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1.
Sci Rep ; 4: 7541, 2014 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-25519512

RESUMO

For estimation of residents' exposure dose after a nuclear accident, the reduction factor, which is the ratio of the indoor dose to the outdoor dose is essential, as most individuals spend a large portion of their time indoors. After the Fukushima nuclear accident, we evaluated the median reduction factor with an interquartile range of 0.43 (0.34-0.53) based on 522 survey results for 69 detached wooden houses in two evacuation zones, Iitate village and Odaka district. The results indicated no statistically significant difference in the median reduction factor to the representative value of 0.4 given in the International Atomic Energy Agency (IAEA)-TECDOC-225 and 1162. However, with regard to the representative range of the reduction factor, we recommend the wider range of 0.2 to 0.7 or at least 0.2 to 0.6, which covered 87.7% and 80.7% of the data, respectively, rather than 0.2 to 0.5 given in the IAEA document, which covered only 66.5% of the data. We found that the location of the room within the house and area topography, and the use of cement roof tiles had the greatest influence on the reduction factor.


Assuntos
Raios gama/efeitos adversos , Monitoramento de Radiação/estatística & dados numéricos , Proteção Radiológica/estatística & dados numéricos , Liberação Nociva de Radioativos/estatística & dados numéricos , Adulto , Acidente Nuclear de Fukushima , Humanos , Centrais Nucleares/estatística & dados numéricos , Doses de Radiação , Madeira
2.
J Trauma ; 71(1): 32-6, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20805775

RESUMO

BACKGROUND: Direct laryngoscopy along with manual inline stabilization (MIS) is currently the standard care for patients with suspected neck injuries. However, cervical collar immobilization is more commonly performed in the prehospital environment, and its early removal is necessary before intubation. We hypothesized that if usability of Airway Scope (AWS) in a difficult airway could also bring merits to intubation under cervical collar immobilization, unnecessary risk caused by the removal of a neck collar may be prevented. METHODS: In this crossover study, 30 consenting patients presenting for surgery were assigned to undergo intubation using AWS. Neck was stabilized manually and by a neck collar in a random order before laryngoscopy was performed by the same anesthesiologist. Measurements include interincisor distance (IID), success rate, intubation time, and fluoroscopic examination of the upper and middle cervical spine. RESULTS: IID was notably narrower after application of a neck collar (mean ± SE: MIS, 19 mm ± 1 mm; collar, 10 mm ± 1 mm; p < 0.01). One and 9 failures were encountered in MIS and collar groups, respectively (p = 0.012). Intubation time proved no statistical significance. Extension of craniocervical junction was observed in both groups, but occipitoatlantal joint was significantly more extended in collar group (median [range]: AWS, 10-degree angle [-1 to 20-degree angle]; collar, 14-degree angle [5 to 26-degree angle]; p < 0.01). DISCUSSION: AWS laryngoscopy under cervical collar immobilization fails to meet our expectation. Intubation failed in 30% of the cases in collar group whereas only 3.3% of the cases in MIS group. Significant difference of mouth opening limitation is probably the major reason, as 7 of 9 failed cases in collar group had IID <10 mm. This was insufficient to insert the 18-mm blade of AWS. In addition, occipitoatlantal joint suffered a greater extension when wearing a neck collar. Differences in the method to stabilize the neck may be the reason. CONCLUSION: When compared with cervical collar immobilization, AWS laryngoscopy along with MIS seems to be a safer and more definite method to secure airway of neck-injured trauma patients because it limits less mouth opening and upper cervical spine movement.


Assuntos
Vértebras Cervicais/lesões , Cinerradiografia/métodos , Imobilização/métodos , Intubação Intratraqueal/instrumentação , Laringoscopia/métodos , Traumatismos da Coluna Vertebral/terapia , Adulto , Idoso , Vértebras Cervicais/diagnóstico por imagem , Estudos Cross-Over , Desenho de Equipamento , Feminino , Humanos , Laringoscópios , Masculino , Pessoa de Meia-Idade , Traumatismos da Coluna Vertebral/diagnóstico , Resultado do Tratamento
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