Surgeon eye lens dose monitoring in interventional neuroradiology, cardiovascular and radiology procedures.

PURPOSE: This study investigated the radiation dose to surgeon eye lens for single procedure and normalised to exposure parameters for eight selected neuroradiology, cardiovascular and radiology interventional procedures. METHODS: The procedures investigated were diagnostic study, Arteriovenous Malformations treatment (AVM) and aneurysm embolization for neuroradiology procedures, Coronary Angiography and Percutaneous Transluminal Coronary Angioplasty (CA-PTCA), Pacemaker and Implantable Cardioverter-Defibrillator implantation (PM-ICD), Endovascular Aortic Repair (EVAR) and Fenestrated Endovascular Aortic Repair (FEVAR) for cardiovascular and electrophysiology procedures. CT-guided lung biopsy was also monitored. All procedures were performed with table-mounted and ceiling-suspended shields (0.5 mm lead equivalent thickness), except for FEVAR and PM-ICD where only a table mounted shield was present, and CT-guided lung biopsy where no shield was used. Dose assessment was performed using a dosemeter positioned close to the most exposed eye of the surgeon, outside the protective eyewear. RESULTS: The surgeon most exposed eye lens median Hp(3) equivalent dose for a single procedure, without protective eyewear contribution, was 18 µSv for neuroradiology diagnostic study, 62 µSv for AVM, 38 µSv for aneurysm embolization, 33 µSv for CA-PTCA, 39 µSv for PM-ICD, 49 µSv for EVAR, 2500 µSv for FEVAR, 153 µSv for CT-guided lung biopsy. CONCLUSIONS: In interventional procedures, the 20 mSv/year dose limit for surgeon eye lens exposure might be exceeded if shields or protective eyewear are not used. Surgeon eye lens doses, normalised to single procedures and to exposure parameters, are a valuable tool for determining appropriate radiation protection measures and dedicated eye lens dosemeter assignment.

C-reactive protein: a marker of neonatal stress?

AIM: To assess whether blood values of C-reactive protein (CRP) in healthy term newborns, are influenced by stress. MATERIAL AND METHODS: Since different types of delivery (vaginal delivery [VD], emergency C-section [EMCS] and elective C-section [ELCS]) are notoriously characterized by different levels of stress for the baby, these three groups were used as models of different levels of stress. The mean CRP values of the three groups obtained in the first hours of life were compared. RESULTS: We retrieved 1012 babies. Median values (3rd-97th ct) were: 0.05 (0.01-0.46), 0.17 (0.02-1.54), 0.30 (0.04-1.77), 0.43 (0.05-1.31), 0.40 (0.04-1.13) at 12, 24, 48, 72 and 96 h, respectively. Mean values in babies born after VD were statistically higher than those born after C-section, and higher CRP values were present in EMCS with respect to ELCS. CONCLUSION: This study described normal blood CRP values in a wide population of term babies. An influence of the type of delivery on blood CRP is evident, and this may be explained by the different amount of perinatal stress induced by anyone of the three types of delivery we considered.

[Incidence and prevalence of anti-HVC antibodies and HBV markers in patients undergoing extracorporeal hemodialysis]. / Incidenza e prevalenza degli anticorpi anti-HCV e dei marcatori di HBV nei pazienti sottoposti ad emodialisi extracorporea.

OBJECT: To assess the prevalence and the incidence of the anti-HCV and HBV markers in extracorporeal dialysis patients. METHOD: From 1990 to 1993, every six months, anti-HCV and anti-HBV markers were determined in 88 dialyzed patients, in 24 health workers from the Nephrology and Dialysis Departments and checked with 4143 blood donors. ALT values were also checked monthly. RESULTS: A 13.6 prevalence of anti-HCV was found while no new anti-HCV case was seen in the three-year observation period. Data referring to HBV infection were affected by vaccination. Statistical survey has shown a significant relation between anti-HCV and blood transfusions and between anti-HBV infection and duration of dialysis. The incidence of HCV infection was 4.1% among health workers who were all HBV vaccinated in the year before the research. COMMENT: We strongly recommend the observance of such rules as hygiene and prophylaxis, disinfection, sterilization and the use of disposable material. Also, a reduction of the number of transfusions seems to cut down the incidence of hematic infections.