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RoFo : Fortschritte Auf Dem Gebiete Der... Nov 2023Sustainability is becoming increasingly important in radiology. Besides climate protection - economic, ecological, and social aspects are integral elements of...
BACKGROUND
Sustainability is becoming increasingly important in radiology. Besides climate protection - economic, ecological, and social aspects are integral elements of sustainability. An overview of the scientific background of the sustainability and environmental impact of radiology as well as possibilities for future concepts for more sustainable diagnostic and interventional radiology are presented below.The three elements of sustainability:1. EcologyWith an annually increasing number of tomographic images, Germany is in one of the leading positions worldwide in a per capita comparison. The energy consumption of an MRI system is comparable to 26 four-person households annually. CT and MRI together make a significant contribution to the overall energy consumption of a hospital. In particular, the energy consumption in the idle or inactive state is responsible for a relevant proportion.2. EconomyA critical assessment of the indications for radiological imaging is important not only because of radiation protection, but also in terms of sustainability and "value-based radiology". As part of the "Choosing Wisely" initiative, a total of 600 recommendations for avoiding unnecessary examinations were compiled from various medical societies, including specific indications in radiological diagnostics.3. Social SustainabilityThe alignment of radiology to the needs of patients and referring physicians is a core aspect of the social component of sustainability. Likewise, ensuring employee loyalty by supporting and maintaining motivation, well-being, and job satisfaction is an essential aspect of social sustainability. In addition, sustainable concepts are of relevance in teaching and research, such as the educational curriculum for residents in radiology, RADUCATION or the recommendations of the International Committee of Medical Journal Editors.
KEY POINTS
· Sustainability comprises three pillars: economy, ecology and the social component.. · Radiologies have a high optimization potential due to a significant demand of these resources.. · A dialogue between medicine, politics and industry is necessary for a sustainable radiology.. · The discourse, knowledge transfer and public communication of recommendations are part of the sustainability network of the German Roentgen Society (DRG)..
CITATION FORMAT
· Palm V, Heye T, Molwitz I et al. Sustainability and Climate Protection in Radiology - An Overview. Fortschr Röntgenstr 2023; 195: 981 - 988.
Topics: Humans; Radiography; Radiology, Interventional; Curriculum; Magnetic Resonance Imaging; Job Satisfaction
PubMed: 37348529
DOI: 10.1055/a-2093-4177 -
Radiology May 2023
Topics: Humans; Artificial Intelligence
PubMed: 36943081
DOI: 10.1148/radiol.230580 -
RoFo : Fortschritte Auf Dem Gebiete Der... Oct 2020
Topics: Germany; History, 19th Century; History, 20th Century; Radiology; X-Rays
PubMed: 32992385
DOI: 10.1055/a-1238-4225 -
RoFo : Fortschritte Auf Dem Gebiete Der... Apr 2020
PubMed: 32187641
DOI: 10.1055/a-1112-8638 -
The International Journal of... Aug 2014Soft tissue and bone sarcomas comprise a heterogeneous group of mesenchymal tumors that include roughly 130 distinct diagnostic entities. Many of them are exceptionally... (Review)
Review
Soft tissue and bone sarcomas comprise a heterogeneous group of mesenchymal tumors that include roughly 130 distinct diagnostic entities. Many of them are exceptionally rare, with only few cases diagnosed worldwide each year. Development of novel targeted treatment in this group of tumors is of special importance since many sarcoma subtypes are resistant to conventional chemotherapy and the effective therapeutic options are limited. In this review we aim to discuss the molecular implications for targeted therapy in selected rare soft tissue and bone sarcoma subtypes, including dermatofibrosarcoma protuberans (DFSP), alveolar soft part sarcoma (ASPS), clear cell sarcoma (CCS), giant cell tumor of bone (GCTB) and perivascular epithelioid cell neoplasms (PEComas). This article is part of a Directed Issue entitled: Rare cancers.
Topics: Dermatofibrosarcoma; Giant Cell Tumor of Bone; Humans; Mesoderm; Molecular Targeted Therapy; Perivascular Epithelioid Cell Neoplasms; Sarcoma, Alveolar Soft Part; Sarcoma, Clear Cell
PubMed: 24704529
DOI: 10.1016/j.biocel.2014.03.024 -
BMC Pregnancy and Childbirth Feb 2018The incidence of Gestational Diabetes Mellitus (GDM) is rising in all developed countries. This study aimed at assessing the short-term economic burden of GDM from the...
BACKGROUND
The incidence of Gestational Diabetes Mellitus (GDM) is rising in all developed countries. This study aimed at assessing the short-term economic burden of GDM from the Italian healthcare system perspective.
METHODS
A model was built over the last pregnancy trimester (i.e., from the 28th gestational week until childbirth included). The National Hospital Discharge Database (2014) was accessed to estimate delivery outcome probabilities and inpatient costs in GDM and normal pregnancies (i.e., euglycemia). International Classification of Disease-9th Revision-Clinical Modification (ICD9-CM) diagnostic codes and Diagnosis-Related Group (DRG) codes were used to identify GDM cases and different types of delivery (i.e., vaginal or cesarean) within the database. Neonatal outcomes probabilities were estimated from the literature and included macrosomia, hypoglycemia, hyperbilirubinemia, shoulder dystocia, respiratory distress, and brachial plexus injury. Additional data sources such as regional documents, official price and tariff lists, national statistics and expert opinion were used to populate the model. The average cost per case was calculated at national level to estimate the annual economic burden of GDM. One-way sensitivity analyses and Monte Carlo simulations were performed to quantify the uncertainty around base case results.
RESULTS
The amount of pregnancies complicated by GDM in Italy was assessed at 54,783 in 2014 using a prevalence rate of 10.9%. The antenatal outpatient cost per case was estimated at €43.7 in normal pregnancies compared to €370.6 in GDM patients, which is equivalent to a weighted sum of insulin- (14%; €1034.6) and diet- (86%; €262.5) treated women's costs. Inpatient delivery costs were assessed at €1601.6 and €1150.3 for euglycemic women and their infants, and at €1835.0 and €1407.7 for GDM women and their infants, respectively. Thus, the overall cost per case difference between GDM and normal pregnancies was equal to €817.8 (+ 29.2%), resulting in an economic burden of about €44.8 million in 2014 at national level. Probabilistic sensitivity analysis yielded a cost per case difference ranging between €464.9 and €1164.8 in 80% of simulations.
CONCLUSIONS
The economic burden of GDM in Italy is substantial even accounting for short-term medical costs only. Future research also addressing long-term consequences from a broader societal perspective is recommended.
Topics: Adult; Cost of Illness; Delivery, Obstetric; Diabetes, Gestational; Female; Health Care Costs; Humans; Infant Health; Italy; Patient Discharge; Pregnancy; Pregnancy Outcome; Pregnancy Trimester, Third
PubMed: 29471802
DOI: 10.1186/s12884-018-1689-1 -
Skin Health and Disease Feb 2023Radiation-induced morphea (RIM) is a rare but recognized late complication of radiotherapy. It was first described in 1905, not long after the initial discovery of...
Radiation-induced morphea (RIM) is a rare but recognized late complication of radiotherapy. It was first described in 1905, not long after the initial discovery of X-rays by Roentgen. Characterized by the deposition of excess collagen in the dermis, it results in thickening of the skin. Its frequency is approximately 2 in 1000. We present a series of three cases involving patients receiving radiotherapy treatment for breast cancer, each of which subsequently developed RIM. Because of its rarity, RIM is often misdiagnosed as infection or metastatic disease. This can lead to delayed diagnosis and treatment, leading to poorer outcomes such as chronic pain issues. Early dermatological involvement and tissue sampling to examine histopathological features can avoid this, leading to better care and improved results. A variety of treatment options are available, ranging from topical to systemic, with early induction more likely to result in a positive response.
PubMed: 36751336
DOI: 10.1002/ski2.148 -
Musculoskeletal Surgery Dec 2021Loosening is considered as a main cause of implant failure in total knee replacement (TKR). Among the predictive signs of loosening, migration is the most investigated... (Review)
Review
Loosening is considered as a main cause of implant failure in total knee replacement (TKR). Among the predictive signs of loosening, migration is the most investigated quantitative parameter. Several studies focused on the migration of the tibial component in TKR, while no reviews have been focused on the migration of the femoral component and its influence on patients' clinical outcomes. The aim of this narrative review was (1) to provide information about of the influence of migration in femoral component of TKR prostheses, (2) to assess how migration may affect patient clinical outcomes and (3) to present alternative solution to the standard cobalt-chrome prostheses. A database search was performed on PubMed Central® according to the PRISMA guidelines for studies about Cobalt-Chrome femoral component migration in people that underwent primary TKR published until May 2020. Overall, 18 articles matched the selection criteria and were included in the study. Few studies investigated the femoral component through the migration, and no clear migration causes emerged. The Roentgen Stereophotogrammetric Analysis has been mostly used to assess the migration for prognostic predictions. An annual migration of 0.10 mm seems compatible with good long-term performance and good clinical and functional outcomes. An alternative solution to cobalt-chrome prostheses is represented by femoral component in PEEK material, although no clinical evaluations have been carried out on humans yet. Further studies are needed to investigate the migration of the femoral component in relation to clinical outcomes and material used.
Topics: Arthroplasty, Replacement, Knee; Chromium Alloys; Humans; Knee Prosthesis; Prosthesis Design; Prosthesis Failure; Tibia
PubMed: 33315156
DOI: 10.1007/s12306-020-00690-8 -
International Journal of Molecular... Nov 2022Allocation of morbidly obese patients to either conservative therapy options-such as lifestyle intervention and/or low-calorie diet (LCD)-or to bariatric...
Allocation of morbidly obese patients to either conservative therapy options-such as lifestyle intervention and/or low-calorie diet (LCD)-or to bariatric surgery-preferably sleeve gastrectomy or Roux-en-Y gastric bypass (RYGB)-represents a crucial decision in order to obtain sustainable metabolic improvement and weight loss. The present study encompasses 160 severely obese patients, 81 of whom participated in an LCD program, whereas 79 underwent RYGB surgery. The post-interventional dynamics of physiologically relevant adipokines and hepatokines (ANGPTL4, CCL5, GDF15, GPNMB, IGFBP6), as well as their correlation with fat mass reduction and improvement of liver fibrosis, were analyzed. Systemic GDF15 was characterized as an excellent predictive marker for hepatic fibrosis as well as type 2 diabetes mellitus. Of note, baseline GDF15 serum concentrations were positively correlated with NFS and HbA1c levels after correction for BMI, suggesting GDF15 as a BMI-independent marker of hepatic fibrosis and T2D in obese individuals. Specific GDF15 cut-off values for both diseases were calculated. Overall, the present data demonstrate that circulating levels of specific adipokines and hepatokines are regulated with therapy-induced fat loss and metabolic improvement and might, therefore, serve as biomarkers for the success of obesity therapy strategies.
Topics: Humans; Obesity, Morbid; Adipokines; Diabetes Mellitus, Type 2; Gastric Bypass; Biomarkers; Liver Cirrhosis; Membrane Glycoproteins
PubMed: 36430499
DOI: 10.3390/ijms232214020 -
Abdominal Radiology (New York) Dec 2021To evaluate gender diversity over time within the leadership and honorees of the Society of Abdominal Radiology with comparison to other radiologic societies. (Observational Study)
Observational Study
PURPOSE
To evaluate gender diversity over time within the leadership and honorees of the Society of Abdominal Radiology with comparison to other radiologic societies.
METHODS
This was a retrospective, observational study of the gender distribution of presidents and gold meal awardees within the Society of Abdominal Radiology (SAR) compared to three national radiology organizations: the American College of Radiology (ACR), the American Roentgen Ray Society (ARRS), and the Radiological Society of North America (RSNA). Data were collected from the inception of each society through 2020. Societies were directly contacted for president and Gold Medal awardee names when this information was not available on society websites. Differences in the proportion of female presidents and Gold Medal awardees before and after 2012, by society, were performed using χ test; 2012 was selected as a threshold year as this represented when SAR was created.
RESULTS
The proportion of female past presidents was 5%, 9%, and 33% for the SGR, SUR, and SAR, respectively, and 5%, 4%, and 7% for the ACR, ARRS, and RSNA, respectively. The proportion of female Gold Medal awardees was 5%, 4%, and 10% for the SGR, SUR, and SAR, respectively, and 5%, 7%, and 7%, respectively, for ACR, ARRS, and RSNA. There was a statistically significant increase in the proportion of women presidents and honorees in all societies after 2012 compared to before 2012, but no significant difference between societies in either time period.
CONCLUSION
A higher proportion of female presidents and honorees were demonstrated across all societies after 2012.
Topics: Female; Humans; Leadership; North America; Radiology; Retrospective Studies; Societies, Medical; United States
PubMed: 33452899
DOI: 10.1007/s00261-020-02922-8