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Interventional radiology

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https://www.readbyqxmd.com/read/29474654/preliminary-investigation-of-radiation-dose-to-patients-from-cardiovascular-interventional-procedures-in-tanzania
#1
J E Ngaile, P K Msaki, R Mvungi, L J Schreiner
Although contemporary cardiac X-ray exams are typically set so benefits outweighs the risk, the growing use and increasing complexity of the cardiovascular interventional radiological (CVIR) procedures does increase the risk of radiation-related tissue effects and stochastic effects to the individual patients and the population. In view of these radiological concerns there is a need to investigate factors that influence the doses received by the patients and enable optimisation needed. The air kerma area product (KAP), cumulative air kerma (CAK) and fluoroscopy time (FT) to patients from two major CVIR procedures: coronary angiography (CA) and percutaneous coronary interventions (PCI), were obtained from two major hospitals in Tanzania...
February 21, 2018: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/29472088/occupational-exposures-during-abdominal-fluoroscopically-guided-interventional-procedures-for-different-patient-sizes-a-monte-carlo-approach
#2
William S Santos, Walmir Belinato, Ana P Perini, Linda V E Caldas, Diego C Galeano, Carla J Santos, Lucio P Neves
In this study we evaluated the occupational exposures during an abdominal fluoroscopically guided interventional radiology procedure. We investigated the relation between the Body Mass Index (BMI), of the patient, and the conversion coefficient values (CC) for a set of dosimetric quantities, used to assess the exposure risks of medical radiation workers. The study was performed using a set of male and female virtual anthropomorphic phantoms, of different body weights and sizes. In addition to these phantoms, a female and a male phantom, named FASH3 and MASH3 (reference virtual anthropomorphic phantoms), were also used to represent the medical radiation workers...
January 2018: Physica Medica: PM
https://www.readbyqxmd.com/read/29471998/baby-on-board-managing-occupational-radiation-exposure-during-pregnancy
#3
M Victoria Marx
This article reviews the issue of occupational radiation exposure as a deterrent to recruitment of women into the field of interventional radiology and provides the reader with three strategies to optimize radiation protection during fluoroscopically guided procedures. These include personal protective shielding, use of ancillary shielding, and techniques that limit fluoroscopy x-ray tube output. When optimal radiation safety practices are implemented as the norm in the IR suite, very little extra needs to be done to ensure that fetal dose of a pregnant interventionalist is negligible...
March 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29471996/the-eyes-have-it
#4
Lindsay Machan
The ocular lens is one of the most susceptible structures in the body to radiation damage. Unfortunately, much of the traditional academic and regulatory thinking on thresholds to develop radiation-induced opacities or cataracts has proven to be false. Individual vulnerability to the effects of radiation is extremely variable, largely because each individual is variably genetically equipped to repair the damage caused by radiation. Therefore many people, including some unsuspecting interventional radiologists may have no, or almost no, threshold at all for cataract development after radiation injury...
March 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29471995/should-we-keep-the-lead-in-the-aprons
#5
Gabriel Bartal, Anna M Sailer, Eliseo Vano
Medical staff should not be exposed to the primary X-ray beam during fluoroscopy-guided interventional procedures (FGIP). The main source of staff exposure is scatter radiation from the patient, which can be significant. Although many aspects of X-ray exposure to the patient as well as occupational exposure to interventional radiologists and other staff are strongly regulated and monitored in most countries, it is surprising how loosely the labeling and testing of the protective aprons is regulated. Interventional radiologists (IRs) have to be experts in interventional radiology as well as in basic facts regarding ways to provide a satisfactory level of protection from occupational exposure...
March 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29471994/ergonomics-in-the-development-and-prevention-of-musculoskeletal-injury-in-interventional-radiologists
#6
Jamaal L Benjamin, Quinn C Meisinger
Interventional radiology is a constantly evolving specialty overlapping with multiple other specialties, including cardiology, vascular surgery, orthopedic surgery, urology, and minimally invasive surgery. Unique ergonomic considerations for interventional radiology include utilization of intraoperative viewing monitors and personal radiation protection equipment. Work-related injuries are common in interventional radiologists,1 often leading to pain while performing procedures or during time away from work...
March 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29470351/severe-unresolved-cholestasis-due-to-unknown-aetiology-leading-to-early-allograft-failure-within-the-first-3-months-of-liver-transplantation
#7
Roberta Angelico, Undine A Gerlach, Bridget K Gunson, Desley Neil, Hynek Mergental, John Isaac, Paolo Muiesan, Darius Mirza, M Thamara Pr Perera
BACKGROUND: Causes of severe cholestasis following liver transplantation(LT) are multi-factorial; whilst the aetiology is predictable in some, others culminate in graft/patient loss without a definitive cause identified. Severe cholestasis is usually associated with overlapped histological findings of rejection and biliary features, and diagnostic interpretation may pose a challenge. METHODS: This is 10-year retrospective analysis of patients with unexplained severe cholestasis resulting in death/graft loss within 90-days of LT...
February 20, 2018: Transplantation
https://www.readbyqxmd.com/read/29468262/a-consensus-based-criterion-standard-for-the-requirement-of-a-trauma-team
#8
Christian Waydhas, Markus Baake, Lars Becker, Boris Buck, Helena Düsing, Björn Heindl, Kai Oliver Jensen, Rolf Lefering, Carsten Mand, T Paffrath, Uwe Schweigkofler, Kai Sprengel, Heiko Trentzsch, Bernd Wohlrath, Dan Bieler
BACKGROUND: Trauma team activation (TTA) represents a considerable expenditure of trauma centre resources. It is mainly triggered by field triage criteria. The overall quality of the criteria may be evaluated based on the rate of over- and undertriage. However, there is no gold standard that defines which adult patients truly require a trauma team. The objective of this study was to develop consensus-based criteria defining the necessity for a trauma team. METHODS: A consensus group was formed by trauma specialists experienced in emergency and trauma care with a specific interest in field triage and having previously participated in guideline development...
February 21, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29465558/analysis-of-clinical-characteristics-and-treatment-of-immunoglobulin-g4-associated-cholangitis-a-retrospective-cohort-study-of-39-iac-patients
#9
Jianchun Xiao, Peiran Xu, Binglu Li, Tao Hong, Wei Liu, Xiaodong He, Chaoji Zheng, Yupei Zhao
Immunoglobulin (Ig)G4-associated cholangitis (IAC) is one of the common organ manifestations of IgG4-related systemic disease (ISD). IAC and autoimmune pancreatitis (AIP) may mimic sclerosing cholangitis, cholangiocarcinoma, or pancreatic carcinoma. Diagnosis is based on a combination of clinical, biochemical, radiological, and histological findings.To study the clinical presentation of and treatment strategy for IAC, we reviewed clinical, serologic, and imaging characteristics, as well as treatment response, in 39 patients with IAC...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29464446/supportive-therapy-in-gastroenteropancreatic-neuroendocrine-tumors-often-forgotten-but-important
#10
REVIEW
Xi-Feng Jin, Matilde P Spampatti, Christine Spitzweg, Christoph J Auernhammer
Neuroendocrine tumors (NETs) are a group of rare and heterogeneous malignancies that can develop in various organs. A significant number of gastroenteropancreatic neuroendocrine tumours (GEP-NETs) is functionally active and presents with symptoms related to the secretion of biologically active substances, leading to the development of distinct clinical syndromes. There are various therapeutic approaches for GEP-NETs, including curative surgery, palliative surgery, local-ablative and loco-regional therapies as well as systemic therapeutic options including peptide receptor radionuclide therapy, cytotoxic therapy, and molecularly targeted therapies...
February 20, 2018: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/29464433/optimizing-travel-time-to-outpatient-interventional-radiology-procedures-in-a-multi-site-hospital-system-using-a-google-maps-application
#11
Jacob E Mandel, Louis Morel-Ovalle, Franz E Boas, Etay Ziv, Hooman Yarmohammadi, Amy Deipolyi, Heeralall R Mohabir, Joseph P Erinjeri
The purpose of this study is to determine whether a custom Google Maps application can optimize site selection when scheduling outpatient interventional radiology (IR) procedures within a multi-site hospital system. The Google Maps for Business Application Programming Interface (API) was used to develop an internal web application that uses real-time traffic data to determine estimated travel time (ETT; minutes) and estimated travel distance (ETD; miles) from a patient's home to each a nearby IR facility in our hospital system...
February 20, 2018: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/29464220/a-rare-cause-of-acute-abdomen-in-the-ed-chemotherapy-induced-pneumatosis-intestinalis
#12
Mesut Ozturk, Ilkay Camlidag, Mehmet Selim Nural, Gokhan Selcuk Ozbalci, Tumay Bekci
Pneumatosis intestinalis (PI) and portomesenteric venous gas (PVG) refers to the presence of air within the intestinal wall and portomesenteric vessels. Most of the time, it is associated with mesenteric ischemia that requires immediate surgical intervention as it has high mortality rate. It may also be seen secondary to various conditions, including infections, surgeries, and some chemotherapeutic drugs. A 61-year old-male was admitted to our emergency department complaining of abdominal pain after chemotherapy...
December 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29463614/consensus-guidelines-on-the-optimal-management-in-interventional-eus-procedures-results-from-the-asian-eus-group-rand-ucla-expert-panel
#13
Anthony Y B Teoh, Vinay Dhir, Mitsuhiro Kida, Ichiro Yasuda, Zhen Dong Jin, Dong Wan Seo, Majid Almadi, Tiing Leong Ang, Kazuo Hara, Ida Hilmi, Takao Itoi, Sundeep Lakhtakia, Koji Matsuda, Nonthalee Pausawasdi, Rajesh Puri, Raymond S Tang, Hsiu-Po Wang, Ai Ming Yang, Robert Hawes, Shyam Varadarajulu, Kenjiro Yasuda, Lawrence Khek Yu Ho
OBJECTIVES: Interventional endoscopic ultrasonography (EUS) procedures are gaining popularity and the most commonly performed procedures include EUS-guided drainage of pancreatic pseudocyst, EUS-guided biliary drainage, EUS-guided pancreatic duct drainage and EUS-guided celiac plexus ablation. The aim of this paper is to formulate a set of practice guidelines addressing various aspects of the above procedures. METHODS: Formulation of the guidelines was based on the best scientific evidence available...
February 20, 2018: Gut
https://www.readbyqxmd.com/read/29463278/clinical-and-radiological-effect-of-medialized-cortical-bone-trajectory-for-lumbar-pedicle-screw-fixation-in-patients-with-degenerative-lumbar-spondylolisthesis-study-protocol-for-a-randomized-controlled-trial-mpact
#14
Anja Tschugg, Pujan Kavakebi, Sebastian Hartmann, Sara Lener, Christoph Wipplinger, Wolfgang N Löscher, Sabrina Neururer, Matthias Wildauer, Claudius Thomé
BACKGROUND: Spinal fusion with pedicle screw fixation represents the gold standard for lumbar degenerative disc disease with instability. Although it is an established technique, it is nevertheless an invasive intervention with high complication rates. Therefore, minimally invasive approaches have been developed, the medialized bilateral screw pedicel fixation (mPACT) being one of them. The study objective is to evaluate prospectively the efficacy and safety of the mPACT technique compared with the traditional trajectory for degenerative lumbar spondylolisthesis...
February 20, 2018: Trials
https://www.readbyqxmd.com/read/29462483/estimation-of-diagnostic-reference-levels-for-ct-coronarography-in-slovakia
#15
Zuzana Bárdyová, Martina Horváthová, Denisa Nikodemová
The coronary CT angiography (CCTA) is a frequent diagnostic method connected with large variability of effective dose. Therefore, it is the type of examination where optimization is very important and the use of a national diagnostic reference level (DRL) recommended. In Slovakia the DRL for interventional radiology examinations until now fails. The objective of our study was to propose the national DRL for CCTA examinations in Slovak Republic, on the basis of a cross-sectional multicenter study, performed in four departments of radiology...
February 16, 2018: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/29462376/estimation-of-radiation-exposure-to-the-patients-in-diagnostic-and-therapeutic-interventional-procedures
#16
Bhupendra Singh Rana, Sanjeev Kumar, Chirag Kamal Ahuja, Narinder Paul Singh, Mukesh Kumar Yadav, Inderjeet Singh Sandhu
The present work reports data of the radiation exposure to the patient in various diagnostic and therapeutic interventional radiological (IR) procedures. The study includes 260 diagnostic and 195 therapeutic exposure data in 455 IR procedures. All the IR procedures were performed on a biplane angiographic machine in a tertiary care hospital. The radiation exposure was estimated from dose-area product (DAP), fluoroscopy time (FT), number of fluoroscopic runs, number of images and cumulative dose (CD) value recorded during the procedure...
February 16, 2018: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/29461894/rethinking-chronic-obstructive-pulmonary-disease-chronic-pulmonary-insufficiency-and-combined-cardiopulmonary-insufficiency
#17
R Graham Barr
Almost 70 years ago, Drs. Baldwin, Cournand, and Richards defined chronic pulmonary insufficiency by the presence of respiratory symptoms, radiologic evidence of pulmonary emphysema on chest radiography, and physiologic gas trapping. A decade later, airflow obstruction on spirometry was added to the definition and insufficiency became a disease. Contemporary studies are reviving the diagnostic approach described by these early luminaries, with researchers finding that symptomatic smokers with preserved spirometry have increased exacerbations and that smokers and non-smokers with normal spirometry but emphysema on chest computed tomography have increased mortality...
February 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29461406/interventional-procedures-outside-of-the-operating-room-results-from-the-national-anesthesia-clinical-outcomes-registry
#18
Beverly Chang, Alan D Kaye, James H Diaz, Benjamin Westlake, Richard P Dutton, Richard D Urman
OBJECTIVES: This study examines the impact of procedural locations and types of anesthetics on patient outcomes in non-operating room anesthesia (NORA) locations. The National Anesthesia Clinical Outcomes Registry database was examined to compare OR to NORA anesthetic complications and patient demographics. METHODS: The National Anesthesia Clinical Outcomes Registry database was examined for all patient procedures from 2010 to 2013. A total of 12,252,846 cases were analyzed, with 205 practices contributing information, representing 1494 facilities and 7767 physician providers...
March 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29459605/evaluation-of-the-results-of-ilizarov-ring-fixation-in-schatzker-type-vi-tibial-plateau-fracture
#19
D G Mostafa, M I Qavi, M M Bari, M Arifuzzaman, M Kamruzzaman, M K Saha
High-energy tibial plateau fractures associated with severe soft tissue injury are difficult to manage. The risk of wound complications following open reduction and internal fixation is notably high owing to extensive soft tissue dissection. Alternatively, application of Ilizarov ring fixator minimizes soft tissue dissection and provides adequate fracture stabilization to allow early range of motion and correction of any mal-alignment. With this technique, soft tissue complications particularly surgical site infections are expected to be significantly reduced...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29458361/health-services-in-trinidad-throughput-throughput-challenges-and-the-impact-of-a-throughput-intervention-on-overcrowding-in-a-public-health-institution
#20
Mandreker Bahall
BACKGROUND: Throughput might be partially responsible for sub-optimum organisational and medical outcomes. The present study examined throughput and the challenges to ensuring optimum throughput in hospitals, and determined the effectiveness of a throughput intervention in reducing overcrowding in a public healthcare institution in Trinidad and Tobago. METHODS: First, a literature review of throughput and its processes in relation to improving hospital care was conducted...
February 20, 2018: BMC Health Services Research
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