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1.
Pediatr Emerg Care ; 38(1): e27-e28, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34986584

RESUMO

OBJECTIVES: Children with hemophilia have the usual childhood risk of falls and head trauma. Head computed tomographies (HCTs) are fast, detailed, and readily available, but increased radiation exposure in the pediatric population is now recognized as causing increased brain malignancy. By examining the incidence of intracranial cerebral hemorrhage in this population, we will be able to weigh risks and benefits of HCT use more accurately. METHODS: Using a retrospective chart review, we examined past medical records of pediatric patients, aged 0 to 15 years, with hemophilia presenting to 1 academic medical center. Primary outcomes included number of head CTs ordered, total and per patient over the years studied, and the incidence of positive findings, as defined by presence of blood products as documented by radiologist final read/interpretation. RESULTS: The mean number of head CTs per child was 2.5 (range, 1-10). None of the HCT scans were read as intracranial cerebral hemorrhage, and none of the patients had findings that lead to neurosurgical intervention. In a sensitivity analysis, applying Pediatric Emergency Care Applied Research Network head injury criteria, 11 HCT scans would be ordered for a reduction of 80 HCTs, or a decrease of 2 HCT scans per child. No incidence of intracranial cerebral hemorrhage would have been missed. CONCLUSIONS: Our findings suggest that in the child with hemophilia and a history of minor head trauma, exposure to the radiation of a HCT based on the diagnosis of hemophilia alone may not be necessary but that imaging decisions need to be made in conjunction with clinical examination findings and neurologic status.


Assuntos
Traumatismos Craniocerebrais , Hemofilia A , Exposição à Radiação , Criança , Traumatismos Craniocerebrais/complicações , Traumatismos Craniocerebrais/diagnóstico por imagem , Traumatismos Craniocerebrais/epidemiologia , Hemofilia A/complicações , Hemofilia A/diagnóstico por imagem , Hemofilia A/epidemiologia , Humanos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
2.
Spine (Phila Pa 1976) ; 47(1): 42-48, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34091564

RESUMO

STUDY DESIGN: Multicenter cohort. OBJECTIVE: To compare the robot time/screw, radiation exposure, robot abandonment, screw accuracy, and 90-day outcomes between robot-assisted percutaneous and robot-assisted open approach for short lumbar fusion (1- and 2-level). SUMMARY OF BACKGROUND DATA: There is conflicting literature on the superiority of robot-assisted minimally invasive spine surgery to open techniques. A large, multicenter study is needed to further elucidate the outcomes and complications between these two approaches. METHODS: We included adult patients (≥18 yrs old) who underwent robot-assisted short lumbar fusion surgery from 2015 to 2019 at four independent institutions. A propensity score matching algorithm was employed to control for the potential selection bias between percutaneous and open surgery. The minimum follow-up was 90 days after the index surgery. RESULTS: After propensity score matching, 310 patients remained. The mean (standard deviation) Charlson comorbidity index was 1.6 (1.5) and 53% of patients were female. The most common diagnoses included high-grade spondylolisthesis (grade >2) (48%), degenerative disc disease (22%), and spinal stenosis (25%), and the mean number of instrumented levels was 1.5(0.5). The operative time was longer in the open (198 min) versus the percutaneous group (167 min, P value = 0.007). However, the robot time/screw was similar between cohorts (P value > 0.05). The fluoroscopy time/ screw for percutaneous (14.4 s) was longer than the open group (10.1 s, P value = 0.021). The rates for screw exchange and robot abandonment were similar between groups (P value > 0.05). The estimated blood loss (open: 146 mL vs. percutaneous: 61.3 mL, P value < 0.001) and transfusion rate (open: 3.9% vs. percutaneous: 0%, P value = 0.013) were greater for the open group. The 90-day complication rate and mean length of stay were not different between cohorts (P value > 0.05). CONCLUSION: Percutaneous robot-assisted spine surgery may increase radiation exposure, but can achieve a shorter operative time and lower risk for intraoperative blood loss for short-lumbar fusion. Percutaneous approaches do not appear to have an advantage for other short-term postoperative outcomes. Future multicenter studies on longer fusion surgeries and the inclusion of patient-reported outcomes are needed.Level of Evidence: 3.


Assuntos
Parafusos Pediculares , Exposição à Radiação , Robótica , Fusão Vertebral , Adulto , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos , Fusão Vertebral/efeitos adversos , Resultado do Tratamento
3.
Environ Pollut ; 292(Pt B): 118479, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34752791

RESUMO

The 2011 Tohoku earthquake-tsunami and the subsequent nuclear accident at the Fukushima Dai-ichi Nuclear Power Station (FDNPS) led to large-scale radionuclide contamination of the marine and freshwater environment. Monitoring studies of marine food products in the Fukushima region have generally demonstrated a declining trend in radiocaesium concentrations. However, the accumulation and elimination of radiocaesium and potential biological effects remain poorly understood for freshwater biota inhabiting highly contaminated areas at Fukushima. Consequently, the present study aimed to assess radiocaesium accumulation and developmental effects on the commercially important catadromous Japanese mitten crab, Eriocheir japonica. E. japonica were collected from four sites along a gradient of radionuclide contamination 4-44 km in distance from the FDNPS in 2017. To determine potential developmental effects, fluctuating asymmetry (FA) was used as a measure of developmental stability. Combined 134Cs and 137Cs values for whole E. japonica from highly contaminated sites 4 and 16 km in distance from the FDNPS were 3040 ± 521 and 2250 ± 908 Bq kg-1 wet weight respectively, 30 and 22 times greater than the Japanese standard limit of 100 Bq kg-1. Estimated total dose rates based on radiocaesium concentrations in whole crabs and sediment ranged from 0.016 to 37.7 µGy h-1. No significant relationship between radiocaesium accumulation and FA was recorded, suggesting that chronic radiation exposure at Fukushima is not inducing developmental effects in E. japonica as measured using fluctuating asymmetry. Furthermore, estimated dose rates were below proposed regulatory limits where significant deleterious effects are expected. The present study will aid in the understanding of the long-term consequences of radiation exposure for non-human biota and the management of radioactively contaminated environments.


Assuntos
Acidente Nuclear de Fukushima , Exposição à Radiação , Monitoramento de Radiação , Poluentes Radioativos da Água , Radioisótopos de Césio/análise , Japão , Poluentes Radioativos da Água/análise
4.
Probl Radiac Med Radiobiol ; 26: 464-478, 2021 Dec.
Artigo em Inglês, Ucraniano | MEDLINE | ID: mdl-34965567

RESUMO

OBJECTIVE: to assess the level of anxiety and characterize the quality of sleep in children living in radioactively con-taminated areas in comparison with children who were not affected by the Chornobyl-affected contingents that werequarantined in connection with the COVID-19 pandemic. MATERIALS AND METHODS: The indicators of the level of anxiety were studied using the scale of self-assessment of thelevel of anxiety Ch.D. Spielberger, sleep quality was assessed using a standardized questionnaire for self-completionof PSQI and 137Cs content was measured in children. The main group consisted of 96 children who were quarantineddue to the COVID-19 pandemic and permanently lived in radioactively contaminated areas of Zhytomyr and Rivneregions with a soil contamination density of 137Cs from 18 kBq/m2 to 235 kBq/m2. The age of children ranged from10 to 17 years. Among them were 33 boys and 63 girls. The comparison group consisted of 52 children of similar age,including 26 boys and 26 girls. These children lived permanently in Kyiv and were not victims of the Chornobyl dis-aster. RESULTS: It was found that children who were quarantined for COVID-19 (both residents of radioactively contami-nated areas and children who do not belong to the contingents affected by the Chornobyl disaster) had an increasedlevel of reactive (RA) and personal anxiety (PA). The comparative analysis showed that children of the same sex ofthe main group and the comparison group did not differ in terms of PA and RA. At the same time, studies have shownthat girls, both in the main group and in the comparison group, were characterized by higher levels of PA and RAthan boys. It was determined that poor sleep quality was common in both children living in radioactively contami-nated areas (42.71 %) and children in the comparison group (42.44 %). Among the sleep disorders in children ofboth observation groups, «day dysfunction¼ was most often detected. CONCLUSIONS: There was a direct correlation between the overall PSQI score and the level of reactive, personal anx-iety and the overall PSQI score. Using regression analysis, the presence of a linear association of the level of incorporated 137Cs (Bq) with the indicator of personal anxiety of children living in radioactively contaminated territory (b = -0.716, p < 0.001) was proved.


Assuntos
Ansiedade/etiologia , COVID-19/psicologia , Quarentena/psicologia , Exposição à Radiação , Isolamento Social/psicologia , Adolescente , Acidente Nuclear de Chernobyl , Criança , Feminino , Humanos , Masculino , Pandemias , SARS-CoV-2 , Ucrânia
5.
Artigo em Inglês | MEDLINE | ID: mdl-34948742

RESUMO

Interventional radiology/cardiology is one of the fields with the highest radiation doses for workers. For this reason, the International Commission on Radiological Protection (ICRP) published new recommendations in 2018 to shield staff from radiation. This study sets out to establish the extent to which these recommendations are observed in Germany. For the study, areas were selected which are known to have relatively high radiation exposure along with good conditions for radiological protection-interventional cardiology, radiology and vascular surgery. The study was advertised with the aid of an information flyer which was distributed via organisations including the German Cardiac Society (Deutsche Gesellschaft für Kardiologie- Herz- und Kreislaufforschung e. V.). Everyone who participated in our study received a questionnaire to record their occupational medical history, dosimetry, working practices, existing interventional installations and personal protective equipment. The results were compared with international recommendations, especially those of the ICRP, based on state-of-the-art equipment. A total of 104 respondents from eight German clinics took part in the survey. Four participants had been medically diagnosed with cataracts. None of the participants had previously worn an additional dosimeter over their apron to determine partial-body doses. The interventional installations recommended by the ICRP have not been fitted in all examination rooms and, where they have been put in place, they are not always used consistently. Just 31 participants (36.6%) stated that they "always" wore protective lead glasses or a visor. This study revealed considerable deficits in radiological protection-especially in connection with shielding measures and dosimetric practices pertaining to the head and neck-during a range of interventions. Examination rooms without the recommended interventional installations should be upgraded in the future. According to the principle of dose minimization, there is considerable potential for improving radiation protection. Temporary measurements should be taken over the apron to determine the organ-specific equivalent dose to the lens of the eye and the head.


Assuntos
Cardiologia , Cristalino , Exposição Ocupacional , Exposição à Radiação , Proteção Radiológica , Humanos , Exposição Ocupacional/análise , Exposição Ocupacional/prevenção & controle , Doses de Radiação , Radiologia Intervencionista
6.
Artigo em Inglês | MEDLINE | ID: mdl-34948816

RESUMO

Ten years have passed since the Great East Japan Earthquake and the subsequent Fukushima Daiichi nuclear power plant accident on 11 March 2011. Okuma is a town hosting the Fukushima Daiichi nuclear power plant. The evacuation order for Okuma was partially lifted in April 2019. To clarify factors associated with risk perceptions of radiation among the residents of Okuma, we conducted a questionnaire survey in January 2021. Our results revealed that resident anxieties regarding the health effects of radiation exposure from living in Okuma were independently associated with positive PCL-Specific score, recognition of the consultation services with radiation experts in the municipal government of Okuma, and planned request for consultation service regarding radiation exposure by radiation experts, along with being female and living with a child. It is important for radiation experts to promote periodic communication of risks with individuals on a small scale to provide accurate information about the health effects of radiation and to provide maternal and child healthcare services and support regarding child-rearing and radiation exposure, to reduce concerns about radiation exposure and facilitate healthy living and wellbeing in Okuma.


Assuntos
Terremotos , Acidente Nuclear de Fukushima , Exposição à Radiação , Feminino , Humanos , Japão , Centrais Nucleares , Percepção , Exposição à Radiação/estatística & dados numéricos
7.
Artigo em Inglês | MEDLINE | ID: mdl-34948989

RESUMO

(1) Background: Health professionals' knowledge, beliefs and perceptions concerning radiation protection may affect their behaviour during surgery and consequently influence the quality of health services. This study highlights the health professionals' average knowledge level and captures the beliefs, perceptions, and behaviours in a large public Greek hospital. (2) Materials and Methods: A cross-sectional study was carried out, including health professionals working in operating rooms. One hundred thirty-two staff members participated by responding to an original questionnaire. The sample consisted of nurses, radiographers and medical doctors of various specialties involved daily in surgical procedures where ionizing radiation is required. The survey was conducted from March to June 2021, and the response rate was 97%. (3) Results: The level of overall knowledge of health professionals regarding radiation protection safety was not satisfactory. Females and employees with a lower level of education had more misconceptions about radiation and radiation protection. Employees of younger ages and with less previous experience were more likely to have negative emotions towards radiation exposure. Finally, employees with fewer children tended to express physical complaints caused by their negative emotions due to radiation exposure. (4) Conclusions: Health professionals' lack of basic and specialized knowledge concerning radiation protection safety had a negative impact on the provision of health services. The continuing training of the staff seemed to be the only solution to reverse this trend. The training should highlight how radiation exposure can be minimized, safeguarding health professionals' trust and sense of security by significantly improving their working environment.


Assuntos
Exposição à Radiação , Proteção Radiológica , Atitude do Pessoal de Saúde , Criança , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Humanos
8.
Wiad Lek ; 74(9 cz 2): 2345-2351, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34824182

RESUMO

OBJECTIVE: The aim: The goal of this research is to find out how much medical staff is acknowledged about radiation protection. PATIENTS AND METHODS: Materials and methods: In Teaching Hospitals, Wasit Province, a questionnaire study in 165 medical personnel was conducted. Part 1 of the questionnaire included sociodemographic information such as age, gender, and employment, whereas part 2 included 16 knowledge-related questions, divided into two sections: health risk (8 questions) and preventative strategies (8 questions). The descriptive analysis was carried out according to the data types: qualitative data were described using frequency and percentages, while quantitative data was described using the mean and standard deviation. The Chi-square test or Fisher's Exact Test were employed to analyze the relationship between the variables. Participants were given a score of 1 for all accurate answers, and a score of 0 for wrong and "don't know" responses. There were 165 participants general, among them 93 males and 72 females; with a mean age of 35.489.570. RESULTS: Results: Only 27 people (16.36%) had a good knowledge score, while more than half (61.21%) earned an average knowledge score. 30% of radiology technicians had a good level of knowledge, and 26.5 % of those working in radiology units had a good level of expertise as well. Increasing the frequency of radiation exposure showed to have a strong relationship with participant knowledge score, with those with repeated exposure during the day having the greatest proportion (21.4%) of good knowledge. CONCLUSION: Conclusions: This study had shown that there is a need to increase awareness about risks of radiation exposures among those who works in this field. Considering the above, the study recommends making training about the risks and methods of radiation protection compulsory, especially for workers in radiography units. In addition, the curricula of medical institutes must be updated and the latest research findings on ways to prevent radiation should be added. Finally, the issue of exposure to radiation is very important and dangerous, therefore, all sectors of society must join for the best awareness of its risks.


Assuntos
Exposição à Radiação , Proteção Radiológica , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hospitais de Ensino , Humanos , Masculino , Corpo Clínico , Exposição à Radiação/efeitos adversos
9.
Jt Dis Relat Surg ; 32(3): 642-648, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34842096

RESUMO

OBJECTIVES: In this study, we aimed to introduce a new technique in which distal locking step was easier and safer for orthopedic trauma surgeons involving in the treatment of long bone fractures using an intranail endoscopic visualization and illumination method. MATERIALS AND METHODS: A total of 20 fresh bovine hind limbs derived from healthy adults and killed for sale were dissected to obtain tibial bones. Two equal groups including 10 samples in each were prepared. We applied a standard nailing process in both groups: the study group (n=10) was locked by the new technique, intranail endoscopic illumination guidance and intranail visualization assistance locking technique and the control group (n=10) was locked by the classical free-hand fluoroscopic guidance technique. We measured the surgical period time and the radiation exposure time required for the distal locking in both groups. RESULTS: The radiation exposure time was statistically significantly lower in the study group compared to the control group. Also, the time period required for distal locking in the study group were statistically significantly lower than the control group. With the use of the intranail endoscopic illumination guidance and visualization assistance technique, the median period time required for the distal locking procedure reduced from 477.5 to 223.5 sec (p<0.001). The median time for radiation exposure dramatically reduced from 13.5 to 2 sec (p<0.001). The median attempt number reduced from 6.5 to 2 times (p<0.001). CONCLUSION: This experimental study indicates that the endoscopic illumination and intranail visualization assistance technique can reduce the radiation exposure time and the period time required for distal locking compared to the free-hand fluoroscopic guidance.


Assuntos
Fixação Intramedular de Fraturas , Exposição à Radiação , Adulto , Animais , Pinos Ortopédicos , Bovinos , Endoscopia , Fluoroscopia , Humanos
10.
Acta Orthop Belg ; 87(3): 545-552, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34808731

RESUMO

A new flat detector and pulsed fluoroscopy technology is available to further reduce radiation exposure in radiological monitoring during scoliosis treatment in children and adolescents. The aim of this study is to compare different settings of the system (opening area(OA) and image quality settings (IQS)) in order to find the optimal parameters with high image quality and the lowest possible radiation exposure. Therefore, we examined four cadaver spines (T1 to sacrum) with the flat detector technique using digital pulsed fluoroscopy and simulated the abdominal soft tissues. The images were merged and evaluated by three different investigators using an established scoring system. For comparison, we used digital radiography images of the cadaver spines. The values for the DAP increased from the small OA (33% ; 0.56 µGy·m²) to the maximum OA (100% ; 0.82 µGy·m²) by 45% (p = .003) and from the low image quality setting (0.57 µGy·m²) to the high setting (0.84 µGy·m²) by 48% (p = .028). Despite the low DAP, the setting 33% OA achieved the best point values for image quality, therefore this setting is clearly preferred. Using a digital fluoroscopy system allows a significant reduction of radiation exposure by a factor of 7.5 (3.88µGy·m² to 0.5µGy·m²) compared to slot- scanning x-ray (EOS). Due to this success, the flat detector and pulsed fluoroscopy technology can be an alternative to established methods such as X-ray and EOS in clinical use.


Assuntos
Exposição à Radiação , Escoliose , Adolescente , Criança , Fluoroscopia , Humanos , Doses de Radiação , Exposição à Radiação/prevenção & controle , Escoliose/diagnóstico por imagem , Tecnologia
11.
Igaku Butsuri ; 41(3): 127-133, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34744123

RESUMO

Since the Fukushima Daiichi Nuclear Power Station accident (hereinafter referred to as the "Fukushima Daiichi accident") occurred in March 2011, many experts around the world have conducted the assessments on radiation doses and health effects attributed to the Fukushima Daiichi accident. During the months soon after the accident while the state of the nuclear reactor was not accurately grasped, the radiation exposure of the residents was estimated based on the predicted environmental behavior of various radionuclides. However, there were significant differences in the estimated doses and effects presented by different researchers and research institutes. As investigations on the causes and progress of the Fukushima Daiichi accident have progressed in last 10 years, now we know better the situation and consequence of the accident. In this article, the contents of relevant papers and reports published during the three years (-2014) after the Fukushima Daiichi accident are briefly reviewed and then compared with the relatively new scientific information obtained in 2015 or later. Through these analyses, the author tries to look back on how correct or incorrect the initial estimates were.


Assuntos
Acidente Nuclear de Fukushima , Exposição à Radiação , Monitoramento de Radiação , Japão
12.
Spine (Phila Pa 1976) ; 46(23): 1669-1675, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34610614

RESUMO

STUDY DESIGN: Retrospective cohort. OBJECTIVE: The aim of this study was to elucidate the relative influence of multiple factors on radiation usage for anterior, lateral, and posterior based lumbar interbody fusion techniques. SUMMARY OF BACKGROUND DATA: There has been substantial global growth in the performance of lumbar interbody fusions, due to evolution of techniques and approaches and increased attention to sagittal alignment. Utilization of intraoperative imaging guidance has similarly expanded, with a predominance of fluoroscopy and consequent increased radiation exposure. There have been no larger-scale studies examining the role of patient and procedural factors in driving radiation exposure across different interbody techniques. METHODS: We used a clinical registry to review all single-level lumbar interbody fusions performed between January 2016 and October 2020. Operative records were reviewed for the amount of radiation exposure during the procedure. Patient age, biologic sex, body mass index (BMI), operative surgeon, surgical level, surgical time, and fusion technique were recorded. Multivariable adjusted analyses using negative binomial regression were used to account for confounding. RESULTS: We included 134 interbody fusions; 80 performed with a posterior approach (TLIF/PLIF), 43 via an anterior approach (ALIF) with posterior pedicle fixation, and 9 performed with a lateral approach (LLIF/XLIF). Average radiation per case was 136.4 mGy (SE 17.3) for ALIF, 108.6 mGy (16.9) for LLIF/XLIF, and 60.5 mGy (7.4) for TLIF/PLIF. We identified lateral approaches, increased BMI, minimally invasive techniques, and more caudal operative levels as significantly associated with increased radiation exposure. CONCLUSION: We identified several novel drivers of radiation exposure during interbody fusion procedures, including the relative importance of technique and the level at which the fusion is performed. More caudal levels of intervention and lateral based techniques had significantly greater radiation exposure.Level of Evidence: 4.


Assuntos
Exposição à Radiação , Fusão Vertebral , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Complicações Pós-Operatórias , Exposição à Radiação/efeitos adversos , Estudos Retrospectivos , Fusão Vertebral/efeitos adversos
13.
Artigo em Chinês | MEDLINE | ID: mdl-34624944

RESUMO

Objective: To study the correlation between occupational radiation exposure and chronic metabolic diseases. Methods: The status of chronic metabolic diseases of medical workers were compared in 5 hospitals in Hangzhou. As representatives of chronic metabolic diseases, diabetes and metabolic syndrome (MS) were compared in association with duration of radiation exposure. Results: Long-term ionizing radiation (IR) exposure was led to increased blood pressure, fasting blood glucose (FBG) , dyslipidemia, gallbladder disease, and MS. The years of radiation exposure was associated with lens opacity, gallstone and MS in men and gallbladder polyps in women. Radiation working more than 10 years is one of the independent risk factors for increased FBG and MS. Moreover, the risk of FBG increase in the group of radiation working more than 10 years was 3.052 times of that the non-exposed group, and the risk of MS occurrence was 4.132 times that of the non-exposed group. Conclusion: Long-term exposure to IR increases the risk of chronic metabolic diseases.


Assuntos
Catarata , Exposição Ocupacional , Traumatismos Ocupacionais , Exposição à Radiação , Lesões por Radiação , Feminino , Humanos , Masculino , Exposição à Radiação/efeitos adversos
14.
Environ Health Prev Med ; 26(1): 103, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34635049

RESUMO

BACKGROUND: Exposure to the ionizing radiation (IR) encountered outside the magnetic field of the Earth poses a persistent threat to the reproductive functions of astronauts. The potential effects of space IR on the circadian rhythms of male reproductive functions have not been well characterized so far. METHODS: Here, we investigated the circadian effects of IR exposure (3 Gy X-rays) on reproductive functional markers in mouse testicular tissue and epididymis at regular intervals over a 24-h day. For each animal, epididymis was tested for sperm motility, and the testis tissue was used for daily sperm production (DSP), testosterone levels, and activities of testicular enzymes (glucose-6-phosphate dehydrogenase (G6PDH), sorbitol dehydrogenase (SDH), lactic dehydrogenase (LDH), and acid phosphatase (ACP)), and the clock genes mRNA expression such as Clock, Bmal1, Ror-α, Ror-ß, or Ror-γ. RESULTS: Mice exposed to IR exhibited a disruption in circadian rhythms of reproductive markers, as indicated by decreased sperm motility, increased daily sperm production (DSP), and reduced activities of testis enzymes such as G6PDH, SDH, LDH, and ACP. Moreover, IR exposure also decreased mRNA expression of five clock genes (Clock, Bmal1, Ror-α, Ror-ß, or Ror-γ) in testis, with alteration in the rhythm parameters. CONCLUSION: These findings suggested potential health effects of IR exposure on reproductive functions of male astronauts, in terms of both the daily overall level as well as the circadian rhythmicity.


Assuntos
Ritmo Circadiano/efeitos da radiação , Expressão Gênica/efeitos da radiação , Genitália Masculina/efeitos da radiação , Exposição à Radiação , Radiação Ionizante , Fenômenos Reprodutivos Fisiológicos/efeitos da radiação , Fatores de Transcrição ARNTL/genética , Fosfatase Ácida , Animais , Proteínas CLOCK/genética , Epididimo/efeitos da radiação , Glucosefosfato Desidrogenase , L-Iditol 2-Desidrogenase , L-Lactato Desidrogenase , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Modelos Animais , Membro 1 do Grupo F da Subfamília 1 de Receptores Nucleares/genética , Membro 2 do Grupo F da Subfamília 1 de Receptores Nucleares/genética , Membro 3 do Grupo F da Subfamília 1 de Receptores Nucleares/genética , RNA Mensageiro/genética , Motilidade Espermática/efeitos da radiação , Espermatozoides/efeitos da radiação , Testículo/enzimologia , Testículo/efeitos da radiação
16.
Med Clin North Am ; 105(6): 1017-1031, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34688412

RESUMO

Thyroid nodules may be discovered in a variety of settings. Familiarity with their management is important for medical specialists. Workup should start with history and physical examination, proceed to laboratory studies, and then to imaging. Nodules are selected for fine needle aspiration (FNA) biopsy based on imaging criteria. Most nodules can be accurately diagnosed on cytopathology, but some may require additional molecular testing to evaluate risk of malignancy. Patients with malignant lesions require additional investigation before referral to an experienced thyroid surgeon. Those who have benign lesions may require monitoring by periodic ultrasound to identify nodules requiring reevaluation.


Assuntos
Nódulo da Glândula Tireoide/patologia , Biópsia por Agulha Fina , Humanos , Iodo/deficiência , Anamnese , Exposição à Radiação , Fatores de Risco , Hormônios Tireóideos/sangue , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/epidemiologia
17.
Isr Med Assoc J ; 23(9): 550-555, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34472229

RESUMO

BACKGROUND: Medical imaging and the resultant ionizing radiation exposure is a public concern due to the possible risk of cancer induction. OBJECTIVES: To assess the accuracy of ultra-low-dose (ULD) chest computed tomography (CT) with denoising versus normal dose (ND) chest CT using the Lung CT Screening Reporting and Data System (Lung-RADS). METHODS: This prospective single-arm study comprised 52 patients who underwent both ND and ULD scans. Subsequently AI-based denoising methods were applied to produce a denoised ULD scan. Two chest radiologists independently and blindly assessed all scans. Each scan was assigned a Lung-RADS score and grouped as 1 + 2 and 3 + 4. RESULTS: The study included 30 men (58%) and 22 women (42%); mean age 69.9 ± 9 years (range 54-88). ULD scan radiation exposure was comparable on average to 3.6-4.8% of the radiation depending on patient BMI. Denoising increased signal-to-noise ratio by 27.7%. We found substantial inter-observer agreement in all scans for Lung-RADS grouping. Denoised scans performed better than ULD scans when negative likelihood ratio (LR-) was calculated (0.04--0.08 vs. 0.08-0.12). Other than radiation changes, diameter measurement differences and part-solid nodules misclassification as a ground-glass nodule caused most Lung-RADS miscategorization. CONCLUSIONS: When assessing asymptomatic patients for pulmonary nodules, finding a negative screen using ULD CT with denoising makes it highly unlikely for a patient to have a pulmonary nodule that requires aggressive investigation. Future studies of this technique should include larger cohorts and be considered for lung cancer screening as radiation exposure is radically reduced.


Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Doses de Radiação , Tomografia Computadorizada por Raios X/métodos , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Estudos Prospectivos , Exposição à Radiação
19.
JMIR Mhealth Uhealth ; 9(9): e29694, 2021 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-34581683

RESUMO

BACKGROUND: Emerging UV radiation (UVR) monitoring devices may present an opportunity to integrate such technology into skin cancer prevention interventions. However, little is known about the effects of using a wearable UVR monitor on adults' and children's sun protection-related behaviors and attitudes (eg, cancer worry and perceived risk). Understanding the potential role of reactivity and seasonal effects will help inform the use of objective monitors in the context of skin cancer prevention research, including intervention studies. OBJECTIVE: The aim of this study is to examine the potential reactivity associated with a wearable personal UVR monitor, specifically the effects associated with reported sun-protective behaviors and skin cancer-related attitudes, which are often the targets of skin cancer preventive interventions. METHODS: Child-parent dyads (n=97 dyads) were asked to wear a UVR monitoring device during waking hours for 2 weeks. Participants were asked to sync the device daily with a smartphone app that stored the UVR exposure data. Participants were blinded to their UVR exposure data during the 2-week period; thus, the smartphone app provided no feedback to the participants on their UVR exposure. Participants completed self-report questionnaires assessing sun-protective behaviors, sunburn, tanning, skin self-examination, skin cancer-related knowledge, perceived risk, cancer worry, response efficacy, and intentions to change behaviors over the 2-week period. Linear regressions were conducted to investigate changes in the outcomes over time and to account for the role of the season of study participation. RESULTS: Regression results revealed that there was a significant decrease over time for several sun protection outcomes in children, including time spent outdoors on weekends (P=.02) and weekdays (P=.008), sunscreen use (P=.03), reapplication (P<.001), and unintentional tanning (P<.001). There were no significant changes over time in children's and parents' UVR exposure, sunburn occurrence, or sun protection attitudes. Season of participation was associated with several outcomes, including lower sunscreen use (P<.001), reapplication (P<.001), sunburns (P=.01), intentions to change sun-protective behaviors (P=.02), and intentional (P=.008) and unintentional tanning (P=.01) for participants who participated in the fall versus the summer. CONCLUSIONS: The findings from this study suggest that daily use of a UVR monitoring device over a 2-week period may result in changes in certain sun-protective behaviors. These results highlight the importance of identifying and addressing potential reactivity to UVR monitoring devices, especially in the context of skin cancer preventive intervention research. Ultimately, objectively assessed UVR exposure could be integrated into the outcome assessment for future testing of skin cancer prevention interventions.


Assuntos
Exposição à Radiação , Neoplasias Cutâneas , Queimadura Solar , Adulto , Humanos , Autorrelato , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/prevenção & controle , Queimadura Solar/tratamento farmacológico , Queimadura Solar/prevenção & controle , Protetores Solares/uso terapêutico
20.
Artigo em Inglês | MEDLINE | ID: mdl-34583823

RESUMO

The Russian Federation is implementing a program for dismantling nuclear-powered submarines and nuclear service vessels decommissioned from the Navy. Program personnel may be exposed to mutagenic and carcinogenic factors, including ionizing radiation. Improved preclinical health diagnostics are desirable, for timely identification of health effects, optimization of preventive measures, and medical interventions. We used an improved version of the buccal micronucleus cytome assay (BMCyt) to conduct cytogenetic status assessment of 59 employees of the Far Eastern Center for Radioactive Waste Management (DalRAO). We observed a statistically significant increase in the frequency of buccal epithelial cells with cytogenetic abnormalities (2.31‰ versus 1.15‰) and a small decrease in the apoptotic index (42 % versus 44 %) in the exposure group vs. controls. An accumulation index of cytogenetic disorders (the ratio of cells with nuclear abnormalities to cells in apoptosis) was determined and significant differences were found between the exposure and control groups. The proposed approach is simple, non-invasive, and highly informative for monitoring the health status of personnel exposed to complex factors in the working environment.


Assuntos
Células Epiteliais/patologia , Testes para Micronúcleos , Exposição Ocupacional , Exposição à Radiação , Resíduos Radioativos , Gerenciamento de Resíduos , Adulto , Idoso , Apoptose , Bochecha , Análise Citogenética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutagênicos/toxicidade
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