Assuntos
Cardiologia/educação , Coração/diagnóstico por imagem , Medicina Nuclear/educação , Cardiologia/organização & administração , Cardiologia/tendências , Competência Clínica , Educação de Pós-Graduação em Medicina , Bolsas de Estudo , Humanos , Cooperação Internacional , Imagem Multimodal/métodos , Imagem Multimodal/tendências , Medicina Nuclear/organização & administração , Medicina Nuclear/tendências , Sociedades Médicas , Estados UnidosRESUMO
OBJECTIVE: This survey was performed to determine the extent of utilization of Coronary Artery Disease Reporting and Data System (CAD-RADS) since its introduction in 2016 among members of cardiovascular imaging societies. METHODS: A survey regarding use of CAD-RADS was distributed to members of North American Society for Cardiovascular Imaging and Society for Cardiovascular Computed Tomography. RESULTS: A total of 246 surveys were completed, and results show that, although most respondents are familiar with CAD-RADS (95%), less than half (45%) report using CAD-RADS for all coronary CTA. Rates of CAD-RADS utilization were similar among physicians who work in a variety of settings. Years of clinical experience did not affect the rates of CAD-RADS utilization; however, a higher weekly volume of cardiac computed tomography was associated with higher rates of CAD-RADS utilization. CONCLUSIONS: Four years after the introduction of CAD-RADS, the reporting system is used by less than half of surveyed members of North American Society for Cardiovascular Imaging and Society for Cardiovascular Computed Tomography regardless of practice model and range of practice experience with cardiac computed tomography.
Assuntos
Doença da Artéria Coronariana/diagnóstico por imagem , Sistemas de Apoio a Decisões Clínicas , Sistemas de Informação em Radiologia , Cardiologia/organização & administração , Competência Clínica , Sistemas de Dados , Humanos , Medicina Nuclear/organização & administração , Sociedades Médicas , Inquéritos e QuestionáriosRESUMO
BACKGROUND: The Covid-19 pandemic led to a complete renewal of clinical activities of Italian hospitals. During the lockdown, all hospitals in Italy had to suspend non-urgent clinical activities. The prolonged suspension of elective activities could have caused a series of problems. METHODS: A new ad hoc protocol was designed. Single-day fast-imaging protocol with regadenoson-stress 99mTc-tetrofosmin imaging was preferred. Patients were contacted by phone 4 days before the test and answered to a questionnaire which will be repeated on the day of the exam. Body temperature <37.5 degrees C and no Covid-19 symptoms were necessary to enter the unit. Patients wore surgical mask and gloves. Social distancing was maintained throughout the examination. Healthcare professionals wore a personal protective equipment. RESULTS: A total of 46 patients were studied from April 7 to May 15, 2020, before the publication of the recommendations from ASNC and SNMMI. None of the patients experienced complications. Follow-up of patients discharged was carried by phone. No Covid-19 infection symptoms were reported. On May 18, 2020 all the healthcare providers of nuclear cardiology department underwent serological testing IgG and IgM and none were positive. CONCLUSION: Strict ad hoc hygiene protocol for Covid-19 pandemic avoids diagnostic-therapeutic delay and lengthening of waiting lists. Our experience confirms that pursuing WHO recommendations and recent indication of ASNC and SNMMI is safe for both health providers and patients. Moreover, the incidence of significant inducible ischemia rises when correct stratification of patients is performed.
Assuntos
COVID-19/prevenção & controle , Hospitais , Controle de Infecções/métodos , Exposição Ocupacional/prevenção & controle , Segurança do Paciente , Idoso , Idoso de 80 Anos ou mais , Temperatura Corporal , COVID-19/transmissão , Cardiologia/organização & administração , Feminino , Humanos , Incidência , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/diagnóstico por imagem , Medicina Nuclear/organização & administração , Compostos Organofosforados , Compostos de Organotecnécio , Equipamento de Proteção Individual , Distanciamento Físico , Inquéritos e Questionários , Tomografia Computadorizada de Emissão de Fóton ÚnicoAssuntos
COVID-19/epidemiologia , COVID-19/terapia , Serviço Hospitalar de Medicina Nuclear/organização & administração , Serviço Hospitalar de Medicina Nuclear/tendências , Medicina Nuclear/organização & administração , Medicina Nuclear/tendências , Admissão e Escalonamento de Pessoal , Planejamento em Desastres , Saúde Global , Departamentos Hospitalares/estatística & dados numéricos , Unidades Hospitalares/organização & administração , Humanos , Controle de Infecções/métodos , Doenças Profissionais/prevenção & controle , Exposição Ocupacional , Pacientes Ambulatoriais , Pandemias , Espanha/epidemiologiaAssuntos
Congressos como Assunto , Medicina Nuclear/organização & administração , Medicina Nuclear/tendências , Sociedades Científicas/organização & administração , COVID-19 , Redes de Comunicação de Computadores , Infecções por Coronavirus/prevenção & controle , Japão , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controleAssuntos
Congressos como Assunto , Medicina Nuclear/organização & administração , Medicina Nuclear/tendências , Sociedades Científicas/organização & administração , COVID-19 , Redes de Comunicação de Computadores , Infecções por Coronavirus/prevenção & controle , Japão , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controleAssuntos
Congressos como Assunto , Medicina Nuclear/organização & administração , Medicina Nuclear/tendências , Sociedades Científicas/organização & administração , COVID-19 , Redes de Comunicação de Computadores , Infecções por Coronavirus/prevenção & controle , Japão , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controleAssuntos
Congressos como Assunto , Medicina Nuclear/organização & administração , Medicina Nuclear/tendências , Sociedades Médicas/organização & administração , COVID-19 , Redes de Comunicação de Computadores , Infecções por Coronavirus/prevenção & controle , Japão , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controleRESUMO
This publication presents criteria and bases for the work organization in the safe practice of Hospital Radiopharmacy, in order to minimize the risk of viral transmission during the COVID-19 pandemic, in a reference facility of the National Energy Commission Atomic of Argentina, while continuing to perform essential services for the health system. For this purpose, documents from the National Energy Commission Atomic, IAEA, WHO and other scientific publications were consulted as reference. These recommendations are under constant review and are permanently updated. Within this framework, the present model of work organization for this essential activity is proposed, including general and specific recommendations and its epidemiological and immunological basis.
Assuntos
COVID-19/epidemiologia , Medicina Nuclear/organização & administração , Pandemias , Serviço de Farmácia Hospitalar/organização & administração , SARS-CoV-2 , Argentina/epidemiologia , COVID-19/diagnóstico , COVID-19/imunologia , COVID-19/prevenção & controle , Teste para COVID-19/métodos , Humanos , Higiene/normas , Medicina Nuclear/normas , Objetivos Organizacionais , Admissão e Escalonamento de Pessoal/organização & administração , Serviço de Farmácia Hospitalar/normas , Compostos Radiofarmacêuticos/normas , SARS-CoV-2/imunologia , Local de Trabalho/organização & administração , Local de Trabalho/normasAssuntos
Betacoronavirus , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Planejamento em Desastres/organização & administração , Medicina Nuclear/organização & administração , Pneumonia Viral/epidemiologia , COVID-19 , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , SARS-CoV-2 , SingapuraAssuntos
Infecções por Coronavirus/epidemiologia , Medicina Nuclear/economia , Pneumonia Viral/epidemiologia , COVID-19 , Infecções por Coronavirus/economia , Alocação de Recursos para a Atenção à Saúde/economia , Recursos em Saúde/economia , Humanos , Medicina Nuclear/organização & administração , Pandemias/economia , Pneumonia Viral/economiaRESUMO
Traditionally, practice in nuclear medicine has involved strong emphasis on radiation safety principles. Nuclear medicine technologists (NMTs) focus on practices that keep patients, the public, and the technologist safe from potentially harmful effects of unnecessary radiation exposure using concepts of time, distance, and shielding as well as ALARA (As low as reasonably achievable) principles. The current COVID-19 pandemic has brought to light the need to apply focus on infection prevention in practice and update knowledge and procedures on such measures. In this article, the authors outline the need for NMTs to develop practices and values focused on infection prevention measures.
Assuntos
Infecções por Coronavirus/epidemiologia , Medicina Nuclear/estatística & dados numéricos , Pneumonia Viral/epidemiologia , COVID-19 , Higiene das Mãos , Serviços de Saúde/provisão & distribuição , Departamentos Hospitalares/organização & administração , Departamentos Hospitalares/estatística & dados numéricos , Humanos , Imagem Molecular , Medicina Nuclear/organização & administração , Pandemias , Alta do Paciente , Alocação de Recursos , Estados Unidos/epidemiologiaRESUMO
Whilst radiopharmaceuticals have an important role to play in both imaging and treatment of patients, most notably cancer patients, nuclear medicine and radiopharmacy are currently facing challenges to create innovative new drugs. Traditional radiopharmaceutical manufacture can be considered as either a routine hospital production or a large-scale industrial production. The gap between these two practices has meant that there is an inability to supply innovative radiopharmaceuticals for use at the local level for mono- or multicentric clinical trials with satisfactory quality and safety specifications. This article highlights the regulatory requirements in aseptic pharmaceutical processing and in nuclear medicine to be able to locally produce radiopharmaceuticals. We validate the proof-of-concept for an "in-house" hospital-based radiopharmacy including an on-site cyclotron, that can fulfill the conflicting requirements between radiation safety and aseptic processing. The ARRONAX in-house radiopharmacy is currently able to provide sterile and pyrogenic-free injectable radiopharmaceutical compounds for both industrial and institutional clinical trials.
Assuntos
Medicina Nuclear , Serviço de Farmácia Hospitalar , Compostos Radiofarmacêuticos , Arquitetura de Instituições de Saúde/normas , Humanos , Medicina Nuclear/métodos , Medicina Nuclear/organização & administração , Medicina Nuclear/normas , Serviço de Farmácia Hospitalar/métodos , Serviço de Farmácia Hospitalar/organização & administração , Serviço de Farmácia Hospitalar/normas , Compostos Radiofarmacêuticos/síntese química , Compostos Radiofarmacêuticos/normasAssuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Medicina Nuclear , Pandemias , Pneumonia Viral/epidemiologia , COVID-19 , Contraindicações de Procedimentos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Medicina Nuclear/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Embolia Pulmonar/diagnóstico por imagem , SARS-CoV-2 , Avaliação de Sintomas/métodosRESUMO
INTRODUCTION: Preparations of health systems to accommodate large number of severely ill COVID-19 patients in March/April 2020 has a significant impact on nuclear medicine departments. MATERIALS AND METHODS: A web-based questionnaire was designed to differentiate the impact of the pandemic on inpatient and outpatient nuclear medicine operations and on public versus private health systems, respectively. Questions were addressing the following issues: impact on nuclear medicine diagnostics and therapy, use of recommendations, personal protective equipment, and organizational adaptations. The survey was available for 6 days and closed on April 20, 2020. RESULTS: 113 complete responses were recorded. Nearly all participants (97â%) report a decline of nuclear medicine diagnostic procedures. The mean reduction in the last three weeks for PET/CT, scintigraphies of bone, myocardium, lung thyroid, sentinel lymph-node are -14.4â%, -47.2â%, -47.5â%, -40.7â%, -58.4â%, and -25.2â% respectively. Furthermore, 76â% of the participants report a reduction in therapies especially for benign thyroid disease (-41.8â%) and radiosynoviorthesis (-53.8â%) while tumor therapies remained mainly stable. 48â% of the participants report a shortage of personal protective equipment. CONCLUSIONS: Nuclear medicine services are notably reduced 3 weeks after the SARS-CoV-2 pandemic reached Germany, Austria and Switzerland on a large scale. We must be aware that the current crisis will also have a significant economic impact on the healthcare system. As the survey cannot adapt to daily dynamic changes in priorities, it serves as a first snapshot requiring follow-up studies and comparisons with other countries and regions.
Assuntos
Infecções por Coronavirus/epidemiologia , Medicina Nuclear/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Inquéritos e Questionários , Áustria , COVID-19 , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/radioterapia , Alemanha , Humanos , Medicina Nuclear/instrumentação , Medicina Nuclear/organização & administração , Pacientes Ambulatoriais , Pandemias , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/radioterapia , SuíçaRESUMO
Among the available imaging techniques, functional imaging provided by nuclear medicine departments represents a tool of choice for the oncoradiotherapist for targeting tumour activity, with positron emission tomography as the main modality. Before, during or after radiotherapy, functional imaging helps guide the oncoradiotherapist in making decisions and in the strategic choice of pathology management. Setting up a working group to ensure perfect coordination at all levels is the first step. Key points for a common and coordinated management between the two departments are the definition of an organizational logistic, training of personnel at every levels, standardization of nomenclatures, the choice of adapted and common equipment, implementation of regulatory controls, and research/clinical routine continuum. The availability of functional examinations dedicated to radiotherapy in clinical routine is possible and requires a convergence of teams and a pooling of tools and techniques.
Assuntos
Neoplasias/radioterapia , Medicina Nuclear/organização & administração , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Radioterapia (Especialidade)/organização & administração , Serviço Hospitalar de Radiologia/organização & administração , Radioterapia Guiada por Imagem/métodos , Agendamento de Consultas , Humanos , Comunicação Interdisciplinar , Neoplasias/diagnóstico por imagem , Radioterapia (Especialidade)/instrumentação , Desenvolvimento de Pessoal , Terminologia como AssuntoRESUMO
Cardiovascular disease (CVD) is the principal cause of death worldwide. Noninvasive studies have been used for the evaluation of CVD. Ensuring an accurate diagnosis of CVD requires well-trained and qualified professionals. IAEA has implemented regional training courses which are mainly aimed at professionals from countries with less economic development in order to raise their professional level so that it is in accordance with international standards and thus be able to homogenize the practice of nuclear cardiology globally.
Assuntos
Cardiologia/educação , Doenças Cardiovasculares/diagnóstico por imagem , Medicina Nuclear/educação , Cardiologia/organização & administração , Humanos , Agências Internacionais , Internacionalidade , Imagem de Perfusão do Miocárdio/métodos , Medicina Nuclear/organização & administração , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Sociedades Médicas , Tomografia Computadorizada de Emissão de Fóton Único/métodosAssuntos
Sistemas de Apoio a Decisões Clínicas , Diagnóstico por Imagem/normas , Medicare/legislação & jurisprudência , Medicare/organização & administração , Medicina Nuclear/normas , Diagnóstico por Imagem/economia , Hospitais , Humanos , Medicare/economia , Medicina Nuclear/economia , Medicina Nuclear/organização & administração , Pacientes Ambulatoriais , Autorização Prévia , Sistema de Pagamento Prospectivo/organização & administração , Estados UnidosAssuntos
Pesquisa Biomédica/organização & administração , Cooperação Internacional , Medicina Nuclear/organização & administração , Participação do Paciente , Participação da Comunidade/legislação & jurisprudência , Atenção à Saúde/organização & administração , Europa (Continente) , Humanos , Guias de Prática Clínica como Assunto , Desenvolvimento de Programas , Garantia da Qualidade dos Cuidados de Saúde , Sociedades Médicas/estatística & dados numéricos , Reino UnidoRESUMO
Cardiovascular diseases (CVDs) are the leading cause of death in Latin America and the Caribbean (LAC) region as well as worldwide. Lifestyle, nutritional habits and the upsurge of obesity have contributed to the increase in the prevalence of CVDs in the region. The role of nuclear cardiology in the management of patients with CVDs is well established. Particularly, myocardial perfusion imaging is widely used in LAC countries and has been increasingly integrated into the healthcare systems in the region for the diagnosis of coronary artery disease, risk stratification and to guide patient management. In its role to support countries around the world to address their health needs through the peaceful applications of nuclear techniques, the International Atomic Energy Agency (IAEA) has provided assistance to the LAC region for the establishment and strengthening of the nuclear cardiology practice. To that extent, the IAEA provides support in building capacities of multidisciplinary teams of professionals, the provision of medical equipment and the promotion of communication and exchange of knowledge among the different stakeholders. In addition, the IAEA encourages the participation of nuclear medicine centers in international multi-center research studies. In this paper, we present some of the projects through which the IAEA has supported the LAC region, including regional technical cooperation projects and coordinated research projects related to cardiology within the current multimodality approach to cardiac imaging.