X-rays

X射线
  • 文章类型: English Abstract
    Interest in the topic of age assessment for forensic medical identification of personality has not decreased for over the past decade. Establishing an exact age have a critical importance for law enforcement authorities, for example in case of wrongdoing by illegal migrants without identity documents. The search and systemic analysis of published researches devoted to age assessment by dental status in children and adolescents with subsequent updating of the directions of development in this scientific subject theme and the possibility of their realization in practice in the Russian Federation were carried out in order to have an objective concept of used methods of dental status assessment in the world practice.
    Интерес к теме оценки возраста для судебно-медицинской идентификации личности не ослабевает на протяжении последнего десятилетия. Установление точного возраста имеет решающее значение для правоохранительных органов, например в случае совершения правонарушений нелегальными мигрантами, не имеющими удостоверяющих личность документов. Для объективного представления об используемых методах оценки стоматологического статуса в мировой практике были проведены поиск и системный анализ опубликованных исследований, посвященных оценке возраста по стоматологическому статусу у детей и подростков, с последующей актуализацией направлений развития данной научной тематики и возможности их реализации на практике на территории Российской Федерации.
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  • 文章类型: Journal Article
    双平面射线照相已成为在生理负荷期间精确测量体内骨骼运动学的黄金标准。这次范围审查的目的是绘制范围,范围,以及2004年至2022年人类双平面射线照相研究的性质。使用术语双平面射线照相术进行了文献检索,双重透视,动态立体X射线,和双翼视频摄影。还评估了纳入出版物中引用的所有文章。然后使用所包含论文中最常出现的主要研究者的名字进行二次搜索。总共确定并包括了379份手稿。2004年发表的第一批研究集中在天然膝盖上,随后在2006年对踝关节复合体进行了研究,在2007年对肩关节进行了研究,在2008年对脊柱进行了研究。所有手稿中有近一半(180,47.5%)研究了膝盖运动学。出版物的平均数量从2012年至2017年的每年21.6增加到2017年至2022年的每年34.6。每个研究的平均参与者人数为16,范围从1到101。共有90.2%的研究以30个或更少的队列为特征。每个关节最多产的研究小组是:大众综合医院(腰椎和膝盖),亨利·福特医院(肩),犹他大学(脚踝和臀部),匹兹堡大学(颈椎),和布朗大学(手/手腕/肘部)。双平面射线照相研究的未来进步取决于这些成像系统的可用性。数据收集协议的标准化,以及加快数据处理的自动化方法的发展。
    Biplane radiography has emerged as the gold standard for accurately measuring in vivo skeletal kinematics during physiological loading. The purpose of this scoping review was to map the extent, range, and nature of biplane radiography research on humans from 2004 through 2022. A literature search was performed using the terms biplane radiography, dual fluoroscopy, dynamic stereo X-ray, and biplane videoradiography. All articles referenced in included publications were also assessed for inclusion. A secondary search was then performed using the names of the most frequently appearing principal investigators among included papers. A total of 379 manuscripts were identified and included. The first studies published in 2004 focused on the native knee, followed by studies of the ankle joint complex in 2006, the shoulder in 2007, and the spine in 2008. Nearly half (180, 47.5%) of all manuscripts investigated knee kinematics. The average number of publications increased from 21.6 per year from 2012 to 2017 to 34.6 per year from 2017 to 2022. The average number of participants per study was 16, with a range from 1 to 101. A total of 90.2% of studies featured cohorts of 30 or less. The most prolific research groups for each joint were: Mass General Hospital (lumbar spine and knee), Henry Ford Hospital (shoulder), the University of Utah (ankle and hip), The University of Pittsburgh (cervical spine), and Brown University (hand/wrist/elbow). Future advancements in biplane radiography research are dependent upon increased availability of these imaging systems, standardization of data collection protocols, and the development of automated approaches to expedite data processing.
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  • 文章类型: Systematic Review
    背景:图像质量是成像优化和诊断的重要因素。图像质量的许多决定因素由射线照相师控制;因此,放射技师主导的策略可能是提高X射线图像质量的关键。这篇评论审查了有关放射线技师主导的诊断评估的文献,以确定其改善X射线图像质量的潜力。
    方法:使用系统审查和Meta分析的首选报告项目扩展范围审查和JoannaBriggs研究所的证据综合范围审查手册来审查与射线照相医师主导的诊断评估对图像质量的影响相关的研究。CINHAL,Embase,Scopus,在WebofScience和Medline数据库中搜索相关文章。搜索词与放射技师同义,评论,使用和图像质量,并审查了检查任何类型的放射线摄影师主导的图像解释及其与基于X射线的模式中的图像质量的关系的研究。
    结果:对符合纳入标准的14项研究进行综述。所有审查的研究都一致报道了X射线摄影图像解释与基于X射线的模态中的图像质量之间的正相关。确定了五个新兴主题,以负责图像质量的改善:增加对图像质量要求的理解,提高技术技能,增强利用补充成像和重复的能力,同事的协作技能提升,以及诊断和射线照相技能之间的互补相互作用,以提高图像质量。
    结论:研究结果表明,射线照相图像解释是优化X射线检查质量的有用策略。
    结论:这些发现突出了改善临床环境中X射线质量的新途径,并支持基于证据的初步图像评估系统的吸收。这些发现还支持将放射线照相师的注释与技术图像质量整合到教学课程中。
    BACKGROUND: Image quality is an important factor in imaging optimisation and diagnosis. Many determinants of image quality are controlled by the radiographer; therefore, radiographer-led strategies may be key to improving X-ray image quality. This review examines the literature on radiographer-led diagnostic evaluation to establish its potential to improve X-ray image quality.
    METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews and the Joanna Briggs Institute Manual for Evidence Synthesis Scoping Review were used to review studies relevant to the impact of radiographer-led diagnostic evaluation on image quality. CINHAL, Embase, Scopus, Web of Science and Medline databases were searched for relevant articles. Search terms synonymous with radiographer, commenting, and image quality were used and studies that examined any type of radiographer-led image interpretation and its relationship to image quality in X-ray based modalities were reviewed.
    RESULTS: Fourteen studies that met the inclusion criteria were reviewed. All the studies reviewed unanimously reported a positive association between radiographer image interpretation and image quality in X-ray based modalities. Five emerging themes were identified to be responsible for the improvement in image quality: increased understanding of image quality requirements, improved technical skills, enhanced ability to utilise supplementary imaging and repeats, collaborative upskilling of colleagues, and a complementary interaction between diagnostic and radiographic skills that serves to enhance image quality.
    CONCLUSIONS: The findings demonstrate that radiographer image interpretation is a useful strategy to optimise the quality of X-ray examinations.
    CONCLUSIONS: The findings highlight a new avenue to improve X-ray quality in the clinical environment and support evidence-based uptake of preliminary image evaluation systems. These findings also support the integration of radiographer commenting alongside technical image quality in teaching curricula.
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  • 文章类型: Meta-Analysis
    乳腺癌是世界上最常见的癌症之一,也是女性癌症相关死亡的主要原因。多项研究表明,X射线修复交叉互补2(XRCC2)的Arg188His(rs3218536)多态性可能与乳腺癌风险有关。然而,这种联系仍然模棱两可。因此,我们进行了荟萃分析,以提供有关该问题的更准确结论.在PubMed中进行全面搜索,GoogleScholar和ISIWebofScience进行了选择所有相关研究。使用具有相应的95%置信区间(CI)的赔率比(OR)来评估关系的强度。总共确定了17项研究,涉及5694例乳腺癌病例和6450例健康受试者。汇总数据显示,在杂合子对比下,XRCC2Arg188His多态性与全球乳腺癌易感性略有差异(OR=0.929,95%CI=0.873-0.987,p=0.018)。此外,按种族划分的亚组分析显示,这种多态性与白种人患乳腺癌的风险相关.总的来说,本研究表明,XRCC2Arg188His多态性可能导致乳腺癌风险增加.
    Breast cancer is one of the most common cancers in the world and leading cause of cancer-related death among women. Several studies indicated that Arg188His (rs3218536) polymorphism of X-ray repair cross-complementing 2 (XRCC2) may be associated with breast cancer risk. However, this association remains ambiguous. Thus, we performed a meta-analysis to provide more precise conclusion on this issue. A comprehensive search in PubMed, Google Scholar and ISI Web of Science was performed to select all relevant studies. Odds ratios (OR) with corresponding 95% confidence intervals (CI) were applied to assess the strength of the relationships. A total of 17 studies with 5694 breast cancer cases and 6450 healthy subjects were identified. The pooled data revealed that XRCC2 Arg188His polymorphism was marginally with susceptibility to breast cancer globally under the heterozygote contrast (OR = 0.929, 95% CI = 0.873-0.987, p=0.018). Moreover, subgroup analysis by ethnicity revealed that this polymorphism was associated with breast cancer risk among Caucasians. On the whole, the present study demonstrates that the XRCC2 Arg188His polymorphism may contribute to an increased risk of breast cancer.
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  • 文章类型: Journal Article
    本报告涵盖了使用INTRABEAM®系统(CarlZeissMeditecAG,Jena,德国)。基于八家机构的集体用户体验,我们讨论了INTRABEAM质量保证(QA)测试的最佳方法,调试测量,临床工作流程,治疗计划,和潜在的研究途径。该指南为IORT提供了相关的背景信息和临床依据。它描述了INTRABEAM系统和调试测量以及TG100风险管理分析,以确保IORT计划的安全性和准确性。安全检查后,进行剂量测量以验证场平坦度和对称性,x射线输出,和深度剂量。还讨论了剂量线性检查,光束各向同性,离子室测量,校准协议,以及使用光学刺激发光剂量计OSLD进行体内剂量测定,和放射变色胶片。强调常规质量保证程序的重要性(每日,每月,和年度)为成功的IORT计划定期执行。安全和准确的剂量输送,强调了IORT临床工作流程的重要组成部分的测试,例如,剂量处方,预处理QA,治疗设置,安全检查,辐射调查,和输送剂量的独立检查。讨论了与体内剂量测量相关的挑战,随着特殊的处理程序和屏蔽要求。参考基于蒙特卡洛的商业治疗计划系统,重点介绍了其主要特征和局限性,审查了IORT中治疗计划的重要性。该报告最后提出了研究的建议主题,包括基于CT的图像引导治疗计划和改进的处方剂量准确性。我们希望这份多机构报告将作为INTRABEAMIORT临床实施和使用的指导文件。
    This report covers clinical implementation of a low kV intraoperative radiation therapy (IORT) program with the INTRABEAM® System (Carl Zeiss Meditec AG, Jena, Germany). Based on collective user experience from eight institutions, we discuss best methods of INTRABEAM quality assurance (QA) tests, commissioning measurements, clinical workflow, treatment planning, and potential avenues for research. The guide provides pertinent background information and clinical justification for IORT. It describes the INTRABEAM system and commissioning measurements along with a TG100 risk management analysis to ensure safety and accuracy of the IORT program. Following safety checks, dosimetry measurements are performed for verification of field flatness and symmetry, x-ray output, and depth dose. Also discussed are dose linearity checks, beam isotropy, ion chamber measurements, calibration protocols, and in-vivo dosimetry with optically stimulated luminescence dosimeters OSLDs, and radiochromic film. Emphasis is placed on the importance of routine QA procedures (daily, monthly, and annual) performed at regular intervals for a successful IORT program. For safe and accurate dose delivery, tests of important components of IORT clinical workflow are emphasized, such as, dose prescription, pre-treatment QA, treatment setup, safety checks, radiation surveys, and independent checks of delivered dose. Challenges associated with in-vivo dose measurements are discussed, along with special treatment procedures and shielding requirements. The importance of treatment planning in IORT is reviewed with reference to a Monte Carlo-based commercial treatment planning system highlighting its main features and limitations. The report concludes with suggested topics for research including CT-based image-guided treatment planning and improved prescription dose accuracy. We hope that this multi-institutional report will serve as a guidance document on the clinical implementation and use of INTRABEAM IORT.
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  • 文章类型: Journal Article
    背景:在体外牙科影像学研究中,需要模拟软组织以尽可能接近地复制临床状况。这项研究旨在找出已研究用于口腔颌面放射学的软组织模拟材料,并显示出与颌面区域软组织的放射密度相似。
    方法:在本范围审查中,WebofScience,Embase,Scopus,谷歌学者和PubMed数据库于2023年4月9日进行了搜索,考虑到以下PICOS:人群:软组织模拟物,干预:基于X射线的成像,比较:-,结果:软组织模拟物的特性,研究设计:体外研究。筛选,研究选择,数据提取由两名独立研究人员完成.在有分歧的情况下,与第三名小组成员进行了磋商。使用用于体外研究的质量评估工具(QUIN工具)对所包括的研究进行质量评估。
    结果:在数据库搜索中检索到的最初1172篇文章中,该综述包括13项研究。七项研究的偏倚风险较低。在8项研究中,计算机断层扫描(CT)或锥形束计算机断层扫描(CBCT),在4项研究中,在2项研究中,使用了全景X线摄影(一项研究使用了CT/CBCT和全景X线摄影)。这些研究在射线照相模式上有所不同,采集参数,选定的结果,和黄金标准。在大多数研究中(n=10,77%),丙烯酸树脂衍生物单独或作为主要成分用于软组织模拟配方中。在8项研究(62%)中,在模拟材料中使用蜡。此外,在3项研究(23%)中,冰/水被用作主要模拟物。
    结论:弹道明胶,膨胀2厘米厚的聚苯乙烯,有或没有1厘米的实用蜡,在采用CBCT扫描的标准化研究中,0.5cm的丙烯酸树脂的射线照相密度与软组织相似。对于口腔内X光片,使用自聚合丙烯酸树脂,公用事业蜡,和木头,以及一个充满水的聚甲基丙烯酸甲酯盒子,厚度范围从4到45毫米,提供合适的射线照相对比度。然而,4和8毫米的蜡和4毫米的水,射线照相对比是不合适的。此外,13-17毫米蜡和14.5毫米丙烯酸树脂在口腔内射线照相中显示出可接受的软组织密度。需要使用具有标准化条件和客观度量的不同成像方式进行进一步研究,以确认用于体外牙科放射学研究的最合适的软组织模拟材料。
    BACKGROUND: In in-vitro dental radiographic research, simulation of soft tissue is required to replicate the clinical condition as close as possible. This study aimed to find out which soft tissue simulation material have been studied to use in dentomaxillofacial radiology and showed similarity in radiodensity to the soft tissues of the maxillofacial region.
    METHODS: In this scoping review, Web of Science, Embase, Scopus, Google scholar and PubMed databases were searched on April 9, 2023, considering the following PICOS: Population: soft tissue simulants, Intervention: X-ray-based imaging, Comparison: -, Outcome: properties of the soft tissue simulants, Study design: in-vitro studies. Screening, study selection, and data extraction were performed by two independent researchers. A third team member was consulted in the case of disagreement. Quality assessment of the included studies was made using Quality Assessment Tool For In-Vitro Studies (QUIN Tool).
    RESULTS: Of the initial 1172 articles retrieved in the database search, 13 studies were included in the review. Seven studies had a low risk of bias. In 8 studies, computed tomography (CT) or cone beam computed tomography (CBCT), in 4 studies intraoral radiography, and in 2 studies panoramic radiography was used (one study has used CT/CBCT and panoramic radiography). The studies varied in the radiographic modality, acquisition parameters, selected outcomes, and gold standard. In the majority of the studies (n = 10, 77%), acrylic resin derivatives were used in the soft tissue simulant formula alone or as a major component. Wax was used in the simulant material in 8 studies (62%). In addition, in 3 studies (23%) ice/water was used as the main simulant.
    CONCLUSIONS: Ballistic gelatin, expanded 2-cm thick polystyrene with or without 1-cm utility wax, and 0.5 cm of acrylic resin were shown to have a radiographic density similar to soft tissue in standardized studies employing CBCT scanning. For intraoral radiographs, using self-polymerizing acrylic resin, utility wax, and wood, as well as a polymethylmethacrylate box filled with water in thicknesses ranging from 4 to 45 mm, provides suitable radiographic contrast. However, for 4 and 8 mm of wax and 4 mm of water, the radiographic contrast is not appropriate. In addition, 13-17 mm wax and 14.5 mm acrylic resin showed acceptable soft tissue densities in intraoral radiography. Further studies using different imaging modalities with standardized conditions and objective metrics are required to confirm the most appropriate soft tissue simulant material for in-vitro dental radiographic research.
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  • 文章类型: Systematic Review
    背景:1990年代初,英国(UK)政府的医疗保健政策为采用技术混合开发和实施X射线诊断技师报告服务铺平了道路。英国公共医疗保健系统内的当前临床实践反映了与1990年代一样的患者影像学需求增加和报告劳动力(放射技师和放射科医师)能力有限的压力。本研究旨在确定,定义和评估纵向宏观,meso,以及在英格兰国家医疗保健系统(NHS)中实施放射诊断技师肌肉骨骼X射线报告服务的微障碍和推动者。
    方法:搜索了多个独立数据库,包括PubMed,OvidMEDLINE;Embase;CINAHL,和谷歌学者,以及期刊数据库(Scopus,Wiley),医疗保健数据库(NHS证据数据库;Cochrane图书馆)和灰色文献数据库(OpenGrey,GreyNetInternational,和大英图书馆EthOS存放处),并记录在PRISMA流程图中。关键词的组合,布尔逻辑,截断,括号和通配符包含/排除标准,时间范围为1995-2022年.这些文献是根据乔安娜·布里格斯研究所的批判性评估清单进行评估的。通过元聚合来合成每篇论文,并使用NVivo编码,将上下文分组为宏,meso,和微观层面的来源,并分类为推动者和障碍的子组。
    结果:广泛多样的数据(n=241篇论文)确定了实施的障碍和促成因素,被归类为宏观的衡量标准,meso,微观层面,和主题类别的背景,文化,环境,和领导力。
    结论:自1995年以来的文献重新讨论了关于实施放射技师报告角色的争论,并在塑造临床实践中发挥了重要作用。对中观(专业机构)和宏观(政府/卫生服务)政策和指导都有明显的影响,这在微观层面的NHS信托组织中形成了变化。有证据表明,围绕技能混合接受度和角色边界,不同中观专业机构内部和之间的文化根深蒂固的传统观点发生了转变。这有助于塑造报告队伍的能力建设。所有这些都有助于对现代放射学服务中的技能组合劳动力的概念理解。
    BACKGROUND: The United Kingdom (UK) government\'s healthcare policy in the early 1990s paved the way adoption of the skills mix development and implementation of diagnostic radiographers\' X-ray reporting service. Current clinical practice within the public UK healthcare system reflects the same pressures of increased demand in patient imaging and limited capacity of the reporting workforce (radiographers and radiologists) as in the 1990s. This study aimed to identify, define and assess the longitudinal macro, meso, and micro barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X-ray reporting service in the National Healthcare System (NHS) in England.
    METHODS: Multiple independent databases were searched, including PubMed, Ovid MEDLINE; Embase; CINAHL, and Google Scholar, as well as journal databases (Scopus, Wiley), healthcare databases (NHS Evidence Database; Cochrane Library) and grey literature databases (OpenGrey, GreyNet International, and the British Library EthOS depository) and recorded in a PRISMA flow chart. A combination of keywords, Boolean logic, truncation, parentheses and wildcards with inclusion/exclusion criteria and a time frame of 1995-2022 was applied. The literature was assessed against Joanna Briggs Institute\'s critical appraisal checklists. With meta-aggregation to synthesize each paper, and coded using NVivo, with context grouped into macro, meso, and micro-level sources and categorised into subgroups of enablers and barriers.
    RESULTS: The wide and diverse range of data (n = 241 papers) identified barriers and enablers of implementation, which were categorised into measures of macro, meso, and micro levels, and thematic categories of context, culture, environment, and leadership.
    CONCLUSIONS: The literature since 1995 has reframed the debates on implementation of the radiographer reporting role and has been instrumental in shaping clinical practice. There has been clear influence upon both meso (professional body) and macro-level (governmental/health service) policies and guidance, that have shaped change at micro-level NHS Trust organisations. There is evidence of a shift in culturally intrenched legacy perspectives within and between different meso-level professional bodies around skills mix acceptance and role boundaries. This has helped shape capacity building of the reporting workforce. All of which have contributed to conceptual understandings of the skills mix workforce within modern radiology services.
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  • 文章类型: Journal Article
    目的:探讨与执业护士(NPs)使用诊断成像相关的同行评审文献的性质和范围,以指导未来的实践和研究。
    背景:护士从业者进行高级评估,诊断,和病人的管理,包括诊断成像的请求和解释。目前尚不清楚近年来有哪些证据与NP对放射学调查的质量使用有关。
    方法:根据JoannaBriggs研究所建议的步骤进行范围审查。
    方法:对Medline数据库的结构化审查,CINAHL和Embase使用关键字和MESH术语“护士执业”进行,\'医学成像\',\'诊断成像\',\'scan\'和\'radiography\'。只包括英语文章,并且没有应用日期限制。数据库审查于2021年5月30日完成。
    结果:确定了八个主题-国家和临床背景,请求诊断成像,进行诊断成像,图像引导干预,解释诊断成像,培训教育和知识,对资源使用的影响以及与医生的比较。与其他国家相比,美国在更广泛的临床专业和成像方式上进行了更多的研究。护士执业通常以医学同事的执业为基准。关于教育准备的研究很少,并且缺乏有关诊断成像的NPs的相关大学课程。
    结论:在美国以外的几个确定的主题中,证据存在显著差距。需要进一步的研究来探索NP对诊断成像的访问和使用,并了解对此的障碍和促进因素。
    结论:本综述纳入了来自四个国家的研究。证据表明,在那里学习,护士从业人员(NPs)可以安全,适当地要求和解释在紧急情况和轻伤情况下的普通X射线。需要进一步的研究来评估NPs在诊断成像及其使用先进成像技术方面的教育需求,尤其是在美国以外。
    没有患者或公众捐款。
    OBJECTIVE: To explore the nature and extent of peer-reviewed literature related to the use of diagnostic imaging by nurse practitioners (NPs) to inform future practice and research.
    BACKGROUND: Nurse practitioners undertake advanced assessment, diagnosis, and management of patients, including requesting and interpretation of diagnostic imaging. It is unclear what evidence exists related to the quality use of radiological investigations by NPs in recent years.
    METHODS: A scoping review based on the steps suggested by the Joanna Briggs Institute.
    METHODS: A structured review of the databases Medline, CINAHL and Embase was undertaken using the keywords and MESH terms \'nurse practitioner\', \'medical imaging\', \'diagnostic imaging\', \'scan\' and \'radiography\'. Only English language articles were included, and no date limit was applied. Database review was completed on 30 May 2021.
    RESULTS: Eight themes were identified-country and clinical context, requesting diagnostic imaging, performing diagnostic imaging, image-guided interventions, interpreting diagnostic imaging, training education and knowledge, impact on resource usage and comparison with medical practitioners. There were more studies across a greater breadth of clinical specialties and imaging modalities in the United States than in other countries. Nurse practitioner practice is frequently benchmarked against that of medical colleagues. There is a paucity of studies focusing on educational preparation and the lack of relevant university curricula for NPs around diagnostic imaging.
    CONCLUSIONS: There are significant gaps in the evidence outside of the United States across several of the identified themes. Further studies are needed to explore NP access to and use of diagnostic imaging and to understand the barriers and facilitators to this.
    CONCLUSIONS: Studies from four countries were included in this review. The evidence suggests that, where studied, nurse practitioners (NPs) can safely and appropriately request and interpret plain x-rays in the emergency and minor injuries setting. Further research is needed to evaluate the educational needs of NPs in relation to diagnostic imaging and their use of advanced imaging techniques, particularly outside of the United States.
    UNASSIGNED: No patient or public contribution.
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  • 文章类型: Journal Article
    在无症状个体中进行常规胸部X光检查(CXR)以评估高压暴露风险是有争议的。在许多情况下,辐射风险可能会掩盖低产量。然而,在某些情况下,产量可能会更高,如结核病流行国家。我们评估了常规CXR在南非潜水和潜艇体检中的实用性。
    对31年的894名潜水员和潜艇运动员的3,568项体能检查中的2,777名CXR记录进行了审查,以确定CXR异常的发生率。使用比值比和二项逻辑回归模型评估相关因素,用Kaplan-Meier图来描述服务的持续时间,直到第一个异常CXR。
    在每人每年的服务中报告了异常的CXR,研究参与者的累积发生率为6.5%(58/894).在他们的病史中只有4个人具有CXR的临床指征。看到了一系列潜在的病理,其中15.5%被宣布不合格,其余(84.5%)接受治疗,或进一步调查显示该人可以被宣布健康。
    在南非,常规CXR在检测与压力暴露不相容的异常方面可以发挥作用。在初次检查期间和有长期服务记录的个人中发现的异常数量最多。在我们研究的31年中,只有4个人具有CXR的临床指征。应进行类似的研究,以便在其他国家和环境中提出建议。
    UNASSIGNED: Performance of routine Chest X-rays (CXRs) in asymptomatic individuals to assess hyperbaric exposure risk is controversial. The radiation risk may overshadow the low yield in many settings. However, the yield may be higher in certain settings, such as tuberculosis-endemic countries. We evaluated the utility of routine CXR in diving and submarine medical examinations in South Africa.
    UNASSIGNED: Records of 2,777 CXRs during 3,568 fitness examinations of 894 divers and submariners spanning 31 years were reviewed to determine the incidence of CXR abnormality. Associated factors were evaluated using odds ratios and a binomial logistic regression model, with a Kaplan-Meier plot to describe the duration of service until first abnormal CXR.
    UNASSIGNED: An abnormal CXR was reported in 1.1% per person year of service, yielding a cumulative incidence of 6.5% (58/894) of the study participants. Only four individuals had a clinical indication for the CXR in their medical history. A range of potential pathologies were seen, of which 15.5% were declared disqualifying and the rest (84.5%) were treated, or further investigation showed that the person could be declared fit.
    UNASSIGNED: In South Africa, a routine CXR has a role to play in detecting abnormalities that are incompatible with pressure exposures. The highest number of abnormalities were found during the initial examinations and in individuals with long service records. Only four individuals had a clinical indication for their CXR during the 31-year span of our study. Similar studies should be performed to make recommendations in other countries and settings.
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  • 文章类型: Journal Article
    澳大利亚医学放射实践委员会(MRPBA)最低能力框架要求所有澳大利亚放射技师在放射图像中识别重要的病理,并采取适当的行动来警告这些紧急发现并确保患者安全。尽管专业机构认可以书面形式提供初步图像评估(PIE),放射技师图像解释往往不一致,非正式,或无证件。这篇叙述性评论的目的是评估文献,以确定以书面放射线摄影师评论形式的PIE是否对澳大利亚医疗保健系统具有价值。使用四个健康研究数据库完成了结构化搜索:CINAHL,Medline,Scopus和WebofScience研究表明,由于成像服务压力的增加,存在评论的上下文需要,放射科医生短缺和随后的报告延误。放射技师似乎处于有利地位,并愿意提供准确的初始输入,并提供证据证明这将在多学科团队中得到重视和赞赏。放射技师的评论也已被证明可以减少诊断和沟通错误,并有可能改善患者管理。最后,研究表明,参与形象解读实践可以加强招聘,放射技师的保留率和工作满意度。因此,当前的文献支持在澳大利亚医疗保健系统中实施放射线照相员评论。
    The Medical Radiation Practice Board of Australia (MRPBA) minimum competency framework requires all Australian radiographers to identify significant pathology in radiological images and take appropriate action to alert these urgent findings and ensure patient safety. Despite professional bodies endorsing the provision of preliminary image evaluations (PIE) in written format, radiographer image interpretation often remains inconsistent, informal, or undocumented. The purpose of this narrative review was to assess the literature to determine if PIE in the form of written radiographer comments is of value to the Australian healthcare system. A structured search was completed using four health research databases: CINAHL, Medline, Scopus and Web of Science. Studies have suggested that there is a contextual need for commenting due to increased imaging service pressures, radiologist shortages and subsequent reporting delays. Radiographers appear well placed and willing to provide accurate initial input with evidence that this would be valued and appreciated within the multidisciplinary team. Radiographer commenting has also been shown to reduce diagnostic and communicative errors with the potential to improve patient management. Finally, it was shown that participation in image interpretation practices can enhance recruitment, retention and job satisfaction among radiographers. Therefore, the current literature supports implementation of radiographer commenting within the Australian healthcare system.
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