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Health Science Reports Jul 2023Trauma patients often suffer from multiple injuries and require undergoing various radiography which is referred to as multifield radiographic examinations. Protective...
BACKGROUND AND AIMS
Trauma patients often suffer from multiple injuries and require undergoing various radiography which is referred to as multifield radiographic examinations. Protective measures may be ignored for these examinations due to stressful emergency situations or patients' conditions. This study was conducted to evaluate the scattered doses received by the pelvis during different common multifield radiographic examinations with an emphasis on field size adjustment.
METHODS
A whole-body phantom, PBU-50, resembling the body mass, was used to carry out the common examinations for trauma patients (extremities, skull, chest, abdomen, pelvis, femur, and lumbar radiography), using a Pars Pad X-ray machine. To measure the primary entrance skin doses, three calibrated GR 200 thermoluminescence dosimeter (TLD) chips were placed in the central X-ray beam of scanned organs. Three TLDs were also placed on the pelvis symphysis pubis to measure the scattered dose received by the pelvis due to each carried-out radiography for standard and clinically used field sizes. A Harshaw 3500 TLD Reader was used to read the chips. TLD readouts (nano-Coulomb) were converted to dose (milli Gray [mGy]) using the predefined calibration curve.
RESULTS
The scattered doses to the pelvis due to scanning a single organ differed from 0.80 to 1.70, and 0.82 to 4.09 mGy for standard and clinically used field sizes, respectively. The scattered doses to the pelvis in multifield examinations varied from 0.80 to 8.43 and 0.82 to 13.6 mGy for standard and clinically used field sizes, respectively, depending on the number of scanned organs and their distances from the pelvis.
CONCLUSIONS
Multiple and repeated radiographs combined with insufficient protective measures can increase the patient's dose. The findings indicate that the scattered doses received by the pelvis can exceed the reference values in multifield radiography, especially if the radiation field is not restricted properly to the scanned organ.
PubMed: 37484057
DOI: 10.1002/hsr2.1424 -
Acta Obstetricia Et Gynecologica... Oct 2023Pelvic girdle pain during and after pregnancy is a major public health problem with significant daily problems for affected women and their families. There is now... (Observational Study)
Observational Study
INTRODUCTION
Pelvic girdle pain during and after pregnancy is a major public health problem with significant daily problems for affected women and their families. There is now accumulating evidence that pregnancy-related pelvic girdle pain originates from the sacroiliac joints and the pubic symphysis as well as their extra-articular ligaments. However, the heritability of the disease remains to be determined. We hypothesized that there is an increased familial risk of pregnancy-related pelvic girdle pain.
MATERIAL AND METHODS
A population-based national database linkage registry study of approximately 9.3 million individuals within 4.2 million families in Sweden with a recruitment period from 1997 to 2018. The Swedish Multi-generation register was used to find female pairs of twins, full siblings, half-siblings and first cousins where both in the pairs had a completed pregnancy. The outcome measure was diagnosis of pregnancy-related pelvic girdle pain (International Classification of Diseases-10 O26.7 [1997-2018]) in the first pregnancy. Data was obtained from the Swedish Hospital Discharge Register, the Swedish Outpatient Care Register, the Swedish Medical Birth Register, the Primary Healthcare Register, and Medical Treatment Register. Cox regression analysis was used to calculate adjusted estimated effect of the exposure variable familial history of pregnancy-related pelvic girdle pain on the outcome variable pregnancy-related pelvic girdle pain at first birth.
RESULTS
From the registers, 1 010 064 women pregnant with their first child within 795 654 families were collected. In total, 109 147 women were diagnosed with pregnancy-related pelvic girdle pain. The adjusted hazard ratio for a familial risk of pregnancy-related pelvic girdle pain was 2.09 (95% CI 1.85-2.37) among twins (monozygotic and dizygotic), 1.78 (95% CI 1.74-1.82) in full siblings, 1.16 (95% CI 1.06-1.28) in half-siblings from the mother, 1.09 (95% CI 1.024-1.16) in half-siblings from the father and 1.09 (95% CI 1.07-1.12) in first cousins.
CONCLUSIONS
This nationwide observational study showed a familial clustering of pregnancy-related pelvic girdle pain. The hazard ratio for the condition was associated with the degree of relatedness, suggesting that heredity factors contribute to the development of pregnancy-related pelvic girdle pain. There is no causal treatment available for pregnancy-related pelvic girdle pain and further studies are now encouraged to clarify the specific genetic factors that contribute to the disease and for future targeted interventions.
Topics: Female; Humans; Pregnancy; Family; Genetic Predisposition to Disease; Heredity; Pelvic Girdle Pain; Pregnancy Complications; Sweden
PubMed: 37470484
DOI: 10.1111/aogs.14646