Analysis of patient medical exposure in X-ray diagnostics in Russia for half a century (1970–2019)

During last 50 years, firstly in the RSFSR in the USSR (1970-80), then in the Russian Federation - RF (1990-2019), the authors studied the radiation safety issues of patients from medical exposure. The reader is offered a complex radiation-hygienic analysis of the 50-year medical exposure of patients and of the population in Russia to inform and analyze the available data on the most common type of use of ionizing radiation sources in the national economy. For a half century, several generations of people have changed and medical diagnostic X-ray equipment and technologies have also radically changed. The information from this article was obtained on the basis of radiation-hygienic statistics, as well as considered our research. The data is presented at the federal level in the form of the volume of research carried out- determined by the number of X-ray procedures, as well as the level of medical exposure in the form of effective dose of patients in Russia - a huge region with a population of about 150 million people, where about 200 million X-Ray procedures were performed annually, i.e. about 10 billion X-Ray procedures for the entire observation period. During the study, a collective effective dose was - 6.5 million person-Sv at the rate of 100 thousand person-Sv and more per year. The paper presents the dynamics and the structure of the studied indicators depending on the type of medical exposure, as well as its localization. The contribution of the X-ray diagnostics to the total volume of radiation diagnostics, which is developing dynamically, is presented. It was found that throughout the study, there were two oppositely directed processes: an increase in the number of X-Ray procedures and a decrease in the effective doses of patients. At present, the minimum dose has been reached, after that it has been increasing began, associated with the use of new computer technologies. It was determined that, depending on the localization, the main radiation load during X-ray procedures falls on the skeleton and digestive organs. It is shown that during the study period (in 1986) there was an accident at the Chernobyl, which significantly affected on medical activities and, in particular, X-ray diagnostic indicators. The paper shows the consequences of these situations. In general, the data presented is huge in volume and significant in information content. The information obtained on the basis of such a unique data is representative and allows, firstly, to analytically study the issues of radiation protection of patients and, secondly, to plan the strategy and tactics of its development.

Transmission of NDM-5-Producing and OXA-48-Producing Escherichia coli Sequence Type 648 by International Visitors without Previous Medical Exposure

Although patients with history of international hospitalization are often subject to screening for multidrug-resistant organisms, it is unclear whether patients who reside in countries where carbapenemase-producing Enterobacterales (CPE) is endemic but have no history of local hospitalization contribute to the transmission of CPE. In this study, NDM-5-producing and OXA-48-producing Escherichia coli sequence type (ST) 648, a recently recognized high-risk, multidrug-resistant clone, were detected from two overseas visitors without previous medical exposure.

A look at the problem of exposure of the population caused by X-ray diagnostics: approaches to analysis and forecasting

The article is devoted to the analysis of limitation of dose load on the population as a result of radiological researches. It is especially actual and represents rather high scientific and practical interest. In this regard, it is very important to have information about the state of the dose load of the population in separate regions and to rank types of diagnostics by the amount of their contribution to the total dose of medical exposure. The aim of the work was to study the state of dose load of the population of Zaporizhzhia region due to X-ray diagnostics, to develop approaches to analysis and forecasting regarding its limitation. Analytical, statistical calculation and logical generalization methods were used in the course of the work. We used the results of studies carried out in accordance with the regional “Program for the Protection of the Population of Zaporizhzhia Region from the Effect of Ionizing Radiation. The authors analyzed scientific publications (15 sources), including 9 Ukrainian and 6 foreign on the relevance of the problem of exposure of the population caused by X-ray diagnostics. The analysis of the results allowed to determine that in 2010-2014 the radiation dose of the population of Zaporizhzhia region due to X-ray diagnostics averaged 0.92 mSv year-1, in 2015-2016 the dose increased and amounted to 0.96 mSv year-1. The proposed approach to the analysis makes it possible to summarize and model data on radiological studies of the population over a long period of time, to identify persistent trends in the contribution of different types of radiation diagnostics to the dose of medical radiation. All this is necessary for the development, first of all, of measures to reduce the frequency of radiography, its replacement by other diagnostic methods. Priority tasks aimed at reducing the dose load of the population due to X-ray examinations are proposed.

General radiographic patient dose monitoring using conformity test data

Currently, the Nuclear Energy Supervisory Agency (BAPETEN) is actively guiding users or license holders related to patient protection against radiation hazards or often referred to as radiation protection and safety on medical exposure. Protection against medical exposure became a big issue when the mandatory compliance test on X-ray equipment for diagnostic and interventional radiology was introduced. In addition, license holders through their medical practitioners are also required to use the level of medical exposure guidelines. While PERKA BAPETEN No. 9, 2011 concerning the Suitability Test of Diagnostic and Interventional Radiology X-Ray device, states that one of the test parameters that directly affect the patient's radiation dose and determine the feasibility of operating the X-Ray device to the patient is information on the dose or rate of radiation dose received by the patient. Monitoring doses with Entrance Surface Air Kerma (ESAK) or what is often referred to as ESD (entrance surface dose) using suitability conformity test data starting from 50,60,70,80,90 and 100 kVp with 20 mAs at SID 100 meters. The results of the research on the value of ESAK was 0.049 mGy, an ESAK value that still met the national I-DRL value from BAPETEN Regulation No. 1211/K/V/2021.

Previous Military Medical Exposure as a Motivator for a Medical Career

ABSTRACT Introduction A variety of factors influence the motivation to choose a medical career; however, the influence of premedical experiences on health professional trainees’ choices is a neglected one. We hypothesize that medical exposure during service in the Israeli Air Force special operations forces (SOFs) has an impact on motivation for medical studies. The Israeli scenario, in which career choice is anteceded by substantial military experience, allows us to examine this hypothesis. Materials and Methods We conducted a retrospective cohort study among physicians and medical students who served as operators in the Israeli Air Force SOF; Unit 669 (an airborne combat search and rescue unit), and Shaldag (an airborne SOF unit). All medical students and physicians enlisted between January 2001 and December 2010 were eligible for enrollment. Results Of over 700 operators screened, 3.7% of Shaldag veterans and 11.1% of Unit 669 veterans had started or finished medical school (P-value < 0.001). Overall, 49 veterans answered the questionnaire and enrolled in the study, of whom 17 (34.7%) were Shaldag veterans and 32 (65.3%) were Unit 669 veterans. Subjective questions implied a significant effect of the service in Unit 669 on career choice. Paramedics had a relative risk of becoming physicians of 7.37 when compared to nonparamedic operators, irrespective of their original unit. Conclusions Medical exposure of Unit 669 operators during military service significantly contributed to their motivation for becoming physicians. Thus, military service in this setting acts de facto as an effective medical immersion program. This adds another factor to the myriad of factors that motivate young adults in their choice of a medical career.

Pediatric Regional Drl Assessment in Common Ct Examinations For Medical Exposure Optimization in Tehran, Iran

The main purpose of this pilot study was to assess the regional diagnostic reference level (RDRL) of computed tomography (CT) examinations to optimise medical exposure in five pediatric medical imaging centers in Tehran, Iran where the most frequent CT examinations were investigated. For each patient, CT volume dose indexes (CTDIvol) and dose length product (DLP) in each group were recorded and their third quartile was calculated and set as RDRL. Pediatrics were divided into four age groups (<1; 1–5; 5–10 and 10–15 years). Then, the third quartile values for head, chest and abdomen-pelvic CTs were, respectively, calculated for each group in terms of CTDIvol: 21.3, 24.4, 24.2 and 36.3 mGy; 2.9, 3.2, 3.7 and 5.7 mGy; 3.7, 5.7, 6.3 and 6.8 mGy; and in terms of DLP: 322.2, 390.1, 424.9 and 694.1 mGy.cm; 53.1, 115.2, 145.3 and 167.6 mGy.cm and 128.7, 317.7, 460.2 and 813.8 mGy.cm. Finally, RDRLs were compared with other countries and preceding data in Iran. As a result, CTDIVOL values were lower than other national and international studies except for chest and abdomen-pelvic values obtained in Europe. Moreover, this matter applied to DLP so that other formerly reported values were higher than the present study but European values for chest and abdomen-pelvic scans and also Tehran studies conducted in 2012. Variation of scan parameters (tube voltage (kVp), tube current (mAs) and scan length), CTDIvol and DLP of different procedures among different age groups were statistically significant (P-value < 0.05). The variations in dose between CT departments as well as between identical scanners suggest a large potential for optimization of examinations relative to which this study provides helpful data.