Collar badge lens dose equivalent values among U.S. physicians performing fluoroscopically-guided interventional procedures

2021 ◽  
Author(s):  
David Borrego ◽  
Craig Yoder ◽  
Stephen Balter ◽  
Cari M. Kitahara
Keyword(s):  
Interventional Procedures ◽  
Dose Equivalent

TERTIARY X-RADIATION—A PROBLEM FOR STAFF PROTECTION?

2020 ◽  
Vol 189 (3) ◽  
pp. 304-311
Author(s):  
H Eder ◽  
M Seidenbusch ◽  
L S Oechler
Keyword(s):  
Clinical Practice ◽  
Protective Effect ◽  
Scattered Radiation ◽  
Interventional Procedures ◽  
Dose Equivalent ◽  
X Ray ◽  
Back Panel ◽  
Staff Protection ◽  
The Impact

Abstract The influence of tertiary x-radiation on the radiological staff is widely unknown. Tertiary radiation is caused as the scattered radiation of the patient impacts the walls, floor, ceiling and surrounding air. The question that arises is does tertiary x-radiation provide a relevant contribution to the staff doses. The impact of tertiary radiation was investigated by means of measurements of the personal dose equivalent Hp(10) on an anthropomorphic Alderson Rando male phantom and also on operators/assistants staying in clinical practice. Further, the protective effect of lead foils, especially under tertiary radiation was also investigated. Correlations could be derived for clinical angiographic/interventional procedures between dose area products (DAPs) and dose length products (DLPs) vs. dorsal doses of staff persons. Generally, the staff doses that are a result of tertiary radiation depend on the x-ray energy and range from 0.15 to 0.55% of the scattered radiation impact caused by irradiation of the patient. Hence, a back panel with 0.125-mm lead equivalent is sufficient to protect the staff from tertiary radiation created within the room environment.

A Cost-effectiveness Analysis of Aspirin versus Oral Anticoagulants after Acute Myocardial Infarction in Italy

1998 ◽  
Vol 80 (12) ◽  
pp. 887-893 ◽  
Author(s):  
Jacopo Gianetti ◽  
Gianfranco Gensini ◽  
Raffaele De Caterina
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Cost Effectiveness ◽  
Interventional Procedures ◽  
Cost Allocation ◽  
Oral Anticoagulants ◽  
The United States ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Artery Disease

SummaryAims. The recent publication of two large trials of secondary prevention of coronary artery disease with oral anticoagulants (WARIS and ASPECT) has caused a revival of the interest for this antithrombotic therapy in a clinical setting where the use of aspirin is common medical practice. Despite this, the preferential use of aspirin has been supported by an American cost-effectiveness analysis (JAMA 1995; 273: 965). Methods and Results. Using the same parameters used in that analysis and incidence of events from the Antiplatelet Trialists Collaboration and the ASPECT study, we re-evaluated the economic odds in favor of aspirin or oral anticoagulants in the Italian Health System, which differs significantly in cost allocation from the United States system and is, conversely, similar to other European settings. Recalculated costs associated with each therapy were 2,150 ECU/ patient/year for oral anticoagulants and 2,187 ECU/patient/year for aspirin. In our analysis, the higher costs of oral anticoagulants versus aspirin due to a moderate excess of bleeding (about 10 ECU/ patient/year) and the monitoring of therapy (168 ECU/ patient/year) are more than offset by an alleged savings for recurrent ischemic syndromes and interventional procedures (249 ECU/ patient/year). Conclusions. Preference of aspirin vs. oral anticoagulants in a pharmaco-economical perspective is highly dependent on the geographical situation whereupon calculations are based. On a pure cost-effectiveness basis, and in the absence of data of direct comparisons between aspirin alone versus I.N.R.-adjusted oral anticoagulants, the latter are not more expensive than aspirin in Italy and, by cost comparisons, in other European countries in the setting of post-myocardial infarction.

Surgical ASD closure in the era of interventional procedures

2005 ◽  
Vol 53 (S 01) ◽  
Author(s):  
A Böning ◽  
N Gerken ◽  
J Scheewe ◽  
G Fischer ◽  
H Kramer ◽  
...  
Keyword(s):  
Interventional Procedures ◽  
Asd Closure

Cardiological Biopharmaceuticals in the Conception of Drug Targeting Delivery: Practical Results and Research Perspectives

Acta Naturae ◽  
2012 ◽  
Vol 4 (3) ◽  
pp. 72-81 ◽  
Author(s):  
A. V. Maksimenko
Keyword(s):  
Cell Adhesion Molecules ◽  
Drug Targeting ◽  
Interventional Procedures ◽  
Target Localization ◽  
Clinical Use ◽  
Protein Conjugates ◽  
Research Perspectives ◽  
Significant Interest ◽  
Targeting Delivery ◽  
Molecular Sizes

The results of the clinical use of thrombolytic and antithrombotic preparations developed on the basis of protein conjugates obtained within the framework of the conception of drug targeting delivery in the organism are considered. A decrease has been noted in the number of biomedical projects focused on these derivatives as a result of various factors: the significant depletion of financial and organizational funds, the saturation of the pharmaceutical market with preparations of this kind, and the appearance of original means for interventional procedures. Factors that actively facilitate the conspicuous potentiation of the efficacy of bioconjugates were revealed: the biomedical testing of protein domains and their selected combinations, the optimization of molecular sizes for the bioconjugates obtained, the density of target localization, the application of cell adhesion molecules as targets, and the application of connected enzyme activities. Enzyme antioxidants and the opportunity for further elaboration of the drug delivery conception via the elucidation and formation of therapeutic targets for effective drug reactions by means of pharmacological pre- and postconditioning of myocardium arouse significant interest.

The Expanding Role of Echocardiography in Interventional Cardiology

2010 ◽  
Vol 6 (2) ◽  
pp. 71 ◽  
Author(s):  
Lindsay A Smith ◽  
Amit Bhan ◽  
Mark J Monaghan ◽  
◽  
◽  
...  
Keyword(s):  
Interventional Procedures ◽  
Imaging Modality ◽  
Interventional Cardiology ◽  
Design And Technology ◽  
Team Approach ◽  
Medical Problems ◽  
Multidisciplinary Team Approach ◽  
Case Selection ◽  
Optimal Imaging

Echocardiography provides excellent realtime imaging of the heart, making it the imaging modality of choice immediately before, during and after cardiac interventional procedures. It helps to guide case selection and execution of the intervention, evaluates the effects of the intervention and enables early detection of complications. Advances in the design and technology of medical devices and delivery systems, coupled with demand for alternative non-surgical therapies for common medical problems, have led to an increase in the volume, variety and complexity of non-coronary cardiac interventional procedures performed. Many of these procedures require a multidisciplinary team approach and demand optimal imaging to ensure successful outcomes. The aim of this article is to review the expanding role of echocardiography in non-coronary interventional cardiology in adults.

Neutron dose evaluation of Elekta Linac at two energies (10 & 18 MV) by MCNP code and comparison with experimental measurements

2014 ◽  
Vol 6 (1) ◽  
pp. 1006-1015
Author(s):  
Negin Shagholi ◽  
Hassan Ali ◽  
Mahdi Sadeghi ◽  
Arjang Shahvar ◽  
Hoda Darestani ◽  
...  
Keyword(s):  
Monte Carlo ◽  
Measurement Data ◽  
Calculated Data ◽  
High Energy ◽  
Neutron Dose ◽  
Dose Assessment ◽  
Photon Flux ◽  
Dose Equivalent ◽  
Monte Carlo Techniques ◽  
Neutron Dose Equivalent

Medical linear accelerators, besides the clinically high energy electron and photon beams, produce other secondary particles such as neutrons which escalate the delivered dose. In this study the neutron dose at 10 and 18MV Elekta linac was obtained by using TLD600 and TLD700 as well as Monte Carlo simulation. For neutron dose assessment in 2020 cm2 field, TLDs were calibrated at first. Gamma calibration was performed with 10 and 18 MV linac and neutron calibration was done with 241Am-Be neutron source. For simulation, MCNPX code was used then calculated neutron dose equivalent was compared with measurement data. Neutron dose equivalent at 18 MV was measured by using TLDs on the phantom surface and depths of 1, 2, 3.3, 4, 5 and 6 cm. Neutron dose at depths of less than 3.3cm was zero and maximized at the depth of 4 cm (44.39 mSvGy-1), whereas calculation resulted  in the maximum of 2.32 mSvGy-1 at the same depth. Neutron dose at 10 MV was measured by using TLDs on the phantom surface and depths of 1, 2, 2.5, 3.3, 4 and 5 cm. No photoneutron dose was observed at depths of less than 3.3cm and the maximum was at 4cm equal to 5.44mSvGy-1, however, the calculated data showed the maximum of 0.077mSvGy-1 at the same depth. The comparison between measured photo neutron dose and calculated data along the beam axis in different depths, shows that the measurement data were much more than the calculated data, so it seems that TLD600 and TLD700 pairs are not suitable dosimeters for neutron dosimetry in linac central axis due to high photon flux, whereas MCNPX Monte Carlo techniques still remain a valuable tool for photonuclear dose studies.

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