Endoscopist’s occupational dose evaluation related to correct wearing of dosimeter during X-ray-guided procedures

Abstract Background Since endoscopists performing procedures in the endoscopy suite can change their position by turning their back, side or front toward the X-ray source, this study aimed to establish whether dosimeter position affects the correct evaluation of an endoscopist’s personal radiation exposure during X-ray-guided procedures. Materials and methods Between January and February 2018, two dosimeters specularly placed outside the lead apron (anterior one on the chest and posterior one on the back) measured endoscopists’ personal dose equivalent (Hp) during 62 X-ray-guided procedures on adult and pediatric patients. Procedures were divided into three groups considering the position taken by the endoscopist with respect to the radiation source. For each group, the difference between mean Hp from the anterior and posterior dosimeters was calculated. Results A statistically significant difference in mean Hp was recorded for the endoscopists’ frontal and back positions (P = 0.014, and P < 0.00001, respectively). No significant difference was found in mean Hp for the side position (P = 0.489). Conclusions The position of personal dosimeters affects the correct evaluation of endoscopists’ radiation exposure during X-ray-guided procedures when frontal and back positions were recorded. To correctly evaluate radiation doses, the whole-body dosimeter should be worn according to the position of the endoscopist with respect to the radiation source; otherwise, it results in an incorrect personal dose evaluation, which may lead to substantial underestimation of staff exposure.

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Digital variance angiography allows about 70% decrease of DSA-related radiation exposure in lower limb X-ray angiography

Scientific Reports ◽

10.1038/s41598-021-01208-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Marcell Gyánó ◽

Márton Berczeli ◽

Csaba Csobay-Novák ◽

Dávid Szöllősi ◽

Viktor I. Óriás ◽

...

Keyword(s):

Radiation Exposure ◽

Lower Limb ◽

Low Dose ◽

X Ray ◽

Reduce Radiation Exposure ◽

Significant Difference ◽

Region Difference ◽

Diagnostic Angiography ◽

The Difference ◽

Artery Disease

AbstractOur aim was to investigate whether the previously observed higher contrast-to-noise ratio (CNR) and better image quality of Digital Variance Angiography (DVA) - compared to Digital Subtraction Angiography (DSA) - can be used to reduce radiation exposure in lower limb X-ray angiography. This prospective study enrolled 30 peripheral artery disease patients (mean ± SD age 70 ± 8 years) undergoing diagnostic angiography. In all patients, both normal (1.2 µGy/frame; 100%) and low-dose (0.36 µGy/frame; 30%) protocols were used for the acquisition of images in three anatomical regions (abdominal, femoral, crural). The CNR of DSA and DVA images were calculated, and the visual quality was evaluated by seven specialists using a 5-grade Likert scale. For investigating non-inferiority, the difference of low-dose DVA and normal dose DSA scores (DVA30-DSA100) was analyzed. DVA produced two- to three-fold CNR and significantly higher visual score than DSA. DVA30 proved to be superior to DSA100 in the crural region (difference 0.25 ± 0.07, p < 0.001), and there was no significant difference in the femoral (− 0.08 ± 0.06, p = 0.435) and abdominal (− 0.10 ± 0.09, p = 0.350) regions. Our data show that DVA allows about 70% reduction of DSA-related radiation exposure in lower limb X-ray angiography, providing a potential new radiation protection tool for the patients and the medical staff.

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Circular frames without x-ray – lessons learned regarding radiation exposure during tibial deformity correction from Low & Middle Income Countries?

Tropical Doctor ◽

10.1177/00494755211043309 ◽

2022 ◽

pp. 004947552110433

Author(s):

James Shelton ◽

Sara Dorman ◽

Yinna Kim ◽

Phillipa Thorpe ◽

Badri Narayan ◽

...

Keyword(s):

Radiation Exposure ◽

Deformity Correction ◽

Treatment Method ◽

Lessons Learned ◽

Phnom Penh ◽

Middle Income ◽

X Ray ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Significant Difference

Circular frames are a successful way of treating difficult fractures and non-unions. At our institution (CSC) in Phnom Penh, Cambodia, our method differs from developed healthcare systems in that we do not use x-ray to site the frames. A retrospective cohort study was performed between CSC and a UK LRS unit. Demographics, diagnosis, frame type, pre- and post-op deformity, proximal and distal construct alignment comparative to the tibia, and time to union or failure. 70 patients in total were identified and were randomly selected from a hospital in UK. Demographics & deformity were similar and failed to reach significant difference on testing: union rate 70% v. 82%, time to union 9.8 v. 8.5 months, and radiation exposure mean 0 v. 74 cGy/cm2 (range 6.4–326.7). These are startlingly homogenous results considering the differing resources available. We believe that ring fixators are a viable treatment method in austere environments where image intensifiers are unavailable, and demand no unnecessary radiation exposure.

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Distribution of Calcium and Phosphate in Cells of the Enamel Organ in the Rat Lower Incisor

Advances in Dental Research ◽

10.1177/08959374870010021201 ◽

1987 ◽

Vol 1 (2) ◽

pp. 236-244 ◽

Cited By ~ 12

Author(s):

T. Kawamoto ◽

M. Shimizu

Keyword(s):

The Other ◽

Whole Body ◽

Enamel Organ ◽

Maturation Stage ◽

Lower Incisor ◽

X Ray ◽

Other Hand ◽

Freeze Dried ◽

Significant Difference ◽

Cell Layers

The distribution of calcium and phosphate in the cells of the enamel organ of the rat lower incisors was investigated by autoradiography and energy-dispersive x-ray spectrometry (EDS). Radioactive calcium or phosphate was injected i.p. into seven-day-old rats of the Wistar strain. The animals were frozen 0.5, 1, and 10 min after injection, and embedded in 5% carboxymethyl cellulose. Sagittal sections of 10 μm thickness were made in which the lower incisor was included as a part of the whole-body section. For autoradiography, the sections were freeze-dried and placed in contact with dry thin films prepared from autoradiographic emulsion. For EDS, sections were mounted on carbon stubs, freeze-dried, coated with carbon, and examined by EDS in a SEM. 45Ca and 32P autoradiograms showed that the radioactivity was located over the papillary layer cells adjacent to the secretory stage ameloblasts and was much higher here than in the ameloblastic layer. On the other hand, there was no significant difference between the amount of radioactivity of these two cell layers in the maturation stage, although higher radioactivity was detectable in the maturation stage enamel than in the secretory stage enamel. Pronounced Ka x-ray peaks were obtained for P, S, Cl, and K originating from the cells of the papillary and ameloblastic layers in the secretory stage, but only very low peaks were obtained for Ca. On the other hand, in addition to these elements, remarkably high Ca and Fe peaks could be detected in the ameloblastic layer of the maturation stage.

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DIAGNOSTIC IMAGING AND IONIZING RADIATION EXPOSURE IN A LEVEL 1 TRAUMA CENTRE POPULATION MET WITH TRAUMA TEAM ACTIVATION: A ONE-YEAR PATIENT RECORD AUDIT

Radiation Protection Dosimetry ◽

10.1093/rpd/ncaa010 ◽

2020 ◽

Vol 189 (1) ◽

pp. 35-47

Author(s):

Anna Bågenholm ◽

Pål Løvhaugen ◽

Rune Sundset ◽

Tor Ingebrigtsen

Keyword(s):

Diagnostic Imaging ◽

Radiation Exposure ◽

Effective Dose ◽

Trauma Team ◽

Trauma Centre ◽

Whole Body ◽

Reference Level ◽

Dose Length Product ◽

Trauma Team Activation ◽

X Ray

Abstract This audit describes ionizing and non-ionizing diagnostic imaging at a regional trauma centre. All 144 patients (males 79.2%, median age 31 years) met with trauma team activation from 1 January 2015 to 31 December 2015 were included. We used data from electronic health records to identify all diagnostic imaging and report radiation exposure as dose area product (DAP) for conventional radiography (X-ray) and dose length product (DLP) and effective dose for CT. During hospitalization, 134 (93.1%) underwent X-ray, 122 (84.7%) CT, 92 (63.9%) focused assessment with sonography for trauma (FAST), 14 (9.7%) ultrasound (FAST excluded) and 32 (22.2%) magnetic resonance imaging. One hundred and sixteen (80.5%) underwent CT examinations during trauma admissions, and 73 of 144 (50.7%) standardized whole body CT (SWBCT). DAP values were below national reference levels. Median DLP and effective dose were 2396 mGycm and 20.42 mSv for all CT examinations, and 2461 mGycm (national diagnostic reference level 2400) and 22.29 mSv for a SWBCT.

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Endoscopist’s occupational dose evaluation related to correct wearing of dosimeter during X-ray-guided procedures

Endoscopy International Open ◽

10.1055/a-0876-6448 ◽

2019 ◽

Vol 07 (03) ◽

pp. C1-C1

Author(s):

Roberta Gerasia ◽

Dario Ligresti ◽

Fabio Cipolletta ◽

Antonino Granata ◽

Ilaria Tarantino ◽

...

Keyword(s):

X Ray ◽

Dose Evaluation ◽

Occupational Dose

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KOMBINASI PENAMBAHAN SHIELDING TIMBAL MESIN FLUOROSCOPY BAGASI DAN PENGATURAN JARAK PEKERJA TERHADAP SUMBER RADIASI MENURUNKAN PAPARAN RADIASI SINAR X DAN KELELAHAN MATA PADA PEKERJA SCREENING DI BANDARA INTERNASIONAL X

Jurnal Ergonomi Indonesia (The Indonesian Journal of Ergonomic) ◽

10.24843/jei.2018.v04.i01.p01 ◽

2018 ◽

Vol 4 (1) ◽

Author(s):

Maghfirotul Iffah ◽

I Putu Gede Adiatmika ◽

I Wayan Bandem Adnyana ◽

I Dewa Putu Sutjana ◽

I Made Muliarta ◽

...

Keyword(s):

Radiation Exposure ◽

Radiation Source ◽

Additional Treatment ◽

Control Group ◽

Control Group Design ◽

X Ray ◽

Post Test ◽

Lead Shielding ◽

Group 2 ◽

Working Distance

Screening is ordinary process airport passanger was machine baggage. X-ray radiation gives impact to eye because eye sensitive of radiation. Many kinds of eye strain symptom got by screening worker such eye poignant. It is neressary to give intervention to decrease the radiation exposure and eye strain for worker by increasing lead shielding on the fluoroscopy machine baggage and setting of worker distance toward the source of radiation. Experimental research with pre-post test control group design. A sampel of 30 people were taken with a simple randomized method which was subdivided into group 1 as a control group without the additional treatment of lead shielding and working distance regulation of the radiation source, group 2 with the addition of a shielding and setting distance as far as 2 m. the study was conducted in August 2017. The variables evaluated were exposure to the received radiation of workes and the strain of the workers eyes. The result of the research is a combination of lead shielding on machine baggage fluoroscopy and setting of working distance to X ray source at X International Ariport significantly (p<0,05) in decreasing radiation exposure received by worker equal to 74,59% and worker eye strain 68,85% for a distance of 1,5 m and decreased radiation exposure to the workers as much as 93, 69% and the eye strain on the worker 89,79% at a distance of 2 m from the radiation source. Concluded that the combination of increasing lead shielding and the setting of worker distance toward the source of radiation decrease thr radiation exposure and eye strain on the screening worker at X International airport.

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THE ERGONOMIC ELDERLY GYM IMPROVING PHYSICAL FITNESS AND INCREASING THE BONE MASS OF THE ELDERLY

International Journal of Industrial Engineering and Engineering Management ◽

10.24002/ijieem.v1i2.2998 ◽

2020 ◽

Vol 1 (2) ◽

pp. 1

Author(s):

N.N. Ariati ◽

N. Adiputra ◽

K. Tirtayasa ◽

I.P.G. Adiatmika ◽

A. Pangkahila ◽

...

Keyword(s):

Bone Mass ◽

Physical Fitness ◽

The Elderly ◽

T Test ◽

Wilcoxon Test ◽

Whole Body ◽

Distribution Data ◽

Paired Sample ◽

Significant Difference ◽

The Difference

The public is increasingly aware of the importance of exercise for the elderly because exercise is an option to reduce complaints due to setbacks and improve the health of the elderly. In fact the implementation in the field is often wrong as in Banjar Benaya which implements routine exercises only once a week with a duration less than 30 minutes, does not pay attention to nutritional needs, does not use sports clothing, and displays that are not clear. The measurement of elderly physical fitness is still relatively low. Based on these problems, improvements were made to the application of ergonomic elderly gymnastics due to improve elderly’s physical fitness and increase the bone mass. This study used a treatment by subject design conducted in April 2017-August 2018. The target population was all elderly in Denpasar and the affordable population was determined by multistage random sampling then selected Banjaya Benaya Peguyangan Village with a sample of 20 people who met the inclusion criteria. The data collection were physical fitness and bone mass. The difference in treatment effects were analyzed using a Paired Sample t-Test with α = 0.05 for data with normal distribution and Wilcoxon test, α = 0.05 for data with abnormal distribution. Data showed that there were differences in physical fitness improvement in Period I and Period II after 8 weeks of gymnastics at 43.43% with very bad categories being bad, the difference in increase in whole body bone mass was 16.76% and leg bone mass 68.67%. Analysis of Paired Sample-t-Test physical fitness data and Wilcoxon test for bone mass data in Period I and Period II after gymnastics for 8 weeks, found that there was a significant difference (p <0.05). It can be concluded that ergonomic elderly gym can significantly improve physical fitness and increase bone mass of the elderly. It is recommended that the elderly continue to exercise with a duration of 30-45 minutes, the frequency of 3 times a week to maintain elderly’s physical fitness.

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Low Bone Mass and Osteoporosis in Women Referring themselves to Dual X-Ray Absorptiometry - Experience with a Health Promotion Action

The Open Epidemiology Journal ◽

10.2174/1874297101003010029 ◽

2010 ◽

Vol 3 (1) ◽

pp. 29-33

Author(s):

Gerhard W. Goerres ◽

Jaap Swanenburg ◽

Daniel Uebelhart

Keyword(s):

Health Promotion ◽

Bone Mass ◽

The Self ◽

Low Bone Mass ◽

X Ray ◽

Female Patients ◽

Bmd Testing ◽

Significant Difference ◽

The Difference ◽

Prevalence Of Osteoporosis

Aims: This retrospective analysis was done to describe the difference in the prevalence of osteoporosis/low bone mass between women referring themselves to bone mineral density (BMD) testing with dual X-ray absorptiometry (DXA) and women referred by their family practitioner. Methods: Women were recruited by a health promotion action in a Swiss weekly periodical and compared with female patients sent by their physician for DXA testing for various medical indications during the same period. Patients under steroid treatment, known previous fracture and undergoing follow-up for low bone mass were excluded. Self referred women were compared to female patients aged 40 years and older and the same evaluation was repeated for women aged 65 and older. Results: No differences were found in the prevalence of osteoporosis /low bone mass in women referred by their physician vs those who were self referred. However, a significant difference was found with age: the self referred women were 63.1 ± 8.6 years of age whereas the patient group’s mean age was 59.7 ± 9.4 (p=0.0001, 95% CI of the difference: 21 – 61 years). Conclusion: We suggest that health promotion actions might be able to recruit the correct candidates for BMD testing, since we found no significant difference in the prevalence of osteoporosis/ low bone mass between self referred and physician referred women. Our data further suggest that physicians may react earlier on their patient’s risk profiles than the time frame of action by the self-referred women.

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In vivo validation of whole body composition estimates from dual-energy X-ray absorptiometry

Journal of Applied Physiology ◽

10.1152/jappl.1997.83.2.623 ◽

1997 ◽

Vol 83 (2) ◽

pp. 623-630 ◽

Cited By ~ 173

Author(s):

Barry M. Prior ◽

Kirk J. Cureton ◽

Christopher M. Modlesky ◽

Ellen M. Evans ◽

Mark A. Sloniger ◽

...

Keyword(s):

Body Composition ◽

Dual Energy ◽

Component Model ◽

Whole Body ◽

Body Density ◽

X Ray ◽

Athletic Status ◽

Musculoskeletal Development ◽

Four Component Model ◽

The Difference

Prior, Barry M., Kirk J. Cureton, Christopher M. Modlesky, Ellen M. Evans, Mark A. Sloniger, Michael Saunders, and Richard D. Lewis. In vivo validation of whole body composition estimates from dual-energy X-ray absorptiometry. J. Appl. Physiol. 83(2): 623–630, 1997.—We validated whole body composition estimates from dual-energy X-ray absorptiometry (DEXA) against estimates from a four-component model to determine whether accuracy is affected by gender, race, athletic status, or musculoskeletal development in young adults. Measurements of body density by hydrostatic weighing, body water by deuterium dilution, and bone mineral by whole body DEXA were obtained in 172 young men ( n = 91) and women ( n = 81). Estimates of body fat (%Fat) from DEXA (%FatDEXA) were highly correlated with estimates of body fat from the four-component model [body density, total body water, and total body mineral (%Fatd,w,m); r = 0.94, standard error of the estimante (SEE) = 2.8% body mass (BM)] with no significant difference between methods [mean of the difference ± SD of the difference = −0.4 ± 2.9 (SD) % BM, P = 0.10] in women and men. On the basis of the comparison with %Fatd,w,m, estimates of %FatDEXA were slightly more accurate than those from body density ( r = 0.91, SEE = 3.4%; mean of the difference ± SD of the difference = −1.2 ± 3.4% BM). Differences between %FatDEXA and %Fatd,w,m were weakly related to body thickness, as reflected by BMI ( r= −0.34), and to the percentage of water in the fat-free mass ( r = −0.51), but were not affected by race, athletic status, or musculoskeletal development. We conclude that body composition estimates from DEXA are accurate compared with those from a four-component model in young adults who vary in gender, race, athletic status, body size, musculoskeletal development, and body fatness.

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Objective Quantification of Trochlea Dysplasia: Assessment of Morphology Difference Between Control and Chronic Patellofemoral Instability Patients

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967117s00139 ◽

2017 ◽

Vol 5 (4_suppl4) ◽

pp. 2325967117S0013

Author(s):

Andreas Voss ◽

Andrea Achtnich ◽

Shin Sanghin ◽

Akin M. Murakami ◽

Cory Edgar

Keyword(s):

Trochlear Dysplasia ◽

Patellofemoral Instability ◽

Volumetric Analysis ◽

Patella Instability ◽

Control Cohort ◽

X Ray ◽

Significant Difference ◽

Trochlea Dysplasia ◽

The Difference ◽

Gender Based

Aims and Objectives: Trochlear dysplasia is an important risk factor associated with patellofemoral instability, but it remains difficult to classify with consistency. Currently there is no objective way to quantify the dysplasia. The purpose of this study to define and quantify objectively the trochlea morphology by volume and length via computed tomography (CT). Hypothesis: A significant difference in trochlea groove volume and length is present within a cohort of patients with recurrent patellofemoral instability if compared to a control cohort of similar patients. Materials and Methods: One-hundred control patients (136 knees) were retrospectively reviewed and compared to 36 consecutive patients (72 knees) who were treated surgically for recurrent patella instability and known trochlea dysplasia based on a lateral x-ray. Trochlea morphology was analyzed from a pre-operative CT and data presented as trochlear sulcus volume trochlea length. To determine where along the trochlea length dysplasia is most variable, the trochlea length was radiographically divided into thirds, volume was quantified along that section and compared to control trochlea. Results: A significant difference in trochlea morphology exists between cohorts, volume (1.98 vs 3.77 cm3) and length (31.97 vs 34.66 mm). However, there appears to be a gender based difference in trochlea morphology. The trochlea volumetric analysis between the female cohorts (L: 2.02 cm3 vs. 2.94 cm3, R: 1.95 cm3 vs. 2.93 cm3) demonstrated significant less volume in instability patients (p<0.001). The proximal 30% of trochlea contributed the majority of dysplasia difference determined by comparing mean trochlea volume, 95% of the difference. This difference decreased in distal sections, 53% and 32% respectively. The total trochlea length did not appear to be significant (L: p=0.858, R: p=0.913). It appears dysplasia alone may not directly lead to symptoms demonstrated by trochlea volumetric comparisons within symptomatic recurrent patella instability and contralateral asymptomatic patella (p=0.274). Conclusion: The authors believe this reproducible technique can be used to quantify the trochlea morphology into measurements to be used describing the severity of the dysplasia. The data confirms that symptomatic trochlea dysplasia is a “proximal” process affecting early knee flexion contact between patella and trochlea.

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