This article presents some of the key findings from a study of bereavement by homicide, based on interviews with bereaved people and personnel from Victim Support, the probation service, the police and voluntary organizations. It outlines some of the emotional and practical aspects of traumatic bereavement and the needs that subsequently arise, with particular regard to bereaved people's involvement with the criminal justice system. Recommendations for improved probation service, police and Victim Support responses are proposed.
The purpose of this study was to investigate the radiation doses to the lower extremities in interventional radiology suites and evaluate the benefit of installation of protective lead shielding. After an alarmingly increased dose to the lower extremity in a preliminary study, nine interventional radiologists wore thermoluminescent dosimeters (TLDs) just above the ankle, over a 4-week period. Two different interventional suites were used with Siemens undercouch fluoroscopy systems. A range of procedures was carried out including angiography, embolization, venous access, drainages, and biopsies. A second identical 4-week study was then performed after the installation of a 0.25-mm lead curtain on the working side of each interventional table. Equivalent doses for all nine radiologists were calculated. One radiologist exceeded the monthly dose limit for a Category B worker (12.5 mSv) for both lower extremities before lead shield placement but not afterward. The averages of both lower extremities showed a statistically significant dose reduction of 64% (p < 0.004) after shield placement. The left lower extremity received a higher dose than the right, 6.49 vs. 4.57 mSv, an increase by a factor of 1.42. Interventional radiology is here to stay but the benefits of interventional radiology should never distract us from the important issue of radiation protection. All possible measures should be taken to optimize working conditions for staff. This study showed a significant lower limb extremity dose reduction with the use of a protective lead curtain. This curtain should be used routinely on all C-arm interventional radiologic equipment.
Considerable doses to the thyroid are incurred during neurointerventional procedures, highlighting the need for increased awareness of patient radiation protection. Thyroid lead shielding yields significant radiation protection, is inexpensive and when not obscuring the field of view, should be used routinely.
The uptake and elimination of 99Tcm labelled MAA were followed by gamma camera and computer over a period of 36 hours in patients undergoing lung scanning and venography. Lungs, stomach, kidneys, GI tract, bladder and thyroid showed significant concentrations of activity at various times after the injection of radiopharmaceutical, with carefully controlled labelling efficiency. There was no indication of accumulation in the liver or spleen. Activity versus time curves were constructed. The lung curve had approximately bi-exponential form with components of effective half-lives 0.88 and 4.56 h. Areas beneath the curves gave cumulated activities for each organ and, using S values (absorbed dose per unit cumulated activity) from MIRD tables, absorbed doses from self-irradiation were calculated for each organ.
The definite diagnosis of osteoid osteoma relies on the demonstration of the nidus, best shown by CT, which also provides precise preoperative localization of the nidus. While bone-block excision to remove the nidus is feasible in the long bones, there may be unacceptable sequelae in the vertebral column and small bones of the hands. By precisely localizing the nidus, radionuclide scintimetry permits excellent therapeutic results, with minimal morbidity.
The chest X-ray is the most commonly performed radiological examination in the intensive care unit. We used TLDs to measure the radiation exposure in 30 ICU patients due to portable chest radiography. The mean number of CXR was 3 (range 1-11). The mean surface entry dose at the xiphisternum was 1.8 mGy (range 0.43-5.14 mGy) per patient and 0.63 mGy per CXR. Very small amounts of radiation were detected at the symphysis pubis and in more than half of the patients no radiation was detected at this site. These values are well above accepted norms. Patient exposure may be reduced by ordering fewer X-rays or by changing to a faster screen-film combination.
We measured radiation doses to the eye and thyroid during diagnostic cerebral angiography to assess the effectiveness of bismuth and lead shields at dose reduction. Phantom head angiographic studies were performed with bismuth (study 1) and lead shields (study 2). In study 1 (12 phantoms), thermoluminescent dosimeters (TLD) were placed over the eyes and thyroid in three groups: (i) no shields (four phantoms); (ii) anterior bismuth shields (four phantoms) and (iii) anterior and posterior bismuth shields (four phantoms). In a second study (eight phantoms), lead shields were placed over the thyroid only and TLD dose measurements obtained in two groups: (i) no shielding (four phantoms) and (ii) thyroid lead shielding (four phantoms). A standard 4-vessel cerebral angiogram was performed on each phantom. Study 1 (bismuth shields) showed higher doses to the eyes compared with thyroid (mean 13.03 vs 5.98 mSv, P < 0.001) and a higher eye dose on the X-ray tube side. Overall, the use of bismuth shielding did not significantly reduce dose to either eyes or thyroid in the measured TLD positions. In study 2, a significant thyroid dose reduction was found with the use of lead shields (47%, mean 2.46 vs 4.62 mSv, P < 0.001). Considerable doses to the eyes and thyroid highlight the need for increased awareness of patient protection. Eye shielding is impractical and interferes with diagnostic capability. Thyroid lead shielding yields significant protection to the thyroid, is not in the field of view and should be used routinely.
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