Aplicação dos princípios de radioproteção em medicina nuclear

The Nuclear Medicine is a medical specialty which uses different radioisotopes for diagnostic and therapeutic purposes. The isotopes are radioactive elements which are administered in vivo and present distribution to specific organs or cell types. The knowledge of radioactivity and notions related to ionizing radiation allow to contextualize the radiological protection measures to be taken in Nuclear Medicine. So it is possible to minimize unnecessary exposure to patients, the public, and individuals occupationally exposed and the environmental. For this it is necessary to relate the physical and technological bases apply to this mode with the standards established by regulatory agencies, including the CNEN (National Nuclear Energy Commission) and ANVISA (National Agency for Sanitary Vigilance). In this scenario, it is important that the theoretical endorse the activities which are periodically audited for verification of compliance with the standards that aim to radioprotection. One role of the Medical Physicist in these services is, therefore, act as Radiation Protection Supervisor exerting numerous activities and ensuring compliance with these standards. In this context the stage in the area of Nuclear Medicine was developed in many customers of the enterprise Rad Dimenstein & Associados LTDA, among them the hospitals Israelita Albert Einstein (HIAE), Nossa Senhora de Lourdes (HNSL), Santa Paula (HSP), Cruz Azul (CRAZ), Grupo Fleury, among other clinics. Following the routine and then carrying out various activities pertaining to the Medical Physicist in the area, it was noted that the measures and actions are extremely effective and fundamental in terms of radiological protection

Análise do plano de radioproteção em radioterapia

Ionizing radiation is used nowadays in various sectors such as agriculture, industry and medicine. The main specialties of medicine which use radiation are the diagnostic radiology, nuclear medicine and radiotherapy. Radiotherapy is a therapeutic modality that is a well established feature for the treatment of malignant disease or not. However, the inadvertent use of ionizing radiation can produce deleterious effects that result in sequels that compromise the welfare of the people involved. The analysis of radiological protection emphasizes the importance of avoiding inappropriate exhibitions aimed at protecting the health of patients, the professionals involved and the general public. The basic principles of radioprotection are justification, optimization and restriction for individual dosage. The departments of radiotherapy are regulated in accordance with specific technical standards of the National Commission of Nuclear Energy (CNEN), which during the inspection for issue and renewal of the authorization of operation requires the submission of a radioprotection plan, this document that requires great demand of time, and has generated much debate among professionals in medical physics, given the difficulties encountered in their preparation. After examining the radioprotection plan of some radiotherapy services, as suggested in order to guide those responsible for drawing up these plans, especially beginners in the career of the physics of radiation, this paper presents a model plan that is in line radioprotection it requires the Technical Standards of CNEN and can easily be the reality of appropriate services

Controle de qualidade e levantamento radiométrico em aparelho de Raios-X médico convencional

Along with the advance of technology, in terms of the expansion of medical exams that uses the ionizing radiation for diagnosis, there is also the concern about quality control for maintaining quality in radiographic imaging and for delivering low dose to the patient. Based on the Federal Order 453 of the Secretariat of Health Surveillance, which takes account of the practical and justification of individual medical exposures, the optimization of radiological protection, limitation of individual dose, and the prevention of accidents, were done through this paper radiodiagnostic tests on medical equipment in order to accept it or not, according to SVS-453. Along with the help and support of P&R Consulting and Medical Physics Marilia, SP, were made Quality Control and Radiometric Control in equipment from various cities across the state of São Paulo. The equipment discussed in this work is classified as conventional X-ray. According to the Federal Order SVS-453, the quality control in the program of quality assurance should include the following minimum set of constancy tests, with following minimum frequency: biennial tests for representative values of dose given to the patients of radiography and CT performed in the service; annual tests for accuracy of the indicator tube voltage (kVp), accuracy of exposure time, half-value layer, aligning the central axis of the beam of x-ray tube, performance (mGy / mA.min.m²), linearity of the rate of kerma on air with the mAs, reproducibility of the kerma on air rates, reproducibility of the automatic exposure, focal spot size, integrity of accessories and clothing for individual protection; semiannually for collimation system accuracy; weekly for temperature processing system and sensitometry processing system. For the room Radiometric Survey it was done a sketch...(Complete abstract click electronic access below)

Avaliação das doses de cães submetidos a exames radiográficos de pulmão

This study aims to determine surface skin doses in dogs (with suspected pulmonary metastasis) submitted to chest X-rays using the technique of thermoluminescence dosimetry. Twenty seven exams from different dogs were performed at the Faculdade de Medicina Veterinária e Zootecnia da Universidade Estadual Paulista (FMVZ-UNESP/Botucatu). The doses were evaluated using thermoluminescent dosimeters of calcium sulphate doped with dysprosium (CaSO4:Dy) produced by the Instituto de Pesquisas Energéticas e Nucleares (IPEN-CNEN). The pulmonary metastasis exams are carried out in three projections, one dorsal-ventral and two lateral-lateral. During the procedures the projection thicknesses and source-skin surface distances were registered. To simulate the dog phantom the dosimeters were positioned in a cubic simulator (30x30x30 cm) of polymethylmethacrylate (PMMA) filled with water and irradiated according to the parameters of projections with the X-ray energies ranging from 45 to 70 kV. To estimate the surface skin dose the dose-response curves were obtained for X-ray energies of 50 and 70 kV using the diagnostic X-ray beam machine of the Instruments Calibration Laboratory of IPEN for doses of 1.5, 2.0, 2.5, 3.5 and 4.0 mGy. The main difficulty of this work was the dog immobilization that is reflected in poor-quality diagnostic imaging and, consequently, demands the repetition of the exams, which contributes to the increase of the doses received by the animals being studied and the clinical staff. The doses evaluated in this type of procedure are between 0.43 and 4.22 mGy. This research has shown to be extremely important for the assessment of doses involved in veterinary diagnostic radiology procedures, and as a parameter in the individual monitoring of pet’s owners who assist the animal positioning and occupationally exposed workers of the Department of Veterinary Radiology

Manutenção da prática de atividade física e indicadores hemodinâmicos, metabólicos e inflamatório em adultos: análise transversal e coorte de 12 meses

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Diretrizes de conduta e tratamento de síndromes febris periódicas associadas à criopirina (Criopirinopatias–CAPS)

To establish guidelines based on cientific evidences for the management of cryopyrin associated periodic syndromes. The Guideline was prepared from 4 clinical questions that were structured through Pico (Patient, Intervention or indicator, Comparison and Outcome), to search in key primary scientific information databases. After defining the potential studies to support the recommendations, these were graduated considering their strength of evidence and grade of recommendation. 1215 articles were retrieved and evaluated by title and abstract; from these, 42 articles were selected to support the recommendations. 1. The diagnosis of Caps is based on clinical history and clinical manifestations, and later confirmed by genetic study. Caps may manifest itself in three phenotypes: FCAS (mild form), MWS (intermediate form) and Cinca (severe form). Neurological, ophthalmic, otorhinolaryngological and radiological assessments may be highly valuable in distinguishing between syndromes; 2. The genetic diagnosis with NLRP3 gene analysis must be conducted in suspected cases of Caps, i.e., individuals presenting before 20 years of age, recurrent episodes of inflammation expressed by a mild fever and urticaria; 3. Laboratory abnormalities include leukocytosis and elevated serum levels of inflammatory proteins; 4. Targeted therapies directed against interleukin-1 lead to rapid remission of symptoms in most patients. However, there are important limitations on the long-term safety. None of the three anti-IL-1β inhibitors prevents progression of bone lesions.

Radioterapia em medicina veterinária: princípios e perspectivas

This work presents a brief historical about the use of ionizing radiations in Veterinary Medicine, instructing the physical beginnings and techniques wrapped in the realization of the proceedings of radiotherapy in animals, illustrating some treated cases, highlighting the difficulties and pointing to the perspectives and importance of the acting of the medical physics in this kind of therapeutic still little used in the national scenery.

Evaluation of femur of orchiectomized guinea pigs by bone densitometry using dual-energy x-ray absortiometry (DXA) and mechanical testing

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Carcinoma escamoso oral: análise retrospectiva de 185 casos

The squamous cell carcinoma is the most common malignancy in the oral cavity, representing over 90% of cancers in this region. This study aimed to conduct an epidemiological study of oral squamous carcinoma cases diagnosed by the Department of Pathology, Department of Pathology and Clinical Propaedeutics in the Dentistry Faculty of Araçatuba - UNESP, in the period between 1995 and 2005. 185 cases were studied, it was observed that the oral floor and tongue were the sites most affected, with predominance in males, white race and aged between 41 and 60 years, noting that the majority of patients were smokers. Knowledge of these data is important for the dental surgeon to act preventively, contributing to early diagnosis of cancer.

Análise comparativa de exposição do operador à radiação entre as técnicas radial, femoral e radial com dispositivo protetor em procedimentos de cardiologia intervencionista

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Avaliação da cavidade uterina com histerossonografia, uma revisão

Sonohysterography was firstly described three decades ago. The saline solution infusion into the uterine cavity favors its use and provides excellent visualization of the anatomy and the inner cavity of the uterus better than the conventional transvaginal sonography To check the current role of sonohysterography in the uterine cavity assessment in women with abnormal uterine bleeding and asymptomatic, a literature review comparing sonohysterograph with conventional transvaginal sonography and/or ambulatory diagnostic hysteroscopy was carried out. To this end, relevant studies were researched in electronic databases Medline/PubMed, SciELO/LILACS. The sonohysterography is an ambulatory procedure, non-invasive, better cost-benefit, better sensitivity and specificity to identify uterine abnormalities, causing minimal discomfort and low complications rate. It was subject to revision which there is no more doubt about its accuracy. It can be concluded that the sonohysterography is a useful tool in the propedeutics to assess uterine cavity of symptomatic patients with abnormal uterine bleeding, infertility, recurrent miscarriages, and embryonic implantation failures in assisted reproduction treatment / in vitro fertilization and in any other intra and extra uterine cavity alteration. Hence, conventional transvaginal sonography is indicated as an initial method of assessment of the uterine cavity previously to ambulatory diagnostic hysteroscopy.

Tenotomia do músculo flexor digital superficial e desmotomia acessória em equinos: goniometria radiometacarpiana, metacarpofalângica e interfalângica

The purpose of this study was to investigate the effects of the superficial digital tenotomy and the superior check ligament desmotomy on the radio-metacarpal, metacarpophalangeal, proximal and distal interphalangeal angles in horses. Under general anesthesia the superficial digital flexor tenotomy and superior check ligament desmotomy were performed, respectively, on the right and left forelimbs in nine horses. Before surgery and on 15th, 30th, and 60th postoperative days the radio-metacarpal, metacarpophalangeal, and proximal and distal interphalangeal angles were measured by radiographic examination. Tenotomy decreased significantly the metacarpophalangeal angle (mean ± standard deviation: preoperative – 140.7º ± 6.85; 60th day – 128.2º ± 5.93) and increased the distal interphalangeal angle (mean ± standard deviation: preoperative – 172.6 ± 1.87; 60th day – 167.6 ± 1.36). Desmotomy decreased the proximal interphalangeal angle (mean ± standard deviation: preoperative – 180.2º ± 5.43; 60th day- 197.3º ± 8.29). These surgical procedures did not change the radio-metacarpal angle. The superficial digital flexor tenotomy and the superior check ligament desmotomy cause different and significant changes in joint angles distal to the carpus.