bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective analysis of diagnostic outcomes in lower gastrointestinal bleeding using angiography and nuclear medicine
Authors: Erskine Brendan J , Marshall Elissa M 
Published: October 2013

AbstractA retrospective analysis of angiography for the investigation of lower gastrointestinal bleeding (LGIB) was conducted at our institution, exploring the factors affecting diagnostic yield and the correlation with nuclear medicine 99 mTc red blood cell (RBC) scintigraphy. During a five‐year period (March 2003 to March 2008), 44 patients were investigated using angiography alone with 15 (34%) positive for LGIB. Within the same period 159, 99 mTc RBC scans were performed with 65 (41%) examinations positive for LGIB. Of these 159 patients, 45 proceeded to angiography within a 24‐hour period with 19 (42%) demonstrating active bleeding. Importantly, 10 patients proceeded to angiography despite a negative RBC scan and none recorded a positive angiogram. Also, 19 of 35 (54%) patients demonstrated active bleeding on angiography following a positive RBC scan. The average time between nuclear medicine and angiography was 5.83 hours (range 0.63–21.5 hours). The study was limited to patients demonstrating active, immediate bleeding on RBC scintigraphy, and when performed within 5 hours following, the diagnostic yield of angiography increased from 34% to 89%. Careful adherence to such criteria will in future increase diagnostic confidence for clinical management of LGIB while reducing the number of unnecessary angiographic investigations.
The impact of IGRT for prostate radiotherapy on dosimetry and the traditional workflow practice of focus to skin distance measurements
Authors: Nguyen Huong , Frantzis Jim , Sisson Toni , Jones Mark , Martin Jarad , Middleton Mark 
Published: October 2013

AbstractPurpose: To assess the relevance of focus to skin distance (FSD) measurements for patients with intraprostatic gold seeds using an image guided radiation therapy (IGRT) protocol. The second aim of this study was to analyse the frequency and nature of isocentre shifts made during a course of treatment for patients with prostate cancer. Additionally, the impact of isocentre shifts on dosimetry, relative to the traditional method of basing dosimetric recalculations on FSD measurements was assessed. Methods and materials: Ten patients underwent prostate radiotherapy with intraprostatic gold seeds and an IGRT protocol. FSD measurements were taken on a daily basis pre‐intervention and also post‐intervention if an isocentre shift was made. Analysis of systematic and random isocentre shifts were made and compared to measured FSDs. An individual case study was carried out assessing the dosimetric impact of multiple isocentre shifts throughout a course of treatment and analysed against measured FSDs. Results: Ten patients received radiotherapy to the prostate (78 Gy/39 fractions). 390 treatment sessions were available for analysis, inclusive of 2340 measured FSDs. Measured FSDs were out of tolerance (greater than 1 cm difference from planned measurement) less than 2% of the total treatment sessions. Of the isocentre shifts made, 66% (160/242) were random and 34% (82/242) were systematic. The individual case study revealed 72% of treatment sessions required an isocentre shift with FSDs being outside tolerance for one session. Conclusions: FSD measurements in the era of intraprostatic gold seed IGRT have been reduced in importance. IGRT has improved the identification of systematic and random errors therefore allowing better visualisation of dosimetric impact these errors may cause. Our data suggest that FSD measurements for men undergoing IGRT for prostate cancer have minimal dosimetric impact.
Diagnostic reference levels as a quality assurance tool
Authors: Edmonds KD 
Published: October 2013

AbstractThe objective of diagnostic reference levels (DRL) in radiology is to assist in the optimisation of radiation dose to patients, while maintaining diagnostic image quality, and to detect unusually high doses that do not contribute significantly to the clinical outcome of a medical imaging examination. DRL have been in existence overseas for more than a decade and its influence has contributed to a steady decline in dose for general radiography and fluoroscopic procedures. High dose modalities such as CT and interventional procedures are increasing dramatically both locally and internationally resulting in the unwanted outcome of a significant increase in population cumulative effective dose. This calls for urgent dose reduction and dose constraint measures. Utilising DRL is one method of optimising patient dose. Some local and international DRL dose levels for some common radiographic, interventional and CT examinations are presented as a suggestion for the application of this methodology in Australian radiology practice.
Radiation therapist‐led weekly patient treatment reviews
Authors: Alfieri F , Le Mottee MA , Arifuddin A , Field N , Milinkovic D , Cox J 
Published: October 2013

AbstractThe purpose of this discussion article is to explore the implementation of radiation therapist‐led treatment reviews as a form of advanced practice for radiation therapists in Australia. The feasibility of such a role, the impact on cancer care services and implementation requirements to enable the position to be implemented effectively in an Australian environment are explored. Current practice involving weekly patient treatment reviews and cases where health professionals other than radiation oncologists have undertaken this role will be evaluated. Recommendations on its implementation in an Australian environment are also given. An extensive literature review was conducted through the databases ScienceDirect, Medline and CINAHL. Searches were carried out using the following keywords; “radi*” and “prescribing”, “radi*” and “patient review” and “radi*” and “role development”. Abstracts of the yielded results were appraised and those that matched criteria for analysis underwent critical review for inclusion in the discussion. Although steps have been taken to implement the advanced practice role of a treatment review radiation therapist in Australia, little has been done to formalise the role. It is evident from the international literature that the radiation therapist‐led reviewer role has resulted in benefits to patients, medical specialists and therapists. This advanced practice role has the potential to increase radiation therapist retention and recruitment. Implementation of this role in the Australian environment would be advantageous; however criteria outlining the scope of practice and remuneration packages need to be established to facilitate the synthesis of this role in a clinical environment.
Designing surveys for radiography and radiation therapy
Authors: O'Connor M , Halkett G 
Published: October 2013

AbstractSurveys using standardised questionnaires are frequently used in the health area for research, to gather information to inform or improve clinical practice and to gage perceptions or attitudes towards particular issues. As we begin to conduct more studies in the areas of radiography and radiation therapy we need to ensure that it is essential that we use reliable and valid research methods so that findings are robust and, importantly, useable in clinical practice. This review focuses on how to design the questionnaire and highlights some key rules to help avoid the many pitfalls in survey design. The importance of the planning stage and time spent reviewing and revising questions is emphasised and the benefits and challenges of using existing instruments are discussed. Questionnaire layout is addressed and also the wording of individual questions as both of these will affect response rates and how people interpret questions. Wording can be difficult and may take a few drafts to get right. Several examples are given to demonstrate the concepts. The key messages in this review are: spend time planning and make the questionnaire brief, easy and safe. Issues such as response rates, types of questions, how to test for reliability and validity; and how to analyse the data will be covered in a further review for The Radiographer.
Preparedness for clinical practice — perceptions of newly qualified radiographers
Authors: Liang W Tan , Reed W , Agudera M 
Published: October 2013

AbstractPurpose: To investigate the perceptions of newly qualified radiographers in the Sydney metropolitan area regarding their preparedness for clinical practice. Methods: Twenty‐three newly qualified radiographers (corresponds to a 43% return) from nine public hospitals and nine private practices within the Sydney metropolitan area were surveyed. The questionnaire assessed newly qualified radiographers' preparedness against a number of items derived from published radiography standards by the Australian Institute of Radiography (AIR) pertaining to knowledge, skills and values radiographers should acquire upon graduation and completion of the Professional Development Year (PDY) programme. Statistical analysis examined differences in preparedness between those who work in public hospitals and those who work in private practices. Results: Significant differences in perceived preparedness between newly qualified radiographers who practice in public hospitals and those who practice in private practices were found in two criteria which include the ability to care for patients with physical or mental disability and equipment manipulation. Positive feedback was given in regards to university degree and PDY programme preparation. Suggestions for degree and PDY programme improvement were provided. Conclusion: Overall, newly qualified radiographers perceived themselves as well prepared for their role as an accredited practitioner.
An investigation of advanced practice carried out by radiographers in New South Wales
Authors: Hardy A , Poulos A , Emanuel N , Reed W 
Published: October 2013

AbstractPurpose: This study investigated advanced practices carried out by radiographers in New South Wales (NSW). Background: Due to a chronic shortage of radiologists, radiographers in the United Kingdom have extended their clinical roles. These additional responsibilities have increased professional accountability, as well as improved the quality of care provided to patients. While it is likely that such professional role extension occurs in Australia, no known study has been performed to date on this topic. Methods: Questionnaires were mailed to Chief Radiographers of medical imaging departments (MIDs) across NSW. Questions related to MIDs demographics and advanced practices of radiographers including triage systems, formal and informal reporting, cannulation, intravenous contrast media administration, roles during diagnostic enemas, and involvement in research. Returned questionnaires were analysed. Results: A total of 69 questionnaires were returned from 115 distributed (60%). Seventeen percent of MIDs with an Emergency department had radiographers involved in the triage process; 39% of MIDs utilised a radiographer‐reported abnormality detection system, whilst 30% provided a verbal report. Radiographer‐performed cannulations and intravenous contrast media administration occurred in 77% and 79% of MIDs respectively. A total of 40% reported radiographers performing roles other than image acquisition during diagnostic enemas, radiographers participated in research in 13% of MIDs while radiographer clinical presentations, journal club participation and conference organisation occurred in 45%, 7%, and 38% of MIDs respectively. Conclusions: This exploratory study provides important baseline information on the extended roles of radiographers in NSW. The results could be used for future planning of radiographer roles and health service delivery techniques.
A retrospective review of multi—slice CT and DSA reports in patients with non—traumatic subarachnoid haemorrhage and the resultant diagnostic yield of aneurysms
Authors: Marshall E , Erskine B 
Published: October 2013

AbstractPurpose: To examine the diagnostic yield differences between computed tomography angiography (CTA) and digital subtraction angiography (DSA) at The Alfred Hospital, Australia in order to justify patient management that results in all subarachnoid haemorrhage (SAH) patients receiving a 4 vessel cerebral angiogram as part of their investigations despite findings on CTA. Methods: The retrospective study of radiology reports in cases of acute non traumatic SAH in which both CTA and DSA had been performed was conducted in July 2006 to December 2008. Results: Sixty‐three patients over two years were included in our study. Twenty (32%) of these patients had no aneurysm identified on CTA or DSA. A total of 68 aneurysms were found in 40 patients. Twelve (30%) of these patients had aneurysms that were only identified on DSA and not on CTA at the time of initial reporting. Three (5%) patients had false positive CTs. While our positive predictive value of CTA approached near 100%, the negative predictive value was found to be less than 70% with an overall diagnostic accuracy of our CTA reports to be 76%. Eighty one percent of the undiagnosed aneurysms on CTA were less than or equal to 3 mm in size. Conclusion: These findings demonstrate the need for a CTA to be used in combination with a formal 4 vessel subtraction angiogram in every case presenting with a SAH despite the findings of the CTA.
A comparison of the frequency of death‐related events and their effect on undergraduate radiation therapy and education students
Authors: Dungey G M , Jasperse M L 
Published: October 2013

AbstractPurpose: This study investigates the frequency and nature of death‐related events and their effect on attitude to life, relationships with other people, and career choices of 70 undergraduate radiation therapy students and 160 education students. Methods: Utilising a purposeful sampling method, a six‐page self‐administered questionnaire was distributed during a lecture to four cohorts of first, second and third year radiation therapy students and to a group of primarily second year education students. Results: Approximately 90% of both cohorts had been exposed to the death of a relative before commencing their university studies. Three main themes emerged from an analysis of the responses: re‐evaluating values and priorities; a desire to help others; and a heightened sense of empathy. A similar number of participants of both cohorts (64%) reported that being exposed to death had resulted in their lives becoming more meaningful. In contrast to education students, 50% of radiation therapy students attributed their career choice to having experienced the death of a relative, especially when cancer related. However, a previous death exposure did not appear to prepare some students for treating patients their own age, young patients or patients undergoing palliative radiation therapy. Conclusion: This study suggests that undergraduate radiation therapy students may benefit from supervision by mentors and access to counselling services, regardless of their previous experiences with death. Future research aims to determine if access to counselling services should be offered to all radiation therapists.
Adverse delayed reactions to the intravenous injection of non—ionic iodinated contrast media
Authors: Chung J , Jones T , Reed W 
Published: October 2013

AbstractAdverse delayed reactions (ADRs) to the intravenous injection of non‐ionic iodinated contrast media (NICM) were first recognised in the mid‐1980s and a growing number of articles in the literature have described such reactions as increasingly common. The aim of this article is to increase the understanding of the risk factors, frequency, signs and symptoms of ADRs amongst healthcare staff especially radiographers, nurses, radiologists and physicians who regularly use contrast media (CM). A literature review of multiple studies assessing ADRs performed from 1990–2010 has revealed various misconceptions, particularly in the frequency of ADRs and the influence of ethnic background most likely due to methodological limitations. Therefore, the use of improved research methods and design has the potential to increase our knowledge in this area. Furthermore, new areas of study such as blood testing as a screening tool can assist in risk assessment and prevention of ADRs.
Low dose CT chest — how low can we go?
Authors: Ardley N , Ditchfield M , Buchan K 
Published: October 2013

AbstractBackground: Radiation dose administration and its associated risks when performing computed tomography (CT) has been increasingly scrutinised in the recent past. The absorbed dose to organs and tissue in CT is high, therefore risks must be outweighed by benefit when considering a CT examination. This is particularly true when imaging the paediatric patient due to their increased radiation sensitivity. CT parameters need to be appropriate for the patient age, region and clinical question. Case Presentation: A 14 month old female paediatric patient underwent a non‐contrast CT scan of their chest post drain tube insertion to the right lung under CT guidance. Multi‐planar reconstruction images and 3D rendered images were produced using an iterative reconstruction (IR) technique. The paediatric radiologist stated that the image quality was diagnostic for the clinical question raised by the examination. Discussion: IR techniques have allowed doses in CT to be significantly lowered while maintaining image quality. Comparative data demonstrates that the doses administered when using IR can be lowered considerably than those traditionally administered when reconstructing with filtered back projection (FBP). Conclusion: This study highlights that advances in dose reduction in CT scanners when used in conjunction with IR techniques are meeting the clinical requirements of CT imaging by answering the clinical question.
Mammographic features of ductal carcinoma in‐situ — a pictorial review
Authors: Peters G , Daniels K , Jones CM 
Published: October 2013

AbstractDuctal carcinoma in situ (DCIS) is a precancerous form of breast cancer which can progress to invasive disease. The vast majority of DCIS cases are detected with mammography, where it is most commonly seen as microcalcification. There are many patterns of microcalcification, and distinguishing between these patterns can be confusing, particularly for inexperienced mammogram readers or clinicians. Analysing the microcalcification morphology and distribution stratifies the risk of DCIS and allows identification of cases with intermediate or high probability. This article gives a pictorial overview of pure DCIS cases detected in a screening programme with a focus on the patterns that are suggestive of DCIS.
Alteration in cellular viability, pro‐inflammatory cytokines and nitric oxide production in nephrotoxicity generation by Amphotericin B: involvement of PKA pathway signaling
Authors: França F. D. , Ferreira A. F. , Lara R. C. , Rossoni J. V. , Costa D. C. , Moraes K. C. M. , Tagliati C. A. , Chaves M. M. 
Published: October 2013

ABSTRACTAmphotericin B is one of the most effective antifungal agents; however, its use is often limited owing to adverse effects, especially nephrotoxicity. The purpose of this study was to evaluate the effect of inhibiting the PKA signaling pathway in nephrotoxicity using Amphotericin B from the assessment of cell viability, pro‐inflammatory cytokines and nitric oxide (NO) production in LLC‐PK1 and MDCK cell lines. Amphotericin B proved to be cytotoxic for both cell lines, as assessed by the mitochondrial enzyme activity (MTT) assay; caused DNA fragmentation, determined by flow cytometry using the propidium iodide (PI) dye; and activated the PKA pathway (western blot assay). In MDCK cells, the inhibition of the PKA signaling pathway (using the H89 inhibitor) caused a significant reduction in DNA fragmentation. In both cells lines the production of interleukin‐6 (IL)‐6 proved to be a dependent PKA pathway, whereas tumor necrosis factor‐alpha (TNF‐α) was not influenced by the inhibition of the PKA pathway. The NO production was increased when cells were pre‐incubated with H89 followed by Amphotericin B, and this production produced a dependent PKA pathway in LLC‐PK1 and MDCK cells lines. Therefore, considering the present study's results as a whole, it can be concluded that the inhibition of the PKA signaling pathway can aid in reducing the degree of nephrotoxicity caused by Amphotericin B. Copyright © 2013 John Wiley & Sons, Ltd.
Three‐dimensional configuration of orientated fibers as guidance structures for cell migration and axonal growth
Authors: Kriebel Andreas , Rumman Muhammad , Scheld Miriam , Hodde Dorothee , Brook Gary , Mey Jörg 
Published: October 2013

AbstractPeripheral nerve injuries can be surgically repaired by suturing the transected nerve stumps or, in case of larger lesions, by the transplantation of an autologous nerve graft. To avoid donor site morbidity, the development of artificial implants is desired. Clinically, hollow conduits have been used for this purpose but are inferior to the autograft because they lack internal guidance cues for Schwann cells and regenerating axons. In this article, we describe the design of a three‐dimensional (3D) scaffold consisting of parallel fibers embedded in a collagen matrix. For this purpose, an electrospinning device was developed to produce and manipulate a 3D array of aligned poly(ɛ‐caprolactone) (PCL) microfibers. This fiber array was then incorporated into biodegradable PCL tubes to serve as artificial nerve bridges. Using primary cultures of embryonic chicken dorsal root ganglia, we show that PCL microfibers in the 3D matrix of our composite scaffold guide the direction of Schwann cell migration and axonal growth. © 2013 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 102B: 356–365, 2014.
N‐Linked Polylactosamine Glycan Synthesis Is Regulated by Co‐Expression of β3GnT2 and GCNT2
Authors: Henion Timothy R. , Schwarting Gerald A. 
Published: October 2013

AbstractPoly‐N‐acetyllactosamine (PLN) is a unique glycan composed of repeating units of the common disaccharide (Galβ1,4‐GlcNAcβ1,3)n. The expression of PLN on glycoprotein core structures minimally requires enzyme activities for β1,4‐galactosyltransferase (β4GalT) and β1,3‐N‐acetylglucosminyltransferase (β3GnT). Because β4GalTs are ubiquitous in most cells, PLN expression is generally ascribed to the tissue‐specific transcription of eight known β3GnT genes in mice. In the olfactory epithelium (OE), β3GnT2 regulates expression of extended PLN chains that are essential for axon guidance and neuronal survival. N‐glycan branching and core composition, however, can also modulate the extent of PLN modification. Here, we show for the first time that the β1,6‐branching glycosyltransferase GCNT2 (formerly known as IGnT) is expressed at high levels specifically in the OE and other sensory ganglia. Postnatally, GCNT2 is maintained in mature olfactory neurons that co‐express β3GnT2 and PLN. This highly specific co‐expression suggests that GCNT2 and β3GnT2 function cooperatively in PLN synthesis. In support of this, β3GnT2 and GCNT2 co‐transfection in HEK293T cells results in high levels of PLN expression on the cell surface and on adenylyl cyclase 3, a major carrier of PLN glycans in the OE. These data clearly suggest that GCNT2 functions in vivo together with β3GnT2 to determine PLN levels in olfactory neurons by regulating β1,6‐branches that promote PLN extension. J. Cell. Physiol. 229: 471–478, 2014. © 2013 Wiley Periodicals, Inc.