This study aimed to investigate the actual noise conditions in adult Intensive Care Units (ICUs) according to type, time, day of the week, and area. Methods: This study was conducted from February to March 2018. ICU noise levels were examined using a noise meter with a microphone an amplifier, auditory correction circuit, and indicator meter capable of directly reading A-weighted decibels (dBA). Noise was measured for 24 hours for seven days and the average dBA, maximum dBA, and minimum dBA were recorded. Results: The highest mean noise level was 58.48 dBA (range of 57.62~65.27), while lowest was 51.65 dBA (range of 51.36~52.86). Average noise levels on weekdays and weekends were over 50 dBA(the open zone was measured at 56.61 dBA, while the isolation zone was measured at 52.45 dBA. Further, daytime, evening work-times and weekdays were measured above 60 dBA, while nighttime noise levels were below 60 dBA. Finally, average noise levels during turnarounds, shift changes, and rounding times were above 60 dBA; open zone had higher average noise levels than the isolation zone. Conclusion: This study showed that ICU noise levels exceeded those recommended by the World Health Organization regardless of type of noise, day of the week, or time. Therefore, studies are proposed to identify the need or importance of noise management by ICU personnel to reduce noise in ICUs. It also proposes studies to develop and apply noise reduction strategies that can be easily used in practice, reflecting the various characteristics of noise in ICUs.
Sesamoid bones and accessory ossicles are normal anatomic variants with varying morphological appearances and incidences. They are usually small osseous fragments with well-corticated margins located adjacent to the joint space and bone. Patients with sesamoid bones and accessory ossicles are usually asymptomatic and commonly encountered in clinical practice. These sesamoids and accessory bones are occasionally painful because of fractures, dislocations, degenerative changes, avascular necrosis, accessory bone infections, or abnormalities of the adjacent tissue, such as nerve entrapment, tenosynovitis, or soft tissue impingement. This article aimed to illustrate the imaging features of symptomatic sesamoids bones and accessory ossicles at various anatomic locations and describe their clinical features and radiological differential diagnosis.
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