting of Diagnostic accuracy studies' (STARD) statement. Sensitivity and specificity of studies reporting two-by-two tables were calculated and summarised. We screened 3296 references for eligibility. Eleven studies, most of them assessing melanoma screening apps, reported 17 two-by-two tables. Quality assessment revealed high risk of bias in all studies. Included papers studied 1048 subjects (758 with the target conditions and 290 healthy volunteers). Overall, the summary estimate for sensitivity was 0.82 (95 % CI 0.56 to 0.94) and 0.89 (95 %CI 0.70 to 0.97) for specificity. The diagnostic evidence of available health apps on Apple's and Google's app stores is scarce. Consumers and healthcare professionals should be aware of this when using or recommending them. 42016033049. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Exploring medical diagnostic performance using interactive, multi-parameter sourced receiver operating characteristic scatter plots.

    Science.gov (United States)

    Moore, Hyatt E; Andlauer, Olivier; Simon, Noah; Mignot, Emmanuel

    2014-04-01

    Determining diagnostic criteria for specific disorders is often a tedious task that involves determining optimal diagnostic thresholds for symptoms and biomarkers using receiver-operating characteristic (ROC) statistics. To help this endeavor, we developed softROC, a user-friendly graphic-based tool that lets users visually explore possible ROC tradeoffs. The software requires MATLAB installation and an Excel file containing threshold symptoms/biological measures, with corresponding gold standard diagnoses for a set of patients. The software scans the input file for diagnostic and symptom/biomarkers columns, and populates the graphical-user-interface (GUI). Users select symptoms/biomarkers of interest using Boolean algebra as potential inputs to create diagnostic criteria outputs. The software evaluates subtests across the user-established range of cut-points and compares them to a gold standard in order to generate ROC and quality ROC scatter plots. These plots can be examined interactively to find optimal cut-points of interest for a given application (e.g. sensitivity versus specificity needs). Split-set validation can also be used to set up criteria and validate these in independent samples. Bootstrapping is used to produce confidence intervals. Additional statistics and measures are provided, such as the area under the ROC curve (AUC). As a testing set, softROC is used to investigate nocturnal polysomnogram measures as diagnostic features for narcolepsy. All measures can be outputted to a text file for offline analysis. The softROC toolbox, with clinical training data and tutorial instruction manual, is provided as supplementary material and can be obtained online at http://www.stanford.edu/~hyatt4/software/softroc or from the open source repository at http://www.github.com/informaton/softroc. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Medication Exposure and Risk of Recurrent Clostridium difficile Infection in Community-Dwelling Older People and Nursing Home Residents.

    Science.gov (United States)

    Haran, John P; Bradley, Evan; Howe, Emily; Wu, Xun; Tjia, Jennifer

    2018-02-01

    It is unclear how medication exposures differ in their association with recurrent Clostridium difficile infection (rCDI) in elderly nursing home (NH) residents and community-dwelling individuals. This study examined these exposures to determine whether the risk of rCDI differs according to living environment. Retrospective. Academic and community healthcare settings. Individuals aged 65 and older with CDI (N = 616). Information on participant characteristics and medications was extracted from the electronic medical record (EMR). We used separate extended Cox models according to living environment to identify the association between medication use and risk of rCDI. Of the 616 elderly adults treated for CDI, 24.1% of those living in the community and 28.1% of NH residents experienced recurrence within 1 year. For community-dwelling participants, the risk of rCDI was 1.6 times as high with antibiotic exposure and 2.5 times as high with acid-reducing medication exposure, but corticosteroid exposure was associated with a 39% lower risk of recurrence. For NH residents, the risk of rCDI was 2.9 times as high with acid-reducing medication exposure and 5.9 times as high with corticosteroid medication exposure. Antibiotic exposure was associated with an increased risk of recurrence only in community-dwelling participants (adjusted hazard ratio = 1.63, 95% confidence interval = 1.00-2.67). Risk of rCDI is greater with acid-reducing medication use than antibiotic use after initial CDI treatment, although the risk varied depending on living environment. Corticosteroid use is associated with greater risk of recurrence in NH residents but lower risk in community-dwelling elderly adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  18. Chapter 7: pregnancy and medical exposure; Chapitre 7: grossesse et exposition medicale

    Energy Technology Data Exchange (ETDEWEB)

    Cordoliani, Y.S.; Foehrenbach, H. [Hopital d' Instruction des Armees du Val-de-Grace, Service d' Imagerie Medicale, 75 - Paris (France)

    2003-04-01

    The situations of child exposure in utero in the frame of medical practice are different according to the type of practice. For the diagnosis, in radiology as well in nuclear medicine, the malformation risk is null. The justification and optimization of exposures stand out, nevertheless to take into account the delayed carcinogenesis risk. In brachytherapy by iodine, the hypothyroidism risk for the fetus and secondary cancer can be prevented by the practice of a pregnancy test or the carried forward of the therapy after the birth. For the radiotherapy, where the fetal doses can be strong, the carcinogenesis risks are confirmed and the risk of bad cerebral development is not null but the development of the child depends on the mother health. There is a rational choice to do, where the ethic and family questions have to take place. (N.C.)

  19. Analysis of medical occupational exposure to ionizing radiation on Taiwan during past two decades

    International Nuclear Information System (INIS)

    Weng, P.-S.; Li, S.-Y.

    1980-01-01

    From the time of inception of the centralized laboratory for personnel dosimetry service operated by the National Tsing Hua University on Taiwan of the Republic of China in 1960 till 1979 the data obtained was analyzed to find the yearly occupational exposure to ionizing radiation. During the 20 year monitoring period, analysis was performed with reference to (1) medical occupational exposure, (2) maximum and average yearly dose-equivalent, (3) range of dose-equivalent, (4) percentage of maximum permissible dose-equivalent, (5) number of workers, including sex and age, (6) detailed quarterly analysis for the years 1977 to 1979, (7) types of radiation sources, and (8) estimation of the genetically significant dose-equivalent. (H.K.)

  20. An analysis of OSHA inspections assessing contaminant exposures in general medical and surgical hospitals.

    Science.gov (United States)

    Knight, Jordan L; Sleeth, Darrah K; Larson, Rodney R; Pahler, Leon F

    2013-04-01

    This study analyzed data from the Occupational Safety and Health Administration's (OSHA) Chemical Exposure Health Database to assess contaminant exposures in general medical and surgical hospitals. Seventy-five inspections conducted in these hospitals from 2005 through 2009 were identified. Five categories of inspections were conducted, the three most common being complaint-based, planned, and referral-based inspections. Complaint-based inspections comprised the majority of inspections-55 (73%) of the 75 conducted. The overall violation rate for all inspection types was 68%. This finding was compared to the violation rates of planned inspections (100%), referral-based inspections (83%), and complaint-based inspections (62%). Asbestos was the hazardous substance most commonly sampled and cited by OSHA in hospitals, with 127 samples collected during 24 inspections; 31% of the total 75 inspections resulting in one or more violations were due to asbestos. Copyright 2013, SLACK Incorporated.

  1. The impact of exposure to shift-based schedules on medical students.

    Science.gov (United States)

    Williams, David A; Kogan, Jennifer R; Hauer, Karen E; Yamashita, Traci; Aagaard, Eva M

    2015-01-01

    With new resident duty-hour regulations, resident work schedules have progressively transitioned towards shift-based systems, sometimes resulting in increased team fragmentation. We hypothesized that exposure to shift-based schedules and subsequent team fragmentation would negatively affect medical student experiences during their third-year internal medicine clerkship. As part of a larger national study on duty-hour reform, 67 of 150 eligible third-year medical students completed surveys about career choice, teaching and supervision, assessment, patient care, well-being, and attractiveness of a career in internal medicine after completing their internal medicine clerkship. Students who rotated to hospitals with shift-based systems were compared to those who did not. Non-demographic variables used a five-point Likert scale. Chi-squared and Fisher's exact tests were used to assess the relationships between exposure to shift-based schedules and student responses. Questions with univariate p ≤ 0.1 were included in multivariable logistic regression models. Thirty-six students (54%) were exposed to shift-based schedules. Students exposed to shift-based schedules were less likely to perceive that their attendings were committed to teaching (odds ratio [OR] 0.35, 95% confidence interval [CI]: 0.13-0.90, p = 0.01) or perceive that residents had sufficient exposure to assess their performance (OR 0.29, 95% CI: 0.09-0.91, p = 0.03). However, those students were more likely to feel their interns were able to observe them at the bedside (OR 1.89, 95% CI: 1.08-3.13, p = 0.02) and had sufficient exposure to assess their performance (OR 3.00, 95% CI: 1.01-8.86, p = 0.05). These findings suggest that shift-based schedules designed in response to duty-hour reform may have important broader implications for the teaching environment.

  2. Relationship Between Exposure to Direct-To-Consumer Prescription Drug Advertising (DTCA) and Patients' Belief Accessibility and Medication Adherence.

    Science.gov (United States)

    Im, Heewon; Huh, Jisu

    2018-03-09

    One of the most frequent and strong arguments for supporting direct-to-consumer prescription drug advertising (DTCA) as a positive influence on individuals and society is that DTCA could contribute to improving patients' medication adherence, but systematic empirical research testing this proposed effect is scant. To address this gap and provide an answer to the unresolved question about DTCA effects, this study examined the relationship between overall DTCA exposure and patients' medication adherence through the mechanism of media priming effect increasing medication-related belief accessibility. Results from a survey with a sample of prescription blood thinner takers revealed no significant relationships between DTCA exposure and patients' belief accessibility regarding their medical conditions and drug benefits and risks, and no support for the hypothesized relationship between DTCA exposure and medication adherence. The findings are discussed within the context of DTCA effect research literature, and theoretical and practical implications are presented.

  3. [Differentiation Study of Chinese Medical Syndrome Typing for Diarrhea-predominant Irritable Bowel Syndrome Based on Information of Four Chinese Medical Diagnostic Methods and Brain-gut Peptides].

    Science.gov (United States)

    Wu, Hao-meng; Xu, Zhi-wei; Ao, Hai-qing; Shi, Ya-fei; Hu, Hai-yan; Ji, Yun-peng

    2015-10-01

    To establish discriminant functions of diarrhea-predominant irritable bowel syndrome (IBS-D) by studying it from quantitative diagnosis angle, hoping to reduce interference of subjective factors in diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D. A Chinese medical clinical epidemiological survey was carried out in 439 IBS-D patients using Clinical Information Collection Table of IBS. Initial syndromes were obtained by cluster analysis. They were analyzed using step-by-step discrimination by taking information of four Chinese medical diagnostic methods and serum brain-gut peptides (BGP) as variables. Clustering results were Gan stagnation Pi deficiency syndrome (GSPDS), Pi-Wei weakness syndrome (PWWS), Gan stagnation qi stasis syndrome (GSQSS), Pi-Shen yang deficiency syndrome (PSYDS), Pi-Wei damp-heat syndrome (PWDHS), cold-damp disturbing Pi syndrome (CDDPS). Of them, GSPDS was mostly often seen with effective percentage of 34. 2%, while CDDPS was the least often seen with effective percentage of 5.5%. A total of 5 discriminant functions for GSPDS, PWWS, GSQSS, PSYDS, and PWDHS were obtained by step-by-step dis- crimination method. The retrospective misjudgment rate was 4.1% (16/390), while the cross-validation misjudgment rate was 15.4% (60/390). The establishment of discriminant functions is of value in objectively diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.

  4. Prenatal exposure to antifungal medication may change anogenital distance in male offspring

    DEFF Research Database (Denmark)

    Mogensen, Djamilla Madelung; Pihl, Maria Bergkvist; Skakkebæk, Niels Erik

    2017-01-01

    Background: Vaginal candidiasis is frequent among pregnant women and it is treated with anti-fungal medication (conazoles). Conazoles have anti-androgenic properties and prenatal exposure in rodents is associated with a shorter (less masculine) anogenital distance (AGD) in male offspring. To our...... (AGDap) and penile width; measured at the base of the penis. Results: Eighty seven women had used antifungal medicine during pregnancy. Maternal use of oral fluconazole (n = 4) was associated with a 6.4 mm shorter AGDas (95% CI: -11.9;-0.9) in the male offspring. Use of antifungal vaginal tablets (n = 21...

  5. Exposure of medical students to pharmaceutical marketing in primary care settings: frequent and influential.

    Science.gov (United States)

    Sarikaya, Ozlem; Civaner, Murat; Vatansever, Kevser

    2009-12-01

    It is known that interaction between pharmaceutical companies and medical professionals may lead to corruption of professional values, irrational use of medicine, and negative effects on the patient-physician relationship. Medical students frequently interact with pharmaceutical company representatives and increasingly accept their gifts. Considering the move toward early clinical encounters and community-based education, which expose students early to pharmaceutical representatives, the influence of those gifts is becoming a matter of concern. This study examines the frequency and influence of student exposure to drug marketing in primary care settings, as well as student perceptions of physician-pharmaceutical company relationships. This was a two-phase study consisting of qualitative research followed by a cross-sectional survey. Clinical experience logbooks of 280 second-year students in one school were analysed, and the themes that emerged were used to develop a survey that was administered to 308 third-year students from two medical schools. Survey results showed a 91.2% exposure to any type of marketing, and 56.8% of students were exposed to all classes of marketing methods studied. Deliberate targeting of students by pharmaceutical representatives, in particular, was correlated with being less sensitive to the negative effects of and having positive opinions about interactions with pharmaceutical companies. The vast majority of students are exposed to drug marketing in primary care settings, and may become more vulnerable to that strategy. Considering that medical students are vulnerable and are targeted deliberately by pharmaceutical companies, interventions aimed at developing skills in the rational use of medicines and in strategies for coping with drug marketing should be devised.

  6. [Delayed appendectomy because of diagnostic malpractice: Experiences of the Arbitration Board of the North German Medical Associations].

    Science.gov (United States)

    Vinz, Heinrich; von Bülow, Markward; Neu, Johann

    2015-01-01

    From 2000 to 2012, 447 panel proceedings concerning acute appendicitis were evaluated. 271 cases (57 %) were related to alleged diagnostic malpractice. This was confirmed in 176 cases (67 %). The following medical specialities were involved (m = quote of malpractice): general surgery 33 %, m = 51 %; paediatric surgery 3 %, m = 44 %; general practitioner and prehospital emergency services 24 %, m = 62 %; internal medicine 19 %, m = 70 %; paediatrics 13 %, m = 57 %; gynaecology 3 %, m = 91 %; urology 2 %, m = 17 %. The most frequent misdiagnosis was gastroenteritis (43 % in adults, 69 % in children), obviously based on the concomitant symptom of diarrhoea. Surgery revealed all stages of advanced appendicitis up to peritoneal sepsis, organic failure and death (n = 5). The evaluation of the files and the experts' reports of the 176 cases of diagnostic malpractice allowed to define the following basic failures, which led to unjustified delay of operation: careless history-taking, no or incomplete physical examination, no follow-up investigations, incorrect interpretation of the patient's complaints and clinical findings, no or incomplete documentation. Conducting a thorough investigation is essential to avoiding diagnostic malpractice. Internal analysis of failures or near failures may contribute to reducing the number of future cases of malpractice. Copyright © 2015. Published by Elsevier GmbH.

  7. The Application of Whole Cell-Based Biosensors for Use in Environmental Analysis and in Medical Diagnostics

    Science.gov (United States)

    Gui, Qingyuan; Lawson, Tom; Shan, Suyan; Yan, Lu; Liu, Yong

    2017-01-01

    Various whole cell-based biosensors have been reported in the literature for the last 20 years and these reports have shown great potential for their use in the areas of pollution detection in environmental and in biomedical diagnostics. Unlike other reviews of this growing field, this mini-review argues that: (1) the selection of reporter genes and their regulatory proteins are directly linked to the performance of celllular biosensors; (2) broad enhancements in microelectronics and information technologies have also led to improvements in the performance of these sensors; (3) their future potential is most apparent in their use in the areas of medical diagnostics and in environmental monitoring; and (4) currently the most promising work is focused on the better integration of cellular sensors with nano and micro scaled integrated chips. With better integration it may become practical to see these cells used as (5) real-time portable devices for diagnostics at the bedside and for remote environmental toxin detection and this in situ application will make the technology commonplace and thus as unremarkable as other ubiquitous technologies. PMID:28703749

  8. Translating silicon nanowire BioFET sensor-technology to embedded point-of-care medical diagnostics

    DEFF Research Database (Denmark)

    Pfreundt, Andrea; Zulfiqar, Azeem; Patou, François

    2013-01-01

    Silicon nanowire and nanoribbon biosensors have shown great promise in the detection of biomarkers at very low concentrations. Their high sensitivity makes them ideal candidates for use in early-stage medical diagnostics and further disease monitoring where low amounts of biomarkers need to be de......Silicon nanowire and nanoribbon biosensors have shown great promise in the detection of biomarkers at very low concentrations. Their high sensitivity makes them ideal candidates for use in early-stage medical diagnostics and further disease monitoring where low amounts of biomarkers need...... to be detected. However, in order to translate this technology from the bench to the bedside, a number of key issues need to be taken into consideration: Integrating nanobiosensors-based technology requires to overcome the difficult tradeoff between imperatives for high device reproducibilty and associated......, which require a specific set of biomakers to be identified and quantified simultaneously, can thus be readily translated onto this platform. After hydrogen termination of the silicon surface an alkyne monolayer is formed based on a hydrosilylation process. Antibodies and other receptor proteins can...

  9. Asthma-like symptoms, diagnostic tests, and asthma medication use in children and adolescents: a population-based nationwide survey.

    Science.gov (United States)

    Ferreira-Magalhães, Manuel; Sá-Sousa, Ana; Morais-Almeida, Mário; Pité, Helena; Azevedo, Luis Filipe; Azevedo, Maria Inês; Bugalho-Almeida, António; Fonseca, João Almeida

    2016-01-01

    This study aimed to estimate the prevalence of asthma-like symptoms, current asthma (CA), asthma diagnostic tests, and inhaled medication use in a nationwide pediatric population (Pediatric-specific data from a cross-sectional, population-based telephone survey (INAsma study) in Portugal were analyzed. CA was defined as lifetime asthma and (1) wheezing, (2) waking with breathlessness, or (3) asthma attack in the previous 12 months, and/or (4) taking asthma medication at the time of the interview. In total, 716 children were included. The prevalence of asthma-like symptoms was 39.4% [95% confidence interval (95% CI): 35.7-43.3]. The most common symptoms were waking with cough (30.9%) and wheezing (19.1%). The prevalence of CA was 8.4% (95% CI: 6.6-10.7). Among children with CA, 79.9% and 52.9% reported prior allergy testing and pulmonary function testing (PFT), respectively. Inhaled medication use in the previous 12 months was reported by 67.6% (reliever inhalers, 40.1%; controller inhalers, 41.5%). Those who only used inhaled reliever medications experienced more asthma attacks [odds ratio (OR): 2.69]. Significantly fewer children with CA living in rural areas than those living in urban areas had undergone PFT or used inhaled medication (OR: 0.06 for PFT, 0.20 for medication]. The prevalence of CA in the Portuguese pediatric population was 8.4%. Only half of children with CA had ever undergone PFT; more than half did not use controller inhalers, and those who only used reliever inhalers reported more asthma attacks. These findings suggest that asthma management has been substandard, mainly in rural areas.

  10. University of Saskatchewan Radiology Courseware (USRC): an assessment of its utility for teaching diagnostic imaging in the medical school curriculum.

    Science.gov (United States)

    Burbridge, Brent; Kalra, Neil; Malin, Greg; Trinder, Krista; Pinelle, David

    2015-01-01

    We have found it very challenging to integrate images from our radiology digital imaging repository into the curriculum of our local medical school. Thus, it has been difficult to convey important knowledge related to viewing and interpreting diagnostic radiology images. We sought to determine if we could create a solution for this problem and evaluate whether students exposed to this solution were able to learn imaging concepts pertinent to medical practice. We developed University of Saskatchewan Radiology Courseware (USRC), a novel interactive web application that enables preclinical medical students to acquire image interpretation skills fundamental to clinical practice. This web application reformats content stored in Medical Imaging Resource Center teaching cases for BlackBoard Learn™, a popular learning management system. We have deployed this solution for 2 successive years in a 1st-year basic sciences medical school course at the College of Medicine, University of Saskatchewan. The "courseware" content covers both normal anatomy and common clinical pathologies in five distinct modules. We created two cohorts of learners consisting of an intervention cohort of students who had used USRC for their 1st academic year, whereas the nonintervention cohort was students who had not been exposed to this learning opportunity. To assess the learning experience of the users we designed an online questionnaire and image review quiz delivered to both of the student groups. Comparisons between the groups revealed statistically significant differences in both confidence with image interpretation and the ability to answer knowledge-based questions. Students were satisfied with the overall usability, functions, and capabilities of USRC. USRC is an innovative technology that provides integration between Medical Imaging Resource Center, a teaching solution used in radiology, and a Learning Management System.

  11. Continuous Improvement of the Regulatory Framework for the Control of Medical Exposure

    International Nuclear Information System (INIS)

    Larcher, A.M.; Ortiz lopez, Pedro; Arias, Cesar; Marechal, Maria H.; Hernandez Alvarez, Ramon; Ferrer Garcia, Natividad; Castaneda Mucino, Antonia; Faller, Blanca

    2011-01-01

    Background: One of the key elements to guide the improvement of the regulatory control is the availability of a self-assessment tool for regulatory performance. Although there is general guidance on self-assessment for regulators and users (IAEA), there is a need for specific advice on how to address challenges and difficulties faced by regulatory bodies, when regulating radiation protection of patients. Examples of these challenges are the need of regulatory initiatives, in cooperation with health and education authorities, professional bodies and equipment suppliers, and to put in place necessary elements that are beyond responsibility of individual users of radiation, to enable them compliance with safety standards. Purpose: within the programme of the Ibero American Forum of Nuclear and Radiation Safety Regulatory Organizations, a project to develop such a self assessment tool for the regulatory control of medical exposure has been designed. Method: national experiences in transposing and enforcing the international radiation safety standards, as to how the requirements are included in national regulations are reviewed. Further, difficulties to the implementation of safety requirements are included in national regulations are analyzed and a self assessment approach and possible regulatory solutions are presented. Results and discussion: in tis study the following documents are being produced: 1) Transposition of international requirements into national regulations in the six countries of the Forum, 2) difficulties to implement and enforce the requirements, 3) guidance on self assessment of regulatory framework for medical exposure, 4) suggested contribution to the revision of international radiation safety standards. (authors)

  12. Continuous improvement of the regulatory framework for the control of medical exposure

    International Nuclear Information System (INIS)

    Larcher, Ana M.; Ortiz Lopez, Pedro; Arias, Cesar; Marechal, Maria H.; Hernandez Alvarez, Ramon; Ferrer Garcia, Natividad; Castaneda Mucino, Antonia; Faller, Blanca

    2008-01-01

    One of the key elements to guide the improvement of the regulatory control is the availability of a self-assessment tool for regulatory performance. Although there is general guidance on self-assessment for regulators and users (IAEA), there is a need for more specific advice on how to address challenges and difficulties faced by regulatory bodies, when regulating radiation protection of patients. Examples of these challenges are the need for regulatory initiatives, in cooperation with health and education authorities, professional bodies and equipment suppliers, and to put in place necessary elements that are beyond responsibility of individual user of radiation, to enable them compliance with safety standards. Purpose: Within the programme of the Ibero American Forum of Nuclear and Radiation Safety Regulatory Organizations, a project to develop such a self-assessment tool for the regulatory control of medical exposure has been designed. Method: National experiences in transposing and enforcing the international radiation safety standards, as to how the requirements are included in national regulations are reviewed. Further, difficulties to the implementation of safety requirements are analyzed and a self-assessment approach and possible regulatory solutions a are presented. Results and discussion: In this study the following documents are being produced: 1) transposition of international requirements into national regulations in the six countries of the Forum, 2) difficulties to implement and enforce the requirements, 3) guidance on self-assessment of regulatory framework for medical exposure, 4) suggested contribution to the revision of international radiation safety standards. (author)

  13. Management system of personnel dosimetry based on ISO 9001:2008 for medical diagnostic

    International Nuclear Information System (INIS)

    Queiroz, Carlos E.B.; Gerber Junior, Walmoli; Jahn, Tiago R.; Hahn, Tiago T.; Fontana, Thiago S.; Bolzan, Vagner

    2013-01-01

    MDose is a computer management system of personal dosimetry in diagnostic radiology services physician based on ISO 9001:9008 management system. According to Brazilian law all service radiology should implement a control of personal dosimetry in addition to radiation doses greater than 1.5 mSv/year service should do research of high dose, which is to identify the causes the resulting dose increase professional. This work is based on the use of the PDCA cycle in a JAVA software developed as a management method in the analysis of high doses in order to promote systematic and continuous improvement within the organization of radiological protection of workers

  14. Course of radiological protection and safety in the medical diagnostic with X-rays; Curso de proteccion y seguridad radiologica en el diagnostico medico con rayos X

    Energy Technology Data Exchange (ETDEWEB)

    Dominguez A, C.E. [Instituto Nacional de Investigaciones Nucleares, A.P. 18-1027, 11801 Mexico D.F. (Mexico)

    1997-07-01

    The obtention of images of human body to the medical diagnostic is one of the more old and generalized applications for X-ray. Therefore the design and performance of equipment and installations as well as the operation procedures must be oriented toward safety with the purpose to guarantee this radiological practice will bring a net positive benefit to the society. Given that in Mexico only exists the standardization related to source and equipment generators of ionizing radiation in the industrial area and medical therapy, but not so to the medical diagnostic area it is the purpose of this work to present those standards related with this application branch. Also it is presented the preparation of a manual for the course named Formation of teachers in radiological protection and safety in the X-ray medical diagnostic in 1997 which was imparted at ININ. (Author)

  15. Risk assessment of medical exposure in X-ray examinations of children

    Directory of Open Access Journals (Sweden)

    I. G. Shatsky

    2017-01-01

    Full Text Available The use of the effective dose (the concept of which was developed for radiation protection of workers and public and the nominal risk coefficients, averaged by sex and age, to assess the radiation risks of medical exposure has some significant limitations. Age and sex distribution of the staff and the entire population may be quite different from the sex and age distribution of patients undergoing medical exposure. Moreover, the structure of the age and sex of patients may be different for various medical examinations. There are simplified methods for evaluating individual risk for patients undergoing medical exposure. The methods are based on the effective dose evaluation and those take in to account age and gender. A more accurate assessment of lifetime risk of delayed stochastic effects for health of the patient is achieved by using the organ doses and the age and gender risk factors. The aim of this work was evaluation of the lifetime risk of long-term stochastic health effects for different gender and age groups of children undergoing various radiographic investigations by using organ doses and the age and gender risk factors, and subsequent classification in accordance with generally accepted international risk scale. Data from surveys of33 X-ray units in 29 specialized pediatric health care organizations in Russia were used in the work. Organ doses and patient’s effective doses were calculated on the basis of the defined for each x-ray machine typical modes for the 12 radiographic procedures (X-ray exam of the skull, chest, cervical spine, thoracic spine, lumbar spine–all in two projections – of the abdomen and pelvis – both in one projectionusing a computer program PCXMC., Radiation risks for selected studies were estimated using the obtained organ doses and the age and gender risk factors calculated for the Russian population. The radiation risks were classified according to the international scale of the risks. It was found

  16. Sociodemographic and diagnostic characteristics of prescribing a second-line lipid-lowering medication

    DEFF Research Database (Denmark)

    Wallach-Kildemoes, Helle; Hansen, Ebba Holme

    2015-01-01

    OBJECTIVE: Ezetimibe is used as a second-line lipid-lowering medication (LLM) if statin therapy is not tolerated or cholesterol targets are not reached by statins alone. We aimed to investigate the impact of sociodemographic factors on ezetimibe initiation as (a) incident LLM therapy, (b) add...

  17. Medical Diagnostic Consultation concerning Mental Retardation: An Analogue Study of School Psychologists' Attitudes

    Science.gov (United States)

    Wodrich, David L.; Tarbox, Jennifer; Balles, John; Gorin, Joanna

    2010-01-01

    Recent research of relevance to school psychologists suggests that the cause, or etiology, of mental retardation can be established by medical diagnosticians in approximately one-half of cases. In the current study, 109 practicing school psychologists considered a hypothetical case of an elementary student with mental retardation and indicated…

  18. Post-exposure vaccination with multi-stage vaccine significantly reduce map level in tissues without interference in diagnostics

    DEFF Research Database (Denmark)

    Thakur, Aneesh; Aagaard, Claus; Melvang, Heidi Mikkelsen

    A new (Fet11) vaccine against paratuberculosis based on recombinant antigens from acute and latent stages of Map infection was developed to be used without interference with diagnostic tests for bovine TB and Johne’s disease. Calves were orally inoculated with 2x10E10 live Map in their third week...... of life and randomly assigned to four groups of seven calves each. One group was left unvaccinated, while other calves were post-exposure vaccinated with either a whole-cell vaccine at 16 weeks, or Fet11 vaccine at 3 and 7, or 16 and 20 weeks of age, respectively. Antibody responses were measured by ID...... Screen® ELISA and individual vaccine protein ELISAs along with FACS and IFN-γ responses to PPDj and to individual vaccine proteins. At termination 8 or 12 months of age, Map burden in a number of gut tissues was determined by quantitative IS900 PCR and histopathology. Fet11 vaccination of calves at 16...

  19. Focal congenital hyperinsulinism managed by medical treatment: a diagnostic algorithm based on molecular genetic screening.

    Science.gov (United States)

    Maiorana, Arianna; Barbetti, Fabrizio; Boiani, Arianna; Rufini, Vittoria; Pizzoferro, Milena; Francalanci, Paola; Faletra, Flavio; Nichols, Colin G; Grimaldi, Chiara; de Ville de Goyet, Jean; Rahier, Jacques; Henquin, Jean-Claude; Dionisi-Vici, Carlo

    2014-11-01

    Congenital hyperinsulinism (CHI) requires rapid diagnosis and treatment to avoid irreversible neurological sequelae due to hypoglycaemia. Aetiological diagnosis is instrumental in directing the appropriate therapy. Current diagnostic algorithms provide a complete set of diagnostic tools including (i) biochemical assays, (ii) genetic facility and (iii) state-of-the-art imaging. They consider the response to a therapeutic diazoxide trial an early, crucial step before proceeding (or not) to specific genetic testing and eventually imaging, aimed at distinguishing diffuse vs focal CHI. However, interpretation of the diazoxide test is not trivial and can vary between research groups, which may lead to inappropriate decisions. Objective of this report is proposing a new algorithm in which early genetic screening, rather than diazoxide trial, dictates subsequent clinical decisions. Two CHI patients weaned from parenteral glucose infusion and glucagon after starting diazoxide. No hypoglycaemia was registered during a 72-h continuous glucose monitoring (CGMS), or hypoglycaemic episodes were present for no longer than 3% of 72-h. Normoglycaemia was obtained by low-medium dose diazoxide combined with frequent carbohydrate feeds for several years. We identified monoallelic, paternally inherited mutations in KATP channel genes, and (18) F-DOPA PET-CT revealed a focal lesion that was surgically resected, resulting in complete remission of hypoglycaemia. Although rare, some patients with focal lesions may be responsive to diazoxide. As a consequence, we propose an algorithm that is not based on a 'formal' diazoxide response but on genetic testing, in which patients carrying paternally inherited ABCC8 or KCNJ11 mutations should always be subjected to (18) F-DOPA PET-CT. © 2014 John Wiley & Sons Ltd.

  20. Mapping very low level occupational exposure in medical imaging: A useful tool in risk communication and decision making

    International Nuclear Information System (INIS)

    Covens, P.; Berus, D.; Mey, J. de; Buls, N.

    2012-01-01

    Objectives: The use of ionising radiation in medical imaging is accompanied with occupational exposure which should be limited by optimised room design and safety instructions. These measures can however not prevent that workers are exposed to instantaneous dose rates, e.g. the residual exposure through shielding or the exposure of discharged nuclear medicine patients. The latter elements are often questioned by workers and detailed assessment should give more information about the impact on the individual radiation dose. Methods: Cumulated radiation exposure was measured in a university hospital during a period of 6 months by means of thermoluminescent dosimeters. Radiation exposure was measured at background locations and at locations where enhanced exposure levels are expected but where the impact on the individual exposure is unclear. Results: The results show a normal distribution of the cumulated background radiation level. No enhanced cumulated radiation exposure which significantly differs from this background level could be found during the operation of intra-oral apparatus, during ultrasonography procedures among nuclear medicine patients and at operator consoles of most CT-rooms. Conclusions: This 6 months survey offers useful information about occupational low level exposure in medical imaging and the findings can be useful in both risk communication and decision making

  1. A Smart Mobile Lab-on-Chip-Based Medical Diagnostics System Architecture Designed For Evolvability

    DEFF Research Database (Denmark)

    Patou, François; Dimaki, Maria; Svendsen, Winnie Edith

    2015-01-01

    Unprecedented knowledge levels in life sciences along with technological advances in micro- and nanotechnologies and microfluidics have recently conditioned the advent of Lab-on-Chip (LoC) devices for In-Vitro Medical Testing (IVMT). Combined with smart-mobile technologies, LoCs are pervasively...... giving rise to opportunities to better diagnose disease, predict and monitor personalised treatment efficacy, or provide healthcare decision-making support at the Point-of-Care (PoC). Although made increasingly available to the consumer market, the adoption of LoC-based PoC In-Vitro Medical Testing (IVMT...... for this work. We introduce a smart-mobile and LoC-based system architecture designed for evolvability. By propagating LoC programmability, instrumentation, and control tools to the highlevel abstraction smart-mobile software layer, our architecture facilitates the realisation of new use...

  2. Heuristic determination of relevant diagnostic procedures in a medical expert system for gynecology.

    Science.gov (United States)

    Small, S L; Muechler, E K

    1989-07-01

    Many professions including medicine have standard operating procedures for the performance of their tasks. In the construction of expert systems, knowledge engineers have exploited this fact in devising heuristic rules that mimic the standard practice among such personnel (i.e., experts). This article suggests that the expert system designer should not stop at the level of the standard operating procedure heuristic but should instead investigate the reasons that the standard procedures have become standard. Because the experts in a field often do not understand the reasons for the standard operating procedures of their profession, this effort not only rewards the system designer but the expert as well. Because medical training does not always emphasize the logical reasoning underlying certain standard operating procedures, the ability to perform this reasoning is especially important in medicine. Further, a medical expert system for consultation or education would make a valuable impact by incorporating such knowledge and inference rules. This article investigates the development of a computerized medical expert system that applies the principles of artificial intelligence by limiting the number of questions and tests to find the solution for an ill-defined complex problem. Finally, we describe a logic program that tests the basic ideas.

  3. The impact of exposure to shift-based schedules on medical students

    Directory of Open Access Journals (Sweden)

    David A. Williams

    2015-06-01

    Full Text Available Background: With new resident duty-hour regulations, resident work schedules have progressively transitioned towards shift-based systems, sometimes resulting in increased team fragmentation. We hypothesized that exposure to shift-based schedules and subsequent team fragmentation would negatively affect medical student experiences during their third-year internal medicine clerkship. Design: As part of a larger national study on duty-hour reform, 67 of 150 eligible third-year medical students completed surveys about career choice, teaching and supervision, assessment, patient care, well-being, and attractiveness of a career in internal medicine after completing their internal medicine clerkship. Students who rotated to hospitals with shift-based systems were compared to those who did not. Non-demographic variables used a five-point Likert scale. Chi-squared and Fisher's exact tests were used to assess the relationships between exposure to shift-based schedules and student responses. Questions with univariate p≤0.1 were included in multivariable logistic regression models. Results: Thirty-six students (54% were exposed to shift-based schedules. Students exposed to shift-based schedules were less likely to perceive that their attendings were committed to teaching (odds ratio [OR] 0.35, 95% confidence interval [CI]: 0.13–0.90, p=0.01 or perceive that residents had sufficient exposure to assess their performance (OR 0.29, 95% CI: 0.09–0.91, p=0.03. However, those students were more likely to feel their interns were able to observe them at the bedside (OR 1.89, 95% CI: 1.08–3.13, p=0.02 and had sufficient exposure to assess their performance (OR 3.00, 95% CI: 1.01–8.86, p=0.05. Conclusions: These findings suggest that shift-based schedules designed in response to duty-hour reform may have important broader implications for the teaching environment.

  4. Turkish Final Year Medical Students' Exposure to and Attitudes Concerning Drug Company Interactions: A Perspective from a Minimally Regulated Environment for Medical Students.

    Directory of Open Access Journals (Sweden)

    Nazim Ercument Beyhun

    Full Text Available Interactions between drug companies and medical students may affect evidence-based medical practice and patient safety. The aim of this study was to assess drug company-medical student interactions in a medical faculty where limited specific national or institutional regulations apply between drug companies and medical students. The objectives of the study were to determine the exposure and attitudes of final year medical students in terms of drug company-medical student and physician interactions, to identify factors affecting those attitudes and to provide data for policymakers working on the regulation of interactions between drug companies and medical students. This anonymous questionnaire-based study of 154 medical final year medical students at the Karadeniz Technical University Medical Faculty, Trabzon, Turkey, in April and May 2015 attracted a response rate of 92.2% (n/N, 154/164. Exposure to interaction with a pharmaceutical representative was reported by 90.3% (139/154 of students, and 68.8% (106/154 reported experiencing such interaction alongside a resident. In addition, 83.7% (128/153 of students reported an interaction during internship. Furthermore, 69.9% (107/153 of students agreed that interactions influence physicians' prescription preferences, while 33.1% (51/154 thought that a medical student should never accept a gift from a drug company and 24.7% (38/154 agreed with the proposition that "drug companies should not hold activities in medical faculties". Students with rational prescription training expressed greater agreement with the statement "I am skeptical concerning the information provided by drug companies during interactions" than those who had not received such training, and this finding was supported by logistic regression [O.R.(C.I, p -3.7(1.2-11.5, p = 0.022]. Acceptance of advertisement brochures was found to significantly reduce the level of agreement with the proposition that "A physician should not accept any

  5. Towards first principle medical diagnostics: on the importance of disease-disease and sign-sign interactions

    Science.gov (United States)

    Ramezanpour, Abolfazl; Mashaghi, Alireza

    2017-07-01

    A fundamental problem in medicine and biology is to assign states, e.g. healthy or diseased, to cells, organs or individuals. State assignment or making a diagnosis is often a nontrivial and challenging process and, with the advent of omics technologies, the diagnostic challenge is becoming more and more serious. The challenge lies not only in the increasing number of measured properties and dynamics of the system (e.g. cell or human body) but also in the co-evolution of multiple states and overlapping properties, and degeneracy of states. We develop, from first principles, a generic rational framework for state assignment in cell biology and medicine, and demonstrate its applicability with a few simple theoretical case studies from medical diagnostics. We show how disease-related statistical information can be used to build a comprehensive model that includes the relevant dependencies between clinical and laboratory findings (signs) and diseases. In particular, we include disease-disease and sign-sign interactions and study how one can infer the probability of a disease in a patient with given signs. We perform comparative analysis with simple benchmark models to check the performances of our models. We find that including interactions can significantly change the statistical importance of the signs and diseases. This first principles approach, as we show, facilitates the early diagnosis of disease by taking interactions into accounts, and enables the construction of consensus diagnostic flow charts. Additionally, we envision that our approach will find applications in systems biology, and in particular, in characterizing the phenome via the metabolome, the proteome, the transcriptome, and the genome.

  6. Toward First Principle Medical Diagnostics: On the Importance of Disease-Disease and Sign-Sign Interactions

    Directory of Open Access Journals (Sweden)

    Abolfazl Ramezanpour

    2017-07-01

    Full Text Available A fundamental problem in medicine and biology is to assign states, e.g., healthy or diseased, to cells, organs or individuals. State assignment or making a diagnosis is often a nontrivial and challenging process and, with the advent of omics technologies, the diagnostic challenge is becoming more and more serious. The challenge lies not only in the increasing number of measured properties and dynamics of the system (e.g., cell or human body but also in the co-evolution of multiple states and overlapping properties, and degeneracy of states. We develop, from first principles, a generic rational framework for state assignment in cell biology and medicine, and demonstrate its applicability with a few simple theoretical case studies from medical diagnostics. We show how disease–related statistical information can be used to build a comprehensive model that includes the relevant dependencies between clinical and laboratory findings (signs and diseases. In particular, we include disease-disease and sign–sign interactions and study how one can infer the probability of a disease in a patient with given signs. We perform comparative analysis with simple benchmark models to check the performances of our models. We find that including interactions can significantly change the statistical importance of the signs and diseases. This first principles approach, as we show, facilitates the early diagnosis of disease by taking interactions into accounts, and enables the construction of consensus diagnostic flow charts. Additionally, we envision that our approach will find applications in systems biology, and in particular, in characterizing the phenome via the metabolome, the proteome, the transcriptome, and the genome.

  7. The medical exposures in UNSCEAR 2000 and the data of Spanish Group

    International Nuclear Information System (INIS)

    Vano, E.

    2001-01-01

    Last year 2000, UNSCEAR published the document Sources and Effects of Ionizing Radiation which is composed of two volumes. Within Volume I: Sources, the Annex D is about medical radiation exposures. The present article summarises the more relevant data presented in this Annex, pointing out the changes that have taken places since the previous UNSCEAR report of 1993. Besides, the actions and results obtained by the Spanish UNSCEAR Working Group are presented. Some of the more relevant data presented in the last UNSCEAR report are: most of the medical applications are performed in developed countries (25% of the world-wide population); the mean effective dose (in developed countries) is approximately 1 mSv/year; the mean world-wide dose is around 0.4 mSv/year and more than 90% of this dose derives from medical diagnosis. In June 1999, the Spanish Ministry of Health and Consumption (Ministerio de Sanidad y consumo) created the UNSCEAR Working Group in which the author of the present article acts as technical coordinator. The objective of the group was to systematically compile the necessary information to edit a periodic report on the estimation of doses to the population due to medical exposures, which additionally could be used by the Health Administration as a complementary element for planning the installations and in the radiation protection programmes of the patients. The final report of the Spanish group, published in February 2000, was elaborated with the data provided by nine Autonomic Communities ( the total number of Autonomic Communities is seventeen) including 44% of the Spanish population (17.4 millions of inhabitants from the nine Autonomic Communities in relation to a total population of 39.9 millions; population data in 01.01.98). The final values in the Spanish report are rather reasonable, although in few cases deviations can appear due to the scarce information available The data provided are validated in origin due to the direct participation of

  8. Value of diagnostic and therapeutic laparoscopy for patients with blunt abdominal trauma: A 10-year medical center experience

    Science.gov (United States)

    Chen, Ying-Da; Chen, Shyr-Chyr

    2018-01-01

    Laparoscopy has been used for the diagnosis and treatment for hemodynamically stable patients with penetrating abdominal trauma. This study evaluated whether diagnostic and therapeutic laparoscopy can be used as effectively in select patients with blunt abdominal trauma. All hemodynamically stable patients undergoing operations for blunt abdominal trauma over a 10-year period (2006–2015) at a tertiary medical center were included. Patients undergoing laparotomy were categorized as group A. Patients who underwent laparoscopy were categorized as group B. The clinical outcomes of the 2 groups were compared. There were 139 patients in group A and 126 patients in group B. Group A patients were more severely injured (mean injury severity score of 23.3 vs. 18.9, P .05). Laparoscopy is a feasible and safe tool for the diagnosis and treatment of hemodynamically stable patients with blunt abdominal trauma who require surgery. PMID:29470527

  9. The Development Of A Diagnostic Reading Test Of English For The Students Of Medical Faculty, Brawijaya University

    Directory of Open Access Journals (Sweden)

    Indah Winarni

    2003-01-01

    Full Text Available This paper describes the development of a diagnostic test of multiple choice reading comprehension as an initial stage in developing teaching materials for medical students learning English. Sample texts were collected from all the departments in the faculty. Selection of relevant texts involved the participation of some subject lecturers. Sixty one items were developed from fifteen texts to be reduced to forty items after pilot testing. Face validity was improved. The main trial was carried out to twenty nine students and item analysis was carried out. The test showed low level of concurrent validity and the internal consistency showed a moderate level of reliability. The low level of concurrent validity was suspected to result from the test being too difficult for the testees as the item analysis had revealed.

  10. Advanced diagnostic approaches and current medical management of insulinomas and adrenocortical disease in ferrets (Mustela putorius furo).

    Science.gov (United States)

    Chen, Sue

    2010-09-01

    Endocrine neoplasia is the most common tumor type in domestic ferrets, especially in middle-aged to older ferrets. Islet cell tumors and adrenocortical tumors constitute the major types of endocrine neoplasms. Insulinoma is a tumor that produces and releases excessive amounts of insulin. Evaluation of fasted blood glucose levels provides a quick diagnostic assessment for the detection of insulinomas. Use of glucocorticoids, diazoxide, and diet modification are some of the medical treatment options for insulinomas. Adrenocortical neoplasia in ferrets usually overproduces one or more sex hormones. Sex hormones which can result in progressive alopecia, vulvar swelling in females, and prostagomegaly in males. Abdominal ultrasonography and sex hormone assays can be used to diagnose adrenocortical neoplasms. Drugs such as leuprolide acetate, deslorelin acetate, and the hormone melatonin can be used to treat adrenocortical neoplasms in ferrets when surgery is not an option. Copyright 2010 Elsevier Inc. All rights reserved.

  11. Does medical students' diagnostic performance improve by observing examples of self-explanation provided by peers or experts?

    Science.gov (United States)

    Chamberland, Martine; Mamede, Sílvia; St-Onge, Christina; Setrakian, Jean; Schmidt, Henk G

    2015-10-01

    Educational strategies that promote the development of clinical reasoning in students remain scarce. Generating self-explanations (SE) engages students in active learning and has shown to be an effective technique to improve clinical reasoning in clerks. Example-based learning has been shown to support the development of accurate knowledge representations. The purpose of this study was to investigate the effect of combining student's SE and observation of peer's or expert's SE examples on diagnostic performance. Fifty-three third-year medical students were assigned to a peer SE example, an expert SE example or control (no example) group. All participants solved a set of the same four clinical cases (training cases), 1-after SE, 2-after listening to a peer or expert SE example or after a control task, and 3-1 week later. They solved a new set of four different cases (transfer cases) also 1 week later. For training cases, students improved significantly their diagnostic performance overtime but the main effect of group was not significant suggesting that students' SE mainly drives the observed effect. On transfer cases, there was no difference between the three groups (p > .05). Educational implications are discussed and further studies on different types of examples and additional strategies to help students actively process examples are proposed.

  12. E.A.O. guidelines for the use of diagnostic imaging in implant dentistry 2011. A consensus workshop organized by the European Association for Osseointegration at the Medical University of Warsaw.

    LENUS (Irish Health Repository)

    Harris, David

    2012-11-01

    Diagnostics imaging is an essential component of patient selection and treatment planning in oral rehabilitation by means of osseointegrated implants. In 2002, the EAO produced and published guidelines on the use of diagnostic imaging in implant dentistry. Since that time, there have been significant developments in both the application of cone beam computed tomography as well as in the range of surgical and prosthetic applications that can potentially benefit from its use. However, medical exposure to ionizing radiation must always be justified and result in a net benefit to the patient. The as low a dose as is reasonably achievable principle must also be applied taking into account any alternative techniques that might achieve the same objectives. This paper reports on current EAO recommendations arising from a consensus meeting held at the Medical University of Warsaw (2011) to update these guidelines. Radiological considerations are detailed, including justification and optimization, with a special emphasis on the obligations that arise for those who prescribe or undertake such investigations. The paper pays special attention to clinical indications and radiographic diagnostic considerations as well as to future developments and trends.

  13. Medical management of severe local radiation injury after acute X-ray exposure

    International Nuclear Information System (INIS)

    Bushmanov, A.; Nadezhina, N.; Kretov, A.

    2008-01-01

    Medical management during acute period in a case of severe local radiation injury after acute X-ray exposure includes 3 stages. During the fist stage patient got conservative treatment according to the common pathogenetic mechanisms of LRI (dis aggregating therapy, stimulation of regeneration, dis intoxication therapy, antibiotic therapy, pain relief therapy, Local anti-burn therapy-specific non-adhesive bandage with antiseptic and anti-burn medicaments); estimation of severity, deepness and area of injury by clinical picture and dates of instrumental methods of examining; defining necessity and volume of surgical treatment; preparing arrangements for surgical treatment. This stage ends with forming of demarcation line of a very hard severity of a Local Radiation Injure. The second stage includes necrectomy of the area of a very hard severity with microsurgical plastic by re vascularized flap and auto dermoplastic. The third stage - adaptation of re vascularized flap and total epithelization of injured area. (author)

  14. Hospital and clinic survey estimates of medical X-ray exposure in Hiroshima and Nagasaki, 2

    International Nuclear Information System (INIS)

    Antoku, Shigetoshi; Hoshi, Masaharu; Sawada, Shozo; Russell, W.J.

    1987-07-01

    The technical factors used during radiological examinations performed in Hiroshima and Nagasaki medical institutions were analyzed. The most frequently performed examination was chest radiography, followed by upper GI series. More than half the radiographic exposures were from upper GI series due to the many spot films made during fluoroscopy. Comparison of the present survey results with those of a previous one showed that relatively high kVp, low mAs and mA, and smaller field sizes are now more widely used. Though there have been decreased in fluoroscopy times and tube currents over the past 10 years, the numbers of spot films used have increased. Based on these technical factors, tables of organ doses from fluoroscopic examinations were compiled. (author)

  15. DIAGNOSTIC AND MEDICAL TREATMENT OF RABIES DISEASE IN HEALTH CENTER OF COMMUNITY

    Directory of Open Access Journals (Sweden)

    Raflizar Raflizar

    2012-11-01

    Full Text Available In Indonesia, Rabies is still considered as the most common zoonotic disease. It is not due to the number of death cases but to the number of human cases of human bitten by rabies virus infected animals or suspected ones. Most of human rabies cases caused by dog bites, besides cat and monkey bites. If rabies can be eliminated from dogs, rabies in cats and monkeys can also be eliminated as spontaneous rabies in these two animals are rare. Rabies is caused by an RNA virus from Rhabdowidae Family and it attacks the central nervous system. It is almost invariably fatal if post-exposure prophylaxis is not administered prior to the onset of severe symptoms in unvaccinated people Diagnose is based on the history of close contacts to infected saliva (via bites or scratches and development of signs and symptoms. The early stage symptoms are fever. malaise, followed by agitation, abnormal behaviours, anxiety, hallucination, progressing to delirium, hypersalivalion, hydrophobia, aerophobia, neurological symptoms such as pharynx spasm. paralysis, seizure, and finally death. Laboratory test to detect rabies virus in saliva can be done by a Reverse transcription followed by Polymerase Cham Reaction (RT/PCR and virus isolation in cultured tissues. Skin biopsies of hair follicles at nape of the neck are exammed for rabies antigen in cutaneous nerves at the base of hair follicles by immunofluoresence staining. The treatment after exposure are cleansing lesion, administering intradermal anti-rabies immunization to accelerate immune response. anti-rabies serum to stop infection process, intravenous and intraventricular ribavirin and alfa interferon, high concentration of ketamine infusion to inhibit rabies virus replication. At last, vaccination is the best prevention. Key words: rabies, RNA-virus, vaccination, diagnosis, treatment

  16. Implementation of Clustering Algorithms for real datasets in Medical Diagnostics using MATLAB

    Directory of Open Access Journals (Sweden)

    B. Venkataramana

    2017-03-01

    Full Text Available As in the medical field, for one disease there require samples given by diagnosis. The samples will be analyzed by a doctor or a pharmacist. As the no. of patients increases their samples also increases, there require more time to analyze samples for deciding the stage of the disease. To analyze the sample every time requires a skilled person. The samples can be classified by applying them to clustering algorithms. Data clustering has been considered as the most important raw data analysis method used in data mining technology. Most of the clustering techniques proved their efficiency in many applications such as decision making systems, medical sciences, earth sciences etc. Partition based clustering is one of the main approach in clustering. There are various algorithms of data clustering, every algorithm has its own advantages and disadvantages. This work reports the results of classification performance of three such widely used algorithms namely K-means (KM, Fuzzy c-means and Fuzzy Possibilistic c-Means (FPCM clustering algorithms. To analyze these algorithms three known data sets from UCI machine learning repository are taken such as thyroid data, liver and wine. The efficiency of clustering output is compared with the classification performance, percentage of correctness. The experimental results show that K-means and FCM give same performance for liver data. And FCM and FPCM are giving same performance for thyroid and wine data. FPCM has more efficient classification performance in all the given data sets.

  17. LEVELS OF PATIENTS EXPOSURE AND A POTENTIAL FOR OPTIMIZATION OF THE PET DIAGNOSTICS IN THE RUSSIAN FEDERATION

    Directory of Open Access Journals (Sweden)

    L. A. Chipiga

    2017-01-01

    Full Text Available This study presents an overview of the most common positron emission tomography examinations in Russia, as well as the acquisition protocols and patient doses. The data collection was performed in 2012–2017 in 19 positron emission tomography departments in 12 regions of the Russian Federation by questioning the staff. The majority of the Russian positron emission tomography departments were equipped by modern positron emission tomography scanners combined with computed tomography. In each investigated department, data on all types of positron emission tomography examinations, radiopharmaceuticals, administered activities used for standard patient (body mass 70±5 kg and parameters of computed tomography protocols was collected. The effective doses of patients from combined positron emission computed tomography examinations were estimated as a sum of the dose from the internal exposure (injected radiopharmaceutical and the external exposure (computed tomography scan. Whole body positron emission tomography examinations in Russia were commonly performed with 18F-fluorodeoxyglucose (18F-FDG, 18F-choline, 11С-choline, 68GaPSMA, 68Ga-DOTA-TATE, 68Ga-DOTA-NOC, brain examinations – 18F-FDG, 11С-metionine, 18F-choline, 18F-tyrosine, myocardial perfusion – 13N-ammonie.The highest patient effective doses (about 17 mSv were observed for whole-body positron emission computed tomography examinations; for brain examinations – 3,4 – 4,8 mSv; for myocardial perfusion – 2,8 mSv. The computed tomography scan contributes up to 65 – 95% to the total patient effective dose for whole body examinations; 20 – 30% for head examinations. For the multiphase computed tomography scan effective doses may be increased to: 15 mSv for head examinations, 25 – 30 mSv for whole body examinations and 35 – 40 mSv for myocardial examinations. A standardization of acquisition and processing protocols is necessary for optimization of positron emission tomography

  18. Principles and practices for keeping occupational radiation exposures at medical institutions as low as reasonably achievable

    International Nuclear Information System (INIS)

    Brodsky, A.

    1982-10-01

    This report is a companion document to Regulatory Guide 8.18, Information Relevant to Ensuring that Occupational Radiation Exposures at Medical Institutions Will Be As Low As Reasonably Achievable. Both documents have now been revised to incorporate many good suggestions received after the original documents were published for comment. This report is a compendium of good practices and helpful information derived from the experience of the radiological and health physics professions and is not be construed in any way as additional regulatory requirements of the Nuclear Regulatory Commission. The information presented, including comprehensive checklists of facilities, equipment, and procedures that should be considered for working with NRC-licensed materials in all types of hospital activities, is intended to aid the NRC licensee in fulfilling the philosophy of maintaining radiation exposures of employees, patients, visitors, and the public as low as reasonably achievable (ALARA). Each subsection of this report is designed to include the major radiation safety considerations pertaining to the respective hospital function. Thus, the busy health professional will neeed to read only a few pages of this document at any one time to obtain the information needed

  19. Shift Work and Related Health Problems among Medical and Diagnostic Staff of the General Teaching Hospitals Affiliated to Shiraz University of Medical Sciences, 2012

    Directory of Open Access Journals (Sweden)

    Zahra Sajjadnia

    2015-07-01

    Full Text Available Introduction:Today, shift work is considered as a necessity in many jobs and for some 24-hour services the use of shift-work is growing. However, shift work can lead to physiological and psycho-social problems for shift workers. This study aimed to determine the effects of shift work on the associated health problems, together with the demographic and job characteristics underlying the problems, among the medical and diagnostic staff of the general teaching hospitals affiliated to Shiraz University of Medical Sciences in 2012. Method:This study was an applied, cross-sectional and descriptive-analytical one. The study employed a sample of 205 employees from the medical and diagnostic staff using stratified sampling proportional to the size and simple random sampling methods. Data were collected using the Survey of Shift workers (SOS questionnaire, validity and reliability of which have already been confirmed. Finally, the collected data were analyzed using SPSS 16.0 software through ANOVA, Chi-square, Independent-Samples T-Test, as well as Pearson Correlation Coefficient. A P<0.05 was considered statistically significant. Results: The results showed that among the demographic and job characteristics studied, the individual, family and social problems had significant associations with work schedules, shift work and job satisfaction. In addition, there were significant associations between musculoskeletal disorders and the satisfaction of shift work; cardiovascular disorders and marital status and occupation; digestive disorders and the work schedules; sleep disorders and the satisfaction of shift work; musculoskeletal disorders, cardiovascular disorders and sleep disorders and age, job experience and shift work experience. And finally, there were significant associations among sleep disorders and age, job experience and the shift work experience. Conclusion: Based on the findings of this study, demographic characteristics such as age, marital

  20. Analysis of medical exposures in digital mammography; Analise das exposicoes medicas em mamografia digital

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Sergio R., E-mail: oliveirasr@fiocruz.br [Escola Politecnica de Saude Joaquim Venancio (EPSJV/FIOCRUZ), Rio de Janeiro, RJ (Brazil); Mantuano, Natalia O.; Albrecht, Afonso S., E-mail: nataliamantuano@gmail.com, E-mail: afonsofismed@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Instituto de Fisica; Flor, Leonardo S., E-mail: leonardo.flor@hsvp.org.br [Hospital Sao Vicente de Paulo (HSVP), Rio de Janeiro, RJ (Brazil)

    2014-07-01

    Currently, the use of digital mammography in the early diagnosis of breast cancer is increasingly common due to the production of high definition image that allows to detect subtle changes in breast images profiles. However it is necessary to be an improvement of the technique used since some devices offer minimization parameters of entrance dose to the skin. Thus, this study seeks to examine how the qualification of technical professionals in radiology interferes with the use of the techniques applied in mammography. For this, survey was carried out in a hospital in the city of Rio de Janeiro, which evaluated the scans of 1190 patients undergoing routine mammography (It is considered routinely the 4 basic exhibitions: with 2 flow skull and 2 medium oblique side, excluding repeats and supplements) in 2013. The medical exposures analyzed obtained from a single full digital equipment, model Senographe DS were compared with three different procedures performed by professionals in mammography techniques. The images were classified according to exposure techniques available in the equipment: Standard (STD), contrast (CNT) and dose (dose), and to be selected as breast density of the patient. Comparing the variation of the radiographic technique in relation to the professional who made the exhibition, what is observed is that the professional B presented the best conduct in relation to radiological protection, because she considered breast density in the choice of technical equipment parameter. The professional A, which is newly formed, and C, which has more service time, almost did not perform variations in the pattern of exposure, even for different breast densities. Thus, we can conclude that there is a need to update the professionals so that the tools available of dose limitation and mamas variability to digital mammography are efficiently employed in the service routine and thus meet the requirements of current legislation.

  1. Differences of X-ray exposure between X-ray diagnostics with a conventional X-ray screen-system and with an image-intensifier-television-unit

    International Nuclear Information System (INIS)

    Loehr, H.; Vogel, H.; Reinhart, J.; Jantzen, R.

    1977-01-01

    During X-ray diagnostics of patients in the II. Medizinische Poliklinik the X-ray exposure was determined. It corresponded to the data described in literature. Two groups were compared: 518 patients examined with a conventional X-ray screen-system and 642 patients examined with an image-intensifier-television-system. The results demonstrated that with exception of thoracical X-ray examination the replacing of the old system by the television system brought a remarkable increase of the X-ray exposure. The doses depended of the patients constitution to a high degree. (orig.) [de

  2. Experimental Exposure to Gamma Radiation of Small Medical Articles and Pharmaceutical Protein Solutions

    International Nuclear Information System (INIS)

    Saint-Aubert, G. de; Valette, L. R.; Plan, R.; Cherby, D.

    1967-01-01

    The behaviour under exposure to gamma rays of small medical articles (multipuncture rings and self-injecting plastic ampoule-syringes) and protein solutions (purified anti-tetanus serum and polyvalent gamma globulins in glass phials) has been studied with a view to considering the applicability of radiosterilization techniques to such articles and solutions. The radiation source used was an assembly of 60 Co rods of the C. E. A. T. 16 type, with a total activity of 41 600 Ci (1. 65 Mrad/h). The articles were exposed to a fixed dose of 3.3 Mrad. Various batches of solutions were exposed to doses ranging from 0. 5 to 3.3 Mrad. The irradiated articles were physically checked for sterility in culture media and also for harmful effects on small animals. Physical checks were carried out on the protein solutions for sterility in culture media, activity in small animals and by serum neutralization, and physico-chemical checks were also performed by immuno-electrophoresis and electrophoresis. The results of these different checks, which showed that the protein solutions were extremely unstable, were studied with a view to assessing the possibility of exposing these medical articles and pharmaceutical solutions to sterilizing doses of gamma radiation. (author) [fr

  3. ANTISPASMODIC MEDICATION WITH DIRECTIVE EFFECT IN CHILDREN WITH ABDOMINAL PAIN AT THE STAGE OF DIAGNOSTIC SEARCH

    Directory of Open Access Journals (Sweden)

    Yu.A. Kozlova

    2010-01-01

    Full Text Available Additional examination is needed for the purpose of detection of its etiology in some patients with abdominal pain, and it takes several days to prove a diagnosis. In most cases this pain is a result of muscle spasm in gastrointestinal tract. The administration of antispasmodic medication with directive effect, particularly, of hyoscine butylbromide (Buscopan, is well-grounded. Hyoscine butylbromide is M-cholinergic antagonist, it does not penetrates blood-brain barrier, does not induce common for cholinergic antagonists vascular reactions and decrease of blood pressure. This drug is used in pediatric practice for a long time, it can be used in patients 6 years old anв older, and it has good safety profile. Key words: abdominal pain, hyoscine butylbromide.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1:168-170

  4. Rapid detection of chromosome rearrangement in medical diagnostic X-ray workers by using fluorescence in situ hybridization and study on dose estimation

    International Nuclear Information System (INIS)

    Wang Zhiquan; Sun Yuanming; Li Jin

    1998-01-01

    Objective: Biological doses were estimated for medical diagnostic X-ray workers. Methods: Chromosome rearrangements in X-ray workers were analysed by fluorescence in situ hybridization (FISH) with composite whole chromosome paintings number 4 and number 7. Results: The frequency of translocation in medical diagnostic X-ray workers was much higher than that in control group (P<0.01). The biological doses to individual X-ray workers were calculated by their translocation frequency. The translocation frequencies of both FISH and G-banding were in good agreement. Conclusion: The biological doses to X-ray workers are estimated by FISH first when their dosimetry records are not documented

  5. Speech disorders in Parkinson's disease: early diagnostics and effects of medication and brain stimulation.

    Science.gov (United States)

    Brabenec, L; Mekyska, J; Galaz, Z; Rektorova, Irena

    2017-03-01

    Hypokinetic dysarthria (HD) occurs in 90% of Parkinson's disease (PD) patients. It manifests specifically in the areas of articulation, phonation, prosody, speech fluency, and faciokinesis. We aimed to systematically review papers on HD in PD with a special focus on (1) early PD diagnosis and monitoring of the disease progression using acoustic voice and speech analysis, and (2) functional imaging studies exploring neural correlates of HD in PD, and (3) clinical studies using acoustic analysis to evaluate effects of dopaminergic medication and brain stimulation. A systematic literature search of articles written in English before March 2016 was conducted in the Web of Science, PubMed, SpringerLink, and IEEE Xplore databases using and combining specific relevant keywords. Articles were categorized into three groups: (1) articles focused on neural correlates of HD in PD using functional imaging (n = 13); (2) articles dealing with the acoustic analysis of HD in PD (n = 52); and (3) articles concerning specifically dopaminergic and brain stimulation-related effects as assessed by acoustic analysis (n = 31); the groups were then reviewed. We identified 14 combinations of speech tasks and acoustic features that can be recommended for use in describing the main features of HD in PD. While only a few acoustic parameters correlate with limb motor symptoms and can be partially relieved by dopaminergic medication, HD in PD seems to be mainly related to non-dopaminergic deficits and associated particularly with non-motor symptoms. Future studies should combine non-invasive brain stimulation with voice behavior approaches to achieve the best treatment effects by enhancing auditory-motor integration.

  6. Evaluation of lead equivalence of patient and hardware materials in medical diagnostic x-ray shielding.

    Science.gov (United States)

    Okunade, Akintunde Akangbe

    2005-02-01

    In the estimation of additional shielding requirements for primary beam apart from that provided by patient and hardware in the x-ray beam, there is the need to distinguish between attenuation and hardening properties of materials in comparison. In this work, numerical comparison of attenuation and hardening properties of phantom (Lucite, soft tissue, water) and hardware (aluminum and steel) materials with those of lead have been carried out. Results presented show that the shielding affordable by lead attenuation equivalent thicknesses (LAE) and lead hardening equivalent thicknesses (LHE) is not strictly equivalent to that affordable by thicknesses of substitutes (phantom materials, aluminum and steel) when there are differences in attenuation and hardening properties. Even though beams through LAE that are not "exact" have equal exposure values, the half value layers are higher than those through thicknesses of lead substitutes. Example calculations show that the use of lead thickness (LAE) that are not "exact" to account for the shielding afforded by the thickness of the patient (water phantom) produces lesser reduction of the primary radiation level in the area indicated for shielding. The "exact" LAE that will reduce the primary radiation level equally as the patient and radiographic table may be higher by close to 20% or more of that which is not "exact."

  7. Estimation of the effective focal spot sizes in medical diagnostic X-ray tube assemblies

    Science.gov (United States)

    Grabska, Iwona; Fabiszewska, Ewa; Pasicz, Katarzyna; Skrzyński, Witold

    2016-06-01

    For evaluation of the effective focal spot sizes (EFSS), a method suggested by the EN 60336:2005 standard (standard) could be used. In this study we checked whether it is possible to make some deviations from the requirements of the standard without a significant effect on the result. An image receptor with one intensifying screen or two intensifying screens may be used, but the optical value of the slit image shall be in the range of 1.0÷1.4 and the X-ray tube power shall be ranged of about 30%÷50% of the nominal anode input power. A precision scaled magnifier (magnification of 5÷10x and scale of 0.1 mm) may be used for the slit radiogram width measurement instead of a time-consuming scanning of the slit radiogram. These deviations from the requirements of the EN 60336:2005 standard allows to shorten measurement time and to decrease tube current value during X-ray exposures, which reduces the risk of the Xray tube damage.

  8. The geographical distribution of diagnostic medical and dental X-ray services in South Africa

    Science.gov (United States)

    Walters; Zietsman; Bhagwandin

    1998-03-01

    AIM: The aim of this study was threefold, viz.: (i) to evaluate the availability and accessiblity of medical and dental X-ray services in South Africa; (ii) to evaluate geographical information systems (GIS) as a tool for management of health care technologies; and (iii) to guide policy and develop a process to provide optimal utilisation of X-ray services in South Africa. METHODS: Information supplied by the Department of Health on licensed X-ray equipment was integrated with census data and processed with GIS. Four key areas were assessed, viz. distribution, accessibility, age and availability of X-ray services in South Africa. RESULTS: The analysis shows a vast inequity in the distribution of X-ray services on a provincial as well as a district level, although on the national level the distribution of X-ray services meets the World health Organisation criteria. CONCLUSION: GIS is a useful tool in evaluating and planning of essential health services/techniques. However, care must be taken in interpreting the data on a macro level, as this masks vast inequities on the district level. RECOMMENDATIONS: The indicators of coverage should be expanded, similar reports should be prepared for the nine provinces, and these data should be integrated into the clinic planning programme. Radiological services should be added to and managed as part of an essential district health care technology package.

  9. [Forensic medical diagnostics of intoxication with certain poisonous mushrooms in the case of the lethal outcome in a hospital].

    Science.gov (United States)

    Zaraf'iants, G N

    2016-01-01

    The present study was undertaken with a view to improving forensic medical diagnostics of intoxication with poisonous mushrooms in the cases of patients' death in a hospital. A total of 15 protocols of forensic medical examination of the corpses of the people who had died from acute poisoning were available for the analysis. The deathly toxins were amanitin and muscarine contained in various combinations in the death cap (Amanita phalloides) and the early false morels (Gyromitra esculenta and G. gigas). The main poisoning season in the former case was May and in the latter case August and September (93.4%). The mortality rate in the case of group intoxication (such cases accounted for 40% of the total) amounted to 28.6%. 40% of the deceased subjects consumed mushrooms together with alcohol. The poisoning caused the development of either phalloidin- or gyromitrin-intoxication syndromes (after consumption of Amanita phalloides and Gyromitra esculenta respectively). It is emphasized that the forensic medical experts must substantiate the diagnosis of poisoning with mushroom toxins based on the results of the chemical-toxicological and/or forensic chemical investigations. The relevant materials taken from the victim or the corpse should be dispatched for analysis not only within the first day but also on days 2-4 after intoxication. The mycological and genetic analysis must include the detection and identification of mushroom microparticles and spores in the smears from the oral cavity, vomiting matter, wash water, gastric and intestinal contents. In addition, the macro- and microscopic morphological signs, clinical data (major syndromes, results of laboratory studies, methods of treatment) should be taken into consideration as well as the time (season) of mushroom gathering, simultaneous poisoning in a group of people, and other pertinent information.

  10. Principle and engineering implementation of 3D visual representation and indexing of medical diagnostic records (Conference Presentation)

    Science.gov (United States)

    Shi, Liehang; Sun, Jianyong; Yang, Yuanyuan; Ling, Tonghui; Wang, Mingqing; Zhang, Jianguo

    2017-03-01

    Purpose: Due to the generation of a large number of electronic imaging diagnostic records (IDR) year after year in a digital hospital, The IDR has become the main component of medical big data which brings huge values to healthcare services, professionals and administration. But a large volume of IDR presented in a hospital also brings new challenges to healthcare professionals and services as there may be too many IDRs for each patient so that it is difficult for a doctor to review all IDR of each patient in a limited appointed time slot. In this presentation, we presented an innovation method which uses an anatomical 3D structure object visually to represent and index historical medical status of each patient, which is called Visual Patient (VP) in this presentation, based on long term archived electronic IDR in a hospital, so that a doctor can quickly learn the historical medical status of the patient, quickly point and retrieve the IDR he or she interested in a limited appointed time slot. Method: The engineering implementation of VP was to build 3D Visual Representation and Index system called VP system (VPS) including components of natural language processing (NLP) for Chinese, Visual Index Creator (VIC), and 3D Visual Rendering Engine.There were three steps in this implementation: (1) an XML-based electronic anatomic structure of human body for each patient was created and used visually to index the all of abstract information of each IDR for each patient; (2)a number of specific designed IDR parsing processors were developed and used to extract various kinds of abstract information of IDRs retrieved from hospital information systems; (3) a 3D anatomic rendering object was introduced visually to represent and display the content of VIO for each patient. Results: The VPS was implemented in a simulated clinical environment including PACS/RIS to show VP instance to doctors. We setup two evaluation scenario in a hospital radiology department to evaluate whether

  11. The moderating impact of interacting with distressed families of decedents on trauma exposure in medical examiner personnel.

    Science.gov (United States)

    Coleman, Jennifer A; Delahanty, Douglas L; Schwartz, Joseph; Murani, Kristina; Brondolo, Elizabeth

    2016-11-01

    Prior research has examined the incidence of posttraumatic stress stemming from either direct or indirect trauma exposure in employees of high-risk occupations. However, few studies have examined the contribution of both direct and indirect trauma exposure in high-risk groups. One particularly salient indirect trauma often endorsed as the most stressful by many occupational groups is interacting with distressed family members of victims of crime, illness, or accidents. The present study examined the extent to which interacting with distressed families moderated the impact of cumulative potentially traumatic event (PTE) exposure on depression and posttraumatic stress disorder (PTSD) symptoms in 245 employees of medical examiner (ME) offices. Employees from 9 ME office sites in the United States participated in an online survey investigating the frequency of work place PTE exposures (direct and indirect) and mental health outcomes. Results revealed that cumulative PTE exposure was associated with higher PTSD symptoms (PTSS) for employees who had higher frequency of exposure to distressed family members. After controlling for cumulative and direct PTE exposure, gender, and office site, exposure to distressed families was significantly associated with depressive symptoms, but not PTSS. Findings of our research underscore the need for training employees in high-risk occupations to manage their reactions to exposure to distraught family members. Employee training may buffer risk for developing PTSD and depression. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  12. Phenotype analysis of early risk factors from electronic medical records improves image-derived diagnostic classifiers for optic nerve pathology

    Science.gov (United States)

    Chaganti, Shikha; Nabar, Kunal P.; Nelson, Katrina M.; Mawn, Louise A.; Landman, Bennett A.

    2017-03-01

    We examine imaging and electronic medical records (EMR) of 588 subjects over five major disease groups that affect optic nerve function. An objective evaluation of the role of imaging and EMR data in diagnosis of these conditions would improve understanding of these diseases and help in early intervention. We developed an automated image processing pipeline that identifies the orbital structures within the human eyes from computed tomography (CT) scans, calculates structural size, and performs volume measurements. We customized the EMR-based phenome-wide association study (PheWAS) to derive diagnostic EMR phenotypes that occur at least two years prior to the onset of the conditions of interest from a separate cohort of 28,411 ophthalmology patients. We used random forest classifiers to evaluate the predictive power of image-derived markers, EMR phenotypes, and clinical visual assessments in identifying disease cohorts from a control group of 763 patients without optic nerve disease. Image-derived markers showed more predictive power than clinical visual assessments or EMR phenotypes. However, the addition of EMR phenotypes to the imaging markers improves the classification accuracy against controls: the AUC improved from 0.67 to 0.88 for glaucoma, 0.73 to 0.78 for intrinsic optic nerve disease, 0.72 to 0.76 for optic nerve edema, 0.72 to 0.77 for orbital inflammation, and 0.81 to 0.85 for thyroid eye disease. This study illustrates the importance of diagnostic context for interpretation of image-derived markers and the proposed PheWAS technique provides a flexible approach for learning salient features of patient history and incorporating these data into traditional machine learning analyses.

  13. Factors affecting exposure level for medical staff during orthopedic procedures under fluoroscopic control

    Directory of Open Access Journals (Sweden)

    Maria A. Staniszewska

    2017-02-01

    Full Text Available Background: Extended control of staff exposure in interventional radiology has been legally required over the last few years. This is determined by a number of factors, including the type of procedure, technical conditions and methodology. In orthopedic procedures fluoroscopy is used to control surgical reconstructions. An influence of particular factors on the registered values of doses received by the members of medical team performing osteosynthesis for limb fractures is presented in this paper. Material and Methods: Doses received by individual interventional team members performing specific functions, operator, assisting physicians and scrub nurse, during a series of the procedures were measured. Each person was equipped with 4 dosimetric tools, containing thermoluminescent dosimeters, to measure the equivalent doses for the eyes, hand skin and the neck (outside the shield and to evaluate effective doses. The investigations were performed in operational theatres of 3 hospitals in Łódź. Results: The equivalent doses per one procedure for the eyes and hand skin of the operator were 0.029–0.073 mSv and 0.366–1.604 mSv, respectively. Significantly higher doses were noted during the procedures of intramedullary osteosynthesis, especially for the operator. An average age and body mass index (BMI of patients treated in the monitored hospitals did not differ statistically. Conclusions: Based on the dosimetric measurements the following conclusions can be drawn: in orthopedic procedures of interventional radiology (IR the exposure of the staff is mostly determined by the type of procedure and more precisely by its complexity and by the optimized use of X-ray unit, including pulsed fluoroscopy. It is also revealed that the operator is the most exposed person in the interventional team. Med Pr 2017;68(1:75–83

  14. Exposure of Iranian emergency medical technicians to workplace violence: a cross-sectional analysis.

    Science.gov (United States)

    Rahmani, Azad; Hassankhani, Hadi; Mills, Jane; Dadashzadeh, Abbas

    2012-02-01

    Emergency medical technicians (EMTs) in Iran experience concerning levels of workplace violence, although until now there has been no investigation of this phenomenon. The objectives of the present study were to describe the exposure of Iranian EMTs to workplace violence and to identify the importance of related factors from their viewpoint. In this descriptive, exploratory study, 160 EMTs agreed to participate in a survey that collected data regarding their exposure to the following forms of workplace violence: verbal abuse, physical assault, cultural harassment, sexual harassment and sexual assault. A total of 138 questionnaires were returned, representing a response rate of 86%. The majority of participants 75% (n = 103) experienced at least one form of workplace violence in the 12 months before completing the questionnaire. The most frequently reported form of workplace violence was verbal abuse (71%), followed by physical assault (38%) and cultural harassment (9%). Violence resulting in serious injuries was reported by only 4% of participants, with no more than 8% of participants experiencing workplace violence that included the use of weapons. The most reported response to workplace violence was to 'invite the offender to calm down'. Participants took this approach because they believed that 'follow up of workplace violence is ineffectual' (34%), considered the workplace violence as a common in their job (30%), and did not know whom to report workplace violence to (13%). Iranian EMTs experience a considerable amount of workplace violence. The present study highlights the recommendation for formal training programmes and clearer protocols about how to manage workplace violence, especially verbal abuse in the Iranian prehospital setting. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  15. The diagnostic suitability of a xerostomia questionnaire and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents

    NARCIS (Netherlands)

    van der Putten, G.J.; Brand, H.S.; Schols, J.M.G.A.; de Baat, C.

    2011-01-01

    The study objective was to explore the diagnostic suitability of the Xerostomia Inventory and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents. A cross-sectional study was carried out in 50 physically impaired nursing home residents (20 men)

  16. Capturing and displaying microscopic images used in medical diagnostics and forensic science using 4K video resolution – an application in higher education

    NARCIS (Netherlands)

    Jan Kuijten; Ajda Ortac; Hans Maier; Gert de Heer

    2015-01-01

    To analyze, interpret and evaluate microscopic images, used in medical diagnostics and forensic science, video images for educational purposes were made with a very high resolution of 4096 × 2160 pixels (4K), which is four times as many pixels as High-Definition Video (1920 × 1080 pixels).

  17. 78 FR 55114 - Access to Employee Exposure and Medical Records; Extension of the Office of Management and Budget...

    Science.gov (United States)

    2013-09-09

    ... Courier Service: When using this method, you must submit a copy of your comments and attachments to the... and costs associated with exposure monitoring and measurement, medical surveillance, and the other... occupationally-related health impairment and disease. Providing the Agency with access to the records permits it...

  18. 75 FR 21662 - Access to Employee Exposure and Medical Records; Extension of the Office of Management and Budget...

    Science.gov (United States)

    2010-04-26

    ..., express mail, messenger, or courier service: When using this method, you must submit three copies of your... costs associated with exposure monitoring and measurement, medical surveillance, and the other... occupationally-related health impairment and disease. Providing the Agency with access to the records permits it...

  19. The long-term fate of epistaxis patients with exposure to antithrombotic medication.

    Science.gov (United States)

    Stadler, Rafael R; Kindler, Rahel; Holzmann, David; Soyka, Michael B

    2016-09-01

    The goal of this study was to evaluate independent risk factors for long-term epistaxis recurrences and their severity. Individual retrospective cohort study-2b level of evidence. The medical information of 603 emergency epistaxis patients was acquired during a former study. This cohort has been contacted 6 years later by conventional mail and asked to answer a specific paper questionnaire. The following parameters were evaluated: recurrent epistaxis episodes, need for a surgical intervention to stop the recurrent bleeding, patient's history for hypertension and diabetes, intake of hemostasis impairing medication now and in the past. One hundred and six (106) patients were included in the study (35.8 % response rate). The mean observation period was 76.58 months. Almost half of the patients (41.5 % = 44/106) reported at least one recurrent epistaxis episode. Patients with exposure to VKA (vitamin K antagonists) showed significantly more frequently a recurrent epistaxis episode. The binary logistic regression confirmed the intake of VKA as an independent and significant risk factor with an odds ratio of 11.6. Every single patient who had to undergo a surgical intervention to stop a recurrent bleeding stated ASA (Acetylsalicylic Acid) intake. We provide evidence that the intake of a vitamin K antagonist is an independent long-term risk factor for recurrent epistaxis episodes. The intake of ASA is a risk factor for the severity of recurrent epistaxis with the increased need for a surgical intervention not only in a short- but also in a long-term perspective. This prognostic investigation, designed as a combined prospective and retrospective cohort study, reaches level 2b level of evidence as it includes retrospective aspects.

  20. Building a diagnostic algorithm on localized neuropathic pain (LNP and targeted topical treatment: focus on 5% lidocaine-medicated plaster

    Directory of Open Access Journals (Sweden)

    Casale R

    2014-04-01

    Full Text Available Roberto Casale,1,2 Consalvo Mattia31Department of Clinical Neurophysiology and Pain Rehabilitation Unit, Foundation “Salvatore Maugeri”, Research and Care Institute, IRCCS, Pavia, Italy; 2EFIC Montescano Pain School, Montescano, Italy; 3Department of Medical-Surgical Sciences, Section of Anaesthesia, Intensive Care and Pain Medicine, Faculty of Medicine and Pharmacy, Sapienza University of Rome, ItalyAbstract: Within the broad definition of neuropathic pain, the refinement of clinical diagnostic procedures has led to the introduction of the concept of localized neuropathic pain (LNP. It is characterized by consistent and circumscribed area(s of maximum pain, which are associated with negative or positive sensory signs and/or spontaneous symptoms typical of neuropathic pain. This description outlines the clinical features (currently lacking in guidelines and treatment recommendations in patients for whom topical targeted treatment with 5% lidocaine-medicated plaster is suggested as first-line therapy. Few epidemiologic data are present in the literature but it is generally estimated that about 60% of neuropathic pain conditions are localized, and therefore identifiable as LNP. A mandatory clinical criterion for the diagnosis of LNP is that signs and symptoms must be present in a clearly identified and defined area(s. Cartographic recordings can help to define each area and to assess variations. The diagnosis of LNP relies on careful neurological examination more than on pain questionnaires, but it is recognized that they can be extremely useful for recording the symptom profiles and establishing a more targeted treatment. The most widely studied frequent/relevant clinical presentations of LNP are postherpetic neuralgia, diabetic neuropathy, and neuropathic postoperative pain. They successfully respond to treatment with 5% lidocaine-medicated plaster with equal if not better pain control but with fewer side effects versus conventional systemic

  1. Relationship between mutation frequency of GPA locus and cumulative dose among medical diagnostic X-ray workers

    International Nuclear Information System (INIS)

    Wang Jixian; Yu Wenru; Li Benxiao; Fan Tiqiang; Li Zhen; Gao Zhiwei; Chen Zhenjun; Zhao Yongcheng

    2000-01-01

    Objective: To explore the feasibility of using GPA locus mutation assay as a bio-dosimeter for occupational exposure to ionizing radiation. Methods: An improved technique of GPA locus mutation assay was used in th study. The frequencies of mutant RBC in peripheral blood of 55 medical X-ray workers and 50 controls employed in different calendar-year periods were detected. The relationship between mutation frequencies (MFs) and period of entry, working years and cumulative doses were analyzed. Results: The MFs were significantly elevated among X-ray workers employed before 1970. This finding is similar to the result of cancer epidemiological study among medical X-ray workers , in which the cancer risk was significantly increased only X-ray workers employed before 1970. The MFs of GPA increased with increasing cumulative dose. The dose-effect relationship of Nφ MF with cumulative dose was closer than that of NN MF. Conclusion: There are many problems to be solved for using GPA MF assay as a bio-dosimeter such as individual variation, specificity and calibration curve of dose-effect relationship

  2. Attitude of medical students towards Early Clinical Exposure in learning endocrine physiology.

    Science.gov (United States)

    Sathishkumar, Solomon; Thomas, Nihal; Tharion, Elizabeth; Neelakantan, Nithya; Vyas, Rashmi

    2007-09-05

    Different teaching-learning methods have been used in teaching endocrine physiology for the medical students, so as to increase their interest and enhance their learning. This paper describes the pros and cons of the various approaches used to reinforce didactic instruction in endocrine physiology and goes on to describe the value of adding an Early Clinical Exposure program (ECE) to didactic instruction in endocrine physiology, as well as student reactions to it as an alternative approach. Various methods have been used to reinforce didactic instruction in endocrine physiology such as case-stimulated learning, problem-based learning, patient-centred learning and multiple-format sessions. We devised a teaching-learning intervention in endocrine physiology, which comprised of traditional didactic lectures, supplemented with an ECE program consisting of case based lectures and a hospital visit to see patients. A focus group discussion was conducted with the medical students and, based on the themes that emerged from it, a questionnaire was developed and administered to further enquire into the attitude of all the students towards ECE in learning endocrine physiology. The students in their feedback commented that ECE increased their interest for the subject and motivated them to read more. They also felt that ECE enhanced their understanding of endocrine physiology, enabled them to remember the subject better, contributed to their knowledge of the subject and also helped them to integrate their knowledge. Many students said that ECE increased their sensitivity toward patient problems and needs. They expressed a desire and a need for ECE to be continued in teaching endocrine physiology for future groups of students and also be extended for teaching other systems as well. The majority of the students (96.4%) in their feedback gave an overall rating of the program as good to excellent on a 5 point Likert scale. The ECE program was introduced as an alternative approach to

  3. Medical imaging exposure in 2007 - evolution at national and international levels

    International Nuclear Information System (INIS)

    Aubert, Bernard; Etard, Cecile; Sinno-Tellier, Sandra

    2011-01-01

    The Institute of Radiation Protection and Nuclear Safety (IRSN) and the Institute for Public Health Surveillance (InVS) have been collaborating since 2003 to provide updated data on medical exposure of the French population, as requested in the European Directive 97/43. This paper is related to 2007 dataset. For private practice, a continuous and representative sample of about 1 % of the population has been followed by the National health insurance since 2006. All exams (radiology and nuclear medicine) performed to people of this sample by private practitioners are registered. They have been analysed according to the type of exam, age and sex of the patient. For public practice, as no registration was available, two national surveys have been specifically conducted: one survey performed in 50 representative radiological departments in public hospitals, and one questionnaire sent to all the 127 public nuclear medicine departments. A mean effective dose has been associated to each type of exam, using the French Dose Reference Levels, the national guidelines in radiology or nuclear medicine, recent French and European studies and data collected through the two surveys. The annual average effective dose per inhabitant in France has increased by 57 % between 2002 and 2007. It has been estimated to 1.3 mSv in 2007. This value is in the range of the European values published: from 0.4 mSv in the UK to 2 mSv in Belgium. (authors)

  4. Current practice in laboratory diagnostics of autoimmune diseases in Croatia. 
Survey of the Working group for laboratory diagnostics of autoimmune diseases of the Croatian Society of Medical Biochemistry and Laboratory Medicine

    Science.gov (United States)

    Kuna, Andrea Tešija; Đerek, Lovorka; Kozmar, Ana; Drvar, Vedrana

    2016-01-01

    Introduction With the trend of increasing incidence of autoimmune diseases, laboratories are faced with exponential growth of the requests for tests relating the diagnosis of these diseases. Unfortunately, the lack of laboratory personnel experienced in this specific discipline of laboratory diagnostic, as well as an unawareness of a method limitation often results in confusion for clinicians. The aim was to gain insight into number and type of Croatian laboratories that perform humoral diagnostics with the final goal to improve and harmonize laboratory diagnostics of autoimmune diseases in Croatia. Materials and methods In order to get insight into current laboratory practice two questionnaires, consisting of 42 questions in total, were created. Surveys were conducted using SurveyMonkey application and were sent to 88 medical biochemistry laboratories in Croatia for the first survey. Out of 33 laboratories that declared to perform diagnostic from the scope, 19 were selected for the second survey based on the tests they pleaded to perform. The survey comprised questions regarding autoantibody hallmarks of systemic autoimmune diseases while regarding organ-specific autoimmune diseases was limited to diseases of liver, gastrointestinal and nervous system. Results Response rate was high with 80 / 88 (91%) laboratories which answered the first questionnaire, and 19 / 19 (1.0) for the second questionnaire. Obtained results of surveys indicate high heterogeneity in the performance of autoantibody testing among laboratories in Croatia. Conclusions Results indicate the need of creating recommendations and algorithms in order to harmonize the approach to laboratory diagnostics of autoimmune diseases in Croatia. PMID:27812306

  5. Exposure of undergraduates to authentic GP teaching and subsequent entry to GP training: a quantitative study of UK medical schools.

    Science.gov (United States)

    Alberti, Hugh; Randles, Hannah L; Harding, Alex; McKinley, Robert K

    2017-04-01

    It has been suggested that the quantity of exposure to general practice teaching at medical school is associated with future choice of a career as a GP. To examine the relationship between general practice exposure at medical school and the percentage of each school's graduates appointed to a general practice training programme after foundation training (postgraduate years 1 and 2). A quantitative study of 29 UK medical schools. The UK Foundation Programme Office (UKFPO) destination surveys of 2014 and 2015 were used to determine the percentage of graduates of each UK medical school who were appointed to a GP training programme after foundation year 2. The Spearman rank correlation was used to examine the correlation between these data and the number of sessions spent in placements in general practice at each medical school. A statistically significant association was demonstrated between the quantity of authentic general practice teaching at each medical school and the percentage of its graduates who entered GP training after foundation programme year 2 in both 2014 (correlation coefficient [r] 0.41, P = 0.027) and 2015 (r 0.3, P = 0.044). Authentic general practice teaching here is described as teaching in a practice with patient contact, in contrast to non-clinical sessions such as group tutorials in the medical school. The authors have demonstrated, for the first time in the UK, an association between the quantity of clinical GP teaching at medical school and entry to general practice training. This study suggests that an increased use of, and investment in, undergraduate general practice placements would help to ensure that the UK meets its target of 50% of medical graduates entering general practice. © British Journal of General Practice 2017.

  6. Development and Implementation of a New HELIOS Diagnostic using a Fast Piezoelectric Valve on the Prototype Material Plasma Exposure eXperiment

    Science.gov (United States)

    Ray, Holly; Biewer, Theodore; Caneses, Juan; Green, Jonathan; Lindquist, Elizabeth; McQuown, Levon; Schmitz, Oliver

    2017-10-01

    A new helium line-ratio spectral monitoring (HELIOS) diagnostic, using a piezoelectric valve with high duty cycles (on/off times ms), allowing for good background correction, and measured particle flowrates on the order of 1020 particles/second is being implemented on Oak Ridge National Laboratory's (ORNL) Prototype Material Plasma Exposure eXperiment (Proto-MPEX). Built in collaboration with the University of Wisconsin - Madison, the HELIOS diagnostic communicates with a Labview program for controlled bursts of helium into the vessel. The open magnetic geometry of Proto-MPEX is ideal for testing and characterizing a HELIOS diagnostic. The circular cross-section with four ports allows for cross comparison between different diagnostics: 1) Helium injection with the piezoelectric puff valve, 2) HELIOS line-of-sight high-gain observation, 3) scan-able Double Langmuir probe, and 4) HELIOS 2D imaging observation. Electron density and temperature measurements from the various techniques will be compared. This work was supported by the US. D.O.E. contract DE-AC05-00OR22725 and DE-SC00013911.

  7. Low-Cost Generic Program Use by Medicare Beneficiaries: Implications for Medication Exposure Misclassification in Administrative Claims Data.

    Science.gov (United States)

    Pauly, Nathan J; Talbert, Jeffery C; Brown, Joshua

    2016-06-01

    Administrative claims data are used for a wide variety of research and quality assurance purposes; however, they are prone to medication exposure misclassification if medications are purchased without using an insurance benefit. Low-cost generic drug programs (LCGPs) offered at major chain pharmacies are a relatively new and sparsely investigated source of exposure misclassification. LCGP medications are often purchased out of pocket; thus, a pharmacy claim may never be submitted, and the exposure may go unobserved in claims data. As heavy users of medications, Medicare beneficiaries have much to gain from the affordable medications offered through LCGPs. This use may put them at increased risk of exposure misclassification in claims data. Many high-risk medications (HRMs) and medications tracked for adherence and utilization quality metrics are available through LCGPs, and exposure misclassification of these medications may impact the quality assurance efforts reliant on administrative claims data. Presently, there is little information regarding the use of these programs among a geriatric population. To (a) quantify the prevalence of LCGP users in a nationally representative population of Medicare beneficiaries; (b) compare clinical and demographic characteristics of LCGP users and nonusers; (c) assess determinants of LCGP use and medications acquired through these programs; and (d) analyze patterns of LCGP use during the years 2007-2012. This study relied on data from the Medical Expenditure Panel Survey (MEPS) from 2007 to 2012. The first 3 objectives were completed with a cohort of individuals in the most recent MEPS panel, while the fourth objective was completed with a separate cohort composed of individuals who participated in MEPS from 2007 to 2012. Inclusion in either study cohort required that individuals were Medicare beneficiaries aged 65 years or greater, used at least 1 prescription drug during their 2-year panel period, and participated in all 5

  8. Perception-based effects of clinical exposure to osteopathic manipulative treatment on first- and second-year osteopathic medical students.

    Science.gov (United States)

    Vazzana, Kathleen M; Yao, Sheldon C; Jung, Min-Kyung; Terzella, Michael J

    2014-07-01

    Little research has been done regarding osteopathic medical students' clinical exposure to osteopathic manipulative treatment (OMT). Most existing research focuses on third- and fourth-year students. To determine the effects of clinical exposure to OMT on first- and second-year osteopathic medical students by assessing the same population's perceptions of OMT. In the present survey-based study, conducted at the New York Institute of Technology College of Osteopathic Medicine, first- and second-year osteopathic medical students were administered an electronic survey containing 18 multiple-choice questions. The first 2 questions were demographic. The next 6 questions had participants identify what, if any, clinical exposure to OMT they had, including clinical shadowing, the MedPrep program, and the Summer Student American Academy of Osteopathy Osteopathic Manipulative Medicine Preceptorship program. The 10 questions that followed assessed the participant's perception of OMT: (1) understanding, (2) attitude toward OMT, (3) scope of practice of OMT, and (4) intention to use OMT in future clinical practice. The survey used the statistically validated Likert scale for all of the scaled questions. Analysis was performed using the Pearson χ(2) test and the Fisher exact test. Of the 600 students who were sent surveys, 364 replied, for a response rate of 60.7%. There was an association with students' anticipated use of OMT in their future clinical practice and the following types of clinical exposures to OMT: MedPrep (P=.04), Summer Student American Academy of Osteopathy Osteopathic Manipulative Medicine Preceptorship (P=.04), extracurricular OMT didactics (P=.048), and shadowing a physician performing OMT before attending osteopathic medical school (P=.007). Being treated with OMT had no association with anticipated future use of OMT. More OMT clinical exposures were associated with more positive responses to the perception questions ([Formula: see text], Pperception of

  9. Exposure to Direct-to-Consumer Pharmaceutical Advertising and Medication Nonadherence Among Patients With Serious Mental Illness.

    Science.gov (United States)

    Green, Charee E; Mojtabai, Ramin; Cullen, Bernadette A; Spivak, Amethyst; Mitchell, Melissa; Spivak, Stanislav

    2017-12-01

    This study explored the association of exposure to direct-to-consumer advertising (DTCA) with medication nonadherence among individuals with serious mental disorders. Results of an anonymous survey administered at an inner-city mental health clinic were examined by using logistic regression. Nonadherence was defined as not taking prescribed medications for at least two out of seven days. Of 246 respondents, 48% reported DTCA exposure and 43% reported nonadherence. Sixty-one percent of those exposed to DTCA reported nonadherence, compared with 26% of those not exposed (adjusted odds ratio=4.96, 95% confidence interval=2.64-9.33, padvertisements and reporting nonadherence, 59% reported changing medication-taking behaviors or stopping prescribed medications because of side effect information in advertisements. Only a minority communicated with providers before becoming nonadherent. This study found an association between self-report of DTCA exposure and self-reported nonadherence. These results support further research on DTCA as a possible risk factor for nonadherence.

  10. Noise exposure during prehospital emergency physicians work on Mobile Emergency Care Units and Helicopter Emergency Medical Services

    DEFF Research Database (Denmark)

    Hansen, Mads Christian Tofte; Schmidt, Jesper Hvass; Brøchner, Anne C

    2017-01-01

    BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS)....... initiatives. Although no hearing loss was demonstrated in the personnel of the ground-based units, a reduced function of the outer sensory hair cells was found in the HEMS group following missions.......BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS......). A second objective was to identify any occupational hearing loss amongst prehospital personnel. METHODS: Noise exposure during work in the MECU and HEMS was measured using miniature microphones worn laterally to the auditory canals or within the earmuffs of the helmet. All recorded sounds were analysed...

  11. Feasibility results of an electromagnetic compatibility test protocol to evaluate medical devices to radio frequency identification exposure.

    Science.gov (United States)

    Seidman, Seth J; Bekdash, Omar; Guag, Joshua; Mehryar, Maryam; Booth, Paul; Frisch, Paul

    2014-08-03

    The use of radio frequency identification (RFID) systems in healthcare is increasing, and concerns for electromagnetic compatibility (EMC) pose one of the biggest obstacles for widespread adoption. Numerous studies have demonstrated that RFID systems can interfere with medical devices; however, the majority of past studies relied on time-consuming and burdensome test schemes based on ad hoc test methods applied to individual RFID systems. This paper presents the results of using an RFID simulator that allows for faster evaluation of RFID-medical device EMC against a library of RFID test signals at various field strengths. The results of these tests demonstrate the feasibility and adequacy of simulator testing and can be used to support its incorporation into applicable consensus standards. This work can aid the medical device community in better assessing the risks associated with medical device exposure to RFID.

  12. Rural exposure during medical education and student preference for future practice location - a case of Botswana.

    Science.gov (United States)

    Arscott-Mills, Tonya; Kebaabetswe, Poloko; Tawana, Gothusang; Mbuka, Deogratias O; Makgabana-Dintwa, Orabile; Sebina, Kagiso; Kebaetse, Masego; Mokgatlhe, Lucky; Nkomazana, Oathokwa

    2016-06-10

    Botswana's medical school graduated its first class in 2014. Given the importance of attracting doctors to rural areas the school incorporated rural exposure throughout its curriculum. This study explored the impact of rural training on students' attitudes towards rural practice. The Univ