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https://www.readbyqxmd.com/read/29790719/less-is-more-as-less-as-reasonably-achievable-stenting-alaras-strategy-in-the-femoropopliteal-area
#1
Koen Deloose, Joren Callaert
BACKGROUND: Although evidence supports that the performance of drug coated balloons seems to be lesion complexity independent, it is quite clear that in long lesions, severe calcified lesions and chronic total occlusions, the bail out stent ratio is very high and that the "leaving nothing behind" strategy remains a dream in a lot of our daily cases. On the other side of the spectrum, "full metal jackets" of nitinol stents are creating even more problems. Stent fractures, intimal hyperplasia and reintervention difficulties complicate the recurrent vascular disease treatment...
May 23, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29789875/ct-angiography-in-the-lower-extremity-peripheral-artery-disease-feasibility-of-an-ultra-low-volume-contrast-media-protocol
#2
Barbora Horehledova, Casper Mihl, Gianluca Milanese, Rutger Brans, Nienke G Eijsvoogel, Babs M F Hendriks, Joachim E Wildberger, Marco Das
PURPOSE: The ALARA principle is not only relevant for effective dose (ED) reduction, but also applicable for contrast media (CM) management. Therefore, the aim was to evaluate the feasibility of an ultra-low CM protocol in the assessment of peripheral artery disease (PAD). MATERIALS AND METHODS: Fifty PAD patients were scanned on third-generation dual-source computed tomography, from diaphragm to the forefoot, as follows: tube voltage: 70 kV, reference effective tube current: 90 mAs, collimation: 192 × 2 × 0...
May 22, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29769516/staying-safe-from-radiation-exposure-in-cath-lab-a-review
#3
K Pasha, H R Khan, A A Sumon
A successful cardiac catheterization Laboratory radiation safety program must manage patient and staff safety by reducing exposure to ionizing radiation to a level that is as low as reasonably achievable (ALARA). The first step in radiation safety is to avoid unnecessary use of ionizing radiation by justification of exposure, one of the basic principles of radiation protection. All individuals involved in fluoroscopic imaging procedures should familiarize themselves to the measures to protect themselves from exposure to unsafe doses of ionizing radiation...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29753411/solar-particle-event-storm-shelter-requirements-for-missions-beyond-low-earth-orbit
#4
REVIEW
L W Townsend, J H Adams, S R Blattnig, M S Clowdsley, D J Fry, I Jun, C D McLeod, J I Minow, D F Moore, J W Norbury, R B Norman, D V Reames, N A Schwadron, E J Semones, R C Singleterry, T C Slaba, C M Werneth, M A Xapsos
Protecting spacecraft crews from energetic space radiations that pose both chronic and acute health risks is a critical issue for future missions beyond low Earth orbit (LEO). Chronic health risks are possible from both galactic cosmic ray and solar energetic particle event (SPE) exposures. However, SPE exposures also can pose significant short term risks including, if dose levels are high enough, acute radiation syndrome effects that can be mission- or life-threatening. In order to address the reduction of short term risks to spaceflight crews from SPEs, we have developed recommendations to NASA for a design-standard SPE to be used as the basis for evaluating the adequacy of proposed radiation shelters for cislunar missions beyond LEO...
May 2018: Life Sciences in Space Research
https://www.readbyqxmd.com/read/29738807/environmental-and-biological-monitoring-on-an-oncology-ward-during-a-complete-working-week
#5
Michael Koller, Antje Böhlandt, Christopher Haberl, Dennis Nowak, Rudolf Schierl
Workplace exposure to antineoplastic drugs (AD) is still of evident concern to all occupationally exposed persons in the healthcare sector as residues in relevant concentrations continue to be present. With respect to the carcinogenic and mutagenic potential of ADs and their toxicity on reproduction, occupational exposure should be kept as low as reasonably achievable (ALARA). In the oncology patient care, the medical staff is involved both in chemotherapy administration and handling of AD-contaminated body fluids of the patients...
May 5, 2018: Toxicology Letters
https://www.readbyqxmd.com/read/29605110/digital-imaging-and-radiographic-practise-in-diagnostic-radiography-an-overview-of-current-knowledge-and-practice-in-europe
#6
S Mc Fadden, T Roding, G de Vries, M Benwell, H Bijwaard, J Scheurleer
INTRODUCTION: Recent research has identified the issue of 'dose creep' in diagnostic radiography and claims it is due to the introduction of CR and DR technology. More recently radiographers have reported that they do not regularly manipulate exposure factors for different sized patients and rely on pre-set exposures. The aim of the study was to identify any variation in knowledge and radiographic practice across Europe when imaging the chest, abdomen and pelvis using digital imaging...
May 2018: Radiography
https://www.readbyqxmd.com/read/29573900/usefulness-of-optic-nerve-ultrasound-to-predict-clinical-progression-in-multiple-sclerosis
#7
S Pérez Sánchez, S Eichau Madueño, M Rus Hidalgo, A M Domínguez Mayoral, A Vilches-Arenas, G Navarro Mascarell, G Izquierdo
INTRODUCTION: Progressive neuronal and axonal loss are considered the main causes of disability in patients with multiple sclerosis (MS). The disease frequently involves the visual system; the accessibility of the system for several functional and structural tests has made it a model for the in vivo study of MS pathogenesis. Orbital ultrasound is a non-invasive technique that enables various structures of the orbit, including the optic nerve, to be evaluated in real time. MATERIAL AND METHODS: We conducted an observational, ambispective study of MS patients...
March 21, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29524969/identifying-and-managing-the-risks-of-medical-ionizing-radiation-in-endourology
#8
Todd Yecies, Timothy D Averch, Michelle J Semins
INTRODUCTION: The risks of exposure to medical ionizing radiation is of increasing concern both among medical professionals and the general public. Patients with nephrolithiasis are exposed to high levels of ionizing radiation through both diagnostic and therapeutic modalities. Endourologists who perform a high-volume of fluoroscopy guided procedures are also exposed to significant quantities of ionizing radiation. The combination of judicious use of radiation-based imaging modalities, application of new imaging techniques such as ultra-low dose computed tomography (CT) scan, and modifying use of current technology such as increasing ultrasound and pulsed fluoroscopy utilization offers the possibility of significantly reducing radiation exposure...
February 2018: Canadian Journal of Urology
https://www.readbyqxmd.com/read/29516610/optimizing-the-target-detectability-of-cone-beam-ct-performed-in-image-guided-radiation-therapy-for-patients-of-different-body-sizes
#9
Ching-Ching Yang, Pei-Chieh Yu, Jau-Ming Ruan, Yu-Cheng Chen
PURPOSE: The target detectability of cone beam computed tomography (CBCT) performed in image-guided radiation therapy (IGRT) was investigated to achieve sufficient image quality for patient positioning over a course of treatment session while maintaining radiation exposure from CBCT imaging as low as reasonably achievable (ALARA). METHODS: Body CBCT scans operated in half-fan mode were acquired with three different protocols: CBCTlowD , CBCTmidD , and CBCThighD , which resulted in weighted CT dose index (CTDIw ) of 0...
March 8, 2018: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/29468678/image-guidance-doses-delivered-during-radiotherapy-quantification-management-and-reduction-report-of-the-aapm-therapy-physics-committee-task-group-180
#10
George X Ding, Parham Alaei, Bruce Curran, Ryan Flynn, Michael Gossman, T Rock Mackie, Moyed Miften, Richard Morin, X George Xu, Timothy C Zhu
BACKGROUND: With radiotherapy having entered the era of image guidance, or image-guided radiation therapy (IGRT), imaging procedures are routinely performed for patient positioning and target localization. The imaging dose delivered may result in excessive dose to sensitive organs and potentially increase the chance of secondary cancers and, therefore, needs to be managed. AIMS: This task group was charged with: a) providing an overview on imaging dose, including megavoltage electronic portal imaging (MV EPI), kilovoltage digital radiography (kV DR), Tomotherapy MV-CT, megavoltage cone-beam CT (MV-CBCT) and kilovoltage cone-beam CT (kV-CBCT), and b) providing general guidelines for commissioning dose calculation methods and managing imaging dose to patients...
February 22, 2018: Medical Physics
https://www.readbyqxmd.com/read/29406414/pediatric-musculoskeletal-interventional-mri
#11
Roberto Blanco Sequeiros, Juha-Jaakko Sinikumpu, Risto Ojala, Jyri Järvinen, Jan Fritz
Minimally invasive procedures play a crucial role in the diagnosis and treatment of many pediatric musculoskeletal conditions. Although computed tomography and fluoroscopy are commonly used for image guidance, the associated exposure to ionizing radiation is especially concerning in pediatric patients. Ultrasonography may be used successfully in a subset of interventions, but it is often not useful for complex, deep, and osseous targets. Interventional magnetic resonance imaging (iMRI) facilitates targeting and treatment of musculoskeletal lesions at many locations with high accuracy due to its excellent tissue contrast...
February 2018: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/29339579/conclusions-and-recommendations-from-the-17th-workshop-of-the-european-alara-network-alara-in-emergency-exposure-situations
#12
Sylvain Andresz, Julie Morgan, Pascal Croüail, Fernand Vermeersch
The European ALARA Network regularly organises workshops on topical issues in radiation protection. In light of the Fukushima accident, the most recent workshop questioned the application of the ALARA principle in emergency exposure situations. This memorandum presents the conclusions and recommendations of this workshop. One of the outcomes is that the process of optimisation in emergency exposure situations should be flexible enough to be able to modify or refine decisions over the course of an accident. In the urgent phase, decisions must be made in a very time-constrained environment, based on scarce, uncertain and sometimes unreliable information...
March 2018: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
https://www.readbyqxmd.com/read/29317468/radiation-exposure-and-procedure-and-fluoroscopy-times-in-endovascular-treatment-of-intracranial-aneurysms-a-methodological-comparison
#13
Nicholas K Cheung, Michelle Boutchard, Michael W Carr, Jens J Froelich
BACKGROUND: Limited data are available for radiation exposure, and procedure and fluoroscopy times in neuroendovascular treatment (NET) strategies. OBJECTIVE: This study establishes and compares related parameters between coil embolization (COIL), balloon assisted coil embolization (BAC), stent assisted coil embolization (SAC), and flow diverting technology (FDT) in NET of intracranial aneurysms. MATERIALS AND METHODS: Between 2010 and 2017, 249 consecutive intracranial aneurysms underwent NET at a single center, all performed by the same operator...
January 9, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29305204/radiation-exposure-to-the-urologist-using-an-overcouch-radiation-source-compared-with-an-undercouch-radiation-source-in-contemporary-urology-practice
#14
Andrew M Harris
OBJECTIVE: To compare radiation dosage to the urologist using an overcouch system, x-ray tube over table, and an undercouch system, x-ray tube under table. Urologists continue to perform more endoscopic surgery requiring fluoroscopy. Fluoroscopy, or electromagnetic radiation, can cause cellular damage when passing through tissues. These systems are compared with respect to radiation dosage to the urologist. METHODS: A single urologic surgeon utilized a dosimeter badge while using an overcouch system...
January 2, 2018: Urology
https://www.readbyqxmd.com/read/29285032/effect-of-filtration-and-thickness-of-cross-sections-of-cone-beam-computed-tomography-images-on-detection-of-proximal-caries
#15
Mehrdad Abdinian, Rahman Nazeri, Marzieh Ghaiour
Objectives: When a patient has cone beam computed tomography (CBCT) images based on the treatment plan, it is possible to use these images for evaluation of caries, and there is no need for new radiographs, according to the "as low as reasonably achievable" (ALARA) principle. The aim of this study was to determine the effect of filtration and thickness of CBCT cross-sections on detection of proximal caries. Materials and Methods: In this in-vitro study, 100 teeth were placed in the dental sockets of a dry skull, and were fixed in normal proximal contacts...
July 2017: Journal of Dentistry of Tehran University of Medical Sciences
https://www.readbyqxmd.com/read/29217953/assessment-of-pediatrics-radiation-dose-from-routine-x-ray-examination-at-jimma-university-hospital-southwest-ethiopia
#16
Mesfin Zewdu, Elias Kadir, Melkamu Berhane
Background: Given the fact that children are more sensitive to ionizing radiation than adults, with an increased risk of developing radiation-induced cancer, special care should be taken when they undergo X-ray examinations. The main aim of the current study was to determine Entrance Surface Dose (ESD) to pediatric patients arising from routine x-ray examination in the Radiology Department of Jimma University Specialized Hospital (JUSH). Methods: Descriptive cross-sectional study was conducted on pediatric patients less than 15 years of age who visited to seek x-ray examinations in JUSH...
September 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/29211686/integration-of-risks-from-multiple-hazards-into-a-holistic-alara-alarp-demonstration
#17
P A Bryant, J Croft, P Cole
The principle of As Low As Reasonable Achievable (ALARA) stems from the field of radiological protection. In the UK, this principle has been incorporated into the Health and Safety at Work Act 1974 and rather than applying solely to radiological hazards, applies to all hazards in totality. Given that the current methods for assessing hazards are somewhat isolated, in that one hazard is assessed independently of another, it can be challenging to ensure a truly holistic view of the risks, and demonstrate they have been reduced to ALARA or As Low As Is Reasonably Practicable (ALARP) as required in the UK regulatory regime...
December 6, 2017: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
https://www.readbyqxmd.com/read/29188790/irpa-consultation-is-the-system-of-protection-fit-for-purpose-and-can-it-be-readily-communicated-views-of-the-radiation-protection-professionals
#18
Roger Coates, Renate Czarwinski
The system of protection, which provides the basic underpinning philosophy and principles for radiation protection, is constantly evolving in the light of developing scientific understanding and practical experience. Over recent times there has been significant learning from experiences relating to the Fukushima accident, and there is also increasing recognition of the importance of enhancing public understanding of radiation and risk. The practical application of radiation protection is undertaken by thousands of practitioners around the world, and it is IRPA's task to ensure that this experience is fed back for the benefit of all...
November 30, 2017: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
https://www.readbyqxmd.com/read/29162024/modern-fixed-imaging-systems-reduce-radiation-exposure-to-patients-and-providers
#19
Lars Stangenberg, Fahad Shuja, I Martijn J van der Bom, Martine H G van Alfen, Allen D Hamdan, Mark C Wyers, Raul J Guzman, Marc L Schermerhorn
High-definition fluoroscopic imaging is required to perform endovascular procedures safely and precisely, especially in complex cases, resulting in longer procedures and increased radiation exposure. This is of importance for training institutions as trainees, even with sound instruction in as low as reasonably achievable (ALARA) principles, tend to have high radiation exposures. Recently, there was an upgrade in the imaging system allowing for comparison of radiation exposure to patients and providers. We performed an analysis of consecutive endovascular aneurysm repair (EVAR) and superficial femoral artery (SFA) interventions in the years 2013 to 2014...
January 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29154759/radiation-exposure-in-pediatric-urology-patients-how-to-adhere-to-alara
#20
EDITORIAL
Michael C Ost
No abstract text is available yet for this article.
February 2018: Journal of Urology
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