Abstract—A survey was conducted among 20 Dutch hospitals about radiation protection for interventional fluoroscopy. This was a follow-up of a previous study in 2007 that led to several recommendations for radiation protection for interventional fluoroscopy. The results indicate that most recommendations have been followed. However, radiation-induced complications from interventional procedures are still often not recorded in the appropriate register. Furthermore, even though professionals with appropriate training in radiation protection are usually involved in interventional procedures, this often is not the case when these procedures are carried out outside the radiology department. Although this involvement is not required by Dutch law, it is recommended to have radiation protection professionals present more often at interventional procedures. Further improvements in radiation protection for interventional fluoroscopy may come from a comparison of dose-reducing practices among hospitals, the introduction of diagnostic reference levels for interventional procedures, and a more thorough form of screening and follow-up of patients
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Abstract Radiology during pregnancy: risks, radiation protection in medical practice, and communication with the patient. Authors: Harmen Bijwaard, Fleur Wit, Colinda Vroonland, has been accepted as POSTER at the 47th Annual Meeting of the European Radiation Research Society (ERRS 2022), which will be held from September 21st until eptember 24th, 2022 in Catania (Italy). We are very excited about the richness of the topics that are covered by the abstracts and look forward to seeing your poster soon! We inform you that on September 24th we are organizing just for our congress attendees the ETNA EXCURSION with alpine and volcanological guide. The departure will be by bus from Catania. All details about our SOCIAL EVENTS at: http://www.sirr2.it/errs2022/errs2022_social-events.html
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Abstract—A survey about radiation protection in pediatric radiology was conducted among 22 general and seven children’s hospitals in the Netherlands. Questions concerned, for example, child protocols used for CT, fluoroscopy and x-ray imaging, number of images and scans made, radiation doses and measures taken to reduce these, special tools used for children, and quality assurance issues. The answers received from 27 hospitals indicate that radiation protection practices differ considerably between general and children’s hospitals but also between the respective general and children’s hospitals. It is recommended that hospitals consult each other to come up with more uniform best practices. Few hospitals were able to supply doses that can be compared to the national Diagnostic Reference Levels (DRLs). The ones that could be compared exceeded the DRLs in one in five cases, which is more than was expected beforehand.
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Atherosclerosis is the development of lipid-laden plaques in arteries and is nowadays considered as an inflammatory disease. It has been shown that high doses of ionizing radiation, as used in radiotherapy, can increase the risk of development or progression of atherosclerosis. To elucidate the effects of radiation on atherosclerosis, we propose a mathematical model to describe radiation-promoted plaque evelopment. This model distinguishes itself from other models by combining plaque initiation and plaque growth, and by incorporating information from biological experiments. It is based on two consecutive processes: a probabilistic dose-dependent plaque initiation process, followed by deterministic plaque growth.
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Diagnostic reference levels (DRLs) for medical x-ray procedures are being implemented currently in the Netherlands. By order of the Dutch Healthcare Inspectorate, a survey has been conducted among 20 Dutch hospitals to investigate the level of implementation of the Dutch DRLs in current radiological practice. It turns out that hospitals are either well underway in implementing the DRLs or have already done so. However, the DRLs have usually not yet been incorporated in the QAsystem of the department nor in the treatment protocols. It was shown that the amount of radiation used, as far as it was indicated by the hospitals, usually remains below the DRLs. A procedure for comparing dose levels to the DRLs has been prescribed but is not Always followed in practice. This is especially difficult in the case of children, as most general hospitals receive few children. Health Phys. 108(4):462–464; 2015
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Concepts to protect wood from factors like ultraviolet (UV) radiation, water and wood-decaying fungi with the help of fungi exist in different variants. The idea to treat wood with the help of linseed oil and the living fungus Aureobasidium pullulans originated in 1996 during an European project assessing sustainable protection systems (Sailer et al., 2010). At that time, wood impregnated with natural oils resulted surprisingly in an evenly dark colored surface. These color changes were usually associated with irregular discoloration and staining and were further investigated. It has been shown that the fungus Aureobasidium pullulans was growing on surfaces treated with linseed oil. The fact that Aureobasium pullulans reproducibly grows on water repellent linseed surfaces in many regions around the world makes it suitable for use in a wide range of applications. Research did show that Aureobasidium pullulans produces pigments and binders on its own. This contribution documents the investigation to, identify the possibilities of biological wood surface treatment with Aureobasidium. The combination of the hydrophobizing effect of linseed oil and the surface treatment with the so-called biofinish creates an aesthetically appealing dark living surface, which significantly prolongs the life of wood outdoors and reduces maintenance costs. Since the idea has been developed into an industrially applicable process (Xyhlo biofinish, 2018). Using this concept, building components e.g. façades can be protected with a biological and functional coating thereby contribution to lessen the environmental impact of buildings.
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Review: With great interest we have read the paper “Pregnancy Screening before Diagnostic Radiography in Emergency Department; an Educational Review” by A.I. Abushouk et al. (1). We agree with the authors that unnecessary fetal radiation exposure should be avoided and that pregnancy screening can be a means to accomplish this. However, in their paper the authors suggest in several instances that radiological imaging during pregnancy can lead to teratogenic effects. In the Abstract it is stated: “Radiation exposure during pregnancy may have serious teratogenic effects to the fetus. Therefore, checking the pregnancy status before imaging women of child bearing age can protect against these effects.”, and in the Introduction: “Therefore, checking the pregnancy status before imaging women of child bearing age can protect against radiation teratogenic effects.” We strongly disagree with these statements: common radiological imaging will usually not give rise to fetal radiation doses high enough to lead to teratogenesis. The statements in the paper may lead to unnecessary worrying of pregnant women and it may discourage themfrom undergoing medically necessary radiological examinations.
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Introduction: In the Netherlands, Diagnostic Reference Levels (DRLs) have not been based on a national survey as proposed by ICRP. Instead, local exposure data, expert judgment and the international scientific literature were used as sources. This study investigated whether the current DRLs are reasonable for Dutch radiological practice. Methods: A national project was set up, in which radiography students carried out dose measurements in hospitals supervised by medical physicists. The project ran from 2014 to 2017 and dose values were analysed for a trend over time. In the absence of such a trend, the joint yearly data sets were considered a single data set and were analysed together. In this way the national project mimicked a national survey. Results: For six out of eleven radiological procedures enough data was collected for further analysis. In the first step of the analysis no trend was found over time for any of these procedures. In the second step the joint analysis lead to suggestions for five new DRL values that are far below the current ones. The new DRLs are based on the 75 percentile values of the distributions of all dose data per procedure. Conclusion: The results show that the current DRLs are too high for five of the six procedures that have been analysed. For the other five procedures more data needs to be collected. Moreover, the mean weights of the patients are higher than expected. This introduces bias when these are not recorded and the mean weight is assumed to be 77 kg. Implications for practice: The current checking of doses for compliance with the DRLs needs to be changed. Both the procedure (regarding weights) and the values of the DRLs should be updated.
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Introduction: The Netherlands does not have a national guideline for performing radiographic examinations on pregnant patients. Radiographic examination is a generic term for all examinations performed using ionizing radiation, including but not limited to radiographs, fluoroscopy and computed tomography. A pilot study amongst radiographers (Medical Radiation Technologists (MRTs)) showed that standardized practice of radiographic examinations on pregnant women is not evident between Radiology departments and that there is a need for a national guideline as the varying practice methods may lead to confusion and uncertainty amongst both patients and MRTs. Methods: Focus groups consisting of MRTs from several Radiology departments within the Netherlands were used to map ideas and requirements as to what should be included in the national guideline. Nine focus group sessions were organized with a total of 52 participants. Using a previous review (Wit, Fleur; Vroonland, Colinda; Bijwaard H. Pre-natal X-ray exposure and the risk of developing paediatric cancer; a systematic review of risk factors and a comparison of international guidelines. Health Physics 2021; 121 (3):225e233), the following key points were chosen as discussion topics for the focus group sessions: dose reduction, confirming pregnancy and risk communication. Results: Results showed that the participating MRTs did not agree on the use of lead aprons. That the national guideline should include standardized methods to adjust parameters to decrease radiation dose. Focus group participants find it difficult to ask a patient's pregnancy status, especially when dealing with relatively young and old (er) patients. When communicating the level of risk associated with a radiographic examination the participating MRTs would like to be able to use examples and comparisons, preferably by means of a multilingual website. Conclusion: A national guideline must include information on justification, available alternatives, dose reductions methods and confirmation of pregnancy requirements when fetal dose is a significant risk. Implications for practice: A national guideline ensures standardized practice can be implemented in Radiology departments, increasing clarity of the issues for both patients and MRTs.
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Een fles rode wijn per dag drinken is ongezond, maar een glas per dag reduceert mogelijk de kans op hartkwalen. Dit is een voorbeeld van ‘hormese’: het verschijnsel dat een agens dat in grote hoeveelheden schadelijk is, bij lage doses juist gezond is. Iets vergelijkbaars geldt voor zonlicht: lage doses worden geassocieerd met positieve gezondseffecten, hoge doses met verbranden en een hogere kans op huidkanker. Er zijn onderzoekers die zich op het omstreden standpunt stellen dat ook ioniserende straling hormetische eigenschappen heeft. In dit artikel gaan we nader in op de verschillende standpunten omtrent lage-dosiseffecten, de argumenten voor en tegen hormese en de consequenties van recente inzichten.
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