Análise crítica da Legislação Federal Brasileira para controle de qualidade: equipamentos de radiodiagnóstico

Introdução: os equipamentos de radiodiagnóstico evoluíram desde unidades muito simples à incorporação de sistemas digitais. Concomitante, a qualidade da imagem gerada por esses equipamentos tem alcançado elevado padrão diagnóstico. Todas as modalidades do radiodiagnostico médico e odontológico têm, nas últimas décadas, incorporado novos recurso de aquisição e processamento da imagem inclusive com a utilização da tecnologia digital. No entanto, normalmente, as regulamentações destinadas à avaliação da segurança e qualidade da imagem, apresentam algum nível de desatualização. Objetivo: o objetivo do presente estudo foi avaliar criticamente a regulamentação brasileira aplicável ao controle de qualidade em radiologia diagnóstica geral, exceto mamografia. Metodologia: foi realizado um estudo comparativo entre quatro documentos: a normativa vigente no Brasil, Portaria SVS/MS 453/98 e três protocolos internacionais: EC Report 162; ARCAL XLIX; Protocolo Español. A verificação; a periodicidade e a tolerância dos testes selecionados foram usadas como critérios da análise. Para melhor compreensão os parâmetros foram analisados em dois conjuntos: (1) gerador e (2) receptor de imagem. Resultados: verifica-se que para sistemas analógicos a regulamentação nacional não contempla todos os parâmetros essenciais. Discussão: para os sistemas digitais a regulamentação federal brasileira deixa uma lacuna de 100% dos testes específicos para avaliação do receptor de imagem digital. Igualmente para novas modalidades, tais como CBCT. As lacunas e as deficiências ocorrem por: definições físicas equivocadas; valores limites e/ou periodicidade aquém do esperado. Conclusão: conclui-se que apesar do Brasil ser signatário de alguns destes documentos internacionais, a desatualização ou omissão de alguns itens fundamentais para avaliação da qualidade da imagem, produzem resultados insatisfatórios na obtenção de imagens diagnósticas

Air kerma area product in cone beam computed tomography

Objective: to evaluate the influence of FOV in air kerma-area product (KAP) and the constancy of exposure parameters on cone beam computed tomography equipments. Methodology: Two cone beam CT (GENDEX CBX 500 and  i-CAT Classic) were used and seven exposures with the following FOVs were performed: (A) 14cm x 8,5cm, (B) 14cm x 6cm, (C) 8,5cm x 8.5cm e (D) 8,5cm x 6cm, for CBX 500; and (E) 14cm x 6.cm, (F) 14cm x 8cm e (G) 14cm x 13cm, for the i-CAT. The technical exposure factors (kV, mA, mAs and voxel), remained constant. The dosimetric evaluation was performed with air KAP meter manufactured by IBA dosimetry, model kerma X plus TinO, positioned at the output of the X-ray beam. To evaluate the constancy of the exposure parameters a semiconductor (Radcal, Rapidose) fixed in front of the tomography image receptor was used. Result: The KAP values ​​obtained ranged between 360.1 mGy.cm² and 1031.2 mGy.cm². The FOV height had a substantial influence on the radiation dose. Repeatability and accuracy of the tube voltage varied less than 10%. Conclusion: The radiation dose is directly related to the height and inversely related with the FOV diameter; even within the recommended limits, the percentage variation of repeatability and accuracy of kV, for the tomography equipments tested, points to the regular equipment calibration, in order to reduce radiation dose to the patient to a minimum

UMA FERRAMENTA PARA ANÁLISE DO DIAGNÓSTICO DA DENGUE, ZIKA E CHIKUNGUNYA.

The app for predicting Dengue, Zika, and Chikungunya diseases can be used by users (patients) or healthcare professionals to assist in early diagnosis and appropriate treatment of these diseases transmitted by the Aedes aegypti mosquito. Besides, the app can also be a valuable tool for the public, enabling users to monitor symptoms and associated risks of the diseases. By utilizing a neural network trained with the characteristic symptoms of each disease, the app has the potential to offer more accurate predictions and aid in the rapid identification of suspected cases. This could result in more effective interventions and targeted control strategies, contributing to the prevention and combat of epidemics of these diseases.O aplicativo para fazer predições sobre as doenças Dengue, Zika e Chikungunya pode ser utilizado por usuários (pacientes) ou profissionais de saúde para auxiliar no diagnóstico precoce e no tratamento adequado dessas doenças transmitidas pelo mosquito aedes aegypti. Além disso, o aplicativo também pode ser uma ferramenta valiosa para a conscientização pública, permitindo que os usuários monitorem os sintomas e riscos associados às doenças. Com o uso de uma rede neural treinada com os sintomas característicos de cada doença, o aplicativo tem o potencial de oferecer predições mais precisas e ajudar na identificação rápida de casos suspeitos. Isso pode resultar em intervenções mais eficazes e estratégias de controle mais direcionadas, contribuindo para a prevenção e o combate às epidemias destas doenças

Radiation risks and the importance of radiological protection in interventional cardiology : a systematic review

Discutimos aqui aspectos vinculados ao enquadramento legal, a recomendações internacionais e a programas de formação em proteção radiológica; ao angiógrafo e à qualidade da imagem; aos efeitos biológicos e aos riscos das radiações ionizantes; às lesões em operadores e pacientes; aos níveis de referência do paciente; ao limite de dose ocupacional e a suas medidas de prevenção. O uso das radiações ionizantes acarreta riscos, que, contudo, justificam-se em procedimentos diagnósticos e terapêuticos. A consciência e o conhecimento desses riscos minimizam o dano, otimizando a qualidade da imagens e o uso seguro das radiações ionizantes. Tem-se demonstrado a ocorrência de cataratas radioinduzidas em trabalhadores de laboratórios de cateterismo. Diversos estudos sugerem que pode haver um risco significativo de opacidade do cristalino, caso não se utilizem adequadamente os dispositivos de proteção radiológica. Adicionalmente, esses tipos de procedimentos intervencionistas são realizados na América Latina, geralmente por médicos especialistas, com a colaboração de enfermeiros, tecnólogos e técnicos, que, muitas vezes, não têm formação adequada em proteção radiológica.We discuss some aspects related to the legal framework, international recommendations and training programs on radiological protection; image quality and equipment; the biological effects and risks of ionizing radiation; lesions in patients and operators; patient’s reference levels; occupational dose limit and preventive actions. The use of ionizing radiation involves risks that are justified in diagnostic and therapeutic procedures. The awareness and knowledge of these risks minimizes the damage, optimizing the quality of images and safe use of ionizing radiation. There is evidence of radiationinduced cataracts in individuals who work in catheterization laboratories. Several studies suggest there may be a significant risk of lens opacity, if radiological protection devices are not properly used. Additionally, these interventional procedures are performed in Latin America, usually by medical specialists in collaboration with nurses, technologists and technicians, who often do not have adequate training in radiological protection

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Measurement of the top quark forward-backward production asymmetry and the anomalous chromoelectric and chromomagnetic moments in pp collisions at √s = 13 TeV

Abstract The parton-level top quark (t) forward-backward asymmetry and the anomalous chromoelectric (d̂ t) and chromomagnetic (μ̂ t) moments have been measured using LHC pp collisions at a center-of-mass energy of 13 TeV, collected in the CMS detector in a data sample corresponding to an integrated luminosity of 35.9 fb−1. The linearized variable AFB(1) is used to approximate the asymmetry. Candidate t t ¯ events decaying to a muon or electron and jets in final states with low and high Lorentz boosts are selected and reconstructed using a fit of the kinematic distributions of the decay products to those expected for t t ¯ final states. The values found for the parameters are AFB(1)=0.048−0.087+0.095(stat)−0.029+0.020(syst),μ̂t=−0.024−0.009+0.013(stat)−0.011+0.016(syst), and a limit is placed on the magnitude of | d̂ t| &lt; 0.03 at 95% confidence level. [Figure not available: see fulltext.

Measurement of B-c(2S)(+) and B-c*(2S)(+) cross section ratios in proton-proton collisions at root s=13 TeV

Peer reviewe

MUSiC : a model-unspecific search for new physics in proton-proton collisions at root s=13TeV

Results of the Model Unspecific Search in CMS (MUSiC), using proton-proton collision data recorded at the LHC at a centre-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 35.9 fb(-1), are presented. The MUSiC analysis searches for anomalies that could be signatures of physics beyond the standard model. The analysis is based on the comparison of observed data with the standard model prediction, as determined from simulation, in several hundred final states and multiple kinematic distributions. Events containing at least one electron or muon are classified based on their final state topology, and an automated search algorithm surveys the observed data for deviations from the prediction. The sensitivity of the search is validated using multiple methods. No significant deviations from the predictions have been observed. For a wide range of final state topologies, agreement is found between the data and the standard model simulation. This analysis complements dedicated search analyses by significantly expanding the range of final states covered using a model independent approach with the largest data set to date to probe phase space regions beyond the reach of previous general searches.Peer reviewe

Measurement of prompt open-charm production cross sections in proton-proton collisions at root s=13 TeV

The production cross sections for prompt open-charm mesons in proton-proton collisions at a center-of-mass energy of 13TeV are reported. The measurement is performed using a data sample collected by the CMS experiment corresponding to an integrated luminosity of 29 nb(-1). The differential production cross sections of the D*(+/-), D-+/-, and D-0 ((D) over bar (0)) mesons are presented in ranges of transverse momentum and pseudorapidity 4 < p(T) < 100 GeV and vertical bar eta vertical bar < 2.1, respectively. The results are compared to several theoretical calculations and to previous measurements.Peer reviewe