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Radiation exposure trauma

Melissa K James, Sebastian D Schubl, Michael P Francois, Geoffrey K Doughlin, Shi-Wen Lee
STUDY OBJECTIVE: The aim of this study is to determine if the introduction of a pan-scan protocol during the initial assessment for blunt trauma activations would affect missed injuries, incidental findings, treatment times, radiation exposure, and cost. METHODS: A 6-month prospective study was performed on patients with blunt trauma at a level 1 trauma center. During the last 3 months of the study, a pan-scan protocol was introduced to the trauma assessment. Categorical data were analyzed by Fisher exact test and continuous data were analyzed by Mann-Whitney nonparametric test...
September 22, 2016: American Journal of Emergency Medicine
Neige M Journy, Kieran McHugh, Richard W Harbron, Mark S Pearce, Amy Berrington de Gonzalez
OBJECTIVE: To describe medical conditions associated with the use of CT in children or young adults with no previous cancer diagnosis. METHODS: Radiologists' reports for scans performed in 1995-2008 in patients <22 years of age were collected from the Radiology Information System in 44 hospitals of Great Britain. By semantic search, an automated procedure identified 192 medical conditions within the radiologists' reports. Manual validation of a subsample by a paediatric radiologist showed a satisfactory performance of the automatic coding procedure...
October 21, 2016: British Journal of Radiology
Felipe P Andrade, Roberto Montoro, Renan Oliveira, Gabriela Loures, Luana Flessak, Roberta Gross, Camille Donnabella, Andrea Puchnick, Lisa Suzuki, Rodrigo Regacini
OBJECTIVES: 1) To verify clinical signs correlated with appropriate cranial computed tomography scan indications and changes in the therapeutic approach in pediatric minor head trauma scenarios. 2) To estimate the radiation exposure of computed tomography scans with low dose protocols in the context of trauma and the additional associated risk. METHODS: Investigators reviewed the medical records of all children with minor head trauma, which was defined as a Glasgow coma scale ≥13 at the time of admission to the emergency room, who underwent computed tomography scans during the years of 2013 and 2014...
October 1, 2016: Clinics
Arvind G Kulkarni, Hussain Bohra, Abhilash Dhruv, Abhishek Sarraf, Anupreet Bassi, Vishwanath M Patil
BACKGROUND: The aim of the present prospective study is to evaluate whether the touted advantages of minimal invasive-transforaminal lumbar interbody fusion (MI-TLIF) translate into superior, equal, or inferior outcomes as compared to open-transforaminal lumbar interbody fusion (O-TLIF). This is the first study from the Indian subcontinent prospectively comparing the outcomes of MI-TLIF and O-TLIF. MATERIALS AND METHODS: All consecutive cases of open and MI-TLIF were prospectively followed up...
September 2016: Indian Journal of Orthopaedics
Paige A Culotta, James E Crowe, Quynh-Anh Tran, Jeremy Y Jones, Amy R Mehollin-Ray, H Brandon Tran, Marcella Donaruma-Kwoh, Cristina T Dodge, Elizabeth A Camp, Andrea T Cruz
BACKGROUND: Young children with suspected abusive head trauma often receive skull radiographs to evaluate for fractures as well as computed tomography (CT) of the head to assess for intracranial injury. Using a CT as the primary modality to evaluate both fracture and intracranial injury could reduce exposure to radiation without sacrificing performance. OBJECTIVE: To evaluate the sensitivity of CT head with (3-D) reconstruction compared to skull radiographs to identify skull fractures in children with suspected abusive head trauma...
October 15, 2016: Pediatric Radiology
Kerri A Van Arnem, David P Supinski, Jonathan E Tucker, Shawn Varney
BACKGROUND: Trauma patients sustaining blunt injuries are exposed to multiple radiologic studies. Evidence indicates that the risk of cancer from exposure to ionizing radiation rises in direct proportion to the cumulative effective dose (CED) received. The purpose of this study is to quantify the amount of ionizing radiation accumulated when arriving directly from point of injury to San Antonio Military Medical Center (SAMMC), a level I trauma center, compared with those transferred from other facilities...
September 13, 2016: American Journal of Emergency Medicine
G F Giannakopoulos, T P Saltzherr, L F M Beenen, G J Streekstra, J B Reitsma, F W Bloemers, J C Goslings, F C Bakker
BACKGROUND: During the initial assessment of patients with potential severe injuries, radiological examinations are performed in order to rapidly diagnose clinically relevant injuries. Previous studies have shown that performing these examinations routinely is not always necessary and that trauma patients are exposed to substantial radiation doses. The aim of this study was to assess the amount and findings of radiological examinations during the initial assessment of trauma patients and to determine the radiation doses to which these patients are exposed to...
September 29, 2016: Langenbeck's Archives of Surgery
A Bauer
The incidence of epithelial skin neoplasms, such as squamous cell carcinoma and basal cell carcinoma is significantly increasing worldwide. Leisure time solar UV exposure is causative in the overwhelming majority of cases in the general population; however, occupational exposure is responsible for a certain percentage of cases. Employees with a relevant exposure to polycyclic aromatic hydrocarbons in soot, raw paraffin, coal tar, anthracene, pitch or similar substances, to sunlight in outdoor occupations as well as to arsenic and ionizing radiation have a significantly increased risk to develop occupational skin cancer compared to the general population...
September 28, 2016: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
O Gonschorek, S Hauck, V Bühren
BACKGROUND: Intraoperative imaging during spinal interventions has experienced significant developments over the last two decades. By the introduction of flat screen detectors, 3D imaging has been made possible and easier and by developing compact and mobile systems computed tomography can even be used in the operating theater. OBJECTIVE: Presentation of modern intraoperative 3D imaging and navigation in spinal surgery. MATERIAL AND METHODS: The techniques of intraoperative 3D imaging and navigation during spinal procedures are presented based on the currently available literature and own experiences at a German national spine and trauma center...
October 2016: Der Unfallchirurg
J F Maempel, O D Stone, A W Murray
Introduction Surgical procedures to manage trauma to the wrist, forearm and elbow in children are very common. Image intensifiers are used routinely, yet studies/guidelines that quantify expected radiation exposure in such procedures are lacking. Methods Information on demographics, injury type, surgeon grade and dose area product (DAP) of radiation exposure per procedure was collected prospectively for 248 patients undergoing manipulation/fixation of injuries to the elbow, forearm or wrist at a paediatric hospital over 1 year...
September 2016: Annals of the Royal College of Surgeons of England
Rosemary Nabaweesi, Raghu H Ramakrishnaiah, Mallikarjuna R Rettiganti, Chunqiao Luo, Charles M Glasier, Robert T Maxson, Mary E Aitken, Philip J Kenney, James M Robbins
PURPOSE: The long-term cancer risks for children exposed to radiologic images can be two to three times higher than for adults because children are more sensitive to radiation and have a longer lifetime in which to accumulate exposure from CT scans. Injured children often undergo repeat CT imaging if they are transferred from non-pediatric hospitals to a Level I pediatric trauma center (PTC). This study determined the impact of a statewide web-based image repository (WBIR) on repeat imaging among transferred injured children...
August 28, 2016: Journal of the American College of Radiology: JACR
Jed H Assam, Thomas H Quinn, Oleg N Militsakh
INTRODUCTION: Variations in the operative situation for complex head and neck defect reconstructions resulting from mechanisms such as trauma, oncologic resection, and prior radiation exposure can result in situations of a vessel-depleted neck. This requires an awareness of alternate, innovative options for use in reconstructive repairs. The purpose of this study was to provide characterization of the third segment of the maxillary artery necessary to consider its use as a recipient vessel in free flap repair of complex midface defects...
August 29, 2016: Microsurgery
Peter James Bruhn, Lene Østerballe, Jens Hillingsø, Lars Bo Svendsen, Frederik Helgstrand
BACKGROUND: Computed tomography (CT) is the gold standard in the initial evaluation of the hemodynamically stable patient with suspected liver trauma. However, the adverse effects of radiation exposure are of specific concern in the pediatric population. It is therefore desirable to explore alternative diagnostic modalities. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are hepatic enzymes, which are elevated in peripheral blood in relation to liver injury. The aim of the present study was to investigate a potential role of normal liver transaminase levels in the decision algorithm in suspected pediatric blunt liver trauma...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
C Quah, R Mehta, F S Shivji, S Hassan, J Chandrasenan, C G Moran, D P Forward
INTRODUCTION Dynamic hip screw (DHS) fixation for proximal femur fractures is one of the most common procedures in trauma that requires the use of fluoroscopy. Emphasis is often placed on producing the 'perfect picture', which may lead to excessive use of fluoroscopy, without added patient benefit. This study, the largest of its kind, aimed to determine the effect of surgical experience on the amount of radiation exposure from fluoroscopy during DHS fixation. METHODS All hospital admissions for extracapsular proximal femur fractures to our institution between 2007 and 2012 were analysed...
August 23, 2016: Annals of the Royal College of Surgeons of England
V Caiaffa, G Vicenti, C Mori, A Panella, V Conserva, G Corina, L Scialpi, A Abate, M Carrozzo, Leonardo Petrelli, G Picca, A Aloisi, G Rollo, M Filipponi, V Freda, A Pansini, A Puce, G Solarino, B Moretti
We investigated whether a proximal femoral nail can be implanted without a distal locking screw in AO/OTA 31-A1 and 31-A2 pertrochanteric stable femur fractures. A multicentre, randomised study was conducted in six level-two trauma centres in our area (Puglia, Italy). A total of 333 patients received their allocated intervention (162 in the locking group [LG] and 171 in the unlocking group [UG]) and 266 patients were included in the final analysis at 1year. Our data showed no statistically significant difference between the two groups at 1-year follow-up for ability to walk, SF-36 questionnaire results, residual pain (visual analogue scale [VAS] score) and level of overall satisfaction...
August 11, 2016: Injury
Marc D Benayoun, Jason W Allen, Brendan P Lovasik, Matthew L Uriell, Robert M Spandorfer, Chad A Holder
BACKGROUND: Computed tomography (CT) of the cervical spine (C-spine) is routinely ordered for low-risk mechanisms of injury, including ground-level fall. Two commonly used clinical decision rules (CDRs) to guide C-spine imaging in trauma are the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian Cervical Spine Rule for Radiography (CCR). METHODS: Retrospective cross-sectional study of 3,753 consecutive adult patients presenting to an urban Level I emergency department who received C-spine CT scans were obtained over a 6-month period...
August 2016: Journal of Trauma and Acute Care Surgery
Teresa S Jones, Robert T Stovall, Edward L Jones, Bryan Knepper, Fredric M Pieracci, Charles J Fox, Ernest E Moore, Clay Cothren Burlew
BACKGROUND: The utility of urinalysis (UA) to diagnose intra-abdominal (IA) or genitourinary (GU) injury after blunt trauma remains controversial. The purpose of this study was to determine the significance of UA in the blunt trauma patient. METHODS: A retrospective review of patients admitted for blunt abdominal trauma from 2011 to 2013. RESULTS: A total of 1,795 patients sustained blunt abdominal trauma: mean age of 44 ± 21 years; mean Injury Severity Score of 13 ± 10...
June 12, 2016: American Journal of Surgery
Erdem Fatihoglu, Sonay Aydin, Fatma Dilek Gokharman, Bunyamin Ece, Pinar Nercis Kosar
RATIONALE AND OBJECTIVES: The increasing use of imaging in the emergency department (ED) services has become an important problem on the basis of cost and unnecessary exposure to radiation. Radiographic examination of the chest has been reported to be performed in 34.4% of ED visits, and chest computerized tomography (CCT) in 15.8%, whereas some patients receive both chest radiography and CCT in the same visit. In the current study, it was aimed to establish instances of medical waste and unnecessary radiation exposure and to show how the inclusion of radiologists in the ordering process would affect the amount of unnecessary imaging studies...
October 2016: Academic Radiology
Sophie Rym Hamada, Nathalie Delhaye, Sebastien Kerever, Anatole Harrois, Jacques Duranteau
BACKGROUND: The initial management of a trauma patient is a critical and demanding period. The use of extended focused assessment sonography for trauma (eFAST) has become more prevalent in trauma rooms, raising questions about the real "added value" of chest X-rays (CXRs) and pelvic X-rays (PXR), particularly in haemodynamically stable trauma patients. The aim of this study was to evaluate the effectiveness of a management protocol integrating eFAST and excluding X-rays in stable trauma patients...
December 2016: Annals of Intensive Care
Mosa Moradi, Nasrollah Naghdi, Hamidreza Hemmati, Majid Asadi-Samani, Mahmoud Bahmani
INTRODUCTION: Public and occupational exposure to electromagnetic fields due to the growing trend of electronic devices may cause adverse effects on human health. This paper describes the risk of mutation and sexual trauma and infertility in masculine sexual cell by mobile phone radiations. METHODS: In this study, we measured the emitted dose from a radiofrequency device, such as switching high voltage at different frequencies using a scintillation detector. The switching high voltage power supply (HVPS) was built for the Single Photon Emission Computed Tomography (SPECT) system...
May 2016: Electronic Physician
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