Modern medicine is unthinkable without X-rays. Accurate diagnosis, leading to effective treatment, is largely based on precise X-ray examinations. The creation of new, modern equipment and various medical procedures t...Modern medicine is unthinkable without X-rays. Accurate diagnosis, leading to effective treatment, is largely based on precise X-ray examinations. The creation of new, modern equipment and various medical procedures that meet the increased requirements are a priority in our time. X-ray examinations are of particular importance for the orthopedic and traumatological clinics, where they provide information about presence of a fracture in the patient’s body, about the concrete operation performed or about the effect of a suitable treatment. Along with their benefits X-rays have also a harmful effect. This requires special care to protect from this radiation. In this direction, research is constantly being done to improve the quality of radiation protection. Park MR, Lee KM and co-authors, compare the dose load obtained using C-arm and O-arm X-ray systems (which have the capability of combined 2D fluoroscopy and 3D computed tomography imaging). In their study, an orthopedic surgical procedure using C-arm and O-arm systems in 2D fluoroscopy modes was simulated. The radiation doses to susceptible organs of the operators were investigated. He results obtained show that the O-arm system delivered higher doses to the sensitive organs of the operator in all configurations [1]. The article of Stephen Balte briefly reviews the available technologies for measuring or estimation of patient skin dose in the interventional fluoroscopic environment, created by various X-ray equipment including C-arm systems. Given that many patients require multiple procedures, this documentation also aids in the planning of follow up visits [2]. Chong Hing Wong, Yoshihisa Kotani and co-authors evaluate the radiation exposures (RE) to the patient and surgeon during minimally invasive lumbar spine surgery with instrumentation using C-arm image intensifier or O-arm intraoperative CT. The results they get are in favor of the O-arm system [3]. The article “Virtual fluoroscopy for intraoperative C-arm positioning and radiation dose reduction” discusses positioning of an intraoperative C-arm system to achieve clear visualization of a particular anatomical feature by a system for virtual fluoroscopy (called FluoroSim) that could dramatically reduce time and received dose during the procedures. FluoroSim was found to reduce the radiation exposure required for C-arm positioning without reducing positioning time or accuracy, providing a potentially valuable tool to assist surgeons [4]. In our study, we performed practical measurements to show how the patient can be treated by applying most effective radiation protection when using a mobile C-arm X-ray system. For the study, we used exposure upon a phantom placed on the patient’s table. For an X-ray shielding, we used a protective apron with a lead equivalent of 1 mm, placed in two layers on the phantom. In each subsequent series of exposures, the protective apron was placed on the phantom, in a different position relative to the X-ray beam. The general conclusion of our study is that in order to obtain maximum protection from scattered radiation when using C-arm X-ray systems, the patient must be protected by a shielding with a suitable lead equivalent for the procedure performed which must be placed between patient’s body and X-ray tube, perpendicular to the X-ray beam pointed toward the region of interest.展开更多
Introduction： Propofol is an intravenous general anesthetic and sedation drug for use in the induction and maintenance of anesthesia or sedation. It is included in WHO Model List of Essential medicines and approved b...Introduction： Propofol is an intravenous general anesthetic and sedation drug for use in the induction and maintenance of anesthesia or sedation. It is included in WHO Model List of Essential medicines and approved by the FDA （food and drug administration） in 1989. The side effects of Propofol have been studied widely in the last 25 years. They can be easily managed and that is why Propofol has become a fn＇st choice drug for the most of the anesthesiologists worldwide. This paper presents a case report of Propofol induced pulmonary edema and also a review of some of the rarest and unusual manifestations of Propofol side effects. Some of them are urine discoloration, tissue necrosis, rhabdomyolysis and postoperative panereatitis. Methods and materials： A case summary of 18-years old woman with unusual postoperative pulmonary reaction was considered along with other documented cases. Several full-text articles were briefly analyzed for estimating the role of Propofol for a number of strange and potentially life threatening conditions. Results： Despite the low incidence rate, the presented case could be determined as a pulmonary edema due to its clinical features. Furthermore, rare drug reactions such as rhabdomyolysis, tissue necrosis, postoperative pancreatitis etc. may remain unrecognized and create diagnostic and therapeutic issues. Conclusions： Although the officially reported dangerous reaction, Propofol remains one of the best hypnotic and sedative agents. The better knowledge of the full list of drug reactions considered as rare and very rare is a guarantee of an adequate and a better therapeutic behavior.展开更多
The aim of this study is to focus on a disease with a potential global health risk--VL （visceral leishmaniasis） or kala-azar. By understanding the mechanism of occurrence, development and countering infection, we ca...The aim of this study is to focus on a disease with a potential global health risk--VL （visceral leishmaniasis） or kala-azar. By understanding the mechanism of occurrence, development and countering infection, we can expect significant improvement in the indicators of morbidity and mortality. The specific method of transmission, as well as the necessary conditions for it, opens wide opportunities for prevention. The biophysical aspects that we present make it possible to assess the seriousness of the advancing physiological changes. This ensures adequate evaluation of the associated risks and search for an optimal therapy. We have found that from the first manifestations ofkala-azar up until today, a series of countermeasures have been taken up. Acknowledging and expecting the massiveness of the infectious process, it is possible for it to cover areas whose population is unprepared to handle the contamination optimally. This requires the continuation of studies aimed at finding the most affordable and biologically tolerable medicine. The available treatment option for visceral leishmaniasis is problematic when it comes to efficacy, adverse effects and cost, making the treatment a complex issue. Not to mention toxicity of the drugs, ability to monitor side effects, length of treatment and capacity of the healthcare service to administer an accurate therapy. The main drugs available for treatment of VL （visceral leishmaniasis） are systemic agents like Antimony, Amphotericin and nowadays the oral drug Miltefosine.展开更多
文摘Modern medicine is unthinkable without X-rays. Accurate diagnosis, leading to effective treatment, is largely based on precise X-ray examinations. The creation of new, modern equipment and various medical procedures that meet the increased requirements are a priority in our time. X-ray examinations are of particular importance for the orthopedic and traumatological clinics, where they provide information about presence of a fracture in the patient’s body, about the concrete operation performed or about the effect of a suitable treatment. Along with their benefits X-rays have also a harmful effect. This requires special care to protect from this radiation. In this direction, research is constantly being done to improve the quality of radiation protection. Park MR, Lee KM and co-authors, compare the dose load obtained using C-arm and O-arm X-ray systems (which have the capability of combined 2D fluoroscopy and 3D computed tomography imaging). In their study, an orthopedic surgical procedure using C-arm and O-arm systems in 2D fluoroscopy modes was simulated. The radiation doses to susceptible organs of the operators were investigated. He results obtained show that the O-arm system delivered higher doses to the sensitive organs of the operator in all configurations [1]. The article of Stephen Balte briefly reviews the available technologies for measuring or estimation of patient skin dose in the interventional fluoroscopic environment, created by various X-ray equipment including C-arm systems. Given that many patients require multiple procedures, this documentation also aids in the planning of follow up visits [2]. Chong Hing Wong, Yoshihisa Kotani and co-authors evaluate the radiation exposures (RE) to the patient and surgeon during minimally invasive lumbar spine surgery with instrumentation using C-arm image intensifier or O-arm intraoperative CT. The results they get are in favor of the O-arm system [3]. The article “Virtual fluoroscopy for intraoperative C-arm positioning and radiation dose reduction” discusses positioning of an intraoperative C-arm system to achieve clear visualization of a particular anatomical feature by a system for virtual fluoroscopy (called FluoroSim) that could dramatically reduce time and received dose during the procedures. FluoroSim was found to reduce the radiation exposure required for C-arm positioning without reducing positioning time or accuracy, providing a potentially valuable tool to assist surgeons [4]. In our study, we performed practical measurements to show how the patient can be treated by applying most effective radiation protection when using a mobile C-arm X-ray system. For the study, we used exposure upon a phantom placed on the patient’s table. For an X-ray shielding, we used a protective apron with a lead equivalent of 1 mm, placed in two layers on the phantom. In each subsequent series of exposures, the protective apron was placed on the phantom, in a different position relative to the X-ray beam. The general conclusion of our study is that in order to obtain maximum protection from scattered radiation when using C-arm X-ray systems, the patient must be protected by a shielding with a suitable lead equivalent for the procedure performed which must be placed between patient’s body and X-ray tube, perpendicular to the X-ray beam pointed toward the region of interest.
文摘Introduction： Propofol is an intravenous general anesthetic and sedation drug for use in the induction and maintenance of anesthesia or sedation. It is included in WHO Model List of Essential medicines and approved by the FDA （food and drug administration） in 1989. The side effects of Propofol have been studied widely in the last 25 years. They can be easily managed and that is why Propofol has become a fn＇st choice drug for the most of the anesthesiologists worldwide. This paper presents a case report of Propofol induced pulmonary edema and also a review of some of the rarest and unusual manifestations of Propofol side effects. Some of them are urine discoloration, tissue necrosis, rhabdomyolysis and postoperative panereatitis. Methods and materials： A case summary of 18-years old woman with unusual postoperative pulmonary reaction was considered along with other documented cases. Several full-text articles were briefly analyzed for estimating the role of Propofol for a number of strange and potentially life threatening conditions. Results： Despite the low incidence rate, the presented case could be determined as a pulmonary edema due to its clinical features. Furthermore, rare drug reactions such as rhabdomyolysis, tissue necrosis, postoperative pancreatitis etc. may remain unrecognized and create diagnostic and therapeutic issues. Conclusions： Although the officially reported dangerous reaction, Propofol remains one of the best hypnotic and sedative agents. The better knowledge of the full list of drug reactions considered as rare and very rare is a guarantee of an adequate and a better therapeutic behavior.
文摘The aim of this study is to focus on a disease with a potential global health risk--VL （visceral leishmaniasis） or kala-azar. By understanding the mechanism of occurrence, development and countering infection, we can expect significant improvement in the indicators of morbidity and mortality. The specific method of transmission, as well as the necessary conditions for it, opens wide opportunities for prevention. The biophysical aspects that we present make it possible to assess the seriousness of the advancing physiological changes. This ensures adequate evaluation of the associated risks and search for an optimal therapy. We have found that from the first manifestations ofkala-azar up until today, a series of countermeasures have been taken up. Acknowledging and expecting the massiveness of the infectious process, it is possible for it to cover areas whose population is unprepared to handle the contamination optimally. This requires the continuation of studies aimed at finding the most affordable and biologically tolerable medicine. The available treatment option for visceral leishmaniasis is problematic when it comes to efficacy, adverse effects and cost, making the treatment a complex issue. Not to mention toxicity of the drugs, ability to monitor side effects, length of treatment and capacity of the healthcare service to administer an accurate therapy. The main drugs available for treatment of VL （visceral leishmaniasis） are systemic agents like Antimony, Amphotericin and nowadays the oral drug Miltefosine.
