A review of teleradiology in Africa ­ Towards mobile teleradiology in Nigeria

eHealth is promoted as a means to strengthen health systems and facilitate universal health coverage. Sub-components (e.g. telehealth, telemedicine, mhealth) are seen as mitigators of healthcare provider shortages and poor rural and remote access. Teleradiology (including mobile teleradiology), widespread in developed nations, is uncommon in developing nations. Decision- and policy-makers require evidence to inform their decisions regarding implementation of mobile teleradiology in Nigeria and other subSaharan countries. To gather evidence, Scopus and PubMed were searched using defined search strings (September 2020). Duplicates were removed, and titles and abstracts reviewed using specified selection criteria. Full-text papers of selected resources were retrieved and reviewed against the criteria. Insight from included studies was charted for eight a priori categories of information: needs assessment, implementation, connectivity, evaluation, costing, image display, image capture and concordance. Fifty-seven articles were identified, duplicates removed and titles and abstracts of remaining articles reviewed against study criteria. Twenty-six papers remained. After review of full-texts, ten met the study criteria. These were summarised, and key insights for the eight categories were charted. Few papers have been published on teleradiology in sub-Saharan Africa. Teleradiology, including mobile teleradiology, is feasible in sub-Saharan Africa for routine X-ray support of patients and healthcare providers in rural and remote locations. Former technical issues (image quality, transmission speed, image compression) have been largely obviated through the high-speed, high-resolution digital imaging and network transmission capabilities of contemporary smartphones and mobile networks, where accessible. Comprehensive studies within the region are needed to guide the widespread introduction of mobile teleradiology.

Pectus excavatum em uma ninhada de Buldogue Francês: relato de caso / Pectus excavatum in a French Bulldog Litter: case report

RESUMO O pectus excavatum é considerado uma patologia da parede torácica, onde há convexidade no aspecto ventral do esterno, o que gera complicações secundárias, como alongamento ventrodorsal do tórax e aumento da pressão intratorácica, entre outras. No presente caso, o corpo de um cachorro Buldogue Francês nasceu com sinais prévios de decaimento e baixo consumo de leito materno, além de uma avaliação médica forense. De acordo com a avaliação patológica, foi encontrada uma fenda no peito esternal relacionada às esternas caudais próximas à cartilagem xifóide, conteúdo espumoso na cartilagem epiglótica da laringe e sinais graves de enfisema nos lobos caudal, craniano e médio pulmonar. Na avaliação cardiológica, foi observada assimetria morfológica invaginante no septo interventricular na mesma área em que a fenda esternal ocorre, por sua vez, na avaliação radiográfica, evidencia uma depressão dorsal do terço caudal do esterno com alterações consideráveis na silhueta cardíaca. Na Colômbia não há relatos de ninhadas completas que apresentem esta alteração, portanto, pretende-se que este seja o primeiro relatório anatomopatológico e de imagem que descreva a patologia em caninos.

ABSTRACT Pectus excavatum is considered a pathology of the chest wall where there is convexity in the ventral aspect of the sternum, which generates secondary complications, such as ventrodorsal stretching of the chest and increased intrathoracic pressure, among others. In the present case, the body of a French bulldog dog was born with previous signs of decay and low consumption of maternal waste, in addition to a forensic medical evaluation. According to the pathological evaluation, a crack was found in the sternal chest related to the caudal sternum close to the xiphoid cartilage, frothy content in the laryngeal epiglottis cartilage and severe signs of emphysema in the caudal, cranial and middle lung lobes. In the cardiological evaluation, an invaginating morphological asymmetry was observed in the interventricular septum in the same area in which the sternal cleft occurs, in turn, in the radiographic evaluation, it shows a dorsal depression of the caudal third of the sternum with considerable changes in the cardiac silhouette. In Colombia there are no reports of complete litters that present this alteration, so it is intended that this is the first anatomopathological and imaging report that describes the pathology in canines.

Sisprad: software for radiological protection management in a hospital environment / Sisprad: software para gestión de protección radiológica en entorno hospitalario / Sisprad: software para gestão da proteção radiológica em ambiente hospitalar

ABSTRACT Objective: to describe the software for the management of radiological protection, SisPRad, and its construction process, as well as to analyze its implementation and use in a radiodiagnosis service. Method: a methodological and quasi-experimental research study carried out between November 2016 and October 2019. The study population consisted of the professionals who make up the Radiological Protection Committee of the service. The model chosen for software engineering was the cascade model. In the implementation phase, an evaluation and analysis of the usability of the software was carried out. Results: the software for radiological protection management presents the structure of the technology and its functionalities. The usability evaluation showed that SisPRad is a tool that will assist the multi-professional and interdisciplinary team of the hospital radiology service in the management of radiological protection. The computerization of the systems and the integration of the sectors that need shared data in the work routines enhance the management of hospital radiological protection for the multi-professional team. The technology was positively evaluated by the multi-professional team working in the hospital radiodiagnosis service. SisPRad generated registration n.. 512019002125-8 by the National Institute of Industrial Property. Conclusion: this tool was developed aiming at the safety of the professionals working in the radiodiagnosis service and of its users, in addition to enabling the constant improvement of the tool, and it can be adapted in other institutions.

RESUMEN Objetivo: describir el software para la gestión de protección radiológica, SisPRad, su proceso de construcción y analizar su implementación y uso en un servicio de radiodiagnóstico. Método: investigación metodológica y cuasiexperimental realizada entre noviembre de 2016 y octubre de 2019. La población de estudio estuvo constituida por los profesionales que integran el Comité de Protección Radiológica del servicio. Para la ingeniería de software, se eligió el modelo en cascada. En la etapa de implementación se realizó la evaluación y el análisis de usabilidad del software. Resultados: el software de gestión de protección radiológica presenta la estructura de la tecnología y sus funcionalidades. La evaluación de usabilidad mostró que SisPRad es una herramienta que ayudará al equipo multidisciplinario e interdisciplinario del servicio de radiología del hospital en la gestión de la protección radiológica. La informatización de sistemas y la integración de sectores que requieren datos en común en las rutinas de trabajo potencian la gestión de la protección radiológica hospitalaria del equipo multidisciplinario. La tecnología fue valorada positivamente por el equipo multiprofesional que cumple sus funciones en el servicio de radiodiagnóstico del hospital. SisPRad generó el registro 512019002125-8 en el Instituto Nacional de Propiedad Industrial. Conclusión: esta herramienta fue desarrollada con el objetivo de promover la seguridad de los profesionales que trabajan en el servicio de radiodiagnóstico y de sus usuarios, además de permitir la mejora constante de la herramienta, que puede ser adaptada a otras instituciones.

RESUMO Objetivo: descrever o software para gestão da proteção radiológica, SisPRad, seu processo de construção e analisar sua implantação e utilização em um serviço de radiodiagnóstico. Método: pesquisa metodológica e quase-experimental realizada entre novembro de 2016 e outubro de 2019. A população do estudo foi constituída pelos profissionais que compõem o Comitê de Proteção Radiológica do serviço. O modelo escolhido para a engenharia do software foi o modelo em cascata. Na fase de implantação foi realizada avaliação e análise da usabilidade do software. Resultados: o software de gestão para proteção radiológica apresenta a estrutura da tecnologia e suas funcionalidades. A avaliação da usabilidade evidenciou que o SisPRad é uma ferramenta que irá auxiliar a equipe multiprofissional e interdisciplinar do serviço de radiologia hospitalar na gestão da proteção radiológica. A informatização dos sistemas e a integração dos setores que necessitam de dados em comum nas rotinas de trabalho potencializam a gestão da proteção radiológica hospitalar para a equipe multiprofissional. A tecnologia foi avaliada positivamente pela equipe multiprofissional atuante no serviço de radiodiagnóstico hospitalar. O SisPRad gerou o registro 512019002125-8 pelo Instituto Nacional de Propriedade Industrial. Conclusão: essa ferramenta foi desenvolvida visando a segurança dos profissionais atuantes no serviço de radiodiagnóstico e seus usuários, além de possibilitar a melhora da ferramenta constantemente, podendo ser adaptada em outras instituições.

Anatomia radiológica vascular e desenvolvimento de plataformas de ensino interativo / Vascular radiological anatomy and the development of interactive teaching platforms

Anatomia e Radiologia são disciplinas amplamente presentes nas grades curriculares de cursos da área da saúde. A interseção entre a Anatomia Radiológica e as tecnologias recentes, como plataformas de ensino interativo, caracteriza-se como uma tendência a ser seguida na esfera educacional, sendo as implicações desse processo ainda não muito debatidas. O Departamento de Anatomia da Universidade Federal de Juiz de Fora iniciou o desenvolvimento de um atlas de anatomia vascular radiológica, o qual apresenta versões impressa e interativa. Possui imagens de angiotomografias computadorizadas feitas em aparelhos multislice de 16 a 128 canais, sendo as imagens de arquivo pessoal dos organizadores. O atlas promove a identificação das estruturas vasculares em questão e propicia a integração do conhecimento adquirido em salas de aula com a visualização de exames de imagem complementares rotineiros. A indiscutível presença de exames de imagem adicionais na rotina dos profissionais da saúde atuais faz com que seja válida a estratégia de integração entre o método tradicional de ensino e as práticas ativas de aprendizagem, as quais vêm ganhando destaque recentemente, devido a sua efetividade na fixação de conhecimentos.

Anatomy and Radiology are subjects widely present in health courses at universities. The intersection between Radiological Anatomy and recent technologies, such as interactive teaching platforms, is characterized as a tendency to be followed in the educational sphere, and the implications of this process are not much debated. The Department of Anatomy of Juiz de Fora Federal University has begun the development of an atlas of radiological vascular anatomy, which features printed and interactived versions. It presents computed tomography images taken on multislice devices from 16 to 128 channels, and the images are from the personal authors' archives. The Radiologic Vascular Atlas provides the identification of vascular structures in study and makes easier the integration of knowledge acquired in classrooms with the visualization of routine complementary imaging exams. The indisputable presence of complementary imaging examinations in the routine of current health professionals makes valid the strategy of integration between the traditional teaching method and active learning practices, which have recently gained prominence, due to its effectiveness in setting knowledge.

Biplanar imaging with tridimensional capabilities: applicability of this new examination to spinal deformities / Imagem biplanar com capacidade tridimensional: aplicabilidade do novo exame nas deformidades na coluna vertebral / Imagen biplanar con capacidad tridimensional: aplicabilidad del nuevo examen en las deformidades en la columna vertebral

ABSTRACT This study presents details about the applicability of the new image acquisition system, called the biplanar imaging system, with three-dimensional capabilities (EOS®) to the treatment of spinal deformities. This system allows radiographic acquisition of the entire body, with a great reduction in the dose of radiation absorbed by the patient and three-dimensional (3D) stereoradiographic image reconstruction of bone structures, including the spine. In the case of adolescent idiopathic scoliosis, the analysis of the spinal deformity with 3D reconstruction allows better understanding of the deformity and surgical planning. In the case of adult spinal deformity, full-body analysis allows an evaluation of the spinopelvic deformity, including loss of sagittal alignment, in addition to an evaluation of compensatory mechanisms recruited by the individual in an attempt to maintain the sagittal balance. Level of evidence III; Descriptive Review.

RESUMO O presente estudo apresenta detalhes sobre a aplicabilidade do novo sistema de aquisição de imagem, denominado sistema de imagem biplanar, com capacidade tridimensional (EOS®) no tratamento de deformidades da coluna vertebral. Tal sistema permite a aquisição radiográfica do corpo inteiro, com grande redução da dose de radiação absorvida pelo paciente e reconstrução estereoradiográfica em imagem tridimensional (3D) das estruturas ósseas, incluindo a coluna vertebral. No caso de escoliose idiopática do adolescente, a análise da deformidade da coluna vertebral com reconstrução 3D permite a melhor compreensão da deformidade e planejamento cirúrgico. No caso da deformidade da coluna vertebral do adulto, a análise do corpo inteiro permite a avaliação da deformidade espinopélvica, incluindo a perda do alinhamento sagital, além da avaliação adicional dos mecanismos compensatórios recrutados pelo indivíduo na tentativa de manter o equilíbrio sagital. Nível de evidência III; Revisão Descritiva.

RESUMEN El presente estudio presenta detalles sobre la aplicabilidad del nuevo sistema de adquisición de imagen denominado sistema de imagen biplanar, con capacidad tridimensional (EOS®) en el tratamiento de deformidades de la columna vertebral. Tal sistema permite la adquisición radiográfica del cuerpo entero, con gran reducción de la dosis de radiación absorbida por el paciente y reconstrucción estereorradiográfica en imagen tridimensional (3D) de las estructuras óseas, incluyendo la columna vertebral. En el caso de escoliosis idiopática del adolescente, el análisis de la deformidad de la columna vertebral con reconstrucción 3D permite la mejor comprensión de la deformidad y planificación quirúrgica. En el caso de la deformidad de la columna vertebral del adulto, el análisis del cuerpo entero permite la evaluación de la deformidad espinopélvica, incluyendo la pérdida de la alineación sagital, además de la evaluación adicional de los mecanismos compensatorios reclutados por el individuo en el intento de mantener el equilibrio sagital. Nivel de evidencia III; Revisión Descriptiva.

The need for DICOM encapsulation of 3D scanning STL data

No abstract available.

Algunos síndromes radiológicos en pediatría / Some radiological syndromes in pediatrics

Las 4 situaciones presentadas son ejemplos de las condensaciones lobares y segmentarias. Habitualmente presentan clínica de neumonía aguda, relacionadas con etiologías bacterianas. Desde el punto de vista de los signos radiológicos presentan imágenes de condensación pulmonar que: Opacifican lóbulos o segmentos,respetando los límites anatómicos. Respetan el volumen o lo aumentan levemente. Mantienen las cisuras en su sitio o las desplazan levemente, generando convexidad. No alteran la situación de los hilios pulmonares. No desplazan el mediastino (AU). Contiene imágenes radiográficas de distintas situaciones clìnicas

Comparison of standard-setting methods for the Korean Radiological Technologist Licensing Examination: Angoff, Ebel, bookmark, and Hofstee / 보건의료교육평가

PURPOSE: This study aimed to compare the possible standard-setting methods for the Korean Radiological Technologist Licensing Examination, which has a fixed cut score, and to suggest the most appropriate method. METHODS: Six radiological technology professors set standards for 250 items on the Korean Radiological Technologist Licensing Examination administered in December 2016 using the Angoff, Ebel, bookmark, and Hofstee methods. RESULTS: With a maximum percentile score of 100, the cut score for the examination was 71.27 using the Angoff method, 62.2 using the Ebel method, 64.49 using the bookmark method, and 62 using the Hofstee method. Based on the Hofstee method, an acceptable cut score for the examination would be between 52.83 and 70, but the cut score was 71.27 using the Angoff method. CONCLUSION: The above results suggest that the best standard-setting method to determine the cut score would be a panel discussion with the modified Angoff or Ebel method, with verification of the rated results by the Hofstee method. Since no standard-setting method has yet been adopted for the Korean Radiological Technologist Licensing Examination, this study will be able to provide practical guidance for introducing a standard-setting process.

An experimental study on the determination of gantry angle and SSD dependencies of TLD and MOSFET dosimeter systems

Background: The purpose of this study was to investigate the various gantry angle and SSD dependencies of TLD and MOSFET dosimeters

Materials and Methods: LiF [Mg] TLD and MOSFET were used in this study. Dosimeter systems were calibrated and then irradiated at various gantry angle and SSD by applying 6 MV photon energy

Results: Based on the results, MOSFET changes were found to be in 2% range between +/-50[9] gantry angles and the rate of dose change was found to be increasing as gantry angle was at the extremes of graph. This increase was especially obvious in tail end of the asymmetric axes. Change in the gantry angle dependency of TLD was -2% till +/- 609 gantry angle and -5% between 60 to 90. Dependency of SSD was +/-1% for TLD and MOSFET

Conclusion: Results indicate that properties of dosimeters must be well known by users for accurate determination of the entire doses on the patient. These observations may lead to better treatment quality and prevention of probable dose errors

Investigação da práxis em enfermagem radiológica: aplicação da metodologia da psicodinâmica do trabalho / Investigación de la práxis en enfermería radiológica: aplicación de la metodología de la psicodinámica del trabajo1 / Research of radiological nursing praxis: application of the psychodynamic of work methodology

RESUMO Objetivo: relatar a utilização do Método da Psicodinâmica do Trabalho, destacando os caminhos percorridos desde a demanda até a interpretação dos dados, de duas pesquisas distintas realizadas com trabalhadores de enfermagem em hemodinâmica e medicina nuclear. Método: trata-se de uma reflexão teórico-metodológica por meio do relato de experiência sobre a utilização da Psicodinâmica do Trabalho em pesquisas de doutorado aplicadas com trabalhadores de enfermagem em dois diferentes serviços, que utilizam as tecnologias radiológicas. Embora ambas as pesquisas tenham utilizado a Psicodinâmica como referencial teórico-metodológico, é possível destacar diferenças entre elas, principalmente quanto a coleta e análise dos dados. Resultados: realiza-se durante toda a discussão uma associação da prática em pesquisas e a aplicação da Psicodinâmica do Trabalho, especialmente quanto à demanda, coleta do material, processo de validação e análise dos dados. Ao fim da reflexão apresenta-se um quadro-síntese do método aplicado nas duas pesquisas, evidenciando os princípios e os dispositivos metodológicos aplicados. Conclusão: o relato das experiências aqui descritas evidenciam que ao utilizar a Psicodinâmica do Trabalho como referencial teórico metodológico é primordial o conhecimento e a familiaridade com o método. Sem dúvida, a adaptação da metodologia da Psicodinâmica do Trabalho e seu aporte teórico, possibilita interessantes discussões bem como reflexões por parte dos trabalhadores, principalmente quanto às necessidade de mudanças na práxis.

RESUMEN Objetivo: relatar la utilización del Método de la Psicodinámica del Trabajo, destacando los caminos recorridos desde la demanda hasta la interpretación de los datos, de dos investigaciones distintas realizadas con trabajadores de enfermería en hemodinámica y medicina nuclear. Método: se trata de una reflexión teórico-metodológica por medio del relato de experiencia sobre la utilización de la Psicodinámica del Trabajo en investigaciones de doctorado aplicadas con trabajadores de enfermería en dos diferentes servicios, que utilizan las tecnologías radiológicas. Aunque ambas investigaciones han utilizado la Psicodinámica como referencial teórico-metodológico, es posible destacar diferencias entre ellas, principalmente en cuanto a la recolección y análisis de los datos. Resultados: se realiza durante toda la discusión una asociación de la práctica en investigaciones y la aplicación de la Psicodinámica del Trabajo, especialmente en cuanto a la demanda, recolección del material, proceso de validación y análisis de los datos. Al final de la reflexión se presenta un cuadro-síntesis del método aplicado en las dos investigaciones, evidenciando los principios y los dispositivos metodológicos aplicados. Conclusión: el relato de las experiencias aquí descritas evidencian que al utilizar la Psicodinámica del Trabajo como referencial teórico metodológico es primordial el conocimiento y la familiaridad con el método. Sin duda, la adaptación de la metodología de la Psicodinámica del Trabajo y su aporte teórico, posibilita interesantes discusiones así como reflexiones por parte de los trabajadores, principalmente en cuanto a las necesidades de cambios en la praxis.

ABSTRACT Objective: to report the use of the Psychodynamics of Work Method, highlighting the varioud stages, from the demand to the interpretation of the data, from two different researches performed with nursing staff from hemodynamics and nuclear medicine services. Method: a theoretical-methodological reflection through reporting experiences regarding the use of Psychodynamics of Work in doctoral researches applied to nursing workers in two different services which use radiological technologies. Although both studies have used Psychodynamics as a theoretical-methodological reference, it is possible to highlight differences between them, mainly regarding data collection and analysis. Results: an association of the practice in research and the application of Psychodynamics of Work, in particular regarding demand, material collection, the validation process and data analysis, is carried out throughout the discussion. A table summary table of the method applied in the two surveys is presented at the end of the reflection, which shows the principles and the methodological tools. Conclusion: the report of the experiments shows that when Psychodynamics of Work is used as a methodological theoretical reference, knowledge and familiarity regarding the method is paramount. Undoubtedly, the adaptation of the Psychodynamics of Work methodology and its theoretical contribution, allows for interesting discussions as well as reflections on the part of the workers, mainly regarding the need for changes in praxis.

Radiologic assessment of angular wrist parameters of asymptomatic Nigerians

Background: Radiographic techniques has availed anatomists the opportunity to study human bony structure in-vivo. Normative data can assist in defining and quantifying abnormalities. This study was carried out to establish normal angular wrist dimensions of adult Nigerians. Methods: A total of 100 standard lateral wrist x-rays were obtained from 50 (26 males [52%] and 24 females [48%]) adult Nigerians. Three (3) angular dimensions; radial tilt, capitolunate angle, and scapholunate angle were measured. Data were analysed using XLSTAT (Addinsoft Version 2015.4.01.21575). Student and paired sample t-test were used to evaluate sex, and side differences respectively. P<0.05 (at 95% confidence level) was taken to be significant. Results: The mean values for the measured angular parameters were as follows; right and left radial tilt (R&L-RT) = 14.06 ± 2.46º, capitolunate angle (CLA)[R=17.48 ± 1.72º, L=17.67 ± 1.67º] and scapholunate angle(SLA) [R=43.70 ± 3.60º, L=45.10 ± 3.44º]. The radial tilt was observed to be identical in the left and right wrists, while the capitolunate and scapholunate angle were observed to be asymmetrical, with the left significantly greater than the right (P<0.01). All right and left wrist parameters were significant inter-predictors (r>0.75; P<0.01), while only the R & L-RT correlated with R-CLA (r>0.302; P<0.033) and L-CLA (r>0.347; P<0.013). Conclusion: It could be concluded that there was no sex difference in angular wrist parameters and asym metry was observed. The variation in the arrangement of wrist bones in both hands could be associated with mechanical impact as a result of use and this must be taken into consideration when evaluating unilateral wrist diseases

The job competency of radiological technologists in Korea based on specialists opinion and questionnaire survey / 보건의료교육평가

PURPOSE: Although there are over 40,000 licensed radiological technologists (RTs) in Korea, job competency standards have yet to be defined. This study aims to clarify the job competency of Korean RTs. METHODS: A task force team of 11 professional RTs were recruited in order to analyze the job competency of domestic and international RTs. A draft for the job competency of Korean RTs was prepared. A survey was then conducted sampling RTs and the attitudes of their competencies were recorded from May 21 to July 30, 2016. RESULTS: We identified five modules of professionalism, patient management, health and safety, operation of equipment, and procedure management and 131 detailed job competencies for RTs in Korea. “Health and safety” had the highest average score and “professionalism” had the lowest average score for both job performance and importance. The content validity ratios for the 131 subcompetencies were mostly valid. CONCLUSION: Establishment of standard guidelines for RT job competency for multidisciplinary healthcare at medical institutions may be possible based on our results, which will help educators of RT training institutions to clarify their training and education.

Pediatric Orbital Medial Wall Trapdoor Fracture with Normal Computed Tomography Findings

With advances in diagnostic technology, radiologic diagnostic methods have been used more frequently, and physical examination may be neglected. The authors report a case of pediatric medial orbital trapdoor fracture in which the surgery was delayed because computed tomography (CT) findings did not indicate bone displacement, incarceration of rectus muscle, or soft tissue herniation. A healthy 6-year-old boy was admitted to the emergency room for right eyebrow laceration. We could not check eyeball movement or diplopia, because the patient was irritable. Thus, we performed facial CT under sedation, but there was normal CT finding. Seven days later, the patient visited our hospital due to persistent nausea and dizziness. We were able to perform a physical examination this time. Lateral gaze of right eye was limited. CT still did not show any findings suggestive of fracture, but we decided to perform exploratory surgery. We performed exploration, and found no bone displacement, but discovered entrapped soft tissue. We returned the soft tissue to its original position. The patient fully recovered six weeks later. To enable early detection and treatment, thorough physical examination and CT reading are especially needed when the patient shows poor compliance, and frequent follow-up observations are also necessary.

Pediatric Orbital Medial Wall Trapdoor Fracture with Normal Computed Tomography Findings

With advances in diagnostic technology, radiologic diagnostic methods have been used more frequently, and physical examination may be neglected. The authors report a case of pediatric medial orbital trapdoor fracture in which the surgery was delayed because computed tomography (CT) findings did not indicate bone displacement, incarceration of rectus muscle, or soft tissue herniation. A healthy 6-year-old boy was admitted to the emergency room for right eyebrow laceration. We could not check eyeball movement or diplopia, because the patient was irritable. Thus, we performed facial CT under sedation, but there was normal CT finding. Seven days later, the patient visited our hospital due to persistent nausea and dizziness. We were able to perform a physical examination this time. Lateral gaze of right eye was limited. CT still did not show any findings suggestive of fracture, but we decided to perform exploratory surgery. We performed exploration, and found no bone displacement, but discovered entrapped soft tissue. We returned the soft tissue to its original position. The patient fully recovered six weeks later. To enable early detection and treatment, thorough physical examination and CT reading are especially needed when the patient shows poor compliance, and frequent follow-up observations are also necessary.

Riscos ocupacionais dos técnicos em radiologia naassistência ao portador de múltiplos traumas / Occupational risks of radiology technicians in care for patients withmultiple trauma

Este estudo objetivou identificar e dar visibilidade aos principais riscos ocupacionais de técnicos em radiologia, associadosà assistência ao paciente portador de múltiplos traumas, em um serviço hospitalar de radiologia convencional. Pesquisaexploratório-descritiva com abordagem qualitativa. A coleta de dados ocorreu por meio da técnica de observaçãoparticipante dos atendimentos efetuados pelos técnicos em radiologia num serviço de radiologia convencional de umhospital geral de Florianópolis entre maio e setembro de 2012. As observações que caracterizaram exposição a riscoocupacional foram descritas em diário de campo sendo posteriormente aproximadas e comparadas com o referencialteórico contido na Portaria N 25/1994. Constatou-se que os riscos ocupacionais a que se encontram expostos ostécnicos em radiologia na assistência ao portador de múltiplos traumas estão relacionados à exposição à radiaçãoionizante, fluídos corporais e riscos ergonômicos, negligencia ao uso de equipamento de proteção individual e defeitosnos equipamentos. Os técnicos em radiologia tornam-se mais vulneráveis aos riscos ocupacionais quando prestamassistência ao paciente politraumatizado.

This study aimed to identify and give visibility to the main occupational hazards of radiology technicians, associated withthe care of multiple trauma patient with a hospital department of conventional radiology. Exploratory and descriptiveresearch with a qualitative approach. The data were collected through participant observation technique of calls madeby radiology technicians in conventional radiology service of a general hospital in Florianópolis between May andSeptember 2012. The observations that have characterized exposure to occupational risk were described in journal fieldsubsequently estimated and compared with the theoretical framework contained in Decree No 25/1994. It was foundthat the occupational risks to which they are technicians exposed in radiology in the care of multiple traumas carrier arerelated to exposure to ionizing radiation, body fluids and ergonomic risks, neglects to personal protective equipmentuse and defects in equipment. The radiology technicians become more vulnerable to occupational risks when assistingpolytrauma patients.

Experience with wide and narrow caliber percutaneous radiologically guided gastrostomy tubes

Objective: To compare the percutaneous radiologically guided gastrostomy [PeRG] tubes of wide caliber with narrow caliber tubes

Methodology: This retrospective study was performed on 36 patients who were referred to Radiology department for PeRG tube placement between 2008 till 2012. Comparison of wide caliber gastrostomy tubes [18-24 Fr] was done with narrow caliber tubes [14 Fr] considering procedure success rate, procedure related complications and catheter related minor and major complications

Results: Out of 36 patients, 18 patients were present in each group. Mean age of patients was 53.944 +/- 19.380. Procedure success rate was 100% in both groups and procedure related immediate complications were none in either groups. Peri-catheter leakage was observed in 1 patient in each group. Tube occlusion was present in 2 patients in narrow caliber group. Two patients had severe pain in wide caliber group and also 3 patients had wound infection in this group

Conclusion: Regardless of the type of radiologic catheter placed, PeRG can be considered as safe and highly successful procedure. Use of a 24 Fr gastrostomy tubes may show promising results if placed under radiological guidance with comparable technical success and complication rates to other caliber tubes

Avaliação da adequação de aparelhos de raios-x intraorais à portaria 453/1998 da secretaria de vigilância sanitária / Assessment of the adequacy of intraoral x-ray equipment to the ordinance 453/ 1998 of the health surveillance secretariat

Introdução: No Brasil, a Portaria 453/98 da Secretaria de Vigilância Sanitária estabelece um conjunto de diretrizes para que os serviços de radiologia trabalhem com segurança equalidade, o que requer o atendimento de uma série de itens relacionados aos equipamentos de raios-X. Objetivo: Avaliar as condições dos aparelhos de raios-X dos consultórios odontológicos de Patos-PB, no que se refere à segurança daqueles que o utilizam segundo a Portaria. Materiais e métodos: Dos 43 consultórios odontológicos visitados, 35aceitaram participar da pesquisa. Realizou-se a inspeçãovisual dos aparelhos de raios-X e entrevista. Foram observados itens como: fabricante, modelo, tensão; presença de seletorde tempo digital; formato e comprimento do localizador;presença de filtro e equivalência de alumínio adequada;existência do botão retardo; tamanho do fio que liga o painelde controle ao aparelho; tempo médio de exposição; existênciade procedimentos de monitoração periódicos e de programasde garantia de qualidade. Resultados: Foram observadas anormalidades em vários consultórios, como a persistência dobotão retardo (31,5%), e do seletor de tempo do tipo mecânico(34,3%). Os itens mais frequentemente encontrados em acordocom a legislação foram o comprimento do fio do controle e oformato do localizador. Notou-se também o desconhecimento da necessidade de calibração periódica do aparelho.Conclusão: Foram observadas muitas falhas na adoção das exigências da Portaria, podendo estar relacionadas com afalta de conscientização, por parte dos profissionais, dos efeitos deletérios das radiações ionizantes. Assim, tornam-senecessários uma maior fiscalização e esclarecimentos aos cirurgiões-dentistas a respeito da legislação vigente.

Introduction: In Brazil, the Ordinance 453/98 of the Health Surveillance Secretariat establishes a set of guidelines forradiology services to work with safety and quality, whichrequires the attendance of a number of items related to Xrayequipment. Objective: To evaluate the conditions of Xraymachines in dental offices in the city of Patos, PB, withregard to the safety of users according to the Ordinance. Materials and Methods: Of the 43 dental offices visited, 35agreed to participate. A visual inspection of the X-ray machine and an interview were carried out. The following information was collected: manufacturer, model, tension; presence ofdigital time selector; format and length of the locator; presenceof suitable filter and aluminum equivalence; existence of thedelay button; size of the wire which connects the controlpanel to the machine; mean duration of exposure; existenceof periodic monitoring procedures and quality assuranceprograms. Results: Some abnormalities were observed invarious offices, such as the persistence of the delay button(31.5%), and mechanical time selector (34.3%). The items most frequently found to comply with the law were the controlwire length and the locator format. We also observedunawareness of the need for periodic instrument calibration.Conclusion: Many failures were observed to adopt ther equirements of the Ordinance, which may be related to thelack of awareness by the professionals about the deleterious effects of ionizing radiation. Thus, it becomes necessary toperform more inspections of the offices as well as providedentists with clarifications about the law.

Through the keyhole: Radiological management of malignant gastric outflow obstruction beyond the pylorus

This review article presents the radiological options for management of malignant gastric outflow obstruction distal to the pylorus. We place these options in context with surgical and endoscopic alternatives and recommend their use, particularly in those institutions where endoscopic alternatives may not be readily available.

Avaliação da epífora de cães usando dacriocistografia e tomografia computadorizada / Epiphora assessment of dogs with dacryocystography and computed tomography

A avaliação da epífora pode ser feita por exames clínicos, testes de excreção lacrimal, exames contrastados, como avaliação radiológica e estudo tomográfico; estes dois últimos permitem análise minuciosa das estruturas. O presente estudo teve como objetivo avaliar a via lacrimal excretora com uso de radiografia e tomografia computadorizada contrastadas, feitas em animais com epífora, comparando-se com animais sadios, sem essa afecção. Foram utilizados 20 cães, de raças e pelagens variadas, machos e fêmeas, com peso de 1 a 20 kg, com 0,7 a 8 anos de idade, apresentando epífora (grupo epífora - GE). Como grupo de controle (GC), foram utilizados 15 cães, sem alterações clínicas de drenagem do sistema lacrimonasal de raças e pelagens variadas, machos e fêmeas, pesando 1 a 20 kg, com 0,7 a 8 anos. Foi proposta a divisão do sistema de drenagem lacrimal em quatro regiões. Na região 1, o GE teve 29 (76,3%) animais com dilatação visibilizada pelo R-X e 32 (84,2%) pela TC; no GC, 4 (12,5%) no R-X e 1 (3,1%) na TC demonstraram dilatação. Na região 3, 13 (34,2%) cães evidenciaram dilatação do DLN no R-X e 14 (36,8%) na TC; e 21 (55,3%) comunicação do ducto lacrimonasal com o seio nasal pelo R-X e 28 (73,7%) pela TC. Já no GC, 15 (46,9%) pelo R-X e 22 (68,7%) pela TC possuíam comunicação do ducto lacrimonasal com o seio nasal. Concluiu-se que: dilatações também podem ser observadas em alguns cães sem sinal clínico da afecção; comunicação do ducto lacrimonasal com o seio nasal não indica alteração causadora de epífora, pois está presente em animais com e sem afecção; os dados do presente estudo confirmam que o exame DCG por si pode dar importantes informações, de forma semelhante à TC, devendo-se recorrer à ela apenas quando houver dúvidas sobre lesões ósseas, fraturas e corpos estranhos não detectados pelo primeiro...

Epiphora evaluation can be done through clinical exams, lachrymal excretion tests, contrasted exams, like radiologic evaluation and tomography studies; those last two allow a detailed analysis of the structures. The present study had as the objective to evaluate the lacrimal drainage system through radiography and contrasted computed tomography, which were made with animals presenting epiphora, comparing them to healthy animals, without the mentioned condition. Twenty dogs were used for tests, from a variety of breeds and coatings, males and females, weight varying from 1kg to 20kg, ages varying from 0.7 to 8 years old, presenting epiphora (epiphora group - GE*). As a control group (GC*) 15 dogs were used, with no clinical alterations of naso-lachrymal drainage system, from different breeds and coatings, males and females, weighing from 1kg to 20kg and ages varying from 0.7 to 8 years old. It was propoused the division of the lacrimal drainage system in four regions. On region 1, the GE had 29 (76.3%) animals with dilation visualized by the RX and 32 (84.2%) by CT, the GC, 4 (12.5%) in the RX and 1 (3.1% ) CT showed dilation. In region 3, 13 (34.2%) dogs showed dilatation of the DLN in RX and 14 (36.8%) on CT, and 21 (55.3%) nasolacrimal duct communication with the sinus and the X-ray 28 (73.7%) by CT. For the CG, 15 (46.9%) the X-ray and 22 (68.7%) by CT had nasolacrimal duct communication with the nasal sinus. It has been concluded that dilations can also be observed in some dogs with no clinical signs of disease; nasolacrimal duct communication to sinus does not indicate epiphora causing alteration, as it is present in animals with and without affection; the present study data confirm that DCG itself can provide important informations, in a similar manner to CT, and should resort to it just in case of doubts about bone lesions, fractures and foreign bodies undetected at first...

The work proces in radiological nursing: invisibility ofionizing raiiation / Procso de trabajjo e enfermería radiológica: la invisibilidad de laa radiación ionizante / Processo de rabaalho na enfermagem radiológica: a invisibilidade da radiação ionizante

ABSTRACT Qualitative descriptive and exploratory research, performed with 20 nursing professionals working in a general radiology unit and surgery center with the "C-arm" equipment, and the hemodynamics unit of a southern Brazilian teaching hospital. Aim was to analyze the dimensions of the work process for radiological technology nurse professionals. This paper made clear that radiological technologies are outside nursing, which leads to the invisibility of ionizing radiation, leading to inappropriate attitudes about radiological protection, which can be related to harm in professionals, caused by lack of knowledge about this issue. Among radiological nursing work process dimensions, the care dimension emerged. The necessity of implementing a continuous educational program in services which utilize radiological technologies was emphasized, thereby promoting, for patients and for nursing professionals, safer environments and integral care.

RESUMEN Investigación cualitativa, descriptiva y exploratoria realizada con 20 profesionales de enfermería que actúan en los sectores de radiología general, centro quirúrgico, con el equipamiento de arco en "C" y el sector de hemodinamia de un hospital-escuela al sur de Brasil. El objetivo fue analizar las dimensiones del proceso de trabajo de los profesionales de enfermería que actúan con las tecnologías radiológicas. Ese estudio evidenció que las tecnologías radiológicas son ajenas a la enfermería, lo que induce a invisibilidad de la radiación ionizante, implicando en prácticas incorrectas de protección que puede relacionarse con desgastes en los trabajadores provocados por poco conocimiento acerca del asunto. Dentro de las dimensiones del proceso de trabajo en enfermería radiológica, la dimensión cuidado sobresalió. Apúntase la necesidad de implementación de un programa de educación permanente en los servicios que utilizan las tecnologías radiológicas para que proporcionen, para los pacientes y los profesionales de enfermería, ambientes más seguros y una asistencia integral.

RESUMO Pesquisa qualitativa, descritiva e exploratória realizada com 20 profissionais de enfermagem que atuam nos setores de radiologia geral, centro cirúrgico com utilização de equipamento de arco em "C" e hemodinâmica de um hospital-escola do Sul do Brasil. Objetivo de analisar as dimensões do processo de trabalho dos profissionais de enfermagem que atuam com as tecnologias radiológicas. O estudo evidenciou que as tecnologias radiológicas são externas à enfermagem, induzindo à invisibilidade da radiação ionizante, o que implica em práticas incorretas de proteção, que podem se relacionar com desgastes nos trabalhadores, provocados pelo pouco conhecimento sobre o assunto. Dentre as dimensões do processo de trabalho na enfermagem radiológica, a dimensão cuidado sobressaiu-se. Aponta-se a necessidade de implantação de um programa de educação permanente nos serviços que utilizam as tecnologias radiológicas para que se proporcionem, aos pacientes e aos trabalhadores de enfermagem, ambientes mais seguros e uma assistência integral.