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BACKGROUND: Accurate assessment of the degree of dehydration is essential in the management and fluid therapy of dehydrated children. The invasiveness of central venous pressure limits its routine clinical use. Fortunately, some studies have suggested that ultrasonographic measurement of inferior vena cava (IVC) diameter: aorta diameter ratio (IADR) is an objective method of assessing intravascular volume. OBJECTIVES: To determine the clinical usefulness of ultrasound measurement of IADR in assessment of children with dehydration. METHODOLOGY: This was a cross-sectional study which compared dehydrated children to age- and sex-matched euvolemic healthy children as controls. The maximum anteroposterior diameter of the abdominal aorta (at peak systole) and maximum IVC diameter (in expiration) were measured. RESULTS: A total of 120 subjects and 120 controls were evaluated. The mean age was 21.73 ± 20.89 months for subjects and 21.19 ± 22.13 months for control. The mean IADR for children with mild, moderate, and severe dehydration was 0.75 ± 0.07, 0.55 ± 0.07, and 0.33 ± 0.05, respectively. The mean IADR for controls was 0.99 ± 0.06. IADR had an inverse relationship with the degree of dehydration in the subjects. A cut-off point of 0.86, with a sensitivity and specificity of 96.7% in predicting dehydration, was derived, with the sensitivity and specificity increasing with increasing level of dehydration. CONCLUSION: IADR is sensitive and specific for assessing moderate and severe dehydration in Nigerian children.
Assuntos
Aorta/diagnóstico por imagem , Desidratação , Ultrassonografia , Veia Cava Inferior/diagnóstico por imagem , Aorta/anatomia & histologia , Estudos de Casos e Controles , Pressão Venosa Central , Criança , Pré-Escolar , Estudos Transversais , Desidratação/diagnóstico , Desidratação/etiologia , Feminino , Gastroenteropatias/complicações , Humanos , Lactente , Recém-Nascido , Masculino , Nigéria , Estudos Prospectivos , Sensibilidade e Especificidade , Índice de Gravidade de DoençaRESUMO
Radiation therapy plays a pivotal role in modern cancer treatment, demanding precise and accurate dose delivery to tumor sites while minimizing harm to surrounding healthy tissues. Monte Carlo simulations have emerged as indispensable tools for achieving this precision, offering detailed insights into radiation transport and interaction at the subatomic level. As the use of scintillation and luminescence dosimetry becomes increasingly prevalent in radiation therapy, there arises a need for validated Monte Carlo tools tailored to optical photon transport applications. In this paper, an evaluation process of the TOPAS (TOol for PArticle Simulation) Monte Carlo tool for Cerenkov light generation, optical photon transport and radioluminescence based dosimetry is presented. Three distinct sources of validation data are utilized: one from a published set of experimental results and two others from simulations performed with the Geant4 code. The methodology employed for evaluation includes the selection of benchmark experiments, making use of opt3 and opt4 Geant4 physics models and simulation setup, with observed slight discrepancies within the calculation uncertainties. Additionally, the complexities and challenges associated with modeling optical photons generation through luminescence or Cerenkov radiation and their transport are discussed. The results of our evaluation suggests that TOPAS can be used to reliably predict Cerenkov generation, luminescence phenomenon and the behavior of optical photons in common dosimetry scenarios.
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We have developed a radioluminescence-based survey meter for use in industries in which there is involvement in naturally occurring radioactive material (NORM), also in support of those needing to detect other weak emitters of radiation. The functionality of the system confronts particular shortcomings of the handheld survey meters that are currently being made use of. The device couples a LYSO:Ce scintillator with a photodetector via a polymer optical fibre waveguide, allowing for "intrinsically safe" inspection within pipework, separators, valves and other such component pieces. The small-diameter optical fibre probe is electrically passive, immune to electromagnetic interference, and chemically inert. The readout circuit is entirely incorporated within a handheld casing housing a silicon photomultiplier (SiPM) detection circuit and a microprocessor circuit connected to an LCD display. A 15 m long flexible PMMA optical fibre waveguide is butt coupled to an ABS plastic probe that retains the LYSO:Ce scintillator. Initial tests have included the use of lab-based mixed gamma-ray sources, measurements being made in concert with a reference conventional GM survey-meter. Characterization, via NORM sources at a decontamination facility, has shown useful sensitivity, covering the dose-rate range 0.10- to 28 µSv h-1 (R-squared 0.966), extending to 80 µSv/h as demonstrated in use of a Cs-137 source. The system is shown to provide an effective tool for detection of radioactivity within hard to access locations, in particular for sources emitting at low radiation levels, down to values that approach background.
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Review is provided of a number of low-dose, low dose rate situations that in study require advances in the development of dosimetric facilities. Using a clinical linac set up to provide doses down to the few mGy level, the performance of a real-time radioluminescence system has then been illustrated, accommodating pulsed as well as continuous dose delivery. The system gate times provide for tracking of the pattern of dose delivery, allowing detailed account of dose and dose-rate variations. The system has been tested in both x-ray and electron mode dose delivery.
Assuntos
Radiometria , Radiometria/métodos , Radiografia , Dosagem Radioterapêutica , Raios XRESUMO
In previous work we investigated the real-time radioluminescence (RL) yield of Ge-doped silica fibres and Al2O3 nanodot media, sensing electron- and x-ray energies and intensities at values familiarly obtained in external beam radiotherapy. The observation of an appreciable low-dose sensitivity has given rise to the realisation that there is strong potential for use of RL dosimetry in diagnostic radiology. Herein use has been made of P-doped silica optical fibre, 2â¯mm diameter, also including a 271⯵m cylindrical doped core. With developing needs for versatile x-ray imaging dosimetry, preliminary investigations have been made covering the range of diagnostic x-ray tube potentials 30 kVp to 120 kVp, demonstrating linearity of RL with kVp as well as in terms of the current-time (mAs) product. RL yields also accord with the inverse-square law. Given typical radiographic-examination exposure durations from tens- to a few hundred milliseconds, particular value is found in the ability to record the influence of x-ray generator performance on the growth and decay of beam intensity, from initiation to termination.