Hypnosis facilitates psychosomatic improvement in a patient with treatment-resistant idiopathic tinnitus.

Chronic tinnitus, also known as phantom sound perception, is a pervasive and often debilitating condition, affecting 15 to 20% of the population. Due to its idiopathic and persistent nature, chronic tinnitus is frequently associated with co-occurring psychiatric disorders as well as decreased sleep and quality of life. Additionally, heterogeneous presentations of tinnitus create challenges for treatment. In this paper, we present a case study of a 70-year-old female patient who presented with severe bilateral tinnitus over a period of 5 years. After failing multiple treatment trials such as transtympanic electric stimulation, acupuncture, Eye Movement Desensitization and Reprocessing, and medication, the patient found relief only through hypnotherapy. Results may be explained by alterations in interoceptive processing, increased cognitive flexibility, or somatosensory changes, with corresponding changes in functional neural structures. Given the results of this case study, we recommend hypnosis as an alternative or adjunct to current treatment modalities for tinnitus and further investigation in this area.

Communication of radiation risk from imaging studies: an IAEA-coordinated international survey.

The purpose of this IAEA-coordinated international study was to understand aspects related to the communication of radiation risk from imaging studies, such as how often imaging department personnel and referring physicians are asked about radiation risks in diagnostic imaging, who asks about these risks, how often professionals are able to provide satisfactory answers using qualitative metrics and how often quantitative risk estimates are needed. A web-based questionnaire with ten questions was completed by 386 healthcare professionals from 63 countries from all four continents, including clinicians/referring physicians (42.5%), radiologists or nuclear medicine physicians (26.7%), medical physicists (23.1%), radiographers/radiological technologists (6.2%) and others (1.6%). The results indicate that radiation risk-related questions are largely asked by patients (73.1%) and parents of child patients (38.6%), and 78% of the professionals believe they are able to answer those questions using qualitative metrics such as very small/minimal, small, medium rather than number of cancers likely occurring. The vast majority, with over three times higher frequency, indicated the purpose of knowing previous radiological exams as 'both clinical information and radiation exposure history' rather than 'only clinical information'. Nearly two-thirds of the clinicians/referring physicians indicated that knowing the radiation exposure history of the patient will affect their decision-making for the next exam, as against only about one-fifth who said 'no, it will not affect their decision-making'. The same question, when addressed to radiologists, resulted in a slightly larger fraction of about three-quarters who said 'yes', as opposed to a smaller fraction of about 12% who said 'no, it will not affect their decision-making'. Mapping the present situation of communication of benefits and risks for patients is important and may be the basis of further analysis, regular monitoring and possibly a target for clinical audits. Further studies focused on specific professional groups might help in obtaining á deeper understanding of the need for practical communication tools.

Organ doses and cancer risk assessment in patients exposed to high doses from recurrent CT exams.

PURPOSE: To estimate cumulative organ doses and age- and gender-stratified cancer mortality risks in patients undergoing recurrent computed tomography (CT) exams. METHODS: Cohorts of patients who received cumulative effective dose ≥ 100 mSv were stratified into age and gender groups. Organ doses of 27 organs using Monte Carlo methods were available, and the relative risk model from the Biological Effects of Ionizing Radiation VII (BEIR VII) was used to estimate lifetime attributable cancer mortality risks (LACMR). RESULTS: Out of the 8956 patients, 6.7% were 16-44 years of age, with median organ doses higher than 200 mGy for stomach and liver, whereas organ doses for nine organs, which included lungs, breasts, colon, red bone marrow, urinary bladder, esophagus, testicles, ovaries, and skin were between 100 and 200 mGy. Thyroid and salivary glands had smaller doses in the range of 45-69 mGy, but the mean dose for each organ was over 100 mGy. The age- and gender-specific median LACMR for the 16-44-years cohort was 0.6 to 0.7 deaths per 100 individuals for males, and 0.8 for females. The mortality estimated figures were highest for patients 16-54 years with slightly lower values for older age groups. Except for the highest age bracket of 75-84 years, the LACMR values for 55-74 years are not lower by orders of magnitude, and thus one cannot ignore risks in this age group. CONCLUSIONS: Organ doses over 100 mGy for most organs and for some organs ≥ 200 mGy with unignorable associated lifetime attributable cancer mortality rates were found.