Dental Radiological Practice in Trinidad and Tobago: A Pilot Project

OBJECTIVE: The aim of this study was to identify the current standards of radiologic practice in Trinidad and Tobago in relation to international ionizing radiation regulations with respect to dentistry. MATERIALS AND METHODS: A 32-point questionnaire that was previously tested was administered to 55 dentists who practice in different regions of Trinidad. The survey aimed to gather information on demographic factors, types of radiographic equipment, techniques and processing and radiation protection measures. RESULTS: The majority of dentists (61.8%) were not aware of the technical details of their equipment. Thirty- three dentists did not know the kVp of their machines and 17 dentists were not aware of the intraoral film speed that they utilize. Of the respondents, 85.5% used rounded collimators. The most common technique for periapical radiography was the paralleling technique (64%). Many respondents own panoramic X-ray units, but the majority of them (90.9%) did not take panoramic radiographs on all patients regardless of the dentists working environment. This was proven to be statistically significant (P<0.05). All dentists reportedly used some form of radiation protection, but only 8 respondents properly disposed of their radiographic waste by incineration. Lead aprons were utilized by 65.5% of respondents. CONCLUSION: The results of this study indicate that current radiological practices utilized by dentists in Trinidad and Tobago need improvement in some areas and there is a dire need for the development of national ionizing radiation guidelines specific to dentistry if best practice is to be maintained.

A Descriptive study of the family physicians' use of radiology in Barbados - abstract

A descriptive study of family physicians' use of radiology in Barbados was carried out. This study examined a total of 691 X-rays, a 10 percent systematic sample of X-rays in chronological order that were done on referral from primary care physicians in 1992 by the Queen Elizabeth Hospital's X-ray Department. Of the 691 X-rays evaluated at the Queen Elizabeth Hospital, 90.5 percent were of 6 types ( chest - 21.9 percent, lower extremity - 18.5 percent, upper extremity - 14.6 percent, contrast - 13.9 percent, spine - 11.1 percent, and head 10.9 percent). For all types of X-rays females were X-rayed more than males (overall 52.2 percent vs 40.1 percent, with no data on 3.8 percent). Forty-two percent (42.8 percent) of X-rays were abnormal, with X-rays of the spine most likely to be abnormal (66.2 percent) and mammogram (9.4 percent) least likely. No seasonal pattern of X-ray use was detected. Public sector referrals were responsible for 78.9 percent of X-rays and the private sector for 21.1 percent. These two sectors of primary care showed similarities in the frequencies of X-ray requests, by gender and result. For private sector referrals, 56.8 percent of patients were over 50 years of age compared to 26.2 percent for public sector referrals. Twenty percent (19.9 percent) of chest X-rays were requested to screen the patient, with 93.3 percent of these being normal, while of the 80.1 percent requested for other reasons 52.1 percent were normal. Most mammograms (62.5 percent) were requested on women under 50 years of age. For barium meals, 58.6 percent were done on patients over 50 years of age, and these showed a greater percentage of abnormal results than those done on patients under 50 years of age. This study provides a foundation on which further investigations of family physicians' use of radiology services can be based (AU)

Rontgenpatologi i Vastindien / Roentgen pathology in the West Indies

Roentgen pathology in Jamaica includes, inter alia, skeletal changes caused by avitaminoses, infectious diseases such as syphillis or tuberculosis, and sickle cell anemia. This form of anaemia may produce also renal papillary necrosis. Worm infection with stronglyoides stercoralis causes extensive inflammatory changes in the small bowel. Malformations of the urinary tract and bones are relatively common. (AU)

Geographical studies on rheumatoid arthritis

The prevalence of rheumatoid arthritis has been compared in eight population samples in America and Europe, in which routine x rays were taken of the hands and feet. All the x rays were read by one observer. No relationship to lattitude was discovered. The prevalence of "definite" arthritis was not significantly different in the three racial groups included in these surveys, but "probable" disease was more common in the Negro population in Jamaica than in the Amerindians or Caucasians. Radiological evidence of erosive arthritis was more frequent in the Jamaican than in the Amerindian, and the Amerindian than the Caucasian. Serological tests for rheumatoid factor were more often positive in the Amerindian and erosive changes more severe. The implications of these findings are discussed.(Summary)

Veno-occlusive disease of the liver: surgical aspects

Veno-occlusive disease of the liver is a recently established disease entity. Its etiology, pathology, and symptomatology, and natural history are discussed on the basis of 99 cases of this disease so far authenticated at the University College of the West Indies. In the surgical literature the disease is added to the list of causes of intra-hepatic portal hypertension, and the cases of 4 patients are presented in detail in whom portacaval anastomoses were performed for the decompression of esophageal varices. The surgical implications of this disease have been stated and some of the difficulties enountered in the treatment of portal hypertension in infants and children outlined (Summary)

Studies of pulmonary alveolar microlithiasis and pulmonary alveolar proteinosis

A case of pulmonary alveolar microlithiasis and a case of pulmonary alveolar proteinosis in West Indian patients are described. A course of therapy with a chelating agent produced no roentgenologic improvement in alveolar microlithiasis. The pathology of these diseases is briefly reviewed, and the possible interrelations of pulmonary alveolar microlithiasis, pulmonary alveolar proteinosis, and pulmonary corpora amylacea are discussed (Summary)