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2.
Cureus ; 14(4): e23823, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35518551

RESUMO

Introduction The supraclavicular approach to the subclavian vein has been cited as having many advantages to the infraclavicular approach, including a larger short-axis cross-sectional area, a greater margin of safety, and fewer complications. Methods To examine whether a larger short-axis cross-sectional area of the subclavian vein at the supraclavicular fossa is a potential explanation for the reduction in attempts with the supraclavicular approach seen in a previous study, we examined computed tomography scans from 50 patients (24 M, 26 F). The short-axis cross-sectional areas of the subclavian vein at the mid-clavicular line, the subclavian vein in the supraclavicular fossa, and the internal jugular vein at the level of the thyroid cartilage were calculated. Results The internal jugular vein short-axis cross-sectional area was significantly larger than the subclavian vein short-axis cross-sections measured at each location. We found no difference between the short-axis cross-sectional areas of the subclavian vein or when comparing measurements as a factor of gender, age, or race. Weight had a significant relationship to the short-axis cross-sectional area of the internal jugular vein and subclavian vein at the mid-clavicular vein. Conclusions On supine computed tomographic imaging, the subclavian vein short-axis cross-section was not larger in the supraclavicular fossa than the mid-clavicular line. The short-axis cross-sectional area of the subclavian vein at the supraclavicular fossa does not appear to contribute to the decrease in attempts to access it. Weight, but not necessarily height, appears to be correlated with central vein size.

4.
J Vasc Interv Radiol ; 28(1): 148-155, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27789076

RESUMO

PURPOSE: To test operator exposures inside radiation protection garments in a simulated clinical setup, examining trends related to multiple characteristics. MATERIALS AND METHODS: Sixteen garment models containing lead or nonlead materials and a suspended device (Zero-Gravity) were tested for operator exposure from X rays scattered from an acrylic patient phantom. Weight and surface area were determined. The operator phantom was a wooden frame containing a dosimeter in its cavity. Garments were draped over the frame, and the setup was placed in a typical working position. RESULTS: There was substantial variability in exposures for all garments, ranging from 0.52 to 13.8 µSv/h (mean, 5.39 µSv/h ± 3.82), with a 12-fold difference for garments labeled 0.5 mm Pb equivalent. Most of the especially poor protectors were nonlead, even when not lightweight. Nonlead models were not more protective per weight overall. For closed-back garments labeled 0.5 mm Pb equivalent, mean exposures were lower for lead than for nonlead materials (mean, 1.48 µSv/h ± 0.434 vs 6.26 µSv/h ± 5.13, respectively). Density per exposure-1 was lower for lead than nonlead materials in the 0.5-mm Pb equivalent group, counter to advertised claims. Open-back configurations were lighter than closed (3.3 kg vs 6.0 kg, respectively), with similar mean exposures (5.30 µSv/h vs 5.39 µSv/h, respectively). The lowest exposure was 0.52 µSv/h (9.8% of the mean of all garments) for the suspended device. CONCLUSIONS: Operator exposure in a realistic interventional setup is highly variable for similarly labeled protective garments, highlighting the necessity of internal validation when considering nonlead and lightweight models.


Assuntos
Exposição Ocupacional/prevenção & controle , Saúde Ocupacional , Rotulagem de Produtos , Roupa de Proteção , Doses de Radiação , Exposição à Radiação/prevenção & controle , Proteção Radiológica/instrumentação , Radiografia Intervencionista/efeitos adversos , Radiologistas , Desenho de Equipamento , Humanos , Teste de Materiais , Doenças Profissionais/etiologia , Doenças Profissionais/prevenção & controle , Exposição Ocupacional/efeitos adversos , Imagens de Fantasmas , Exposição à Radiação/efeitos adversos , Lesões por Radiação/etiologia , Lesões por Radiação/prevenção & controle , Monitoramento de Radiação/métodos , Proteção Radiológica/métodos , Espalhamento de Radiação
6.
Proc (Bayl Univ Med Cent) ; 26(3): 290-2, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23814395

RESUMO

Pulmonary tumor embolism syndrome is a rare phenomenon that can occur in patients who have an occult neoplasm that metastasizes. We describe a case of an elderly woman with an undiagnosed colon cancer who suffered from respiratory distress and compromised pulmonary blood flow from micrometastasis in the pulmonary arteries.

7.
Phys Rev Lett ; 99(12): 124301, 2007 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-17930506

RESUMO

The ultrasonic attenuation coefficient, phase velocity, and group velocity spectra are reported for a suspension that supports negative group velocities. The suspension consists of plastic microspheres with an average radius of 80 microm in an aqueous medium at a volume fraction of 3%. The spectra are measured using a broadband method covering a range from 2 to 20 MHz. The suspension exhibits negative group delays over a band near 4.5 MHz, with the group velocity magnitude exceeding 4.3 x 10(8) m/s at one point. The causal consistency of these results is confirmed using Kramers-Kronig relations.

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