ABSTRACT
Objetivo. Analizar la exposición a radiaciones ionizantes por parte de dos cirujanos ortopédicos en su práctica diaria y revisar las principales recomendaciones nacionales e internacionales al respecto. Material y método. Se efectúo un estudio retrospectivo de la actividad quirúrgica con uso de fluoroscopia realizado por dos cirujanos ortopédicos en un año. Se calculó la radiación recibida basándose en mediciones por procesos publicados en la bilbliografía. Revisión bibliográfica de recomendaciones y normativas internacionales. Resultado. La radiación recibida en un año por los dos cirujanos ortopédicos no sobrepasó el límite de la legislación actual ni el de las nuevas recomendaciones europeas e internacionales. La exposición fue asimétrica, siendo las manos la zona más radiada. Las nuevas recomendaciones rebajan los niveles permitidos de radiación en ojos. Discusión. La estimación de radiación recibida hace necesario proteger y vigilar especialmente las manos y los ojos. Son necesarios conocimientos del funcionamiento del fluoroscopio y de las medidas de radioprotección (AU)
Objective. To analyse the exposure of two Orthopaedic Surgeons to ionizing radiations in their daily work, and to review the main national and international recommendations on this subject. Material and methods. A retrospective study was conducted on the surgical treatments that use fluoroscopy performed by two Orthopaedic Surgeons during a one year period. An evaluation was made of the radiation received, based on measurements of the processes published in the bibliography section. A literature review of international recommendations and regulations is also presented. Results. The radiation received by the two Orthopaedic Surgeons during one year did not exceed the limits of present-day legislation or the new European and international recommendations. The exposure was asymmetrical, with the hands being the most radiated part. The new recommendations reduce the permitted level of radiation on eyes. Discussion. The evaluation of the radiation received demonstrates the need for radiation protection, paying particular attention to the hands and eyes. Good knowledge of operating a fluoroscope and radiation safety measures are also essential (AU)
Subject(s)
Humans , Male , Female , Radiation , Radiation Exposure , Radiation Protection/methods , Radiation Protection/standards , Radiation Measurement , Radiometry/methods , Radiometry , Dosimetry/methods , Operating Rooms , Radiation Protection/legislation & jurisprudence , Radiation Protection/statistics & numerical data , Fluoroscopy/methods , Fluoroscopy , Retrospective Studies , Radiometry/instrumentation , Radiometry/trendsABSTRACT
OBJECTIVE: To analyse the exposure of two Orthopaedic Surgeons to ionizing radiations in their daily work, and to review the main national and international recommendations on this subject. MATERIAL AND METHODS: A retrospective study was conducted on the surgical treatments that use fluoroscopy performed by two Orthopaedic Surgeons during a one year period. An evaluation was made of the radiation received, based on measurements of the processes published in the bibliography section. A literature review of international recommendations and regulations is also presented. RESULTS: The radiation received by the two Orthopaedic Surgeons during one year did not exceed the limits of present-day legislation or the new European and international recommendations. The exposure was asymmetrical, with the hands being the most radiated part. The new recommendations reduce the permitted level of radiation on eyes. DISCUSSION: The evaluation of the radiation received demonstrates the need for radiation protection, paying particular attention to the hands and eyes. Good knowledge of operating a fluoroscope and radiation safety measures are also essential.
Subject(s)
Fluoroscopy , Occupational Exposure , Orthopedic Procedures , Orthopedics , Radiation Exposure , Humans , Occupational Exposure/adverse effects , Operating Rooms , Radiation Exposure/adverse effects , Radiation Protection , Retrospective StudiesABSTRACT
OBJECTIVE: To evaluate the efficacy of a cognitive-motor program in patients with early Alzheimer disease (AD) who are treated with a cholinesterase inhibitor (ChEI). METHODS: Patients with mild cognitive impairment (MCI) (12), mild AD (48), and moderate AD (24) (Global Deterioration Scale stages 3, 4, and 5) were randomized to receive psychosocial support plus cognitive-motor intervention (experimental group) or psychosocial support alone (control group). Cognitive-motor intervention (CMI) consisted of a 1-year structured program of 103 sessions of cognitive exercises, plus social and psychomotor activities. The primary efficacy measure was the cognitive subscale of the AD Assessment Scale (ADAS-cog). Secondary efficacy measures were the Mini-Mental State Examination, the Functional Activities Questionnaire, and the Geriatric Depression Scale. Evaluations were conducted at 1, 3, 6, and 12 months by blinded evaluators. RESULTS: Patients in the CMI group maintained cognitive status at month 6, whereas patients in the control group had significantly declined at that time. Cognitive response was higher in the patients with fewer years of formal education. In addition, more patients in the experimental group maintained or improved their affective status at month 12 (experimental group, 75%; control group, 47%; p = 0.017). CONCLUSIONS: A long-term CMI in ChEI-treated early Alzheimer disease patients produced additional mood and cognitive benefits.
Subject(s)
Alzheimer Disease/therapy , Cognition Disorders/therapy , Cognitive Behavioral Therapy , Physical Therapy Modalities , Aged , Aged, 80 and over , Alzheimer Disease/drug therapy , Caregivers/psychology , Cholinesterase Inhibitors/therapeutic use , Cognition Disorders/drug therapy , Combined Modality Therapy , Donepezil , Female , Follow-Up Studies , Humans , Indans/therapeutic use , Male , Middle Aged , Patient Satisfaction , Patients/psychology , Phenylcarbamates/therapeutic use , Piperidines/therapeutic use , Psychomotor Disorders/therapy , Rivastigmine , Single-Blind Method , Treatment OutcomeSubject(s)
Anticonvulsants/therapeutic use , Antidepressive Agents/therapeutic use , Antipsychotic Agents/therapeutic use , Dementia/complications , Psychomotor Agitation/drug therapy , Psychomotor Agitation/etiology , Aged , Aggression/psychology , Female , Humans , Male , Psychomotor Agitation/diagnosisABSTRACT
BACKGROUND: Alzheimer's family caregivers suffer from psychological and physical morbidity associated with the care of the Alzheimer's patient. The objectives of the study were to compare stress and psychological morbidity between family caregivers of Alzheimer's disease patients and family caregivers of aged non-demented chronically ill patients and to explore the impact of cognitive and non-cognitive patient symptoms on caregivers. METHOD: Fifty-eight caregivers of Alzheimer's patients (cases) and 32 caregivers of non-demented chronically ill patients (controls) were studied. A cross-sectional case-control design was employed using validated scales to assess patient symptomatology and self-report questionnaires to measure stress and psychological morbidity in caregivers. RESULTS: Compared to controls, stress and psychological morbidity were higher in caregivers of Alzheimer's patients. Behavioral symptoms and impairment in instrumental activities of daily living were associated with caregiver stress. Length of care was associated with caregiver psychological morbidity. CONCLUSIONS: Caregiver stress may be reduced with special attention paid to the treatment and management of behavioral and functional symptoms in the Alzheimer's disease patient. Caregiver education and coping skills should also be included.
