EACVI survey on radiation exposure in interventional echocardiography.

AIMS: The European Association of Cardiovascular Imaging (EACVI) Scientific Initiatives Committee performed a global survey on radiation exposure in interventional echocardiography. The survey aimed to collect data on local practices for radioprotection in interventional echocardiography and to assess the awareness of echocardiography operators about radiation-related risks. METHODS AND RESULTS: A total of 258 interventional echocardiographers from 52 different countries (48% European) responded to the survey. One hundred twenty-two (47%) participants were women. Two-thirds (76%) of interventional echocardiographers worked in tertiary care/university hospitals. Interventional echocardiography was the main clinical activity for 34% of the survey participants. The median time spent in the cath-lab for the echocardiographic monitoring of structural heart procedures was 10 (5-20) hours/month. Despite this, only 28% of interventional echocardiographers received periodic training and certification in radioprotection and 72% of them did not know their annual radiation dose. The main adopted personal protection devices were lead aprons and thyroid collars (95% and 92% of use, respectively). Dedicated architectural protective shielding was not available for 33% of interventional echocardiographers. Nearly two-thirds of responders thought that the radiation exposure of interventional echocardiographers was higher than that of interventional cardiologists and 72% claimed for an improvement in the radioprotection measures. CONCLUSION: Radioprotection measures for interventional echocardiographers are widely variable across centres. Radioprotection devices are often underused by interventional echocardiographers, portending an increased radiation-related risk. International scientific societies working in the field should collaborate to endorse radioprotection training, promote reliable radiation dose assessment, and support the adoption of radioprotection shielding dedicated to interventional echocardiographers

use of bone health agents bhas in patients pts with metastatic castration resistant prostate cancer mcrpc treated with radium 223 ra 223 after abiraterone abi an interim review of reassure

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Sandbar Breaches Control of the Biogeochemistry of a Micro-Estuary

Micro-estuaries in semi-arid areas, despite their small size (shallow depth of a few meters, length of a few kilometers, and a surface area of less than 1 km2) are important providers of ecosystem services. Despite their high abundance, tendency to suffer from eutrophication and vulnerability to other anthropogenic impacts, such systems are among the least studied water bodies in the world. In low tidal amplitude regions, micro-estuaries often have limited rate of sea-river water exchange, somewhat similar to fjord circulation, caused by a shallow sandbar forming at the coastline. The long-term study, we report here was inspired by the idea that, due to their small size and low discharges regime, relatively small interventions can have large effects on micro-estuaries. We used a stationary array of sensors and detailed monthly water sampling to characterize the Alexander estuary, a typical micro-estuary in the S.E. Mediterranean, and to identify the main stress factors in this aquatic ecosystem. The Alexander micro-estuary is stratified throughout the year with median bottom salinity of 18 PSU. Prolonged periods of hypoxia were identified as the main stress factor. Those were alleviated by breaching of the sandbar at the estuary mouth by sea-waves or stormwater runoff events (mostly during winter) that flush the anoxic bottom water. Analysis of naturally occurring sandbar breaches, and an artificial breach experiment indicate that the current oxygen consumption rate of the Alexander micro-estuary is too high to consider sandbar breaches as a remedy for the anoxia. Nevertheless, it demonstrates and provides the tools to assess the feasibility of small-scale interventions to control micro-estuaries hydrology and biogeochemistry

Sons of low-ranking female rhesus macaques can attain high dominance rank in their natal groups

Five adult and subadult sons of middle- and low-ranking female rhesus macaques ( Macaca mulatta ) were observed to hold high dominance rank in their natal groups during a 12-month study at Cayo Santiago, Puerto Rico. Three of these males also experienced high mating success during at least one mating season. These findings contrast with all previously published accounts of rank acquisition by natal male rhesus macaques in provisioned colonies, and they present a challenge to the hypothesis that natal transfer functions to increase male access to fertile females.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41609/1/10329_2006_Article_BF02382622.pd

Cholesterol granuloma presenting as a mass obstructing the external ear canal

<p>Abstract</p> <p>Background</p> <p>Cholesterol granuloma (CG) may involve the middle ear, the mastoid bone and the petrous apex. However, CG presenting as a mass obstructing the external ear canal (EEC) is relatively rare and it can be a diagnostic challenge.</p> <p>Case Presentation</p> <p>We report a case of a CG occupying the mastoid antrum and presenting as a mass into the EEC. Temporal bone computerized tomography showed a soft tissue mass which eroded the posterior-superior bony wall of the EEC. On magnetic resonance imaging, the mass revealed a high signal on both T1 and T2-weighted images. The CG was removed by a mastoidectomy procedure and the histopathologic report confirmed the diagnosis of CG. A type III tympanoplasty was performed.</p> <p>Conclusions</p> <p>The postoperative course was uneventful.</p

Ross operation in children and young adults: the Alder Hey case series

BACKGROUND: The ideal prosthesis for aortic valve replacement in children and young adults has not been found yet. In recent years there has been a renewed interest in the replacement of aortic valve with the pulmonary autograft owing to its advantages of lack of anticoagulation, potential for growth and excellent haemodynamic performance. The purpose of this study was to review our institutional experience at Alder Hey hospital with the Ross procedure in children and young adults. METHODS: From November 1996 to September 2003, 38 patients (mean age, 13.1 ± 5.7 years) underwent the Ross procedure for various aortic valve diseases using the root replacement technique. Clinical and echocardiographic follow-up was performed early (within 30 days), 3 to 6 months, and yearly after surgery. Medical records of all patients were reviewed retrospectively. RESULTS: There was 1 perioperative death. The patients were followed-up for a median interval of 36 months and up to 7 years. One patient died 3 years after surgery secondary to ventricular arrhythmia with overall mortality of 5.3%. Actuarial survival at 7 years was 94 ± 2.5% and there was 100% freedom from reoperation for autograft valve dysfunction or any other cause. Balloon dilatation was required in 2 patients for pulmonary homograft stenosis. The haemodynamics at the latest follow-up were also similar to those at the time of discharge after surgery. There was no progression in the degree of aortic regurgitation for 11 patients with trivial and 3 with mild regurgitation. CONCLUSION: Our experience demonstrates that Ross operation is an attractive option for aortic valve replacement in children and young adults. Not only can the operation be accomplished with a low operative risk but the valve function stays normal over a long period of time with minimal alteration in lifestyle and no need for repeated operations to replace the valve as a result of somatic growth of the children