Protecção radiológica do doente em tomografia computorizada

RESUMO - A preocupação com os conhecimentos, atitudes, crenças e práticas, no que concerne à utilização de radiações ionizantes para fins de diagnóstico, e a sensibilização de todos os agentes envolvidos, médicos, técnicos, físicos, utentes e responsáveis pela Saúde Publica, relativamente aos níveis de radiação emitida nos exames de Tomografia Computorizada (TC), assume particular importância no domínio da Saúde Pública, na medida em que é necessário influenciar o desenvolvimento de práticas que promovam, auditem e garantam a prestação do controlo da qualidade radiológica e dosimétrica nos serviços de Radiologia a nível Nacional. Para tal, e no âmbito da publicação de estudos já realizados ao nível da União Europeia, ―Orientações Europeias dos Critérios de Qualidade para a Tomografia Computorizada (1999) ‖, é proposto estabelecer orientações na realização de estudos que permitam, numa primeira fase, estabelecer a comparação com os resultados obtidos pelos mecanismos de Controlo da Qualidade (CQ), analisar e proceder aos ajustes (se necessário) e, numa segunda fase, implementar uma moldura sistemática de avaliação periódica dos níveis de dose de radiação por exame TC e que permita a monitorização dos dados. Nesse sentido, propõe-se a realização de um Estudo Nacional que envolva a rede hospitalar pública, privada e universitária, partindo da metodologia utilizada em estudos prévios noutros países da Europa, como seja, selecção do equipamento de TC existente na Instituição Hospitalar, onde serão reunidas informações através do preenchimento de questionários relativos ao equipamento a utilizar. Serão recolhidos dados relativos ao utente, ao equipamento e parâmetros de aquisição de imagem, que permitam identificar os níveis de referência de diagnóstico (NRD) em TC, na realidade Portuguesa. Foi efectuado um estudo piloto numa instituição EPE e os valores obtidos não são significativos, nem podem assumir valor preditivo dado o reduzido tamanho da amostra. Apesar disso, sugerem a existência de parâmetros que podem ser alterados e com isso podem fazer variar a dose de radiação utilizada. ENSP/UNL Maria de Fátima Vaz de Carvalho 5 Espera-se obter com este estudo, como foi referido, a base do estabelecimento dos NRD em TC em Portugal. ----------------- ABSTRACT - The purpose of this study, in an empirical point of view, emerges from concern with the knowledge, attitudes, beliefs and practices regarding the use of ionizing radiation for diagnostic purposes and awareness of all actors involved, medical physical, technical, and responsible public health for the development of practices that promote, audited and ensure the provision of radiological quality control and dosing in radiology service at national level. In view of the complexity and characteristics involved in relation to ionizing radiation, all assume their part in protecting the physical integrity of each user and a global perspective, to ensure the safeguarding of public health, while global and globalizing factor. To this end, and in the context of the publication of studies already carried out at European Union level, "European guidelines for quality criteria for computed tomography", it is proposed to establish guidelines in conducting studies to initially establish the comparison with the results obtained by QC and make adjustments if necessary, and subsequently implement a systematic periodic assessment frame that allows monitoring of data. Accordingly, it is proposed to conduct a national study involving the public network, private and University hospitals, that extends from the methodology used in previous studies in other countries of Europe, as is, selection of equipment of existing CT in Hospital Institution, where information will be gathered by filling out questionnaires concerning the equipment to be used. Data will be collected for the wearer, equipment and parameters of image acquisition, identifying diagnostic reference levels (NRD) in CT in Portuguese fact. A pilot study was carried out in an institution EPE and the values obtained are not significant, nor can they take predictive value given the small sample size. Despite this, suggest the existence of parameters that can be changed and this can vary the dose of radiation used It is hoped to get with this study, as mentioned, the basis of the establishment of NRD in CT in Portugal.

An Extension of Estimation of Domain of Attraction for Fractional Order Linear System Subject to Saturation Control

This paper employs the Lyapunov direct method for the stability analysis of fractional order linear systems subject to input saturation. A new stability condition based on saturation function is adopted for estimating the domain of attraction via ellipsoid approach. To further improve this estimation, the auxiliary feedback is also supported by the concept of stability region. The advantages of the proposed method are twofold: (1) it is straightforward to handle the problem both in analysis and design because of using Lyapunov method, (2) the estimation leads to less conservative results. A numerical example illustrates the feasibility of the proposed method.

An efficient numerical scheme for solving multi-dimensional fractional optimal control problems with a quadratic performance index

The shifted Legendre orthogonal polynomials are used for the numerical solution of a new formulation for the multi-dimensional fractional optimal control problem (M-DFOCP) with a quadratic performance index. The fractional derivatives are described in the Caputo sense. The Lagrange multiplier method for the constrained extremum and the operational matrix of fractional integrals are used together with the help of the properties of the shifted Legendre orthonormal polynomials. The method reduces the M-DFOCP to a simpler problem that consists of solving a system of algebraic equations. For confirming the efficiency and accuracy of the proposed scheme, some test problems are implemented with their approximate solutions.

Echinococcosis in southern Brazil: efforts toward implementation of a control program in Santana do Livramento, Rio Grande do Sul

This investigation aimed to design a strategy for echinococcosis control in Santana do Livramento county, an endemic area in state of Rio Grande do Sul (Brazil). Fecal samples from 65 dogs were obtained from urban, suburban and rural areas. Purging with Arecoline Bromhidrate (AB) was done to visualize Echinococcus granulosus, and Enzyme Linked Immunosorbent Assay (ELISA) was performed to detect parasite coproantigen. Samples were obtained at the beginning and at the end of treatment with Praziquantel. A third fecal sampling was also done in rural areas four months after the end of treatment. Each dog was treated immediately after the first purging and every 30 days for eight months. In urban and suburban areas no infected dogs were found. In rural areas, first evaluation showed 11.36% and 27.69% of infected dogs by AB and ELISA, respectively. No infected dogs were diagnosed in the second evaluation and in the third evaluation 36.84% and 47.37% infected dogs were identified by AB and ELISA, respectively. Medication program to combat dog infection resulted in successful interruption of parasite transmission, but the project failed to create awareness of the need for dog prophylaxis among rural populations as well as to establish a permanent control program in this municipality.

Influence of dual-task on sit-to-stand-to-sit postural control in Parkinson's disease

Postural control deficits are the most disabling aspects of Parkinson's disease (PD), resulting in decreased mobility and functional independence. The aim of this study was to assess the postural control stability, revealed by variables based on the centre of pressure (CoP), in individuals with PD while performing a sit-to-stand-to-sit sequence under single- and dual-task conditions. An observational, analytical and cross-sectional study was performed. The sample consisted of 9 individuals with PD and 9 healthy controls. A force platform was used to measure the CoP displacement and velocity during the sit-to-stand-to-sit sequence. The results were statistically analysed. Individuals with PD required greater durations for the sit-to-stand-to-sit sequence than the controls (p < 0.05). The anteroposterior and mediolateral CoP displacement were higher in the individuals with PD (p < 0.05). However, only the anteroposterior CoP velocity in the stand-to-sit phase (p = 0.006) was lower in the same individuals. Comparing the single- and dual-task conditions in both groups, the duration, the anteroposterior CoP displacement and velocity were higher in the dual-task condition (p < 0.05). The individuals with PD presented reduced postural control stability during the sit-to-stand-to-sit sequence, especially when under the dual-task condition. These individuals have deficits not only in motor performance, but also in cognitive performance when performing the sit-to-stand-to-sit sequence in their daily life tasks. Moreover, both deficits tend to be intensified when two tasks are performed simultaneously.

Manoeuvre Based Mission Control System for an Autonomous Surface Vehicle

In this work the mission control and supervision system developed for the ROAZ Autonomous Surface Vehicle is presented. Complexity in mission requirements coupled with flexibility lead to the design of a modular hierarchical mission control system based on hybrid systems control. Monitoring and supervision control for a vehicle such as ROAZ mission is not an easy task using tools with low complexity and yet powerful enough. A set of tools were developed to perform both on board mission control and remote planning and supervision. “ROAZ- Mission Control” was developed to be used in support to bathymetric and security missions performed in river and at seas.

AUV Control and Communication using Underwater Acoustic Networks

Underwater acoustic networks can be quite effective to establish communication links between autonomous underwater vehicles (AUVs) and other vehicles or control units, enabling complex vehicle applications and control scenarios. A communications and control framework to support the use of underwater acoustic networks and sample application scenarios are described for single and multi-AUV operation.

An automated maneuver control framework for a remotely operated vehicle

OCEANS, 2001. MTS/IEEE Conference and Exhibition (Volume:2 )

A control framework for a remotely operated vehicle

A control framework enabling the automated maneuvering of a Remotely Operate Vehicle (ROV) is presented. The control architecture is structured according to the principle of composition of vehicle motions from a minimal set of elemental maneuvers that are designed and verified independently. The principled approach is based on distributed hybrid systems techniques, and spans integrated design, simulation and implementation as the same model is used throughout. Hybrid systems control techniques are used to synthesize the elemental maneuvers and to design protocols, which coordinate the execution of elemental maneuvers within a complex maneuver. This work is part of the Inspection of Underwater Structures (IES) project whose main objective is the implementation of a ROV-based system for the inspection of underwater structures.

Design of the ISePorto robocup Middle-Size League Robotic Soccer Team: Control, Localisation and Coordination

Proceedings of the 10th Mediterranean Conference on Control and Automation - MED2002 Lisbon, Portugal, July 9-12, 2002

Control and Localisation for the ISePorto Robotic Soccer Team

International Conference on Advanced Robotics, Coimbra, Portugal, Julho 2003

A moção de censura em Portugal nos últimos 35 anos, a sua utilização como instrumento político de controlo

O presente artigo intenta plasmar o uso da moção de censura enquanto instituto de controlo político do Governo na actividade parlamentar portuguesa das últimas três décadas. Da análise às diversas legislaturas e sessões legislativas dos vários governos constitucionais sistematizam-se aqueles mecanismos de controlo com referência à responsabilidade política do Governo.