Radiation Risk Assessment in Patients for Chest CT Diagnostics of COVID-19

2021 ◽  
Vol 66 (2) ◽  
pp. 59-66
Author(s):  
E. Matkevich
Keyword(s):  
Older Persons ◽  
Radiation Risk ◽  
Chest Ct ◽  
Risk Indicators ◽  
Radiation Doses ◽  
Diagnostic Center ◽  
Adolescents And Adults ◽  
Male Patients ◽  
Effective Radiation

Purpose: To assess effective radiation doses for chest CT for the diagnosis of COVID-19 and calculate the radiation risk of the effects of this exposure. Material and methods: We analyzed the results of 1003 CT examinations of the chest performed in patients (6.2 %‒children 12–14 years, 15.3 %‒adolescents 15–19 years, 60.1 %‒adults 20–64 years, 18.4 %‒older persons 65 years and older) with suspected COVID-19 during one week in October 2020 in the city diagnostic center. In each group, the average effective dose (ED, mSv) was calculated. Results: The average ED values and confidence intervals (P=0.05) for patients with a single CT scan were: in children 2.59±0.19 mSv, in adolescents 3.23±0.17 mSv, in adults 3.43±0.08 mSv, in older persons 3.28±0.19 mSv. The maximum radiation risk indicators were observed in groups of children (24.1×10-5) and adolescents (23.3×10-5). For adult patients the means risk was 14.4×10-5. In groups of women radiation risk was 1.3–2.3 twice as high, as in male patients. The risk values in children, adolescents and adults are in the range 10×10-5 – 100×10-5 (low), for the older patients were 2.6×10-5 (very low). Conclusion: Because of the study established effective radiation doses for chest CT of patients with the diagnosis of COVID-19 and the radiation risk for 1-3 times chest CT by age and sex of patients was calculated. It was found that the radiation risk for single, double and triple chest CT for patients under 65 is low, 65 and older is very low. Taking into account the radiation risk during CT is necessary to reduce the long-term consequences of radiation exposure on the population.

scholarly journals Radiation Doses and Risk Assessment during Computed Tomography of the Chest in COVID-19 Patients

2021 ◽  
Author(s):  
Elena Ivanovna Matkevich ◽  
Ivan Vasilievich Ivanov
Keyword(s):  
Radiation Risk ◽  
Age Groups ◽  
Chest Ct ◽  
Radiation Doses ◽  
Diagnostic Center ◽  
Carcinogenic Effects ◽  
Long Term Consequences ◽  
Effective Radiation ◽  
The City

Accounting for the effective dose (ED, mSv) and calculating the radiation risk during CT is necessary to predict the long-term consequences of radiation exposure on the population. We analyzed the results of 1003 CT examinations of the chest in patients with suspected COVID-19 in the city diagnostic center. The average ED and confidence intervals (p ≤ 0.05) for patients with a single CT scan were: children (12–14 years) 2.59 ± 0.19 mSv, adolescents (15–19 years) 3.23 ± 0.17 mSv, adults (20–64 years), 3.43 ± 0.08 mSv, older persons (65 years and older) 3.28 ± 0.19 mSv. The maximum radiation risk values were 31.2*10–5 in women children and 29.3*10–5 in women adolescents, which exceeds the risk values for men in these age groups by 2.3 and 1.9 times, respectively. For the group of adult patients the risk was 11.2*10–5 in men and 17.4*10–5 in women, which is 1.6 times higher than in men. All these risk values are in the range of 10*10–5–100*10–5, which corresponds to the level LOW. For the group of older age patients, the radiation risk was 2.6*10–5, which corresponds to the level of 1*10–5–10*10–5, VERY LOW. Our materials shows in detail the technique to evaluate effective radiation doses for chest CT and calculate the radiation risk of the carcinogenic effects of this exposure.

Radiopharmacology: Hazard or/and Benefit

1984 ◽  
Vol 23 (02) ◽  
pp. 87-91 ◽  
Author(s):  
K. Flemming
Keyword(s):  
Ionizing Radiation ◽  
Late Effects ◽  
Radiation Risk ◽  
Dose Effect ◽  
Radiation Hazard ◽  
Radiation Doses ◽  
Low Doses ◽  
Medical Radiology ◽  
Experimental Findings ◽  
In The Beginning

SummaryIn the beginning of medical radiology, only the benefit of ionizing radiation was obvious, and radiation was handled and applied generously. After late effects had become known, the radiation exposure was reduced to doses following which no such effects were found. Thus, it was assumed that one could obtain an optimal medical benefit without inducing any hazard. Later, due to experimental findings, hypotheses arose (linear dose-effect response, no time factor) which led to the opinion that even low and lowest radiation doses were relevant for the induction of late effects. A radiation fear grew, which was unintentionally strengthened by radiation protection decrees: even for low doses a radiation risk could be calculated. Therefore, it was believed that there could still exist a radiation hazard, and the radiation benefit remained in question. If, however, all presently known facts are considered, one must conclude that large radiation doses are hazardous and low doses are inefficient, whereas lowest doses have a biopositive effect. Ionizing radiation, therefore, may cause both, hazard as well as benefit. Which of the two effects prevails is determined by the level of dose.

Radiation Minimisation and Outcome Maximisation in Cardiac Computed Tomograpy

2010 ◽  
Vol 6 (1) ◽  
pp. 15
Author(s):  
James P Earls ◽  
Jonathon A Leipsic ◽  
◽  
Keyword(s):  
Radiation Dose ◽  
Dose Reduction ◽  
New Technologies ◽  
Cardiac Computed Tomography ◽  
Substantial Reduction ◽  
Radiation Doses ◽  
Tube Current ◽  
Prospective Triggering ◽  
Effective Radiation ◽  
Selection Of

Recent reports have raised general awareness that cardiac computed tomography (CT) has the potential for relatively high effective radiation doses. While the actual amount of risk this poses to the patient is controversial, the increasing concern has led to a great deal of research on new CT techniques capable of imaging the heart at substantially lower radiation doses than was available only a few years ago. Methods of dose reduction include optimised selection of user-defined parameters, such as tube current and voltage, as well as use of new technologies, such as prospective triggering and iterative reconstruction. These techniques have each been shown to lead to substantial reduction in radiation dose without loss of diagnostic accuracy. This article will review the most frequently used and widely available methods for radiation dose reduction in cardiac CT and give practical advice on their use and limitations.

Physical activity and cognitive function in older persons

2016 ◽  
Vol 64 (2) ◽  
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Executive Functions ◽  
Cognitive Aging ◽  
Clinical Studies ◽  
Older Persons ◽  
Positive Effects ◽  
Critical Challenge

Strategies to improve cognitive aging are highly needed. Among those, promotion of exercise and physical activity appears as one of the most attractive and beneficial intervention. Indeed, results from basic and clinical studies suggest that exercise and physical activity have positive effects on cognition in older persons without cognitive impairment, as well as in those with dementia. Despite inconsistent results, aerobic exercise appears to have the strongest potential to enhance cognition. However, even limited periods of walking (45 minutes, three times a week, over a 6-month period) have also been shown to enhance cognition, particularly executive functions. Changing long-term lifestyle habits in these older persons remains a critical challenge and attractive programs susceptible to gain adherence are needed to succeed in achieving improved cognitive aging.

scholarly journals Long-Term Results of a Standard Algorithm for Intravenous Port Implantation

2021 ◽  
Vol 11 (5) ◽  
pp. 344
Author(s):  
Ching-Feng Wu ◽  
Jui-Ying Fu ◽  
Chi-Tsung Wen ◽  
Chien-Hung Chiu ◽  
Ming-Ju Hsieh ◽  
...  
Keyword(s):  
Operative Time ◽  
Functional Results ◽  
Long Term Results ◽  
Related Complication ◽  
Standard Algorithm ◽  
Port Implantation ◽  
Male Patients ◽  
Catheter Fracture ◽  
Guided Puncture

Intravenous ports serve as vascular access and are indispensable in cancer treatment. Most studies are not based on a systematic and standardized approach. Hence, the aim of this study was to demonstrate long-term results of port implantation following a standard algorithm. A total of 2950 patients who underwent intravenous port implantation between March 2012 and December 2018 were included. Data of patients managed following a standard algorithm were analyzed for safety and long-term outcomes. The cephalic vein was the predominant choice of entry vessel. In female patients, wire assistance without use of puncture sheath was less likely and echo-guided puncture via internal jugular vein (IJV) with use of puncture sheath was more likely to be performed, compared to male patients (p < 0.0001). The procedure-related complication rate was 0.07%, and no pneumothorax, hematoma, catheter kinking, catheter fracture, or pocket erosion was reported. Catheter implantations by echo-guided puncture via IJV notably declined from 4.67% to 0.99% (p = 0.027). Mean operative time gradually declined from 37.88 min in 2012 to 23.20 min in 2018. The proposed standard algorithm for port implantation reduced the need for IJV echo-guided approach and eliminated procedure-related catastrophic complications. In addition, it shortened operative time and demonstrated good functional results.

scholarly journals Magnesium and Hypertension in Old Age

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 139 ◽  
Author(s):  
Ligia J. Dominguez ◽  
Nicola Veronese ◽  
Mario Barbagallo
Keyword(s):  
Older Persons ◽  
Magnesium Deficiency ◽  
Favorable Effect ◽  
Processed Food ◽  
Negative Consequences ◽  
Magnesium Supplementation ◽  
Cerebrovascular Complications ◽  
Close Relationship ◽  
Causes Of Mortality

Hypertension is a complex condition in which various actors and mechanisms combine, resulting in cardiovascular and cerebrovascular complications that today represent the most frequent causes of mortality, morbidity, disability, and health expenses worldwide. In the last decades, there has been an exceptional amount of experimental, epidemiological, and clinical studies confirming a close relationship between magnesium deficit and high blood pressure. Multiple mechanisms may help to explain the bulk of evidence supporting a protective effect of magnesium against hypertension and its complications. Hypertension increases sharply with advancing age, hence older persons are those most affected by its negative consequences. They are also more frequently at risk of magnesium deficiency by multiple mechanisms, which may, at least in part, explain the higher frequency of hypertension and its long-term complications. The evidence for a favorable effect of magnesium on hypertension risk emphasizes the importance of broadly encouraging the intake of foods such as vegetables, nuts, whole cereals and legumes, optimal dietary sources of magnesium, avoiding processed food, which are very poor in magnesium and other fundamental nutrients, in order to prevent hypertension. In some cases, when diet is not enough to maintain an adequate magnesium status, magnesium supplementation may be of benefit and has been shown to be well tolerated.

Influence of Sex on Outcomes After Thoracic Endovascular Repair for Type B Aortic Dissection

Angiology ◽  
2021 ◽  
pp. 000331972098795
Author(s):  
Songyuan Luo ◽  
Yi Zhu ◽  
Enmin Xie ◽  
Huanyu Ding ◽  
Fan Yang ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Landing Zone ◽  
End Point ◽  
Male Patients ◽  
Long Term Mortality

We aimed to investigate whether sex differences influence the clinical outcomes of patients who undergo thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD). We retrospectively analyzed a prospectively maintained single-center cohort of patients with TBAD who underwent TEVAR between January 2010 and June 2017. We evaluated the in-hospital and long-term mortality and composite end point. Of the 913 patients, 793 (86.8%) were male and 120 (13.1%) were female. Compared to male patients, the female patients were older, more likely to have diabetes mellitus, but less likely to smoke or have hypertension. The proximal landing zone in 0 and 1 was higher in male patients ( P = .023), who were more likely to require an aortic arch bypass. Endoleak, delirium, and ICU stay after stent-graft implantation were also more frequent in men. Sex factor was not associated with in-hospital or long-term mortality or the composite end point in the multivariable regression analyses and Cox regression model. The mean estimated survival time was similar between males and females (2462.9 ± 141.2 vs 2804.1 ± 117.4 days, P = .167) in the propensity score–matched cohort. Despite distinct characteristics between sex, there was no sex-related difference in long-term clinical outcomes after TEVAR for TBAD.

Addressing Communication Breakdowns during Emergency Care Transitions of Older Adults: Evaluation of a Standardized Inter-Facility Health Care Communication Form

2021 ◽  
pp. 1-11
Author(s):  
Patrick McLane ◽  
Kaitlyn Tate ◽  
R. Colin Reid ◽  
Brian H. Rowe ◽  
Carole Estabrooks ◽  
...  
Keyword(s):  
Older Persons ◽  
Chart Review ◽  
Care Transitions ◽  
Unintended Consequences ◽  
Term Care ◽  
Usual Practice ◽  
Improvement Programs ◽  
Quality Improvement Programs ◽  
Communication Breakdowns

Abstract Transitions for older persons from long-term care (LTC) to the emergency department (ED) and back, can result in adverse events. Effective communication among care settings is required to ensure continuity of care. We implemented a standardized form for improving consistency of documentation during LTC to ED transitions of residents 65 years of age or older, via emergency medical services (EMS), and back. Data on form use and form completion were collected through chart review. Practitioners’ perspectives were collected using surveys. The form was used in 90/244 (37%) LTC to ED transitions, with large variation in data element completion. EMS and ED reported improved identification of resident information. LTC personnel preferred usual practice to the new form and twice reported prioritizing form completion before calling 911. To minimize risk of harmful unintended consequences, communication forms should be implemented as part of broader quality improvement programs, rather than as stand-alone interventions.

scholarly journals Psoas Muscle Density Evaluated by Chest CT and Long-Term Mortality in COPD Patients

2021 ◽  
Author(s):  
Ana Ezponda ◽  
Ciro Casanova ◽  
Carlos Cabrera ◽  
Ángela Martin-Palmero ◽  
Marta Marín ◽  
...  
Keyword(s):  
Psoas Muscle ◽  
Chest Ct ◽  
Muscle Density ◽  
Copd Patients ◽  
Long Term Mortality
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