The future point-of-care detection of disease and its data capture and handling.

Point-of-care detection is a widely studied area that attracts effort and interest from a large number of fields and companies. However, there is also increased interest from the general public in this type of device, which has driven enormous changes in the design and conception of these developments and the way data is handled. Therefore, future point-of-care detection has to include communication with front-end technology, such as smartphones and networks, automation of manufacture, and the incorporation of concepts like the Internet of Things (IoT) and cloud computing. Three key examples, based on different sensing technology, are analyzed in detail on the basis of these items to highlight a route for the future design and development of point-of-care detection devices and their data capture and handling.

[Radiation protection provided by tungsten bismuth caps during interventional cardiology]. / ¿Es eficiente la protección anti-radiación otorgada por gorros de pabellón de tungsteno-bismuto en cardiología intervencionista?

BACKGROUND: The effectiveness against radiation of tungsten bismuth caps, used in interventional cardiology is not well known. AIM: To determine the degree of radiation protection conferred by these caps in real work conditions. MATERIAL AND METHODS: We compared the gross electric charges received at brain lobe levels by three occupationally exposed professionals who participated in 22 consecutive procedures, inside and outside of the tungsten bismuth cap. RESULTS: The median electric charges outside and inside the cap were 3.71 (range 1.46-5.62) and 2.2 (range 1.29-3.93) nC, which correspond to a 40% radiation attenuation. However, the protection was heterogeneous. CONCLUSIONS: Tungsten bismuth caps provide an adequate attenuation, but its degree is heterogeneous.

Impact of climate change on the geographical distribution of ticks of public health significance in Colombia: Amblyomma ovale (Ixodida: Ixodidae), the Amblyomma maculatum (Ixodida: Ixodidae) complex and the Amblyomma cajennense (Ixodida: Ixodidae) complex.

Ticks of the Amblyomma maculatum (Ixodida Ixodidae) complex, the Amblyomma cajennense (Ixodida Ixodidae) complex and Amblyomma ovale (Ixodida Ixodidae) are known to transmit various Rickettsia species in Colombia, but their exact distribution is unknown. We built several models based on current climate and projected future climate changes using a maximum entropy approach. A total of 314 records of the A. cajennense complex (65.9%; n = 207), A. ovale (22.9%; n = 72), and the A. maculatum complex (11.1%; n = 35) were obtained. Amblyomma ovale has a current distribution in the Pacific, Caribbean and Andean regions and could be potentially found in the Amazon. Amblyomma maculatum has a current distribution in the Andean and could potentially be found in the Caribbean and Orinoco regions. Amblyomma mixtum can be found near the Caribbean Sea and in the Pacific region, and A. patinoi is likely to be found in the Andean region and the Caribbean. In 2070, it will be possible to find an expansion of A. ovale and A. maculatum and a decrease of A. mixtum and A. patinoi. The variables that best predict the distribution of these species are isothermality (small fluctuations in temperature) and annual precipitation. Amblyomma cajennense s.l and A. ovale, A. cajennese s.l and A. patinoi, as well as A. maculatum and A. patinoi, have an important environmental sympatry. Epidemiological and acarological surveillance is crucial to investigate rickettsiosis caused by R. parkeri in A. ovale regions, by R. rickettsii in A. patinoi and A. mixtum areas, and by R. parkeri s.s in A. maculatum regions.

[Protection against ionizing radiation by leaded glass googles during interventional cardiology]. / ¿Es suficiente la protección otorgada por gafas plomadas en cardiología intervencionista?

BACKGROUND: It is not known whether leaded glass goggles with 0.25 mm Pb equivalency, used in interventional cardiology procedures, attenuate radiation below the levels established by the latest recommendation of the International Commission on Radiological Protection (ICRP). AIM: To assess if the degree of attenuation of the secondary ionizing radiation achieved by the use of 0.25 mm Pb leaded glass goggles, in occupationally exposed workers in interventional cardiology procedures, meets the latest ICRP recommendations. MATERIAL AND METHODS: A prospective investigation was carried out to compare the eye exposure to secondary ionizing radiation received by occupationally exposed personnel in a 9 months period. A set of two thermo luminescent dosimeters was arranged in the front and back of leaded glass goggles in a cohort of seven members of an interventional cardiology service, exposed to 1057 consecutive procedures. RESULTS: The monthly dose equivalent measurement performed in front of the goggles ranged between 1.1 and 6.5 mSv, for paramedics and interventional cardiologists. The radiation measured in the back of the glass varied between 0.66 and 2.75 mSv, respectively. The degree of attenuation of the dose at eye level ranged from 40% to 57.7%, respectively. The projected annual exposure would reach 33 mSv for the interventional cardiologist. CONCLUSIONS: With a similar load of work and wearing 0.25 mm Pb equivalent glass goggles, interventional cardiologists will exceed the crystalline equivalent dose limit recommended by the ICRP (20 mSv/year averaged over the past 5 years).

Rehabilitación del sector anterior con disilicato de litio. Relato de un caso / Rehabilitation of the previous sector with lithium disilicate. Case report

Mediante este caso se describen los criterios de selección del color en restauraciones indirectas con disilicato de litio en el sector anterior. Mujer de 34 años, atendida en la Facultad de Odontología de la Universidad Nacional de Concepción (FOUNC), Paraguay, por una preocupación estética del sector anterior, en especial la diferencia de color de las piezas dentarias. La rehabilitación consistió en la confección de coronas de disilicato de litio de las piezas 11, 12, 13, 14, 21, 22, 24, 25 y laminado para carillas de la pieza 23. Fueron aplicadas técnicas de selección de color individualizadas, pruebas de color y cementación antes del cementado final para obtener resultados altamente estéticos. Gracias a los resultados fue posible observar la conjunción de factores como la correcta selección del color del sustrato dentario, el cemento resinoso, el material de restauración y la comunicación eficiente con el laboratorio, fundamental para el éxito del tratamiento.

This case describes the color selection criteria for indirect lithium disilicate restorations in the anterior sector. A 34-year-old woman treated at the Faculty of Dentistry of the National University of Concepción (FOUNC), Paraguay, due to an aesthetic concern in the anterior sector, especially the difference in color of the teeth. The rehabilitation consisted of making lithium disilicate crowns for teeth 11, 12, 13, 14, 21, 22, 24, 25 and laminate for veneers for tooth 23. Individualized color selection techniques, color and cementation prior to final cementation for highly esthetic results. Thanks to the results, it was possible to observe the conjunction of factors such as the correct selection of the color of the dental substrate, the resinous cement, the restorative material, and efficient communication with the laboratory, essential for the success of the treatment.

Análisis citogenético en linfocitos de trabajadores expuestos a radiación ionizante en una unidad de cardiología intervencional de Chile: estudio piloto y revisión de la literatura / Citogenetic effects upon lymphocyes in subjects exposed to ionizing radiadion in an interventional laboratory cardiology: pilot study and literature review

ANTECEDENTES: Un número creciente de artículos está llamando la atención en forma consistente sobre la eventual asociación que existe entre los denominados trabajadores ocupacionalmente expuestos a bajos niveles de radiación ionizante (POEs) y una mayor frecuencia de aberraciones cromosómicas, a nivel Sudamericano estos estudios son escasos. OBJETIVO: Evaluar la frecuencia de aberraciones cromosómicas en linfocitos de sangre periférica de POEs de un hospital y de sujetos sanos. Adicionalmente, se realizó una revisión exhaustiva de los artículos que a la fecha abordaron este tema. MATERIAL Y MÉTODO: Se condujo un análisis citogenético destinado a cuantificar las aberraciones cromosómicas en sangre periférica de linfocitos de 6 POEs de la unidad de Cardiología Intervencional y, como controles, 6 muestras de sujetos de la población general fueron analizadas. RESULTADOS: Se observó un importante contraste en el número de aberraciones cromosómicas presentadas en los POEs versus la población general no expuesta a radiaciones ionizantes, siendo esta de una relación de 6:1, respectivamente. CONCLUSIÓN: Los resultados preliminares indican una mayor frecuencia de aberraciones cromosómicas en los POEs versus la población general, sin embargo, se deberá esperar los resultados de la segunda fase de investigación, donde al ampliar la muestra en análisis se podrán obtener conclusiones estadísticamente significativas.

BACKGROUND: There is growing evidence of an increased number of chromosomes aberrations in subjects exposed to low levels of ionizing radiation (POEs). There are few studies on this subject in Latin America AIM: To evaluate the frequency of chromosome aberrations in lymphocytes obtained from peripheral blood in subjects working in laboratories where low levels of ionizing radiation are present and to compare these findings to those of unexposed subjects. METHODS: A cytogenic analysis to quantify chromosome aberrations was performed in 6 POs subjects from a cardiology invasive laboratory and 6 controls from a general unexposed population. RESULTS: Compared to controls, an approximately 6-fold increase in the number of chromosome aberrations was observed.in subjects exposed to ionizing radiation CONCLUSION: These preliminary results indicate that there is an increased number of chromosome aberrations in subjects exposed to low levels of ionizing radiation, as occurs in people working in a cardiology interventional laboratory. Studies in large numbers of subjects and preferably followed prospectively are needed to evaluate more precisely this effect.

Descripción de elementos de radioprotección y dosimetría en unidades de cardiología intervencionista sudamericanas: un estudio piloto / Radioprotection and dosimetry in Interventional cardiology units in South America. a pilot study

ANTECEDENTES: Las unidades de Cardiología intervencional han evidenciado un número creciente de procedimientos, cada vez más variados y complejos, lo cual podría eventualmente generar daños a los profesionales ocupacionalmente expuestos a radiaciones ionizantes (POEs) de no contar con los adecuados elementos de radioprotección y un uso correcto de ellos. OBJETIVO: Caracterizar la disponibilidad y utilización de los elementos de radioprotección y dosimetría de unidades de cardiología intervencionista de centros Sudamericanos. MATERIAL Y MÉTODOS: Se realizó una encuesta autoaplicada a 139 POEs, de ambos sexos de 7 países, a través de una plataforma on-line, se les consultó sobre características demográficas, dosimétricas y de radioprotección. RESULTADOS: Los elementos de radioprotección más tradicionales; delantales y cuellos plomados se utilizaron un 99,5 % y 98,4 % respectivamente, aquellos elementos más recientes como gafas, gorros y paños plomados solo alcanzaron un 36,8 %, 6,8 % y 34,2%, de utilización respectivamente, en cuanto a la utilización de los dosímetros, solo un 7,9 % lo hace apegado a las normas de la Organización Internacional de Energía Atómica (OIEA). CONCLUSIÓN: Se constató en la muestra analizada una falta de elementos de radioprotección y un uso inadecuado de ellos, urge realizar intervenciones educativas y técnicas para mejorar estos datos.

BACKGROUND: Due to the increasing number of interventional cardiology procedures currently performed, health professionals (POE) are exposed to ionizing radiation unless adequate protective elements are used. AIM: to describe the use of radioprotection elements and dosimetry in interventional cardiology laboratories in South America. METHODS: A self-administered survey was performed on 139 POE of both sexes and 7 countries using an online platform. Demographic data, dosimetry and characteristics of radioprotection analyzed. RESULTS: Commonly used radioprotective elements (lead aprons and collars) were used in 99.5% and 98% respectively. Recently introduced protection elements like lead goggles, caps and drapery were used in 36.8, 6.8 and 34.2% , respectively. Dosimetry according to the International Atomic Energy Commission (OIAE) was performed in only 7.9% of the procedures. CONCLUSION: there is a severe lack of adequate radioprotection during interventional cardiology procedures. Urgent measures, including technical implementation and educational interventions are needed to improve radioprotection in interventional cardiology.

¿Son reproducibles las mediciones dosimétricas a bajas dosis en cardiología intervencionista? / Are dosimetric measurements at low doses reproducible in interventional cardiology?

Abstract. There are several methods for measuring the absorbed radiation dose of occupationally exposed professionals, but it is unknown if these are reproducible at low doses. The aim of this study is to determine the level of reproducibility of thermoluminescent dosimeters (TLD) and optically stimulated luminescence dosimeters (OSL) in simulated conditions. A reproducibility study was performed using two types of dosimeters, which were placed in the location of medical interventionist work area inside the catheter laboratory. An anthropomorphic phantom was used as a patient and the same projections, collimation and radiographic techniques that were employed in the past 30 angiographies, an examination considered as low exposure in the context of interventional cardiology. Lin's concordance coefficient correlation was calculated, obtaining a value of -0.006 with a 95% CI of -0.069 to 0.056 for TLD dosimeters with OSL. The data obtained showed poor reproducibility at low doses of radiation.

Resumen. Existen varios métodos para medir la dosis de radiación absorbida por los profesionales ocupacionalmente expuestos, pero se desconoce si estos son reproducibles entre sí a bajas dosis. El objetivo del estudio fue determinar el grado de reproducibilidad entre los dosímetros termoluminiscentes (TLD) y los dosímetros luminiscentes ópticamente estimulados (OSL), en condiciones simuladas. Se realizó un estudio de reproducibilidad, empleando 2 tipos de dosímetros, los cuales se dispusieron en la ubicación de trabajo del médico intervencionista dentro del pabellón. Se empleó un fantoma antropomórfico como paciente y se replicaron las mismas proyecciones, colimación y técnicas radiológicas empleadas en las últimas 30 coronariografías, examen considerado de baja exposición en el contexto de cardiología intervencionista. Se aplicó el coeficiente de correlación de concordancia de Lin, obteniéndose un valor de -0,006 con un IC al 95% de -0,069 a 0,056 para los dosímetros TLD con OSL. Los datos obtenidos mostraron una escasa reproducibilidad a bajas dosis de radiación.

¿Es eficiente la protección anti-radiación otorgada por gorros de pabellón de tungsteno-bismuto en cardiología intervencionista? / Radiation protection provided by tungsten bismuth caps during interventional cardiology

Background: The effectiveness against radiation of tungsten bismuth caps, used in interventional cardiology is not well known. Aim: To determine the degree of radiation protection conferred by these caps in real work conditions. Material and Methods: We compared the gross electric charges received at brain lobe levels by three occupationally exposed professionals who participated in 22 consecutive procedures, inside and outside of the tungsten bismuth cap. Results: The median electric charges outside and inside the cap were 3.71 (range 1.46-5.62) and 2.2 (range 1.29-3.93) nC, which correspond to a 40% radiation attenuation. However, the protection was heterogeneous. Conclusions: Tungsten bismuth caps provide an adequate attenuation, but its degree is heterogeneous.

¿Es suficiente la protección otorgada por gafas plomadas en cardiología intervencionista? / Protection against ionizing radiation by leaded glass googles during interventional cardiology

Background: It is not known whether leaded glass goggles with 0.25 mm Pb equivalency, used in interventional cardiology procedures, attenuate radiation below the levels established by the latest recommendation of the International Commission on Radiological Protection (ICRP). Aim: To assess ifthe degree of attenuation of the secondary ionizing radiation achieved by the use of 0.25 mm Pb leaded glass goggles, in occupationally exposed workers in interventional cardiology procedures, meets the latest ICRP recommendations. Material and Methods: A prospective investigation was carried out to compare the eye exposure to secondary ionizing radiation received by occupationally exposed personnel in a 9 months period. A set of two thermo luminescent dosimeters was arranged in the front and back of leaded glass goggles in a cohort ofseven members of an interventional cardiology service, exposed to 1057 consecutive procedures. Results: The monthly dose equivalent measurement performed in front ofthe goggles ranged between 1.1 and 6.5 mSv, for paramedics and interventional cardiologists. The radiation measured in the back of the glass varied between 0.66 and 2.75 mSv, respectively. The degree of attenuation of the dose at eye level ranged from 40% to 57.7%, respectively. The projected annual exposure would reach 33 mSvfor the interventional cardiologist. Conclusions: With a similar load ofwork and wearing 0.25 mm Pb equivalent glass goggles, interventional cardiologists will exceed the crystalline equivalent dose limit recommended by the ICRP (20 mSv/year averaged over the past 5 years).