Staff Radiation Doses in a Real-Time Display Inside the Angiography Room

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sanchez, Roberto, E-mail: rmsanchez.hcsc@salud.madrid.org; Vano, E.; Fernandez, J. M.

MethodsThe evaluation of a new occupational Dose Aware System (DAS) showing staff radiation doses in real time has been carried out in several angiography rooms in our hospital. The system uses electronic solid-state detectors with high-capacity memory storage. Every second, it archives the dose and dose rate measured and is wirelessly linked to a base-station screen mounted close to the diagnostic monitors. An easy transfer of the values to a data sheet permits further analysis of the scatter dose profile measured during the procedure, compares it with patient doses, and seeks to find the most effective actions to reduce operatormore » exposure to radiation.ResultsThe cumulative occupational doses measured per procedure (shoulder-over lead apron) ranged from 0.6 to 350 {mu}Sv when the ceiling-suspended screen was used, and DSA (Digital Subtraction Acquisition) runs were acquired while the personnel left the angiography room. When the suspended screen was not used and radiologists remained inside the angiography room during DSA acquisitions, the dose rates registered at the operator's position reached up to 1-5 mSv/h during fluoroscopy and 12-235 mSv/h during DSA acquisitions. In such case, the cumulative scatter dose could be more than 3 mSv per procedure.ConclusionReal-time display of doses to staff members warns interventionists whenever the scatter dose rates are too high or the radiation protection tools are not being properly used, providing an opportunity to improve personal protection accordingly.« less

Workplace victimization risk and protective factors for suicidal behavior among active duty military personnel.

PubMed

Hourani, Laurel L; Williams, Jason; Lattimore, Pamela K; Morgan, Jessica K; Hopkinson, Susan G; Jenkins, Linda; Cartwright, Joel

2018-04-22

Workplace victimization is a potential risk factor for suicidal behaviors (SB) among military personnel that has been largely overlooked. This paper examines both the impact of workplace victimization on reported SB and several potential protective factors associated with such suicidal behaviors in a large sample of active duty soldiers. A case-control study was conducted with 71 soldiers who reported SB in the past 12 months, each matched on sociodemographic characteristics to two others without reported suicidal behaviors. A multiple regression model was estimated to assess the effects of risk and protective factors while controlling for other variables. SB was associated with several aspects of victimization, mental health and substance abuse conditions, pain, impulsivity, stressors, negative life events, work-family conflict, active coping behaviors and positive military-related factors. Controlling for other variables, those with SB were more likely to have sought mental health or substance abuse services, to be depressed, anxious, impulsive, and less resilient than non-SB personnel. Study limitations included the use of retrospective self-report data, absence of some known SB predictors, and a population restricted to active duty Army personnel. SB among active duty personnel is associated with victimization since joining the military and is protected by resiliency. These findings suggest that in addition to the usual mental health factors, these additional predictors should be accounted for in SB intervention and prevention planning for active duty personnel. Copyright © 2018 Elsevier B.V. All rights reserved.

33 CFR 150.608 - Who is responsible for ensuring that the personnel use or wear protective equipment and are...

Code of Federal Regulations, 2011 CFR

2011-07-01

... DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Personal Protective Equipment § 150.608 Who is...) Each deepwater port operator must ensure that all personnel wear personal protective equipment when... that the personnel use or wear protective equipment and are trained in its use? 150.608 Section 150.608...

33 CFR 150.608 - Who is responsible for ensuring that the personnel use or wear protective equipment and are...

Code of Federal Regulations, 2010 CFR

2010-07-01

... DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Personal Protective Equipment § 150.608 Who is...) Each deepwater port operator must ensure that all personnel wear personal protective equipment when... that the personnel use or wear protective equipment and are trained in its use? 150.608 Section 150.608...

33 CFR 150.620 - What are the requirements for protecting personnel from machinery?

Code of Federal Regulations, 2010 CFR

2010-07-01

... deepwater port operator must ensure that all personnel are protected from the risks created by operating..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: OPERATIONS Workplace Safety and...

40 CFR 792.29 - Personnel.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Personnel. 792.29 Section 792.29 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 792.29 Personnel. (a) Each individual...

40 CFR 160.29 - Personnel.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Personnel. 160.29 Section 160.29 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.29 Personnel. (a) Each individual engaged in the...

Protecting military personnel from high risk dietary supplements.

PubMed

Deuster, Patricia A; Lieberman, Harris R

2016-01-01

It is legal tomarketmost naturally occurring substances as dietary supplements in the USA without manufacturers demonstrating they are safe or effective, and an endless variety of ingredients, from esoteric botanicals to unapproved pharmaceuticals, can be found in dietary supplements. Use of certain supplements can pose a risk, but since a robust reporting systemdoes not exist in the USA it is difficult to know which are problematic and the number of adverse events (AE) resulting from their use. Certain populations, includingmilitary personnel, aremore likely to use dietary supplements than the general population. Approximately 70% of military personnel take dietary supplements while about 50% of civilians do. Service members prefer supplements purported to enhance physical performance such as supposedly natural stimulants, protein and amino acids, and combination products. Since some of thesemay be problematic, Servicemembers are probably at higher risk of injury than the general population. Ten percent of military populations appear to be taking potentially risky supplements, and the US Department of Defense (DoD) has taken variousmeasures to protect uniformed personnel including education, policy changes, and restricting sales. Actions taken include launching Operation Supplement Safety (OPSS), introducing a High Risk Supplement list, educating health care professionals on reporting AE thatmight be associated with dietary supplements, recommending policy for reporting AE, and developing an online AE reporting system. OPSS is a DoD-wide effort to educate service members, leaders, health care providers, military families, and retirees on how to safely select supplements

Efficacy of RADPAD protective drape during coronary angiography.

PubMed

Kherad, B; Jerichow, T; Blaschke, F; Noutsias, M; Pieske, B; Tschöpe, C; Krackhardt, F

2018-06-01

Ionizing radiation is an integral part of percutaneous coronary angiographies. Chronic exposure to low-dose radiation confers a risk for skin damage, eye lens opacities or cataracts, and malignant diseases to staff in the catheter laboratory. The RADPAD is a sterile surgical drape that reduces the effect of scatter radiation on the operator. We sought to assess the efficacy of RADPAD shields in reducing radiation dose experienced by operators during routine diagnostic coronary angiography. Sixty consecutive patients due to undergo elective coronary angiography were randomized in a 1:1 pattern to have their procedures performed with and without the RADPAD drape in situ. Dosimetry was performed on the left arm of the primary operator. There was no significant difference in the two main determents of radiation exposure in both groups: the screening times (102 ± 86 s for the RADPAD group vs. 105 ± 36 s for the control group, p = 0.9) and body mass index (BMI; 27.7 ± 4.2 kg/m 2 for the RADPAD group vs. 27.9 ± 5.5 kg/m 2 for the control group, p = 0.8). Moreover, there was no difference in the dose-area ratio (1337 ± 582 cGy/cm 2 for the RADPAD group vs. 1541 ± 804 cGy/cm 2 for the control group, p = 0.3) between the two patient groups. The primary operator radiation dose was significantly lower in the RADPAD group at 8.0 µSv (Q1: 3.2, Q3: 20.1) compared with 19.6 µSv (Q1: 7.1, Q3: 37.7) for the control group (p = 0.02). The RADPAD significantly reduces radiation exposure to primary operators during routine diagnostic coronary angiography in patients with a BMI > 25 kg/m 2 . It reduces total radiation exposure to primary operators by 59%, and the radiation exposure rate by 47%.

Coronary angiography

MedlinePlus

... Angiogram - coronary; Coronary artery disease - angiography; CAD - angiography; Angina - angiography; Heart disease - angiography ... Coronary angiography may be done if: You have angina for the first time. Your angina that is ...

Belonging protects against postdeployment depression in military personnel.

PubMed

Bryan, Craig J; Heron, Elizabeth A

2015-05-01

Depression among U.S. military personnel has received relatively little empirical attention compared to posttraumatic stress disorder, despite evidence that depression is associated with poor psychosocial outcomes and increased suicide risk. Even less is known about factors that protect against depression in military populations. A sample of 168 active duty Air Force convoy operators completed self-report measures of depression, posttraumatic stress, and sense of "belonging" before deploying to Iraq, and again at 1, 3, 6, and 12 months following their return. Linear growth modeling was used to test the associations of the variables over time. Mean depression scores remained low and stable across the deployment and 12-month follow-up period. Increased depression severity was significantly associated with low belonging (P < .001) and with posttraumatic stress symptoms (P < .001) at every time point. Relatively small, predominantly male sample utilizing self-report methods. A sense of belongingness may protect service members from depression at all stages of the deployment cycle, from predeployment preparations through deployment and postdeployment adjustment. © 2015 Wiley Periodicals, Inc.

Consideration of the Protection Curtain's Shielding Ability after Identifying the Source of Scattered Radiation in the Angiography.

PubMed

Sato, Naoki; Fujibuchi, Toshioh; Toyoda, Takatoshi; Ishida, Takato; Ohura, Hiroki; Miyajima, Ryuichi; Orita, Shinichi; Sueyoshi, Tomonari

2017-06-15

To decrease radiation exposure to medical staff performing angiography, the dose distribution in the angiography was calculated in room using the particle and heavy ion transport code system (PHITS), which is based on Monte Carlo code, and the source of scattered radiation was confirmed using a tungsten sheet by considering the difference shielding performance among different sheet placements. Scattered radiation generated from a flat panel detector, X-ray tube and bed was calculated using the PHITS. In this experiment, the source of scattered radiation was identified as the phantom or acrylic window attached to the X-ray tube thus, a protection curtain was placed on the bed to shield against scattered radiation at low positions. There was an average difference of 20% between the measured and calculated values. The H*(10) value decreased after placing the sheet on the right side of the phantom. Thus, the curtain could decrease scattered radiation. © Crown copyright 2016.

77 FR 20743 - Protective Force Personnel Medical, Physical Readiness, Training, and Access Authorization Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-06

...-HQ-2012-0002] RIN 1992-AA40 Protective Force Personnel Medical, Physical Readiness, Training, and... the proposed rule to amend the standards for medical, physical performance, training, and access... proposed rule to revise the standards for medical, physical performance, training, and access...

Radiation exposure to operating staff during rotational flat-panel angiography and C-arm cone beam computed tomography (CT) applications.

PubMed

Schulz, Boris; Heidenreich, Ralf; Heidenreich, Monika; Eichler, Katrin; Thalhammer, Axel; Naeem, Naguib Nagy Naguib; Vogl, Thomas Josef; Zangos, Stefan

2012-12-01

To evaluate the radiation exposure for operating personnel associated with rotational flat-panel angiography and C-arm cone beam CT. Using a dedicated angiography-suite, 2D and 3D examinations of the liver were performed on a phantom to generate scattered radiation. Exposure was measured with a dosimeter at predefined heights (eye, thyroid, breast, gonads and knee) at the physician's location. Analysis included 3D procedures with a field of view (FOV) of 24 cm × 18 cm (8s/rotation, 20s/rotation and 5s/2 rotations), and 47 cm×18 cm (16s/2 rotations) and standard 2D angiography (10s, FOV 24 cm×18 cm). Measurements showed the highest radiation dose at the eye and thyroid level. In comparison to 2D-DSA (3.9 μSv eye-exposure), the 3D procedures caused an increased radiation exposure both in standard FOV (8s/rotation: 28.0 μSv, 20s/rotation: 79.3 μSv, 5s/2 rotations: 32.5 μSv) and large FOV (37.6 μSv). Proportional distributions were measured for the residual heights. With the use of lead glass, irradiation of the eye lens was reduced to 0.2 μSv (2D DSA) and 10.6 μSv (3D technique with 20s/rotation). Rotational flat-panel angiography and C-arm cone beam applications significantly increase radiation exposure to the attending operator in comparison to 2D angiography. Our study indicates that the physician should wear protective devices and leave the examination room when performing 3D examinations. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

CT Angiography (CTA)

MedlinePlus

... News Physician Resources Professions Site Index A-Z CT Angiography (CTA) Computed tomography angiography (CTA) uses an ... are the limitations of CT Angiography? What is CT Angiography? Angiography is a minimally invasive medical test ...

Cerebral angiography

MedlinePlus

... Carotid angiogram; Cervicocerebral catheter-based angiography; Intra-arterial digital subtraction angiography; IADSA ... with the dye are seen. This is called digital subtraction angiography (DSA). After the x-rays are ...

Leishmaniasis: Who Uses Personal Protection among Military Personnel in Colombia?

PubMed

González, Aida M; Solís-Soto, María Teresa; Radon, Katja

Leishmaniasis is common in Colombia, negatively affecting the health of military personnel active in endemic areas. The disease is transmitted by sand fly bites. Therefore, during duty, use of long-sleeved uniforms and other clothes treated with permethrin and application of mosquito repellent are important personal preventive measures. The objective of this study was to assess personal and occupational factors associated with the use of personal protection in male soldiers deployed to Leishmaniasis-endemic areas. Three hundred soldiers participated in a cross-sectional questionnaire study (response 84.3%). The self-administered questionnaire contained questions about sociodemographics, duration of service, compliance with personal mosquito protection, and knowledge about leishmaniasis. Descriptive analyses were followed by multiple logistic regression models adjusted for potential confounders (EpiInfo Version 7.0) FINDINGS: Overall, 23% of the soldiers reported complete use of the recommended personal protection measures. About 83% of the participants had heard about leishmaniasis. In the adjusted regression model, knowledge about leishmaniasis (adjusted odds ratio = 2.9; 95% confidence interval: 1.1-7.2) and being enrolled in the army for more than 5 years (2.2; 1.1-4.1) increased the odds of using personal protection. Improving knowledge about leishmaniasis is one measure to increase use of personal protection, thereby diminishing the risk of infection. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

The Respiratory Protection Effectiveness Clinical Trial (ResPECT): a cluster-randomized comparison of respirator and medical mask effectiveness against respiratory infections in healthcare personnel.

PubMed

Radonovich, Lewis J; Bessesen, Mary T; Cummings, Derek A; Eagan, Aaron; Gaydos, Charlotte; Gibert, Cynthia; Gorse, Geoffrey J; Nyquist, Ann-Christine; Reich, Nicholas G; Rodrigues-Barradas, Maria; Savor-Price, Connie; Shaffer, Ronald E; Simberkoff, Michael S; Perl, Trish M

2016-06-02

Although N95 filtering facepiece respirators and medical masks are commonly used for protection against respiratory infections in healthcare settings, more clinical evidence is needed to understand the optimal settings and exposure circumstances for healthcare personnel to use these devices. A lack of clinically germane research has led to equivocal, and occasionally conflicting, healthcare respiratory protection recommendations from public health organizations, professional societies, and experts. The Respiratory Protection Effectiveness Clinical Trial (ResPECT) is a prospective comparison of respiratory protective equipment to be conducted at multiple U.S. study sites. Healthcare personnel who work in outpatient settings will be cluster-randomized to wear N95 respirators or medical masks for protection against infections during respiratory virus season. Outcome measures will include laboratory-confirmed viral respiratory infections, acute respiratory illness, and influenza-like illness. Participant exposures to patients, coworkers, and others with symptoms and signs of respiratory infection, both within and beyond the workplace, will be recorded in daily diaries. Adherence to study protocols will be monitored by the study team. ResPECT is designed to better understand the extent to which N95s and MMs reduce clinical illness among healthcare personnel. A fully successful study would produce clinically relevant results that help clinician-leaders make reasoned decisions about protection of healthcare personnel against occupationally acquired respiratory infections and prevention of spread within healthcare systems. The trial is registered at clinicaltrials.gov, number NCT01249625 (11/29/2010).

40 CFR 265.16 - Personnel training.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Personnel training. 265.16 Section 265... FACILITIES General Facility Standards § 265.16 Personnel training. (a)(1) Facility personnel must successfully complete a program of classroom instruction or on-the-job training that teaches them to perform...

40 CFR 264.16 - Personnel training.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Personnel training. 264.16 Section 264... Facility Standards § 264.16 Personnel training. (a)(1) Facility personnel must successfully complete a program of classroom instruction or on-the-job training that teaches them to perform their duties in a way...

40 CFR 264.16 - Personnel training.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Personnel training. 264.16 Section 264... Facility Standards § 264.16 Personnel training. (a)(1) Facility personnel must successfully complete a program of classroom instruction or on-the-job training that teaches them to perform their duties in a way...

33 CFR 150.623 - What are the requirements for protecting personnel from hazards associated with confined spaces?

Code of Federal Regulations, 2011 CFR

2011-07-01

... associated with entering the port's confined spaces, and develop a confined space safe entry program that... implement the confined space safe entry program, the deepwater port operator must determine the education... protecting personnel from hazards associated with confined spaces? 150.623 Section 150.623 Navigation and...

Gadolinium-enhanced magnetic resonance angiography in renal artery stenosis: comparison with digital subtraction angiography.

PubMed

Law, Y M; Tay, K H; Gan, Y U; Cheah, F K; Tan, B S

2008-04-01

To evaluate the accuracy of gadolinium-enhanced magnetic resonance angiography in assessing renal artery stenosis compared to catheter digital subtraction angiography. Retrospective study. Singapore General Hospital. Records of patients who underwent magnetic resonance angiography as well as digital subtraction angiography for assessment of renal artery stenosis from January 2003 to December 2005 were reviewed. There were 27 patients (14 male, 13 female) with a mean age of 62 (range, 44-77) years. There were 10 patients with renal transplants; their native renal arteries were not evaluated. Each of the two experienced interventional and body magnetic resonance radiologists, who were blinded to the results, reviewed the digital subtraction angiography and magnetic resonance angiography images respectively. Digital subtraction angiography was used as the standard of reference. A total of 39 renal arteries from these 27 patients were evaluated. One of the arteries was previously stented and could not be assessed with magnetic resonance angiography due to severe artefacts. Of the remaining 38 renal arteries, two were graded as normal, seven as having mild stenosis (<50%), eight as having moderate stenosis (> or =50% but <75%), and 21 as having severe stenosis (> or =75%). Magnetic resonance angiography and digital subtraction angiography were concordant in 89% of the arteries; magnetic resonance angiography overestimated the degree of stenosis in 8% and underestimated it in 3% of them. In the evaluation of clinically significant renal artery stenosis (> or =50%) with magnetic resonance angiography, the overall sensitivity, specificity, positive predictive value, and negative predictive value were 97%, 67%, 90%, and 86% respectively. The sensitivity and specificity of magnetic resonance angiography in transplant renal artery stenosis was 100%. CONCLUSION. Our experience suggested that gadolinium-enhanced magnetic resonance angiography is a sensitive non

77 FR 13206 - Protective Force Personnel Medical, Physical Readiness, Training, and Access Authorization Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-06

...The Department of Energy (DOE or Department) proposes to revise the regulation governing the standards for medical, physical performance, training, and access authorizations for protective force (PF) personnel employed by contractors providing security services to the Department. The existing version of this regulation was promulgated in 1993 and substantial portions of the regulation date to the mid- 1980s. Since 1993 DOE policy has placed greater reliance upon technology, vehicular response, and increased firepower and, correspondingly, has reduced its reliance upon the ability of PF personnel to perform the running tasks required in the current regulation. Furthermore, this shift in emphasis has placed a greater premium upon the retention of mature, tactically experienced, and technically sophisticated personnel, particularly since these personnel represent a considerable investment by DOE in security background investigations and training. The proposed revisions bring DOE PF medical and physical readiness requirements in line with these tactical and organizational priorities. The proposed revisions reduce the exposure of the PF population to injuries related to physical readiness testing. They would create a PF readiness classification designed specifically to encourage the retention of experienced personnel. The revisions would further ensure that PF personnel would be evaluated on a case-by-case basis on their ability to perform the essential functions of their positions without posing a direct threat to themselves or site personnel, the facility, or the general public. The proposed revisions would further ensure that reasonable accommodations would be considered before a determination is made that an individual cannot perform the essential functions of a particular position. The proposed rule also would provide for new medical review processes for PF personnel disqualified from medical certification. The proposed rule would ensure that DOE PF medical and

3D multimodal cardiac data reconstruction using angiography and computerized tomographic angiography registration.

PubMed

Moosavi Tayebi, Rohollah; Wirza, Rahmita; Sulaiman, Puteri S B; Dimon, Mohd Zamrin; Khalid, Fatimah; Al-Surmi, Aqeel; Mazaheri, Samaneh

2015-04-22

Computerized tomographic angiography (3D data representing the coronary arteries) and X-ray angiography (2D X-ray image sequences providing information about coronary arteries and their stenosis) are standard and popular assessment tools utilized for medical diagnosis of coronary artery diseases. At present, the results of both modalities are individually analyzed by specialists and it is difficult for them to mentally connect the details of these two techniques. The aim of this work is to assist medical diagnosis by providing specialists with the relationship between computerized tomographic angiography and X-ray angiography. In this study, coronary arteries from two modalities are registered in order to create a 3D reconstruction of the stenosis position. The proposed method starts with coronary artery segmentation and labeling for both modalities. Then, stenosis and relevant labeled artery in X-ray angiography image are marked by a specialist. Proper control points for the marked artery in both modalities are automatically detected and normalized. Then, a geometrical transformation function is computed using these control points. Finally, this function is utilized to register the marked artery from the X-ray angiography image on the computerized tomographic angiography and get the 3D position of the stenosis lesion. The result is a 3D informative model consisting of stenosis and coronary arteries' information from the X-ray angiography and computerized tomographic angiography modalities. The results of the proposed method for coronary artery segmentation, labeling and 3D reconstruction are evaluated and validated on the dataset containing both modalities. The advantage of this method is to aid specialists to determine a visual relationship between the correspondent coronary arteries from two modalities and also set up a connection between stenosis points from an X-ray angiography along with their 3D positions on the coronary arteries from computerized

Risk assessments for exposure of deployed military personnel to insecticides and personal protective measures used for disease-vector management.

PubMed

Macedo, Paula A; Peterson, Robert K D; Davis, Ryan S

2007-10-01

Infectious diseases are problematic for deployed military forces throughout the world, and, historically, more military service days have been lost to insect-vectored diseases than to combat. Because of the limitations in efficacy and availability of both vaccines and therapeutic drugs, vector management often is the best tool that military personnel have against most vector-borne pathogens. However, the use of insecticides may raise concerns about the safety of their effects on the health of the military personnel exposed to them. Therefore, our objective was to use risk assessment methodologies to evaluate health risks to deployed U.S. military personnel from vector management tactics. Our conservative tier-1, quantitative risk assessment focused on acute, subchronic, and chronic exposures and cancer risks to military personnel after insecticide application and use of personal protective measures in different scenarios. Exposures were estimated for every scenario, chemical, and pathway. Acute, subchronic, and chronic risks were assessed using a margin of exposure (MOE) approach. Our MOE was the ratio of a no-observed-adverse-effect level (NOAEL) to an estimated exposure. MOEs were greater than the levels of concern (LOCs) for all surface residual and indoor space spraying exposures, except acute dermal exposure to lambda-cyhalothrin. MOEs were greater than the LOCs for all chemicals in the truck-mounted ultra-low-volume (ULV) exposure scenario. The aggregate cancer risk for permethrin exceeded 1 x 10(-6), but more realistic exposure refinements would reduce the cancer risk below that value. Overall, results indicate that health risks from exposures to insecticides and personal protective measures used by military personnel are low.

33 CFR 150.623 - What are the requirements for protecting personnel from hazards associated with confined spaces?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false What are the requirements for protecting personnel from hazards associated with confined spaces? 150.623 Section 150.623 Navigation and... national consensus standard, as that term is defined in 29 CFR 1910.2, or that is set by a nationally...

Comparison of CT angiography with conventional arterial angiography in aortoiliac occlusive disease.

PubMed

Tins, B; Oxtoby, J; Patel, S

2001-03-01

This study compared the results of conventional and CT angiography of the aortoiliac segment in 35 patients with occlusive disease. Disease severity was graded into five categories. Two assessors independently assessed the segment from the distal abdominal aorta to the proximal superficial femoral artery and a consensus was formed. There was interobserver agreement in 87% of segments for conventional angiography and in 78% for CT angiography. Comparison of the two modalities gave identical grading in 84% of segments. Dissimilar grading was found in 16%, with a roughly equal number of undergrading and overgrading. CT angiography has the advantages of being minimally invasive, requiring only an intravenous injection of contrast medium and imaging surrounding soft tissues. Multiplanar reconstruction aids the visualization of asymmetrical stenoses, and collateral blood supply is readily appreciated. However, CT angiography may fail to demonstrate short stenoses owing to limited z-axis resolution.

CT angiography versus conventional digital angiography in preoperative assessment for Chinese living kidney donors.

PubMed

Yap, Desmond Yat Hin; Chu, Ferdinand Siu Kay; Chu, Sai Man; Tam, Po Chor; Tam, Sidney; Chan, Tak Mao; Lai, Kar Neng; Tang, Sydney Chi Wai

2010-01-01

Computed tomography (CT) angiography is used for preoperative evaluation of living kidney donors, but its correlation with intraoperative findings during the transplant operation remains unknown. Between April 1997 and October 2008, 34 consecutive pairs of living kidney transplants were carried out. Conventional digital angiography was employed for the preoperative assessment in the first 19 pairs, and CT angiography in the subsequent 15 pairs. The radiological reports and operative findings during kidney harvest were carefully examined and compared. Among the 34 cases in our cohort, we found 9 early branching renal arteries (26.4%) and 6 double renal arteries (17%). Venous and ureteral anomalies were rare, with only 1 case (2.9%) of each. CT angiography offered excellent and equal accuracy (accuracy 100%) when compared with conventional digital angiography for renal arterial anatomy. CT angiography showed superior performance compared with conventional angiography in the domain of venous and collecting system anomalies (accuracy 100% vs. 94.7%, respectively). No contrast nephropathy or allergy was documented in our series. CT angiography showed excellent correlations with surgical findings in the Chinese population. It is associated with minimal risk of contrast nephropathy as well as lower cost and therefore should be adopted as the standard preoperative assessment of living kidney donors.

21 CFR 21.32 - Personnel records.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Personnel records. 21.32 Section 21.32 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROTECTION OF PRIVACY Requirements for Specific Categories of Records § 21.32 Personnel records. (a) Present and former...

Pedal angiography in peripheral arterial occlusive disease: first-pass i.v. contrast-enhanced MR angiography with blood pool contrast medium versus intraarterial digital subtraction angiography.

PubMed

Kos, Sebastian; Reisinger, Clemens; Aschwanden, Markus; Bongartz, Georg M; Jacob, Augustinus L; Bilecen, Deniz

2009-03-01

The purpose of this study was to prospectively evaluate first-pass i.v. gadofosveset-enhanced MR angiography in patients with peripheral arterial occlusive disease for visualization of the pedal arteries and stenosis or occlusion of those arteries with intraarterial digital subtraction angiography as the reference standard. Twenty patients with peripheral arterial occlusive disease (nine women, 11 men; age-range 58-83 years) were prospectively enrolled. Gadofosveset first-pass contrast-enhanced MR angiography was performed with a 1.5-T system, a dedicated foot coil, and cuff compression to the calf. Arterial segments were assessed for degree of arterial stenosis, arterial visibility, diagnostic utility, and venous contamination. Detection of vessel stenosis or occlusion was evaluated in comparison with findings at digital subtraction angiography. The unpaired Student's t test was used to test arterial visibility with the two techniques. First-pass MR angiography with gadofosveset had good diagnostic utility in 83.9% of all segments and no venous contamination in 96.8% of all segments. There was no difference between the performance of intraarterial digital subtraction angiography and that of i.v. contrast-enhanced MR angiography in arterial visibility overall (p = 0.245) or in subgroup analysis of surgical arterial bypass targets (p = 0.202). The overall sensitivity, specificity, and accuracy of i.v. gadofosveset-enhanced MR angiography for characterization of clinically significant stenosis and occlusion were 91.4%, 96.1%, and 93.9%. In the subgroup analysis, the sensitivity, specificity, and accuracy were 85.5%, 96.5%, and 92.1%. Gadofosveset-enhanced MR angiography of the pedal arteries in patients with peripheral arterial occlusive disease has arterial visibility equal to that of digital subtraction angiography and facilitates depiction of clinically significant stenosis and occlusion.

Campus Protective Services: A Self-Instructional Training Course for Campus Security Personnel.

ERIC Educational Resources Information Center

Mullendore, Philip

While most college campuses use non-sworn personnel, mostly students, to supplement regular security or peace officer personnel, there is no legal requirement or formal strategy for training these non-sworn officers. This handbook presents a self-instructional training course for non-sworn campus security personnel and was prepared to meet…

CT Angiography after 20 Years

PubMed Central

Rubin, Geoffrey D.; Leipsic, Jonathon; Schoepf, U. Joseph; Fleischmann, Dominik; Napel, Sandy

2015-01-01

Through a marriage of spiral computed tomography (CT) and graphical volumetric image processing, CT angiography was born 20 years ago. Fueled by a series of technical innovations in CT and image processing, over the next 5–15 years, CT angiography toppled conventional angiography, the undisputed diagnostic reference standard for vascular disease for the prior 70 years, as the preferred modality for the diagnosis and characterization of most cardiovascular abnormalities. This review recounts the evolution of CT angiography from its development and early challenges to a maturing modality that has provided unique insights into cardiovascular disease characterization and management. Selected clinical challenges, which include acute aortic syndromes, peripheral vascular disease, aortic stent-graft and transcatheter aortic valve assessment, and coronary artery disease, are presented as contrasting examples of how CT angiography is changing our approach to cardiovascular disease diagnosis and management. Finally, the recently introduced capabilities for multispectral imaging, tissue perfusion imaging, and radiation dose reduction through iterative reconstruction are explored with consideration toward the continued refinement and advancement of CT angiography. PMID:24848958

5 CFR 353.302 - Retention protections.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Retention protections. 353.302 Section 353.302 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RESTORATION... protections. An injured employee enjoys no special protection in a reduction in force. Separation by reduction...

75 FR 29366 - Hyginus U. Aguzie v. Office of Personnel Management

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-25

.... Office of Personnel Management AGENCY: Merit Systems Protection Board. ACTION: Notice. SUMMARY: The Merit Systems Protection Board (MSPB) is providing notice of an extension of time in which parties may file amicus briefs in the matter of Hyginus U. Aguzie v. Office of Personnel Management, MSPB Docket Number DC...

Comparative analysis of fluorescent angiography, computed tomographic angiography and magnetic resonance angiography for planning autologous breast reconstruction

PubMed Central

Chae, Michael P.; Hunter-Smith, David J.

2015-01-01

Background The high incidence of breast cancer and growing number of breast cancer patients undergoing mastectomy has led to breast reconstruction becoming an important part of holistic treatment for these patients. In planning autologous reconstructions, preoperative assessment of donor site microvascular anatomy with advanced imaging modalities has assisted in the appropriate selection of flap donor site, individual perforators, and lead to an overall improvement in flap outcomes. In this review, we compare the accuracy of fluorescent angiography, computed tomographic angiography (CTA), and magnetic resonance angiography (MRA) and their impact on clinical outcomes. Methods A review of the published English literature dating from 1950 to 2015 using databases, such as PubMed, Medline, Web of Science, and EMBASE was undertaken. Results Fluorescent angiography is technically limited by its inability to evaluate deep-lying perforators and hence, it has a minimal role in the preoperative setting. However, it may be useful intraoperatively in evaluating microvascular anastomotic patency and the mastectomy skin perfusion. CTA is currently widely considered the standard, due to its high accuracy and reliability. Multiple studies have demonstrated its ability to improve clinical outcomes, such as operative length and flap complications. However, concerns surrounding exposure to radiation and nephrotoxic contrast agents exist. MRA has been explored, however despite recent advances, the image quality of MRA is considered inferior to CTA. Conclusions Preoperative imaging is an essential component in planning autologous breast reconstruction. Fluorescent angiography presents minimal role as a preoperative imaging modality, but may be a useful intraoperative adjunct to assess the anastomosis and the mastectomy skin perfusion. Currently, CTA is the gold standard preoperatively. MRA has a role, particularly for women of younger age, iodine allergy, and renal impairment. PMID

Carotid artery stenting for vulnerable plaques on MR angiography and ultrasonography: utility of dual protection and blood aspiration method.

PubMed

Sakamoto, Shigeyuki; Kiura, Yoshihiro; Okazaki, Takahito; Shinagawa, Katsuhiro; Ishii, Daizo; Ichinose, Nobuhiko; Kurisu, Kaoru

2016-10-01

Carotid artery stenting (CAS) for internal carotid artery (ICA) stenosis with vulnerable plaques is controversial. We analyzed the effect of a dual protection and blood aspiration method during CAS in patients with vulnerable plaques. A total of 111 patients with ICA stenosis underwent CAS using the dual protection (simultaneous flow reversal and distal filter) and blood aspiration method. In 103 of 111 patients, preoperative carotid plaque was estimated by both 3 T MRI and ultrasonography (US). ICA plaques with a high intensity signal on time-of-flight-MR angiography (TOF-MRA) and/or mobile component on US were defined as vulnerable plaques. We assessed major adverse events (MAE) (ie, major stroke, myocardial infarction, and death) and hyperintense spots on diffusion-weighted images (DWI) after CAS. We then evaluated the visible debris captured by dual protection and blood aspiration during CAS. The preoperative ICA plaque on TOF-MRA and US was judged to be vulnerable in 48.5% (50/103 patients). The success rate of the CAS procedure was 100% with no MAE within 30 days. DWI showed small hyperintense spots in 18% (9/50 patients) and 18.9% (10/53 patients) in the vulnerable and non-vulnerable plaque groups, respectively. Visible debris was captured in 68% (34/50 patients) and 45.3% (24/53 patients) in the vulnerable and non-vulnerable plaque groups, respectively (p=0.0286). The combination of dual protection and blood aspiration could provide effective distal embolic protection although vulnerable plaques on TOF-MRA and US had a high incidence of debris during CAS. Thus, CAS using dual protection and blood aspiration is safe in patients with vulnerable plaques. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Infrared-laser-based fundus angiography

NASA Astrophysics Data System (ADS)

Klingbeil, Ulrich; Canter, Joseph M.; Lesiecki, Michael L.; Reichel, Elias

1994-06-01

Infrared fundus angiography, using the fluorescent dye indocyanine green (ICG), has shown great potential in delineating choroidal neovascularization (CNV) otherwise not detectable. A digital retinal imaging system containing a diode laser for illumination has been developed and optimized to perform high sensitivity ICG angiography. The system requires less power and generates less pseudo-fluorescence background than nonlaser devices. During clinical evaluation at three retinal centers more than 200 patients, the majority of which had age-related macular degeneration, were analyzed. Laser based ICG angiography was successful in outlining many of the ill-defined or obscure CNV as defined by fluorescein angiography. The procedure was not as successful with classic CNV. ICG angiograms were used to prepare and guide laser treatment.

[Radiation exposure of radiologists during angiography: dose measurements outside the lead apron].

PubMed

Fischer, H; Przetak, C; Teubert, G; Ewen, K; Mödder, U

1995-02-01

The aim of this study was to provide practical information to angiographers concerning radiation exposure to body parts not covered by lead aprons. Individual doses to the neck and hands of radiologists measured in micro-Sieverts were obtained during the course of 80 angiographies of various types. The number of diagnostic and interventional procedures, which might lead to exceeding permissible doses, have been calculated. Possibilities of estimating doses during angiography by means of parameters such as screening times were examined statistically. Especially with regard to the hands, estimations of the doses are insufficient (correlation r = 0.21). Radiologists who undertake much angiographic and particularly interventional work may reach exposure levels requiring protective measures in addition to lead aprons.

Diagnostic Accuracy of Computed Tomography Angiography as Compared to Conventional Angiography in Patients Undergoing Noncoronary Cardiac Surgery

PubMed Central

Joshi, Hasit; Shah, Ronak; Prajapati, Jayesh; Bhangdiya, Vipin; Shah, Jayal; Kandre, Yogini; Shah, Komal

2016-01-01

Objective: To compare the diagnostic accuracy of multi-slice computed tomography (MSCT) angiography with conventional angiography in patients undergoing major noncoronary cardiac surgeries. Materials and Methods: We studied fifty major noncoronary cardiac surgery patients scheduled for invasive coronary angiography, 29 (58%) female and 21 (42%) male. Inclusion criteria of the study were age of the patients ≥40 years, having low or intermediate probability of coronary artery disease (CAD), left ventricular ejection fraction (LVEF) >35%, and patient giving informed consent for undergoing MSCT and conventional coronary angiography. The patients with LVEF <35%, high pretest probability of CAD, and hemodynamically unstable were excluded from the study. Results: The diagnostic accuracy of CT coronary angiography was evaluated regarding true positive, true negative values. The overall sensitivity and specificity of CT angiography technique was 100% (95% confidence interval [CI]: 39.76%–100%) and 91.30% (95% CI: 79.21%–97.58%). The positive (50%; 95% CI: 15.70%–84.30%) and negative predictive values (100%; 95% CI: 91.59%–100%) of CT angiography were also fairly high in these patients. Conclusion: Our study suggests that this non-invasive technique may improve perioperative risk stratification in patients undegoing non-cardiac surgery. PMID:27867455

CT angiography - abdomen and pelvis

MedlinePlus

... this page: //medlineplus.gov/ency/article/007674.htm CT angiography - abdomen and pelvis To use the sharing features on this page, please enable JavaScript. CT angiography combines a CT scan with the injection ...

CT angiography - arms and legs

MedlinePlus

... this page: //medlineplus.gov/ency/article/007675.htm CT angiography - arms and legs To use the sharing features on this page, please enable JavaScript. CT angiography combines a CT scan with the injection ...

CT angiography - head and neck

MedlinePlus

... this page: //medlineplus.gov/ency/article/007677.htm CT angiography - head and neck To use the sharing features on this page, please enable JavaScript. CT angiography (CTA) combines a CT scan with the ...

10 CFR 50.120 - Training and qualification of nuclear power plant personnel.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Mechanical maintenance personnel. (vii) Radiological protection technician. (viii) Chemistry technician. (ix) Engineering support personnel. (3) The training program must incorporate the instructional requirements...

10 CFR 50.120 - Training and qualification of nuclear power plant personnel.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) Mechanical maintenance personnel. (vii) Radiological protection technician. (viii) Chemistry technician. (ix) Engineering support personnel. (3) The training program must incorporate the instructional requirements...

10 CFR 50.120 - Training and qualification of nuclear power plant personnel.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) Mechanical maintenance personnel. (vii) Radiological protection technician. (viii) Chemistry technician. (ix) Engineering support personnel. (3) The training program must incorporate the instructional requirements...

Mesenteric angiography

MedlinePlus

... Arteriogram - abdomen; Mesenteric angiogram Images Mesenteric arteriography References Kaufman JA. Fundamentals of angiography. In: Kaufman JA, Lee MJ, eds. Vascular and Interventional Radiology: ...

5 CFR 353.209 - Retention protections.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Retention protections. 353.209 Section 353.209 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RESTORATION... protections. (a) During uniformed service. An employee may not be demoted or separated (other than military...

ORGAN-SPECIFIC EXTERNAL DOSE COEFFICIENTS AND PROTECTIVE APRON TRANSMISSION FACTORS FOR HISTORICAL DOSE RECONSTRUCTION FOR MEDICAL PERSONNEL

PubMed Central

Simon, Steven L.

2014-01-01

the ICRP/ICRU mono-energetic DCCs and the functions integrated over the air-kerma weighted photon fluence of the 12 defined x-ray spectra. The air kerma-weighted DCCs in this work were developed specifically for an irradiation geometry of anterior to posterior (AP) and for the following tissues: thyroid, breast, ovary, lens of eye, lung, colon, testes, heart, skin (anterior side only), red bone marrow (RBM), heart, and brain. In addition, a series of functional relationships to predict DT per Ka values for RBM dependent on body mass index [BMI (kg m−2) ≡ weight per height2] and average photon energy were derived from a published analysis. Factors to account for attenuation of radiation by protective lead aprons were also developed. Because lead protective aprons often worn by radiology personnel not only reduce the intensity of x-ray exposure but also appreciably harden the transmitted fluence of bremsstrahlung x rays, DCCs were separately calculated for organs possibly protected by lead aprons by considering three cases: no apron, 0.25 mm Pb apron, and 0.5 mm Pb apron. For estimation of organ doses from conducting procedures with radioisotopes, continuous functions of the reported mono-energetic values were developed and DCCs were derived by estimation of the function at relevant energies. By considering the temporal changes in primary exposure-related parameters, e.g., energy distribution, the derived DCCs and transmission factors presented here allow for more realistic historical dose reconstructions for medical personnel when monitoring badge readings are the primary data on which estimation of an individual's organ doses are based. PMID:21617389

Organ-specific external dose coefficients and protective apron transmission factors for historical dose reconstruction for medical personnel.

PubMed

Simon, Steven L

2011-07-01

ICRP/ICRU mono-energetic DCCs and the functions integrated over the air-kerma weighted photon fluence of the 12 defined x-ray spectra. The air kerma-weighted DCCs in this work were developed specifically for an irradiation geometry of anterior to posterior (AP) and for the following tissues: thyroid, breast, ovary, lens of eye, lung, colon, testes, heart, skin (anterior side only), red bone marrow (RBM), and brain. In addition, a series of functional relationships to predict DT Ka-1 values for RBM dependent on body mass index [BMI (kg m-2) ≡ weight per height] and average photon energy were derived from a published analysis. Factors to account for attenuation of radiation by protective lead aprons were also developed. Because lead protective aprons often worn by radiology personnel not only reduce the intensity of x-ray exposure but also appreciably harden the transmitted fluence of bremsstrahlung x-rays, DCCs were separately calculated for organs possibly protected by lead aprons by considering three cases: no apron, 0.25 mm Pb apron, and 0.5 mm Pb apron. For estimation of organ doses from conducting procedures with radioisotopes, continuous functions of the reported mono-energetic values were developed, and DCCs were derived by estimation of the function at relevant energies. By considering the temporal changes in primary exposure-related parameters (e.g., energy distribution), the derived DCCs and transmission factors presented here allow for more realistic historical dose reconstructions for medical personnel when monitoring badge readings are the primary data on which estimation of an individual's organ doses are based.

Intravenous volume tomographic pulmonary angiography imaging

NASA Astrophysics Data System (ADS)

Ning, Ruola; Strang, John G.; Chen, Biao; Conover, David L.; Yu, Rongfeng

1999-05-01

This study presents a new intravenous (IV) tomographic angiography imaging technique, called intravenous volume tomographic digital angiography (VTDA) for cross sectional pulmonary angiography. While the advantages of IV-VTDA over spiral CT in terms of volume scanning time and resolution have been validated and reported in our previous papers for head and neck vascular imaging, the superiority of IV-VTDA over spiral CT for cross sectional pulmonary angiography has not been explored yet. The purpose of this study is to demonstrate the advantage of isotropic resolution of IV-VTDA in the x, y and z directions through phantom and animal studies, and to explore its clinical application for detecting clots in pulmonary angiography. A prototype image intensifier-based VTDA imaging system has been designed and constructed by modifying a GE 8800 CT scanner. This system was used for a series of phantom and dog studies. A pulmonary vascular phantom was designed and constructed. The phantom was scanned using the prototype VTDA system for direct 3D reconstruction. Then the same phantom was scanned using a GE CT/i spiral CT scanner using the routine pulmonary CT angiography protocols. IV contrast injection and volume scanning protocols were developed during the dog studies. Both VTDA reconstructed images and spiral CT images of the specially designed phantom were analyzed and compared. The detectability of simulated vessels and clots was assessed as the function of iodine concentration levels, oriented angles, and diameters of the vessels and clots. A set of 3D VTDA reconstruction images of dog pulmonary arteries was obtained with different IV injection rates and isotropic resolution in the x, y and z directions. The results of clot detection studies in dog pulmonary arteries have also been shown. This study presents a new tomographic IV angiography imaging technique for cross sectional pulmonary angiography. The results of phantom and animal studies indicate that IV-VTDA is

Aortic angiography

MedlinePlus

Angiography - aorta; Aortography; Abdominal aorta angiogram; Aortic arteriogram; Aneurysm - aortic arteriogram ... this needle. The catheter is moved into the aorta. The doctor can see live images of the ...

Pulmonary Thromboembolism: Evaluation By Intravenous Angiography

NASA Astrophysics Data System (ADS)

Pond, Gerald D.; Cook, Glenn C.; Woolfenden, James M.; Dodge, Russell R.

1981-11-01

Using perfusion lung scans as a guide, digital video subtraction angiography of the pulmonary arteries was performed in human subjects suspected of having pulmonary embolism. Dogs were employed as a pulmonary embolism model and both routine pulmonary angiography and intravenous pulmonary angiograms were obtained for comparison purposes. We have shown by our preliminary results that the technique is extremely promising as a safe and accurate alternative to routine pulmonary angiography in selected patients.

Fairness in the coronary angiography queue.

PubMed

Alter, D A; Basinski, A S; Cohen, E A; Naylor, C D

1999-10-05

Since waiting lists for coronary angiography are generally managed without explicit queuing criteria, patients may not receive priority on the basis of clinical acuity. The objective of this study was to examine clinical and nonclinical determinants of the length of time patients wait for coronary angiography. In this single-centre prospective cohort study conducted in the autumn of 1997, 357 consecutive patients were followed from initial triage until a coronary angiography was performed or an adverse cardiac event occurred. The referring physicians' hospital affiliation (physicians at Sunnybrook & Women's College Health Sciences Centre, those who practice at another centre but perform angiography at Sunnybrook and those with no previous association with Sunnybrook) was used to compare processes of care. A clinical urgency rating scale was used to assign a recommended maximum waiting time (RMWT) to each patient retrospectively, but this was not used in the queuing process. RMWTs and actual waiting times for patients in the 3 referral groups were compared; the influence clinical and nonclinical variables had on the actual length of time patients waited for coronary angiography was assessed; and possible predictors of adverse events were examined. Of 357 patients referred to Sunnybrook, 22 (6.2%) experienced adverse events while in the queue. Among those who remained, 308 (91.9%) were in need of coronary angiography; 201 (60.0%) of those patients received one within the RMWT. The length of time to angiography was influenced by clinical characteristics similar to those specified on the urgency rating scale, leading to a moderate agreement between actual waiting times and RMWTs (kappa = 0.53). However, physician affiliation was a highly significant (p < 0.001) and independent predictor of waiting time. Whereas 45.6% of the variation in waiting time was explained by all clinical factors combined, 9.3% of the variation was explained by physician affiliation alone

Optical Coherence Tomography Angiography Features of Diabetic Retinopathy

PubMed Central

Hwang, Thomas S.; Jia, Yali; Gao, Simon S.; Bailey, Steven T.; Lauer, Andreas K.; Flaxel, Christina J.; Wilson, David J.; Huang, David

2015-01-01

Purpose To describe the optical coherence tomography (OCT) angiography features of diabetic retinopathy Methods Using a 70kHz OCT and the split-spectrum amplitude decorrelation angiography (SSADA) algorithm, 6 × 6 mm 3-dimensional angiograms of the macula of 4 patients with diabetic retinopathy were obtained and compared with fluorescein angiography (FA) for features catalogued by the Early Treatment of Diabetic Retinopathy Study. Results OCT angiography detected enlargement and distortion of the foveal avascular zone, retinal capillary dropout, and pruning of arteriolar branches. Areas of capillary loss obscured by fluorescein leakage on FA were more clearly defined on OCT angiography. Some areas of focal leakage on FA that were thought to be microaneurysms were found to be small tufts of neovascularization that extended above the inner limiting membrane. Conclusion OCT angiography does not show leakage, but can better delineate areas of capillary dropout and detect early retinal neovascularization. This new noninvasive angiography technology may be useful for routine surveillance of proliferative and ischemic changes in diabetic retinopathy. PMID:26308529

Stenosis detection in native hemodialysis fistulas with MDCT angiography.

PubMed

Heye, Sam; Maleux, Geert; Claes, Kathleen; Kuypers, Dirk; Oyen, Raymond

2009-04-01

The objective of our study was to assess the diagnostic value of 64-MDCT angiography in the evaluation of failing hemodialysis arteriovenous fistulas (AVFs) in comparison with conventional digital subtraction angiography (DSA). Thirty-six patients (22 men; mean age +/- SD, 65 +/- 15 years) with hemodialysis fistula dysfunction underwent MDCT angiography before DSA. Linear weighted kappa was used to calculate interobserver agreement for stenosis for both MDCT angiography and DSA on a 5-point scale. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the detection of >/= 50% stenosis or occlusion on MDCT angiography was calculated using DSA as the standard of reference. Wilcoxon's signed rank test and Mann-Whitney U test were used to compare differences in image quality between MDCT angiography and DSA and between MDCT angiography with the patient's arm stretched overhead or alongside the body, respectively. Interobserver agreement for detecting stenosis was excellent for both DSA (kappa = 0.86; 95% CI, 0.81-0.91) and MDCT angiography (kappa = 0.82; 95% CI, 0.77-0.87). Accuracy, sensitivity, specificity, PPV, and NPV of MDCT angiography for detecting >/= 50% stenosis or occlusion was 92.0% (95% CI, 86.8-95.3%), 90.2% (77.8-96.3%), 92.8% (85.9-96.6%), 85.2% (72.3-92.9%), and 95.4% (89.0-98.3%), respectively. No significant difference in image quality was seen between MDCT angiography and DSA (p = 0.3008) or between MDCT angiography with the patient's arm stretched overhead or alongside the body (p = 0.2912). MDCT angiography is a reproducible and reliable imaging technique for detection of >/= 50% stenosis or occlusion in dysfunctional hemodialysis fistulas.

5 CFR 736.103 - Protecting the identity of a source.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Protecting the identity of a source. 736.103 Section 736.103 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) PERSONNEL INVESTIGATIONS Scope § 736.103 Protecting the identity of a source. When a...

5 CFR 736.103 - Protecting the identity of a source.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Protecting the identity of a source. 736.103 Section 736.103 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) PERSONNEL INVESTIGATIONS Scope § 736.103 Protecting the identity of a source. When a...

5 CFR 736.103 - Protecting the identity of a source.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Protecting the identity of a source. 736.103 Section 736.103 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) PERSONNEL INVESTIGATIONS Scope § 736.103 Protecting the identity of a source. When a...

5 CFR 736.103 - Protecting the identity of a source.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Protecting the identity of a source. 736.103 Section 736.103 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) PERSONNEL INVESTIGATIONS Scope § 736.103 Protecting the identity of a source. When a...

5 CFR 736.103 - Protecting the identity of a source.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Protecting the identity of a source. 736.103 Section 736.103 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) PERSONNEL INVESTIGATIONS Scope § 736.103 Protecting the identity of a source. When a...

Utilization of cardiac computed tomography angiography and outpatient invasive coronary angiography in Ontario, Canada.

PubMed

Roifman, Idan; Rezai, Mohammad R; Wijeysundera, Harindra C; Chow, Benjamin J W; Wright, Graham A; Tu, Jack V

2015-01-01

Cardiac computed tomography angiography (coronary CTA) has emerged as a non-invasive method of diagnosing coronary artery disease. The extent of utilization and uptake of this technology since initiation of its funding by the government of Ontario is unknown. The aim of our study was to examine coronary CTA utilization and the rates of elective invasive coronary angiography and revascularization before and after funding initiation. We studied all coronary CTAs performed on adults in Ontario after initiation of funding. We also used an interrupted time series analysis to compare the average monthly rates of invasive angiography and revascularization before and after initiation of funding. There was an initial steep increase in age-and sex-standardized rates of coronary CTA from 5.0 to 11.4/100,000 over the first two quarters after funding initiation. Afterwards, there was a gradual increase in utilization from 11.4 to 17.1/100,000 over two subsequent calendar years. There was a significant reduction in both the mean monthly outpatient invasive coronary angiography (from 20.7 to 19.9 per 100,000 (p = 0.0004)) and revascularization (from 4.9 to 4.4 per 100,000 (p < 0.0001)) rates in the three years following introduction of the coronary CTA billing code as compared to the three prior to its introduction. Since the introduction of coronary CTA funding in Ontario, there has been a steady and controlled increase in its utilization. The increasing use of coronary CTA was associated with a reduction in both the rates of invasive angiography and revascularization. Copyright © 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

CDC guidance for evaluating health-care personnel for hepatitis B virus protection and for administering postexposure management.

PubMed

Schillie, Sarah; Murphy, Trudy V; Sawyer, Mark; Ly, Kathleen; Hughes, Elizabeth; Jiles, Ruth; de Perio, Marie A; Reilly, Meredith; Byrd, Kathy; Ward, John W

2013-12-20

This report contains CDC guidance that augments the 2011 recommendations of the Advisory Committee on Immunization Practices (ACIP) for evaluating hepatitis B protection among health-care personnel (HCP) and administering post-exposure prophylaxis. Explicit guidance is provided for persons working, training, or volunteering in health-care settings who have documented hepatitis B (HepB) vaccination years before hire or matriculation (e.g., when HepB vaccination was received as part of routine infant [recommended since 1991] or catch-up adolescent [recommended since 1995] vaccination). In the United States, 2,890 cases of acute hepatitis B were reported to CDC in 2011, and an estimated 18,800 new cases of hepatitis B occurred after accounting for underreporting of cases and asymptomatic infection. Although the rate of acute hepatitis B virus (HBV) infections have declined approximately 89% during 1990-2011, from 8.5 to 0.9 cases per 100,000 population in the United States, the risk for occupationally acquired HBV among HCP persists, largely from exposures to patients with chronic HBV infection. ACIP recommends HepB vaccination for unvaccinated or incompletely vaccinated HCP with reasonably anticipated risk for blood or body fluid exposure. ACIP also recommends that vaccinated HCP receive postvaccination serologic testing (antibody to hepatitis B surface antigen [anti-HBs]) 1-2 months after the final dose of vaccine is administered (CDC. Immunization of health-care personnel: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2011;60 [No. RR-7]). Increasing numbers of HCP have received routine HepB vaccination either as infants (recommended since 1991) or as catch-up vaccination (recommended since 1995) in adolescence. HepB vaccination results in protective anti-HBs responses among approximately 95% of healthy-term infants. Certain institutions test vaccinated HCP by measuring anti-HBs upon hire or matriculation, even when anti

The potential for neurovascular intravenous angiography using K-edge digital subtraction angiography

NASA Astrophysics Data System (ADS)

Schültke, E.; Fiedler, S.; Kelly, M.; Griebel, R.; Juurlink, B.; LeDuc, G.; Estève, F.; Le Bas, J.-F.; Renier, M.; Nemoz, C.; Meguro, K.

2005-08-01

Background: Catheterization of small-caliber blood vessels in the central nervous system can be extremely challenging. Alternatively, intravenous (i.v.) administration of contrast agent is minimally invasive and therefore carries a much lower risk for the patient. With conventional X-ray equipment, volumes of contrast agent that could be safely administered to the patient do not allow acquisition of high-quality images after i.v. injection, because the contrast bolus is extremely diluted by passage through the heart. However, synchrotron-based digital K-edge subtraction angiography does allow acquisition of high-quality images after i.v. administration of relatively small doses of contrast agent. Materials and methods: Eight adult male New Zealand rabbits were used for our experiments. Animals were submitted to both angiography with conventional X-ray equipment and synchrotron-based digital subtraction angiography. Results: With conventional X-ray equipment, no contrast was seen in either cerebral or spinal blood vessels after i.v. injection of iodinated contrast agent. However, using K-edge digital subtraction angiography, as little as 1 ml iodinated contrast agent, when administered as i.v. bolus, yielded images of small-caliber blood vessels in the central nervous system (both brain and spinal cord). Conclusions: If it would be possible to image blood vessels of the same diameter in the central nervous system of human patients, the synchrotron-based technique could yield high-quality images at a significantly lower risk for the patient than conventional X-ray imaging. Images could be acquired where catheterization of feeding blood vessels has proven impossible.

Stent sizing strategies in renal artery stenting: the comparison of conventional invasive renal angiography with renal computed tomographic angiography.

PubMed

Kadziela, Jacek; Michalowska, Ilona; Pregowski, Jerzy; Janaszek-Sitkowska, Hanna; Lech, Katarzyna; Kabat, Marek; Staruch, Adam; Januszewicz, Andrzej; Witkowski, Adam

2016-01-01

Randomized trials comparing invasive treatment of renal artery stenosis with standard pharmacotherapy did not show substantial benefit from revascularization. One of the potential reasons for that may be suboptimal procedure technique. To compare renal stent sizing using two modalities: three-dimensional renal computed tomography angiography (CTA) versus conventional angiography. Forty patients (41 renal arteries), aged 65.1 ±8.5 years, who underwent renal artery stenting with preprocedural CTA performed within 6 months, were retrospectively analyzed. In CTA analysis, reference diameter (CTA-D) and lesion length (CTA_LL) were measured and proposed stent diameter and length were recorded. Similarly, angiographic reference diameter (ANGIO_D) and lesion length (ANGIO_LL) as well as proposed stent dimensions were obtained by visual estimation. The median CTA_D was 0.5 mm larger than the median ANGIO_D (p < 0.001). Also, the proposed stent diameter in CTA evaluation was 0.5 mm larger than that in angiography (p < 0.0001). The median CTA_LL was 1 mm longer than the ANGIO_LL (p = NS), with significant correlation of these variables (r = 0.66, p < 0.0001). The median proposed stent length with CTA was equal to that proposed with angiography. The median diameter of the implanted stent was 0.5 mm smaller than that proposed in CTA (p < 0.0005) and identical to that proposed in angiography. The median length of the actual stent was longer than that proposed in angiography (p = 0.0001). Renal CTA has potential advantages as a tool adjunctive to angiography in appropriate stent sizing. Careful evaluation of the available CTA scans may be beneficial and should be considered prior to the planned procedure.

5 CFR 841.204 - Deemed application to protect survivors.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Deemed application to protect survivors. 841.204 Section 841.204 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL... for Benefits § 841.204 Deemed application to protect survivors. (a) A former employee is deemed to...

5 CFR 841.204 - Deemed application to protect survivors.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Deemed application to protect survivors. 841.204 Section 841.204 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL... for Benefits § 841.204 Deemed application to protect survivors. (a) A former employee is deemed to...

5 CFR 841.204 - Deemed application to protect survivors.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Deemed application to protect survivors. 841.204 Section 841.204 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL... for Benefits § 841.204 Deemed application to protect survivors. (a) A former employee is deemed to...

5 CFR 841.204 - Deemed application to protect survivors.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Deemed application to protect survivors. 841.204 Section 841.204 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL... for Benefits § 841.204 Deemed application to protect survivors. (a) A former employee is deemed to...

5 CFR 841.204 - Deemed application to protect survivors.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Deemed application to protect survivors. 841.204 Section 841.204 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL... for Benefits § 841.204 Deemed application to protect survivors. (a) A former employee is deemed to...

Preventing Youth Suicide: Issues for Law Enforcement Personnel

PubMed Central

Walsh, Elaine; Eggert, Leona L.

2008-01-01

Suicide is a leading cause of death for adolescents. A number of problem behaviors associated with youth suicide fall into the purview of law enforcement personnel, and they are therefore in a position to detect risk and prevent suicidal behaviors. Eight hundred one youth identified as having school difficulty, a group at increased risk for both suicide and legal problems, participated in a paper and pencil survey followed by an interview focusing on suicide risk and protective factors. Linear regression was used to examine the ability of factors within each risk and protective factor dimension to predict current suicide risk. The study goal was to determine the most relevant factors influencing suicide risk in each domain examined. Findings are discussed in terms of implications for assessment and policy for law enforcement personnel. PMID:18644625

5 CFR 1320.6 - Public protection.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Public protection. 1320.6 Section 1320.6 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES CONTROLLING PAPERWORK BURDENS ON THE PUBLIC § 1320.6 Public protection. (a) Notwithstanding any other provision of law, no person shall be...

Personnel emergency carrier vehicle

NASA Technical Reports Server (NTRS)

Owens, Lester J. (Inventor); Fedor, Otto H. (Inventor)

1987-01-01

A personnel emergency carrier vehicle is disclosed which includes a vehicle frame supported on steerable front wheels and driven rear wheels. A supply of breathing air is connected to quick connect face mask coupling and umbilical cord couplings for supplying breathing air to an injured worker or attendant either with or without a self-contained atmospheric protection suit for protection against hazardous gases at an accident site. A non-sparking hydraulic motion is utilized to drive the vehicle and suitable direction and throttling controls are provided for controlling the delivery of a hydraulic driving fluid from a pressurized hydraulic fluid accumulator. A steering axis is steerable through a handle to steer the front wheels through a linkage assembly.

Stent sizing strategies in renal artery stenting: the comparison of conventional invasive renal angiography with renal computed tomographic angiography

PubMed Central

Michalowska, Ilona; Pregowski, Jerzy; Janaszek-Sitkowska, Hanna; Lech, Katarzyna; Kabat, Marek; Staruch, Adam; Januszewicz, Andrzej; Witkowski, Adam

2016-01-01

Introduction Randomized trials comparing invasive treatment of renal artery stenosis with standard pharmacotherapy did not show substantial benefit from revascularization. One of the potential reasons for that may be suboptimal procedure technique. Aim To compare renal stent sizing using two modalities: three-dimensional renal computed tomography angiography (CTA) versus conventional angiography. Material and methods Forty patients (41 renal arteries), aged 65.1 ±8.5 years, who underwent renal artery stenting with preprocedural CTA performed within 6 months, were retrospectively analyzed. In CTA analysis, reference diameter (CTA-D) and lesion length (CTA_LL) were measured and proposed stent diameter and length were recorded. Similarly, angiographic reference diameter (ANGIO_D) and lesion length (ANGIO_LL) as well as proposed stent dimensions were obtained by visual estimation. Results The median CTA_D was 0.5 mm larger than the median ANGIO_D (p < 0.001). Also, the proposed stent diameter in CTA evaluation was 0.5 mm larger than that in angiography (p < 0.0001). The median CTA_LL was 1 mm longer than the ANGIO_LL (p = NS), with significant correlation of these variables (r = 0.66, p < 0.0001). The median proposed stent length with CTA was equal to that proposed with angiography. The median diameter of the implanted stent was 0.5 mm smaller than that proposed in CTA (p < 0.0005) and identical to that proposed in angiography. The median length of the actual stent was longer than that proposed in angiography (p = 0.0001). Conclusions Renal CTA has potential advantages as a tool adjunctive to angiography in appropriate stent sizing. Careful evaluation of the available CTA scans may be beneficial and should be considered prior to the planned procedure. PMID:27279870

Are the urology operating room personnel aware about the ionizing radiation?

PubMed Central

Tok, Adem; Akbas, Alparslan; Aytan, Nimet; Aliskan, Tamer; Cicekbilek, Izzet; Kaba, Mehmet; Tepeler, Abdulkadir

2015-01-01

ABSTRACT Purpose: We assessed and evaluated attitudes and knowledge regarding ionizing radiation of urology surgery room staff. Materials and Methods: A questionnaire was sent by e-mail to urology surgery room personnel in Turkey, between June and August 2013. The questionnaire included demographic questions and questions regarding radiation exposure and protection. Results: In total, 127 questionnaires were answered. Of them, 62 (48.8%) were nurses, 51 (40.2%) were other personnel, and 14 (11%) were radiological technicians. In total, 113 (89%) participants had some knowledge of radiation, but only 56 (44.1%) had received specific education or training regarding the harmful effects of radiation. In total, 92 (72.4%) participants indicated that they used a lead apron and a thyroid shield. In the subgroup that had received education about the harmful effects of radiation, the use ratio for all protective procedures was 21.4% (n=12); this ratio was only 2.8% (n=2) for those with no specific training; the difference was statistically significant (p=0.004). Regarding dosimeters, the use rates were 100% for radiology technicians, 46.8% for nurses, and 31.4% for other hospital personnel; these differences were statistically significant (p<0.001). No significant relationship between working period in the surgery room, number of daily fluoroscopy procedures, education, task, and use of radiation protection measures was found. Conclusions: It is clear that operating room-allied health personnel exposed to radiation do not have sufficient knowledge of ionizing radiation and they do not take sufficient protective measures. PMID:26689525

Evolution of digital angiography systems.

PubMed

Brigida, Raffaela; Misciasci, Teresa; Martarelli, Fabiola; Gangitano, Guido; Ottaviani, Pierfrancesco; Rollo, Massimo; Marano, Pasquale

2003-01-01

The innovations introduced by digital subtraction angiography in digital radiography are briefly illustrated with the description of its components and functioning. The pros and cons of digital subtraction angiography are analyzed in light of present and future imaging technologies. In particular, among advantages there are: automatic exposure, digital image subtraction, digital post-processing, high number of images per second, possible changes in density and contrast. Among disadvantages there are: small round field of view, geometric distortion at the image periphery, high sensitivity to patient movements, not very high spatial resolution. At present, flat panel detectors represent the most suitable substitutes for digital subtraction angiography, with the introduction of novel solutions for those artifacts which for years have hindered its diagnostic validity. The concept of temporal artifact, reset light and possible future evolutions of this technology that may afford both diagnostic and protectionist advantages, are analyzed.

MR Angiography (MRA)

MedlinePlus

... resonance angiography (MRA), a powerful magnetic field, radio frequency waves and a computer produce detailed images of ... test. If you have claustrophobia (fear of enclosed spaces) or anxiety, you may want to ask your ...

36 CFR 902.52 - Records related solely to internal personnel rules and practices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Corporation Records § 902.52 Records related solely to internal personnel rules and practices. (a) Records... hiring, training, promotion, demotion, and discharge of employees, and management plans, records, or... protection of any record related to internal personnel rules and practices dealing with the relations between...

36 CFR 902.52 - Records related solely to internal personnel rules and practices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Corporation Records § 902.52 Records related solely to internal personnel rules and practices. (a) Records... hiring, training, promotion, demotion, and discharge of employees, and management plans, records, or... protection of any record related to internal personnel rules and practices dealing with the relations between...

36 CFR 902.52 - Records related solely to internal personnel rules and practices.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Corporation Records § 902.52 Records related solely to internal personnel rules and practices. (a) Records... hiring, training, promotion, demotion, and discharge of employees, and management plans, records, or... protection of any record related to internal personnel rules and practices dealing with the relations between...

36 CFR 902.52 - Records related solely to internal personnel rules and practices.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Corporation Records § 902.52 Records related solely to internal personnel rules and practices. (a) Records... hiring, training, promotion, demotion, and discharge of employees, and management plans, records, or... protection of any record related to internal personnel rules and practices dealing with the relations between...

Does CT Angiography Matter for Patients with Cervical Spine Injuries?

PubMed

Hagedorn, John C; Emery, Sanford E; France, John C; Daffner, Scott D

2014-06-04

Cervical injury can be associated with vertebral artery injury. This study was performed to determine the impact of computed tomography (CT) angiography of the head and neck on planning treatment of cervical spine fracture, if these tests were ordered appropriately, and to estimate cost and associated exposure to radiation and contrast medium. This retrospective review included all patients who underwent CT of the cervical spine and CT angiography of the head and neck from January 2010 to August 2011 at one institution. Patients were divided into those with and those without cervical spine fracture seen on CT of the cervical spine. We determined if the CT angiography of the head and neck was positive for vascular injury in the patients with a cervical fracture. Vascular injury treatment and alterations in surgical fracture treatment due to positive CT angiography of the head and neck were recorded. A scan was deemed appropriate if it had been ordered per established institutional protocol. Of the 381 patients who underwent CT angiography of the head and neck, 126 had a cervical injury. Sixteen of the CT angiography studies were appropriately ordered for non-spinal indications, and twenty-three were inappropriately ordered. The CT angiography was positive for one patient for whom the imaging was off protocol and one for whom the indication was non-spinal. Nineteen patients had positive CT angiography of the head and neck; no patient underwent surgical intervention for a vascular lesion. Eleven patients underwent surgical intervention for a cervical fracture; the operative plan was changed because of vascular injury in one case. The CT angiography was positive for eleven of forty-eight patients who had sustained a C2 fracture; this group accounted for eleven of the nineteen positive CT angiography studies. Noncontiguous injuries occurred in nineteen patients; three had positive CT angiography of the head and neck. The approximate charge for the CT angiography was

Magnetic resonance angiography in the follow-up of distal lower-extremity bypass surgery: comparison with duplex ultrasound and digital subtraction angiography.

PubMed

Meissner, Oliver A; Verrel, Frauke; Tató, Federico; Siebert, Uwe; Ramirez, Heldin; Ruppert, Volker; Schoenberg, Stefan O; Reiser, Maximilian

2004-11-01

The danger of limb loss as a consequence of acute occlusion of infrapopliteal bypasses underscores the requirement for careful patient follow-up. The objective of this study was to determine the agreement and accuracy of contrast material-enhanced moving-table magnetic resonance (MR) angiography and duplex ultrasonography (US) in the assessment of failing bypass grafts. In cases of discrepancy, digital subtraction angiography (DSA) served as the reference standard. MR angiography was performed in 24 consecutive patients with 26 femorotibial or femoropedal bypass grafts. Each revascularized limb was divided into five segments--(i) native arteries proximal to the graft; (ii) proximal anastomosis; (iii) graft course; (iv) distal anastomosis; and (v) native arteries distal to the graft-resulting in 130 vascular segments. Three readers evaluated all MR angiograms for image quality and the presence of failing grafts. The degree of stenosis was compared to the findings of duplex US, and in case of discrepancy, to DSA findings. Two separate analyses were performed with use of DSA only and a combined diagnostic endpoint as the reference standard. Image quality was rated excellent or intermediate in 119 of 130 vascular segments (92%). Venous overlay was encountered in 26 of 130 segments (20%). In only two segments was evaluation of the outflow region not feasible. One hundred seventeen of 130 vascular segments were available for quantitative analysis. In 109 of 117 segments (93%), MR angiography and duplex US showed concordant findings. In the eight discordant segments in seven patients, duplex US overlooked four high-grade stenoses that were correctly identified by MR angiography and confirmed by DSA. Percutaneous transluminal angioplasty was performed in these cases. In no case did MR angiography miss an area of stenosis of sufficient severity to require treatment. Total accuracy for duplex US ranged from 0.90 to 0.97 depending on the reference standard used, whereas MR

Quantitative depth resolved microcirculation imaging with optical coherence tomography angiography (Part ΙΙ): Microvascular network imaging.

PubMed

Gao, Wanrong

2017-04-17

In this work, we review the main phenomena that have been explored in OCT angiography to image the vessels of the microcirculation within living tissues with the emphasis on how the different processing algorithms were derived to circumvent specific limitations. Parameters are then discussed that can quantitatively describe the depth-resolved microvascular network for possible clinic diagnosis applications. Finally,future directions in continuing OCT development are discussed. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Routine Use of Three-Dimensional Contrast-Enhanced Moving-Table MR Angiography in Patients with Peripheral Arterial Occlusive Disease: Comparison with Selective Digital Subtraction Angiography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Deutschmann, Hannes A.; Schoellnast, Helmut; Portugaller, Horst R.

2006-10-15

Purpose. To compare the diagnostic accuracy of contrast-enhanced (CE) three-dimensional (3D) moving-table magnetic resonance (MR) angiography with that of selective digital subtraction angiography (DSA) for routine clinical investigation in patients with peripheral arterial occlusive disease. Methods. Thirty-eight patients underwent CE 3D moving-table MR angiography of the pelvic and peripheral arteries. A commercially available large-field-of-view adapter and a dedicated peripheral vascular phased-array coil were used. MR angiograms were evaluated for grade of arterial stenosis, diagnostic quality, and presence of artifacts. MR imaging results for each patient were compared with those of selective DSA. Results. Two hundred and twenty-six arterial segments inmore » 38 patients were evaluated by both selective DSA and MR angiography. No complications related to MR angiography were observed. There was agreement in stenosis classification in 204 (90.3%) segments; MR angiography overgraded 16 (7%) segments and undergraded 6 (2.7%) segments. Compared with selective DSA, MR angiography provided high sensitivity and specificity and excellent interobserver agreement for detection of severe stenosis (97% and 95%, {kappa} = 0.9 {+-} 0.03) and moderate stenosis (96.5% and 94.3%, {kappa} = 0.9 {+-} 0.03). Conclusion. Compared with selective DSA, moving-table MR angiography proved to be an accurate, noninvasive method for evaluation of peripheral arterial occlusive disease and may thus serve as an alternative to DSA in clinical routine.« less

Anthropometric Cockpit Compatibility Assessment of US Army Aircraft for Large and Small Personnel Wearing A Cold Weather, Armored Vest, Chemical Defense Protective Clothing Configuration

DTIC Science & Technology

1984-07-01

12 5. Survival Vest-Armor Plate Insert Configurations Employed ...................... 14 6. Summary of Critical Anthropometric Measure- ments...to assure an adequate aviator-to-cockpit fit for personnel wearing cold weather, survival vest with armor plate , and chemical defense protective...trousers (NSN 8415-00-407-1060). Survival vest, armor plated (NSN 8470-00-935-3192) The armor- plated survival vest could have the armor inserted in

41 CFR Appendix C to Part 60 - 250-Review of Personnel Processes

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true 250-Review of Personnel Processes C Appendix C to Part 60 Public Contracts and Property Management Other Provisions Relating to... PROTECTED VETERANS Pt. 60-250, App. C Appendix C to Part 60-250—Review of Personnel Processes The following...

41 CFR Appendix C to Part 60 - 250-Review of Personnel Processes

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false 250-Review of Personnel Processes C Appendix C to Part 60 Public Contracts and Property Management Other Provisions Relating to... PROTECTED VETERANS Pt. 60-250, App. C Appendix C to Part 60-250—Review of Personnel Processes The following...

41 CFR Appendix C to Part 60 - 250-Review of Personnel Processes

Code of Federal Regulations, 2012 CFR

2012-07-01

... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true 250-Review of Personnel Processes C Appendix C to Part 60 Public Contracts and Property Management Other Provisions Relating to... PROTECTED VETERANS Pt. 60-250, App. C Appendix C to Part 60-250—Review of Personnel Processes The following...

41 CFR Appendix C to Part 60 - 250-Review of Personnel Processes

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true 250-Review of Personnel Processes C Appendix C to Part 60 Public Contracts and Property Management Other Provisions Relating to... PROTECTED VETERANS Pt. 60-250, App. C Appendix C to Part 60-250—Review of Personnel Processes The following...

Enhancing Resilience in Active Duty Military Personnel.

PubMed

Crabtree-Nelson, Sonya; DeYoung, Lcdr Peter

2017-02-01

A systematic, evidence-based training program to support active duty military personnel through building unit-level resiliency in preparation for anticipated individual times of crisis is needed. Mental health nurses and social workers in the military possess critical training and expertise in identifying and supporting individual and community resilience factors. Their knowledge of the protective aspects of resilience can and should be used to educate all active duty military personnel, ensure military leaders are knowledgeable in how best to support their units, and provide research on the effectiveness of pre-combat resilience training. [Journal of Psychosocial Nursing and Mental Health Services, 55(2), 44-48.]. Copyright 2017, SLACK Incorporated.

Harbin 2020 R&D Personnel Demand Forecast Based on Manufacturing Green Innovation System

NASA Astrophysics Data System (ADS)

Jiang, Xin; Duan, Yu Ting; Shen, Jun Yi; Zhang, Dong Ying

2018-06-01

Because of the constraints of energy conservation and the impact on the environment, the manufacturing industry has adopted sustainable development as the goal, and a green manufacturing innovation system based on environmental protection has emerged. In order to provide R&D personnel support to manufacturing enterprises in Harbin, and in order to promote the construction of a green innovation system for manufacturing and the realization of the 13th Five-Year Plan, this article used the grey forecasting model and the univariate linear regression prediction to predict the number of R&D personnel in Harbin in 2020 based on the number of R&D personnel in 2010-2016, and the predicted values were 24,952 and 31,172 respectively. The results show that if Harbin continues to use its original development model, it will not be able to achieve the established development goals by 2020 because of the shortage of R&D personnel. Therefore, it is necessary to increase investment in R&D personnel so as to achieve the 13th Five-Year Plan of Harbin City and protect the ecological green development goals.

Patch test results of the dental personnel with contact dermatitis.

PubMed

Kocak, Oguzhan; Gul, Ulker

2014-12-01

Dental personnel have high risk of occupational contact dermatitis. The aim of this study is to detect the materials which cause contact sensitization and the frequency of contact dermatitis by using patch tests with European standard series and dental screening series in dental personnel. Between August 2008 and July 2009, 461 dental personnel working in Ankara (Turkey) were examined and age, gender, previous history of dermatitis, area of the skin affected and clinical diagnosis were noted. About 198 (43%) of the dental personnel were diagnosed contact dermatitis. Sixty-five of the dental personnel accepted to be patch tested. Dental technicians, dentists and dental nurses constitute 69.2%, 24.6% and 6.2% of patch tested 65 patients, respectively. Positive reactions to at least one allergen were detected with European standard series at 20% and with dental series at 10.8% among the dental personnel. The most common allergens were nickel sulfate (12.3%), acrylates (6.1%) and para-tertiary-butylphenol-formaldehyde resin (4.6%). The most common acrylate was ethyleneglycol dimethacrylate (3.1%). We believe our study will be helpful to dermatologists about frequency of contact dermatitis among dental personnel and allergens that cause contact sensitivity for developing new methods to protect the personnel in dentistry against sensitization.

Unusual Congenital Aortic Anomaly with Rare Common Celiamesenteric Trunk Variation: MR Angiography and Digital Substraction Angiography Findings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tosun, Ozgur; Sanlidilek, Umman; Cetin, Huseyin

2007-09-15

Magnetic resonance angiography and digital substraction angiography (DSA) findings in a case with a rare congenital thoracoabdominal aortic hypoplasia and common celiamesenteric trunk variation with occlusion of infrarenal abdominal aorta are described here. To our knowledge, this aortic anomaly has not been previously described in the English literature. DSA is the optimum imaging modality for determination of aortic hypoplasia, associated vascular malformations, collateral vessels, and direction of flow within vessels.

New insights into diabetic retinopathy by OCT angiography.

PubMed

Liu, Guodong; Xu, Ding; Wang, Fang

2018-06-04

Diabetic retinopathy (DR) is one of the most common diabetic complications, which has become a leading cause for vision loss, mainly because of macular edema and vitreous hemorrhage. Optical coherence tomography (OCT) angiography is a novel technique to visualize vascular changes including microaneurysm, non-perfusion area, intraretinal microvascular abnormalities, and neovascularization. Recently, it is possible to quantify vascular density, foveal avascular zone area, non-perfusion area objectively using OCT angiography. In addition, OCT angiography also provides an alternative method to evaluate the effect of anti-vascular endothelial growth factor (VEGF) treatments by providing high resolution images of macular microcirculatory abnormalities. Thus OCT angiography is an effective method to investigate the vascular changes of the disease, and can also be potentially applied in the diagnosis, treatment, and follow up of DR. Copyright © 2018 Elsevier B.V. All rights reserved.

Indocyanine green angiography of juvenile X-linked retinoschisis.

PubMed

Souied, Eric H; Goritsa, Anna; Querques, Giuseppe; Coscas, Gabriel; Soubrane, Gisele

2005-09-01

In juvenile X-linked retinoschisis (XLRS), fluorescein angiography is usually unremarkable and contributes poorly to the diagnosis. However, indocyanine green (ICG) angiography features in eyes that are affected with XLRS were not yet described. Retrospective observational case series. A complete ophthalmologic examination that included ICG angiography was performed on three unrelated male patients (six eyes) who were 15, 22, and 48 years old. A distinct hyperfluorescent stellate pattern in the macular area that was associated with radial lines of hypofluorescence that were centered on the foveola was observed on the early phase of ICG examination (six of six eyes). This feature disappeared on the late phase of ICG examination. On these six XLRS eyes, early phases of ICG examination revealed an unusual radial aspect on the macula. This finding suggests that ICG angiography may be useful for the diagnosis of XLRS.

Mandatory influenza vaccination for all healthcare personnel: a review on justification, implementation and effectiveness.

PubMed

Wang, Tiffany L; Jing, Ling; Bocchini, Joseph A

2017-10-01

As healthcare-associated influenza is a serious public health concern, this review examines legal and ethical arguments supporting mandatory influenza vaccination policies for healthcare personnel, implementation issues and evidence of effectiveness. Spread of influenza from healthcare personnel to patients can result in severe harm or death. Although most healthcare personnel believe that they should be vaccinated against seasonal influenza, the Centers for Disease Control and Prevention (CDC) report that only 79% of personnel were vaccinated during the 2015-2016 season. Vaccination rates were as low as 44.9% in institutions that did not promote or offer the vaccine, compared with rates of more than 90% in institutions with mandatory vaccination policies. Policies that mandate influenza vaccination for healthcare personnel have legal and ethical justifications. Implementing such policies require multipronged approaches that include education efforts, easy access to vaccines, vaccine promotion, leadership support and consistent communication emphasizing patient safety. Mandatory influenza vaccination for healthcare personnel is a necessary step in protecting patients. Patients who interact with healthcare personnel are often at an elevated risk of complications from influenza. Vaccination is the best available strategy for protecting against influenza and evidence shows that institutional policies and state laws can effectively increase healthcare personnel vaccination rates, decreasing the risk of transmission in healthcare settings. There are legal and ethical precedents for institutional mandatory influenza policies and state laws, although successful implementation requires addressing both administrative and attitudinal barriers.

Patient radiation dose from computed tomography angiography and digital subtraction angiography of the brain

NASA Astrophysics Data System (ADS)

Netwong, Y.; Krisanachinda, A.

2016-03-01

The 64-row multidetector computed tomography angiography (64-MDCTA) provides vascular image quality of the brain similar to digital subtraction angiography (DSA), but the effective dose of CTA is lower than DSA studied in phantom. The purpose of this study is to evaluate the effective dose from 64-MDCTA and DSA. Effective dose (according to ICRP 103) from 64-MDCTA and DSA flat panel detector for cerebral vessels examination of the brain using standard protocols as recommended by the manufacturer was calculated for 30 cases of MDCTA (15 male and 15 female).The mean patient age was 49.5 (23-89) yrs. 30 cases of DSA (14 male and 16 female), the mean patient age was 46.8 (21-81) yrs. For CTA, the mean effective dose was 3.7 (2.82- 5.19) mSv. For DSA, the mean effective dose was 5.78 (3.3-10.06) mSv. The effective dose of CTA depends on the scanning protocol and scan length. Low tube current can reduce patient dose whereas the number of exposures and number of series in 3D rotational angiography (3D RA) resulted in increasing effective dose in DSA patients.

36 CFR § 902.52 - Records related solely to internal personnel rules and practices.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Corporation Records § 902.52 Records related solely to internal personnel rules and practices. (a) Records... hiring, training, promotion, demotion, and discharge of employees, and management plans, records, or... protection of any record related to internal personnel rules and practices dealing with the relations between...

Family and medical leave. Office of Personnel Management. Final rule.

PubMed

2000-05-08

The Office of Personnel Management is issuing final regulations on the Family and Medical Leave Act of 1993 to ensure that both employees' and agencies' rights are protected and their responsibilities fulfilled.

Angiography Before Posterior Mediastinal Tumor Resection: Selection Criteria and Patient Outcomes.

PubMed

Madariaga, Maria Lucia; Borges, Lawrence F; Rabinov, James D; Chang, David C; Lanuti, Michael; Mathisen, Douglas J; Gaissert, Henning A

2018-04-01

Resection of posterior mediastinal tumors may be complicated by bleeding or neurologic injury. Preoperative spinal angiography of mediastinal tumors has been underreported or not commonly practiced. This study evaluated the selection criteria and outcomes of patients with posterior mediastinal tumors who underwent preoperative angiography and embolization. This was a single-institution retrospective study of patients with posterior mediastinal tumors from 2002 to 2016. Multilevel spinal angiography was performed, with or without selective arterial embolization of vascular supply, in patients selected by thoracic or neurologic surgeons. Ten of 87 patients (11%) with posterior mediastinal tumors underwent preoperative angiography. A mean of 11 arteries (range, 2 to 25) were studied. Embolization in 7 of 10 patients successfully occluded 1 to 3 arteries. There was no significant difference in age, sex, body mass index, American Society of Anesthesiologists Physical Status Classification, operative time, operative blood loss, complications, or death between patients with or without angiography. Patients who underwent angiography had larger tumors (1,490 vs 97 cm 3 , p < 0.0001), involvement of the neuroforamen (44% vs 10%, p < 0.05), and a longer hospital stay (9 vs 4.5 days, p < 0.05). Angiography was complicated in 1 patient by vocal cord ulceration after intubation of a tumor-compressed trachea. Shared blood supply between the tumor and the spinal cord precluded embolization and tumor resection in 1 patient. Use of angiography increased over time. Selective preoperative angiography for evaluation of posterior mediastinal tumors identifies arterial variations, threatened spinal arteries, and targets for embolization. The specific role of angiography and embolization requires further investigation to standardize indications and protocols for the number of arteries examined. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights

Transient cortical blindness after coronary angiography.

PubMed Central

Parry, R; Rees, J R; Wilde, P

1993-01-01

Transient visual loss lasting three days developed after transfemoral coronary angiography in a 62 year old man. Computed tomography (CT) showed bilateral leakage of contrast medium into the occipital cortex. A repeat CT scan after his sight recovered showed clearance of contrast with no underlying infarction. A breakdown of the blood-brain barrier with direct neurotoxicity of the contrast media seemed to be the cause of these neurological changes after coronary angiography which apparently have not been reported before. Images PMID:8280526

MSFC Respiratory Protection Services

NASA Technical Reports Server (NTRS)

CoVan, James P.

1999-01-01

An overview of the Marshall Space Flight Center Respiratory Protection program is provided in this poster display. Respiratory protection personnel, building, facilities, equipment, customers, maintenance and operational activities, and Dynatech fit testing details are described and illustrated.

Comparison between digital subtraction angiography and magnetic resonance angiography in investigation of nonlacunar ischemic stroke in young patients: preliminary results.

PubMed

Conforto, Adriana Bastos; Fregni, Felipe; Puglia, Paulo; Leite, Claudia da Costa; Yamamoto, Fabio Iuji; Coracini, Karen F; Scaff, Milberto

2006-06-01

We preliminarily investigated the relevance of performing digital subtraction angiography (DSA) in addition to magnetic resonance angiography (MRA) in definition of ischemic stroke etiology in young patients. DSAs and MRAs from 17 young patients with nonlacunar ischemic stroke were blindly analyzed and their impact on stroke management was evaluated. Etiologies were the same considering results of either DSA or MRA in 12/17 cases. In 15/17 patients no changes would have been made in treatment, regardless of the modality of angiography considered. These preliminary results suggest that DSA may be redundant in two thirds of ischemic strokes in young patients. Further larger prospective studies are necessary to determine indications of DSA in this age group.

Operation United Assistance: infectious disease threats to deployed military personnel.

PubMed

Murray, Clinton K; Yun, Heather C; Markelz, Ana Elizabeth; Okulicz, Jason F; Vento, Todd J; Burgess, Timothy H; Cardile, Anthony P; Miller, R Scott

2015-06-01

As part of the international response to control the recent Ebola outbreak in West Africa, the Department of Defense has deployed military personnel to train Liberians to manage the disease and build treatment units and a hospital for health care volunteers. These steps have assisted in providing a robust medical system and augment Ebola diagnostic capability within the affected nations. In order to prepare for the deployment of U.S. military personnel, the infectious disease risks of the regions must be determined. This evaluation allows for the establishment of appropriate force health protection posture for personnel while deployed, as well as management plans for illnesses presenting after redeployment. Our objective was to detail the epidemiology and infectious disease risks for military personnel in West Africa, particularly for Liberia, along with lessons learned from prior deployments. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

29 CFR 1918.103 - Head protection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Personal Protective Equipment § 1918.103 Head protection. (a) The employer shall ensure that each affected employee wears a protective helmet when working... Personnel Protection—Protective Headwear for Industrial Workers—Requirements,” which is incorporated by...

29 CFR 1918.103 - Head protection.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Personal Protective Equipment § 1918.103 Head protection. (a) The employer shall ensure that each affected employee wears a protective helmet when working... Personnel Protection—Protective Headwear for Industrial Workers—Requirements,” which is incorporated by...

Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study.

PubMed

Grabherr, Silke; Heinemann, Axel; Vogel, Hermann; Rutty, Guy; Morgan, Bruno; Woźniak, Krzysztof; Dedouit, Fabrice; Fischer, Florian; Lochner, Stefanie; Wittig, Holger; Guglielmi, Giuseppe; Eplinius, Franziska; Michaud, Katarzyna; Palmiere, Cristian; Chevallier, Christine; Mangin, Patrice; Grimm, Jochen M

2018-05-01

Purpose To determine if postmortem computed tomography (CT) and postmortem CT angiography help to detect more lesions than autopsy in postmortem examinations, to evaluate the strengths and weaknesses of each method, and to define their indications. Materials and Methods Postmortem CT angiography was performed on 500 human corpses and followed by conventional autopsy. Nine centers were involved. All CT images were read by an experienced team including one forensic pathologist and one radiologist, blinded to the autopsy results. All findings were recorded for each method and categorized by anatomic structure (bone, organ parenchyma, soft tissue, and vascular) and relative importance in the forensic case (essential, useful, and unimportant). Results Among 18 654 findings, autopsies helped to identify 61.3% (11 433 of 18 654), postmortem CT helped to identify 76.0% (14 179 of 18 654), and postmortem CT angiography helped to identify 89.9% (16 780 of 18 654; P < .001). Postmortem CT angiography was superior to autopsy, especially at helping to identify essential skeletal lesions (96.1% [625 of 650] vs 65.4% [425 of 650], respectively; P < .001) and vascular lesions (93.5% [938 of 1003] vs 65.3% [655 of 1003], respectively; P < .001). Among the forensically essential findings, 23.4% (1029 of 4393) were not detected at autopsy, while only 9.7% (428 of 4393) were missed at postmortem CT angiography (P < .001). The best results were obtained when postmortem CT angiography was combined with autopsy. Conclusion Postmortem CT and postmortem CT angiography and autopsy each detect important lesions not detected by the other method. More lesions were identified by combining postmortem CT angiography and autopsy, which may increase the quality of postmortem diagnosis. Online supplemental material is available for this article.

Immunity to Diphtheria and Tetanus in Army Personnel and Adult Civilians in Mashhad, Iran.

PubMed

Hosseini Shokouh, Seyyed Javad; Mohammadi, Babak; Rajabi, Jalil; Mohammadian Roshan, Ghasem

2017-03-24

This study aimed to investigate serologic immunity to diphtheria and tetanus in army personnel and a sample population of adult civilians in Mashhad, Iran. Army personnel (n = 180) and civilians (n = 83) who presented at Mashhad army hospital participated in this study. Diphtheria and tetanus antitoxin levels were determined by enzyme-linked immunosorbent assay. Approximately 77% and 94% of army personnel aged 18-34 years had at least basic protection against diphtheria (antitoxin level ≥0.1 IU/mL) and tetanus (antitoxin level >0.1 IU/mL), respectively. For civilians in this age group, the proportions were 76% for both diseases. Antitoxin levels waned with age. Thus, participants older than 50 years had lower immunity; this decrease in immunity was more pronounced for tetanus than for diphtheria in both army personnel and civilians. For both diseases, geometric mean antitoxin titers and the proportion of participants with at least basic protection were higher in subjects with a history of vaccination in the last 10 years (P < 0.001), higher in men than women, and in army personnel than civilians in each age group. Young army personnel and civilians (18-34 years old) had adequate immunity to diphtheria and tetanus. However, the large number of susceptible older adults (>50 years old) calls for improved booster vaccination protocols.

Laser-assisted indocyanine green angiography: a critical appraisal.

PubMed

Wu, Cindy; Kim, Sendia; Halvorson, Eric G

2013-05-01

Laser-assisted indocyanine green angiography (ICG-A) has been promoted to assess perfusion of random skin, pedicled, and free flaps. Few studies address its potential limitations. Thirty-seven patients who underwent reconstructive procedures with ICG-A were studied retrospectively to determine the correlation between clinical findings and ICG-A. Indocyanine green angiography underestimated perfusion when areas of less than or equal to 25% uptake were not debrided and remained perfused. Indocyanine green angiography overestimated perfusion when areas with greater than 25% uptake developed necrosis. Of 14 random skin flaps, ICG-A underestimated perfusion in 14% and overestimated in 14%. In 16 patients undergoing perforator flap breast reconstruction, ICG-A correlated with computed tomographic angiogram (CTA) in 85%. Indocyanine green angiography underestimated perfusion in 7% and overestimated in 7%. In 8/11 patients undergoing fasciocutaneous flaps, ICG-A aided in donor site selection. In 3/6 ALT flaps, a better unilateral blush was found that correlated with Doppler. In all 3, a dominant perforator was found. In 11 patients, there was a 9% underestimation of flap perfusion. In 3 pedicled flaps, there was a 66% underestimation and 33% overestimation of perfusion. Indocyanine green angiography often confirmed our clinical/radiologic findings in abdominal perforator and fasciocutaneous flaps. It tended to underestimate perfusion in pedicle and skin flaps. When clinical examination was obvious, ICG-A rendered clear-cut findings. When clinical examination was equivocal, ICG-A tended to provide ambiguous findings, demonstrating that a distinct cutoff point does not exists for every patient or flap. Indocyanine green angiography is a promising but expensive technology that would benefit from standardization. Further research is needed before ICG-A can become a reliable tool for surgeons.

Coronary angiography in worsening heart failure: determinants, findings and prognostic implications.

PubMed

Ferreira, João Pedro; Rossignol, Patrick; Demissei, Biniyam; Sharma, Abhinav; Girerd, Nicolas; Anker, Stefan D; Cleland, John G; Dickstein, Kenneth; Filippatos, Gerasimos; Hillege, Hans L; Lang, Chim C; Metra, Marco; Ng, Leong L; Ponikowski, Piotr; Samani, Nilesh J; van Veldhuisen, Dirk J; Zwinderman, Aeilko H; Voors, Adriaan; Zannad, Faiez

2018-04-01

Coronary angiography is regularly performed in patients with worsening signs and/or symptoms of heart failure (HF). However, little is known on the determinants, findings and associated clinical outcomes of coronary angiography performed in patients with worsening HF. The BIOSTAT-CHF (a systems BIOlogy Study to TAilored Treatment in Chronic Heart Failure) programme enrolled 2516 patients with worsening symptoms and/or signs of HF, either hospitalised or in the outpatient setting. All patients were included in the present analysis. Of the 2516 patients included, 315 (12.5%) underwent coronary angiography within the 30 days after the onset of worsening symptoms and/or signs of HF. Subjects who underwent angiography were more often observed as inpatients, had more often an overt acute coronary syndrome, had higher troponin I levels, were younger and had better renal function (all p≤0.01). Patients who underwent coronary angiography had a lower risk of the primary outcome of death and/or HF hospitalisation (adjusted HR=0.71, 95% CI 0.57 to 0.89, p=0.003) and death (adjusted HR=0.59, 95% CI 0.43 to 0.80, p=0.001). Among the patients who underwent coronary angiography, those with a coronary stenosis (39%) had a worse prognosis than those without stenosis (adjusted HR for the primary outcome=1.71, 95% CI 1.10 to 2.64, p=0.016). Coronary angiography was performed in <13% of patients with symptoms and/or signs of worsening HF. These patients were remarkably different from those who did not undergo coronary angiography and had a lower risk of subsequent events. The presence of coronary stenosis on coronary angiography was associated with a worse prognosis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The evaluation of a formalized queue management system for coronary angiography waiting lists.

PubMed

Alter, D A; Newman, Alice M; Cohen, Eric A; Sykora, Kathy; Tu, Jack V

2005-11-01

Lengthy waiting lists for coronary angiography have been described in many health care systems worldwide. The extent to which formal queue management systems may improve the prioritization and survival of patients in the angiography queue is unknown. To prospectively evaluate the performance of a formal queue management system for patients awaiting coronary angiography in Ontario. The coronary angiography urgency scale, a formal queue management system developed in 1993 using a modified Delphi panel, allocates recommended maximum waiting times (RMWTs) in accordance with clinical necessity. By using a provincial clinical registry, 35,617 consecutive patients referred into the coronary angiography queue between April 1, 2001, and March 31, 2002, were prospectively tracked. Cox proportional hazards models were used to examined mortality risk across urgency after adjusting for additional clinical and comorbid factors. Good agreement was determined in urgency ratings between scores from the coronary angiography urgency scale and implicit physician judgement, which was obtained independently at the time of the index referral (weighted kappa = 0.49). The overall mortality in the queue was 0.3% (0.47%, 0.26% and 0.13% for urgent, semiurgent and elective patients, respectively). Urgency, as specified by the coronary angiography urgency scale, was the strongest predictor of death in the queue (P<0.001). However, when patients were censored according to their RMWTs, mortality was similar across different levels of urgency. Consequently, up to 18.5 deaths per 10,000 patients could have potentially been averted had patients been triaged and undergone coronary angiography within the RMWT as specified by the coronary angiography urgency scale. The incorporation of the coronary angiography urgency scale as a formal queue management system may decrease mortality in the coronary angiography queue. The authors recommend its implementation in health care systems where patients

Multislice CT Angiography in Renal Artery Stent Evaluation: Prospective Comparison with Intra-Arterial Digital Subtraction Angiography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Raza, Syed A.; Chughtai, Aamer R.; Wahba, Mona

2004-01-15

Purpose: To assess the role of multislice computed tomography angiography (MCTA) in the evaluation of renal artery stents, using intra-arterial digital subtraction angiography (DSA) as the gold standard. Methods: Twenty consecutive patients (15 men, 5 women) with 23 renal artery stents prospectively underwent both MCTA and DSA. Axial images, multiplanar reconstructions and maximum intensity projection images were used for diagnosis. The MCTA and DSA images were each interpreted without reference to the result of the other investigation. Results:The three cases of restenosis on DSA were detected correctly by MCTA; in 19 cases where MCTA showed a fully patent stent, themore » DSA was also negative. Sensitivity and negative predictive value (NPV) of MCTA were therefore 100%. In four cases, MCTA showed apparently minimal disease which was not shown on DSA. These cases are taken as false positive giving a specificity of 80% and a positive predictive value of 43%. Conclusion: The high sensitivity and NPV suggest MCTA may be useful as a noninvasive screen for renal artery stentrestenosis. MCTA detected mild disease in a few patients which was not confirmed on angiography.« less

Pelvic packing or angiography: competitive or complementary?

PubMed

Suzuki, Takashi; Smith, Wade R; Moore, Ernest E

2009-04-01

Pelvic angiography is an established technique that has evolved into a highly effective means of controlling arterial pelvic haemorrhage. The current dominant paradigm for haemodynamically unstable patients with pelvic fractures is angiographic management combined with mechanical stabilisation of the pelvis. However, an effective rapid screening tool for arterial bleeding in pelvic fracture patients has yet to be identified. There is also no precise way to determine the major source of bleeding responsible for haemodynamic instability. In many pelvic fracture patients, bleeding is from venous lacerations which are not effectively treated with angiography to fractured bony surfaces. Modern pelvic packing consists of time-saving and minimally invasive techniques which appear to result in effective control of the haemorrhage via tamponade. This review article focuses on the recent body of knowledge on angiography and pelvic packing. We propose the optimal role for each modality in trauma centres.

46 CFR Sec. 5 - Measures to protect ship's payrolls.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Measures to protect ship's payrolls. Sec. 5 Section 5... SHIP'S PERSONNEL Sec. 5 Measures to protect ship's payrolls. (a) General Agents are not required to... paying off the crew should be either the Master, or purser, or some other member of the ship's personnel...

46 CFR Sec. 5 - Measures to protect ship's payrolls.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 8 2011-10-01 2011-10-01 false Measures to protect ship's payrolls. Sec. 5 Section 5... SHIP'S PERSONNEL Sec. 5 Measures to protect ship's payrolls. (a) General Agents are not required to... paying off the crew should be either the Master, or purser, or some other member of the ship's personnel...

46 CFR Sec. 5 - Measures to protect ship's payrolls.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 8 2014-10-01 2014-10-01 false Measures to protect ship's payrolls. Sec. 5 Section 5... SHIP'S PERSONNEL Sec. 5 Measures to protect ship's payrolls. (a) General Agents are not required to... paying off the crew should be either the Master, or purser, or some other member of the ship's personnel...

46 CFR Sec. 5 - Measures to protect ship's payrolls.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 8 2013-10-01 2013-10-01 false Measures to protect ship's payrolls. Sec. 5 Section 5... SHIP'S PERSONNEL Sec. 5 Measures to protect ship's payrolls. (a) General Agents are not required to... paying off the crew should be either the Master, or purser, or some other member of the ship's personnel...

Tricuspid regurgitation by radionuclide angiography and contrast right ventriculography: a preliminary observation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lumia, F.J.; Patil, A.; Germon, P.A.

In a retrospective study correlating the degree of tricuspid regurgitation seen on first-pass radionuclide angiography with that seen on contrast right ventriculography in 51 patients, ten had no tricuspid regurgitation by contrast ventriculography, whereas by radionuclide angiography nine had no regurgitation and one had minimal regurgitation. Of eight patients with minimal tricuspid regurgitation by contrast ventriculography, five had minimal regurgitation by nuclide angiography and three had no regurgitation. Of the 11 patients with mild to moderate tricuspid regurgitation by contrast studies, ten had mild to moderate regurgitation and one had severe regurgitation by nuclide angiography. Of 22 patients with moderatemore » to severe tricuspid regurgitation by contrast studies, 15 had moderate to severe regurgitation and seven had mild to moderate regurgitation by nuclear angiography. In this preliminary study comparing radionuclide angiography with contrast right ventriculography, there were three false-negative and one false-positive nuclide angiograms, giving a sensitivity of 93% and a specificity of 90%.« less

Developments in Decontamination Technologies of Military Personnel and Equipment

NASA Astrophysics Data System (ADS)

Sata, Utkarsh R.; Ramkumar, Seshadri S.

Individual protection is important for warfighters, first responders and civilians to meet the current threat of toxic chemicals and chemical warfare (CW) agents. Within the realm of individual protection, decontamination of warfare agents is not only required on the battlefield but also in laboratory, pilot plants, production and agent destruction sites. It is of high importance to evaluate various decontaminants and decontamination techniques for implementing the best practices in varying scenarios such as decontamination of personnel, sites and sensitive equipment.

3D Deep Learning Angiography (3D-DLA) from C-arm Conebeam CT.

PubMed

Montoya, J C; Li, Y; Strother, C; Chen, G-H

2018-05-01

Deep learning is a branch of artificial intelligence that has demonstrated unprecedented performance in many medical imaging applications. Our purpose was to develop a deep learning angiography method to generate 3D cerebral angiograms from a single contrast-enhanced C-arm conebeam CT acquisition in order to reduce image artifacts and radiation dose. A set of 105 3D rotational angiography examinations were randomly selected from an internal data base. All were acquired using a clinical system in conjunction with a standard injection protocol. More than 150 million labeled voxels from 35 subjects were used for training. A deep convolutional neural network was trained to classify each image voxel into 3 tissue types (vasculature, bone, and soft tissue). The trained deep learning angiography model was then applied for tissue classification into a validation cohort of 8 subjects and a final testing cohort of the remaining 62 subjects. The final vasculature tissue class was used to generate the 3D deep learning angiography images. To quantify the generalization error of the trained model, we calculated the accuracy, sensitivity, precision, and Dice similarity coefficients for vasculature classification in relevant anatomy. The 3D deep learning angiography and clinical 3D rotational angiography images were subjected to a qualitative assessment for the presence of intersweep motion artifacts. Vasculature classification accuracy and 95% CI in the testing dataset were 98.7% (98.3%-99.1%). No residual signal from osseous structures was observed for any 3D deep learning angiography testing cases except for small regions in the otic capsule and nasal cavity compared with 37% (23/62) of the 3D rotational angiographies. Deep learning angiography accurately recreated the vascular anatomy of the 3D rotational angiography reconstructions without a mask. Deep learning angiography reduced misregistration artifacts induced by intersweep motion, and it reduced radiation exposure

7 CFR 91.21 - Protecting samples.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 3 2011-01-01 2011-01-01 false Protecting samples. 91.21 Section 91.21 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... SERVICES AND GENERAL INFORMATION Samples § 91.21 Protecting samples. Laboratory personnel shall protect...

7 CFR 91.21 - Protecting samples.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 3 2013-01-01 2013-01-01 false Protecting samples. 91.21 Section 91.21 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... SERVICES AND GENERAL INFORMATION Samples § 91.21 Protecting samples. Laboratory personnel shall protect...

7 CFR 91.21 - Protecting samples.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Protecting samples. 91.21 Section 91.21 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... SERVICES AND GENERAL INFORMATION Samples § 91.21 Protecting samples. Laboratory personnel shall protect...

7 CFR 91.21 - Protecting samples.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 3 2012-01-01 2012-01-01 false Protecting samples. 91.21 Section 91.21 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... SERVICES AND GENERAL INFORMATION Samples § 91.21 Protecting samples. Laboratory personnel shall protect...

7 CFR 91.21 - Protecting samples.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 3 2014-01-01 2014-01-01 false Protecting samples. 91.21 Section 91.21 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... SERVICES AND GENERAL INFORMATION Samples § 91.21 Protecting samples. Laboratory personnel shall protect...

7 CFR 75.40 - Protecting samples.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Protecting samples. 75.40 Section 75.40 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... § 75.40 Protecting samples. Inspection personnel shall protect each sample from manipulation...

7 CFR 75.40 - Protecting samples.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 3 2011-01-01 2011-01-01 false Protecting samples. 75.40 Section 75.40 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... § 75.40 Protecting samples. Inspection personnel shall protect each sample from manipulation...

33 CFR 142.39 - Respiratory protection.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Respiratory protection. 142.39... Respiratory protection. (a) Personnel in an atmosphere specified under ANSI Z88.2, requiring the use of respiratory protection equipment shall wear the type of respiratory protection equipment specified in ANSI Z88...

33 CFR 142.39 - Respiratory protection.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Respiratory protection. 142.39... Respiratory protection. (a) Personnel in an atmosphere specified under ANSI Z88.2, requiring the use of respiratory protection equipment shall wear the type of respiratory protection equipment specified in ANSI Z88...

33 CFR 142.39 - Respiratory protection.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Respiratory protection. 142.39... Respiratory protection. (a) Personnel in an atmosphere specified under ANSI Z88.2, requiring the use of respiratory protection equipment shall wear the type of respiratory protection equipment specified in ANSI Z88...

33 CFR 142.39 - Respiratory protection.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Respiratory protection. 142.39... Respiratory protection. (a) Personnel in an atmosphere specified under ANSI Z88.2, requiring the use of respiratory protection equipment shall wear the type of respiratory protection equipment specified in ANSI Z88...

33 CFR 142.39 - Respiratory protection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Respiratory protection. 142.39... Respiratory protection. (a) Personnel in an atmosphere specified under ANSI Z88.2, requiring the use of respiratory protection equipment shall wear the type of respiratory protection equipment specified in ANSI Z88...

5 CFR 293.505 - Establishment and protection of Employee Medical Folder.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Establishment and protection of Employee Medical Folder. 293.505 Section 293.505 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL RECORDS Employee Medical File System Records § 293.505 Establishment and...

5 CFR 293.505 - Establishment and protection of Employee Medical Folder.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Establishment and protection of Employee Medical Folder. 293.505 Section 293.505 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL RECORDS Employee Medical File System Records § 293.505 Establishment and...

5 CFR 293.505 - Establishment and protection of Employee Medical Folder.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Establishment and protection of Employee Medical Folder. 293.505 Section 293.505 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL RECORDS Employee Medical File System Records § 293.505 Establishment and...

5 CFR 293.505 - Establishment and protection of Employee Medical Folder.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Establishment and protection of Employee Medical Folder. 293.505 Section 293.505 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL RECORDS Employee Medical File System Records § 293.505 Establishment and...

5 CFR 293.505 - Establishment and protection of Employee Medical Folder.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Establishment and protection of Employee Medical Folder. 293.505 Section 293.505 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL RECORDS Employee Medical File System Records § 293.505 Establishment and...

[Hospital hygiene - clothing in hospitals: protection for staff and patients].

PubMed

Kerwat, Klaus; Wulf, Hinnerk

2008-03-01

Hospital clothing worn by medical personnel in German hospitals can be divided into two groups, work clothing and protective clothing. Work clothing is not changed between patient visits and hence is no measure of infection control. Its function is to protect private clothing and to identify medical personnel. Protective clothing on the other hand should protect staff and patients from nosocomial infections. It has to be changed between patient visits and is especially recommended with invasive procedures and immunocompromised patients.

Mid-term outcomes of endovascular aortic aneurysm repair with carbon dioxide-guided angiography.

PubMed

Takeuchi, Yuriko; Morikage, Noriyasu; Matsuno, Yutaro; Nakamura, Tamami; Samura, Makoto; Ueda, Koshiro; Harada, Takasuke; Ikeda, Yoshitaka; Suehiro, Kotaro; Ito, Hiroshi; Sakata, Kensuke; Hamano, Kimikazu

2018-05-14

Although iodinated contrast (IC) agents are commonly used in endovascular aneurysm repair (EVAR), perioperative use in patients with renal dysfunction or IC allergies is avoided. Carbon dioxide (CO 2 )-guided angiography is a promising alternative. We aimed to evaluate short-term and mid-term outcomes of EVAR using CO 2 -guided angiography. Three hundred and eighty-one patients who underwent EVAR from January 2012 to September 2016 were retrospectively reviewed and divided into an IC-EVAR group (n=351) and CO 2 -EVAR group (n=30). Subjects in the CO 2 -EVAR group had severe renal dysfunction (n=27) and IC allergy (n=4). Intraoperative, postoperative, and follow-up variables were compared. Compared to the IC-EVAR group, preoperative serum creatinine level was significantly higher (2.0 vs. 0.92 mg/dL, P < .0001) and mean IC dose significantly lower (18 vs. 55 mL P < .0001) in the CO 2 -EVAR group. The fluoroscopy time, operative time, number of stent grafts placed, and technical success rates of the groups were similar; no type I and/or type III endoleaks were detected on completion angiography. There was no acute kidney injury and one case of intestinal necrosis in the CO 2 -EVAR group, potentially due to cholesterol embolism. Postoperative endoleak, enlargement of aneurysms, survival, freedom from secondary intervention, and renal function change up to 3 months postoperatively were similar between groups. CO 2 -EVAR is technically feasible and exhibits prominent renal protection. However, consideration of the aortic lumen status remains an important challenge. Copyright © 2018. Published by Elsevier Inc.

Three-dimensional magnetic resonance angiography of vascular lesions in children.

PubMed

Katayama, H; Shimizu, T; Tanaka, Y; Narabayashi, I; Tamai, H

2000-01-01

We applied three-dimensional (3D) magnetic resonance (MR) angiography to vascular lesions in children and evaluated the clinical usefulness of this technique. Ten patients, whose ages ranged from 1 month to 16 years, underwent 3D MR angiography for 12 vascular lesions, including lesions in seven pulmonary arteries, two thoracic aortae, a pair of renal arteries, and one iliac artery. Three-dimensional MR angiography was performed with body-or pelvic-phased array coils on a 1.5-T scanner using fast spoiled gradient echo sequence. Data were acquired with the following parameters: TE, 1.9 ms; TR, 10.1 ms; flip angle, 20-60 degrees ; 1 or 2 NEX; field of view, 24-48 x 18-40 cm; matrix, 256 or 512 x 128 or 256; slice thickness, 1.2-7.5 mm; and 12, 28, or 60 partitions. Vascular imaging was enhanced with 20% gadolinium-diethylenetriaminepentaacetic acid. The examination was performed under breath-holding in six patients and with shallow breathing in four patients. In a comparative study with other noninvasive methods, 3D MR angiography was superior in seven of nine cases to other noninvasive examinations and in two cases, all methods evaluated the lesions. Furthermore, six cases were compared with conventional angiography. In five of the six cases, both methods depicted the lesions similarly, and in one case, MR angiography was more effective. A quantitative comparison of vascular diameter in the MR image was made with that in the conventional angiographic image. The correlation between them was excellent: y = 1.145x-2.090 (r = 0.987; P < 0.0001), where x is the diameter in the conventional angiographic images, y is the diameter in the MR images, and r is the correlation coefficient. In conclusion, 3D MR angiography is useful for depicting peripheral vascular lesions in children.

IntAct: Intraoperative Fluorescence Angiography (IFA) to Prevent Anastomotic Leak in Rectal Cancer Surgery: A Randomised Controlled Trial.

PubMed

Armstrong, G; Croft, J; Corrigan, N; Brown, J M; Goh, V; Quirke, P; Hulme, C; Tolan, D; Kirby, A; Cahill, R; O'Connell, R; Miskovic, D; Coleman, M; Jayne, D G

2018-05-11

Anastomotic leak (AL) is a major complication of rectal cancer surgery. Despite advances in surgical practice, rates of AL have remained static at around 10-15%. The aetiology of AL is multifactorial, but one of the most crucial risk factors, which is mostly under the control of the surgeon, is blood supply to the anastomosis. The MRC/NIHR IntAct study will determine whether assessment of anastomotic perfusion using a fluorescent dye (Indocyanine Green) and near-infrared laparoscopy can minimise the rate of anastomotic leak as compared to conventional white light laparoscopy. Two mechanistic sub-studies will explore the role of the rectal microbiome in AL and the predictive value of CT angiography/perfusion studies. IntAct is a prospective, unblinded, parallel group, multicentre, European, randomised controlled trial comparing surgery with intraoperative fluorescence angiography (IFA) against standard care (surgery with no IFA). The primary end-point is rate of clinical anastomotic leak at 90-days following surgery. Secondary endpoints include all AL (clinical and radiological), change in planned anastomosis, complications and re-interventions, use of stoma, cost effectiveness of the intervention and quality of life. Patients should have a diagnosis of adenocarcinoma of the rectum suitable for potentially curative surgery by anterior resection. Over three years, 880 patients from 25 European centres will be recruited and followed up for 90 days. IntAct will rigorously evaluate the use of IFA in rectal cancer surgery and explore the role of the microbiome in AL and the predictive value of preoperative CT angiography/perfusion scanning. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

33 CFR 142.36 - Protective clothing.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) OUTER CONTINENTAL SHELF ACTIVITIES WORKPLACE SAFETY AND HEALTH Personal Protective Equipment § 142.36 Protective clothing. Personnel in areas where there are flying particles, molten metal, radiant energy, heavy... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Protective clothing. 142.36...

33 CFR 142.36 - Protective clothing.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) OUTER CONTINENTAL SHELF ACTIVITIES WORKPLACE SAFETY AND HEALTH Personal Protective Equipment § 142.36 Protective clothing. Personnel in areas where there are flying particles, molten metal, radiant energy, heavy... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Protective clothing. 142.36...

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures.

PubMed

López, P Ortiz; Dauer, L T; Loose, R; Martin, C J; Miller, D L; Vañó, E; Doruff, M; Padovani, R; Massera, G; Yoder, C

2018-03-01

In recent publications, such as Publications 117 and 120, the Commission provided practical advice for physicians and other healthcare personnel on measures to protect their patients and themselves during interventional procedures. These measures can only be effective if they are encompassed by a framework of radiological protection elements, and by the availability of professionals with responsibilities in radiological protection. This framework includes a radiological protection programme with a strategy for exposure monitoring, protective garments, education and training, and quality assurance of the programme implementation. Professionals with responsibilities in occupational radiological protection for interventional procedures include: medical physicists; radiological protection specialists; personnel working in dosimetry services; clinical applications support personnel from the suppliers and maintenance companies; staff engaged in training, standardisation of equipment, and procedures; staff responsible for occupational health; hospital administrators responsible for providing financial support; and professional bodies and regulators. This publication addresses these elements and these audiences, and provides advice on specific issues, such as assessment of effective dose from dosimeter readings when an apron is worn, estimation of exposure of the lens of the eye (with and without protective eyewear), extremity monitoring, selection and testing of protective garments, and auditing the interventional procedures when occupational doses are unusually high or low (the latter meaning that the dosimeter may not have been worn).

[The status and current problems of the radiation protection support for Naval personnel].

PubMed

Sharaevskiĭ, G Iu; Murin, M B; Belikov, A D; Petrov, O I

1999-07-01

The article focuses on the radiation problems for the Navy personnel dealing with the nuclear and radioactive waste, since the existing standards become obsolete due to some new technologies in the development of the materials, endangering the environment and people's health.

Combining stereotactic angiography and 3D time-of-flight magnetic resonance angiography in treatment planning for arteriovenous malformation radiosurgery.

PubMed

Bednarz, G; Downes, B; Werner-Wasik, M; Rosenwasser, R H

2000-03-15

This study was initiated to evaluate the advantages of using three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA), as an adjuvant to conventional stereotactic angiography, in obtaining three-dimensional information about an arteriovenous malformation (AVM) nidus and in optimizing radiosurgical treatment plans. Following angiography, contrast-enhanced MRI and MRA studies were obtained in 22 consecutive patients undergoing Gamma Knife radiosurgery for AVM. A treatment plan was designed, based on the angiograms and modified as necessary, using the information provided by MRA. The quantitative analysis involved calculation of the ratio of the treated volume to the MRA nidus volume (the tissue volume ratio [TVR]) for the initial and final treatment plans. In 12 cases (55%), the initial treatment plans were modified after including the MRA information in the treatment planning process. The mean TVR for the angiogram-based plans was 1.63 (range 1.17-2.17). The mean coverage of the MRA nidus by the angiogram-based plans was 93% (range 73-99%). The mean MRA nidus volume was 2.4 cc (range 0. 6-5.3 cc). The MRA-based modifications resulted in increased conformity with the mean TVR of 1.46 (range 1.20-1.74). These modifications were caused by MRA revealing irregular nidi and/or vascular components superimposed on the angiographic projections of the nidi. In a number of cases, the information from MRA was essential in defining the nidus when the projections of the angiographic outlines showed different superior and/or inferior extent of the nidus. In two cases, MRA revealed irregular nidi, correlating well with the angiograms and showed that the angiographically acceptable plans undertreated 27% of the MRA nidus in one case and 18% of the nidus in the other case. In the remaining 10 cases (45%), both MRI and MRA failed to detect the nidus due to surgical clip artifacts and the presence of embolizing glue. The 3D TOF MRA provided information on irregular

Nonrigid Image Registration in Digital Subtraction Angiography Using Multilevel B-Spline

PubMed Central

2013-01-01

We address the problem of motion artifact reduction in digital subtraction angiography (DSA) using image registration techniques. Most of registration algorithms proposed for application in DSA, have been designed for peripheral and cerebral angiography images in which we mainly deal with global rigid motions. These algorithms did not yield good results when applied to coronary angiography images because of complex nonrigid motions that exist in this type of angiography images. Multiresolution and iterative algorithms are proposed to cope with this problem, but these algorithms are associated with high computational cost which makes them not acceptable for real-time clinical applications. In this paper we propose a nonrigid image registration algorithm for coronary angiography images that is significantly faster than multiresolution and iterative blocking methods and outperforms competing algorithms evaluated on the same data sets. This algorithm is based on a sparse set of matched feature point pairs and the elastic registration is performed by means of multilevel B-spline image warping. Experimental results with several clinical data sets demonstrate the effectiveness of our approach. PMID:23971026

THE RELATIONSHIP OF FLUORIDE IN DRINKING WATER TO CARIES EXPERIENCE AMONG CARIES RESISTANT NAVAL PERSONNEL.

DTIC Science & Technology

TEETH, FLUORIDES ), DISEASES, RESISTANCE(BIOLOGY), WATER , NAVAL PERSONNEL, STATISTICAL ANALYSIS, EXPOSURE(PHYSIOLOGY), DENTISTRY, MEDICAL RESEARCH, IMMUNITY, TABLES(DATA), PROTECTION, NAVAL RESEARCH.

CT angiography of the renal arteries and veins: normal anatomy and variants.

PubMed

Hazırolan, Tuncay; Öz, Meryem; Türkbey, Barış; Karaosmanoğlu, Ali Devrim; Oğuz, Berna Sayan; Canyiğit, Murat

2011-03-01

Conventional angiography has long been regarded as gold standard imaging modality for evaluation of the renal vasculature. Introduction of multidetector computed tomography (MDCT) angiography had a groundbreaking impact on evaluation of the renal vessels and is gradually replacing conventional angiography as standard imaging. Herein, we review and illustrate the normal and variant anatomy of renal vessels with special emphasis on imaging protocols and reconstruction techniques in MDCT.

[On new screening biomarker to evaluate health state in personnel engaged into chemical weapons extinction].

PubMed

Voitenko, N G; Garniuk, V V; Prokofieva, D S; Gontcharov, N V

2015-01-01

The work was aimed to find new screeding parameters (biomarkers) for evaluation of health state of workers engaged into enterprises with hazardous work conditions, as exemplified by "Maradykovskyi" object of chemical weapons extinction. Analysis of 27 serum cytokines was conducted in donors and the object personnel with various work conditions. Findings are statistically significant increase of serum eotaxin in the personnel of "dirty" zone, who are regularly exposed to toxic agents in individual filter protective means over the working day. For screening detection of health disorders in the object personnel, the authors suggested new complex biomarker--ratio Eotaxin* IFNγ/TNFα that demonstrates 67.9% sensitivity and 87.5% specificity in differentiating the "dirty" zone personnel and other staffers.

Key Personnel and “Long Distance” Settings: Determining Who Must Report Financial Conflict of Interest

PubMed Central

Lynch, John; Lindsell, Chris J.

2010-01-01

Conflicts of interest can impact the integrity of scientific research. While public imagination has focused on scientists, regulatory discourse recognizes a broader range of individuals who might have financial COIs. This essay asks, for personnel who enroll subjects at a physical and organizational remove from the primary research team, whether reporting COI to an institutional review board or COI committee protects research integrity. After examining definitions of COI, regulations on COI, and rubrics for evaluating COI policies, we argue that requiring recruitment personnel working at a distance from the primary research team to report potential COI protects neither research integrity nor human subjects. PMID:20597019

[Indocyanine green infrared fluorescence angiography and vascular cast--preparation in experimental choroidal circulatory disturbance].

PubMed

Matsunaga, H; Andoh, A; Matsubara, T; Fukushima, I; Takahashi, K; Ohkuma, H; Uyama, M

1996-03-01

We performed experiments in 20 monkey eyes in order to clarify basic problems about interpretation of indocyanine green fluorescence angiography (ICG angiography). We severed the temporal group of posterior ciliary arteries to produce choroidal circulatory disturbance. ICG angiography was performed immediately, and 2 days, 4 days, and 2 weeks later. Following each ICG angiography, the eye was studied by plastic vascular cast technique with scanning electron microscopy. Immediately after occlusion, ICG angiography showed filling defect in the temporal choroidal hemisphere during the early phase. In the later phase, this area was gradually filled by the dye from choroidal arteries in the nasal hemisphere and the anterior ciliary arteries. Vascular cast preparations showed filling defect in the temporal choroidal hemisphere, corresponding with the early ICG angiogaphic findings. Both filling delay in ICG angiography and filling defect in vascular casts improved daily after occlusion. Two weeks after occlusion, The area of choroidal infarct temporal to the macula turned into chorioretinal atrophy. This area showed hypofluorescence in the early-phase ICG angiography and filling defect of the choriocapillaris in plastic casts. The early-phase ICG angiographic findings thus corresponded well with observations of vascular casts. We conclude that ICG angiography correctly reflects the actual circulatory disturbances in the choroid.

64-slice MDCT angiography of upper extremity in assessment of native hemodialysis access.

PubMed

Wasinrat, Jitladda; Siriapisith, Thanongchai; Thamtorawat, Somrach; Tongdee, Trongtum

2011-01-01

To compare multidetector row computed tomographic (MDCT) angiography with conventional digital subtraction angiography (DSA) in the evaluation of vascular access stenoses in hemodialysis patients. Twenty-one consecutive patients were imaged with MDCT angiography and subsequent DSA. The superficial vein of leg was used as the route for intravenous administration. The vascular stenosis was assessed in not significant (<50% stenosis), moderate stenosis (50%-74% stenosis), severe stenosis (75%-99%), and total occlusion (100%). The accuracy, sensitivity, specificity, positive, and negative predictive values were calculated for significant vascular stenosis using DSA as the standard reference. The sensitivity and specificity of MDCT angiography for the detection of significant hemodialysis vascular access were 100% (95% CI, 89.3%-100%) and 94.8% (95% CI, 89.1%-97.6%), respectively. The positive and negative predictive values were 84.2% (95% CI, 68.1%-93.4%) and 100% (95% CI, 95.8%-100%), respectively. The accuracy of MDCT angiography for detection of significant stenoses was 95.9% (95% CI, 91.4%-97.0%). MDCT angiography provides excellent correlation in vascular stenosis as compared with DSA in hemodialysis access. Complete assessment of entire vascular segments could be performing with MDCT angiography in planning before endovascular intervention or surgical correction.

Optical Coherence Tomography Angiography versus Dye Angiography in Age-Related Macular Degeneration: Sensitivity and Specificity Analysis.

PubMed

Nikolopoulou, Eleni; Lorusso, Massimo; Micelli Ferrari, Luisa; Cicinelli, Maria Vittoria; Bandello, Francesco; Querques, Giuseppe; Micelli Ferrari, Tommaso

2018-01-01

Optical coherence tomography angiography (OCTA) could be a valid tool to detect choroidal neovascularization (CNV) in neovascular age-related macular degeneration (nAMD), allowing the analysis of the type, the morphology, and the extension of CNV in most of the cases. To determine the sensitivity and specificity of OCTA in detecting CNV secondary to nAMD, compared to fluorescein angiography (FA) and indocyanine green angiography (ICGA). Prospective observational study. Patients with suspected nAMD were recruited between May and December 2016. Patients underwent FA, ICGA, spectral domain OCT, and OCTA (AngioVue, Optovue, Inc.). Sensitivity and specificity of FA, with or without ICGA, were assessed and compared with OCTA. Seventy eyes of 70 consecutive patients were included: 32 eyes (45.7%) with type I CNV, 8 eyes (11.4%) with type II CNV, 4 eyes (5.7%) with type III CNV, 6 eyes (8.6%) with mixed type I and type II CNV, and 20 eyes (28.6%) with no CNV. Sensitivity of OCTA was 88% and specificity was 90%. Concordance between FA/ICGA and OCTA was very good (0,91; range 0,81-1,00). OCTA showed high sensitivity and specificity for detection of CNV. Concordance between OCTA and gold-standard dye-based techniques was excellent. OCTA may represent a first-line noninvasive method for the diagnosis of nAMD.

CAPILLARY NETWORK ANOMALIES IN BRANCH RETINAL VEIN OCCLUSION ON OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY.

PubMed

Rispoli, Marco; Savastano, Maria Cristina; Lumbroso, Bruno

2015-11-01

To analyze the foveal microvasculature features in eyes with branch retinal vein occlusion (BRVO) using optical coherence tomography angiography based on split spectrum amplitude decorrelation angiography technology. A total of 10 BRVO eyes (mean age 64.2 ± 8.02 range between 52 years and 76 years) were evaluated by optical coherence tomography angiography (XR-Avanti; Optovue). The macular angiography scan protocol covered a 3 mm × 3 mm area. The focus of angiography analysis were two retinal layers: superficial vascular network and deep vascular network. The following vascular morphological congestion parameters were assessed in the vein occlusion area in both the superficial and deep networks: foveal avascular zone enlargement, capillary non-perfusion occurrence, microvascular abnormalities appearance, and vascular congestion signs. Image analyses were performed by 2 masked observers and interobserver agreement of image analyses was 0.90 (κ = 0.225, P < 0.01). In both superficial and deep network of BRVO, a decrease in capillary density with foveal avascular zone enlargement, capillary non-perfusion occurrence, and microvascular abnormalities appearance was observed (P < 0.01). The deep network showed the main vascular congestion at the boundary between healthy and nonperfused retina. Optical coherence tomography angiography in BRVO allows to detect foveal avascular zone enlargement, capillary nonperfusion, microvascular abnormalities, and vascular congestion signs both in the superficial and deep capillary network in all eyes. Optical coherence tomography angiography technology is a potential clinical tool for BRVO diagnosis and follow-up, providing stratigraphic vascular details that have not been previously observed by standard fluorescein angiography. The normal retinal vascular nets and areas of nonperfusion and congestion can be identified at various retinal levels. Optical coherence tomography angiography provides noninvasive images of the retinal

Accuracy of computed tomographic angiography for stenosis quantification using quantitative coronary angiography or intravascular ultrasound as the gold standard.

PubMed

Joshi, Subodh B; Okabe, Teruo; Roswell, Robert O; Weissman, Gaby; Lopez, Cristian F; Lindsay, Joseph; Pichard, Augusto D; Weissman, Neil J; Waksman, Ron; Weigold, Wm Guy

2009-10-15

Computed tomographic angiography (CTA) is considered to have limited accuracy for quantifying exact percent diameter stenosis in coronary arteries. However, most studies evaluating CTA use quantitative coronary angiography (QCA) as the gold standard, a technique with its own limitations. We sought to determine whether CTA measurements of stenosis severity correlate better with intravascular ultrasound (IVUS) than with QCA. Luminal dimensions of 67 de novo coronary lesions were measured by CTA, IVUS, and QCA. IVUS was performed when lesion severity by angiography was equivocal. Mean percent diameter stenosis by QCA was 51 +/- 9.8% and mean IVUS minimal luminal area was 3.8 +/- 1.8 mm(2). There was a moderate correlation between CTA minimal luminal area and IVUS minimal luminal area (r(2) = 0.41, p <0.001), but no relation between CTA and QCA measurements of minimal luminal diameter (r(2) = 0.01, p = 0.57) or diameter stenosis (r(2) = 0.02, p = 0.31). There was also no relation between IVUS minimal luminal area and QCA diameter stenosis (r(2) = 0.01, p = 0.50). When lesions with moderate or severe calcification were excluded, the correlation between CTA minimal luminal area and IVUS minimal luminal area was good (r(2) = 0.68, p <0.001). In conclusion, in this cohort of patients with intermediate-grade lesions on cardiac catheterization, absolute measurements of stenosis severity on CTA correlated with IVUS but not with QCA. Our findings suggest that limitations of quantitative coronary angiography as a gold standard need to be considered in studies evaluating the accuracy of coronary CTA.

A Survey of Sun Protection Policy and Education in Secondary Schools

PubMed Central

Buller, David B.; Buller, Mary Klein; Reynolds, Kim D.

2006-01-01

Background The Centers for Disease Control and Prevention (CDC) issued recommendations for school programs to reduce skin cancer. Objective Personnel at U.S. secondary schools were surveyed to describe sun protection policy and education prior to these recommendations. Methods School principals or other personnel at 484 secondary schools in 27 cities responded to a telephone survey in January and February 2002 (response rate = 31%). Results A sun protection policy was reported at 10% of the schools but sun protection education occurred at nearly all schools (96%). Policies were more prevalent in regions with high ultraviolet radiation (p<.0001) but education was not. Many personnel were willing to adopt a policy (41%) and interested in obtaining a sun safety curriculum (96%). Limitations Self-report measures, non-response, and new schools not in the sampling frame. Conclusion Sun protection was a low policy priority for U.S. schools. Sun safety education was prevalent but written materials were used infrequently. A substantial proportion of school personnel were receptive to the CDC’s advice. PMID:16488293

Optical coherence tomography angiography in age-related macular degeneration: The game changer.

PubMed

Lupidi, Marco; Cerquaglia, Alessio; Chhablani, Jay; Fiore, Tito; Singh, Sumit Randhir; Cardillo Piccolino, Felice; Corbucci, Roberta; Coscas, Florence; Coscas, Gabriel; Cagini, Carlo

2018-04-01

Optical coherence tomography angiography is one of the biggest advances in ophthalmic imaging. It enables a depth-resolved assessment of the retinal and choroidal blood flow, far exceeding the levels of detail commonly obtained with dye angiographies. One of the first applications of optical coherence tomography angiography was in detecting the presence of choroidal neovascularization in age-related macular degeneration and establishing its position in relation to the retinal pigmented epithelium and Bruch's membrane, and thereby classifying the CNV as type 1, type 2, type 3, or mixed lesions. Optical coherence tomography angiograms, due to the longer wavelength used by optical coherence tomography, showed a more distinct choroidal neovascularization vascular pattern than fluorescein angiography, since there is less suffering from light scattering or is less obscured by overlying subretinal hemorrhages or exudation. Qualitative and quantitative assessments of optical coherence tomography angiography findings in exudative and nonexudative age-related macular degeneration have been largely investigated within the past 3 years both in clinical and experimental settings. This review constitutes an up-to-date of all the potential applications of optical coherence tomography angiography in age-related macular degeneration in order to better understand how to translate its theoretical usefulness into the current clinical practice.

Observations on personnel dosimetry for radiotherapy personnel operating high-energy LINACs.

PubMed

Glasgow, G P; Eichling, J; Yoder, R C

1986-06-01

A series of measurements were conducted to determine the cause of a sudden increase in personnel radiation exposures. One objective of the measurements was to determine if the increases were related to changing from film dosimeters exchanged monthly to TLD-100 dosimeters exchanged quarterly. While small increases were observed in the dose equivalents of most employees, the dose equivalents of personnel operating medical electron linear accelerators with energies greater than 20 MV doubled coincidentally with the change in the personnel dosimeter program. The measurements indicated a small thermal neutron radiation component around the accelerators operated by these personnel. This component caused the doses measured with the TLD-100 dosimeters to be overstated. Therefore, the increase in these personnel dose equivalents was not due to changes in work habits or radiation environments. Either film or TLD-700 dosimeters would be suitable for personnel monitoring around high-energy linear accelerators. The final choice would depend on economics and personal preference.

Job stress, depression, work performance, and perceptions of supervisors in military personnel.

PubMed

Pflanz, Steven E; Ogle, Alan D

2006-09-01

Recent studies have identified high levels of job stress in military personnel. This study examined the relationship among job stress, depression, work performance, types of stressors, and perceptions about supervisors in military personnel. Eight hundred nine military personnel answered a 43-item survey on work stress, physical and emotional health, work performance, perceptions about leadership, job stressors, and demographics. More than one- quarter (27.4%) of this military population reported suffering from significant job stress. Both the report of work stress and depression were significantly related to impaired work performance, more days of missed work, poorer physical health, and negative perceptions about the abilities of supervisors and commanders. Depression and job stress were significantly and positively related to each other. These results support accumulating data indicating that work stress is a significant occupational health hazard in the routine military work environment. Targeting and eliminating sources of job stress should be a priority for the U.S. military to preserve and protect the mental health of military personnel.

Personal Protective Equipment

EPA Pesticide Factsheets

Response personnel must wear the appropriate level of protection whenever near a hazardous release site. Level A is for the greatest exposure potential, and D is the minimum level. Examples range from totally encapsulated suits to hard hats.

Interventional Radiologists: a Necessary Evaluation of Technical, Protective and Technological Operation.

PubMed

Rahimi, Sayed Ali; Pourkaveh, Maryam

2016-02-01

To present the results of occupational radiation doses investigated through a Hospitals of Mazandaran Medical Science Universities in north of Iran. Radiology unit has an important role in diagnosis of many disorders with providing suitable and high quality pictures. A good picture was provided using correct technical criteria and suitable circumstance of patient. Finally, operation and knowledge of radiology personnel directly has a primary role in determining quality of radiography. This study was done in order to determine personnel operation in the units of hospitals radiologist related to University of Mazandaran Medical Science. Data collection tools are made of a researcher check list that was used after obtaining suitable letter and validity indexes. All of the 73 personnel of radiology unit related to Mazandaran Medical Science were studied. 35 operations (in technical, protective and technological fields) of any personnel, in three distinct shifts were observed and recorded. All of them were tested regarding these three fields with a total of 40 questions. The total scores received from personnel in technical part in the morning, evening and night shift were 66.4, 53.9 and 60.2 percent respectively. Received scores from personnel in the protective fields were 68.1, 59.5 and 60.2 percent. Moreover, received scores from personnel in the technological operation fields were 47.8, 39.95 and 43.65 percent respectively. Comparison of these three scores in technical, protective and technological operation fields showed a meaningful difference (p<0.05). The overall quality of personnel operations were nearly desirable and in need of continuous education, supervision and evaluation. Emphasizing protection to beams, accessibility of necessary tools, continuous supervision regarding the usage of these equipments and respecting the other security points have an important role in decreasing patients absorbed doses.

Interventional Radiologists: a Necessary Evaluation of Technical, Protective and Technological Operation

PubMed Central

Rahimi, Sayed Ali; Pourkaveh, Maryam

2016-01-01

Background and purpose: To present the results of occupational radiation doses investigated through a Hospitals of Mazandaran Medical Science Universities in north of Iran. Radiology unit has an important role in diagnosis of many disorders with providing suitable and high quality pictures. A good picture was provided using correct technical criteria and suitable circumstance of patient. Finally, operation and knowledge of radiology personnel directly has a primary role in determining quality of radiography. Materials and Methods: This study was done in order to determine personnel operation in the units of hospitals radiologist related to University of Mazandaran Medical Science. Data collection tools are made of a researcher check list that was used after obtaining suitable letter and validity indexes. All of the 73 personnel of radiology unit related to Mazandaran Medical Science were studied. 35 operations (in technical, protective and technological fields) of any personnel, in three distinct shifts were observed and recorded. All of them were tested regarding these three fields with a total of 40 questions. Results: The total scores received from personnel in technical part in the morning, evening and night shift were 66.4, 53.9 and 60.2 percent respectively. Received scores from personnel in the protective fields were 68.1, 59.5 and 60.2 percent. Moreover, received scores from personnel in the technological operation fields were 47.8, 39.95 and 43.65 percent respectively. Comparison of these three scores in technical, protective and technological operation fields showed a meaningful difference (p<0.05). Conclusion: The overall quality of personnel operations were nearly desirable and in need of continuous education, supervision and evaluation. Emphasizing protection to beams, accessibility of necessary tools, continuous supervision regarding the usage of these equipments and respecting the other security points have an important role in decreasing patients

49 CFR 179.400-22 - Protective housings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... protective housing must be operable by personnel wearing heavy gloves and must incorporate provisions for locks or seals. A protective housing and its cover must be constructed of metal not less than 0.119 inch...

48 CFR 31.205-29 - Plant protection costs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Plant protection costs. 31....205-29 Plant protection costs. Costs of items such as (a) wages, uniforms, and equipment of personnel engaged in plant protection, (b) depreciation on plant protection capital assets, and (c) necessary...

48 CFR 31.205-29 - Plant protection costs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Plant protection costs. 31....205-29 Plant protection costs. Costs of items such as (a) wages, uniforms, and equipment of personnel engaged in plant protection, (b) depreciation on plant protection capital assets, and (c) necessary...

Rash, fever, and chills after intravenous fluorescein angiography.

PubMed

Johnson, R N; McDonald, H R; Schatz, H

1998-12-01

To report a previously unreported complication associated with intravenous injection of fluorescein dye. Case report. A 75-year-old man developed a unique complication after intravenous injection of fluorescein dye for angiography. Two hours after receiving an intravenous injection of fluorescein for angiography, the patient developed a fever, rash, and chills. Admission to a hospital and careful systemic evaluation determined that this reaction was a noninfectious allergic response to intravenous fluorescein dye injection. A delayed allergic response to intravenous fluorescein dye injection can occur.

Imaging Foveal Microvasculature: Optical Coherence Tomography Angiography Versus Adaptive Optics Scanning Light Ophthalmoscope Fluorescein Angiography.

PubMed

Mo, Shelley; Krawitz, Brian; Efstathiadis, Eleni; Geyman, Lawrence; Weitz, Rishard; Chui, Toco Y P; Carroll, Joseph; Dubra, Alfredo; Rosen, Richard B

2016-07-01

To compare the use of optical coherence tomography angiography (OCTA) and adaptive optics scanning light ophthalmoscope fluorescein angiography (AOSLO FA) for characterizing the foveal microvasculature in healthy and vasculopathic eyes. Four healthy controls and 11 vasculopathic patients (4 diabetic retinopathy, 4 retinal vein occlusion, and 3 sickle cell retinopathy) were imaged with OCTA and AOSLO FA. Foveal perfusion maps were semiautomatically skeletonized for quantitative analysis, which included foveal avascular zone (FAZ) metrics (area, perimeter, acircularity index) and vessel density in three concentric annular regions of interest. On each set of OCTA and AOSLO FA images, matching vessel segments were used for lumen diameter measurement. Qualitative image comparisons were performed by visual identification of microaneurysms, vessel loops, leakage, and vessel segments. Adaptive optics scanning light ophthalmoscope FA and OCTA showed no statistically significant differences in FAZ perimeter, acircularity index, and vessel densities. Foveal avascular zone area, however, showed a small but statistically significant difference of 1.8% (P = 0.004). Lumen diameter was significantly larger on OCTA (mean difference 5.7 μm, P < 0.001). Microaneurysms, fine structure of vessel loops, leakage, and some vessel segments were visible on AOSLO FA but not OCTA, while blood vessels obscured by leakage were visible only on OCTA. Optical coherence tomography angiography is comparable to AOSLO FA at imaging the foveal microvasculature except for differences in FAZ area, lumen diameter, and some qualitative features. These results, together with its ease of use, short acquisition time, and avoidance of potentially phototoxic blue light, support OCTA as a tool for monitoring ocular pathology and detecting early disease.

Practical protective tools for occupational exposure: 1) double focus spectacles for the aged with highly refracted glass lens 2) remodeled barrier for radiation protection.

PubMed

Kurokawa, S; Yabe, S; Takamura, A; Ishizaki, H; Aizawa, S

2000-11-30

Two practical protective tools for occupational exposure for neurointerventional radiologists are presented. The first purpose of this study was to investigate the effectiveness of double focus spectacles for the aged with a highly refracted glass lens (special spectacles for the aged) for radiation protection of the crystalline lens of the eye in comparison with other spectacles on the market, based on the measurement of film density which was obtained by exposure of X-ray through those spectacles. As a result of the film densitometry mentioned above, the effectiveness of special spectacles for the aged in radiation protection was nearly equal to the effectiveness of a goggle type shield which is made with a 0.07 mm lead-equivalent plastic lens. The second purpose of this study was to investigate the effectiveness of the protective barrier, which we remodeled for cerebral angiography or neuroendovascular therapy, for radiation exposure, based on the measurement in a simulated study with a head phantom, and on the measurement of radiation exposure in operaters during procedures of clinical cases. In the experimental study radiation exposure in supposed position of the crystalline lens was reduced to about one third and radiation exposure in supposed position of the gonadal glands was reduced to about one seventh, compared to radiation exposure without employing the barrier. The radiation exposure was monitored at the left breast of three radiologists, in 215 cases of cerebral angiography. Employing the barrier in cerebral angiography, average equivalent dose at the left breast measured 1.49mu Sv during 10 min of fluoroscopy. In three kinds of neuroendovascular therapy in 40 cases, radiation exposure in an operator was monitored in the same fashion and the dose was recorded less than the result reported in previous papers in which any protective barrier have not been employed in the procedure (1,2). As a result, the two above mentioned protective tools are

Fluorescein and Indocyanine Green Angiography for Uveitis

PubMed Central

Herbort, Carl P

2009-01-01

In recent years enormous progress has been achieved in investigational procedures for uveitis. Imaging is one such example with the advent of new methods such as indocyanine green angiography, ultrasound biomicroscopy and optical coherence tomography to cite only the most important. This tremendous increase in precision and accuracy in the assessment of the level and degree of inflammation and its monitoring comes in parallel with the development of extremely potent and efficacious therapies. In view of these developments, our whole attitude in the appraisal and investigation of the uveitis patient has to be adapted and correctly reoriented integrating the recent developments and this is no different for ocular angiography. PMID:20404985

Methods and algorithms for optical coherence tomography-based angiography: a review and comparison

NASA Astrophysics Data System (ADS)

Zhang, Anqi; Zhang, Qinqin; Chen, Chieh-Li; Wang, Ruikang K.

2015-10-01

Optical coherence tomography (OCT)-based angiography is increasingly becoming a clinically useful and important imaging technique due to its ability to provide volumetric microvascular networks innervating tissue beds in vivo without a need for exogenous contrast agent. Numerous OCT angiography algorithms have recently been proposed for the purpose of contrasting microvascular networks. A general literature review is provided on the recent progress of OCT angiography methods and algorithms. The basic physics and mathematics behind each method together with its contrast mechanism are described. Potential directions for future technical development of OCT based angiography is then briefly discussed. Finally, by the use of clinical data captured from normal and pathological subjects, the imaging performance of vascular networks delivered by the most recently reported algorithms is evaluated and compared, including optical microangiography, speckle variance, phase variance, split-spectrum amplitude decorrelation angiography, and correlation mapping. It is found that the method that utilizes complex OCT signal to contrast retinal blood flow delivers the best performance among all the algorithms in terms of image contrast and vessel connectivity. The purpose of this review is to help readers understand and select appropriate OCT angiography algorithm for use in specific applications.

Indocyanine green video angiography predicts outcome of extravasation injuries.

PubMed

Haslik, Werner; Pluschnig, Ursula; Steger, Günther G; Zielinski, Christoph C; Schrögendorfer, K F; Nedomansky, Jakob; Bartsch, Rupert; Mader, Robert M

2014-01-01

Extravasation of cytotoxic drugs is a serious complication of systemic cancer treatment. Still, a reliable method for early assessment of tissue damage and outcome prediction is missing. Here, we demonstrate that the evaluation of blood flow by indocyanine green (ICG) angiography in the extravasation area predicts for the need of surgical intervention. Twenty-nine patients were evaluated by ICG angiography after extravasation of vesicant or highly irritant cytotoxic drugs administered by peripheral i.v. infusion. Tissue perfusion as assessed by this standardized method was correlated with clinical outcome. The perfusion index at the site of extravasation differed significantly between patients with reversible tissue damage and thus healing under conservative management (N = 22) versus those who needed surgical intervention due to the development of necrosis (N = 7; P = 0.0001). Furthermore, in patients benefiting from conservative management, the perfusion index was significantly higher in the central extravasation area denoting hyperemia, when compared with the peripheral area (P = 0.0001). In this patient cohort, ICG angiography as indicator of local perfusion within the extravasation area was of prognostic value for tissue damage. ICG angiography could thus be used for the early identification of patients at risk for irreversible tissue damage after extravasation of cytotoxic drugs.

The Predictive Value of Pulse Oximeters for Pulse Improvement after Angiography in Infants and Children

PubMed Central

Alipour, Mohammad-Reza; Rastegar, Mazyar; Ghaderian, Mehdi; Namayandeh, Seyedeh-Mahdieh; Faraji, Reza; Pezeshkpour, Zohreh

2016-01-01

Background Information from pulse oximeter waves confirms the presence of a pulse and helps obtain waves from tissue when the supplying artery is not readily accessible. Objectives This study determined the predictive value of pulse oximeters for detecting improved arterial pulses after angiography. Patients and Methods This cross-sectional, multi-center study included 467 4-day-old to 12-year-old patients and was conducted from January 2012 to January 2016. Angiographies were performed on 12-year-old or younger children for various medical reasons using venous, arterial, or both types of paths. The posterior malleolar or dorsalis pedis were palpated in punctured lower extremities. In the absence of a pulse, pulse oximetry was performed to identify pulse curves at 1 hour, 6 hours, and 12 hours after each angiography. Results Pulse oximetry displayed the pulses of 319 patients immediately following each angiography. Of these, 262 patients had palpable pulses at 6 hours after angiography (P < 0.0001), while 57 patients had no palpable pulse. Of these 57 patients, 15 had no palpable pulse at 12 hours after angiography (P < 0.0001). The odds of pulse improvement in children 6 hours after catheter angiography were 76% for the arterial path, 90% for the venous path, and 83.2% for both paths. At 12 hours after catheter angiography, these values increased to 91.6% for the arterial path, 100% for the venous path, and 95.9% for both paths. Conclusions The pulse oximeter can display the pulse curve immediately (1 hour) after angiography and indicate pulse improvement at 12 hours maximally following an angiography. In this case, heparin alone may be used instead of thrombolytic agents. PMID:28203338

Guidelines for Protection in Evaluation.

ERIC Educational Resources Information Center

Mainzer, Richard W.; And Others

The report examines due process protections and requirements in evaluation as mandated by P.O. 94-142 (The Education for All Handicapped Children Act) and Maryland special education Bylaw. A checklist guide for Admission, Review, and Dismissal (ARD) personnel to ensure protection in evaluation is provided. Self check guidelines touch on 16…

The Association Between Psychological Distress and Decision Regret During Armed Conflict Among Hospital Personnel.

PubMed

Ben-Ezra, Menachem; Bibi, Haim

2016-09-01

The association between psychological distress and decision regret during armed conflict among hospital personnel is of interest. The objective of this study was to learn of the association between psychological distress and decision regret during armed conflict. Data was collected from 178 hospital personnel in Barzilai Medical Center in Ashkelon, Israel during Operation Protective Edge. The survey was based on intranet data collection about: demographics, self-rated health, life satisfaction, psychological distress and decision regret. Among hospital personnel, having higher psychological distress and being young were associated with higher decision regret. This study adds to the existing knowledge by providing novel data about the association between psychological distress and decision regret among hospital personnel during armed conflict. This data opens a new venue of future research to other potentially detrimental factor on medical decision making and medical error done during crisis.

The utility of postmortem computed tomography selective coronary angiography in parallel with autopsy.

PubMed

Inokuchi, Go; Yajima, Daisuke; Hayakawa, Mutsumi; Motomura, Ayumi; Chiba, Fumiko; Torimitsu, Suguru; Makino, Yohsuke; Iwase, Hirotaro

2013-12-01

Historically, coronary angiography of the isolated heart has played an important role in the detection of stenotic or occlusive lesions that are difficult to identify by autopsy alone. Meanwhile, although the application of multidetector computed tomography (MDCT) to forensic fields has accelerated recently, isolated single organ angiography with MDCT is rarely performed. In this article, we present an evaluation of postmortem selective coronary CT angiography of the isolated heart with MDCT and discuss its utility for autopsy. First, in a preliminary experiment using pig coronary artery, we examined the behavior of water soluble contrast material on postmortem computed tomography angiography (PMCTA) and found that better angiographic images were acquired when the viscosity of the contrast material was increased and CT was performed under conditions of sustained perfusion. Based on these results, we devised a selective coronary angiography procedure using a pressurized bag for drip infusion that can be performed easily, quickly, and at low cost. The angiographic images obtained provided useful supportive evidence of autopsy findings suggestive of ischemic heart disease. With active discussions underway in forensic fields on the proper use of postmortem computed tomography, PMCTA has also naturally attracted attention as it compensates for some of the shortcomings of CT alone. Although PMCTA typically involves whole-body angiography, if we view PMCTA as one of the many useful and supplementary tools available for autopsy, then isolated heart angiography continues to have utility in autopsy today.

The use of carbon dioxide angiography for renal sympathetic denervation: a technical report.

PubMed

Renton, Mary; Hameed, Mohammad A; Dasgupta, Indranil; Hoey, Edward T D; Freedman, Jonathan; Ganeshan, Arul

2016-12-01

Hypertension is the leading attributable cause of cardiovascular mortality worldwide. Patients with hypertension have multiple comorbidities including high rates of concomitant renal disease. Current pharmacological approaches are inadequate in the treatment of resistant hypertension. Renal sympathetic denervation (RDN) has been shown to effectively treat resistant hypertension. The traditional use of iodinated contrast in RDN is contraindicated in patients with significant renal insufficiency. In patients with renal impairment, carbon dioxide (CO 2 ) can be used as an alternative contrast material for RDN. This article describes the technical aspects of RDN using CO 2 angiography. Our centre is experienced in the innovative RDN procedure using CO 2 angiography. We describe the protocol for CO 2 angiography for RDN using a home-made CO 2 delivery system and the Symplicity ™ (Minneapolis MN 55432 USA) catheter (Medtronic) device. CO 2 angiography is an excellent alternative to iodinated contrast for RDN procedures. CO 2 angiography for RDN is a safe and effective alternative to iodinated contrast. RDN using CO 2 angiography is an easy and feasible procedure that can be used in patients with renal insufficiency or iodinated contrast allergies. Advances in knowledge: There is a paucity of descriptive reports for CO 2 angiography for RDN and we provide details of the optimal protocol for the procedure. In particular, we describe the use of a Symplicity Spyral ™ catheter (Medtronic), which has not been reported to date for use in this procedure.

NASA Developments in Personnel Protective Equipment

NASA Technical Reports Server (NTRS)

Graf, John

2015-01-01

NASA has some unique and challenging PPE needs: there are credible threats to air quality (fire, ammonia leak, hydrazine leak)that require a contingency breathing apparatus that operates for many hours - but there is not enough space or up-mass to provide supplied air tanks. We cannot use "Scott Air Tanks" commonly used by firefighters and other first responders. NASA has developed a respirator based emergency breathing device. It uses a "one size fits everybody in the astronaut corps" hooded mask with excellent chemical permeability and fire resistance properties, and a filtering respirator cartridge that protects the wearer from ammonia leaks, hydrazine leaks, or products of combustion. If you need a small, lightweight emergency breathing system that lasts longer than a supplied air system, we should meet and learn if NASA sponsored technology development can help.

Fatigue and mental health in Australian rural and regional ambulance personnel.

PubMed

Pyper, Zoe; Paterson, Jessica L

2016-02-01

Australian ambulance personnel experience stress, fatigue and exposure to traumatic events. These risks have been extensively researched in metropolitan paramedics. However, there has been limited research in rural and regional personnel. Rural and regional ambulance personnel make up a significant proportion of the Australian ambulance workforce and may be exposed to unique stressors. The aim of the current study was to investigate levels of fatigue, stress, and emotional trauma in rural and regional ambulance personnel. A sample of 134 (103 male, 31 female) rural and regional ambulance personnel completed a mixed methods survey assessing fatigue, stress and emotional trauma. Data were analysed using a combination of descriptive analysis and qualitative, deductive analysis that involved data immersion, coding, and categorisation. Participants reported high levels of fatigue and emotional trauma. Qualitative data revealed stressors including community expectations and 'office politics'. Participants also reported negative effects of fatigue including errors in drug administration and falling asleep while driving. The majority of participants reported normal levels of stress. It may be the case that working with known individuals in a community offers some degree of 'protective' impact for stress in rural and regional ambulance personnel. This is one of the first studies to investigate fatigue, stress, and emotional trauma in a rural and regional ambulance population. Results indicate a complex and unique profile of risks and challenges for this critical and understudied community resource. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Arterial Obstruction on Computed Tomographic or Magnetic Resonance Angiography and Response to Intravenous Thrombolytics in Ischemic Stroke

PubMed Central

Mair, Grant; von Kummer, Rüdiger; Adami, Alessandro; White, Philip M.; Adams, Matthew E.; Yan, Bernard; Demchuk, Andrew M.; Farrall, Andrew J.; Sellar, Robin J.; Sakka, Eleni; Palmer, Jeb; Perry, David; Lindley, Richard I.; Sandercock, Peter A.G.

2017-01-01

Background and Purpose— Computed tomographic angiography and magnetic resonance angiography are used increasingly to assess arterial patency in patients with ischemic stroke. We determined which baseline angiography features predict response to intravenous thrombolytics in ischemic stroke using randomized controlled trial data. Methods— We analyzed angiograms from the IST-3 (Third International Stroke Trial), an international, multicenter, prospective, randomized controlled trial of intravenous alteplase. Readers, masked to clinical, treatment, and outcome data, assessed prerandomization computed tomographic angiography and magnetic resonance angiography for presence, extent, location, and completeness of obstruction and collaterals. We compared angiography findings to 6-month functional outcome (Oxford Handicap Scale) and tested for interactions with alteplase, using ordinal regression in adjusted analyses. We also meta-analyzed all available angiography data from other randomized controlled trials of intravenous thrombolytics. Results— In IST-3, 300 patients had prerandomization angiography (computed tomographic angiography=271 and magnetic resonance angiography=29). On multivariable analysis, more extensive angiographic obstruction and poor collaterals independently predicted poor outcome (P<0.01). We identified no significant interaction between angiography findings and alteplase effect on Oxford Handicap Scale (P≥0.075) in IST-3. In meta-analysis (5 trials of alteplase or desmoteplase, including IST-3, n=591), there was a significantly increased benefit of thrombolytics on outcome (odds ratio>1 indicates benefit) in patients with (odds ratio, 2.07; 95% confidence interval, 1.18–3.64; P=0.011) versus without (odds ratio, 0.88; 95% confidence interval, 0.58–1.35; P=0.566) arterial obstruction (P for interaction 0.017). Conclusions— Intravenous thrombolytics provide benefit to stroke patients with computed tomographic angiography or magnetic

Arterial Obstruction on Computed Tomographic or Magnetic Resonance Angiography and Response to Intravenous Thrombolytics in Ischemic Stroke.

PubMed

Mair, Grant; von Kummer, Rüdiger; Adami, Alessandro; White, Philip M; Adams, Matthew E; Yan, Bernard; Demchuk, Andrew M; Farrall, Andrew J; Sellar, Robin J; Sakka, Eleni; Palmer, Jeb; Perry, David; Lindley, Richard I; Sandercock, Peter A G; Wardlaw, Joanna M

2017-02-01

Computed tomographic angiography and magnetic resonance angiography are used increasingly to assess arterial patency in patients with ischemic stroke. We determined which baseline angiography features predict response to intravenous thrombolytics in ischemic stroke using randomized controlled trial data. We analyzed angiograms from the IST-3 (Third International Stroke Trial), an international, multicenter, prospective, randomized controlled trial of intravenous alteplase. Readers, masked to clinical, treatment, and outcome data, assessed prerandomization computed tomographic angiography and magnetic resonance angiography for presence, extent, location, and completeness of obstruction and collaterals. We compared angiography findings to 6-month functional outcome (Oxford Handicap Scale) and tested for interactions with alteplase, using ordinal regression in adjusted analyses. We also meta-analyzed all available angiography data from other randomized controlled trials of intravenous thrombolytics. In IST-3, 300 patients had prerandomization angiography (computed tomographic angiography=271 and magnetic resonance angiography=29). On multivariable analysis, more extensive angiographic obstruction and poor collaterals independently predicted poor outcome (P<0.01). We identified no significant interaction between angiography findings and alteplase effect on Oxford Handicap Scale (P≥0.075) in IST-3. In meta-analysis (5 trials of alteplase or desmoteplase, including IST-3, n=591), there was a significantly increased benefit of thrombolytics on outcome (odds ratio>1 indicates benefit) in patients with (odds ratio, 2.07; 95% confidence interval, 1.18-3.64; P=0.011) versus without (odds ratio, 0.88; 95% confidence interval, 0.58-1.35; P=0.566) arterial obstruction (P for interaction 0.017). Intravenous thrombolytics provide benefit to stroke patients with computed tomographic angiography or magnetic resonance angiography evidence of arterial obstruction, but the sample was

RADIATION POISONING OF DOCTORS AND NURSING PERSONNEL IN GYNECOLOGICAL RADIATION THERAPY (in German)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leetz, H.; Masch, F.; Mohr, H.

Because Curietherapy in general, and the treatment of gynecological carcinomas in particular, represents a bottle-neck as to the observance of regulations for adequate protection of the personnel against irradiation burns, the actual conditions in a heavily frequented major hospital are described on the strength of personal experiences. The ray load of the personnel in typical, frequently recurring working processes, such as preparation and application, as well as during regular nursing at the sick-bed, is analyzed. Under present conditions it is difficult to keep within the admissible. weekly maximum doses whenever radium work exceeds a certain amount. Additional protective measures ofmore » various kinds, among which periodical relevant schooling of the stab proved particularly effective, were unavoidable and shall also be continued in the future in order to obtain a further decrease in the actual individual doses. (auth)« less

Personnel Management.

ERIC Educational Resources Information Center

Naval Personnel Program Support Activity, Washington, DC.

The document serves as a basic text for the indoctrination of all naval officers and as an introductory text for the officer who specializes in personnel administration or manpower management. Chapter 1 contains an introductory summary of the various functions of naval personnel administration and manpower management and describes the processes of…

Intra-arterial Ultra-low-Dose CT Angiography of Lower Extremity in Diabetic Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Özgen, Ali, E-mail: draliozgen@hotmail.com; Sanioğlu, Soner; Bingöl, Uğur Anıl

2016-08-15

PurposeTo image lower extremity arteries by CT angiography using a very low-dose intra-arterial contrast medium in patients with high risk of developing contrast-induced nephropathy (CIN).Materials and MethodsThree cases with long-standing diabetes mellitus and signs of lower extremity atherosclerotic disease were evaluated by CT angiography using 0.1 ml/kg of the body weight of contrast medium given via 10-cm-long 4F introducer by puncturing the CFA. Images were evaluated by an interventional radiologist and a cardiovascular surgeon. Density values of the lower extremity arteries were also calculated. Findings in two cases were compared with digital subtraction angiography images performed for percutaneous revascularization. Blood creatininemore » levels were followed for possible CIN.ResultsIntra-arterial CT angiography images were considered diagnostic in all patients and optimal in one patient. No patient developed CIN after intra-arterial CT angiography, while one patient developed CIN after percutaneous intervention.ConclusionIntra-arterial CT angiography of lower extremity might be performed in selected patients with high risk of developing CIN. Our limited experience suggests that as low as of 0.1 ml/kg of the body weight of contrast medium may result in adequate diagnostic imaging.« less

Case Report of Bullous Pemphigoid following Fundus Fluorescein Angiography

PubMed Central

Demirci, Goktug; Demirci, Gulsen Tukenmez; Gulkilik, Gokhan

2010-01-01

Purpose To report a first case of bullous pemphigoid (BP) following intravenous fluorescein for fundus angiography. Clinical Features: A 70-year-old male patient was admitted to the intensive care unit with BP and sepsis. He reported a history of fundus fluorescein angiography with a pre-diagnosis of senile macular degeneration 2 months prior to presentation. At that time, fluorescein extravasated at the antecubital region. Following the procedure, pruritus and erythema began at the wrists bilaterally, and quickly spread to the entire body. The patient also reported a history of allergy to human albumin solution (Plamasteril®; Abbott) 15 years before, during bypass surgery. On dermatologic examination, erythematous patches were present on the scalp, chest and anogenital region. Vesicles and bullous lesions were present on upper and lower extremities. On day 2 of hospitalization, tense bullae appeared on the upper and lower extremities. The patient was treated with oral methylprednisolone 48 mg (Prednol®; Mustafa Nevzat), topical clobetasol dipropionate 0.05% cream (Dermovate®; Glaxo SmithKline), and topical 4% urea lotion (Excipial Lipo®; Orva) for presumptive bullous pemphigoid. Skin punch biopsy provided tissue for histopathology, direct immunofluorescence examination, and salt extraction, which were all consistent with BP. After 1 month, the patient was transferred to the intensive care unit with sepsis secondary to urinary tract infection; he died 2 weeks later from sepsis and cardiac failure. Conclusions To our knowledge, this is the first reported case of BP following fundus fluorescein angiography in a patient with known human albumin solution allergy. Consideration should be made to avoid fluorescein angiography, change administration route, or premedicate with antihistamines in patients with known human albumin solution allergy. The association between fundus fluorescein angiography and BP should be further investigated. PMID:20737052

Use of the 2.8 French Progreat microcatheter in diagnostic cerebral angiography.

PubMed

Griauzde, Julius; Gemmete, Joseph J; Shastri, Ravi; Pandey, Aditya S; Chaudhary, Neeraj

2017-01-01

Tortuous vascular anatomy poses a significant challenge to performing diagnostic cerebral angiography. To report a new cerebral angiography technique for overcoming tortuous aortic and supra-aortic anatomy using a 2.8 French (F) Progreat microcatheter (0.028 inch (internal diameter) (Terumo; Somerset, New Jersey, USA) to obtain a diagnostic cerebral angiogram. A retrospective analysis of consecutive cases undergoing diagnostic cerebral angiography at our institution between 1 January 2013 and 30 November 2015 in which a 2.8F Progreat microcatheter was used. Clinical and operative notes were reviewed and correlated with imaging. Radiologic imaging, including CT, MRI, and digital subtraction angiography, was reviewed. Neurologic, systemic, and local complications were recorded on the basis of clinical follow-up results after each angiographic examination. Events that occurred within 24 h of the angiography were considered to be complications of the procedure. Initial attempts at catheterization of the target vessel with various 4F and 5F catheters were unsuccessful owing to tortuosity, atherosclerotic disease, or occlusion of the catheter in the target vessel. Microcatheterization of the target vessel was successful in 59/62 (95%) target vessels. A diagnostic cerebral angiogram with a power injection was obtained in 59 (100%) of the successfully catheterized vessels. In one case, angiography proceeded to aneurysm coiling after over-the-wire exchange. In two cases, angiography proceeded to mechanical thrombectomy after over-the-wire exchange. No procedural complications were seen. The 2.8F Progreat microcatheter can be used to obtain a diagnostic cerebral angiogram in patients with anatomic challenges limiting catheterization by standard techniques. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Ultra-wide-field angiography improves the detection and classification of diabetic retinopathy.

PubMed

Wessel, Matthew M; Aaker, Grant D; Parlitsis, George; Cho, Minhee; D'Amico, Donald J; Kiss, Szilárd

2012-04-01

To evaluate patients with diabetic retinopathy using ultra-wide-field fluorescein angiography and to compare the visualized retinal pathology with that seen on an overly of conventional 7 standard field (7SF) imaging. Two hundred and eighteen eyes of 118 diabetic patients who underwent diagnostic fluorescein angiography using the Optos Optomap Panoramic 200A imaging system were included. The visualized area of the retina, retinal nonperfusion, retinal neovascularization, and panretinal photocoagulation were quantified by two independent masked graders. The respective areas identified on the ultra-wide-field fluorescein angiography image were compared with an overly of a modified 7SF image as outlined in the Early Treatment Diabetic Retinopathy Study. Ultra-wide-field fluorescein angiograms imaging, on average, demonstrated 3.2 times more total retinal surface area than 7SF. When compared with 7SF, ultra-wide-field fluorescein angiography showed 3.9 times more nonperfusion (P < 0.001), 1.9 times more neovascularization (P = 0.036), and 3.8 times more panretinal photocoagulation (P < 0.001). In 22 eyes (10%), ultra-wide-field fluorescein angiography demonstrated retinal pathology (including nonperfusion and neovascularization) not evident in an 7SF overly. Compared with conventional 7SF imaging, ultra-wide-field fluorescein angiography reveals significantly more retinal vascular pathology in patients with diabetic retinopathy. Improved retinal visualization may alter the classification of diabetic retinopathy and may therefore influence follow-up and treatment of these patients.

Benefit of cone-beam computed tomography angiography in acute management of angiographically undetectable ruptured arteriovenous malformations.

PubMed

Rahal, Jason P; Malek, Adel M

2013-10-01

Ruptured arteriovenous malformations (AVMs) are a frequent cause of intracerebral hemorrhage (ICH). In some cases, compression from the associated hematoma in the acute setting can partially or completely occlude an AVM, making it invisible on conventional angiography techniques. The authors report on the successful use of cone-beam CT angiography (CBCT-A) to precisely identify the underlying angioarchitecture of ruptured AVMs that are not visible on conventional angiography. Three patients presented with ICH for which they underwent examination with CBCT-A in addition to digital subtraction angiography and other imaging modalities, including MR angiography and CT angiography. All patients underwent surgical evacuation due to mass effect from the hematoma. Clinical history, imaging studies, and surgical records were reviewed. Hematoma volumes were calculated. In all 3 cases, CBCT-A demonstrated detailed anatomy of an AVM where no lesion or just a suggestion of a draining vein had been seen with other imaging modalities. Magnetic resonance imaging demonstrated enhancement in 1 patient; CT angiography demonstrated a draining vein in 1 patient; 2D digital subtraction angiography and 3D rotational angiography demonstrated a suggestion of a draining vein in 2 cases and no finding in the third. In the 2 patients in whom CBCT-A was performed prior to surgery, the demonstrated AVM was successfully resected without evidence of a residual lesion. In the third patient, CBCT-A allowed precise targeting of the AVM nidus using Gamma Knife radiosurgery. Cone-beam CT angiography should be considered in the evaluation and subsequent treatment of ICH due to ruptured AVMs. In cases in which the associated hematoma compresses the AVM nidus, CBCT-A can have higher sensitivity and anatomical accuracy than traditional angiographic modalities, including digital subtraction angiography.

Pulmonary Angiography and Embolization for Severe Hemoptysis Due to Cavitary Pulmonary Tuberculosis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sanyika, Charles; Corr, Peter; Royston, Duncan

1999-11-15

Purpose: To identify the role of pulmonary angiography in the diagnosis and treatment of severe hemoptysis due to cavitary pulmonary tuberculosis. Methods: Selective pulmonary angiography was performed on eight patients with severe hemoptysis uncontrolled by previous bronchial and systemic arterial embolization. Results: Three (38%) patients had Rasmussen aneurysms, which were successfully embolized with steel coils. Five patients demonstrated pulmonary arterial hypoperfusion in the diseased lung. Conclusions: We recommend pulmonary angiography in cavitary tuberculous patients with severe hemoptysis who do not respond to systemic arterial embolization. Rasmussen aneurysms are effectively treated by steel coil occlusion.

Prevalence and patterns of alcohol consumption among Royal Thai Army personnel.

PubMed

Viravathana, Nantaporn

2009-02-01

To determine the prevalence and patterns of alcohol consumption among the army personnel. A cross-sectional study was carried out during the annual health examination between 2000 and 2001 in two army units located in the central region of Thailand. A total of 843 active duty army personnel participated in the present study. Data on demographic characteristics, smoking status and alcohol consumption were collected using a self-rating questionnaire. Drinking patterns during the past year were measured in the following aspects: frequency, quantity, binge drinking and beverage preference. Eight hundred and thirty-one (98.6%) studied personnel provided complete information and were included in the analysis. All were males with the mean age of 37.2 +/- 7.7 years. Five hundred and ninety-three (71.4%) study personnel were current drinkers. The majority of 57.5% drank at least five drinks per drinking day. With regard to the frequency of drinking, 10.7% reported that they drank as often as daily or nearly every day. Additionally, 22.7% had five drinks or more per drinking day at least weekly. Up to 28.2% had binge drinking or episodic heavy drinking practices. The most common type of alcoholic beverage for drinkers was mixed spirit and beer (30.7%). Only three (0.4%) personnel reported drinking wine. The results suggest that alcohol abuse becomes a significant problem among the army personnel. Most drinking patterns established among the army personnel are more likely to be harmful and unsafe to their health than beneficial effects. Thus, there is an urgent need to initiate appropriate action to prevent the harm from alcohol use and to protect the military performance and readiness.

10 CFR 73.56 - Personnel access authorization requirements for nuclear power plants.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 2 2012-01-01 2012-01-01 false Personnel access authorization requirements for nuclear power plants. 73.56 Section 73.56 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PHYSICAL PROTECTION... authorization requirements for nuclear power plants. (a) Introduction. (1) By March 31, 2010, each nuclear power...

10 CFR 73.56 - Personnel access authorization requirements for nuclear power plants.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 2 2013-01-01 2013-01-01 false Personnel access authorization requirements for nuclear power plants. 73.56 Section 73.56 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PHYSICAL PROTECTION... authorization requirements for nuclear power plants. (a) Introduction. (1) By March 31, 2010, each nuclear power...

10 CFR 73.56 - Personnel access authorization requirements for nuclear power plants.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Personnel access authorization requirements for nuclear power plants. 73.56 Section 73.56 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PHYSICAL PROTECTION... authorization requirements for nuclear power plants. (a) Introduction. (1) By March 31, 2010, each nuclear power...

10 CFR 73.56 - Personnel access authorization requirements for nuclear power plants.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Personnel access authorization requirements for nuclear power plants. 73.56 Section 73.56 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PHYSICAL PROTECTION... authorization requirements for nuclear power plants. (a) Introduction. (1) By March 31, 2010, each nuclear power...

Optical Coherence Tomography Angiography of Optic Disc Perfusion in Glaucoma

PubMed Central

Jia, Yali; Wei, Eric; Wang, Xiaogang; Zhang, Xinbo; Morrison, John C.; Parikh, Mansi; Lombardi, Lori H.; Gattey, Devin M.; Armour, Rebecca L.; Edmunds, Beth; Kraus, Martin F.; Fujimoto, James G.; Huang, David

2014-01-01

Purpose To compare optic disc perfusion between normal and glaucoma subjects using optical coherence tomography (OCT) angiography and detect optic disc perfusion changes in glaucoma. Design Observational, cross-sectional study. Participants Twenty-four normal subjects and 11 glaucoma patients were included. Methods One eye of each subject was scanned by a high-speed 1050 nm wavelength swept-source OCT instrument. The split-spectrum amplitude-decorrelation angiography algorithm (SSADA) was used to compute three-dimensional optic disc angiography. A disc flow index was computed from four registered scans. Confocal scanning laser ophthalmoscopy (cSLO) was used to measure disc rim area, and stereo photography was used to evaluate cup/disc ratios. Wide field OCT scans over the discs were used to measure retinal nerve fiber layer (NFL) thickness. Main Outcome Measurements Variability was assessed by coefficient of variation (CV). Diagnostic accuracy was assessed by sensitivity and specificity. Comparisons between glaucoma and normal groups were analyzed by Wilcoxon rank-sum test. Correlations between disc flow index, structural assessments, and visual field (VF) parameters were assessed by linear regression. Results In normal discs, a dense microvascular network was visible on OCT angiography. This network was visibly attenuated in glaucoma subjects. The intra-visit repeatability, inter-visit reproducibility, and normal population variability of the optic disc flow index were 1.2%, 4.2%, and 5.0% CV respectively. The disc flow index was reduced by 25% in the glaucoma group (p = 0.003). Sensitivity and specificity were both 100% using an optimized cutoff. The flow index was highly correlated with VF pattern standard deviation (R2 = 0.752, p = 0.001). These correlations were significant even after accounting for age, cup/disc area ratio, NFL, and rim area. Conclusions OCT angiography, generated by the new SSADA algorithm, repeatably measures optic disc perfusion. OCT

Alkali metal protective garment and composite material

DOEpatents

Ballif, III, John L.; Yuan, Wei W.

1980-01-01

A protective garment and composite material providing satisfactory heat resistance and physical protection for articles and personnel exposed to hot molten alkali metals, such as sodium. Physical protection is provided by a continuous layer of nickel foil. Heat resistance is provided by an underlying backing layer of thermal insulation. Overlying outer layers of fireproof woven ceramic fibers are used to protect the foil during storage and handling.

5 CFR 410.405 - Protection of Government interest.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Protection of Government interest. 410... TRAINING Paying for Training Expenses § 410.405 Protection of Government interest. The head of an agency shall establish such procedures as he or she considers necessary to protect the Government's interest...

Navy-Wide Personnel Survey (NPS) 1991: Graphic Presentation of Results for Enlisted Personnel

DTIC Science & Technology

1992-07-01

102 Foreword The Navy-wide Personnel Survey (NPS), which is administered annually, is one part of the Navy Personnel Survey System ( NPSS ) originated by...the Navy Personnel Research and Develop- ment Center. The NPSS is designed to manage and control Navy personnel surveys to minimize intrusion into...fleet and shore operations and to serve as a vehicle for attitude and survey research. The NPSS is composed of NPS, special surveys, and quick-response

Personnel Attrition Rates in Historical Land Combat Operations: Susceptibility and Vulnerability of Major Anatomical Regions

DTIC Science & Technology

1993-08-01

effectiveness , estimate personnel attr;i"on, perform studies and analyses. or assess protective equipment for personnel. i II CAA-RP-93-3 DEPARTMENT OF THE...weapons or weapons effects that are difficult to localize are excluded from the 1-1 CAA-RP-93-3 scope of this paper Some examples of the types of weapons...or weapon effects excluded atr" .;i,nical weapons (encompassing war gases and other toxic substances, flame weapons. and biological agents), nuclear

Dark and white lesions observed in central serous chorioretinopathy on optical coherence tomography angiography.

PubMed

De Bats, Flore; Cornut, Pierre-Loïc; Wolff, Benjamin; Kodjikian, Laurent; Mauget-Faÿsse, Martine

2018-03-01

To describe abnormal dark (hyposignal) and white (hypersignal) lesions observed on optical coherence tomography angiography in central serous chorioretinopathy. Prospective, multicenter, and descriptive study including patients with active or quiescent central serous chorioretinopathy. All patients had undergone a complete ophthalmic examination. Abnormal dark lesions were detected as "dark spots" and "dark areas" on optical coherence tomography angiography. A "dark spot" could correspond to six different abnormalities: pigment epithelium detachment, subretinal deposit, "Lucency" within surrounding subretinal fibrin, choroidal cavitation, choroidal excavation, and choroidal fluid. A "dark area" could be related to a serous retinal detachment or choriocapillary compression. Abnormal white lesions were also detected: A "white spot" could correspond with the leaking point on fluorescein angiography or with hyper-reflective dots; A "white filamentous pattern" at the Brüch's membrane level corresponded to abnormal choroidal neovascular vessels. A semiology is described using optical coherence tomography angiography in central serous chorioretinopathy as abnormal dark and white lesions. Multimodal imaging is mandatory in addition to optical coherence tomography angiography to diagnose non-neovascular retinal and choroidal central serous chorioretinopathy lesions. However, optical coherence tomography angiography alone is helpful in detecting choroidal neovascular membrane in central serous chorioretinopathy.

Mono-Energy Coronary Angiography with a Compact Synchrotron Source

NASA Astrophysics Data System (ADS)

Eggl, Elena; Mechlem, Korbinian; Braig, Eva; Kulpe, Stephanie; Dierolf, Martin; Günther, Benedikt; Achterhold, Klaus; Herzen, Julia; Gleich, Bernhard; Rummeny, Ernst; Noёl, Peter B.; Pfeiffer, Franz; Muenzel, Daniela

2017-02-01

X-ray coronary angiography is an invaluable tool for the diagnosis of coronary artery disease. However, the use of iodine-based contrast media can be contraindicated for patients who present with chronic renal insufficiency or with severe iodine allergy. These patients could benefit from a reduced contrast agent concentration, possibly achieved through application of a mono-energetic x-ray beam. While large-scale synchrotrons are impractical for daily clinical use, the technology of compact synchrotron sources strongly advanced during the last decade. Here we present a quantitative analysis of the benefits a compact synchrotron source can offer in coronary angiography. Simulated projection data from quasi-mono-energetic and conventional x-ray tube spectra is used for a CNR comparison. Results show that compact synchrotron spectra would allow for a significant reduction of contrast media. Experimentally, we demonstrate the feasibility of coronary angiography at the Munich Compact Light Source, the first commercial installation of a compact synchrotron source.

76 FR 8529 - Science and Technology Reinvention Laboratory (STRL) Personnel Management Demonstration Project...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-14

... Group, Scientific and Engineering Career Group, Medical Career Group and Investigative and Protective Services Career Group. The STRL will have hiring flexibilities that neither the Navy Personnel Management... Authority (DSAA) for Scientific and Engineering Positions, and Non-Citizen Hiring flexibilities are only...

Vocabulary for Healthcare Personnel.

ERIC Educational Resources Information Center

Falagrady, Teresa

Developed by educators from the Emily Griffith Opportunity School, this teacher's guide presents a course in health care vocabulary for secretaries, medical records personnel, laboratory assistants, shipping personnel, and patient relations personnel in health care facilities. The course, which should require 10-14 hours of instruction, contains…

Coronary CT Angiography-derived Fractional Flow Reserve: Machine Learning Algorithm versus Computational Fluid Dynamics Modeling.

PubMed

Tesche, Christian; De Cecco, Carlo N; Baumann, Stefan; Renker, Matthias; McLaurin, Tindal W; Duguay, Taylor M; Bayer, Richard R; Steinberg, Daniel H; Grant, Katharine L; Canstein, Christian; Schwemmer, Chris; Schoebinger, Max; Itu, Lucian M; Rapaka, Saikiran; Sharma, Puneet; Schoepf, U Joseph

2018-04-10

Purpose To compare two technical approaches for determination of coronary computed tomography (CT) angiography-derived fractional flow reserve (FFR)-FFR derived from coronary CT angiography based on computational fluid dynamics (hereafter, FFR CFD ) and FFR derived from coronary CT angiography based on machine learning algorithm (hereafter, FFR ML )-against coronary CT angiography and quantitative coronary angiography (QCA). Materials and Methods A total of 85 patients (mean age, 62 years ± 11 [standard deviation]; 62% men) who had undergone coronary CT angiography followed by invasive FFR were included in this single-center retrospective study. FFR values were derived on-site from coronary CT angiography data sets by using both FFR CFD and FFR ML . The performance of both techniques for detecting lesion-specific ischemia was compared against visual stenosis grading at coronary CT angiography, QCA, and invasive FFR as the reference standard. Results On a per-lesion and per-patient level, FFR ML showed a sensitivity of 79% and 90% and a specificity of 94% and 95%, respectively, for detecting lesion-specific ischemia. Meanwhile, FFR CFD resulted in a sensitivity of 79% and 89% and a specificity of 93% and 93%, respectively, on a per-lesion and per-patient basis (P = .86 and P = .92). On a per-lesion level, the area under the receiver operating characteristics curve (AUC) of 0.89 for FFR ML and 0.89 for FFR CFD showed significantly higher discriminatory power for detecting lesion-specific ischemia compared with that of coronary CT angiography (AUC, 0.61) and QCA (AUC, 0.69) (all P < .0001). Also, on a per-patient level, FFR ML (AUC, 0.91) and FFR CFD (AUC, 0.91) performed significantly better than did coronary CT angiography (AUC, 0.65) and QCA (AUC, 0.68) (all P < .0001). Processing time for FFR ML was significantly shorter compared with that of FFR CFD (40.5 minutes ± 6.3 vs 43.4 minutes ± 7.1; P = .042). Conclusion The FFR ML algorithm performs equally in

12 CFR 14.60 - Qualification and licensing requirements for insurance sales personnel.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Qualification and licensing requirements for insurance sales personnel. 14.60 Section 14.60 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY CONSUMER PROTECTION IN SALES OF INSURANCE § 14.60 Qualification and licensing...

12 CFR 343.60 - Qualification and licensing requirements for insurance sales personnel.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Qualification and licensing requirements for insurance sales personnel. 343.60 Section 343.60 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY CONSUMER PROTECTION IN SALES OF INSURANCE § 343.60 Qualification...

Quality Assurance Specifications for Planetary Protection Assays

NASA Astrophysics Data System (ADS)

Baker, Amy

As the European Space Agency planetary protection (PP) activities move forward to support the ExoMars and other planetary missions, it will become necessary to increase staffing of labo-ratories that provide analyses for these programs. Standardization of procedures, a comprehen-sive quality assurance program, and unilateral training of personnel will be necessary to ensure that the planetary protection goals and schedules are met. The PP Quality Assurance/Quality Control (QAQC) program is designed to regulate and monitor procedures performed by labora-tory personnel to ensure that all work meets data quality objectives through the assembly and launch process. Because personnel time is at a premium and sampling schedules are often de-pendent on engineering schedules, it is necessary to have flexible staffing to support all sampling requirements. The most productive approach to having a competent and flexible work force is to establish well defined laboratory procedures and training programs that clearly address the needs of the program and the work force. The quality assurance specification for planetary protection assays has to ensure that labora-tories and associated personnel can demonstrate the competence to perform assays according to the applicable standard AD4. Detailed subjects included in the presentation are as follows: • field and laboratory control criteria • data reporting • personnel training requirements and certification • laboratory audit criteria. Based upon RD2 for primary and secondary validation and RD3 for data quality objectives, the QAQC will provide traceable quality assurance safeguards by providing structured laboratory requirements for guidelines and oversight including training and technical updates, standardized documentation, standardized QA/QC checks, data review and data archiving.

Diagnosis of myocardial ischemia combining multiphase postmortem CT-angiography, histology, and postmortem biochemistry.

PubMed

Vanhaebost, Jessica; Ducrot, Kewin; de Froidmont, Sébastien; Scarpelli, Maria Pia; Egger, Coraline; Baumann, Pia; Schmit, Gregory; Grabherr, Silke; Palmiere, Cristian

2017-02-01

The aim of this study was to assess whether the identification of pathological myocardial enhancement at multiphase postmortem computed tomography angiography was correlated with increased levels of troponin T and I in postmortem serum from femoral blood as well as morphological findings of myocardial ischemia. We further aimed to investigate whether autopsy cases characterized by increased troponin T and I concentrations as well as morphological findings of myocardial ischemia were also characterized by pathological myocardial enhancement at multiphase postmortem computed tomography angiography. Two different approaches were used. In one, 40 forensic autopsy cases that had pathological enhancement of the myocardium (mean Hounsfield units ≥95) observed at postmortem angiography were retrospectively selected. In the second approach, 40 forensic autopsy cases that had a cause of death attributed to acute myocardial ischemia were retrospectively selected. The preliminary results seem to indicate that the identification of a pathological enhancement of the myocardium at postmortem angiography is associated with the presence of increased levels of cardiac troponins in postmortem serum and morphological findings of ischemia. Analogously, a pathological enhancement of the myocardium at postmortem angiography can be retrospectively found in the great majority of autopsy cases characterized by increased cardiac troponin levels in postmortem serum and morphological findings of myocardial ischemia. Multiphase postmortem computed tomography angiography is a useful tool in the postmortem setting for investigating ischemically damaged myocardium.

Self-contained clothing system provides protection against hazardous environments

NASA Technical Reports Server (NTRS)

1966-01-01

Self-contained clothing system protects personnel against hazardous environments. The clothing has an environmental control system and a complete protection envelope consisting of an outer garment, inner garment, underwear, boots, gloves, and helmet.

Ultrahigh-speed non-invasive widefield angiography

NASA Astrophysics Data System (ADS)

Blatter, Cedric; Klein, Thomas; Grajciar, Branislav; Schmoll, Tilman; Wieser, Wolfgang; Andre, Raphael; Huber, Robert; Leitgeb, Rainer A.

2012-07-01

Retinal and choroidal vascular imaging is an important diagnostic benefit for ocular diseases such as age-related macular degeneration. The current gold standard for vessel visualization is fluorescence angiography. We present a potential non-invasive alternative to image blood vessels based on functional Fourier domain optical coherence tomography (OCT). For OCT to compete with the field of view and resolution of angiography while maintaining motion artifacts to a minimum, ultrahigh-speed imaging has to be introduced. We employ Fourier domain mode locking swept source technology that offers high quality imaging at an A-scan rate of up to 1.68 MHz. We present retinal angiogram over ˜48 deg acquired in a few seconds in a single recording without the need of image stitching. OCT at 1060 nm allows for high penetration in the choroid and efficient separate characterization of the retinal and choroidal vascularization.

Influence of spirituality on depression, posttraumatic stress disorder, and suicidality in active duty military personnel.

PubMed

Hourani, Laurel L; Williams, Jason; Forman-Hoffman, Valerie; Lane, Marian E; Weimer, Belinda; Bray, Robert M

2012-01-01

Understanding the role of spirituality as a potential coping mechanism for military personnel is important given growing concern about the mental health issues of personnel returning from war. This study seeks to determine the extent to which spirituality is associated with selected mental health problems among active duty military personnel and whether it moderates the relationship between combat exposure/deployment and (a) depression, (b) posttraumatic stress disorder (PTSD), and (c) suicidality in active duty military personnel. Data were drawn from the 2008 Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel. Over 24,000 randomly selected active duty personnel worldwide completed an anonymous self-report questionnaire. High spirituality had a significant protective effect only for depression symptoms. Medium, as opposed to high or low, levels of spirituality buffered each of the mental health outcomes to some degree. Medium and low spirituality levels predicted depression symptoms but only among those with moderate combat exposure. Medium spirituality levels also predicted PTSD symptoms among those with moderate levels of combat exposure and predicted self-reported suicidal ideation/attempt among those never deployed. These results point to the complex relationship between spirituality and mental health, particularly among military personnel and the need for further research.

Mono-energy coronary angiography with a compact light source

NASA Astrophysics Data System (ADS)

Eggl, Elena; Mechlem, Korbinian; Braig, Eva; Kulpe, Stephanie; Dierolf, Martin; Günther, Benedikt; Achterhold, Klaus; Herzen, Julia; Gleich, Bernhard; Rummeny, Ernst; Noël, Peter B.; Pfeiffer, Franz; Muenzel, Daniela

2017-03-01

While conventional x-ray tube sources reliably provide high-power x-ray beams for everyday clinical practice, the broad spectra that are inherent to these sources compromise the diagnostic image quality. For a monochromatic x-ray source on the other hand, the x-ray energy can be adjusted to optimal conditions with respect to contrast and dose. However, large-scale synchrotron sources impose high spatial and financial demands, making them unsuitable for clinical practice. During the last decades, research has brought up compact synchrotron sources based on inverse Compton scattering, which deliver a highly brilliant, quasi-monochromatic, tunable x-ray beam, yet fitting into a standard laboratory. One application that could benefit from the invention of these sources in clinical practice is coronary angiography. Being an important and frequently applied diagnostic tool, a high number of complications in angiography, such as renal failure, allergic reaction, or hyperthyroidism, are caused by the large amount of iodine-based contrast agent that is required for achieving sufficient image contrast. Here we demonstrate monochromatic angiography of a porcine heart acquired at the MuCLS, the first compact synchrotron source. By means of a simulation, the CNR in a coronary angiography image achieved with the quasi-mono-energetic MuCLS spectrum is analyzed and compared to a conventional x-ray-tube spectrum. The results imply that the improved CNR achieved with a quasi-monochromatic spectrum can allow for a significant reduction of iodine contrast material.

Comparison between optical coherence tomography angiography and fluorescein angiography findings in retinal vasculitis.

PubMed

Abucham-Neto, Julio Zaki; Torricelli, André Augusto Miranda; Lui, Aline Cristina Fioravanti; Guimarães, Sarah Napoli; Nascimento, Heloisa; Regatieri, Caio Vinícius

2018-01-01

To describe optical coherence tomography angiography (OCT-A) findings in patients with retinal vasculitis and to compare them to current fluorescein angiography (FA) findings. This was an observational case series. Nineteen eyes in 10 patients with retinal vasculitis of various etiologies were imaged with FA (TRC-50DX, Topcon) and OCT-A (SD-OCT, Optovue). The images were reviewed and analyzed. The mean age was 36 years (range 24-67 years); there were three males and seven females. The primary vessels involved were veins (89%). Fourteen eyes (74%) had active inflammatory disease during the study period, with signs of vascular sheathing and perivascular leakage on FA. Interestingly, in this group, OCT-A was not able to detect clear signs of active inflammation around the affected vessels. Nevertheless, OCT-A was able to detect secondary lesions in fourteen eyes (74%), including some findings not clearly shown on FA. Most of these were within the macular area. OCT-A was particularly effective in cases of capillary dropout, increased foveal avascular zone, telangiectasias, shunts, and areas of neovascularization. FA remains an essential complementary exam for detection of retinal vasculitis. However, OCT-A extends FA findings and affords better assessment of secondary complications.

Magnetic resonance angiography of the pediatric abdomen and pelvis: techniques and imaging findings.

PubMed

Sada, David M; Vellody, Ranjith; Liu, Peter S

2013-11-01

Although traditional catheter-based angiography has been the gold standard for pediatric abdominal and pelvic vascular imaging for the past several decades, advances in magnetic resonance angiography (MRA) have made it a viable alternative. MRA offers several advantages in that it is noninvasive, can be performed without ionizing radiation, and does not necessarily rely on contrast administration. The ability of modern MRA techniques to define variant vascular anatomy and detect vascular disease may obviate traditional angiography in some patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Angiography reveals novel features of the retinal vasculature in healthy and diabetic mice.

PubMed

McLenachan, Samuel; Magno, Aaron Len; Ramos, David; Catita, Joana; McMenamin, Paul G; Chen, Fred Kuanfu; Rakoczy, Elizabeth Piroska; Ruberte, Jesus

2015-09-01

The mouse retina is a commonly used animal model for the study of pathogenesis and treatment of blinding retinal vascular diseases such as diabetic retinopathy. In this study, we aimed to characterize normal and pathological variations in vascular anatomy in the mouse retina using fluorescein angiography visualized with scanning laser ophthalmoscopy and optical coherence tomography (SLO-OCT). We examined eyes from C57BL/6J wild type mice as well as the Ins2(Akita) and Akimba mouse models of diabetic retinopathy using the Heidelberg Retinal Angiography (HRA) and OCT system. Angiography was performed on three focal planes to examine distinct vascular layers. For comparison with angiographic data, ex vivo analyses, including Indian ink angiography, histology and 3D confocal scanning laser microscopy were performed in parallel. All layers of the mouse retinal vasculature could be readily visualized during fluorescein angiography by SLO-OCT. Blood vessel density was increased in the deep vascular plexus (DVP) compared with the superficial vascular plexus (SVP). Arteriolar and venular typologies were established and structural differences were observed between venular types. Unexpectedly, the hyaloid artery was found to persist in 15% of C57BL/6 mice, forming anastomoses with peripheral retinal capillaries. Fluorescein leakage was easily detected in Akimba retinae by angiography, but was not observed in Ins2(Akita) mice. Blood vessel density was increased in the DVP of 6 month old Ins2(Akita) mice, while the SVP displayed reduced branching in precapillary arterioles. In summary, we present the first comprehensive characterization of the mouse retinal vasculature by SLO-OCT fluorescein angiography. Using this clinical imaging technique, we report previously unrecognized variations in C57BL/6J vascular anatomy and novel features of vascular retinopathy in the Ins2(Akita) mouse model of diabetes. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Real-time colour pictorial radiation monitoring during coronary angiography: effect on patient peak skin and total dose during coronary angiography.

PubMed

Wilson, Sharon M; Prasan, Ananth M; Virdi, Amy; Lassere, Marissa; Ison, Glenn; Ramsay, David R; Weaver, James C

2016-10-10

The aim of this study was to evaluate whether a real-time (RT) colour pictorial radiation dose monitoring system reduces patient skin and total radiation dose during coronary angiography and intervention. Patient demographics, procedural variables and radiation parameters were recorded before and after institution of the RT skin dose recording system. Peak skin dose as well as traditionally available measures of procedural radiation dose were compared. A total of 1,077 consecutive patients underwent coronary angiography, of whom 460 also had PCI. Institution of the RT skin dose recording system resulted in a 22% reduction in peak skin dose after accounting for confounding variables. Radiation dose reduction was most pronounced in those having PCI but was also seen over a range of subgroups including those with prior coronary artery bypass surgery, high BMI, and with radial arterial access. This was associated with a significant reduction in the number of patients placed at risk of skin damage. Similar reductions in parameters reflective of total radiation dose were also demonstrated after institution of RT radiation monitoring. Institution of an RT skin dose recording reduced patient peak skin and total radiation dose during coronary angiography and intervention. Consideration should be given to widespread adoption of this technology.

[Radiation protection in interventional cardiology].

PubMed

Durán, Ariel

2015-01-01

INTERVENTIONAL: cardiology progress makes each year a greater number of procedures and increasing complexity with a very good success rate. The problem is that this progress brings greater dose of radiation not only for the patient but to occupationally exposed workers as well. Simple methods for reducing or minimizing occupational radiation dose include: minimizing fluoroscopy time and the number of acquired images; using available patient dose reduction technologies; using good imaging-chain geometry; collimating; avoiding high-scatter areas; using protective shielding; using imaging equipment whose performance is controlled through a quality assurance programme; and wearing personal dosimeters so that you know your dose. Effective use of these methods requires both appropriate education and training in radiation protection for all interventional cardiology personnel, and the availability and use of appropriate protective tools and equipment. Regular review and investigation of personnel monitoring results, accompanied as appropriate by changes in how procedures are performed and equipment used, will ensure continual improvement in the practice of radiation protection in the interventional suite. Copyright © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

Sac Angiography and Glue Embolization in Emergency Endovascular Aneurysm Repair for Ruptured Abdominal Aortic Aneurysm

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koike, Yuya, E-mail: r06118@hotmail.co.jp; Nishimura, Jun-ichi, E-mail: jun-ichi-n@nifty.com; Hase, Soichiro, E-mail: haseman@hotmail.co.jp

PurposeThe purpose of this study was to demonstrate a sac angiography technique and evaluate the feasibility of N-butyl cyanoacrylate (NBCA) embolization of the ruptured abdominal aortic aneurysm (AAA) sac in emergency endovascular aneurysm repair (EVAR) in hemodynamically unstable patients.MethodsA retrospective case series of three patients in whom sac angiography was performed during emergency EVAR for ruptured AAA was reviewed. After stent graft deployment, angiography within the sac of aneurysm (sac angiography) was performed by manually injecting 10 ml of contrast material through a catheter to identify the presence and site of active bleeding. In two patients, sac angiography revealed active extravasationmore » of the contrast material, and NBCA embolization with a coaxial catheter system was performed to achieve prompt sealing.ResultsSac angiography was successful in all three patients. In the two patients who underwent NBCA embolization for aneurysm sac bleeding, follow-up computed tomography (CT) images demonstrated the accumulation of NBCA consistent with the bleeding site in preprocedural CT images.ConclusionsEVAR is associated with a potential risk of ongoing bleeding from type II or IV endoleaks into the disrupted aneurysm sac in patients with severe coagulopathy. Therefore, sac angiography and NBCA embolization during emergency EVAR may represent a possible technical improvement in the treatment of ruptured AAA in hemodynamically unstable patients.« less

Your Radiologist Explains Magnetic Resonance Angiography (MRA)

MedlinePlus Videos and Cool Tools

... mild sedative prior to the examination. For more information about Magnetic Resonance Angiography of MRA or any ... Inc. (RSNA). To help ensure current and accurate information, we do not permit copying but encourage linking ...

A malaria vaccine for travelers and military personnel: Requirements and top candidates.

PubMed

Teneza-Mora, Nimfa; Lumsden, Joanne; Villasante, Eileen

2015-12-22

Malaria remains an important health threat to non-immune travelers with the explosive growth of global travel. Populations at high risk of acquiring malaria infections include once semi-immune travelers who visit friends and relatives, military forces, business travelers and international tourists with destinations to sub-Saharan Africa, where malaria transmission intensity is high. Most malaria cases have been associated with poor compliance with existing preventive measures, including chemoprophylaxis. High risk groups would benefit immensely from an efficacious vaccine to protect them against malaria infection and together make up a sizable market for such a vaccine. The attributes of an ideal malaria vaccine for non-immune travelers and military personnel include a protective efficacy of 80% or greater, durability for at least 6 months, an acceptable safety profile and compatibility with existing preventive measures. It is very likely that a malaria vaccine designed to effectively prevent infection and clinical disease in the non-immune traveler and military personnel will also protect semi-immune residents of malaria-endemic areas and contribute to malaria elimination by reducing or blocking malaria transmission. The RTS,S vaccine (GlaxoSmithKline) and the PfSPZ Vaccine (Sanaria Inc) are the leading products that would make excellent vaccine candidates for these vulnerable populations. Published by Elsevier Ltd.

49 CFR 193.2717 - Training: fire protection.

Code of Federal Regulations, 2013 CFR

2013-10-01

... under § 193.2801. (b) A written plan of continuing instruction, including plant fire drills, must be... 49 Transportation 3 2013-10-01 2013-10-01 false Training: fire protection. 193.2717 Section 193...: fire protection. (a) All personnel involved in maintenance and operations of an LNG plant, including...

49 CFR 193.2717 - Training: fire protection.

Code of Federal Regulations, 2011 CFR

2011-10-01

... under § 193.2801. (b) A written plan of continuing instruction, including plant fire drills, must be... 49 Transportation 3 2011-10-01 2011-10-01 false Training: fire protection. 193.2717 Section 193...: fire protection. (a) All personnel involved in maintenance and operations of an LNG plant, including...

49 CFR 193.2717 - Training: fire protection.

Code of Federal Regulations, 2012 CFR

2012-10-01

... under § 193.2801. (b) A written plan of continuing instruction, including plant fire drills, must be... 49 Transportation 3 2012-10-01 2012-10-01 false Training: fire protection. 193.2717 Section 193...: fire protection. (a) All personnel involved in maintenance and operations of an LNG plant, including...

49 CFR 193.2717 - Training: fire protection.

Code of Federal Regulations, 2014 CFR

2014-10-01

... under § 193.2801. (b) A written plan of continuing instruction, including plant fire drills, must be... 49 Transportation 3 2014-10-01 2014-10-01 false Training: fire protection. 193.2717 Section 193...: fire protection. (a) All personnel involved in maintenance and operations of an LNG plant, including...

Types of diaphragmatic motion during hepatic angiography.

PubMed

Katsuda, T; Kuroda, C; Fujita, M

1997-01-01

To determine the types and causes of diaphragmatic motion during hepatic angiography, the authors used transarterial cut-film portography (TAP) to study movement of the diaphragm during breath-holding. Thirty-three TAP sequences were studied, and the patients' diaphragmatic motions were classified into four categories according to the distance their diaphragms moved. Results showed that the diaphragm was stationary in 33% of the TAP studies, while perpetual motion occurred in 15% of the studies, early-phase motion occurred in 12% and late-phase motion occurred in 40%. Ten sequences showed diaphragmatic motion of more than 10 mm, with eight sequences showing caudal motion and two showing cranial motion. This article discusses the cause of diaphragmatic motion during breath-holding for hepatic angiography and presents suggestions to reduce motion artifacts during the exam.

[APPLICATION VALUE OF INDOCYANINE GREEN ANGIOGRAPHY IN FLAP RECONSTRUCTIVE SURGERY].

PubMed

Yang, Kai; Mu, Lan; Liu, Yan; Peng, Zhe; Li, Guangxue

2015-09-01

To investigate the utility of indocyanine green angiography in flap reconstructive surgery and possibility of decrease the complications. Indocyanine green angiography was performed on 14 patients undergoing flap reconstructive surgery between February and December 2014 to evaluate the blood perfusion of the flap and to adjust the operation plan. Of 14 cases, 2 were male and 12 were female, aged 23-58 years (mean, 35.5 years); 11 flaps were used for breast reconstruction [including 3 free deep inferior epigastric antery perforator (DIEP) flaps, 4 pedicled transverse rectus abdominis myocutaneous flaps (TRAM), 2 pedicled TRAM and free TRAM, and 2 pedicled latissimus dorsi myocutaneous flaps and prosthesis], 1 pedicled latissimus dorsi myocutaneous flap for repairing chest wall defect, 1 pedicled profunda artery perforator (PAP) flap for upper leg defect, and 1 pedicled descending genicular artery perforator flap for knee defect. The size of the flaps ranged from 9 cm x 6 cm to 26 cm x 12 cm. A total of 32 indocyanine green angiography were performed. There was no adverse reactions to the infusion of indocyanine green. The surgery management was adjusted according to results of indocyanine green angiography findings in 5 of 14 cases. The distal part of flap were discarded because of poor perfusion in 3 cases (1 DIEP flap, 1 TRAM, and 1 PAP flap) and the other 2 cases (pedicled TRAM) needed additional free anastomosis to ensure sufficient blood supply (pedicled TRAM and free TRAM); the other flaps were harvested according to preoperative plan and repaired defect successfully. The mean follow-up was 5 months (range, 1-9 months). The other flaps survived without infection or fat necrosis except 1 PAP flap with distal necrosis. Intraoperative indocyanine green angiography can provide real-time information of flap perfusion and then the operation plan can be adjusted in time to ensure the flap survival.

Doppler Fourier Domain Optical Coherence Tomography for Label-Free Tissue Angiography

NASA Astrophysics Data System (ADS)

Leitgeb, Rainer A.; Szkulmowski, Maciej; Blatter, Cedric; Wojtkowski, Maciej

Information about tissue perfusion and the vascular structure is certainly most important for assessment of tissue state or personal health and the diagnosis of any pathological conditions. It is therefore of key medical interest to have tools available for both quantitative blood flow assessment as well as qualitative vascular imaging. The strength of optical techniques is the unprecedented level of detail even for small capillary structures or microaneurysms and the possibility to combine different techniques for additional tissue spectroscopy giving insight into tissue metabolism. There is an immediate diagnostic and pharmacological demand for high-resolution, label-free, tissue angiography and flow assessment that in addition allow for precise depth gating of flow information. The most promising candidate is Doppler optical coherence tomography (DOCT) being noncontact, label free, and without employing hazardous radiation. DOCT provides fully quantitative volumetric information about blood flow together with the vascular and structural anatomy. Besides flow quantification, analysis of OCT signal fluctuations allows to contrast moving scatterers in tissue such as red blood cells from static tissue. This allows for non-invasive optical angiography and yields high resolution even for smallest capillaries. Because of the huge potential of DOCT and lable-free optical angiography for diagnosis, the last years saw a rapid increase of publications in this field with many different approaches. The present chapter gives an overview over existing Doppler OCT approaches and angiography techniques. It furthermore discusses limitations and noise issues, and gives examples for angiography in the eye and the skin.

Quality of abdominal computed tomography angiography: hand versus mechanical intravenous contrast administration in children.

PubMed

Ayyala, Rama S; Zurakowski, David; Lee, Edward Y

2015-11-01

Abdominal CT angiography has been increasingly used for evaluation of various conditions related to abdominal vasculature in the pediatric population. However, no direct comparison has evaluated the quality of abdominal CT angiography in children using hand versus mechanical administration of intravenous (IV) contrast agent. To compare hand versus mechanical administration of IV contrast agent in the quality of abdominal CT angiography in the pediatric population. We retrospectively reviewed the electronic medical record to identify pediatric patients (≤18 years) who had abdominal CT angiography between August 2012 and August 2013. The information obtained includes: (1) type of administration of IV contrast agent (hand [group 1] versus mechanical [group 2]), (2) size (gauge) of IV catheter, (3) amount of contrast agent administered and (4) rate of contrast agent administration (ml/s). Two reviewers independently performed qualitative and quantitative evaluation of abdominal CT angiography image quality. Qualitative evaluation of abdominal CT angiography image quality was performed by visual assessment of the degree of contrast enhancement in the region of interest (ROI) based on a 4-point scale. Quantitative evaluation of each CT angiography examination was performed by measuring the Hounsfield unit (HU) using an ROI within the abdominal aorta at two levels (celiac axis and the inferior mesenteric artery) for each child. Analysis of variance (ANOVA) using the F-test was applied to compare contrast enhancement within the abdominal aorta at two levels (celiac axis and inferior mesenteric artery) between hand administration and mechanical administration of IV contrast methods with adjustment for age. We identified 46 pediatric patients (24 male, 22 female; mean age 7.3 ± 5.5 years; range 5 weeks to 18 years) with abdominal CT angiography performed during the study period. Of these patients, 16 (35%; 1.7 ± 2.2 years; range 5 weeks to 5 years) had hand

Feasibility and clinical utility of ultra-widefield indocyanine green angiography.

PubMed

Klufas, Michael A; Yannuzzi, Nicolas A; Pang, Claudine E; Srinivas, Sowmya; Sadda, Srinivas R; Freund, K Bailey; Kiss, Szilárd

2015-03-01

To evaluate the feasibility and clinical utility of a novel noncontact scanning laser ophthalmoscope-based ultra-widefield indocyanine green angiographic system. Ultra-widefield indocyanine green angiographic images were captured using a modified Optos P200Tx that produced high-resolution images of the choroidal vasculature with up to a 200° field. Ultra-widefield indocyanine green angiography was performed on patients with a variety of retinal conditions to assess utility of this imaging technique for diagnostic purposes and disease treatment monitoring. Ultra-widefield indocyanine green angiography was performed on 138 eyes of 69 patients. Mean age was 58 ± 16.9 years (range, 24-85 years). The most common ocular pathologies imaged included central serous chorioretinopathy (24 eyes), uveitis (various subtypes, 16 eyes), age-related macular degeneration (12 eyes), and polypoidal choroidal vasculopathy (4 eyes). In all eyes evaluated with ultra-widefield indocyanine green angiography, high-resolution images of choroidal and retinal circulation were obtained with sufficient detail out to 200° of the fundus. In this series of 138 eyes, scanning laser ophthalmoscope-based ultra-widefield indocyanine green angiography was clinically practical and provided detailed images of both the central and peripheral choroidal circulation. Future studies are needed to refine the clinical value of this imaging modality and the significance of peripheral choroidal vascular changes in the diagnosis, monitoring, and treatment of ocular diseases.

[3-D angiography in diagnosis and treatment of intracranial aneurysm].

PubMed

Wang, D; Ling, F; Liu, S

2001-09-01

To summarize the results of initial application of three-dimensional angiography (3D-Angio) in diagnosis and treatment of intracranial aneurysms. From August 1999 to January 2001, standard digital subtraction angiography (two-dimensional angiography, 2D-Angio) and 3D-Angio(obtained by reconstruction of rotational angiography) were performed in 65 patients with confirmed or suspected aneurysms. Sixty-six aneurysms were found in 60 patients and nothing was found in 5. Of 66 the aneurysms (60 cases), 46 (43 cases) were treated by intrasaccule embolizotion with coils, 3 (3 cases) by occluding the parent artery with detachable balloon, 10 (10 cases) by surgery, and 1 (1 case) by combination of extracranial-intracranial bypass and balloon occlusion of parent artery. Six (3 cases) were not treated. Two aneurysms that could not be detected by 2D-Angio were diagnosed by 3D-Angio. Three aneurysms that were difficult or dangerous to embolize by 2D-Angio were embolized successfully with the help of 3D-Angio. Three aneurysms seemed to be embolized on 2D-Angio were proved impossible to be embolized on 3D-Angio. Of the 46 aneurysms embolized intrasaccularly, 38(82.6%) were completely embolized on 2D-Angio. In the 38, 8 had residual aneurysm on 3D-Angio. More accurate diagnosis and secure treatment of intracranial aneurysm can be reached by 3D-Angio.

Implication of health care personnel in measles transmission

PubMed Central

Torner, Núria; Solano, Ruben; Rius, Cristina; Domínguez, Angela; Surveillance Network of Catalonia, Spain, the Measles Elimination Program

2014-01-01

Healthcare personnel (HCP) play an important role in transmission of highly contagious diseases such as measles. Current immunization guidelines in Catalonia include Measles-Mumps-Rubella (MMR) immunization for HCP born after 1967 without evidence of immunity. Despite high vaccination coverage (90%) a high burden of measles cases related to outbreaks have occurred. The aim of this study was to assess the implication of HCP in measles transmission related to healthcare setting. A review of surveillance case data from 2001 to 2013 gathered through the Measles Elimination Program in Catalonia was performed. Twenty six outbreaks involving 797 cases were reported, 52 (6.5%) were HCP aged 21–41 years, 72,5% (38) patient were care personnel (doctors and nurses) and 22,5% (14) other health care related personnel. Forty six 87%) were unvaccinated, 4(10%) had only one dose and 2 had two doses of MMR. In community outbreaks 30 clusters with HCP involved were observed, yet none were identified as index cases. Non-vaccinated HCPs against measles were all under 45 years of age. Vaccination is the only reliable protection against nosocomial spread of measles from HCPs. Assessing vaccination status of HCPs and implementing a 2 dose vaccination in those lacking evidence of immunity is needed in order to set to zero the risk of acquiring and spreading measles in healthcare (HC) settings. PMID:25483548

[Evaluation of diabetic microangiopathy using optical coherence tomography angiography].

PubMed

Czakó, Cecília; Sándor, Gábor László; Ecsedy, Mónika; Szepessy, Zsuzsanna; Borbándy, Ágnes; Resch, Miklós; Papp, András; Récsán, Zsuzsa; Horváth, Hajnalka; Nagy, Zoltán Zsolt; Kovács, Illés

2018-02-01

Optical coherence tomography angiography is a non-invasive imaging technique that is able to visualize the different retinal vascular layers using motion contrast to detect blood flow without intravenous dye injection. This method might help to assess microangiopathy in diabetic retinopathy during screening and follow-up. To quantify retinal microvasculature alterations in both eyes of diabetic patients in relation to systemic risk factors using optical coherence tomography angiography. Both eyes of 36 diabetic patients and 45 individuals without diabetes were examined. Duration of diabetes, insulin therapy, blood pressure, HbA 1c , dyslipidemia, axial length and the presence of diabetic retinopathy were recorded. Retinal vessel density was measured by optical coherence tomography angiography. The effect of risk factors on vessel density and between-eye asymmetry was assessed using multivariable regression analysis. Vessel density was significantly lower and between-eye difference was significantly higher in diabetic patients compared to controls (p<0.05). Both vessel density and between-eye asymmetry significantly correlated with diabetes duration (p<0.05) after controlling for the effect of risk factors. The between-eye asymmetry in vessel density was significantly higher in patients without clinically detectable diabetic retinopathy compared to control subjects (p<0.001). There is a decrease in retinal vessel density and an increase in between-eye asymmetry in patients with diabetes compared to healthy subjects. By using optical coherence tomography angiography, the detection of these microvascular alterations is possible before clinically detectable diabetic retinopathy and might serve as a useful tool in both screening and timing of treatment. Orv Hetil. 2018; 159(8): 320-326.

Federal Personnel Research Programs and Demonstration Projects: Catalysts for Change

DTIC Science & Technology

1992-12-01

47 of title 5 involves the temporary some checks and balances to safeguard affected waiver of Federal personnel law or regulation, employees’ rights...continue a recent report on balancing work respon- successful change at the end of a demon- sibilities and family needs identified stration project...Protection Board, " Balancing Work Responsibilities and Family Needs: The Federal Civil Service Response," Washington, DC, November 1991, pp. 59-62. 25

Optical Coherence Tomography Angiography Features of Iris Racemose Hemangioma in 4 Cases.

PubMed

Chien, Jason L; Sioufi, Kareem; Ferenczy, Sandor; Say, Emil Anthony T; Shields, Carol L

2017-10-01

Optical coherence tomography angiography (OCTA) allows visualization of iris racemose hemangioma course and its relation to the normal iris microvasculature. To describe OCTA features of iris racemose hemangioma. Descriptive, noncomparative case series at a tertiary referral center (Ocular Oncology Service of Wills Eye Hospital). Patients diagnosed with unilateral iris racemose hemangioma were included in the study. Features of iris racemose hemangioma on OCTA. Four eyes of 4 patients with unilateral iris racemose hemangioma were included in the study. Mean patient age was 50 years, all patients were white, and Snellen visual acuity was 20/20 in each case. All eyes had sectoral iris racemose hemangioma without associated iris or ciliary body solid tumor on clinical examination and ultrasound biomicroscopy. By anterior segment OCT, the racemose hemangioma was partially visualized in all cases. By OCTA, the hemangioma was clearly visualized as a uniform large-caliber vascular tortuous loop with intense flow characteristics superimposed over small-caliber radial iris vessels against a background of low-signal iris stroma. The vascular course on OCTA resembled a light bulb filament (filament sign), arising from the peripheral iris (base of light bulb) and forming a tortuous loop on reaching its peak (midfilament) near the pupil (n = 3) or midzonal iris (n = 1), before returning to the peripheral iris (base of light bulb). Intravenous fluorescein angiography performed in 1 eye depicted the iris hemangioma; however, small-caliber radial iris vessels were more distinct on OCTA than intravenous fluorescein angiography. Optical coherence tomography angiography is a noninvasive vascular imaging modality that clearly depicts the looping course of iris racemose hemangioma. Optical coherence tomography angiography depicted fine details of radial iris vessels, not distinct on intravenous fluorescein angiography.

Socioeconomic characteristics of patients undergoing ambulatory diagnostic cerebral angiography in four US States.

PubMed

Bekelis, K; Missios, S; Eskey, C; Labropoulos, N

2014-02-01

Several groups have demonstrated the safety of ambulatory cerebral angiography, with no patients experiencing complications related to early discharge. Although this practice appears to be safe, the socioeconomic characteristics factoring in the selection of the patients have not been investigated. We performed a retrospective cohort study involving 45,226 patients undergoing outpatient and 159,046 undergoing inpatient cerebral angiography, who were registered in the State Ambulatory Surgery Databases (SASD) and State Inpatient Databases (SID) respectively for 4 US States (New York, California, Florida, North Carolina). In a multivariate analysis of diagnostic cerebral angiography, Caucasian race (OR 1.36, 95% CI, 1.31, 1.42) and male gender (OR 1.36, 95% CI, 1.31, 1.41), were significantly associated with outpatient procedures. Higher Charlson Comorbidity Index (CCI) (OR 0.60, 95% CI, 0.54, 0.67), high income (OR 0.70, 95% CI, 0.67, 0.73), high volume hospitals (OR 0.69, 95% CI, 0.66, 0.73), and coverage by Medicare/Medicaid (OR 0.96, 95% CI, 0.92, 0.99) were associated with a decreased chance of outpatient procedures. Institutional charges were significantly less for outpatient cerebral angiography. The median charge for inpatient diagnostic cerebral angiography was $26,968 as compared to $16,151 in the outpatient setting (P < 0.0001, Student's t-test). Access to ambulatory diagnostic cerebral angiography appears to be more common for patients with private insurance and less comorbidities, in the setting of lower volume hospitals. Further investigation is needed in the direction of mapping these disparities in resource utilization.

Spontaneous rectus sheath hematoma: The utility of CT angiography.

PubMed

Pierro, Antonio; Cilla, Savino; Modugno, Pietro; Centritto, Enrico Maria; De Filippo, Carlo Maria; Sallustio, Giuseppina

2018-04-01

We described the utility of computed tomography (CT) angiography in detection of bleeding vessels for a rapid percutaneous arterial embolization of the spontaneous rectus sheath hematoma. A 70-year-old woman comes to our attention with acute abdominal pain and a low hemoglobin level. An unenhanced CT was performed demonstrating a large rectus sheath hematoma. A conservative management was initially established. Despite this therapy, the abdominal pain increased together with a further decrease of hemoglobin values. A CT angiography was then performed, demonstrating an active bleeding within the hematoma and addressing the patient to a rapid percutaneous arterial embolization.

Comparison of fluoro and cine coronary angiography: balancing acceptable outcomes with a reduction in radiation dose.

PubMed

Olcay, Ayhan; Guler, Ekrem; Karaca, Ibrahim Oguz; Omaygenc, Mehmet Onur; Kizilirmak, Filiz; Olgun, Erkam; Yenipinar, Esra; Cakmak, Huseyin Altug; Duman, Dursun

2015-04-01

Use of last fluoro hold (LFH) mode in fluoroscopy, which enables the last live image to be saved and displayed, could reduce radiation during percutaneous coronary intervention when compared with cine mode. No previous study compared coronary angiography radiation doses and image quality between LFH and conventional cine mode techniques. We compared cumulative dose-area product (DAP), cumulative air kerma, fluoroscopy time, contrast use, interobserver variability of visual assessment between LFH angiography, and conventional cine angiography techniques. Forty-six patients were prospectively enrolled into the LFH group and 82 patients into the cine angiography group according to operator decision. Mean cumulative DAP was higher in the cine group vs the LFH group (50058.98 ± 53542.71 mGy•cm² vs 11349.2 ± 8796.46 mGy•cm²; P<.001). Mean fluoroscopy times were higher in the cine group vs the LFH group (3.87 ± 5.08 minutes vs 1.66 ± 1.51 minutes; P<.01). Mean contrast use was higher in the cine group vs the LFH group (112.07 ± 43.79 cc vs 88.15 ± 23.84 cc; P<.001). Mean value of Crombach's alpha was not statistically different between visual estimates of three operators between cine and LFH angiography groups (0.66680 ± 0.19309 vs 0.54193 ± 0.31046; P=.20). Radiation doses, contrast use, and fluoroscopy times are lower in fluoroscopic LFH angiography vs cine angiography. Interclass variability of visual stenosis estimation between three operators was not different between cine and LFH groups. Fluoroscopic LFH images conventionally have inferior diagnostic quality when compared with cine coronary angiography, but with new angiographic systems with improved LFH image quality, these images may be adequate for diagnostic coronary angiography.

Optical Coherence Tomography Angiography in Retinal Diseases.

PubMed

Chalam, K V; Sambhav, Kumar

2016-01-01

Optical coherence tomography angiography (OCTA) is a new, non-invasive imaging system that generates volumetric data of retinal and choroidal layers. It has the ability to show both structural and blood flow information. Split-spectrum amplitude-decorrelation angiography (SSADA) algorithm (a vital component of OCTA software) helps to decrease the signal to noise ratio of flow detection thus enhancing visualization of retinal vasculature using motion contrast. Published studies describe potential efficacy for OCTA in the evaluation of common ophthalmologic diseases such as diabetic retinopathy, age related macular degeneration (AMD), retinal vascular occlusions and sickle cell disease. OCTA provides a detailed view of the retinal vasculature, which allows accurate delineation of microvascular abnormalities in diabetic eyes and vascular occlusions. It helps quantify vascular compromise depending upon the severity of diabetic retinopathy. OCTA can also elucidate the presence of choroidal neovascularization (CNV) in wet AMD. In this paper, we review the knowledge, available in English language publications regarding OCTA, and compare it with the conventional angiographic standard, fluorescein angiography (FA). Finally, we summarize its potential applications to retinal vascular diseases. Its current limitations include a relatively small field of view, inability to show leakage, and tendency for image artifacts. Further larger studies will define OCTA's utility in clinical settings and establish if the technology may offer a non-invasive option of visualizing the retinal vasculature, enabling us to decrease morbidity through early detection and intervention in retinal diseases.

Optical Coherence Tomography Angiography in Retinal Diseases

PubMed Central

Chalam, K. V.; Sambhav, Kumar

2016-01-01

Optical coherence tomography angiography (OCTA) is a new, non-invasive imaging system that generates volumetric data of retinal and choroidal layers. It has the ability to show both structural and blood flow information. Split-spectrum amplitude-decorrelation angiography (SSADA) algorithm (a vital component of OCTA software) helps to decrease the signal to noise ratio of flow detection thus enhancing visualization of retinal vasculature using motion contrast. Published studies describe potential efficacy for OCTA in the evaluation of common ophthalmologic diseases such as diabetic retinopathy, age related macular degeneration (AMD), retinal vascular occlusions and sickle cell disease. OCTA provides a detailed view of the retinal vasculature, which allows accurate delineation of microvascular abnormalities in diabetic eyes and vascular occlusions. It helps quantify vascular compromise depending upon the severity of diabetic retinopathy. OCTA can also elucidate the presence of choroidal neovascularization (CNV) in wet AMD. In this paper, we review the knowledge, available in English language publications regarding OCTA, and compare it with the conventional angiographic standard, fluorescein angiography (FA). Finally, we summarize its potential applications to retinal vascular diseases. Its current limitations include a relatively small field of view, inability to show leakage, and tendency for image artifacts. Further larger studies will define OCTA's utility in clinical settings and establish if the technology may offer a non-invasive option of visualizing the retinal vasculature, enabling us to decrease morbidity through early detection and intervention in retinal diseases. PMID:27195091

OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY SHOWS INNER CHOROIDAL ISCHEMIA IN ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY.

PubMed

Dolz-Marco, Rosa; Sarraf, David; Giovinazzo, Vincent; Freund, K Bailey

2017-01-01

To describe multimodal imaging findings of an evolving case of acute posterior multifocal placoid pigment epitheliopathy occurring in a young healthy male. Case report of a patient with acute posterior multifocal placoid pigment epitheliopathy including comprehensive systemic and ocular examinations. Ultra-widefield autofluorescence, fluorescein angiography, indocyanine green angiography, and serial optical coherence tomography angiography were performed. A 34-year-old male presented with acute vision loss in his left eye for 2 weeks. His best-corrected visual acuity was 20/20 in his right eye and 20/200 in his left eye. Dilated funduscopic examination revealed multiple creamy white deep retinal lesions showing macular involvement of the left eye with a diffuse area of pigmentary changes. The presence of multiple areas of hypoperfusion of the inner choroid were demonstrated with fluorescein and indocyanine green angiography. Serial optical coherence tomography angiography showed multiple evolving areas of decreased flow at the level of the inner choroid. Although the pathogenesis of acute posterior multifocal placoid pigment epitheliopathy remains unknown, there is growing evidence of a primary choroidal involvement with secondary damage to the overlying retinal pigment epithelium and the outer retinal layers. Optical coherence tomography angiography may provide valuable information for the diagnosis and follow-up of this condition avoiding invasive angiographic procedures.

DETECTION OF NONEXUDATIVE CHOROIDAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION WITH OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY.

PubMed

Palejwala, Neal V; Jia, Yali; Gao, Simon S; Liu, Liang; Flaxel, Christina J; Hwang, Thomas S; Lauer, Andreas K; Wilson, David J; Huang, David; Bailey, Steven T

2015-11-01

To evaluate eyes with age-related macular degeneration and high-risk characteristics for choroidal neovascularization (CNV) with optical coherence tomographic (OCT) angiography to determine whether earlier detection of CNV is possible. Eyes with drusen, pigmentary changes, and with CNV in the fellow eye were scanned with a 70-kHz spectral domain OCT system (Optovue RTVue-XR Avanti). The split-spectrum amplitude-decorrelation angiography (SSADA) algorithm was used to distinguish blood flow from static tissue. Two masked graders reviewed scans for CNV, defined as flow in the outer retinal/sub-RPE slab. Choroidal neovascularization flow area repeatability and between-grader reproducibility were calculated. Of 32 eyes, 2 (6%) were found to have Type 1 CNV with OCT angiography. The lesions were not associated with leakage on fluorescein angiography or fluid on OCT. One case was followed for 8 months without treatment, and the CNV flow area enlarged slightly without fluid buildup on OCT or vision loss. Between-grader reproducibility of the CNV flow area was 9.4% (coefficient of variation) and within-visit repeatability was 5.2% (pooled coefficient of variation). Optical coherence tomographic angiography can detect the presence of nonexudative CNV, lesions difficult to identify with fluorescein angiography and OCT. Further study is needed to understand the significance and natural history of these lesions.

Magnetic resonance angiography of fetal vasculature at 3.0 T.

PubMed

Neelavalli, Jaladhar; Krishnamurthy, Uday; Jella, Pavan K; Mody, Swati S; Yadav, Brijesh K; Hendershot, Kelly; Hernandez-Andrade, Edgar; Yeo, Lami; Cabrera, Maria D; Haacke, Ewart M; Hassan, Sonia S; Romero, Roberto

2016-12-01

Magnetic resonance angiography has not been used much previously for visualizing fetal vessels in utero for reasons that include a contraindication for the use of exogenous contrast agents, maternal respiratory motion and fetal motion. In this work, we report the feasibility of using an appropriately modified clinical time-of-flight magnetic resonance imaging sequence for non-contrast angiography of human fetal and placental vessels at 3.0 T. Using this 2D angiography technique, it is possible to visualize fetal vascular networks in late pregnancy. • 3D-visualization of fetal vasculature is feasible using non-contrast MRA at 3.0 T. • Visualization of placental vasculature is also possible with this method. • Fetal MRA can serve as a vascular localizer for quantitative MRI studies. • This method can be extended to 1.5 T.

Models of Personnel Needs Assessment.

ERIC Educational Resources Information Center

Mattson, Beverly

This report presents samples of models and strategies for determining professional development needs of special education personnel. The following areas are covered: definitions of needs and the needs assessment process; personnel needs assessment regulations under the Comprehensive System of Personnel Development, the Individuals with…

Indocyanine green angiography in patients with human T cell-lymphotropic virus type 1 uveitis.

PubMed

Sakurai, Toshiya; Yukawa, Eiichi; Hara, Yoshiaki; Miyata, Norio; Mochizuki, Manabu

2002-02-01

To determine the indocyanine green (ICG) angiographic features and to evaluate the choroidal involvement of human T-cell lymphotropic virus type 1 (HTLV-1)-associated uveitis. We performed ICG angiography using scanning laser ophthalmoscopy in 54 eyes of 27 patients (8 men and 19 women) diagnosed with HTLV-1 uveitis. The patient's mean age was 51.5 years with a range of 24-65 years. The early phase of ICG angiography revealed ICG leakage from the choroidal vessels in the posterior pole, hyperfluorescent spots that which were not detected with fluorescein angiography, and small hypofluorescent lesions in the macula which most likely corresponded to microcirculatory disturbances in the choriocapillaris. We suggest that the ICG angiographic findings reflect choroidal lesions such as infiltration with leukocytes and edema. ICG angiography may provide useful information on choroidopathy in HTLV-1 uveitis.

Optical Coherence Tomography Angiography

PubMed Central

Gao, Simon S.; Jia, Yali; Zhang, Miao; Su, Johnny P.; Liu, Gangjun; Hwang, Thomas S.; Bailey, Steven T.; Huang, David

2016-01-01

Optical coherence tomography angiography (OCTA) is a noninvasive approach that can visualize blood vessels down to the capillary level. With the advent of high-speed OCT and efficient algorithms, practical OCTA of ocular circulation is now available to ophthalmologists. Clinical investigations that used OCTA have increased exponentially in the past few years. This review will cover the history of OCTA and survey its most important clinical applications. The salient problems in the interpretation and analysis of OCTA are described, and recent advances are highlighted. PMID:27409483

LIMITED-USE CHEMICAL PROTECTIVE CLOTHING FOR EPA SUPERFUND ACTIVITIES

EPA Science Inventory

Because contractor field personnel complained about the poor durability and fit of limited-use chemical protective clothing (CPC) most commonly used at hazardous waste site operations, the U.S. Environmental Protection Agency (EPA) initiated a study to characterize use of CPC; de...

LIMITED-USE CHEMICAL PROTECTIVE CLOTHING FOR EPA SUPERFUND ACTIVITIES

EPA Science Inventory

Because contractor field personnel complained about the poor durability and fit of limited-use chemical protective clothing (CPC) most commonly used at hazardous waste site operations, the U.S. Environmental Protection Agency (EPA) initiated a study to • characterize use of CPC...

33 CFR 142.27 - Eye and face protection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Eye and face protection. 142.27... Eye and face protection. (a) Personnel engaged in or observing welding, grinding, machining, chipping, handling hazardous materials, or acetylene burning or cutting shall wear the eye and face protector...

33 CFR 142.27 - Eye and face protection.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Eye and face protection. 142.27... Eye and face protection. (a) Personnel engaged in or observing welding, grinding, machining, chipping, handling hazardous materials, or acetylene burning or cutting shall wear the eye and face protector...

33 CFR 142.27 - Eye and face protection.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Eye and face protection. 142.27... Eye and face protection. (a) Personnel engaged in or observing welding, grinding, machining, chipping, handling hazardous materials, or acetylene burning or cutting shall wear the eye and face protector...

33 CFR 142.27 - Eye and face protection.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Eye and face protection. 142.27... Eye and face protection. (a) Personnel engaged in or observing welding, grinding, machining, chipping, handling hazardous materials, or acetylene burning or cutting shall wear the eye and face protector...

33 CFR 142.27 - Eye and face protection.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Eye and face protection. 142.27... Eye and face protection. (a) Personnel engaged in or observing welding, grinding, machining, chipping, handling hazardous materials, or acetylene burning or cutting shall wear the eye and face protector...

Acceptable Practices in Maintaining Personnel Files.

ERIC Educational Resources Information Center

American Association of School Personnel Administrators, Seven Hills, OH.

Determining acceptable practices in maintaining personnel files is a pertinent issue for school personnel administrators today. Recognizing this, the Georgia Association of School Personnel Administrators accepted the study of this topic as a committee assignment from the American Association of School Personnel Administrators. A survey instrument…

Making the optimal decision in selecting protective clothing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Price, J. Mark

2007-07-01

Protective Clothing plays a major role in the decommissioning and operation of nuclear facilities. Literally thousands of employee dress-outs occur over the life of a decommissioning project and during outages at operational plants. In order to make the optimal decision on which type of protective clothing is best suited for the decommissioning or maintenance and repair work on radioactive systems, a number of interrelating factors must be considered, including - Protection; - Personnel Contamination; - Cost; - Radwaste; - Comfort; - Convenience; - Logistics/Rad Material Considerations; - Reject Rate of Laundered Clothing; - Durability; - Security; - Personnel Safety includingmore » Heat Stress; - Disposition of Gloves and Booties. In addition, over the last several years there has been a trend of nuclear power plants either running trials or switching to Single Use Protective Clothing (SUPC) from traditional protective clothing. In some cases, after trial usage of SUPC, plants have chosen not to switch. In other cases after switching to SUPC for a period of time, some plants have chosen to switch back to laundering. Based on these observations, this paper reviews the 'real' drivers, issues, and interrelating factors regarding the selection and use of protective clothing throughout the nuclear industry. (authors)« less

46 CFR 310.5 - Personnel.

Code of Federal Regulations, 2010 CFR

2010-10-01

... for State, Territorial or Regional Maritime Academies and Colleges § 310.5 Personnel. (a) Selection... same criteria used in the employment of such personnel in State-supported colleges and universities... watch aboard at all times. (c) Insignia for officers and other School personnel. The State may furnish...

Safety, efficacy, and cost of intraoperative indocyanine green angiography compared to intraoperative catheter angiography in cerebral aneurysm surgery.

PubMed

Hardesty, Douglas A; Thind, Harjot; Zabramski, Joseph M; Spetzler, Robert F; Nakaji, Peter

2014-08-01

Intraoperative angiography in cerebrovascular neurosurgery can drive the repositioning or addition of aneurysm clips. Our institution has switched from a strategy of intraoperative digital subtraction angiography (DSA) universally, to a strategy of indocyanine green (ICG) videoangiography with DSA on an as-needed basis. We retrospectively evaluated whether the rates of perioperative stroke, unexpected postoperative aneurysm residual, or parent vessel stenosis differed in 100 patients from each era (2002, "DSA era"; 2007, "ICG era"). The clip repositioning rate for neck residual or parent vessel stenosis did not differ significantly between the two eras. There were no differences in the rate of perioperative stroke or rate of false-negative studies. The per-patient cost of intraoperative imaging within the DSA era was significantly higher than in the ICG era. The replacement of routine intraoperative DSA with ICG videoangiography and selective intraoperative DSA in cerebrovascular aneurysm surgery is safe and effective. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

5 CFR 352.707 - Employee appeals to the Merit Systems Protection Board.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Protection Board. 352.707 Section 352.707 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS REEMPLOYMENT RIGHTS Reemployment Rights of Former Bureau of Indian Affairs and Indian Health Service Employees After Service Under the Indian Self-Determination Act in Tribal Organizations...

5 CFR 352.707 - Employee appeals to the Merit Systems Protection Board.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Protection Board. 352.707 Section 352.707 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS REEMPLOYMENT RIGHTS Reemployment Rights of Former Bureau of Indian Affairs and Indian Health Service Employees After Service Under the Indian Self-Determination Act in Tribal Organizations...

5 CFR 352.707 - Employee appeals to the Merit Systems Protection Board.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Protection Board. 352.707 Section 352.707 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS REEMPLOYMENT RIGHTS Reemployment Rights of Former Bureau of Indian Affairs and Indian Health Service Employees After Service Under the Indian Self-Determination Act in Tribal Organizations...

5 CFR 352.707 - Employee appeals to the Merit Systems Protection Board.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Protection Board. 352.707 Section 352.707 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS REEMPLOYMENT RIGHTS Reemployment Rights of Former Bureau of Indian Affairs and Indian Health Service Employees After Service Under the Indian Self-Determination Act in Tribal Organizations...

5 CFR 352.707 - Employee appeals to the Merit Systems Protection Board.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Protection Board. 352.707 Section 352.707 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS REEMPLOYMENT RIGHTS Reemployment Rights of Former Bureau of Indian Affairs and Indian Health Service Employees After Service Under the Indian Self-Determination Act in Tribal Organizations...

Training Personnel for Special Needs

ERIC Educational Resources Information Center

Tomlinson, Robert M.; Fabac, John N.

1978-01-01

Attempting to develop a framework for personnel development programs which train personnel to work with individuals who have special needs, this article discusses the inadequacies of traditional grouping patterns in education, then identifies those special skills needed by school personnel in addition to the skills taught in traditional teacher…

Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding.

PubMed

Haber, Zachary M; Charles, Hearns W; Erinjeri, Joseph P; Deipolyi, Amy R

2017-04-18

Conventional angiography is used to evaluate and treat possible sources of intraabdominal bleeding, though it may cause complications such as contrast-induced nephropathy (CIN). The study's purpose was to identify factors predicting active extravasation and complications during angiography for acute intraabdominal bleeding. All conventional angiograms for acute bleeding (January 2013-June 2015) were reviewed retrospectively, including 75 angiograms for intraabdominal bleeding in 70 patients. Demographics, comorbidities, vital signs, complications within one month, and change in hematocrit (ΔHct) and fluids and blood products administered over the 24 h prior to angiography were recorded. Of 75 exams, 20 (27%) demonstrated extravasation. ΔHct was the only independent predictor of extravasation ( p = 0.017), with larger ΔHct (-17%) in patients with versus those without extravasation (-1%) ( p = 0.01). CIN was the most common complication, occurring in 10 of 66 angiograms (15%). Glomerular filtration rate (GFR) was the only independent predictor ( p = 0.03); 67% of patients with GFR < 30, 29% of patients with GFR 30-60, and 8% of patients with GFR > 60 developed CIN. For patients with intraabdominal bleeding, greater ΔHct decrease over 24 h before angiography predicts active extravasation. Pre-existing renal impairment predicts CIN. Patients with large hematocrit declines should be triaged for rapid angiography, though benefits can be weighed with the risk of renal impairment.

Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding

PubMed Central

Haber, Zachary M.; Charles, Hearns W.; Erinjeri, Joseph P.; Deipolyi, Amy R.

2017-01-01

Conventional angiography is used to evaluate and treat possible sources of intraabdominal bleeding, though it may cause complications such as contrast-induced nephropathy (CIN). The study’s purpose was to identify factors predicting active extravasation and complications during angiography for acute intraabdominal bleeding. All conventional angiograms for acute bleeding (January 2013–June 2015) were reviewed retrospectively, including 75 angiograms for intraabdominal bleeding in 70 patients. Demographics, comorbidities, vital signs, complications within one month, and change in hematocrit (ΔHct) and fluids and blood products administered over the 24 h prior to angiography were recorded. Of 75 exams, 20 (27%) demonstrated extravasation. ΔHct was the only independent predictor of extravasation (p = 0.017), with larger ΔHct (−17%) in patients with versus those without extravasation (–1%) (p = 0.01). CIN was the most common complication, occurring in 10 of 66 angiograms (15%). Glomerular filtration rate (GFR) was the only independent predictor (p = 0.03); 67% of patients with GFR < 30, 29% of patients with GFR 30–60, and 8% of patients with GFR > 60 developed CIN. For patients with intraabdominal bleeding, greater ΔHct decrease over 24 h before angiography predicts active extravasation. Pre-existing renal impairment predicts CIN. Patients with large hematocrit declines should be triaged for rapid angiography, though benefits can be weighed with the risk of renal impairment. PMID:28420210

ZEISS Angioplex™ Spectral Domain Optical Coherence Tomography Angiography: Technical Aspects.

PubMed

Rosenfeld, Philip J; Durbin, Mary K; Roisman, Luiz; Zheng, Fang; Miller, Andrew; Robbins, Gillian; Schaal, Karen B; Gregori, Giovanni

2016-01-01

ZEISS Angioplex™ optical coherence tomography (OCT) angiography generates high-resolution three-dimensional maps of the retinal and choroidal microvasculature while retaining all of the capabilities of the existing CIRRUS™ HD-OCT Model 5000 instrument. Angioplex™ OCT angiographic imaging on the CIRRUS™ HD-OCT platform was made possible by increasing the scanning rate to 68,000 A-scans per second and introducing improved tracking software known as FastTrac™ retinal-tracking technology. The generation of en face microvascular flow images with Angioplex™ OCT uses an algorithm known as OCT microangiography-complex, which incorporates differences in both the phase and intensity information contained within sequential B-scans performed at the same position. Current scanning patterns for en face angiographic visualization include a 3 × 3 and a 6 × 6 mm scan pattern on the retina. A volumetric dataset showing erythrocyte flow information can then be displayed as a color-coded retinal depth map in which the microvasculature of the superficial, deep, and avascular layers of the retina are displayed together with the colors red, representing the superficial microvasculature; green, representing the deep retinal vasculature; and blue, representing any vessels present in the normally avascular outer retina. Each retinal layer can be viewed separately, and the microvascular layers representing the choriocapillaris and the remaining choroid can be viewed separately as well. In addition, readjusting the contours of the slabs to target different layers of interest can generate custom en face flow images. Moreover, each en face flow image is accompanied by an en face intensity image to help with the interpretation of the flow results. Current clinical experience with this technology would suggest that OCT angiography should replace fluorescein angiography for retinovascular diseases involving any area of the retina that can be currently scanned with the CIRRUS™ HD

Navy-Wide Personnel Survey 1993: Statistical Tables for Enlisted Personnel

DTIC Science & Technology

1994-04-01

WIDE PERSONNEL SURVEY, ENLISTED NPRDC SAN DIEGO. Q92 HOW OFTEN EAT 5 SERVINGS VEGGIES BY Q21 PAYGRADE Q21 PAYGRADE ROW E2-E3 E4-E6 E7-E9 TOTAL Q92 142...OBSERVATIONS: 61 1993 NAVY-WIDE PERSONNEL SURVEY, ENLISTED NPRDC SAN DIEGO Q92 HOW OFTEN EAT 5 SERVINGS VEGGIES BY Q2 GENDER Q2 ROW MALE FEMALE TOTAL

21 CFR 58.29 - Personnel.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Personnel. 58.29 Section 58.29 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Organization and Personnel § 58.29 Personnel. (a) Each individual engaged in...

Personnel Management: Two Year Colleges.

ERIC Educational Resources Information Center

Ohio Board of Regents, Columbus. Management Improvement Program.

This document is one of five manuals designed to improve management practices in Ohio two-year colleges. A chapter on organizing for personnel management discusses basic personnel functions, roles and responsibilities of administrators, and the need for a central statewide office of personnel affairs. A chapter on planning, policies, and…

Exploring Unsubstantiated Reports by Educational Personnel of Suspected Child Abuse and Neglect in New York State Using Geographic Information System Technology: Is There a Disproportionate Impact on African American Children?

ERIC Educational Resources Information Center

Krase, Kathryn S.

2009-01-01

"Educational personnel" serve as an important conduit for family involvement in child protective services (CPS). Educational personnel are the largest source of reports of suspected child maltreatment in the United States (United States Department of Health and Human Services, 2007). However, reports made by educational personnel are…

5 CFR 772.102 - Interim personnel actions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Interim personnel actions. 772.102 Section 772.102 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) INTERIM RELIEF General § 772.102 Interim personnel actions. When an employee or...

5 CFR 772.102 - Interim personnel actions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Interim personnel actions. 772.102 Section 772.102 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) INTERIM RELIEF General § 772.102 Interim personnel actions. When an employee or...

Comparison of standard- and low-tube voltage 320-detector row volume CT angiography in detection of intracranial aneurysms with digital subtraction angiography as gold standard.

PubMed

Sun, Gang; Ding, Juan; Lu, Yang; Li, Min; Li, Li; Li, Guo-ying; Zhang, Xu-ping

2012-03-01

The aim of this study was to prospectively assess the effect of low-tube voltage (80 kVp) 320-detector row volume computed tomographic (CT) angiography (L-VCTA) in the detection of intracranial aneurysms, with three-dimensional (3D) spin digital subtraction angiography (DSA) as the gold standard. Forty-eight patients with clinically suspected subarachnoid hemorrhages were divided into two groups. One group underwent L-VCTA and DSA, while the other group underwent conventional-tube voltage (120 kVp) volume CT angiography (C-VCTA) and DSA. Vascular enhancement, image quality, detection accuracy of aneurysms, and radiation dose were compared between the two groups. For objective image quality, the L-VCTA group had higher mean vessel attenuation, correlated with higher image noise and lower signal-to-noise ratio, than the C-VCTA group. For subjective image quality, there were no significant differences between the two groups regarding scores for arterial enhancement, depiction of small arterial detail, interference of venous structures, and overall image quality scores. The mean effective dose for the L-VCTA group was significantly lower than for the C-VCTA group (0.56 ± 0.25 vs 1.84 ± 0.002 mSv), with a reduction of radiation dose of 69.73%. With 3D DSA as the reference standard, the sensitivity, specificity, and accuracy in the L-VCTA and C-VCTA groups were 94.12%, 100%, 94.4% and 100%, 100%, and 100%, respectively. In both groups, there were significant correlations for maximum aneurysm diameter measurements between volume CT angiography and 3D DSA; no statistical difference in the mean maximum diameter of each aneurysm was measured between volume CT angiography and 3D DSA. L-VCTA is helpful in detecting intracranial aneurysms, with results similar to those of 3D DSA, but at a lower radiation dose than C-VCTA. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

[Current situation and future perspectives for malaria prophylaxis among travellers and military personnel].

PubMed

Touze, Jean-Etienne; Debonne, Jean-Marc; Boutin, Jean-Paul

2007-10-01

Malaria remains a major public health problem, both for travellers and for the 40,000 French soldiers deployed each year to endemic areas. Epidemiological data show that imported malaria (IM) is on the increase, and that migrants account for more than 60% of malaria cases notified each year in France. The increase in IM among French military personnel is explained by prematurely terminated chemoprophylaxis on return, repeated short missions, and more cases of P. vivax and P. ovale infection. The choice of chemoprophylaxis depends mainly on the level of chloroquine resistance in the country visited. The atovaquone-proguanil combination is well tolerated and only requires 7 days of intake on return from the endemic area. Doxycycline monohydrate is cheaper and better-tolerated than mefloquine, and is thus preferred for French military personnel. However, its short half-life necessitates very good compliance. Chemoprophylaxis should be combined with vector control measures and with personal protection (impregnated bednets, protective clothing, repellents, and indoor insecticide spraying). The need for these measures should be clearly explained before departure, during the stay, and after return.

Inactive Health Personnel Project: Final Report.

ERIC Educational Resources Information Center

Schiavone, Geraldine R. S.

The Inactive Health Personnel Project, conducted by the New Jersey Department of Health in 1967, had as objectives to increase the supply of health manpower by locating health personnel and promoting their active employment; to develop the details of health personnel needs by category of personnel and geographic area; and to assist in the return…

[Embolic complications by ink clots removed from syringes during cerebral angiography].

PubMed

Kohyama, Shinya; Ishihara, Shoichiro; Yamane, Fumitaka; Ishihara, Hideaki; Kanazawa, Ryuzaburo; Suzuki, Masanori; Neki, Hiroaki; Ohkawara, Mai

2009-01-01

We noted, during cerebral angiography, that the contrast medium was contaminated with numerous small black ink clots from gradation marks on syringes. In this report, we show that ink can be removed from syringes in solid form, and that they may result in embolic complications during cerebral angiography. To demonstrate that the ink from gradation marks on syringes can come off in a solid form and attach itself to the gloves during cerebral angiography, syringes were gripped many times (just as in an angiographic procedure) after immersion in contrast medium or 0.9% saline for 10 minutes. To see if difference of contrast medium and syringes could affect the removing of ink, five types of nonangiographic syringes and one type of angiographic syringe were rubbed with gauze after certain time periods after immersing them in four kinds of contrast medium or 0.9% saline. Ink attached itself to the gloves in a solid form by repeated gripping due to adherence of contrast medium. Ink was removed from all nonangiographic syringes by rubbing after immersion in any type of contrast medium for two hours. Gradation marks on angiographic syringes were stable with all types of contrast medium. Thus, ink for gradation marks on nonangiographic syringes, which is easily removed in a solid form due to contrast medium, can be the source of embolic complication during cerebral angiography.

Comparison of Intraoperative Indocyanine Green Angiography and Digital Subtraction Angiography for Clipping of Intracranial Aneurysms

PubMed Central

Doss, Vinodh T.; Goyal, Nitin; Humphries, William; Hoit, Dan; Arthur, Adam; Elijovich, Lucas

2015-01-01

Background Residual aneurysm after microsurgical clipping carries a risk of aneurysm growth and rupture. Digital subtraction angiography (DSA) remains the standard to determine the adequacy of clipping. Intraoperative indocyanine green (ICG) angiography is increasingly utilized to confirm optimal clip positioning across the neck and to evaluate the adjacent vasculature. Objective We evaluated the correlation between ICG and DSA in clipped intracranial aneurysms. Methods A retrospective study of patients who underwent craniotomy and microsurgical clipping of intracranial aneurysms with ICG for 2 years. Patient characteristics, presentation details, operative reports, and pre- and postclipping angiographic images were reviewed to determine the adequacy of the clipping. Results Forty-seven patients underwent clipping with ICG and postoperative DSA: 57 aneurysms were clipped; 23 patients (48.9%) presented with subarachnoid hemorrhage. Nine aneurysms demonstrated a residual on DSA not identified on ICG (residual sizes ranged from 0.5 to 4.3 mm; average size: 1.8 mm). Postoperative DSA demonstrated no branch occlusions. Conclusion Intraoperative ICG is useful in the clipping of intracranial aneurysms to ensure a gross patency of branch vessels; however, the presence of residual aneurysms and subtle changes in flow in branch vessels is best seen by DSA. This has important clinical implications with regard to follow-up imaging and surgical/endovascular management. PMID:26279659

Latest-generation catheterization systems enable invasive submillisievert coronary angiography.

PubMed

Kuon, E; Weitmann, K; Hummel, A; Dörr, M; Reffelmann, T; Riad, A; Busch, M C; Felix, S B; Hoffmann, W; Empen, K

2015-05-01

The radiation risk of patients undergoing invasive cardiology remains considerable and includes skin injuries and cancer. To date, submillisievert coronary angiography has not been considered feasible. In 2011, we compared results from 100 consecutive patients undergoing elective coronary angiography using the latest-generation flat-panel angiography system (FPS) with results from examinations by the same operator using 106 historic controls with a conventional image-intensifier system (IIS) that was new in 2002. The median patient exposure parameters were measured as follows: dose-area product (DAP) associated with radiographic cine acquisitions (DAP(R)) and fluoroscopy (DAP(F)) scenes, radiographic frames and runs, and cumulative exposure times for radiography and fluoroscopy. On the FPS as compared to the traditional IIS, radiographic detector entrance dose levels were reduced from 164 to 80 nGy/frame and pulse rates were lowered from 12.5/s to 7.5/s during radiography and from 25/s to 4/s during fluoroscopy. The cardiologist's performance patterns remained comparable over the years: fluoroscopy time was constant and radiography time even slightly increased. Overall patient DAP decreased from 7.0 to 2.4 Gy × cm(2); DAP(R), from 4.2 to 1.7 Gy × cm(2); and DAP(F), from 2.8 to 0.6 Gy × cm(2). Time-adjusted DAP(R)/s decreased from 436 to 130 mGy × cm(2) and DAP(F)/s, from 21.6 to 4.4 mGy × cm(2). Cumulative patient skin dose with the FPS amounted to 67 mGy, and the median (interquartile range) of effective dose was 0.5 (0.3 … 0.7) mSv. Consistent application of radiation-reducing techniques with the latest-generation flat-panel systems enables submillisievert coronary angiography in invasive cardiology.

En face optical coherence tomography angiography for corneal neovascularisation.

PubMed

Ang, Marcus; Cai, Yijun; Shahipasand, Shahab; Sim, Dawn A; Keane, Pearse A; Sng, Chelvin C A; Egan, Catherine A; Tufail, Adnan; Wilkins, Mark R

2016-05-01

Recently, there has been an increasing clinical need for objective evaluation of corneal neovascularisation, a condition which cause significant ocular morbidity. We describe the use of a rapid, non-invasive 'en face' optical coherence tomography angiography (OCTA) system for the assessment of corneal neovascularisation. Consecutive patients with abnormal corneal neovascularisation were scanned using a commercially available AngioVue OCTA system (Optovue, Fremont, California, USA) with the split-spectrum amplitude decorrelation angiography algorithm, using an anterior segment lens adapter. Each subject had four scans in each eye by a trained operator and two independent masked assessors analysed all images. Main outcome measures were scan quality (signal strength, image quality), area of neovascularisation and repeatability of corneal vascular grade. We performed OCTA in 20 patients (11 men, 9 women, mean age 49.27±17.23 years) with abnormal corneal neovascularisation. The mean area of corneal neovascularisation was 0.57±0.30 mm(2) with a mean neovascularisation grade of 3.5±0.2 in the OCTA scans. We found the OCTA to produce good quality images of the corneal vessels (signal strength: 36.95±13.97; image quality score 2.72±1.07) with good repeatability for assessing neovascularisation grade (κ=0.84). In this preliminary clinical study, we describe a method for acquiring angiography images with 'en face' views, using an OCTA system adapted for the evaluation of corneal neovascularisation. Further studies are required to compare the scans to other invasive angiography techniques for the quantitative evaluation of abnormal corneal vessels. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

46 CFR Sec. 5 - Measures to protect ship's payrolls.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 8 2012-10-01 2012-10-01 false Measures to protect ship's payrolls. Sec. 5 Section 5 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY BONDING OF SHIP'S PERSONNEL Sec. 5 Measures to protect ship's payrolls. (a) General Agents are not required to...

Targeting clinical outcomes: Endovascular simulation improves diagnostic coronary angiography skills.

PubMed

Schimmel, Daniel R; Sweis, Ranya; Cohen, Elaine R; Davidson, Charles; Wayne, Diane B

2016-02-15

The purpose of this study is to determine the effects of simulation-based medical education (SBME) on the skills required to perform coronary angiography in the cardiac catheterization laboratory. Cardiovascular fellows commonly learn invasive procedures on patients. Because this approach is not standardized, it can result in inconsistent skill acquisition through exclusion of concepts and skills. Also, the learning curve varies between trainees yielding variability in skill acquisition. Therefore, coronary angiography skills are an excellent target for SBME in an environment in which direct patient care is not jeopardized. From January 2013 to June 2013, 14 cardiovascular fellows entering the cardiac catheterization laboratory at a tertiary care teaching hospital were tested on an endovascular simulator to assess baseline skills. All fellows subsequently underwent didactic teaching and preceptor-lead training on the endovascular simulator. Topics included basic catheterization skills and a review of catheterization laboratory systems. Following training, all fellows underwent a post-training assessment on the endovascular simulator. Paired t tests were used to compare items on the skills checklist and simulator defined variables. Cardiovascular fellows scored significantly higher on a diagnostic coronary angiography skills checklist following SBME using an endovascular simulator. The mean pretest score was 66.6% (SD = 9.7%) compared to 86.0% (SD = 6.3%) following simulator training (P < 0.001). Additional findings include significant reduction in procedure time and use of cine-fluoroscopy at posttest. SBME significantly improved cardiovascular fellows' performance of simulated coronary angiography skills. Standardized simulation-based education is a valuable adjunct to traditional clinical education for cardiovascular fellows. © 2015 Wiley Periodicals, Inc.

The increased use of computed tomography angiography and magnetic resonance angiography as the sole imaging modalities prior to infrainguinal bypass has had no effect on outcomes.

PubMed

Shue, Bing; Damle, Rachelle N; Flahive, Julie; Kalish, Jeffrey A; Stone, David H; Patel, Virendra I; Schanzer, Andres; Baril, Donald T

2015-08-01

Angiography remains the gold standard imaging modality before infrainguinal bypass. Computed tomography angiography (CTA) and magnetic resonance angiography (MRA) have emerged as noninvasive alternatives for preoperative imaging. We sought to examine contemporary trends in the utilization of CTA and MRA as isolated imaging modalities before infrainguinal bypass and to compare outcomes following infrainguinal bypass in patients who underwent CTA or MRA versus those who underwent conventional arteriography. Patients undergoing infrainguinal bypass within the Vascular Study Group of New England were identified (2003-2012). Patients were stratified by preoperative imaging modality: CTA/MRA alone or conventional angiography. Trends in utilization of these modalities were examined and demographics of these groups were compared. Primary end points included primary patency, secondary patency, and major adverse limb events (MALE) at 1 year as determined by Kaplan-Meier analysis. Multivariable Cox proportional hazards models were constructed to evaluate the effect of imaging modality on primary patency, secondary patency, and MALE after adjusting for confounders. In 3123 infrainguinal bypasses, CTA/MRA alone was used in 462 cases (15%) and angiography was used in 2661 cases (85%). Use of CTA/MRA alone increased over time, with 52 (11%) bypasses performed between 2003 and 2005, 189 (41%) bypasses performed between 2006 and 2009, and 221 (48%) bypasses performed between 2010 and 2012 (P < 0.001). Patients with CTA/MRA alone, compared with patients with angiography, more frequently underwent bypass for claudication (33% vs. 26%, P = 0.001) or acute limb ischemia (13% vs. 5%, P < 0.0001), more frequently had prosthetic conduits (39% vs. 30%, P = 0.001), and less frequently had tibial/pedal targets (32% vs. 40%, P = 0.002). After adjusting for these and other confounders, multivariable analysis demonstrated that the use of CTA/MRA alone was not associated with a significant

Non-deployment factors affecting psychological wellbeing in military personnel: literature review.

PubMed

Brooks, Samantha K; Greenberg, Neil

2018-02-01

Most military mental health research focuses on the impact of deployment-related stress; less is known about how everyday work-related factors affect wellbeing. This systematic narrative literature review aimed to identify non-deployment-related factors contributing to the wellbeing of military personnel. Electronic literature databases were searched and the findings of relevant studies were used to explore non-deployment-related risk and resilience factors. Fifty publications met the inclusion criteria. Determinants of non-deployment stress were identified as: relationships with others (including leadership/supervisory support; social support/cohesion; harassment/discrimination) and role-related stressors (role conflict; commitment and effort-reward imbalance; work overload/job demands; family-related issues/work-life balance; and other factors including control/autonomy, physical work environment and financial strain). Factors positively impacting wellbeing (such as exercise) were also identified. The literature suggests that non-deployment stressors present a significant occupational health hazard in routine military environments and interpersonal relationships at work are of fundamental importance. Findings suggest that in order to protect the wellbeing of personnel and improve performance, military organisations should prioritise strengthening relationships between employees and their supervisors/colleagues. Recommendations for addressing these stressors in British military personnel were developed.

Malaria in Tunisian Military Personnel after Returning from External Operation

PubMed Central

Ajili, Faïda; Battikh, Riadh; Laabidi, Janet; Abid, Rim; Bousetta, Najeh; Jemli, Bouthaina; Ben abdelhafidh, Nadia; Bassem, Louzir; Gargouri, Saadia; Othmani, Salah

2013-01-01

Introduction. Malaria had been eliminated in Tunisia since 1979, but there are currently 40 to 50 imported cases annually. Soldiers are no exception as the incidence of imported malaria is increasing in Tunisian military personnel after returning from malaria-endemic area, often in Sub-Saharan Africa. Methods. We retrospectively analyzed the clinical and biological presentations, treatment, and outcomes of 37 Tunisian military personnel hospitalized at the Department of Internal Medicine, the Military Hospital of Tunis, between January 1993 and January 2011, for imported malaria. The clinical and laboratory features were obtained from the medical records and a questionnaire was filled by the patients about the compliance of malaria prophylaxis. Results. Thirty-seven male patients, with a mean age of 41 years, were treated for malaria infection. Twenty-two were due to Plasmodium falciparum. The outcome was favourable for all patients, despite two severe access. The long-term use of chemoprophylaxis has been adopted by only 21 (51%) of expatriate military for daily stresses. Moreover, poor adherence was found in 32 patients. Conclusion. The risk of acquiring malaria infection in Tunisian military personnel can largely be prevented by the regular use of chemoprophylactic drugs combined with protective measures against mosquito bites. PMID:23766922

Retrospective analysis of patients for development of nephrogenic systemic fibrosis following conventional angiography using gadolinium-based contrast agents.

PubMed

Hoppe, Hanno; Spagnuolo, Sara; Froehlich, Johannes M; Nievergelt, Helga; Dinkel, Hans-Peter; Gretener, Silvia; Thoeny, Harriet C

2010-03-01

The purpose was to retrospectively review the data of 27 patients with renal insufficiency who underwent conventional angiography with gadolinium-based contrast agents (GDBCA) as alternative contrast agents and assess the occurrence of nephrogenic systemic fibrosis (NSF) together with associated potential risk factors. This HIPAA-compliant study had institutional review board approval, and informed consent was waived. Statistical analysis was performed for all available laboratory and clinical data, including dermatology reports. Type and amount of the GDBCA used were recorded for angiography and additional MRI studies, if applicable. Serum creatinine levels (SCr) pre- and post-angiography were recorded, and estimated glomerular filtration rates (eGFR) were calculated. Ten female and 17 male patients who underwent angiography with GDBCA were included. The mean amount of GDBCA administered was 44 +/- 15.5 ml (range 15-60 ml) or 0.24 + 0.12 mmol/kg (range 0.1-0.53 mmol/kg). At the time of angiography all patients had renal insufficiency (eGFR <60 ml/min/1.73 m(2)). Mean eGFR pre-angiography was 26 ml/min/1.73 m(2) and 33 ml/min/1.73 m(2) post-angiography. The mean follow-up period covers 28 months, range 1-84 months. Additional MRI studies with GDBCA administration were performed in 15 patients. One patient with typical skin lesions had developed biopsy-confirmed NSF. Conventional arterial angiography with GDBCA may play a role in the development of NSF in patients with renal insufficiency. Alternative contrast agents, such as CO(2) angiography or rather the use of low doses of iodinated contrast agents, should be considered in these patients.

5 CFR 842.208 - Firefighters, customs and border protection officers, law enforcement officers, members of the...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Firefighters, customs and border protection officers, law enforcement officers, members of the Capitol or Supreme Court Police, and nuclear materials couriers. 842.208 Section 842.208 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED)...

5 CFR 842.208 - Firefighters, customs and border protection officers, law enforcement officers, members of the...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Firefighters, customs and border protection officers, law enforcement officers, members of the Capitol or Supreme Court Police, and nuclear materials couriers. 842.208 Section 842.208 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED)...

5 CFR 842.208 - Firefighters, customs and border protection officers, law enforcement officers, members of the...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Firefighters, customs and border protection officers, law enforcement officers, members of the Capitol or Supreme Court Police, and nuclear materials couriers. 842.208 Section 842.208 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED)...

Imaging of Corneal Neovascularization: Optical Coherence Tomography Angiography and Fluorescence Angiography.

PubMed

Brunner, Matthias; Romano, Vito; Steger, Bernhard; Vinciguerra, Riccardo; Lawman, Samuel; Williams, Bryan; Hicks, Nicholas; Czanner, Gabriela; Zheng, Yalin; Willoughby, Colin E; Kaye, Stephen B

2018-03-01

The purpose of this study was to compare optical coherence tomography angiography (OCTA) and indocyanine green angiography (ICGA) for the assessment of corneal neovascularization (CoNV). Patients with CoNV extending at least 3 mm into the cornea were included. All patients underwent corneal imaging at the same visit. Images were recorded using the AngioVue OCTA system (Optovue, Inc.) with the long corneal adaptor module (CAM-L). ICGA images were recorded with fluorescent filters using the Heidelberg system (HRA2 Scanning Laser Ophthalmoscope; Heidelberg Engineering). Images were graded for quality by two independent observers. Vessel parameters: area, number, diameter, branch and end points, and tortuosity, were compared between devices. Bland-Altman plots were used to assess differences between parameters. Fifteen patients with CoNV predominantly associated with microbial keratitis were included. Mean subjective image quality score was better for ICGA (3.3 ± 0.9) than for OCTA (2.1 ± 1.2, P = 0.002), with almost perfect interobserver agreement for ICGA images (κ = 0.83) and substantial agreement for OCTA images (κ = 0.69). Agreement of grading of all investigated vessel parameters between ICGA and OCT images was slight to moderate, with significant differences found for vessel diameter (-8.98 μm, P = 0.01, 95% limits of agreement [LOA]: -15.89 to -2.07), number of branch (25.93, P = 0.09, 95% LOA: -4.31 to 56.17), and terminal points (49, P = 0.05, 95% LOA: 0.78 to 97.22). Compared with ICGA, current OCTA systems are less precise in capturing small vessels in CoNV complexes, and validation studies are needed for OCTA segmentation software. OCTA, however, complements ICGA by providing evidence of red blood cell flow, which together with depth information, may be helpful when planning treatment of CoNV.

Noninvasive coronary artery angiography using electron beam computed tomography

NASA Astrophysics Data System (ADS)

Rumberger, John A.; Rensing, Benno J.; Reed, Judd E.; Ritman, Erik L.; Sheedy, Patrick F., II

1996-04-01

Electron beam computed tomography (EBCT), also known as ultrafast-CT or cine-CT, uses a unique scanning architecture which allows for multiple high spatial resolution electrocardiographic triggered images of the beating heart. A recent study has demonstrated the feasibility of qualitative comparisons between EBCT derived 3D coronary angiograms and invasive angiography. Stenoses of the proximal portions of the left anterior descending and right coronary arteries were readily identified, but description of atherosclerotic narrowing in the left circumflex artery (and distal epicardial disease) was not possible with any degree of confidence. Although these preliminary studies support the notion that this approach has potential, the images overall were suboptimal for clinical application as an adjunct to invasive angiography. Furthermore, these studies did not examine different methods of EBCT scan acquisition, tomographic slice thicknesses, extent of scan overlap, or other segmentation, thresholding, and interpolation algorithms. Our laboratory has initiated investigation of these aspects and limitations of EBCT coronary angiography. Specific areas of research include defining effects of cardiac orientation; defining the effects of tomographic slice thickness and intensity (gradient) versus positional (shaped based) interpolation; and defining applicability of imaging each of the major epicardial coronary arteries for quantitative definition of vessel size, cross-sectional area, taper, and discrete vessel narrowing.

Indocyanine green laser angiography improves deep inferior epigastric perforator flap outcomes following abdominal suction lipectomy.

PubMed

Casey, William J; Connolly, Katharine A; Nanda, Alisha; Rebecca, Alanna M; Perdikis, Galen; Smith, Anthony A

2015-03-01

The reliability of deep inferior epigastric artery perforator (DIEP) flap reconstruction following abdominal liposuction is controversial. The authors' early cases were technically successful; however, they experienced high partial flap loss and fat necrosis rates. The authors sought to compare DIEP flap outcomes in the setting of prior liposuction after the use of intraoperative indocyanine green angiography compared to when flaps were assessed on clinical grounds alone. A retrospective review of a consecutive series of DIEP flaps following liposuction at a single institution was performed, comparing those evaluated on clinical grounds alone and those in which indocyanine green angiography was used intraoperatively. Outcomes measured included anastomotic complications, total flap loss, partial flap loss, fat necrosis, and postoperative abdominal wounds. Thirteen DIEP flaps following prior liposuction were performed on 11 patients from July of 2003 through January of 2014. All patients had preoperative imaging with duplex ultrasound or computed tomographic angiography to analyze perforator suitability before surgical exploration. Seven flaps were evaluated intraoperatively on clinical grounds alone. Six flaps were assessed and modified based on indocyanine green angiography. All flaps were successful; however, partial flap loss and fat necrosis rates dropped from 71.4 percent to 0 percent when indocyanine green angiography was used intraoperatively (p = 0.02). Indocyanine green angiography is an excellent vascular imaging modality for intraoperative use to assess flap perfusion, and improves outcomes in DIEP flaps when harvested after prior abdominal suction lipectomy.

49 CFR 179.400-22 - Protective housings.

Code of Federal Regulations, 2012 CFR

2012-10-01

... must be operable by personnel wearing heavy gloves and must incorporate provisions for locks or seals. A protective housing and its cover must be constructed of metal not less than 0.119 inch thick. ...

49 CFR 179.400-22 - Protective housings.

Code of Federal Regulations, 2011 CFR

2011-10-01

... must be operable by personnel wearing heavy gloves and must incorporate provisions for locks or seals. A protective housing and its cover must be constructed of metal not less than 0.119 inch thick. ...

49 CFR 179.400-22 - Protective housings.

Code of Federal Regulations, 2014 CFR

2014-10-01

... must be operable by personnel wearing heavy gloves and must incorporate provisions for locks or seals. A protective housing and its cover must be constructed of metal not less than 0.119 inch thick. ...

49 CFR 179.400-22 - Protective housings.

Code of Federal Regulations, 2013 CFR

2013-10-01

... must be operable by personnel wearing heavy gloves and must incorporate provisions for locks or seals. A protective housing and its cover must be constructed of metal not less than 0.119 inch thick. ...

Grounding and lightning protection. Volume 5

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robinson, M.D.

1987-12-31

Grounding systems protect personnel and equipment by isolating faulted systems and dissipating transient currents. Lightning protection systems minimize the possible consequences of a direct strike by lightning. This volume focuses on design requirements of the grounding system and on present-day concepts used in the design of lightning protection systems. Various types of grounding designs are presented, and their advantages and disadvantages discussed. Safety, of course, is the primary concern of any grounding system. Methods are shown for grounding the non-current-carrying parts of electrical equipment to reduce shock hazards to personnel. Lightning protection systems are installed on tall structures (such asmore » chimneys and cooling towers) to minimize the possibility of structural damage caused by direct lightning strokes. These strokes may carry currents of 200,000 A or more. The volume examines the formation and characteristics of lightning strokes and the way stroke characteristics influence the design of lightning protection systems. Because a large portion of the grounding system is buried in soil or concrete, it is not readily accessible for inspection or repair after its installation. The volume details the careful selection and sizing of materials needed to ensure a long, maintenance-free life for the system. Industry standards and procedures for testing the adequacy of the grounding system are also discussed.« less

The Dangers of Electrosurgical Smoke to Operating Room Personnel: A Review.

PubMed

Bree, Kevin; Barnhill, Spencer; Rundell, William

2017-11-01

A 2007 study in the United Kingdom showed that three of 98 surgeons surveyed admitted using dedicated smoke extractors; 72% of respondents believed inadequate precautions were in place to protect staff from the potential dangers of electrosurgical smoke. Surgical smoke contains harmful chemicals (e.g., hydrogen cyanide, acetylene, and butadiene) that can circumvent standard masks used in the operating room (OR). In addition, bacteria and viruses can be transmitted through this smoke. The topic of electrosurgical smoke is important to occupational health nurses not only because of their responsibility to protect workers, but also because they, like other health care providers, may be exposed to smoke routinely. The authors of this review recommend the regular use of smoke evacuation in ORs and avoidance of electrosurgery whenever possible to protect OR personnel from the potential long-term harmful effects of electrosurgical smoke.

The assessment of the AH-64D, longbow, mast-mounted assembly noise hazard for maintenance personnel

NASA Astrophysics Data System (ADS)

Mozo, Ben T.; Gordon, Elmaree

1994-07-01

Noise levels around the AH-64 helicopter exceed safe limits. Maintenance personnel are required to wear hearing protection to reduce hazard to hearing while performing maintenance procedures. This evaluation was directed at determining the contribution to noise levels by the auxiliary power unit (APU), auxiliary ground power unit (AGPU), environmental control system (ECS), and mast mounted assembly (MMA) at a variety of maintenance positions and establish protection capabilities of standard protectors for those noise levels.

In Response to Laovirojjanakul W, Acharya N and Gonzales JA's "Ultra-Widefield Fluorescein Angiography in Intermediate Uveitis".

PubMed

Babu, Kalpana; Kumaradas, Mrinalini

2017-12-28

We read with great interest the article by Laovirojjanakul et al. on ultra-widefield fluorescein angiography in intermediate uveitis. We would like to share a similar case of chronic intermediate uveitis highlighting a fern-like pattern of diffuse vascular leakage on fluorescein angiography, with good visual acuity, absence of clinically active inflammation, and a similar fluorescein angiography picture over a follow-up of 4 years.

Quality of life after acute myocardial infarction among patients treated at sites with and without on-site availability of angiography.

PubMed

Pilote, Louise; Lauzon, Claude; Huynh, Thao; Dion, Danielle; Roux, René; Racine, Normand; Carignan, Suzanne; Diodati, Jean G; Lévesque, Claude; Charbonneau, François; Pouliot, Joël; Joseph, Lawrence; Eisenberg, Mark J

2002-03-11

Previous studies have compared the treatment and outcome of patients with acute myocardial infarction (AMI) admitted at sites with and without availability of angiography. Although mortality rates do not differ, it is unknown if quality of life (QOL) and functional status differ. We measured QOL and functional status in patients with AMI treated within Québec at 5 sites with (n = 253) and 5 sites without (n = 334) angiography. At admission, clinical characteristics, complication rates, and baseline measures of QOL and functional status were similar at sites with and without angiography. During hospitalization, patients treated at sites with angiography were more likely to undergo an invasive cardiac procedure than patients admitted at sites without angiography (angiography, 63% vs 26%; percutaneous transluminal coronary angioplasty, 33% vs 13%; and coronary artery bypass graft, 12% vs 5%). At 30 days and 6 months after AMI, QOL was slightly superior at sites with angiography, but by 1 year, most measures of QOL were back to baseline at both types of sites and were similar between the 2 groups. At 6 months, most standard health-related QOL components were similar; only physical and emotional role limitations were higher at sites with angiography. Return to work occurred earlier (at 30 days, 23% vs 12%), and a lower proportion of patients was readmitted for angina (within 1 year after AMI, 12% vs 18%) at sites with angiography. In the early post-AMI period, the QOL of patients admitted at sites with angiography was higher than that of patients admitted at sites without angiography. However, by 1 year, the QOL and functional status of patients was similar in both groups. Differences in QOL were greatest when differences in treatment were greatest, lending support to a positive albeit small association between an early invasive approach to post-AMI care and improved QOL.

Optical Coherence Tomography Angiography of Retinal Cavernous Hemangioma.

PubMed

Pierro, Luisa; Marchese, Alessandro; Gagliardi, Marco; Bandello, Francesco

2017-08-01

Retinal cavernous hemangioma is a rare, benign, retinal tumor characterized by angiomatous proliferation of vessels within the inner retina or the optic disc.1 Here we report a case of retinal cavernous hemangioma on the margin of the optic disc in the right eye of a 61-year-old asymptomatic female. The lesion was studied with multimodal imaging which included structural optical coherence tomography, fluorescein angiography, blue fundus auto-fluorescence, optical coherence tomography angiography (OCTA) (DRI OCT Triton; Topcon, Tokyo, Japan) and visual field examination. Blood circulation inside retinal cavernous hemangioma lesion is typically low-stagnant.2 However, OCTA demonstrated blood flow inside the lesion, illustrating its vascular circulation.3 Visual field was within the normal limits, except from a slight enlargement of the blind spot. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:684-685.]. Copyright 2017, SLACK Incorporated.

Child Maltreatment Reporting by Educational Personnel: Implications for Racial Disproportionality in the Child Welfare System

ERIC Educational Resources Information Center

Krase, Kathryn Suzanne

2015-01-01

African American children are disproportionally overrepresented in the U.S. child protection system. Because educational personnel are a significant source of reports of suspected child maltreatment across the country and in all states, the present study examines the impact of these reports on racial disproportionality and disparity at the…

New stroboscopic light source and technique for intraoperative retinal fluorescein angiography during penetrating keratoplasty

NASA Astrophysics Data System (ADS)

Krueger, Ronald R.; Morales, Ronald B.; Chong, Lawrence P.; Smith, Ronald E.

1994-06-01

We report the development of a new stroboscopic light source system and technique for performing intraoperative fluorescein angiography during penetrating keratoplasty for aphakic or pseudophakic bullous keratopathy. A controllable pulse xenon light source system with a fiber optic endoilluminator probe is used to perform high-quality intraoperative fluorescein angiography during penetrating keratoplasty in pigmented rabbits and human subjects. Following corneal trephination and extraction of the intraocular lens, a temporary Cobo keratoprosthesis is secured while a 20-gauge endoilluminator is inserted into the vitreous cavity through a limbal incision. The endoilluminator is advanced to a retinal illumination area of approximately 3 DD and 10% fluorescein is injected intravenously. A microscope camera coupled to a 50:50 beamsplitter photographs the passage of fluorescein dye while the surgeon maintains an unaltered view through the operating microscope. Angiograms through a keratoprosthesis show excellent contrast and resolution, comparable to standard fluorescein angiography. Fine peripapillary vessels are seen reproducibly and with great detail in the rabbits. All the phases of retinal angiography can be seen, including arteriolar constriction and capillary nonperfusion in one of four human subjects examined. High quality intraoperative fluorescein angiography can be performed in patients undergoing penetrating keratoplasty for aphakic/ pseudophakic bullous keratopathy. With this technology, preexisting retinal disorders such as cystoid macular edema might be identified in the perioperative setting allowing for important management decisions to be made intraoperatively.

Image Quality and Stenosis Assessment of Non-Contrast-Enhanced 3-T Magnetic Resonance Angiography in Patients with Peripheral Artery Disease Compared with Contrast-Enhanced Magnetic Resonance Angiography and Digital Subtraction Angiography

PubMed Central

Liu, Jiayi; Zhang, Nan; Fan, Zhaoyang; Luo, Nan; Zhao, Yike; Bi, Xiaoming; An, Jing; Chen, Zhong; Liu, Dongting; Wen, Zhaoying; Fan, Zhanming; Li, Debiao

2016-01-01

Purpose To evaluate the diagnostic performance of flow-sensitive dephasing (FSD)-prepared steady-state free precession (SSFP) magnetic resonance angiography (MRA) at 3 T for imaging infragenual arteries relative to contrast-enhanced MRA (CE-MRA) and digital subtraction angiography (DSA). Materials and Methods A series of 16 consecutive patients with peripheral arterial disease (PAD) underwent a combined peripheral MRA protocol consisting of FSD-MRA for the calves and large field-of-view CE-MRA. DSA was performed on all patients within 1 week of the MR angiographies. Image quality and degree of stenosis was assessed by two readers with rich experience. Inter-observer agreement was determined using kappa statistics. Receiver operating characteristic (ROC) curve analysis determined the diagnostic value of FSD-MRA, CE-MRA, and CE-MRA combined with FSD-MRA (CE+FSD MRA) in predicting vascular stenosis. Results At the calf station, no significantly difference of subjective image quality scores was found between FSD-MRA and CE-MRA. Inter-reader agreement was excellent for both FSD-MRA and CE-MRA. Both of FSD-MRA and CE-MRA carry a stenosis overestimation risk relative to DSA standard. With DSA as the reference standard, ROC curve analysis showed that the area under the curve was largest for CE+FSD MRA. The greatest sensitivity and specificity were obtained when a cut-off stenosis score of 2 was used. Conclusion In patients with severe PAD,3 T FSD-MRA provides good-quality diagnostic images without a contrast agent and is a good supplement for CE-MRA. CE+FSD MRA can improve the accuracy of vascular stenosis diagnosis. PMID:27861626

A four-panel enclosure protects from explosion

NASA Technical Reports Server (NTRS)

King, P. V.

1972-01-01

Development of multi-layered baffle as enclosure to protect personnel from effects of explosion during production of ammunition is discussed. Advantages of new system over previous systems are described. Illustration of typical panel structure is provided.

The Prone Protected Posture

DTIC Science & Technology

1980-08-01

5K 2. METHODOLOGY . . . . . . . . . . . . . . . . . . . . 5 3. RESULTS . . . . . . . . . . . . . . . . . . . . . . 23I 4...2. METHODOLOGY The first step required in this study was to characterize the prone protected posture. Basically, a man in the prone posture differs...reduction in the presented area of target personnel. Reference 6 contains a concise discussion of the methodology used to generate the shielding functions

Calibration of optical coherence tomography angiography with a microfluidic chip

NASA Astrophysics Data System (ADS)

Su, Johnny P.; Chandwani, Rahul; Gao, Simon S.; Pechauer, Alex D.; Zhang, Miao; Wang, Jie; Jia, Yali; Huang, David; Liu, Gangjun

2016-08-01

A microfluidic chip with microchannels ranging from 8 to 96 μm was used to mimic blood vessels down to the capillary level. Blood flow within the microfluidic channels was analyzed with split-spectrum amplitude-decorrelation angiography (SSADA)-based optical coherence tomography (OCT) angiography. It was found that the SSADA decorrelation value was related to both blood flow speed and channel width. SSADA could differentiate nonflowing blood inside the microfluidic channels from static paper. The SSADA decorrelation value was approximately linear with blood flow velocity up to a threshold Vsat of 5.83±1.33 mm/s (mean±standard deviation over the range of channel widths). Beyond this threshold, it approached a saturation value Dsat. Dsat was higher for wider channels, and approached a maximum value Dsm as the channel width became much larger than the beam focal spot diameter. These results indicate that decorrelation values (flow signal) in capillary networks would be proportional to both flow velocity and vessel caliber but would be capped at a saturation value in larger blood vessels. These findings are useful for interpretation and quantification of clinical OCT angiography results.

Ultra-widefield fluorescein angiography reveals retinal phlebitis in Susac's syndrome.

PubMed

Klufas, Michael A; Dinkin, Marc J; Bhaleeya, Swetangi D; Chapman, Kristin O; Riley, Claire S; Kiss, Szilárd

2014-01-01

A 23-year-old woman with history of headaches and auditory changes presented with acute-onset visual field loss in the right eye. The combination of multiple retinal branch artery occlusions of the right eye on funduscopic examination, characteristic white matter lesions in the corpus callosum on magnetic resonance imaging, and hearing loss on audiometric testing led to a diagnosis of Susac's syndrome. Ultra-widefield fluorescein angiography revealed involvement of the retinal veins, which has not been previously reported with this condition. Additionally, ultra-widefield indocyanine green angiography demonstrated changes in the choroidal circulation, which are controversial in this syndrome. Copyright 2014, SLACK Incorporated.

Pediatric head and neck lesions: assessment of vascularity by MR digital subtraction angiography.

PubMed

Chooi, Weng Kong; Woodhouse, Neil; Coley, Stuart C; Griffiths, Paul D

2004-08-01

Pediatric head and neck lesions can be difficult to characterize on clinical grounds alone. We investigated the use of dynamic MR digital subtraction angiography as a noninvasive adjunct for the assessment of the vascularity of these abnormalities. Twelve patients (age range, 2 days to 16 years) with known or suspected vascular abnormalities were studied. Routine MR imaging, time-of-flight MR angiography, and MR digital subtraction angiography were performed in all patients. The dynamic sequence was acquired in two planes at one frame per second by using a thick section (6-10 cm) selective radio-frequency spoiled fast gradient-echo sequence and an IV administered bolus of contrast material. The images were subtracted from a preliminary mask sequence and viewed as a video-inverted cine loop. In all cases, MR digital subtraction angiography was successfully performed. The technique showed the following: 1) slow flow lesions (two choroidal angiomas, eyelid hemangioma, and scalp venous malformation); 2) high flow lesions that were not always suspected by clinical examination alone (parotid hemangioma, scalp, occipital, and eyelid arteriovenous malformations plus a palatal teratoma); 3) a hypovascular tumor for which a biopsy could be safely performed (Burkitt lymphoma); and 4) a hypervascular tumor of the palate (cystic teratoma). Our early experience suggests that MR digital subtraction angiography can be reliably performed in children of all ages without complication. The technique provided a noninvasive assessment of the vascularity of each lesion that could not always have been predicted on the basis of clinical examination or routine MR imaging alone.

Vascularized osseous flaps and assessing their bipartate perfusion pattern via intraoperative fluorescence angiography.

PubMed

Valerio, Ian; Green, J Marshall; Sacks, Justin M; Thomas, Shane; Sabino, Jennifer; Acarturk, T Oguz

2015-01-01

Large segmental bone and composite tissue defects often require vascularized osseous flaps for definitive reconstruction. However, failed osseous flaps due to inadequate perfusion can lead to significant morbidity. Utilization of indocyanine green (ICG) fluorescence angiography has been previously shown to reliably assess soft tissue perfusion. Our group will outline the application of this useful intraoperative tool in evaluating the perfusion of vascularized osseous flaps. A retrospective review was performed to identify those osseous and/or osteocutaneous bone flaps, where ICG angiography was employed. Data analyzed included flap types, success and failure rates, and perfusion-related complications. All osseous flaps were evaluated by ICG angiography to confirm periosteal and endosteal perfusion. Overall 16 osseous free flaps utilizing intraoperative ICG angiography to assess vascularized osseous constructs were performed over a 3-year period. The flaps consisted of the following: nine osteocutaneous fibulas, two osseous-only fibulas, two scapular/parascapular with scapula bone, two quadricep-based muscle flaps, containing a vascularized femoral bone component, and one osteocutaneous fibula revision. All flap reconstructions were successful with the only perfusion-related complication being a case of delayed partial skin flap loss. Intraoperative fluorescence angiography is a useful adjunctive tool that can aid in flap design through angiosome mapping and can also assess flap perfusion, vascular pedicle flow, tissue perfusion before flap harvest, and flap perfusion after flap inset. Our group has successfully extended the application of this intraoperative tool to assess vascularized osseous flaps in an effort to reduce adverse outcomes related to preventable perfusion-related complications. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A comparative analysis of noncontrast flow-spoiled versus contrast-enhanced magnetic resonance angiography for evaluation of peripheral arterial disease.

PubMed

Kassamali, Rahil Hussein; Hoey, Edward T D; Ganeshan, Arul; Littlehales, Tracey

2013-01-01

This feasibility study aimed to obtain initial data to assess the performance of a novel noncontrast spoiled magnetic resonance (MR) angiography technique (fresh-blood imaging [FBI]) compared to gadolinium-enhanced MR (Gd-MR) angiography for evaluation of the aorto-iliac and lower extremity arteries. Thirteen patients with suspected lower extremity arterial disease that had undergone Gd-MR angiography and FBI at the same session were randomly included in the study. FBI was performed using an ECG-gated ow-spoiled T2-weighted half-Fourier fast spin-echo sequence. For analysis, the aortoiliac and lower limb arteries were divided into 18 anatomical segments. Two blinded readers individually graded image quality of FBI and also assessed the presence and severity of any stenotic lesions. A similar analysis was performed for the Gd-MR angiography images. A total of 385 arterial segments were analyzed; 34 segments were excluded due to degraded image quality (1.3% of Gd- MR vs. 8% of FBI-MR angiography images). FBI-MR angiography had comparable accuracy to Gd-MR angiography for assessment of the above knee vessels with high kappa statistics (large arteries, 0.91; small arteries, 0.86) and high sensitivity (large arteries, 98.1%; small arteries, 88.6%) and specificity (large arteries, 97.2%; small arteries, 97.6%) using Gd-MR angiography as the gold standard. Initial results show good agreement between FBI-MR angiography and Gd-MR angiography in the diagnosis of peripheral arterial disease, making FBI a potential alternative in patients with renal impairment. FBI showed highest accuracy in the above knee vessels. Technological refinements are required to improve accuracy for assessing the calf and pedal vessels.

Protection of Hardware: Powering Systems (Power Converter, Normal Conducting, and Superconducting Magnets)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pfeffer, H.; Flora, B.; Wolff, D.

2016-01-01

Along with the protection of magnets and power converters, we have added a section on personnel protection because this is our highest priority in the design and operation of power systems. Thus, our topics are the protection of people, power converters, and magnet loads (protected from the powering equipment), including normal conducting magnets and superconducting magnets.

Magnetic Resonance Angiography in the Diagnosis of Cerebral Arteriovenous Malformation and Dural Arteriovenous Fistulas: Comparison of Time-Resolved Magnetic Resonance Angiography and Three Dimensional Time-of-Flight Magnetic Resonance Angiography

PubMed Central

Cheng, Yu-Ching; Chen, Hung-Chieh; Wu, Chen-Hao; Wu, Yi-Ying; Sun, Ming-His; Chen, Wen-Hsien; Chai, Jyh-Wen; Chi-Chang Chen, Clayton

2016-01-01

Background Traditional digital subtraction angiography (DSA) is currently the gold standard diagnostic method for the diagnosis and evaluation of cerebral arteriovenous malformation (AVM) and dural arteriovenous fistulas (dAVF). Objectives The aim of this study was to analyze different less invasive magnetic resonance angiography (MRA) images, time-resolved MRA (TR-MRA) and three-dimensional time-of-flight MRA (3D TOF MRA) to identify their diagnostic accuracy and to determine which approach is most similar to DSA. Patients and Methods A total of 41 patients with AVM and dAVF at their initial evaluation or follow-up after treatment were recruited in this study. We applied time-resolved angiography using keyhole (4D-TRAK) MRA to perform TR-MRA and 3D TOF MRA examinations simultaneously followed by DSA, which was considered as a standard reference. Two experienced neuroradiologists reviewed the images to compare the diagnostic accuracy, arterial feeder and venous drainage between these two MRA images. Inter-observer agreement for different MRA images was assessed by Kappa coefficient and the differences of diagnostic accuracy between MRA images were evaluated by the Wilcoxon rank sum test. Results Almost all vascular lesions (92.68%) were correctly diagnosed using 4D-TRAK MRA. However, 3D TOF MRA only diagnosed 26 patients (63.41%) accurately. There were statistically significant differences regarding lesion diagnostic accuracy (P = 0.008) and venous drainage identification (P < 0.0001) between 4D-TRAK MRA and 3D TOF MRA. The results indicate that 4D-TRAK MRA is superior to 3D TOF MRA in the assessment of lesions. Conclusion Compared with 3D TOF MRA, 4D-TRAK MRA proved to be a more reliable screening modality and follow-up method for the diagnosis of cerebral AVM and dAVF. PMID:27679690

49 CFR 193.2711 - Personnel health.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false Personnel health. 193.2711 Section 193.2711 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Personnel Qualifications and Training § 193.2711 Personnel health. Each operator...

49 CFR 193.2711 - Personnel health.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Personnel health. 193.2711 Section 193.2711 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Personnel Qualifications and Training § 193.2711 Personnel health. Each operator...

49 CFR 193.2711 - Personnel health.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Personnel health. 193.2711 Section 193.2711 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Personnel Qualifications and Training § 193.2711 Personnel health. Each operator...

49 CFR 193.2711 - Personnel health.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Personnel health. 193.2711 Section 193.2711 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Personnel Qualifications and Training § 193.2711 Personnel health. Each operator...

49 CFR 193.2711 - Personnel health.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Personnel health. 193.2711 Section 193.2711 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Personnel Qualifications and Training § 193.2711 Personnel health. Each operator...

Airway hyperreactivity in asymptomatic military personnel.

PubMed

Morris, Michael J; Schwartz, Darin S; Nohrenberg, Jana L; Dooley, Sean N

2007-11-01

Asthma is frequently diagnosed in military personnel despite strict guidelines that disqualify persons with active disease or a recent history of asthma. It is generally considered incompatible with military service, because of the regular physical training, outdoor training exercises, and deployments to remote locations. The objective of this study was to determine the prevalence of airway hyperreactivity in asymptomatic military personnel, as an estimate of subclinical reactive airway disease. A prospective study of healthy, asymptomatic, military personnel with no previous history of asthma and <1 year on active duty status was conducted. After completion of a screening questionnaire, personnel underwent baseline spirometry with a portable spirometer. Personnel with obstructive indices (based on published guidelines) and matched control subjects participated in an exercise test (1.5-mile run), with pre- and postexercise spirometry. A total of 222 asymptomatic military personnel completed baseline spirometry, and 31 (14%) were found have airway obstruction. A normal matched control group of 31 military personnel and 26 personnel with obstruction performed exercise spirometry. Twenty-three percent of the participants with obstruction demonstrated increased airway hyper-reactivity after exercise, based on a reduction in forced expiratory volume at 1 second, compared with 19% of control subjects. Asymptomatic airway obstruction has a prevalence of 14% in young military personnel. A significant percentage of individuals also have evidence of worsening obstruction during exercise. These data suggest that screening spirometry may identify early reactive airway disease in asymptomatic individuals and should be considered as a method to identify persons predisposed to developing symptomatic asthma.

Human and Organizational Risk Modeling: Critical Personnel and Leadership in Network Organizations

DTIC Science & Technology

2006-08-01

NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Carnegie Mellon University,School of Computer...Science,Pittsburgh,PA,15213 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S...organization can help improve performance and protect against the risk of loss. But the study of critical personnel has traditionally used static structural

21 CFR 225.10 - Personnel.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Qualified personnel and adequate personnel training and supervision are essential for the proper formulation, manufacture, and control of medicated feeds. Training and experience leads to proper use of equipment...

21 CFR 225.10 - Personnel.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Qualified personnel and adequate personnel training and supervision are essential for the proper formulation, manufacture, and control of medicated feeds. Training and experience leads to proper use of equipment...

The Personnel Effectiveness Grid (PEG): A New Tool for Estimating Personnel Department Effectiveness

ERIC Educational Resources Information Center

Petersen, Donald J.; Malone, Robert L.

1975-01-01

Examines the difficulties inherent in attempting a formal personnel evaluation system, the major formal methods currently used for evaluating personnel department accountabilities, some parameters that should be part of a valid evaluation program, and a model for conducting the evaluation. (Available from Office of Publications, Graduate School of…

Reduction of scatter radiation during transradial percutaneous coronary angiography: a randomized trial using a lead-free radiation shield.

PubMed

Politi, Luigi; Biondi-Zoccai, Giuseppe; Nocetti, Luca; Costi, Tiziana; Monopoli, Daniel; Rossi, Rosario; Sgura, Fabio; Modena, Maria Grazia; Sangiorgi, Giuseppe M

2012-01-01

Occupational radiation exposure is a growing problem due to the increasing number and complexity of interventional procedures performed. Radial artery access has reduced the number of complications at the price of longer procedure duration. Radpad® scatter protection is a sterile, disposable bismuth-barium radiation shield drape that should be able to decrease the dose of operator radiation during diagnostic and interventional procedures. Such radiation shield has never been tested in a randomized study in humans. Sixty consecutive patients undergoing coronary angiography by radial approach were randomized 1:1 to Radpad use versus no radiation shield protection. The sterile shield was placed around the area of right radial artery sheath insertion and extended medially to the patient trunk. All diagnostic procedures were performed by the same operator to reduce variability in radiation absorption. Radiation exposure was measured blindly using thermoluminescence dosimeters positioned at the operator's chest, left eye, left wrist, and thyroid. Despite similar fluoroscopy time (3.52 ± 2.71 min vs. 3.46 ± 2.77 min, P = 0.898) and total examination dose (50.5 ± 30.7 vs. 45.8 ± 18.0 Gycm(2), P = 0.231), the mean total radiation exposure to the operator was significantly lower when Radpad was utilized (282.8 ± 32.55 μSv vs. 367.8 ± 105.4 μSv, P < 0.0001) corresponding to a 23% total reduction. Moreover, mean radiation exposure was lower with Radpad utilization at all body locations ranging from 13 to 34% reduction. This first-in-men randomized trial demonstrates that Radpad significantly reduces occupational radiation exposure during coronary angiography performed through right radial artery access. Copyright © 2011 Wiley Periodicals, Inc.

Staff Development Concerns for the Personnel Manager.

ERIC Educational Resources Information Center

Locke, William E.

The most unique responsibility of the school personnel worker may be the evaluation of teachers. Unlike the personnel manager of a non-educational enterprise, a school personnel manager must provide remediation training to a tenured teacher not performing competently. Those involved in personnel decisions should be aware of what research has…

Angiography with a multifunctional line scanning ophthalmoscope

PubMed Central

Ferguson, R. Daniel; Patel, Ankit H.; Vazquez, Vanessa; Husain, Deeba

2012-01-01

Abstract. A multifunctional line scanning ophthalmoscope (mLSO) was designed, constructed, and tested on human subjects. The mLSO could sequentially acquire wide-field, confocal, near-infrared reflectance, fluorescein angiography (FA), and indocyanine green angiography (ICGA) retinal images. The system also included a retinal tracker (RT) and a photodynamic therapy laser treatment port. The mLSO was tested in a pilot clinical study on human subjects with and without retinal disease. The instrument exhibited robust retinal tracking and high-contrast line scanning imaging. The FA and ICGA angiograms showed a similar appearance of hyper- and hypo-pigmented disease features and a nearly equivalent resolution of fine capillaries compared to a commercial flood-illumination fundus imager. An mLSO-based platform will enable researchers and clinicians to image human and animal eyes with a variety of modalities and deliver therapeutic beams from a single automated interface. This approach has the potential to improve patient comfort and reduce imaging session times, allowing clinicians to better diagnose, plan, and conduct patient procedures with improved outcomes. PMID:22463040

Relationship between the Self-Rating Anxiety Scale score and the success rate of 64-slice computed tomography coronary angiography.

PubMed

Li, Hui; Jin, Dan; Qiao, Fang; Chen, Jianchang; Gong, Jianping

Computed tomography coronary angiography, a key method for obtaining coronary artery images, is widely used to screen for coronary artery diseases due to its noninvasive nature. In China, 64-slice computed tomography systems are now the most common models. As factors that directly affect computed tomography performance, heart rate and rhythm control are regulated by the autonomic nervous system and are highly related to the emotional state of the patient. The aim of this prospective study is to use a pre-computed tomography scan Self-Rating Anxiety Scale assessment to analyze the effects of tension and anxiety on computed tomography coronary angiography success. Subjects aged 18-85 years who were planned to undergo computed tomography coronary angiography were enrolled; 1 to 2 h before the computed tomography scan, basic patient data (gender, age, heart rate at rest, and family history) and Self-Rating Anxiety Scale score were obtained. The same group of imaging department doctors, technicians, and nurses performed computed tomography coronary angiography for all the enrolled subjects and observed whether those subjects could finish the computed tomography coronary angiography scan and provide clear, diagnostically valuable images. Participants were divided into successful (obtained diagnostically useful coronary images) and unsuccessful groups. Basic data and Self-Rating Anxiety Scale scores were compared between the groups. The Self-Rating Anxiety Scale standard score of the successful group was lower than that of the unsuccessful group (P = 0.001). As the Self-Rating Anxiety Scale standard score rose, the success rate of computed tomography coronary angiography decreased. The Self-Rating Anxiety Scale score has a negative relationship with computed tomography coronary angiography success. Anxiety can be a disadvantage in computed tomography coronary angiography examination. The pre-computed tomography coronary angiography scan Self-Rating Anxiety Scale

33 CFR 143.105 - Personnel landings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Personnel landings. 143.105...) OUTER CONTINENTAL SHELF ACTIVITIES DESIGN AND EQUIPMENT OCS Facilities § 143.105 Personnel landings. (a) Sufficient personnel landings shall be provided on each manned OCS facility to assure safe access and egress...

33 CFR 143.105 - Personnel landings.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Personnel landings. 143.105...) OUTER CONTINENTAL SHELF ACTIVITIES DESIGN AND EQUIPMENT OCS Facilities § 143.105 Personnel landings. (a) Sufficient personnel landings shall be provided on each manned OCS facility to assure safe access and egress...

21 CFR 211.28 - Personnel responsibilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Personnel responsibilities. 211.28 Section 211.28 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... from contamination. (b) Personnel shall practice good sanitation and health habits. (c) Only personnel...

21 CFR 211.28 - Personnel responsibilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Personnel responsibilities. 211.28 Section 211.28 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... from contamination. (b) Personnel shall practice good sanitation and health habits. (c) Only personnel...

21 CFR 211.28 - Personnel responsibilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Personnel responsibilities. 211.28 Section 211.28 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... from contamination. (b) Personnel shall practice good sanitation and health habits. (c) Only personnel...

21 CFR 211.28 - Personnel responsibilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Personnel responsibilities. 211.28 Section 211.28 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... from contamination. (b) Personnel shall practice good sanitation and health habits. (c) Only personnel...

5 CFR 293.302 - Establishment of Official Personnel Folder.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Establishment of Official Personnel Folder. 293.302 Section 293.302 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL RECORDS Official Personnel Folder § 293.302 Establishment of Official Personnel Folder...

5 CFR 293.302 - Establishment of Official Personnel Folder.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Establishment of Official Personnel Folder. 293.302 Section 293.302 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL RECORDS Official Personnel Folder § 293.302 Establishment of Official Personnel Folder...

Parathyroid gland angiography with indocyanine green fluorescence to predict parathyroid function after thyroid surgery

PubMed Central

Vidal Fortuny, J.; Belfontali, V.; Sadowski, S. M.; Karenovics, W.; Guigard, S.

2016-01-01

Background Postoperative hypoparathyroidism remains the most common complication following thyroidectomy. The aim of this pilot study was to evaluate the use of intraoperative parathyroid gland angiography in predicting normal parathyroid gland function after thyroid surgery. Methods Angiography with the fluorescent dye indocyanine green (ICG) was performed in patients undergoing total thyroidectomy, to visualize vascularization of identified parathyroid glands. Results Some 36 patients underwent ICG angiography during thyroidectomy. All patients received standard calcium and vitamin D supplementation. At least one well vascularized parathyroid gland was demonstrated by ICG angiography in 30 patients. All 30 patients had parathyroid hormone (PTH) levels in the normal range on postoperative day (POD) 1 and 10, and only one patient exhibited asymptomatic hypocalcaemia on POD 1. Mean(s.d.) PTH and calcium levels in these patients were 3·3(1·4) pmol/l and 2·27(0·10) mmol/l respectively on POD 1, and 4·0(1.6) pmol/l and 2·32(0·08) mmol/l on POD 10. Two of the six patients in whom no well vascularized parathyroid gland could be demonstrated developed transient hypoparathyroidism. None of the 36 patients presented symptomatic hypocalcaemia, and none received treatment for hypoparathyroidism. Conclusion PTH levels on POD 1 were normal in all patients who had at least one well vascularized parathyroid gland demonstrated during surgery by ICG angiography, and none required treatment for hypoparathyroidism. PMID:26864909

The functions of social support as protective factors for suicidal ideation in a sample of air force personnel.

PubMed

Bryan, Craig J; Hernandez, Ann Marie

2013-10-01

This study examined various functions of social support (i.e., tangible, esteem, belonging, and appraisal) were examined as protective factors for suicidal ideation in a sample of 273 active duty Air Force Security Forces personnel. Generalized linear regression analyses were conducted to determine if various social support functions were differentially associated with the presence and severity of suicidal ideation, both as main effects and as moderators of emotional distress. None of the four social support functions differentiated suicidal from nonsuicidal Airmen, but esteem support (i.e., feeling respected, encouraged, and valued by others) was associated with significantly less severe suicidal ideation (B = -.074, SE = .025, p = .003). A significant interaction of tangible support (i.e., access to material resources) with emotional distress indicated that emotional distress was associated with more severe suicidal ideation only among Airmen reporting low levels of tangible support (B = .006, SE = .003, p = .018). When considered concurrently, both tangible and self-esteem functions of social support are differentially associated with decreased suicidal ideation among Airmen, but belonging (i.e., having someone to do things with) and appraisal (i.e., having someone to talk to about problems) functions were not. Findings suggest that different aspects of social support affect suicidal ideation in different ways. © 2013 The American Association of Suicidology.

Murine fundus fluorescein angiography: An alternative approach using a handheld camera.

PubMed

Ehrenberg, Moshe; Ehrenberg, Scott; Schwob, Ouri; Benny, Ofra

2016-07-01

In today's modern pharmacologic approach to treating sight-threatening retinal vascular disorders, there is an increasing demand for a compact, mobile, lightweight and cost-effective fluorescein fundus camera to document the effects of antiangiogenic drugs on laser-induced choroidal neovascularization (CNV) in mice and other experimental animals. We have adapted the use of the Kowa Genesis Df Camera to perform Fundus Fluorescein Angiography (FFA) in mice. The 1 kg, 28 cm high camera has built-in barrier and exciter filters to allow digital FFA recording to a Compact Flash memory card. Furthermore, this handheld unit has a steady Indirect Lens Holder that firmly attaches to the main unit, that securely holds a 90 diopter lens in position, in order to facilitate appropriate focus and stability, for photographing the delicate central murine fundus. This easily portable fundus fluorescein camera can effectively record exceptional central retinal vascular detail in murine laser-induced CNV, while readily allowing the investigator to adjust the camera's position according to the variable head and eye movements that can randomly occur while the mouse is optimally anesthetized. This movable image recording device, with efficiencies of space, time, cost, energy and personnel, has enabled us to accurately document the alterations in the central choroidal and retinal vasculature following induction of CNV, implemented by argon-green laser photocoagulation and disruption of Bruch's Membrane, in the experimental murine model of exudative macular degeneration. Copyright © 2016 Elsevier Ltd. All rights reserved.

Developing the Rehabilitation Facility Personnel Manual.

ERIC Educational Resources Information Center

Gilbertson, Alan D.

This guide is intended to provide rehabilitation facilities with assistance in developing or improving their facility personnel manual, along with examples of what some rehabilitation facilities are including within their personnel manuals. The introduction to the guide discusses how a facility can begin the formulation of its personnel manual.…

Effectiveness of Fluorography versus Cineangiography at Reducing Radiation Exposure During Diagnostic Coronary Angiography

PubMed Central

Shah, Binita; Mai, Xingchen; Tummala, Lakshmi; Kliger, Chad; Bangalore, Sripal; Miller, Louis H.; Sedlis, Steven P.; Feit, Frederick; Liou, Michael; Attubato, Michael; Coppola, John; Slater, James

2014-01-01

Coronary angiography is the gold standard for defining obstructive coronary disease. However, radiation exposure remains an unwanted hazard. Patients referred for coronary angiography with abdominal circumference <45 inches and glomerular filtration rate >60mL/min were randomized to the Fluorography (n=25) or Cineangiography (n=25) group. Patients in the Fluorography group underwent coronary angiography using retrospectively-stored fluorography with repeat injection under cineangiography only when needed for better resolution per operator’s discretion. Patients in the Cineangiography group underwent coronary angiography using routine cineangiography. The primary endpoint was patient radiation exposure measured by radiochromic film. Secondary endpoints included the radiation output measurement of kerma-area product (KAP) and air kerma at the interventional reference point (Ka,r), and operator radiation exposure measured by dosimeter. Patient radiation exposure (158.2mGy [76.5–210.2] vs 272.5mGy [163.3–314.0], p=0.001), KAP (1323μGy m2 [826–1765] vs 3451μGy m2 [2464–4818], p<0.001), and Ka,r (175 mGy [112–252] vs 558 mGy [313–621], p<0.001)was significantly lower in the Fluorography compared with Cineangiography group (42%, 62%, and 69% relative reduction, respectively). Operator radiation exposure trended in the same direction though statistically non-significant (Fluorography 2.35 μGy [1.24–6.30] vs Cineangiography 5.03μGy [2.48–7.80], p=0.059). In conclusion, the use of fluorography in a select group of patients during coronary angiography with repeat injection under cineangiography only when needed was efficacious at reducing patient radiation exposure. PMID:24513469

BIRDSHOT CHORIORETINITIS LESIONS ON INDOCYANINE GREEN ANGIOGRAPHY AS AN INDICATOR OF DISEASE ACTIVITY.

PubMed

Cao, Jennifer H; Silpa-Archa, Sukhum; Freitas-Neto, Clovis A; Foster, C Stephen

2016-09-01

To determine whether classical indocyanine green angiography lesions in patients with birdshot chorioretinitis can be used to monitor disease activity. A retrospective case series was performed on 26 eyes in 26 consecutive patients with birdshot chorioretinitis who had at least one indocyanine green angiography performed during disease activity and another during disease quiescence. Using Photoshop, the mean number, area, and area per spot on indocyanine green angiography were compared between disease activity and quiescence using a paired ratio test. The mean total lesion number, area, and area per spot during disease activity were 75.27 spots, 24,525 pixels, and 364 pixels/spots, respectively. The mean total lesion number, area, and area per spot size during disease quiescence were 28.35 spots (P < 0.01), 7,411 pixels (P < 0.01), and 279 pixels/spot (P = 0.12), respectively. There was a statistically significant decrease in the mean total area and number of lesions between the time of disease activity and disease quiescence (P < 0.01). Our results suggest that indocyanine green angiography has a role not only in diagnosis but also in monitoring treatment effectiveness; lesions can be reversible with treatment and their reappearance may be an indicator of disease relapse.

Costing Child Protective Services Staff Turnover.

ERIC Educational Resources Information Center

Graef, Michelle I.; Hill, Erick L.

2000-01-01

Details process of determining a child welfare agency's actual dollar costs directly attributed to protective services staff turnover, using the agency's human resources database and interviews with administrative personnel. Provides formulas and process for calculating specific cost elements due to employee separation, replacement, and training.…

Study of computerized spirometric parameters of traffic police personnel of Saurashtra region, Gujarat, India.

PubMed

Makwana, Amit H; Solanki, Jayesh D; Gokhale, Pradnya A; Mehta, Hemant B; Shah, Chinmay J; Gadhavi, Bhakti P

2015-01-01

Air pollution due to road traffic is a serious health hazard and air quality crisis in cities is mainly due to vehicular emission. Thus the persons who are continuously exposed are at an increased risk. The study was carried out to evaluate the extent of impairment in lung function in traffic police personnel compared to matched unexposed control group. A cross-sectional study was conducted to measure the spirometric parameters of 100 traffic police personnel, aged 20-55 years, working in Saurashtra region, as compared to matched control group, consisting of 100 unexposed males. Measurement of lung volumes and capacities was done with SPIROEXCEL. The statistical analysis was carried out with Graph pad instat 3. Traffic police personnel had significantly declined forced vital capacity (FVC), forced expiratory volume in one second (FEV 1), slow vital capacity (SVC) and maximum voluntary ventilation (MVV) when compared with predictive normal values, which is probably due to exposure to vehicular exhaust. Comparison of test values between groups showed significantly reduced FVC, MVV and increased FEV1/FVC ratio and insignificantly declined FEV1 and SVC in cases as compared to controls. Traffic personnel with longer duration of exposure showed significantly reduced lung functions than those with shorter duration. Smokers showed lower test values as compared to non-smokers with significance only in unexposed group. The effect of pollution by vehicular exhausts may be responsible for these pulmonary function impairments and traffic police personnel should be offered personal protective or preventive measures.

Management of Spinal Arteriovenous Fistulae with Intraarterial Indocyanine Green Angiography: A Case Report.

PubMed

Caglar, Y Sukru; Ozdemir, Mevci; Kahilogullari, Gokmen; Bozkurt, Melih; Attar, Ayhan

2018-01-01

We describe herein intraoperative effectiveness of indocyanine green (ICG) video angiography to confirm dural arteriovenous fistulae. A 62-year-old man with a residual symptomatic dural arteriovenous fistula that was previously embolized at another institution is presented. On neurological examination, the motor strength in his both lower extremities was documented as grade 4 and the patella reflex was slightly increased. After verifying the presence of abnormal early venous drainage and retrograde flow with indocyanine green video angiography, the fistula was repaired. Postoperatively there was no additional neurologic deficit. Five days after the operation, the patient was discharged. Intraoperative ICG video angiography provides non-invasive and realtime information, reduction of spinal cord ischemic damage, rapid identification of feeding artery and confirmation of its complete disconnection during surgery, reduction of operative time, and improved outcome with no radiation hazard.

Computed tomography imaging and angiography - principles.

PubMed

Kamalian, Shervin; Lev, Michael H; Gupta, Rajiv

2016-01-01

The evaluation of patients with diverse neurologic disorders was forever changed in the summer of 1973, when the first commercial computed tomography (CT) scanners were introduced. Until then, the detection and characterization of intracranial or spinal lesions could only be inferred by limited spatial resolution radioisotope scans, or by the patterns of tissue and vascular displacement on invasive pneumoencaphalography and direct carotid puncture catheter arteriography. Even the earliest-generation CT scanners - which required tens of minutes for the acquisition and reconstruction of low-resolution images (128×128 matrix) - could, based on density, noninvasively distinguish infarct, hemorrhage, and other mass lesions with unprecedented accuracy. Iodinated, intravenous contrast added further sensitivity and specificity in regions of blood-brain barrier breakdown. The advent of rapid multidetector row CT scanning in the early 1990s created renewed enthusiasm for CT, with CT angiography largely replacing direct catheter angiography. More recently, iterative reconstruction postprocessing techniques have made possible high spatial resolution, reduced noise, very low radiation dose CT scanning. The speed, spatial resolution, contrast resolution, and low radiation dose capability of present-day scanners have also facilitated dual-energy imaging which, like magnetic resonance imaging, for the first time, has allowed tissue-specific CT imaging characterization of intracranial pathology. © 2016 Elsevier B.V. All rights reserved.

Personal Protective Equipment in Animal Research

PubMed Central

Villano, Jason S; Follo, Janet M; Chappell, Mark G; Jr, Morris T Collins

2017-01-01

The occupational health and safety program is an integral component of a comprehensive animal care and use program. It is important to mitigate the risk of exposures of animal care and research personnel to allergens and physical, chemical, radiologic, and biologic hazards during the conduct of various tasks. This need is especially true in infectious disease and biocontainment research. One aspect of the program is the provision of personal protective equipment (PPE). Commercially available PPE should be carefully evaluated based on their material composition and performance according to manufacturer data. To help institutions and end users by providing them guidance on choosing appropriate PPE, we here discuss the regulatory framework, device standards, and materials engineering for various PPE, including gloves, shoe covers, head caps, gowns, aprons, masks, hearing and eye protection devices, and respirators. Ultimately, the choice of appropriate PPE is based on the risk assessment, which should include consideration for personnel comfort, correct device fitting, and the containment level for the hazard used. PMID:28662749

Personnel Safety on Electrified Railroads

DOT National Transportation Integrated Search

1980-06-01

Potential electrical hazards to fire, police, and rescue personnel responding to emergencies on electrified railways are examined. Data on descriptions of electrical facilities, types of accidents and danger to emergency personnel, and reviews of ope...

Malaria in Brazilian military personnel deployed to Angola.

PubMed

Sanchez, J L; Bendet, I; Grogl, M; Lima, J B; Pang, L W; Guimaraes, M F; Guedes, C M; Milhous, W K; Green, M D; Todd, G D

2000-01-01

of morbidity among Brazilian Army military personnel deployed to Angola. Mefloquine prophylaxis appeared to protect soldiers from clinical, but not subclinical, P. falciparum infections. Mefloquine noncompliance and an erratic chemoprophylaxis prevention policy contributed to this large outbreak in nonimmune personnel. This report highlights the pressing need for development of newer, more efficacious and practical, prophylactic drug regimens that will reduce the malaria threat to military forces and travelers.

33 CFR 150.611 - What head protection is required?

Code of Federal Regulations, 2010 CFR

2010-07-01

... of injury from falling objects or contact with electrical conductors, personnel working or visiting such an area wear head protectors designed to protect them against such injury and complying with 29...

A randomized-controlled trial examining the effects of reflexology on anxiety of patients undergoing coronary angiography.

PubMed

Molavi Vardanjani, Mehdi; Masoudi Alavi, Negin; Razavi, Narges Sadat; Aghajani, Mohammad; Azizi-Fini, Esmail; Vaghefi, Seied Morteza

2013-09-01

The anxiety reduction before coronary angiography has clinical advantages and is one of the objectives of nursing. Reflexology is a non-invasive method that has been used in several clinical situations. Applying reflexology might have effect on the reduction of anxiety before coronary angiography. The aim of this randomized clinical trial was to investigate the effect of reflexology on anxiety among patients undergoing coronary angiography. This trial was conducted in Shahid Beheshti Hospital, in Kashan, Iran. One hundred male patients who were undergoing coronary angiography were randomly enrolled into intervention and placebo groups. The intervention protocol was included 30 minutes of general foot massage and the stimulation of three reflex points including solar plexus, pituitary gland, and heart. The placebo group only received the general foot massage. Spielbergers state trait anxiety inventory was used to assess the anxiety experienced by patients. Data was analyzed using Man-Witney, Wilcoxon and Chi-square tests. The stepwise multiple regressions used to analyze the variables that are involved in anxiety reduction. The mean range of anxiety decreased from 53.24 to 45.24 in reflexology group which represented 8 score reduction (P = 0.0001). The reduction in anxiety was 5.9 score in placebo group which was also significant (P = 0.0001). The anxiety reduction was significantly higher in reflexology group (P = 0.014). The stepwise multiple regression analysis showed that doing reflexology can explain the 7.5% of anxiety reduction which made a significant model. Reflexology can decrease the anxiety level before coronary angiography. Therefore, reflexology before coronary angiography is recommended.

Assessment of an introductory cervicocerebral catheter angiography learning program: a pilot study.

PubMed

Lui, Y W; Farinhas, J M; Basalely, A M; Hsu, K A; Freeman, K; Bello, J A

2012-06-01

There is no standardized curriculum currently available at most institutions for establishing procedural competency in trainees performing cervicocerebral angiography. The purpose of this study was to evaluate a simple learning program to supplement the teaching of basic cervicocerebral angiography. An 11-session interactive curriculum was implemented covering anatomic, clinical, and radiographic topics for the novice cervicocerebral angiographer. The target learner was the neuroradiology fellow. Data were gathered regarding fellow comfort level on topics relating to cervicocerebral angiography by using a 5-point Likert scale. Improvement in scores on knowledge-based questions after completion of the curriculum was calculated (McNemar test). Trainee-perceived utility of the program was also recorded by using a 5-point Likert scale. Focus sessions were held at the completion of the curriculum to gather feedback regarding the strengths and weaknesses of the program from participants. Ten subjects were enrolled in this pilot study for 3 years. Topics where participants reported a poor initial comfort level (4 or higher) included selection of injection rates and volumes and reformation of reverse-curve catheters. Trainees demonstrated a statistically significant change in the distribution of scores of 29.3% (49.4%-78.7% correct response rate, P < .0001). The average perceived utility was 1.5 (1 = most useful, 5 = least useful). This simple learning program was a useful adjunct to the training of fellows in diagnostic cervicocerebral angiography, resulting in quantitative improvements in knowledge.

EVALUATION OF BURIED CONDUITS AS PERSONNEL SHELTERS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Albright, G.H.; LeDoux, J.C.; Mitchell, R.A.

1960-07-14

Supersedes ITR-1421. Twelve large-diameter buried conduit sections of various shapes were tested in the 60- to l49-psi overpressure region of Burst Priscilla to make an empirical determination of the degree of personnel protection afforded by commercially available steel and concrete conduits at depths of burial of 5, 7.5, and 10 feet below grade. Essentially, it was desired to assure that Repartment of Defense Class I, 100psi and comparable radiations, and Class II, 50-psi and comparable radiations, protection is afforded by use of such conduits of various configurations. Measurements were made of free-field overpressure at the ground surface above the structure;more » pressure inside the structures; acceleration of each structure; deflection of each structure; dust inside each structure; fragmentary missiles inside the concrete structures; and gamma and neutron radiation dose inside each structure. All buried conduit sections tested provided adequate Class I protection for the conditions under which the conduits were tested. Standard 8-foot concrete sewer pipe withstood 126-psi overpressure without significant damage, minor tension cracks observed; standard 10-gage corrugated-steel 8-foot circular conduit sections withstood 126- psi overpressure without significant damage; and standard 10-gage corrugated- steel cattle-pass conduits withstood 149-psi overpressure without significant damage. Durations of positive pressure were from 206 to 333 milliseconds. (auth)« less

Gamma Knife surgery for arteriovenous malformations in the brain: integration of time-resolved contrast-enhanced magnetic resonance angiography into dosimetry planning. Technical note.

PubMed

Taschner, Christian A; Le Thuc, Vianney; Reyns, Nicolas; Gieseke, Juergen; Gauvrit, Jean-Yves; Pruvo, Jean-Pierre; Leclerc, Xavier

2007-10-01

The aim of this study was to develop an algorithm for the integration of time-resolved contrast-enhanced magnetic resonance (MR) angiography into dosimetry planning for Gamma Knife surgery (GKS) of arteriovenous malformations (AVMs) in the brain. Twelve patients harboring brain AVMs referred for GKS underwent intraarterial digital subtraction (DS) angiography and time-resolved MR angiography while wearing an externally applied cranial stereotactic frame. Time-resolved MR angiography was performed on a 1.5-tesla MR unit (Achieva, Philips Medical Systems) using contrast-enhanced 3D fast field echo sequencing with stochastic central k-space ordering. Postprocessing with interactive data language (Research Systems, Inc.) produced hybrid data sets containing dynamic angiographic information and the MR markers necessary for stereotactic transformation. Image files were sent to the Leksell GammaPlan system (Elekta) for dosimetry planning. Stereotactic transformation of the hybrid data sets containing the time-resolved MR angiography information with automatic detection of the MR markers was possible in all 12 cases. The stereotactic coordinates of vascular structures predefined from time-resolved MR angiography matched with DS angiography data in all cases. In 10 patients dosimetry planning could be performed based on time-resolved MR angiography data. In two patients, time-resolved MR angiography data alone were considered insufficient. The target volumes showed a notable shift of centers between modalities. Integration of time-resolved MR angiography data into the Leksell GammaPlan system for patients with brain AVMs is feasible. The proposed algorithm seems concise and sufficiently robust for clinical application. The quality of the time-resolved MR angiography sequencing needs further improvement.

Automatic segmentation and co-registration of gated CT angiography datasets: measuring abdominal aortic pulsatility

NASA Astrophysics Data System (ADS)

Wentz, Robert; Manduca, Armando; Fletcher, J. G.; Siddiki, Hassan; Shields, Raymond C.; Vrtiska, Terri; Spencer, Garrett; Primak, Andrew N.; Zhang, Jie; Nielson, Theresa; McCollough, Cynthia; Yu, Lifeng

2007-03-01

Purpose: To develop robust, novel segmentation and co-registration software to analyze temporally overlapping CT angiography datasets, with an aim to permit automated measurement of regional aortic pulsatility in patients with abdominal aortic aneurysms. Methods: We perform retrospective gated CT angiography in patients with abdominal aortic aneurysms. Multiple, temporally overlapping, time-resolved CT angiography datasets are reconstructed over the cardiac cycle, with aortic segmentation performed using a priori anatomic assumptions for the aorta and heart. Visual quality assessment is performed following automatic segmentation with manual editing. Following subsequent centerline generation, centerlines are cross-registered across phases, with internal validation of co-registration performed by examining registration at the regions of greatest diameter change (i.e. when the second derivative is maximal). Results: We have performed gated CT angiography in 60 patients. Automatic seed placement is successful in 79% of datasets, requiring either no editing (70%) or minimal editing (less than 1 minute; 12%). Causes of error include segmentation into adjacent, high-attenuating, nonvascular tissues; small segmentation errors associated with calcified plaque; and segmentation of non-renal, small paralumbar arteries. Internal validation of cross-registration demonstrates appropriate registration in our patient population. In general, we observed that aortic pulsatility can vary along the course of the abdominal aorta. Pulsation can also vary within an aneurysm as well as between aneurysms, but the clinical significance of these findings remain unknown. Conclusions: Visualization of large vessel pulsatility is possible using ECG-gated CT angiography, partial scan reconstruction, automatic segmentation, centerline generation, and coregistration of temporally resolved datasets.

Rotational Angiography Based Three-Dimensional Left Atrial Reconstruction: A New Approach for Transseptal Puncture.

PubMed

Koektuerk, Buelent; Yorgun, Hikmet; Koektuerk, Oezlem; Turan, Cem H; Gorr, Eduard; Horlitz, Marc; Turan, Ramazan G

2016-02-01

Rotational angiography is a well-known method for the three-dimensional (3-D) reconstruction of left atrium and pulmonary veins during left-sided atrial arrhythmia ablation procedures. In our study, we aimed to review our experience in transseptal puncture (TSP) using 3-D rotational angiography. We included a total of 271 patients who underwent atrial fibrillation ablation using cryoballoon. Rotational angiography was performed to get the three-dimensional left atrial and pulmonary vein reconstructions using cardiac C-arm computed tomography. The image reconstruction was made using the DynaCT Cardiac software (Siemens, Erlangen, Germany). The mean age of the study population was 61 ± 10 years. The indications for left atrial arrhythmia ablation were paroxysmal AF in 140 patients (52%) and persistent AF patients in 131 (48%) patients. The success rate of TSP using only rotational guidance was (264/271 patients, 97.4%). In the remaining seven patients, transesophageal guidance was used after the initial attempt due to thick interatrial septum in five patients and difficult TSP due to abnormal anatomy and mild pericardial effusion in the remaining two patients. Mean fluoroscopy dosage of the rotational angiography was 4896.4 ± 825.3 μGym(2). The mean time beginning from femoral vein puncture to TSP was 12.3 ± 5.5 min. TSP guided by rotational angiography is a safe and effective method. Our results indicate that integration of rotational angiographic images into the real-time fluoroscopy can guide the TSP during the procedure. © 2015 John Wiley & Sons Ltd.

75 FR 32833 - Privacy Act of 1974, as Amended; Computer Matching Program (SSA/Office of Personnel Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-09

... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2009-0077] Privacy Act of 1974, as Amended; Computer Matching Program (SSA/ Office of Personnel Management (OPM))--Match 1307 AGENCY: Social Security... INFORMATION: A. General The Computer Matching and Privacy Protection Act of 1988 (Public Law (Pub. L.) 100-503...

Advantages and Disadvantages of the National Security Personnel System as Compared to the General Schedule Personnel System

DTIC Science & Technology

2005-12-01

NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA JOINT APPLIED PROJECT Advantages and Disadvantages of the National Security...Applied Project 4. TITLE AND SUBTITLE: Advantages and Disadvantages of the National Security Personnel System as Compared to the General...compare and contrast the advantages and disadvantages of the new personnel system (NSPS) versus the General Schedule (GS) personnel system currently

[Preoperative CT angiography for planning free perforator flaps in breast reconstruction].

PubMed

Kuekrek, H; Müller, D; Paepke, S; Dobritz, M; Machens, H-G; Giunta, R E

2011-04-01

Preoperative Doppler ultrasonography for planning free perforator flaps is widely established to identify preoperatively perforators. The method allows one to localise the penetrating point of the perforator through the abdominal fascia. By this means it is not possible to see the intramuscular course or the position of the perforator in relation to the inferior epigastric artery. Lately the technique of computed tomographic angiography provides an opportunity for visualising the course of perforator vessels in these tissues. This paper summarises our experience with the preoperative CT angiography in our breast centre. Since spring 2009 we have reconstructed the breasts of 44 female patients by using free flaps from the lower abdominal wall. 6 of these were bilateral. In a total number of 50 breast reconstructions we used 23 deep inferior epigastric perforator (DIEP) flaps and 27 muscle-sparing transverse rectus abdominis muscle (TRAM) flaps. In addition to the preoperative ultrasonography, a CT angiography of the lower abdomen was conducted in 29 patients. On average they showed at least 2 perforators on the left as well as right abdominal sides, which could be used as flap vessels based on their signal intensity. Based on their estimated microsurgical dissection complexity, the perforator vessels could be classified into 3 groups: 1) direct perforators of category A with short intramuscular course (39%), 2) perforators with long intramuscular course of category B (50%) and 3) "turn around" perforators of category C, which pass medially around the rectus abdominis (11%). The technique of CT angiography permits a reliable preoperative visualisation of perforators in their entire course and facilitates the selection of the supplying perforator as well as the intraoperative procedure for the surgeon. The suggested classification of perforators into 3 groups simplifies the preoperative assessment of the microsurgical dissection effort. Compared to the commonly used

Indocyanine green fluorescence angiography for free flap monitoring: A pilot study.

PubMed

Hitier, Marine; Cracowski, Jean-Luc; Hamou, Cynthia; Righini, Christian; Bettega, Georges

2016-11-01

We evaluated the feasibility and the tolerance of repeated fluorescent indocyanine green angiography in free flap monitoring, and determined the intraoperative predictive values of flap vitality. The free flap failure rate has been significantly reduced, but free flap loss still occurs and remains a costly disaster. Repeated clinical examinations are commonly used for flap monitoring, but they can be unreliable because of their subjectivity. Laser-induced fluorescence of indocyanine green is a new method for assessing tissue perfusion. 20 patients undergoing microsurgical reconstruction were monitored by indocyanine green fluorescence angiography, intraoperatively, and during 4 days after surgery, with 18 injections. Monitoring was made by clinical examination, and then compared to angiographic findings. The vascular complication rate was 15% (3/20) with 2 cases of venous thrombosis and one case of partial necrosis of the flap skin paddle. Both cases of venous thrombosis were salvaged by secondary surgery. There was no total flap loss. ICG angiography allowed detecting each intra and postoperative complication, earlier than clinical examination. The mean per-operative intensity of fluorescence was significantly lower in flaps with vascular complications (23.8 GL/ms; p = 0.008). The postoperative slope (p = 0.02) and amplitude (p = 0.03) of the fluorescent signal were both significantly lower than for uncomplicated flaps, before surgical revision. These 2 parameters came back to normal values after secondary surgery. There was no adverse effect of ICG despite the repeated injections. ICG angiography is a feasible and safe technique for the detection of free flap vascular complications. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

A cost-utility analysis of the use of preoperative computed tomographic angiography in abdomen-based perforator flap breast reconstruction.

PubMed

Offodile, Anaeze C; Chatterjee, Abhishek; Vallejo, Sergio; Fisher, Carla S; Tchou, Julia C; Guo, Lifei

2015-04-01

Computed tomographic angiography is a diagnostic tool increasingly used for preoperative vascular mapping in abdomen-based perforator flap breast reconstruction. This study compared the use of computed tomographic angiography and the conventional practice of Doppler ultrasonography only in postmastectomy reconstruction using a cost-utility model. Following a comprehensive literature review, a decision analytic model was created using the three most clinically relevant health outcomes in free autologous breast reconstruction with computed tomographic angiography versus Doppler ultrasonography only. Cost and utility estimates for each health outcome were used to derive the quality-adjusted life-years and incremental cost-utility ratio. One-way sensitivity analysis was performed to scrutinize the robustness of the authors' results. Six studies and 782 patients were identified. Cost-utility analysis revealed a baseline cost savings of $3179, a gain in quality-adjusted life-years of 0.25. This yielded an incremental cost-utility ratio of -$12,716, implying a dominant choice favoring preoperative computed tomographic angiography. Sensitivity analysis revealed that computed tomographic angiography was costlier when the operative time difference between the two techniques was less than 21.3 minutes. However, the clinical advantage of computed tomographic angiography over Doppler ultrasonography only showed that computed tomographic angiography would still remain the cost-effective option even if it offered no additional operating time advantage. The authors' results show that computed tomographic angiography is a cost-effective technology for identifying lower abdominal perforators for autologous breast reconstruction. Although the perfect study would be a randomized controlled trial of the two approaches with true cost accrual, the authors' results represent the best available evidence.

Optical coherence tomography angiography retinal vascular network assessment in multiple sclerosis.

PubMed

Lanzillo, Roberta; Cennamo, Gilda; Criscuolo, Chiara; Carotenuto, Antonio; Velotti, Nunzio; Sparnelli, Federica; Cianflone, Alessandra; Moccia, Marcello; Brescia Morra, Vincenzo

2017-09-01

Optical coherence tomography (OCT) angiography is a new method to assess the density of the vascular networks. Vascular abnormalities are considered involved in multiple sclerosis (MS) pathology. To assess the presence of vascular abnormalities in MS and to evaluate their correlation to disease features. A total of 50 MS patients with and without history of optic neuritis (ON) and 46 healthy subjects were included. All underwent spectral domain (SD)-OCT and OCT angiography. Clinical history, Expanded Disability Status Scale (EDSS), Multiple Sclerosis Severity Score (MSSS) and disease duration were collected. Angio-OCT showed a vessel density reduction in eyes of MS patients when compared to controls. A statistically significant reduction in all SD-OCT and OCT angiography parameters was noticed both in eyes with and without ON when compared with control eyes. We found an inverse correlation between SD-OCT parameters and MSSS ( p = 0.003) and between vessel density parameters and EDSS ( p = 0.007). We report a vessel density reduction in retina of MS patients. We highlight the clinical correlation between vessel density and EDSS, suggesting that angio-OCT could be a good marker of disease and of disability in MS.

Navy-wide Personnel Survey (NPS) 2007-2008: Tabulated Results

DTIC Science & Technology

2011-02-01

wide Personnel Survey (NPS) is a major product of the Navy Personnel Survey System ( NPSS ). Administered regularly by the Navy Personnel Research...2008 NPS was conducted under the sponsorship of the Chief of Naval Personnel (N1) within the Navy Personnel Survey System ( NPSS ) funding line...the Chief of Naval Personnel instituted the Navy Personnel Survey System ( NPSS ) as a means of collecting and organizing information regarding the

20 CFR 416.1021 - Personnel.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Personnel. 416.1021 Section 416.1021 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Determinations of Disability Administrative Responsibilities and Requirements § 416.1021 Personnel...

20 CFR 404.1621 - Personnel.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Personnel. 404.1621 Section 404.1621 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determinations of Disability Administrative Responsibilities and Requirements § 404.1621 Personnel. (a) Equal...

Evaluation of Collaterals and Clot Burden Using Time-Resolved C-Arm Conebeam CT Angiography in the Angiography Suite: A Feasibility Study.

PubMed

Yang, P; Niu, K; Wu, Y; Struffert, T; Doerfler, A; Holter, P; Aagaard-Kienitz, B; Strother, C; Chen, G-H

2017-04-01

The assessment of collaterals and clot burden in patients with acute ischemic stroke provides important information about treatment options and clinical outcome. Time-resolved C-arm conebeam CT angiography has the potential to provide accurate and reliable evaluations of collaterals and clot burden in the angiographic suite. Experience with this technique is extremely limited, and feasibility studies are needed to validate this technique. Our purpose was to present such a feasibility study. Ten C-arm conebeam CT perfusion datasets from 10 subjects with acute ischemic stroke acquired before endovascular treatment were retrospectively processed to generate time-resolved conebeam CTA. From time-resolved conebeam CTA, 2 experienced readers evaluated the clot burden and collateral flow in consensus by using previously reported scoring systems and assessed the clinical value of this novel imaging technique independently. Interobserver agreement was analyzed by using the intraclass correlation analysis method. Clot burden and collateral flow can be assessed by using the commonly accepted scoring systems for all eligible cases. Additional clinical information (eg, the quantitative dynamic information of collateral flow) can be obtained from this new imaging technique. Two readers agreed that time-revolved C-arm conebeam CTA is the preferred method for evaluating the clot burden and collateral flow compared with other conventional imaging methods. Comprehensive evaluations of clot burden and collateral flow are feasible by using time-resolved C-arm conebeam CTA data acquired in the angiography suite. This technique further enriches the imaging tools in the angiography suite to enable a "one-stop- shop" imaging workflow for patients with acute ischemic stroke. © 2017 by American Journal of Neuroradiology.

Fire protection for a Martian colony

NASA Astrophysics Data System (ADS)

Beattie, Robert M., Jr.

The fire prevention failures that occurred in Apollo 1 and Challenger accidents are reviewed and used to discuss fire protection measures that should be taken in a Martian colony. Fire detection systems, classes of fire, and suppression agents are described. The organization of fire fighting personnel appropriate for Mars is addressed.

Protecting your eyes in the laser operating room.

PubMed

Sallavanti, R A

1995-01-01

1. Laser protective eyewear is nearly as important to the OR nurse as the surgical mask in an operating room where laser surgery is performed. 2. Most hospitals require OR personnel to wear protective eyewear during laser procedures in voluntary compliance with American National Standards Institute (ANSI) Z136.3 for the safe use of lasers in health care facilities. 3. The basic steps to protecting your eyes are as follows: Select the appropriate eyewear (plastic or glass); make sure the eyewear fits properly; wear the protective lenses during laser testing and operation; and heed your laser safety officer.

Optical coherence tomography angiography in glaucoma care.

PubMed

Chansangpetch, Sunee; Lin, Shan C

2018-05-14

Rapid improvements in optical coherence tomography (OCT) technology have allowed for enhancement of both image resolution and scanning speed, and the development of vascular assessment modality. Optical coherence tomography angiography (OCTA) is the non-invasive in vivo imaging of the vasculature located within the retina and optic nerve head area. The principle of OCTA is to use the variations in OCT signals caused by moving particles as the contrast mechanism for imaging of flow. Several algorithms which aim to maximize the contrast signal and minimize the noise have been developed including the phase-based techniques, intensity-based techniques (e.g., split-spectrum amplitude decorrelation angiography (SSADA)), and complex-based techniques (e.g., optical microangiography (OMAG)). With its reliable technique, high image resolution, and current availability, OCTA has been widely used in the assessment of posterior segment diseases including glaucoma in which ocular perfusion dysfunction has been proposed as a pathophysiological mechanism. This review will provide the reader with information on the principle techniques of OCTA; the current literature on OCTA reproducibility; its applications to glaucoma detection and monitoring of progression; and the role of OCTA in the assessment of the vascular component in glaucoma pathogenesis.

Dispensing Medical Countermeasures: Emergency Use Authorities and Liability Protections

PubMed Central

2015-01-01

The Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (PAHPRA) enhances emergency use authorities with respect to both approved and unapproved medical countermeasures (MCMs). PAHPRA authorities can also be critical to preserving tort liability protections for public health stakeholders, since these protections are often contingent upon appropriate authorizations for the MCMs utilized. This article details the evolution of emergency use authorities and liability protections, analyzes how these separate legal doctrines can intersect in practice, and discusses implications for facilitating preparedness and response activities and for protecting associated personnel. PMID:25813980

29 CFR 1917.27 - Personnel.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 7 2011-07-01 2011-07-01 false Personnel. 1917.27 Section 1917.27 Labor Regulations...) MARINE TERMINALS Marine Terminal Operations § 1917.27 Personnel. (a) Qualifications of machinery...) elements of accident prevention; (iii) attitudes, leadership and motivation; (iv) hazards of longshoring...

21 CFR 58.29 - Personnel.

Code of Federal Regulations, 2011 CFR

2011-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Organization and Personnel § 58.29 Personnel. (a) Each individual engaged in the conduct of or responsible for the supervision of a nonclinical laboratory study shall have...

The Dartnell Personnel Director's Handbook.

ERIC Educational Resources Information Center

Scheer, Wilbert E.

This handbook for personnel directors is designed to help improve the acquisition, selection, development, welfare, and general administration and control of business and industrial employees. Overall objectives and functions of personnel management are considered first. Part 2 (Employment) stresses advance planning; recruiting and interviewing;…

Characterization of normal feline renal vascular anatomy with dual-phase CT angiography.

PubMed

Cáceres, Ana V; Zwingenberger, Allison L; Aronson, Lillian R; Mai, Wilfried

2008-01-01

Helical computed tomography angiography was used to evaluate the renal vascular anatomy of potential feline renal donors. One hundred and fourteen computed tomography angiograms were reviewed. The vessels were characterized as single without bifurcation, single with bifurcation, double, or triple. Multiplicity was most commonly seen for the right renal vein (45/114 vs. 3/114 multiple left renal veins, 0/114 multiple right renal arteries, and 8/114 multiple left renal arteries). The right kidney was 13.3 times more likely than the left to have multiple renal veins. Additional vascular variants included double caudal vena cava and an accessory renal artery. For the left kidney, surgery and computed tomography angiography findings were in agreement in 92% of 74 cats. For the right kidney, surgery and computed tomography angiography findings were in agreement in 6/6 cats. Our findings of renal vascular anatomy variations in cats were similar to previous reports in humans. Identifying and recognizing the pattern of distribution of these vessels is important when performing renal transplantation.

A Randomized-Controlled Trial Examining the Effects of Reflexology on Anxiety of Patients Undergoing Coronary Angiography

PubMed Central

Molavi Vardanjani, Mehdi; Masoudi Alavi, Negin; Razavi, Narges Sadat; Aghajani, Mohammad; Azizi-Fini, Esmail; Vaghefi, Seied Morteza

2013-01-01

Background: The anxiety reduction before coronary angiography has clinical advantages and is one of the objectives of nursing. Reflexology is a non-invasive method that has been used in several clinical situations. Applying reflexology might have effect on the reduction of anxiety before coronary angiography. Objectives: The aim of this randomized clinical trial was to investigate the effect of reflexology on anxiety among patients undergoing coronary angiography. Patients and Methods: This trial was conducted in Shahid Beheshti Hospital, in Kashan, Iran. One hundred male patients who were undergoing coronary angiography were randomly enrolled into intervention and placebo groups. The intervention protocol was included 30 minutes of general foot massage and the stimulation of three reflex points including solar plexus, pituitary gland, and heart. The placebo group only received the general foot massage. Spielbergers state trait anxiety inventory was used to assess the anxiety experienced by patients. Data was analyzed using Man-Witney, Wilcoxon and Chi-square tests. The stepwise multiple regressions used to analyze the variables that are involved in anxiety reduction. Results: The mean range of anxiety decreased from 53.24 to 45.24 in reflexology group which represented 8 score reduction (P = 0.0001). The reduction in anxiety was 5.9 score in placebo group which was also significant (P = 0.0001). The anxiety reduction was significantly higher in reflexology group (P = 0.014). The stepwise multiple regression analysis showed that doing reflexology can explain the 7.5% of anxiety reduction which made a significant model. Conclusions: Reflexology can decrease the anxiety level before coronary angiography. Therefore, reflexology before coronary angiography is recommended. PMID:25414869

Optical coherence tomography based angiography [Invited

PubMed Central

Chen, Chieh-Li; Wang, Ruikang K.

2017-01-01

Optical coherence tomography (OCT)-based angiography (OCTA) provides in vivo, three-dimensional vascular information by the use of flowing red blood cells as intrinsic contrast agents, enabling the visualization of functional vessel networks within microcirculatory tissue beds non-invasively, without a need of dye injection. Because of these attributes, OCTA has been rapidly translated to clinical ophthalmology within a short period of time in the development. Various OCTA algorithms have been developed to detect the functional micro-vasculatures in vivo by utilizing different components of OCT signals, including phase-signal-based OCTA, intensity-signal-based OCTA and complex-signal-based OCTA. All these algorithms have shown, in one way or another, their clinical values in revealing micro-vasculatures in biological tissues in vivo, identifying abnormal vascular networks or vessel impairment zones in retinal and skin pathologies, detecting vessel patterns and angiogenesis in eyes with age-related macular degeneration and in skin and brain with tumors, and monitoring responses to hypoxia in the brain tissue. The purpose of this paper is to provide a technical oriented overview of the OCTA developments and their potential pre-clinical and clinical applications, and to shed some lights on its future perspectives. Because of its clinical translation to ophthalmology, this review intentionally places a slightly more weight on ophthalmic OCT angiography. PMID:28271003

[Radiation protection in interventional radiology].

PubMed

Adamus, R; Loose, R; Wucherer, M; Uder, M; Galster, M

2016-03-01

The application of ionizing radiation in medicine seems to be a safe procedure for patients as well as for occupational exposition to personnel. The developments in interventional radiology with fluoroscopy and dose-intensive interventions require intensified radiation protection. It is recommended that all available tools should be used for this purpose. Besides the options for instruments, x‑ray protection at the intervention table must be intensively practiced with lead aprons and mounted lead glass. A special focus on eye protection to prevent cataracts is also recommended. The development of cataracts might no longer be deterministic, as confirmed by new data; therefore, the International Commission on Radiological Protection (ICRP) has lowered the threshold dose value for eyes from 150 mSv/year to 20 mSv/year. Measurements show that the new values can be achieved by applying all X‑ray protection measures plus lead-containing eyeglasses.

Wall-to-lumen ratio of intracranial arteries measured by indocyanine green angiography

PubMed Central

Nakagawa, Daichi; Shojima, Masaaki; Yoshino, Masanori; Kin, Taichi; Imai, Hideaki; Nomura, Seiji; Saito, Toki; Nakatomi, Hirofumi; Oyama, Hiroshi; Saito, Nobuhito

2016-01-01

Background: The wall-to-lumen ratio (WLR) is an important parameter in vascular medicine because it indicates the character of vascular wall as well as the degree of stenosis. Despite the advances in medical imaging technologies, it is still difficult to measure the thin-walled normal intracranial arteries, and the reports on the WLR of normal intracranial artery are limited. It might be possible to calculate the WLR using the indocyanine green (ICG) angiography, which is used to observe intracranial vessels during microsurgery. Purpose: To evaluate the WLR of normal intracranial arteries using ICG angiography. Materials and Methods: From the three cases in which ICG angiography was recorded with a ruler during microsurgery, 20 measurement points were chosen for the analysis. The ICG was injected intravenously with a dose of 0.2 mg/kg, and the vessels were inspected at high magnification using an operating microscope equipped with near-infrared illumination system. The vessel outer diameter and the luminal diameter were measured using the images before and after the ICG arrival based on the pixel ratio method using a ruler as reference, respectively. The WLR was calculated as 0.5 × (vessel outer diameter − vessel luminal diameter). Results: The WLR (mean ± standard deviation) of normal intracranial arteries was 0.086 ± 0.022. The WLR tended to be high in small arteries. Conclusion: The WLR of normal intracranial arteries calculated using ICG angiography was consistent with the WLR reported in the previous reports based on human autopsy. PMID:27695538

SU-E-P-20: Personnel Lead Apparel Integrity Inspection: Where We Are and What We Need?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smith, S; Zhang, J; Anaskevich, L

Purpose: In recent years, tremendous efforts have been devoted to radiation dose reduction, especially for patients who are directly exposed to primary radiation or receive radiopharmaceuticals. Limited efforts have been focused on those personnel who are exposed to secondary radiation while fulfilling their work responsibilities associated with diagnostic imaging and image-guided interventions. Occupational exposure is compounded in daily practice and can lead to a significant radiation dose over time. Personnel lead apparel is a well-accepted engineering control to protect healthcare workers when radiation is inevitable. The question is, do we have a nationally established program to protect personnel? This studymore » is to investigate the lead apparel inspection programs among the USA. Methods: A series of surveys of state regulations, the University Health System Consortium, and federal regulations and regulations determined by accrediting bodies were conducted. The surveys were used to determine the current status of lead apparel programs regarding integrity inspections. Based on the survey results, a thorough program was proposed accordingly. Results: Of 50 states, seventeen states and Washington D.C. require lead apparel integrity inspections within their state regulations. Eleven of these states specify that the inspection is required on an annual basis. Two of these states require lead apron integrity checks to be performed semi-annually. Eleven out of the two hundred academic medical centers surveyed responded. The results show that the method (visually vs. fluoroscopy) used to conduct lead apparel integrity checks differ greatly amongst healthcare organizations. The FDA, EPA, CRCPD and NCRP require lead apparel integrity checks. However, the level of policies is different. A standard program is not well established and clearly there is a lack of standardization. Conclusion: A program led by legislative (state or federal government) and with specific

When is rotational angiography superior to conventional single-plane angiography for planning coronary angioplasty?

PubMed

Morris, Paul D; Taylor, Jane; Boutong, Sara; Brett, Sarah; Louis, Amal; Heppenstall, James; Morton, Allison C; Gunn, Julian P

2016-03-01

To investigate the value of rotational coronary angiography (RoCA) in the context of percutaneous coronary intervention (PCI) planning. As a diagnostic tool, RoCA is associated with decreased patient irradiation and contrast use compared with conventional coronary angiography (CA) and provides superior appreciation of three-dimensional anatomy. However, its value in PCI remains unknown. We studied stable coronary artery disease assessment and PCI planning by interventional cardiologists. Patients underwent either RoCA or conventional CA pre-PCI for planning. These were compared with the referral CA (all conventional) in terms of quantitative lesion assessment and operator confidence. An independent panel reanalyzed all parameters. Six operators performed 127 procedures (60 RoCA, 60 conventional CA, and 7 crossed-over) and assessed 212 lesions. RoCA was associated with a reduction in the number of lesions judged to involve a bifurcation (23 vs. 30 lesions, P < 0.05) and a reduction in the assessment of vessel caliber (2.8 vs. 3.0 mm, P < 0.05). RoCA improved confidence assessing lesion length (P = 0.01), percentage stenosis (P = 0.02), tortuosity (P < 0.04), and proximity to a bifurcation (P = 0.03), particularly in left coronary artery cases. X-ray dose, contrast agent volume, and procedure duration were not significantly different. Compared with conventional CA, RoCA augments quantitative lesion assessment, enhances confidence in the assessment of coronary artery disease and the precise details of the proposed procedure, but does not affect X-ray dose, contrast agent volume, or procedure duration. © 2015 The Authors. Catheterization and Cardiovascular Interventions. Published by Wiley Periodicals, Inc.

76 FR 81359 - National Security Personnel System

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-28

... contains regulatory documents #0;having general applicability and legal effect, most of which are keyed #0... Security Personnel System AGENCY: Department of Defense; Office of Personnel Management. ACTION: Final rule... concerning the National Security Personnel System (NSPS). Section 1113 of the National Defense Authorization...

78 FR 43796 - Indebtedness of Military Personnel

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-22

... DEPARTMENT OF DEFENSE Department of the Army 32 CFR Part 513 Indebtedness of Military Personnel... regulations concerning indebtedness of military personnel. The regulations are being removed because they are... policy and guidance codified at 32 CFR Part 112, ``Indebtedness of Military Personnel,'' and DoD...

Modeling Personnel Turnover in the Parametric Organization

NASA Technical Reports Server (NTRS)

Dean, Edwin B.

1991-01-01

A primary issue in organizing a new parametric cost analysis function is to determine the skill mix and number of personnel required. The skill mix can be obtained by a functional decomposition of the tasks required within the organization and a matrixed correlation with educational or experience backgrounds. The number of personnel is a function of the skills required to cover all tasks, personnel skill background and cross training, the intensity of the workload for each task, migration through various tasks by personnel along a career path, personnel hiring limitations imposed by management and the applicant marketplace, personnel training limitations imposed by management and personnel capability, and the rate at which personnel leave the organization for whatever reason. Faced with the task of relating all of these organizational facets in order to grow a parametric cost analysis (PCA) organization from scratch, it was decided that a dynamic model was required in order to account for the obvious dynamics of the forming organization. The challenge was to create such a simple model which would be credible during all phases of organizational development. The model development process was broken down into the activities of determining the tasks required for PCA, determining the skills required for each PCA task, determining the skills available in the applicant marketplace, determining the structure of the dynamic model, implementing the dynamic model, and testing the dynamic model.

Towards the use of OCT angiography in clinical dermatology

NASA Astrophysics Data System (ADS)

Baran, Utku; Choi, Woo June; Wang, Ruikang K.

2016-02-01

Optical coherence tomography (OCT) is a popular imaging technique used in ophthalmology, and on the way to become clinically viable alternative in dermatology due to its capability of acquiring histopathology level images of in vivo tissue, noninvasively. In this study, we demonstrate the capabilities of OCT-based angiography (OMAG) in detecting high-resolution, volumetric structural and microvascular features of in vivo human skin with various conditions using a swept source OCT system that operates on a central wavelength of 1310 nm with an A-line rate of 100 kHz. OMAG images provide detailed in vivo visualization of microvasculature of abnormal human skin conditions from face, chest and belly. Moreover, the progress of wound healing on human skin from arm is monitored during longitudinal wound healing process. The presented results promise the clinical use of OCT angiography in treatment of prevalent cutaneous diseases within human skin, in vivo.

Cost-effectiveness of 64-slice CT angiography compared to conventional coronary angiography based on a coverage with evidence development study in Ontario.

PubMed

Goeree, Ron; Blackhouse, Gord; Bowen, James M; O'Reilly, Daria; Sutherland, Simone; Hopkins, Robert; Chow, Benjamin; Freeman, Michael; Provost, Yves; Dennie, Carole; Cohen, Eric; Marcuzzi, Dan; Iwanochko, Robert; Moody, Alan; Paul, Narinder; Parker, John D

2013-10-01

Conventional coronary angiography (CCA) is the standard diagnostic for coronary artery disease (CAD), but multi-detector computed tomography coronary angiography (CTCA) is a non-invasive alternative. A multi-center coverage with evidence development study was undertaken and combined with an economic model to estimate the cost-effectiveness of CTCA followed by CCA vs CCA alone. Alternative assumptions were tested in patient scenario and sensitivity analyses. CCA was found to dominate CTCA, however, CTCA was relatively more cost-effective in females, in advancing age, in patients with lower pre-test probabilities of CAD, the higher the sensitivity of CTCA and the lower the probability of undergoing a confirmatory CCA following a positive CTCA. RESULTS were very sensitive to alternative patient populations and modeling assumptions. Careful consideration of patient characteristics, procedures to improve the diagnostic yield of CTCA and selective use of CCA following CTCA will impact whether CTCA is cost-effective or dominates CCA.

5 CFR 300.706 - Office of Personnel Management adjudication.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Office of Personnel Management adjudication. 300.706 Section 300.706 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE... Service Law § 300.706 Office of Personnel Management adjudication. (a) OPM will determine whether failure...

5 CFR 300.706 - Office of Personnel Management adjudication.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Office of Personnel Management adjudication. 300.706 Section 300.706 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE... Service Law § 300.706 Office of Personnel Management adjudication. (a) OPM will determine whether failure...

Relationship between basic protective health behaviours and health related quality of life in Greek urban hospital employees.

PubMed

Tountas, Yannis; Manios, Yannis; Dimitrakaki, Christine; Tzavara, Chara

2007-01-01

The study aimed to explore the association between the presence of several protective health behaviors and physical and mental wellbeing/functioning among healthy hospital employees in Greece. A randomly selected representative sample of 395 employees working in seven hospitals, both public and private, within the wider region of Athens participated in the study. Participants were assigned to the following professional categories: administrative, auxiliary and technical personnel, medical doctors and nurses. Four basic protective health behaviors were examined: following the Mediterranean diet, exercising, no smoking and moderate alcohol drinking. Employees' health related quality of life was assessed with the self-administered SF-36 generic health status measure. Technical and administrative hospital personnel reported more healthy behaviors than medical and auxiliary personnel. There was an increased likelihood of scoring higher in almost all SF-36 Physical health subscales in the accumulation of the above four protective heath behaviors. In terms of mental health, even the presence of two or more protective health behaviors significantly increase the score on most SF-36 Mental health subscales. Results indicate that the protective role of basic health behaviors extends beyond physical health to mental wellbeing.

Personnel Preparation.

ERIC Educational Resources Information Center

Fair, George, Ed.; Stodden, Robert, Ed.

1981-01-01

Three articles comprise a section on personnel preparation in vocational education. Articles deal with two inservice programs in career/vocational education for the handicapped and a project to train paraprofessionals to assist special educators in vocational education. (CL)

Using synchrotron radiation angiography with a highly sensitive detector to identify impaired peripheral perfusion in rat pulmonary emphysema

PubMed Central

Ito, Hiromichi; Matsushita, Shonosuke; Hyodo, Kazuyuki; Sato, Yukio; Sakakibara, Yuzuru

2013-01-01

Owing to limitations in spatial resolution and sensitivity, it is difficult for conventional angiography to detect minute changes of perfusion in diffuse lung diseases, including pulmonary emphysema (PE). However, a high-gain avalanche rushing amorphous photoconductor (HARP) detector can give high sensitivity to synchrotron radiation (SR) angiography. SR angiography with a HARP detector provides high spatial resolution and sensitivity in addition to time resolution owing to its angiographic nature. The purpose of this study was to investigate whether this SR angiography with a HARP detector could evaluate altered microcirculation in PE. Two groups of rats were used: group PE and group C (control). Transvenous SR angiography with a HARP detector was performed and histopathological findings were compared. Peak density of contrast material in peripheral lung was lower in group PE than group C (p < 0.01). The slope of the linear regression line in scattering diagrams was also lower in group PE than C (p < 0.05). The correlation between the slope and extent of PE in histopathology showed significant negative correlation (p < 0.05, r = 0.61). SR angiography with a HARP detector made it possible to identify impaired microcirculation in PE by means of its high spatial resolution and sensitivity. PMID:23412496

Angiography in the Isolated Perfused Kidney: Radiological Evaluation of Vascular Protection in Tissue Ablation by Nonthermal Irreversible Electroporation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wendler, Johann Jakob, E-mail: johann.wendler@med.ovgu.de; Pech, Maciej; Blaschke, Simon

2012-04-15

Purpose: The nonthermal irreversible electroporation (NTIRE) is a novel nonthermal tissue ablation technique by local application of high-voltage current within microseconds leading to a delayed apoptosis. The purpose of this experimental study was the first angiographic evaluation of the acute damage of renal vascular structure in NTIRE. Methods: Results of conventional dynamic digital substraction angiography (DSA) and visualization of the terminal vascular bed of renal parenchyma by high-resolution X-ray in mammography technique were evaluated before, during, and after NTIRE of three isolated perfused porcine ex vivo kidneys. Results: In the dedicated investigation, no acute vascular destruction of the renal parenchymamore » and no dysfunction of the kidney perfusion model were observed during or after NTIRE. Conspicuous were concentric wave-like fluctuations of the DSA contrast agent simultaneous to the NTIRE pulses resulting from NTIRE pulse shock wave. Conclusion: The NTIRE offers an ablation method with no acute collateral vascular damage in angiographic evaluation.« less

Personnel Practices for Small Colleges.

ERIC Educational Resources Information Center

Bouchard, Ronald A.

Personnel administration in higher education is the focus of this "hands-on, how-to-do-it" guide that provides fundamental materials for developing and maintaining a sound personnel program. Part One (Employment) examines government regulations, employee recruitment and selection, pre-employment inquiries and screening, post-employment process,…

21 CFR 820.25 - Personnel.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Personnel. 820.25 Section 820.25 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES QUALITY SYSTEM REGULATION Quality System Requirements § 820.25 Personnel. (a) General. Each manufacturer...

21 CFR 606.20 - Personnel.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Personnel. 606.20 Section 606.20 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS CURRENT GOOD MANUFACTURING PRACTICE FOR BLOOD AND BLOOD COMPONENTS Organization and Personnel § 606.20...

Non-enhanced, ECG-gated MR angiography of the pedal vasculature: comparison with contrast-enhanced MR angiography and digital subtraction angiography in peripheral arterial occlusive disease.

PubMed

Schubert, Tilman; Takes, Martin; Aschwanden, Markus; Klarhoefer, Markus; Haas, Tanja; Jacob, Augustinus L; Liu, David; Gutzeit, Andreas; Kos, Sebastian

2016-08-01

This study was conducted in order to compare a high resolution, non-contrast-enhanced MRA (NATIVE SPACE, NE-MRA) of the pedal vasculature with contrast-enhanced MRA (CE-MRA) and digital subtraction angiography (DSA) in patients with peripheral arterial occlusive disease (PAOD). The prospective study consists of 20 PAOD patients. All patients underwent percutaneous transluminal angioplasty or stenting and received MR angiographies the following day. With CE-MRA, 75.7 % of vessel segments showed good, 16.4 % suboptimal and 7.9 % not usable image quality. With NE-MRA, 64.6 % showed good, 18.6 % suboptimal and 16.8 % not usable image quality. CE-MRA showed a sensitivity and negative predictive value of 90 %/95 % regarding significant stenosis (greater than 50 %), and specificity and positive predictive value were 88 %/77 %. Accordingly, sensitivity and negative predictive value for the NE-MRA were 96 %/97 % and specificity and positive predictive value were 80 %/69 % for stenoses greater than 50 %. The applied NE-MRA technique achieves high diagnostic accuracy even in very small distal arteries of the foot. However, the rate of non-diagnostic vessel segments is considerably higher for NE-MRA than for CE-MRA. NE-MRA is a valuable alternative to CE-MRA in selected patients. • Comparison of non-enhanced MRA with contrast-enhanced MRA and DSA as gold standard. • High resolution MRA at 3 T for the depiction of small pedal vessels. • Evaluation of high resolution non-enhanced MRA in PAOD patients.

Fit for the frontline? A focus group exploration of auditory tasks carried out by infantry and combat support personnel.

PubMed

Bevis, Zoe L; Semeraro, Hannah D; van Besouw, Rachel M; Rowan, Daniel; Lineton, Ben; Allsopp, Adrian J

2014-01-01

In order to preserve their operational effectiveness and ultimately their survival, military personnel must be able to detect important acoustic signals and maintain situational awareness. The possession of sufficient hearing ability to perform job-specific auditory tasks is defined as auditory fitness for duty (AFFD). Pure tone audiometry (PTA) is used to assess AFFD in the UK military; however, it is unclear whether PTA is able to accurately predict performance on job-specific auditory tasks. The aim of the current study was to gather information about auditory tasks carried out by infantry personnel on the frontline and the environment these tasks are performed in. The study consisted of 16 focus group interviews with an average of five participants per group. Eighty British army personnel were recruited from five infantry regiments. The focus group guideline included seven open-ended questions designed to elicit information about the auditory tasks performed on operational duty. Content analysis of the data resulted in two main themes: (1) the auditory tasks personnel are expected to perform and (2) situations where personnel felt their hearing ability was reduced. Auditory tasks were divided into subthemes of sound detection, speech communication and sound localization. Reasons for reduced performance included background noise, hearing protection and attention difficulties. The current study provided an important and novel insight to the complex auditory environment experienced by British infantry personnel and identified 17 auditory tasks carried out by personnel on operational duties. These auditory tasks will be used to inform the development of a functional AFFD test for infantry personnel.

Physical Assault of School Personnel

ERIC Educational Resources Information Center

Kajs, Lawrence T.; Schumacher, Gary; Vital, Cheryl A.

2014-01-01

Physical assault against school personnel is a serious problem, although not highly publicized. This workplace violence can result in debilitating injury to school employees along with major monetary costs. This article looks at legal issues that address physical assault against school personnel as well as the roles professional associations have…

21 CFR 226.10 - Personnel.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Personnel. 226.10 Section 226.10 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL.... The key personnel and any consultants involved in the manufacture and control of the Type A medicated...

21 CFR 226.10 - Personnel.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Personnel. 226.10 Section 226.10 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL.... The key personnel and any consultants involved in the manufacture and control of the Type A medicated...

21 CFR 226.10 - Personnel.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Personnel. 226.10 Section 226.10 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL.... The key personnel and any consultants involved in the manufacture and control of the Type A medicated...

21 CFR 226.10 - Personnel.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Personnel. 226.10 Section 226.10 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL.... The key personnel and any consultants involved in the manufacture and control of the Type A medicated...

21 CFR 226.10 - Personnel.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Personnel. 226.10 Section 226.10 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL.... The key personnel and any consultants involved in the manufacture and control of the Type A medicated...

14 CFR 133.21 - Personnel.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Personnel. 133.21 Section 133.21... OPERATIONS Certification Rules § 133.21 Personnel. (a) The applicant must hold, or have available the..., with a rating appropriate for the rotorcraft prescribed in § 133.19, issued by the Administrator. (b...

Readings in Professional Personnel Assessment.

ERIC Educational Resources Information Center

International Personnel Management Association, Washington, DC.

Thirteen papers are presented that discuss issues in public personnel decision making, specifically in the area of personnel selection. After an introduction by James P. Springer, the following papers are presented: (1) "History of Employment Testing" (Matthew Hale); (2) "Job Families: A Review and Discussion of Their Implications for Personnel…

Personnel Development Practices in Turkish Education System

ERIC Educational Resources Information Center

Ozdemir, Tuncay Yavuz

2016-01-01

Nowadays everything develops and changes very quickly and sustainability of organizational goals will be possible only when personnel can keep up with these changes. From administrative aspect it is important to enhance personnel's potential and prompt them to achieve organizational goals. Personnel development is a process which influences and…

49 CFR 1544.217 - Law enforcement personnel.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Law enforcement personnel. 1544.217 Section 1544... AND COMMERCIAL OPERATORS Operations § 1544.217 Law enforcement personnel. (a) The following applies to... for law enforcement personnel meeting the qualifications and standards specified in §§ 1542.215 and...

49 CFR 1542.217 - Law enforcement personnel.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Law enforcement personnel. 1542.217 Section 1542... Law enforcement personnel. (a) Each airport operator must ensure that law enforcement personnel used... the criminal laws of the State and local jurisdictions in which the airport is located— (1) A crime...

The Modification of Fluorescein Angiography and Its Applications in Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy.

PubMed

Peng, Qing; Chen, Yutong; Hua, Rui

2018-06-07

To establish a novel retinal angiography method, red-free angiography (RFA), to investigate retinal changes in age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV). Following the venous phase of fundus fluorescein angiography (FFA), the detection mode was switched to red-free reflectance to acquire RFA images using the same parameters. RFA showed subretinal fluid, polyps, and outer retinal tubulation, with a higher definition than the FFA and red-free reflectance results. The absorption coefficients in RFA provided more detailed images for AMD and PCV diagnosis. RFA is therefore a promising approach to supplement FFA. © 2018 S. Karger AG, Basel.

Coronary CT angiography using 64 detector rows: methods and design of the multi-centre trial CORE-64.

PubMed

Miller, Julie M; Dewey, Marc; Vavere, Andrea L; Rochitte, Carlos E; Niinuma, Hiroyuki; Arbab-Zadeh, Armin; Paul, Narinder; Hoe, John; de Roos, Albert; Yoshioka, Kunihiro; Lemos, Pedro A; Bush, David E; Lardo, Albert C; Texter, John; Brinker, Jeffery; Cox, Christopher; Clouse, Melvin E; Lima, João A C

2009-04-01

Multislice computed tomography (MSCT) for the noninvasive detection of coronary artery stenoses is a promising candidate for widespread clinical application because of its non-invasive nature and high sensitivity and negative predictive value as found in several previous studies using 16 to 64 simultaneous detector rows. A multi-centre study of CT coronary angiography using 16 simultaneous detector rows has shown that 16-slice CT is limited by a high number of nondiagnostic cases and a high false-positive rate. A recent meta-analysis indicated a significant interaction between the size of the study sample and the diagnostic odds ratios suggestive of small study bias, highlighting the importance of evaluating MSCT using 64 simultaneous detector rows in a multi-centre approach with a larger sample size. In this manuscript we detail the objectives and methods of the prospective "CORE-64" trial ("Coronary Evaluation Using Multidetector Spiral Computed Tomography Angiography using 64 Detectors"). This multi-centre trial was unique in that it assessed the diagnostic performance of 64-slice CT coronary angiography in nine centres worldwide in comparison to conventional coronary angiography. In conclusion, the multi-centre, multi-institutional and multi-continental trial CORE-64 has great potential to ultimately assess the per-patient diagnostic performance of coronary CT angiography using 64 simultaneous detector rows.

Personnel Needs--Allied Health Personnel Meeting the Demands of Part H, P.L. 99-457.

ERIC Educational Resources Information Center

Yoder, David E.; And Others

This report describes personnel development issues relating to the involvement of occupational therapists, physical therapists, and speech-language pathologists in implementing Part H of Public Law 99-457, which calls for early intervention services for infants and toddlers with disabilities and their families. To determine personnel needs for…

Diagnostic Accuracy of Computer Tomography Angiography and Magnetic Resonance Angiography in the Stenosis Detection of Autologuous Hemodialysis Access: A Meta-Analysis

PubMed Central

Liu, Shiyuan

2013-01-01

Purpose To compare the diagnostic performances of computer tomography angiography (CTA) and magnetic resonance angiography (MRA) for detection and assessment of stenosis in patients with autologuous hemodialysis access. Materials and Methods Search of PubMed, MEDLINE, EMBASE and Cochrane Library database from January 1984 to May 2013 for studies comparing CTA or MRA with DSA or surgery for autologuous hemodialysis access. Eligible studies were in English language, aimed to detect more than 50% stenosis or occlusion of autologuous vascular access in hemodialysis patients with CTA and MRA technology and provided sufficient data about diagnosis performance. Methodological quality was assessed by the Quality Assessment of Diagnostic Studies (QUADAS) instrument. Sensitivities (SEN), specificities (SPE), positive likelihood ratio (PLR), negative likelihood values (NLR), diagnostic odds ratio (DOR) and areas under the receiver operator characteristic curve (AUC) were pooled statistically. Potential threshold effect, heterogeneity and publication bias was evaluated. The clinical utility of CTA and MRA in detection of stenosis was also investigated. Result Sixteen eligible studies were included, with a total of 500 patients. Both CTA and MRA were accurate modality (sensitivity, 96.2% and 95.4%, respectively; specificity, 97.1 and 96.1%, respectively; DOR [diagnostic odds ratio], 393.69 and 211.47, respectively) for hemodialysis vascular access. No significant difference was detected between the diagnostic performance of CTA (AUC, 0.988) and MRA (AUC, 0.982). Meta-regression analyses and subgroup analyses revealed no statistical difference. The Deek’s funnel plots suggested a publication bias. Conclusion Diagnostic performance of CTA and MRA for detecting stenosis of hemodialysis vascular access had no statistical difference. Both techniques may function as an alternative or an important complement to conventional digital subtraction angiography (DSA) and may be able to

10 CFR 72.126 - Criteria for radiological protection.

Code of Federal Regulations, 2014 CFR

2014-01-01

.... Radiation protection systems must be provided for all areas and operations where onsite personnel may be exposed to radiation or airborne radioactive materials. Structures, systems, and components for which..., fabricated, located, shielded, controlled, and tested so as to control external and internal radiation...

10 CFR 72.126 - Criteria for radiological protection.

Code of Federal Regulations, 2012 CFR

2012-01-01

.... Radiation protection systems must be provided for all areas and operations where onsite personnel may be exposed to radiation or airborne radioactive materials. Structures, systems, and components for which..., fabricated, located, shielded, controlled, and tested so as to control external and internal radiation...

10 CFR 72.126 - Criteria for radiological protection.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... Radiation protection systems must be provided for all areas and operations where onsite personnel may be exposed to radiation or airborne radioactive materials. Structures, systems, and components for which..., fabricated, located, shielded, controlled, and tested so as to control external and internal radiation...

10 CFR 72.126 - Criteria for radiological protection.

Code of Federal Regulations, 2013 CFR

2013-01-01

.... Radiation protection systems must be provided for all areas and operations where onsite personnel may be exposed to radiation or airborne radioactive materials. Structures, systems, and components for which..., fabricated, located, shielded, controlled, and tested so as to control external and internal radiation...

The White Mountain Apache Child Protection Service Training Curriculum. Nohwii Chaghashe Baa da gontzaa (Protect Our Apache Children).

ERIC Educational Resources Information Center

Gonzalez-Santin, Edwin, Comp.

This curriculum manual provides 8 days of training for child protective services (CPS) personnel (social workers and administrators) working in the White Mountain Apache tribal community. Each of the first seven units in the manual contains a brief description of contents, course objectives, time required, key concepts, possible discussion topics,…

Protection or Penalty: The Implications of a Guardianship Petition.

ERIC Educational Resources Information Center

Beidel, Deborah C.; Marshak, Laura E.

1982-01-01

The article examines the process of appointing guardianship for the severely disabled, its legal and therapeutic implications, and some alternatives to guardianship. In addition, the role of habilitation personnel in providing protective services is addressed. (Author/SB)

48 CFR 952.215-70 - Key Personnel.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Key Personnel. 952.215-70... SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 952.215-70 Key Personnel. As prescribed in 915.408-70, the contracting officer shall insert the following clause: Key Personnel (DEC 2000...

48 CFR 952.215-70 - Key Personnel.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Key Personnel. 952.215-70... SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 952.215-70 Key Personnel. As prescribed in 915.408-70, the contracting officer shall insert the following clause: Key Personnel (DEC 2000...

48 CFR 952.215-70 - Key Personnel.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Key Personnel. 952.215-70... SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 952.215-70 Key Personnel. As prescribed in 915.408-70, the contracting officer shall insert the following clause: Key Personnel (DEC 2000...

48 CFR 952.215-70 - Key Personnel.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Key Personnel. 952.215-70... SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 952.215-70 Key Personnel. As prescribed in 915.408-70, the contracting officer shall insert the following clause: Key Personnel (DEC 2000...

48 CFR 952.215-70 - Key Personnel.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Key Personnel. 952.215-70... SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 952.215-70 Key Personnel. As prescribed in 915.408-70, the contracting officer shall insert the following clause: Key Personnel (DEC 2000...

Variations of the superficial middle cerebral vein: classification using three-dimensional CT angiography.

PubMed

Suzuki, Y; Matsumoto, K

2000-05-01

Classification of variations of the superficial middle cerebral vein (SMCV) remains ambiguous. We propose a new classification system based on embryologic development for preoperative examination. Three-dimensional CT angiography was used to evaluate 500 SMCVs (in 250 patients). The outflow vessels from the SMCV were classified into seven types on the basis of embryologic development. The 3D CT angiograms in axial stereoscopic and oblique views and multiple intensity projection images were evaluated by the same neurosurgeon on two occasions. Inconsistent interpretations were regarded as equivocal. Three-dimensional CT angiography clearly depicted the SMCV running along the lesser wing or the middle cranial fossa. However, the outflow vessel could not be confirmed as the sphenoparietal, cavernous, or emissary type in 39 (8%) of the sides. SMCVs running in the middle cranial fossa to join the transverse sinus or superior petrosal sinus were accurately identified. SMCVs were present in 456 sides: 62% entered the sphenoparietal sinus or the cavernous sinus and 12% joined the emissary vein. Nine vessels were the superior petrosal type, 10 the basal type, 12 the squamosal type, and 44 the undeveloped type. Three-dimensional CT angiography can depict the vessels and their anatomic relationship to the bone structure, allowing identification of the SMCV variant in individual patients. Preoperative planning for skull base surgery requires such information to reduce the invasiveness of the procedure. With the use of our classification system, 3D CT angiography can provide exact and practical information concerning the SMCV.

Intracranial vascular stenosis and occlusion: Diagnostic accuracy of three-dimensional, fourier transform, time-of-flight MR angiography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Korogi, Yukunori; Takahashi, Mutsumasa; Mabuchi, Nobuhisa

1994-10-01

To assess the accuracy of three-dimensional, Fourier transform, time-of-flight magnetic resonance (MR) angiography in the detection of intracranial steno-occlusive diseases. One hundred thirty-one patients (62 male and 69 female patients, aged 6-77 years [mean, 53 years 8 months]) underwent MR and conventional angiography for evaluation of possible intracranial vascular disease. A total of 502 arteries were assessed. Eight projections and a collapsed image postprocessed by means of a maximum-intensity projection algorithm were reviewed by five observers in a blinded manner, with conventional angiography as the standard. A total of 32 steno-occlusive lesions were available for review. Receiver operating characteristic analysismore » from the pooled data revealed overall sensitivities of 85% and 88% and specificities of 96% and 97% for the internal carotid artery and the middle cerebral artery, respectively. MR angiography is useful as the primary diagnostic tool for evaluating suspected intracranial steno-occlusive disease. 22 refs., 7 figs., 5 tabs.« less

Evaluation of computed tomography in patients with atypical angina or chest pain clinically referred for invasive coronary angiography: randomised controlled trial

PubMed Central

Rief, Matthias; Martus, Peter; Kendziora, Benjamin; Feger, Sarah; Dreger, Henryk; Priem, Sascha; Knebel, Fabian; Böhm, Marko; Schlattmann, Peter; Hamm, Bernd; Schönenberger, Eva; Laule, Michael; Zimmermann, Elke

2016-01-01

Objective To evaluate whether invasive coronary angiography or computed tomography (CT) should be performed in patients clinically referred for coronary angiography with an intermediate probability of coronary artery disease. Design Prospective randomised single centre trial. Setting University hospital in Germany. Participants 340 patients with suspected coronary artery disease and a clinical indication for coronary angiography on the basis of atypical angina or chest pain. Interventions 168 patients were randomised to CT and 172 to coronary angiography. After randomisation one patient declined CT and 10 patients declined coronary angiography, leaving 167 patients (88 women) and 162 patients (78 women) for analysis. Allocation could not be blinded, but blinded independent investigators assessed outcomes. Main outcome measure The primary outcome measure was major procedural complications within 48 hours of the last procedure related to CT or angiography. Results Cardiac CT reduced the need for coronary angiography from 100% to 14% (95% confidence interval 9% to 20%, P<0.001) and was associated with a significantly greater diagnostic yield from coronary angiography: 75% (53% to 90%) v 15% (10% to 22%), P<0.001. Major procedural complications were uncommon (0.3%) and similar across groups. Minor procedural complications were less common in the CT group than in the coronary angiography group: 3.6% (1% to 8%) v 10.5% (6% to 16%), P=0.014. CT shortened the median length of stay in the angiography group from 52.9 hours (interquartile range 49.5-76.4 hours) to 30.0 hours (3.5-77.3 hours, P<0.001). Overall median exposure to radiation was similar between the CT and angiography groups: 5.0 mSv (interquartile range 4.2-8.7 mSv) v 6.4 mSv (3.4-10.7 mSv), P=0.45. After a median follow-up of 3.3 years, major adverse cardiovascular events had occurred in seven of 167 patients in the CT group (4.2%) and six of 162 (3.7%) in the coronary angiography group (adjusted hazard

A Life Events Scale for Armed Forces personnel

PubMed Central

Chaudhury, Suprakash; Srivastava, Kalpana; Raju, M.S.V. Kama; Salujha, S.K.

2006-01-01

Background: Armed Forces personnel are routinely exposed to a number of unique stressful life events. None of the available scales are relevant to service personnel. Aim: To construct a scale to measure life events in service personnel. Methods: In the first stage of the study open-ended questions along with items generated by the expert group by consensus method were administered to 50 soldiers. During the second stage a scale comprising 59 items and open-ended questions was administered to 165 service personnel. The final scale of 52 items was administered to 200 service personnel in group setting. Weightage was assigned on a 0 to 100 range. For normative study the Armed Forces Medical College Life Events Scale (AFMC LES) was administered to 1200 Army, 100 Air Force and 100 Navy personnel. Results: Service personnel experience an average of 4 life events in past one year and 13 events in a life-time. On an average service personnel experience 115 life change unit scores in past one year and 577 life change unit scores in life-time on the AFMC LES. The scale has concurrent validity when compared with the Presumptive Stressful Life Events Scale (PSLES). There is internal consistency in the scale with the routine items being rated very low. There is a pattern of uniformity with the civilian counterparts along with differences in the items specific to service personnel. Conclusions: The AFMC LES includes the unique stresses of service personnel that are not included in any life events scale available in India or in the west and should be used to assess stressful life events in service personnel. PMID:20844647

Coping and survival skills: the role school personnel play regarding support for bullied sexual minority-oriented youth.

PubMed

Marshall, Alexandra; Yarber, William L; Sherwood-Laughlin, Catherine M; Gray, Mary L; Estell, David B

2015-05-01

Research has shown that bullying has serious health consequences, and sexual minority-oriented youth are disproportionately affected. Sexual minority-oriented youth include lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) individuals. This study examined the bullying experiences of sexual minority-oriented youth in a predominantly rural area of a Midwestern state. The purpose of this study was to have bullied youth describe their experiences and to present their perspectives. Using critical qualitative inquiry, 16 in-depth interviews were conducted in-person or online with youth, ages 15-20, who self-identified as having been bullied based on their perceived minority sexual orientation status. The role of supportive school personnel was found to be meaningful, and supportive school personnel were mentioned as assisting with the coping and survival among this group of bullied sexual minority youth. Supportive school personnel are crucial to the coping and survival of these youth. All school personnel need to be aware of the anti-bullying policies in their school corporations. They may then work to strengthen and enforce their policies for the protection of bullied youth. © 2015, American School Health Association.

Use of Coronary Computed Tomographic Angiography to Guide Management of Patients With Coronary Disease

PubMed Central

Williams, Michelle C.; Hunter, Amanda; Shah, Anoop S.V.; Assi, Valentina; Lewis, Stephanie; Smith, Joel; Berry, Colin; Boon, Nicholas A.; Clark, Elizabeth; Flather, Marcus; Forbes, John; McLean, Scott; Roditi, Giles; van Beek, Edwin J.R.; Timmis, Adam D.; Newby, David E.

2016-01-01

Background In a prospective, multicenter, randomized controlled trial, 4,146 patients were randomized to receive standard care or standard care plus coronary computed tomography angiography (CCTA). Objectives The purpose of this study was to explore the consequences of CCTA-assisted diagnosis on invasive coronary angiography, preventive treatments, and clinical outcomes. Methods In post hoc analyses, we assessed changes in invasive coronary angiography, preventive treatments, and clinical outcomes using national electronic health records. Results Despite similar overall rates (409 vs. 401; p = 0.451), invasive angiography was less likely to demonstrate normal coronary arteries (20 vs. 56; hazard ratios [HRs]: 0.39 [95% confidence interval (CI): 0.23 to 0.68]; p < 0.001) but more likely to show obstructive coronary artery disease (283 vs. 230; HR: 1.29 [95% CI: 1.08 to 1.55]; p = 0.005) in those allocated to CCTA. More preventive therapies (283 vs. 74; HR: 4.03 [95% CI: 3.12 to 5.20]; p < 0.001) were initiated after CCTA, with each drug commencing at a median of 48 to 52 days after clinic attendance. From the median time for preventive therapy initiation (50 days), fatal and nonfatal myocardial infarction was halved in patients allocated to CCTA compared with those assigned to standard care (17 vs. 34; HR: 0.50 [95% CI: 0.28 to 0.88]; p = 0.020). Cumulative 6-month costs were slightly higher with CCTA: difference $462 (95% CI: $303 to $621). Conclusions In patients with suspected angina due to coronary heart disease, CCTA leads to more appropriate use of invasive angiography and alterations in preventive therapies that were associated with a halving of fatal and non-fatal myocardial infarction. (Scottish COmputed Tomography of the HEART Trial [SCOT-HEART]; NCT01149590) PMID:27081014

MRAP (Mine Resistant Ambush Protected) Vehicles - U.S. Department of

Science.gov Websites

available is no longer being updated and may no longer be applicable as a result of changes in law . Sgt. Brad Hughes double-checks the load information on a pair of Mine Resistant Ambush Protected . Photo - see caption below Air Force personnel load a Mine Resistant Ambush Protected vehicle onto a C-5

Likelihood of aneurysmal subarachnoid haemorrhage in patients with normal unenhanced CT, CSF xanthochromia on spectrophotometry and negative CT angiography.

PubMed

Rana, A K; Turner, H E; Deans, K A

2013-01-01

Patients with suspected subarachnoid haemorrhage, a normal noncontrast computed tomography (CT) and cerebrospinal fluid (CSF) evidence of haemoglobin breakdown products often undergo CT angiography (CTA). If this is normal, then invasive catheter angiography may be offered. In current clinical practice, haemoglobin breakdown products are detected by spectrophotometry rather than visible xanthochromia, and CTA is performed on multidetector scanners. The aim of this study was to determine if such patients should still have a catheter angiography, given the associated risks. Patients positive for CSF spectrophotometry (n=26) were retrospectively identified from the clinical biochemistry information system and imaging data from the electronic radiology records were reviewed. Discharge letters were consulted to relate the biochemistry and radiology results to the final diagnosis. 15 patients with CT angiography were found. Nine patients had normal CT angiography. No causative aneurysms had been missed. One patient had small, coincidental aneurysms missed on initial reading of the CTA. The likelihood of a clinically significant aneurysm in a patient who is CT negative, lumbar puncture positive and CTA negative is low. Double reporting of negative CT angiograms may be advisable.

Endovascular treatment of atherosclerotic popliteal artery disease based on dynamic angiography findings.

PubMed

Cui, Chaoyi; Huang, Xintian; Liu, Xiaobing; Li, Weimin; Lu, Xinwu; Lu, Min; Jiang, Mier; Yin, Minyi

2017-01-01

To evaluate efficacy, safety, and midterm patency of endovascular treatment of obstructive popliteal artery (PA) disease. A retrospective evaluation of patients with atherosclerotic PA disease who underwent percutaneous transluminal balloon angioplasty and provisional stent, based on both conventional and dynamic angiographies, was conducted from June 2011 to June 2014. Forty-three patients were included in the study, and most patients had limited surgical revascularization options. Demographic characteristics, angiographic findings, interventional data, complications, vessel patency, limb salvage rates, and survival rates were analyzed. The median lesion length was 5 cm with 72.1% having total occlusions. The second popliteal segment (P2) was involved most frequently (60.5%, n = 26). Critical limb ischemia was present in 69.8%. The technical success rate was 92.9% (42/43 limbs), with 29 cases requiring adjunctive nitinol stents after balloon angioplasty (47.6% based on conventional angiography, 21.4% based on dynamic angiography, and 4.8% additional stents based on dynamic angiography). Complications included thromboembolism (2.3%), perforation (2.3%), pseudoaneurysm (2.3%), and myocardial infarction (2.3%). Stent fracture was present in three cases (7.1%) during the mean follow-up period of 18.3 months. The baseline ankle-brachial index significantly improved after the intervention, from 0.49 ± 0.11 to 0.92 ± 0.14 (P < .01). The Rutherford-Becker class decreased from 3.95 ± 0.76 to 1.76 ± 0.95 (P < .01) at 12 months. The 1-year primary, primary-assisted, and secondary patency rates were 75.2% ± 6.8%, 82.4% ± 6.0%, and 89.9% ± 4.8%, respectively. The limb salvage and amputation-free survival rates at 12 months were 91.6% and 87.0%, respectively. Balloon angioplasty with a provisional stent based on dynamic angiography is a feasible, safe, and effective therapy for patients with obstructive PA disease. Although the occurrence of stent fracture

Quantitative Spatial and Temporal Analysis of Fluorescein Angiography Dynamics in the Eye

PubMed Central

Hui, Flora; Nguyen, Christine T. O.; Bedggood, Phillip A.; He, Zheng; Fish, Rebecca L.; Gurrell, Rachel; Vingrys, Algis J.; Bui, Bang V.

2014-01-01

Purpose We describe a novel approach to analyze fluorescein angiography to investigate fluorescein flow dynamics in the rat posterior retina as well as identify abnormal areas following laser photocoagulation. Methods Experiments were undertaken in adult Long Evans rats. Using a rodent retinal camera, videos were acquired at 30 frames per second for 30 seconds following intravenous introduction of sodium fluorescein in a group of control animals (n = 14). Videos were image registered and analyzed using principle components analysis across all pixels in the field. This returns fluorescence intensity profiles from which, the half-rise (time to 50% brightness), half-fall (time for 50% decay) back to an offset (plateau level of fluorescence). We applied this analysis to video fluorescein angiography data collected 30 minutes following laser photocoagulation in a separate group of rats (n = 7). Results Pixel-by-pixel analysis of video angiography clearly delineates differences in the temporal profiles of arteries, veins and capillaries in the posterior retina. We find no difference in half-rise, half-fall or offset amongst the four quadrants (inferior, nasal, superior, temporal). We also found little difference with eccentricity. By expressing the parameters at each pixel as a function of the number of standard deviation from the average of the entire field, we could clearly identify the spatial extent of the laser injury. Conclusions This simple registration and analysis provides a way to monitor the size of vascular injury, to highlight areas of subtle vascular leakage and to quantify vascular dynamics not possible using current fluorescein angiography approaches. This can be applied in both laboratory and clinical settings for in vivo dynamic fluorescent imaging of vasculature. PMID:25365578

Changes of choroidal neovascularization in indocyanine green angiography after intravitreal ranibizumab injection.

PubMed

Lee, Ji Eun; Kim, Hyun Woong; Lee, Sang Joon; Lee, Joo Eun

2015-05-01

To investigate vascular structural changes of choroidal neovascularization (CNV) followed by intravitreal ranibizumab injections using indocyanine green angiography. A total of 31 patients with exudative age-related macular degeneration and CNV whose structures were identifiable in indocyanine green angiography were included. Ranibizumab was injected into the vitreous cavity once a month for 3 months and then as needed for the next 3 months prospectively. Indocyanine green angiography was performed at baseline, 3, and 6 months. Early to midphase images of the indocyanine green angiography in the details of vascular structure of the CNV were discerned the best were used in the image analysis. Vascular structures of CNV were described as arteriovenular and capillary components, and structural changes were assessed. Arteriovenular components were observed in 29 eyes (94%). Regression of the capillary components was observed in most cases. Although regression of arteriovenular component was noted in 14 eyes (48%), complete resolution was not observed. The eyes were categorized into 3 groups according to CNV structural changes: the regressed (Group R, 10 eyes, 31%), the matured (Group M, 7 eyes, 23%), and the growing (Group G, 14 eyes, 45%). In Group R, there was no regrowth of CNV found at 6 months. In Group M, distinct vascular structures were observed at 3 months and persisted without apparent changes at 6 months. In Group G, growth or reperfusion of capillary components from the persisting arteriovenular components was noted at 6 months. Both capillary and arteriovenular components were regressed during monthly ranibizumab injections. However, CNV regrowth was observed in a group of patients during the as-needed treatment phase.

An Approach to Analyze Personnel Injury of Reflective Spall from Small-Arms Protective Body Armor

DTIC Science & Technology

2011-07-01

2  Figure 2. Protective plate system on the ORCA human anatomy . .................................................2  Figure 3...stature and is fitted with a medium size protective plate. Representation of the ORCA human anatomy wearing the protective plate system is shown in...Figure 1. Gelatin block placement for experimental testing. Figure 2. Protective plate system on the ORCA human anatomy . Ballistic Gelatin Test

Integrative Medicine Interventions for Military Personnel (Interventions medicales integrantes a destination du personnel militaire)

DTIC Science & Technology

2017-03-01

and head pain is one of the top reasons for using CAM. One practical way to organize components of integrative health is into psychological ...chronic pain and the integrative strategy, the impact of yoga was shown on performance, physiology, psychology and spirituality. Yoga shows positive...REPORT TR-HFM-195 Integrative Medicine Interventions for Military Personnel (Interventions médicales intégrantes à destination du personnel militaire

Multiresolution image registration in digital x-ray angiography with intensity variation modeling.

PubMed

Nejati, Mansour; Pourghassem, Hossein

2014-02-01

Digital subtraction angiography (DSA) is a widely used technique for visualization of vessel anatomy in diagnosis and treatment. However, due to unavoidable patient motions, both externally and internally, the subtracted angiography images often suffer from motion artifacts that adversely affect the quality of the medical diagnosis. To cope with this problem and improve the quality of DSA images, registration algorithms are often employed before subtraction. In this paper, a novel elastic registration algorithm for registration of digital X-ray angiography images, particularly for the coronary location, is proposed. This algorithm includes a multiresolution search strategy in which a global transformation is calculated iteratively based on local search in coarse and fine sub-image blocks. The local searches are accomplished in a differential multiscale framework which allows us to capture both large and small scale transformations. The local registration transformation also explicitly accounts for local variations in the image intensities which incorporated into our model as a change of local contrast and brightness. These local transformations are then smoothly interpolated using thin-plate spline interpolation function to obtain the global model. Experimental results with several clinical datasets demonstrate the effectiveness of our algorithm in motion artifact reduction.

Novel Application of Postmortem CT Angiography for Evaluation of the Intracranial Vascular Anatomy in Cadaver Heads.

PubMed

van Eijk, Ruben P A; van der Zwan, Albert; Bleys, Ronald L A W; Regli, Luca; Esposito, Giuseppe

2015-12-01

Postmortem CT angiography is a common procedure used to visualize the entire human vasculature. For visualization of a specific organ's vascular anatomy, casting is the preferred method. Because of the permanent and damaging nature of casting, the organ cannot be further used as an experimental model after angiography. Therefore, there is a need for a minimally traumatic method to visualize organ-specific vascular anatomy. The purpose of this study was to develop and evaluate a contrast enhancement technique that is capable of visualizing the intracranial vascular anatomy while preserving the anatomic integrity in cadaver heads. Seven human heads were used in this study. Heads were prepared by cannulating the vertebral and internal carotid arteries. Contrast agent was injected as a mixture of tap water, polyethylene glycol 600, and an iodinated contrast agent. Postmortem imaging was executed on a 64-MDCT scanner. Primary image review and 3D reconstruction were performed on a CT workstation. Clear visualization of the major cerebral arteries and smaller intracranial branches was achieved. Adequate visualization was obtained for both the anterior and posterior intracranial circulation. The minimally traumatic angiography method preserved the vascular integrity of the cadaver heads. A novel application of postmortem CT angiography is presented here. The technique can be used for radiologic evaluation of the intracranial circulation in cadaver heads. After CT angiography, the specimen can be used for further experimental or laboratory testing and teaching purposes.

Electrocardiograph-gated single photon emission computed tomography radionuclide angiography presents good interstudy reproducibility for the quantification of global systolic right ventricular function.

PubMed

Daou, Doumit; Coaguila, Carlos; Vilain, Didier

2007-05-01

Electrocardiograph-gated single photon emission computed tomography (SPECT) radionuclide angiography provides accurate measurement of right ventricular ejection fraction and end-diastolic and end-systolic volumes. In this study, we report the interstudy precision and reliability of SPECT radionuclide angiography for the measurement of global systolic right ventricular function using two, three-dimensional volume processing methods (SPECT-QBS, SPECT-35%). These were compared with equilibrium planar radionuclide angiography. Ten patients with chronic coronary artery disease having two SPECT and planar radionuclide angiography acquisitions were included. For the right ventricular ejection fraction, end-diastolic volume and end-systolic volume, the interstudy precision and reliability were better with SPECT-35% than with SPECT-QBS. The sample sizes needed to objectify a change in right ventricular volumes or ejection fraction were lower with SPECT-35% than with SPECT-QBS. The interstudy precision and reliability of SPECT-35% and SPECT-QBS for the right ventricle were better than those of equilibrium planar radionuclide angiography, but poorer than those previously reported for the left ventricle with SPECT radionuclide angiography on the same population. SPECT-35% and SPECT-QBS present good interstudy precision and reliability for right ventricular function, with the results favouring the use of SPECT-35%. The results are better than those of equilibrium planar radionuclide angiography, but poorer than those previously reported for the left ventricle with SPECT radionuclide angiography. They need to be confirmed in a larger population.

[Indocyanine green angiography in "multiple evanescent white dot syndrome" (MEWDS)].

PubMed

Desarnaulds, A B; Borruat, F X; Herbort, C P; de Courten, C

1998-05-01

Multiple evanescent white dot syndrome (MEWDS) is a benign acquired chorioretinal disorder occurring mostly in young adults. Its pathophysiology is unknown. To describe the results of indocyanine green angiography (ICGA) in MEWDS. Four patients with MEWDS were investigated by ICGA. In all cases, ICGA revealed numerous choroidal hypofluorescent lesions that largely outnumbered the lesions visible with either fundoscopy or fluorescein angiography. Three cases showed a blind spot enlargement on perimetry associated with the presence of a large peripapillary hypofluorescent zone on ICGA. Three cases showed macular granularity on fundoscopy correlating with a significant subfoveal hypfluorescent lesion on ICGA. Evolution was always favorable with disappearance of the hypofluorescent choroidal lesions. Our results confirm that MEWDS is primarily a choroidal disorder. The blind spot enlargement and the macular granularity, frequently detected in MEWDS, result from larger peripapillary and subfoveal choroidal lesions.

Indocyanine green angiography in posterior uveitis

PubMed Central

Agrawal, Rupesh V; Biswas, Jyotirmay; Gunasekaran, Dinesh

2013-01-01

Literature review for indocyanine green angiography and evaluate the role of indocyanine green angiogram (ICGA) in patients with posterior uveitis seen at a tertiary referral eye care centre. Detailed review of the literature on ICGA was performed. Retrospective review of medical records of patients with posterior uveitis and dual fundus and ICGA was done after institutional board approval. Eighteen patients (26 eyes) had serpiginous choroiditis out of which 12 patients had active choroiditis and six patients had healed choroiditis, six patients (12 eyes) had ampiginous choroiditis, six patients (12 eyes) had acute multifocal posterior placoid pigment epitheliopathy, eight patients (10 eyes) had multifocal choroiditis, four patients (eight eyes) had presumed ocular histoplasmosis syndrome, four patients (eight eyes) had presumed tuberculous choroiditis, two patients (four eyes) had multiple evanescent white dot syndrome and two patients (four eyes) had Vogt Koyanagi Harada (VKH) syndrome. The most characteristic feature noted on ICGA was the presence of different patterns of hypofluorescent dark spots, which were present at different stages of the angiogram. ICGA provides the clinician with a powerful adjunctive tool in choroidal inflammatory disorders. It is not meant to replace already proven modalities such as the fluorescein angiography, but it can provide additional information that is useful in establishing a more definitive diagnosis in inflammatory chorioretinal diseases associated with multiple spots. It still needs to be determined if ICGA can prove to be a follow up parameter to evaluate disease progression. PMID:23685486

Comparison of anterior segment optical coherence tomography angiography and fluorescein angiography for iris vasculature analysis.

PubMed

Zett, Claudio; Stina, Deborah M Rosa; Kato, Renata Tiemi; Novais, Eduardo Amorim; Allemann, Norma

2018-04-01

The aim of this study is to perform imaging of irises of different colors using spectral domain anterior segment optical coherence tomography angiography (AS-OCTA) and iris fluorescein angiography (IFA) and compare their effectiveness in examining iris vasculature. This is a cross-sectional observational clinical study. Patients with no vascular iris alterations and different pigmentation levels were recruited. Participants were imaged using OCTA adapted with an anterior segment lens and IFA with a confocal scanning laser ophthalmoscope (cSLO) adapted with an anterior segment lens. AS-OCTA and IFA images were then compared. Two blinded readers classified iris pigmentation and compared the percentage of visible vessels between OCTA and IFA images. Twenty eyes of 10 patients with different degrees of iris pigmentation were imaged using AS-OCTA and IFA. Significantly more visible iris vessels were observed using OCTA than using FA (W = 5.22; p < 0.001). Iris pigmentation was negatively correlated to the percentage of visible vessels in both imaging methods (OCTA, rho = - 0.73, p < 0.001; IFA, rho = - 0.77, p < 0.001). Unlike FA, AS-OCTA could not detect leakage of dye, delay, or impregnation. Nystagmus and inadequate fixation along with motion artifacts resulted in lower quality images in AS-OCTA than in IFA. AS-OCTA is a new imaging modality which allows analysis of iris vasculature. In both AS-OCTA and IFA, iris pigmentation caused vasculature imaging blockage, but AS-OCTA provided more detailed iris vasculature images than IFA. Additional studies including different iris pathologies are needed to determine the most optimal scanning parameters in OCTA of the anterior segment.

Postmortem dynamic cerebral angiography for detecting aneurysm and bleeding sites in cases of subarachnoid hemorrhage.

PubMed

Inokuchi, Go; Yajima, Daisuke; Hayakawa, Mutsumi; Motomura, Ayumi; Chiba, Fumiko; Torimitsu, Suguru; Makino, Yohsuke; Iwase, Hirotaro

2014-12-01

One of the advantages of postmortem imaging is its ability to obtain diagnostic findings in a non-destructive manner when autopsy is either difficult or may destroy forensic evidence. In recent years, efforts have been made to incorporate computed tomography (CT) based postmortem angiography into forensic pathology; however, it is not currently clear how well the modality can determine sites of bleeding in cases of subarachnoid hemorrhage. Therefore, in this study, we investigated the utility of postmortem cerebral angiography using multi-detector row CT (MDCT) by injecting a contrast medium through a catheter inserted into the internal carotid and vertebral arteries of 10 subarachnoid hemorrhage cases. While postmortem MDCT angiography (PMCTA) was capable of detecting aneurysms in a non-destructive manner, it was sometimes difficult to identify the aneurysm and bleeding sites because of a large amount of contrast medium leaking into the extravascular space. To overcome this problem, we developed the novel contrast imaging method "dynamic cerebral angiography," which involves scanning the same area multiple times while injecting contrast medium to enable real-time observation of the contrasted vasculature. Using multiphase contrast images acquired by this method, we successfully captured the moment when contrast medium leaked from the hemorrhage site. This method will be useful for identifying exact bleeding sites on PMCTA.

Multidetector CT angiography in living donor renal transplantation: accuracy and discrepancies in right venous anatomy.

PubMed

Kulkarni, S; Emre, S; Arvelakis, A; Asch, W; Bia, M; Formica, R; Israel, G

2011-01-01

Multidetector computed tomography (MDCT) angiography is a reliable technique for assessing pre-operative renal anatomy in living kidney donors. The method has largely evolved into protocols that eliminate dedicated venous phase and instead utilize a combined arterial/venous phase to delineate arterial and venous anatomy simultaneously. Despite adoption of this protocol, there has been no study to assess its accuracy. To assess whether or not MDCT angiography compares favorably to intra-operative findings, 102 donors underwent MDCT angiography without a dedicated venous phase with surgical interpretation of renal anatomy. Anatomical variants included multiple arteries (12%), multiple veins (7%), early arterial bifurcation (13%), late venous confluence (5%), circumaortic renal veins (5%), retroaortic vein (1%), and ureteral duplication (2%). The sensitivity and specificity of multiple arterial anomalies were 100% and 97%, respectively. The sensitivity and specificity of multiple venous anomalies were 92% and 98%, respectively. The most common discrepancy was noted exclusively in the interpretation of right venous anatomy as it pertained to the renal vein/vena cava confluence (3%). MDCT angiography using a combined arterial/venous contrast-enhanced phase provides suitable depiction of renal donor anatomy. Careful consideration should be given when planning a right donor nephrectomy whether the radiographic interpretation is suggestive of a late confluence. © 2010 John Wiley & Sons A/S.

Clinical performance of a free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced pediatric abdominal MR angiography

PubMed Central

Yousaf, Ufra; Hsiao, Albert; Cheng, Joseph Y.; Alley, Marcus T.; Lustig, Michael; Pauly, John M.; Vasanawala, Shreyas S.

2015-01-01

Background Pediatric contrast-enhanced MR angiography is often limited by respiration, other patient motion and compromised spatiotemporal resolution. Objective To determine the reliability of a free-breathing spatiotemporally accelerated 3-D time-resolved contrast enhanced MR angiography method for depicting abdominal arterial anatomy in young children. Materials and methods With IRB approval and informed consent, we retrospectively identified 27 consecutive children (16 males and 11 females; mean age: 3.8 years, range: 14 days to 8.4 years) referred for contrast enhanced MR angiography at our institution, who had undergone free-breathing spatiotemporally accelerated time-resolved contrast enhanced MR angiography studies. An radio-frequency-spoiled gradient echo sequence with Cartesian variable density k-space sampling and radial view ordering, intrinsic motion navigation and intermittent fat suppression was developed. Images were reconstructed with soft-gated parallel imaging locally low-rank method to achieve both motion correction and high spatiotemporal resolution. Quality of delineation of 13 abdominal arteries in the reconstructed images was assessed independently by two radiologists on a five-point scale. Ninety-five percent confidence intervals of the proportion of diagnostically adequate cases were calculated. Interobserver agreements were also analyzed. Results Eleven out of 13 arteries achieved acceptable image quality (mean score range: 3.9–5.0) for both readers. Fair to substantial interobserver agreement was reached on nine arteries. Conclusion Free-breathing spatiotemporally accelerated 3-D time-resolved contrast enhanced MR angiography frequently yields diagnostic image quality for most abdominal arteries for pediatric contrast enhanced MR angiography. PMID:26040509

Evaluation of computed tomography in patients with atypical angina or chest pain clinically referred for invasive coronary angiography: randomised controlled trial.

PubMed

Dewey, Marc; Rief, Matthias; Martus, Peter; Kendziora, Benjamin; Feger, Sarah; Dreger, Henryk; Priem, Sascha; Knebel, Fabian; Böhm, Marko; Schlattmann, Peter; Hamm, Bernd; Schönenberger, Eva; Laule, Michael; Zimmermann, Elke

2016-10-24

 To evaluate whether invasive coronary angiography or computed tomography (CT) should be performed in patients clinically referred for coronary angiography with an intermediate probability of coronary artery disease.  Prospective randomised single centre trial.  University hospital in Germany.  340 patients with suspected coronary artery disease and a clinical indication for coronary angiography on the basis of atypical angina or chest pain.  168 patients were randomised to CT and 172 to coronary angiography. After randomisation one patient declined CT and 10 patients declined coronary angiography, leaving 167 patients (88 women) and 162 patients (78 women) for analysis. Allocation could not be blinded, but blinded independent investigators assessed outcomes.  The primary outcome measure was major procedural complications within 48 hours of the last procedure related to CT or angiography.  Cardiac CT reduced the need for coronary angiography from 100% to 14% (95% confidence interval 9% to 20%, P<0.001) and was associated with a significantly greater diagnostic yield from coronary angiography: 75% (53% to 90%) v 15% (10% to 22%), P<0.001. Major procedural complications were uncommon (0.3%) and similar across groups. Minor procedural complications were less common in the CT group than in the coronary angiography group: 3.6% (1% to 8%) v 10.5% (6% to 16%), P=0.014. CT shortened the median length of stay in the angiography group from 52.9 hours (interquartile range 49.5-76.4 hours) to 30.0 hours (3.5-77.3 hours, P<0.001). Overall median exposure to radiation was similar between the CT and angiography groups: 5.0 mSv (interquartile range 4.2-8.7 mSv) v 6.4 mSv (3.4-10.7 mSv), P=0.45. After a median follow-up of 3.3 years, major adverse cardiovascular events had occurred in seven of 167 patients in the CT group (4.2%) and six of 162 (3.7%) in the coronary angiography group (adjusted hazard ratio 0.90, 95% confidence interval 0.30 to 2.69, P=0.86). 79% of patients

Insufficient platelet inhibition is related to silent embolic cerebral infarctions after coronary angiography.

PubMed

Kim, Bum Joon; Lee, Seung-Whan; Park, Seong-Wook; Kang, Dong-Wha; Kim, Jong S; Kwon, Sun U

2012-03-01

Considering that insufficient platelet inhibition is related to thrombotic complications after coronary angiography, we hypothesized that the extent of platelet inhibition by antiplatelet agents is related to the occurrence of silent embolic cerebral infarction (SECI) after coronary angiography. Among the patients scheduled for coronary artery bypass surgery, we retrospectively analyzed the location of SECI on diffusion-weighted imaging of 272 patients, which was performed after coronary angiography, as a presurgical evaluation in Phase 1 study. In Phase 2 study, we have prospectively recruited 102 patients to compare the extent of platelet inhibition measured by the VerifyNow system among patients with and without SECI. SECI is observed in 45 patients (16.5%) in Phase 1 and 17 (16.7%) in Phase 2. The lesions were slightly more frequent in the right hemisphere. In the Phase 2 study, aspirin reaction units and P(2)Y(12) reaction units were higher in the patients with SECI than those without (aspirin reaction units: 490±72 versus 446±53, P=0.03; P(2)Y(12) reaction units: 352±65 versus 300±77, P=0.009). The incidence of SECI increased with the number of resistant antiplatelets; resistance to both antiplatelet agent (50%), resistance to 1 antiplatelet agent (22%), and no resistance (4%; P=0.023). From the result of logistic regression, higher aspirin reaction units, white blood cell count, low hemoglobin, and nonresponsiveness to antiplatelet agents were independent risk factors. Insufficient platelet inhibition after administration of antiplatelet agents is related with SECI appearing after coronary angiography.

Contrast Enhancement of the Right Ventricle during Coronary CT Angiography--Is It Necessary?

PubMed

Kok, Madeleine; Kietselaer, Bas L J H; Mihl, Casper; Altintas, Sibel; Nijssen, Estelle C; Wildberger, Joachim E; Das, Marco

2015-01-01

It is unclear if prolonged contrast media injection, to improve right ventricular visualization during coronary CT angiography, leads to increased detection of right ventricle pathology. The purpose of this study was to evaluate right ventricle enhancement and subsequent detection of right ventricle disease during coronary CT angiography. 472 consecutive patients referred for screening coronary CT angiography were retrospectively evaluated. Every patient underwent multidetector-row CT of the coronary arteries: 128x 0.6mm coll., 100-120kV, rot. time 0.28s, ref. mAs 350 and received an individualized (P3T) contrast bolus injection of iodinated contrast medium (300 mgI/ml). Patient data were analyzed to assess right ventricle enhancement (HU) and right ventricle pathology. Image quality was defined good when right ventricle enhancement >200HU, moderate when 140-200HU and poor when <140HU. Good image quality was found in 372 patients, moderate in 80 patients and poor in 20 patients. Mean enhancement of the right ventricle cavity was 268HU±102. Patients received an average bolus of 108±24 ml at an average peak flow rate of 6.1±2.2 ml/s. In only three out of 472 patients (0.63%) pathology of the right ventricle was found (dilatation) No other right ventricle pathology was detected. Right ventricle pathology was detected in three out of 472 patients; the dilatation observed in these three cases may have been picked up even without dedicated enhancement of the right ventricle. Based on our findings, right ventricle enhancement can be omitted during screening coronary CT angiography.

[Evaluation of acoustic effectiveness of personnel protectors from extra-aural exposure to aviation noise].

PubMed

Dragan, S P; Soldatov, S K; Bogomolov, A V; Drozdov, S V; Poliakov, N M

2013-01-01

Purpose of the investigation was to validate testing acoustic effectiveness of a personnel vest-like protector (PP) from extra-aural exposure to aviation noise. Levels of aviation noise for PP testing were determined through calculation. Vest effectiveness in protecting from acoustic vibration generated by high-intensity aviation noise was evaluated both in laboratory and field tests. For comparison analysis, PP was also tested with a dummy exposed on a special tester, i.e. acoustic interferometer.

Introduction to Personnel Management: Participants' Manual.

ERIC Educational Resources Information Center

Civil Service Commission, Denver, CO. Regional Training Center.

This manual for the introductory Federal personnel management course covers: major personnel laws and sources of information; position classification (standards and task analysis); staffing and placement (competitive appointments, temporary appointments/promotions, recruitment, and noncompetitive actions); merit promotion; qualification standards;…

34 CFR 303.361 - Personnel standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... trained personnel to provide early intervention services to eligible children, including, in a geographic... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES Program and Service Components of a Statewide System of Early Intervention Services Personnel...

14 CFR 145.151 - Personnel requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) SCHOOLS AND OTHER CERTIFICATED AGENCIES REPAIR STATIONS Personnel § 145.151 Personnel requirements. Each certificated repair station must— (a) Designate a repair station employee as the accountable manager; (b..., preventive maintenance, or alterations performed under the repair station certificate and operations...

14 CFR 145.151 - Personnel requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) SCHOOLS AND OTHER CERTIFICATED AGENCIES REPAIR STATIONS Personnel § 145.151 Personnel requirements. Each certificated repair station must— (a) Designate a repair station employee as the accountable manager; (b..., preventive maintenance, or alterations performed under the repair station certificate and operations...

14 CFR 145.151 - Personnel requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) SCHOOLS AND OTHER CERTIFICATED AGENCIES REPAIR STATIONS Personnel § 145.151 Personnel requirements. Each certificated repair station must— (a) Designate a repair station employee as the accountable manager; (b..., preventive maintenance, or alterations performed under the repair station certificate and operations...

Intelligent Processing Equipment Within the Environmental Protection Agency

NASA Technical Reports Server (NTRS)

Greathouse, Daniel G.; Nalesnik, Richard P.

1992-01-01

Protection of the environment and environmental remediation requires the cooperation, at all levels, of government and industry. Intelligent processing equipment, in addition to other artificial intelligence based tools, was used by the Environmental Protection Agency to provide personnel safety and improve the efficiency of those responsible for protection and remediation of the environment. These exploratory efforts demonstrate the feasibility and utility of expanding development and widespread use of these tools. A survey of current intelligent processing equipment applications in the Agency is presented and is followed by a brief discussion of possible uses in the future.

Dental utilization by active duty Army personnel.

PubMed

Chisick, M C

1993-10-01

In spring 1989, a random, Army-wide sample of 15,364 enlisted and 4,529 officer personnel was surveyed on dental utilization. Results show no difference in annual dental utilization between officer and enlisted personnel when age is controlled. Because annual dental utilization increases with age and enlisted ranks contain a disproportionately large number of younger personnel, a difference in annual dental utilization between enlisted and officer personnel emerges when age is not controlled. Check-ups are the most common reason for dental visits. Nearly all soldiers seek care exclusively in military dental clinics. Non-use is highest among 18- to 19-year-olds (12.2%).

Anger rumination, social support, and cardiac symptoms in patients undergoing angiography.

PubMed

Closa León, Trini; Nouwen, Arie; Sheffield, David; Jaumdally, Rumi; Lip, Gregory Y H

2010-11-01

Socially isolated individuals report more cardiac symptoms, suffer increased cardiovascular morbidity and mortality, and experience higher levels of stress and anxiety than those with more effective support resources. However, the complex interactions of psychosocial factors implicated in the disease process remain to be fully elucidated. We sought to explore these relationships, with the addition of a novel psychosocial variable, anger rumination, which could be associated with increased cardiovascular risk. We examined the association of psychological stress, social support, and anger rumination, with surgical anxiety, self-reported cardiac symptoms, and angiographically documented coronary artery disease, using a correlational ex post facto design. One hundred and one patients scheduled for elective coronary angiography completed questionnaires during the week prior to angiography. Disease severity was objectively assessed using the Gensini scoring system. Self-reported cardiac symptom severity was significantly correlated with higher perceived stress, less social support, and higher anger rumination, but none of the psychosocial variables predicted Gensini score. Social support partially mediated the relationship between anger rumination and surgical anxiety. Perceived stress mediated the relationship between anger rumination and cardiac symptoms. For patients awaiting angiography, stress, and lack of social support are important predictors of self-reported cardiac symptoms, irrespective of actual disease severity. Intervention could focus on reducing perceived stress by encouraging reappraisal and a support seeking, rather than a ruminative, anger coping style.

Variations in the origins of the thyroid arteries on CT angiography.

PubMed

Esen, Kaan; Ozgur, Anil; Balci, Yuksel; Tok, Sermin; Kara, Engin

2018-02-01

To investigate the anatomical variations in the origins of the thyroid arteries on CT angiography images. The presence and the origins of the superior thyroid artery, the inferior thyroid artery, and the thyroidea ima artery were retrospectively evaluated based on carotid CT angiography examinations. The bifurcation level of the common carotid artery with respect to the cervical vertebrae and disc spaces was also determined. A total of 640 patients were included in the study. The right and left superior thyroid arteries arose from the external carotid artery in 413 (64.5%) and 254 (39.7%) patients, from the bifurcation of the common carotid artery in 131 (20.5%) and 148 (23.1%) patients, and from the common carotid artery in 90 (14.1%) and 226 (35.3%) patients, respectively. We could not observe the right and the left superior thyroid arteries in 6 (0.9%) and 12 (1.9%) of the patients, respectively. However, the right and left inferior thyroid arteries were not identified in 14 (2.2%) and 45 (7%) of the patients, respectively. The thyroidea ima artery was detected in 2.3% of the patients. The visualization of thyroid arteries on CT angiography images enables the anatomy of the arterial supply system of the thyroid gland to be explored in a noninvasive manner prior to surgery.

Extremely long posterior communicating artery diagnosed by MR angiography: report of two cases.

PubMed

Uchino, Akira; Suzuki, Chihiro; Tanaka, Masahiko

2015-07-01

We report two cases of an extremely long left posterior communicating artery (PCoA) diagnosed by magnetic resonance (MR) angiography. The PCoA arose from the normal point of the supraclinoid internal carotid artery and fused with the posterior cerebral artery (PCA) at its posterior ambient segment, forming an extremely long PCoA and extremely long precommunicating segment of the PCA. To our knowledge, this is the first report of such variation. Careful observation of MR angiographic images is important for detecting rare arterial variations. To identify these anomalous arteries on MR angiography, partial maximum-intensity-projection images are useful.

Correction of rotational distortion for catheter-based en face OCT and OCT angiography

PubMed Central

Ahsen, Osman O.; Lee, Hsiang-Chieh; Giacomelli, Michael G.; Wang, Zhao; Liang, Kaicheng; Tsai, Tsung-Han; Potsaid, Benjamin; Mashimo, Hiroshi; Fujimoto, James G.

2015-01-01

We demonstrate a computationally efficient method for correcting the nonuniform rotational distortion (NURD) in catheter-based imaging systems to improve endoscopic en face optical coherence tomography (OCT) and OCT angiography. The method performs nonrigid registration using fiducial markers on the catheter to correct rotational speed variations. Algorithm performance is investigated with an ultrahigh-speed endoscopic OCT system and micromotor catheter. Scan nonuniformity is quantitatively characterized, and artifacts from rotational speed variations are significantly reduced. Furthermore, we present endoscopic en face OCT and OCT angiography images of human gastrointestinal tract in vivo to demonstrate the image quality improvement using the correction algorithm. PMID:25361133

Monitoring of health care personnel employee and occupational health immunization program practices in the United States.

PubMed

Carrico, Ruth M; Sorrells, Nikka; Westhusing, Kelly; Wiemken, Timothy

2014-01-01

Recent studies have identified concerns with various elements of health care personnel immunization programs, including the handling and management of the vaccine. The purpose of this study was to assess monitoring processes that support evaluation of the care of vaccines in health care settings. An 11-question survey instrument was developed for use in scripted telephone surveys. State health departments in all 50 states in the United States and the District of Columbia were the target audience for the surveys. Data from a total of 47 states were obtained and analyzed. No states reported an existing monitoring process for evaluation of health care personnel immunization programs in their states. Our assessment indicates that vaccine evaluation processes for health care facilities are rare to nonexistent in the United States. Identifying existing practice gaps and resultant opportunities for improvements may be an important safety initiative that protects patients and health care personnel. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

5 CFR 250.101 - Standards and requirements for agency personnel actions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... personnel actions. 250.101 Section 250.101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL MANAGEMENT IN AGENCIES Authority for Personnel Actions in Agencies § 250.101... Personnel Management (OPM), the instructions OPM has published in the Guide to Processing Personnel Actions...

5 CFR 250.101 - Standards and requirements for agency personnel actions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... personnel actions. 250.101 Section 250.101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL MANAGEMENT IN AGENCIES Authority for Personnel Actions in Agencies § 250.101... Personnel Management (OPM), the instructions OPM has published in the Guide to Processing Personnel Actions...

SENSITIVITY AND SPECIFICITY OF DETECTING POLYPOIDAL CHOROIDAL VASCULOPATHY WITH EN FACE OPTICAL COHERENCE TOMOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY.

PubMed

de Carlo, Talisa E; Kokame, Gregg T; Kaneko, Kyle N; Lian, Rebecca; Lai, James C; Wee, Raymond

2018-03-20

Determine sensitivity and specificity of polypoidal choroidal vasculopathy (PCV) diagnosis with structural en face optical coherence tomography (OCT) and OCT angiography (OCTA). Retrospective review of the medical records of eyes diagnosed with PCV by indocyanine green angiography with review of diagnostic testing with structural en face OCT and OCTA by a trained reader. Structural en face OCT, cross-sectional OCT angiograms alone, and OCTA in its entirety were reviewed blinded to the findings of indocyanine green angiography and each other to determine if they could demonstrate the PCV complex. Sensitivity and specificity of PCV diagnosis was determined for each imaging technique using indocyanine green angiography as the ground truth. Sensitivity and specificity of structural en face OCT were 30.0% and 85.7%, of OCT angiograms alone were 26.8% and 96.8%, and of the entire OCTA were 43.9% and 87.1%, respectively. Sensitivity and specificity were improved for OCT angiograms and OCTA when looking at images taken within 1 month of PCV diagnosis. Sensitivity of detecting PCV was low using structural en face OCT and OCTA but specificity was high. Indocyanine green angiography remains the gold standard for PCV detection.

Electrostatic forces for personnel restraints