Neonatal risk mortality scores as predictors for health-related quality of life of infants treated in NICU: a prospective cross-sectional study.

PURPOSE: To determine the relationship of Apgar scores, gestational age and neonatal risk mortality scores to health-related quality of life (HRQoL) for infants at the age of 8 months treated after birth in neonatal intensive care unit (NICU). METHODS: All surviving infants treated in two-third level NICUs in Rijeka, Croatia (from August 2013 to August 2014) were included in this prospective, cross-sectional study. For all neonates, the Score for Neonatal Acute Physiology (SNAP), SNAP with Perinatal Extension (SNAP-PE) and their simplified modifications (SNAP II and SNAP-PE II) were calculated. At the corrected age of 8 months, the Pediatric Quality of Life Questionnaire (PedsQL)-infant scale-was completed by parents of surviving infants. Multiple regression analysis was performed in order to assess the value of neonatal risk mortality scores, Apgar scores and gestational age as possible predictors of HRQoL, measured by questionnaire score. RESULTS: A strong correlation has been found between SNAP and 5-min Apgar scores to HRQoL. A positive correlation was also found between gestational age and HRQoL. CONCLUSION: SNAP and 5-min Apgar scores are important outcome indicators, can aid clinicians' and parents' decision making on the benefits and burdens of acute medical interventions and help determine quantities of medical treatment. Educated medical staff, effective and efficient medical treatment and a high quality of care which prevent adverse events in the first minute of life should be a priority in efforts to improve the future quality of life.

Radioiodine uptake in thyroid cancer patients after diagnostic application of low-dose 131I.

The aim of this study was to investigate the influence of the diagnostic administration of 74 MBq 131I on subsequent uptake of therapeutic radioiodine in thyroid cancer patients. Retention measurements were performed using a whole-body counter in 24 patients 6 weeks after total thyroidectomy. Profile scans were performed 2, 24, 48 and 72 h after the administration of the diagnostic dose and 72 h after the administration of the ablation-therapeutic dose (4.4 GBq). The mean ( +/- S.D.) effective half-life of the diagnostic dose in thyroid remnants was 40.3 +/- 23.0 h. The uptake in the thyroid remnants of the subsequent ablation dose 72 h after administration was 30.4 +/- 19.8% of that predicted from the diagnostic study. The greater reduction in uptake was associated with the longer half-life of iodine and higher uptake in the thyroid remnants at 24 h, with a longer interval between surgery and administration of the diagnostic dose and a shorter period between administration of the diagnostic and ablation doses. Our results show that a diagnostic dose of 74 MBq 131I markedly reduces thyroid uptake of an ablation dose of 131I. This should be taken into account during radiation dose planning whenever a quantitative dosimetric study is to be performed.

Determination of small objects from pinhole scintigrams.

This study assessed the possibility of measuring the linear dimensions of small structures using pinhole scintigraphy. A number of glass objects were made with a spherical, cylindrical or conical shape. Their maximum dimensions (diameters and heights) were 3.5-22.5 mm. These glass objects were filled with 131I, placed inside a plastic neck phantom and imaged using a gamma camera equipped with a pinhole collimator. The source-to-collimator distance was varied from 2 to 12 cm. An algorithm for image segmentation (threshold selection) was used to divide the image into object and background. On the segmented image, the number of non-zero pixels in the direction of the principal axes was multiplied by the appropriate calibration factor to obtain the linear dimensions of the object. Spatial resolution of the pinhole collimator, expressed as the full-width at half-maximum (FWHM), varied from 8 to 10 mm for the range of source-to-collimator distances examined. We found that, for dimensions up to 1.5 x FWHM, finite spatial resolution affects the accuracy of measurement. Non-linear correlation between true and calculated dimensions was used to take the latter into account. Our results are now being used to improve quantitation of remnant thyroid tissue masses for the calculation of radioiodine ablation doses.