Retrospective analysis of selected quality parameters lumbar-sacral spine radiography

Wprowadzenie: Radiografia kręgosłupa w odcinku lędźwiowo-krzyżowym (RTG LS) należy do najczęściej wykonywanych procedur diagnostyki obrazowej. W 2010 roku współczynnik częstości na 1000 mieszkańców Unii Europejskiej wynosił 40,6. Cel: Celem pracy była retrospektywna analiza parametrów jakości radiografii kręgosłupa w odcinku lędźwiowo-krzyżowym. Materiały i metodyka: Analizie retrospektywnej poddano 420 losowo wybranych zdjęć kręgosłupa lędźwiowo-krzyżowego (210 w projekcji przednio-tylnej, AP oraz 210 w projekcji bocznej, LAT). Analiza obejmowała: miejsce padania promienia centralnego, zakres badania, symetrię radiogramu, fazę oddechową, w jakiej wykonano radiografię boczną, poprawność pozycjonowania względem komory automatyki ekspozycji, częstość stosowania lateralizacji oraz przygotowanie pacjenta. Za punkt padania promienia centralnego przyjęto miejsce przecięcia przekątnych radiogramu. Ocenę zakresu badania wykonano, porównując z zakresem anatomicznym opisanym w procedurze wzorcowej. Zebrane dane poddano analizie statystycznej przy użyciu programu Statistica 13.3 przy zastosowaniu poziomu istotności p = 0,05. Wyniki: Promień centralny najczęściej (58; 27,62%) na zdjęciach AP padał na środową część czwartego kręgu lędźwiowego, natomiast na zdjęciach bocznych (53; 25,24%) na trzon trzeciego kręgu lędźwiowego. Na zaledwie 15 (7,14%) radiogramach obszar objęty badaniem był zgodny z opisanym w procedurze wzorcowej. Symetrią pozycjonowania pacjenta w zakresie zachowania płaszczyzny strzałkowej i czołowej charakteryzowało się 120 (57,14%) zdjęć AP, natomiast zachowaniem symetrii w linii pośrodkowej 102 (48,57%) rentgenogramów. W znaczącej większość radiografii (198; 94,29%) przednio-tylnych system automatyki ekspozycji został wykorzystany poprawnie. Natomiast w przypadku projekcji bocznych odsetek zdjęć z prawidłowym pozycjonowaniem względem komory automatyki ekspozycji był niższy (116; 55,24%). Większość (120; 57,14%) zdjęć bocznych wykonanych zostało na wydechu, 74 (35,24%) na wdechu, a w przypadku 30 (14,29%) radiogramu ocena fazy oddechowej nie była możliwa. Określenie strony badanej pacjenta znalazło się na 208 (99,05%) zdjęć przednio-tylnych oraz 62 (29,59%) bocznych. Przygotowanie pacjenta do badania ocenione zostało jako poprawne w przypadku 4 (1,90%) zdjęć AP oraz 24 (11,43%) radiogramów bocznych. Projekcja radiogramów wpływała w istotny statystycznie sposób na częstość oceny przygotowania pacjenta za poprawny (p < 0,001). Wnioski: Ocena miejsca padania promienia centralnego wiązki promieniowania i obszaru objętego badaniem są cennymi czynnikami oceny jakości radiogramów. Analiza materiału własnego wskazuje na konieczność ciągłego doskonalenia z zakresu pozycjonowania pacjenta.Introduction: Radiography of the lumbosacral spine is one of the most frequently performed diagnostic imaging procedures. In 2010, the frequency ratio per 1000 inhabitants of the European Union was 40,6. Aim: The aim of the study was a retrospective analysis of the quality parameters of the spine radiography in the lumbosacral segment. Material and methods: 420 randomly selected X-rays of the lumbosacral spine (210 in anterior-posterior projection and 210 in lateral projection) were retrospectively analyzed. Included in the analysis was: the place of central radius incidence, the scope of the examination, symmetry of the radiograph, the respiration phase in which the lateral radiography was performed, correctness of positioning relative to the automatic exposure control chamber, frequency of lateralization and patient preparation. The intersection of the radiographs was taken as the point of incidence of the central ray. The assessment of the scope of the examination was made by comparison with the anatomical scope described in the reference procedure. The collected data was subjected to statistical analysis using Statistica 13.3 with the significance level p = 0,05. Results: In the AP X-rays the central ray most often (58; 27,62%) was directed on the middle part of the fourth lumbar vertebra, while on the lateral views it was most often (53; 25,24%) directed on the body of the third lumbar vertebra. The area covered by the examination was consisted with that described in the reference procedure only on 15 (7,14%) radiographs. The symmetry of patient positioning in terms of maintaining the sagittal and frontal planes was described in 120 (57,14%) AP images, while maintaining symmetry of the median line was described in 102 (48,57%) of the radiographs. In the vast majority of the anteroposterior radiographs (198; 94,29%) automatic exposure control system was used correctly. However, in lateral views the percentage of X-rays with correct positioning relative to the automatic exposure chamber was lower (116; 55,24%). The majority (120; 57,14%) of the lateral views were taken with exhalation, 74 (35.24%) with inspiration, and in case of 30 (14,29%) radiographs respiratory phase assessment was not possible. Lateralization was present in 208 (99,05%) anteroposterior views and in 62 (29,59%) lateral views. Patient preparation for the examination was assessed as correct for 4 (1,90%) AP radiographs and 24 (11,43%) lateral radiographs. Radiographic projection had a statistically significant effect on the frequency of assessing patient preparation as correct (p < 0,001). Conclusions: The evaluation of the place of central radius incidence and the area covered by the exam are valuable factors in the quality assessment of radiographs. The analysis of our own material indicates the need for continuous improvement in patient positioning

Is Peracetic Acid Fumigation Effective in Public Transportation?

The COVID-19 pandemic made more people aware of the danger of viruses and bacteria, which is why disinfection began to be used more and more often. Epidemiological safety must be ensured not only in gathering places, but also in home and work environments. It is especially challenging in public transportation, which is a perfect environment for the spread of infectious disease. Therefore, the aim of the study was the identification of bacteria in crowded places and the evaluation of the effect of fumigation with peracetic acid (PAA) in public transportation. Inactivation of microorganisms in buses and long-distance coaches was carried out using an automatic commercial fogging device filled with a solution of peracetic acid stabilized with acetic acid (AA) and hydrogen peroxide (H2O2). Before and after disinfection, samples were taken for microbiological tests. The most prevalent bacteria were Micrococcus luteus and Bacillus licheniformis.Staphylococcus epidermidis was only present in buses, whereas Staphylococcus hominis and Exiguobacterium acetylicum were only present in coaches. Statistical analysis showed a significant reduction in the number of microorganisms in samples taken from different surfaces after disinfection in vehicles. The overall effectiveness of disinfection was 81.7% in buses and 66.5% in coaches. Dry fog fumigation with peracetic acid is an effective method of disinfecting public transport vehicles

Rotational Thromboelastometry (ROTEM^®) in Relation to Inflammatory Biomarkers and Clinical Outcome in COVID-19 Patients

Background: The pathogenesis of hypercoagulability in COVID-19 patients is complex and not fully understood. Rotational thromboelastometry (ROTEM®) is a viscoelastic method that allows the definition of a patient’s hemostatic profile. This study aimed to assess the relationship between ROTEM® parameters, the profile of inflammatory cytokines, and clinical outcomes in COVID-19 patients. Methods: A total of 63 participants (n = 29 symptomatic non-ICU COVID-19 patients, and n = 34 healthy controls) were prospectively included in the study. We assessed the relationship between the parameters of three ROTEM® tests (NATEM®, EXTEM®, and FIBTEM®) and levels of CRP, interleukin-8, interleukin-1β, interleukin-6, interleukin-10, tumor necrosis factor, interleukin 12p70, and clinical outcomes. Results: ROTEM® indicated hypercoagulability in COVID-19 patients in all the tests performed. The levels of all inflammatory cytokines were significantly higher in COVID-19 patients. NATEM more frequently detected hypercoagulability in COVID-19 patients compared to EXTEM. The strongest correlations with inflammatory biomarkers and CT severity score were with FIBTEM parameters. The elevated maximum clot elasticity (MCE) in FIBTEM was the strongest predictor of poor outcomes. Conclusions: Increased FIBTEM MCE may be associated with greater severity of COVID-19. Non-activated ROTEM (NATEM test) seems to be more valuable for detecting hypercoagulability in COVID-19 patients compared to the tissue factor activated test (EXTEM)

Does Hospitalization Change the Perception of COVID-19 Vaccines among Unvaccinated Patients?

The COVID-19 vaccination has been the subject of unprecedented misinformation, false news, and public concerns. This study presents a unique analysis comprising persons who were not vaccinated and became ill. It investigates reasons for not vaccinating and evaluates how the personal experience of COVID-19 affected further attitudes and decisions related to health. The study included 730 consecutive unvaccinated patients hospitalized in 12 centers in Poland during the autumn 2021 pandemic wave. The most frequent reason behind the refusal to receive the vaccine was concern over the adverse effects, disbelief that the vaccine was sufficiently tested, and one’s conviction that COVID-19 will not affect a patient. Online information, friends, spouse, children/grandchildren, and other family members were most often the source of discouragement from vaccination. Most individuals regretted their decision not to receive a vaccine (66.0%), declared to promote COVID-19 vaccination after discharge (64.0%), and to receive a COVID-19 vaccine in the time recommended for convalescents (69.5%). Individuals expressing no regrets of vaccine refusal more frequently revealed conspiracy beliefs. The study shows that personal experience with severe COVID-19 can influence the perception of vaccination, but approximately one-third of unvaccinated hospitalized patients still appear to express vaccine hesitancy