Sierzenski P.R.,Christiana Care Health Services |
Amis Jr. E.S.,Yeshiva University |
Courtney D.M.,Northwestern University |
Larson P.A.,Fox Valley |
And 9 more authors.
Journal of the American College of Radiology | Year: 2014
Availability, reliability, and technical improvements have led to continued expansion of computed tomography (CT) imaging. During a CT scan, there is substantially more exposure to ionizing radiation than with conventional radiography. This has led to questions and critical conclusions about whether the continuous growth of CT scans should be subjected to review and potentially restraints or, at a minimum, closer investigation. This is particularly pertinent to populations in emergency departments, such as children and patients who receive repeated CT scans for benign diagnoses. During the last several decades, among national medical specialty organizations, the American College of Emergency Physicians and the American College of Radiology have each formed membership working groups to consider value, access, and expedience and to promote broad acceptance of CT protocols and procedures within their disciplines. Those efforts have had positive effects on the use criteria for CT by other physician groups, health insurance carriers, regulators, and legislators. © 2014 American College of Radiology.
Sierzenski P.R.,Christiana Care Health Services |
Amis Jr. E.S.,Yeshiva University |
Courtney D.M.,Northwestern University |
Larson P.A.,Radiology Associates of the Fox Valley |
And 9 more authors.
Annals of Emergency Medicine | Year: 2014
Availability, reliability, and technical improvements have led to continued expansion of computed tomography (CT) imaging. During a CT scan, there is substantially more exposure to ionizing radiation than with conventional radiography. This has led to questions and critical conclusions about whether the continuous growth of CT scans should be subjected to review and potentially restraints or, at a minimum, closer investigation. This is particularly pertinent to populations in emergency departments, such as children and patients who receive repeated CT scans for benign diagnoses. During the last several decades, among national medical specialty organizations, the American College of Emergency Physicians and the American College of Radiology have each formed membership working groups to consider value, access, and expedience and to promote broad acceptance of CT protocols and procedures within their disciplines. Those efforts have had positive effects on the use criteria for CT by other physician groups, health insurance carriers, regulators, and legislators. © 2013 American College of Emergency Physicians.
Guo Y.,Vanderbilt Ingram Cancer Center |
Li C.-I.,Chiayi University |
Sheng Q.,Vanderbilt Ingram Cancer Center |
Winther J.F.,Danish Cancer Society |
And 3 more authors.
Journal of Genetics and Genomics | Year: 2013
Little is known about the inheritance of very low heteroplasmy mitochondria DNA (mtDNA) variations. Even with the development of new next-generation sequencing methods, the practical lower limit of measured heteroplasmy is still about 1% due to the inherent noise level of the sequencing. In this study, we sequenced the mitochondrial genome of 44 individuals using Illumina high-throughput sequencing technology and obtained high-coverage mitochondria sequencing data. Our study population contains many mother-offspring pairs. This unique study design allows us to bypass the usual heteroplasmy limitation by analyzing the correlation of mutation levels at each position in the mtDNA sequence between maternally related pairs and non-related pairs. The study showed that very low heteroplasmy variants, down to almost 0.1%, are inherited maternally and that this inheritance begins to decrease at about 0.5%, corresponding to a bottleneck of about 200 mtDNA. © 2013.
Madanat-Harjuoja L.-M.,Institute for Statistical and Epidemiological Cancer Research |
Lahteenmaki P.M.,University of Turku |
Dyba T.,Institute for Statistical and Epidemiological Cancer Research |
Gissler M.,Finnish National Institute for Health and Welfare |
And 5 more authors.
Acta Oncologica | Year: 2013
Background. Increased awareness of the adverse effects of cancer treatments has prompted the development of fertility preserving regimens for the growing population of cancer survivors who desire to have children of their own. Material and methods. We conducted a registry-based study to evaluate the risk of stillbirth, early death and neonatal morbidity among children of female cancer survivors (0-34 years at diagnosis) compared with children of female siblings. A total of 3501 and 16 908 children of female cancer patients and siblings, respectively, were linked to the national medical birth and cause-of-death registers. Results. The risk of stillbirth or early death was not significantly increased among offspring of cancer survivors as compared to offspring of siblings: the risk [Odds Ratio (OR)] of early neonatal death, i.e. mortality within the first week was 1.35, with a 95% confidence interval (CI) of 0.58-3.18, within 28 days 1.40, 95% CI 0.46-4.24 and within the first year of life 1.11, 95% CI 0.64-1.93 after adjustment for the main explanatory variables. All these risk estimates were reduced towards one after further adjustment for duration of pregnancy. Measures of serious neonatal morbidity were not significantly increased among the children of survivors. However, there was a significant increase in the monitoring of children of cancer survivors for neonatal conditions (OR 1.56, 95% CI 1.35-1.80), which persisted even after correcting for duration of pregnancy, that might be related to parental cancer and its treatment or increased surveillance among the children. Conclusion. Offspring of cancer survivors were more likely to require monitoring or care in a neonatal intensive care unit, but the risk of early death or stillbirth was not increased after adjustment for prematurity. Due to the rarity of the mortality outcomes studied, collaborative studies may be helpful in ruling out the possibility of an increased risk among offspring of cancer survivors. © 2013 Informa Healthcare.
Linton O.,International Society of Radiology |
Tenforde T.S.,National Council on Radiation Protection and Measurements |
Amis E.S.,Yeshiva University |
Sierzenski P.,Christiana Care Health System
Journal of the American College of Radiology | Year: 2011
This paper addresses the increasing use of CT in medical radiologic imaging, with a focus on applications in emergency medicine. The rapidly increasing use of CT in medical imaging over the past 3 decades has been a major subject in many recent publications, including a discussion of concerns about patient radiation doses, unnecessary CT examinations, and the costs of CT examinations. One area of these concerns has been the use of CT examinations for triage, selection of treatment options, and release of patients from emergency medical settings. On September 23 and 24, 2009, the National Council on Radiation Protection and Measurements held a workshop on appropriate uses of CT imaging with emergency patients. The workshop was cosponsored by 8 private and government organizations: the American Association of Physicists in Medicine, the American College of Emergency Physicians, the ACR, the American Society of Emergency Radiology, the Centers for Disease Control and Prevention, Landauer, Inc, the Society for Academic Emergency Medicine, and the US Environmental Protection Agency. This paper presents a summary of discussions at the workshop and recommendations for important areas of consideration in a subsequent consensus paper to be prepared on clinical guidance for applications of CT in emergency medicine procedures. © 2011 American College of Radiology.
Verschaeve L.,University of Antwerp |
Juutilainen J.,University of Eastern Finland |
Lagroye I.,French National Center for Scientific Research |
Miyakoshi J.,Hirosaki University |
And 6 more authors.
Mutation Research - Reviews in Mutation Research | Year: 2010
There has been growing concern about the possibility of adverse health effects resulting from exposure to radiofrequency radiations (RFR), such as those emitted by wireless communication devices. Since the introduction of mobile phones many studies have been conducted regarding alleged health effects but there is still some uncertainty and no definitive conclusions have been reached so far. Although thermal effects are well understood they are not of great concern as they are unlikely to result from the typical low-level RFR exposures. Concern rests essentially with the possibility that RFR-exposure may induce non-thermal and/or long-term health effects such as an increased cancer risk. Consequently, possible genetic effects have often been studied but with mixed results. In this paper we review the data on alleged RFR-induced genetic effects from in vitro and in vivo investigations as well as from human cytogenetic biomonitoring surveys. Attention is also paid to combined exposures of RFR with chemical or physical agents. Again, however, no entirely consistent picture emerges. Many of the positive studies may well be due to thermal exposures, but a few studies suggest that biological effects can be seen at low levels of exposure. Overall, however, the evidence for low-level genotoxic effects is very weak. © 2010 Elsevier B.V.
Brink J.A.,Yale University |
Boice Jr. J.D.,National Council on Radiation Protection and Measurements |
Boice Jr. J.D.,Vanderbilt University
Radiology | Year: 2012
A novel mixture of antioxidants was shown to reduce formation of double-strand DNA breaks (DSBs), as indicated by phosphorylated histone variant γ-H2AX foci, in human lymphocytes following in vitro radiation with a radiation dose equivalent to 10 mGy (1). While provocative, it is too soon to conclude that antioxidant supplements should be used to protect against any future harmful effects of ionizing radiation potentially associated with medical imaging (2). It is unclear whether γ-H2AX foci are associated with increased cancer rates, no experimental study has found any protective agent to reduce future cancer rates, and exposures typical of diagnostic imaging examinations are in the range that epidemiologic investigation is unable to detect an increase in cancer rates (even if one exists). Nonetheless, such research is encouraged as medical radiation is the number one source of population exposure in the United States. Patients who undergo frequent medical imaging examinations can accumulate doses that are in the range at which excess cancers have been demonstrated, and any protection afforded by a nontoxic antioxidant compound would be an exciting accomplishment. © RSNA, 2012.
Boice J.D.,National Council on Radiation Protection and Measurements |
Boice J.D.,Vanderbilt Ingram Cancer Center
Health Physics | Year: 2014
Radiation is in the public eye because of Fukushima, computed tomography examinations, airport screenings, and possible terrorist attacks. What if the Boston Marathon pressure cooker had also contained a radioactive source? Nuclear power may be on the resurgence. Because of the increasing uses of radiation, the increases in population exposures, and the increasing knowledge of radiation effects, constant vigilance is needed to keep up with the changing times. Psychosocial disorders associated with the inappropriate (but real) fear of radiation need to be recognized as radiation detriments. Radiation risk communication, radiation education, and communication must improve at all levels: to members of the public, to the media, to other scientists, and to radiation professionals. Stakeholders must continue to be involved in all radiation protection initiatives. Finally, we are at a crisis as the number of war babies (me) and baby boomers (you?) who are also radiation professionals continues its rapid decline, and there are few in the pipeline to fill the current and looming substantial need: "The old road is rapidly agin'" (Dylan). NCRP has begun the WARP initiative - Where Are the Radiation Professionals? - an attempt to rejuvenate the pipeline of future professionals before the trickle becomes tiny drops. A Workshop was held in July 2013 with government agencies, military, private sector, universities, White House representatives, and societies to develop a coordinated and national action plan. A "Manhattan Project" is needed to get us "Back to the Future" in terms of the funding levels that existed in years past that provided the necessary resources to train, engage, and retain (a.k.a., jobs) the radiation professionals needed for the nation. If we don't keep swimmin' (Disney's Nemo) we'll "sink like a stone" (Dylan). © 2014 Health Physics Society.
Schauer D.A.,National Council on Radiation Protection and Measurements
AIP Conference Proceedings | Year: 2011
According to a recently released report from the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) medical exposures account for 98 % of the contribution from manmade sources of ionizing radiation and are now the second largest contributor to population dose worldwide1. Almost 3/4ths of the worldwide collective effective dose from medical imaging is accounted for by healthcare level 1 countries (e.g., Australia, France, United States). An overview of these data will be provided and actions taken by responsible national and international authorities will be described. © 2011 American Institute of Physics.
PubMed | National Council on Radiation Protection and Measurements
Type: Journal Article | Journal: Health physics | Year: 2016
The National Council on Radiation Protection and Measurements (NCRP) believes that the most critical need for the nation in radiation protection is to train, engage, and retain radiation professionals for the future. Not only is the pipeline shrinking, but for some areas there is no longer a pipe! When the call comes to respond, there may be no one to answer the phone! The NCRP Where are the Radiation Professionals? initiative, Council Committee (CC) 2, and this years annual meeting are to focus our efforts to find solutions and not just reiterate the problems. Our next major initiative is CC 1, where the NCRP is making recommendations for the United States on all things dealing with radiation protection. Our last publication was NCRP Report No. 116, Limitation of Exposure to Ionizing Radiation, in 1993-time for an update. NCRP has seven active Program Area Committees on biology and epidemiology, operational concerns, emergency response and preparedness, medicine, environmental issues and waste management, dosimetry, and communications. A major scientific research initiative is the Million Person Study of Low Dose Radiation Health Effects. It includes workers from the Manhattan Project, nuclear weapons test participants (atomic veterans), industrial radiographers, and early medical workers such as radiologists and technologists. This research will answer the one major gap in radiation risk evaluation: what are the health effects when the exposure occurs gradually over time? Other cutting edge initiatives include a re-evaluation of science behind recommendations for lens of the eye dose limits, recommendations for emergency responders on dosimetry after a major radiological incident, guidance to the National Aeronautics and Space Administration with regard to possible central nervous system effects from galactic cosmic rays (the high energy, high mass particles bounding through space), re-evaluating the population exposure to medical radiation (NCRP Report No. 160, Ionizing Radiation Exposure of the Population of the United States, is over 10 y old, and computed tomography exams have increased substantially since then), and concerning whether the linear no-, threshold model is still the best available for purposes of radiation protection (not for risk assessment). We believe evaluation of heart disease and cerebral vascular disease following low-dose and dose-rate exposure is important for assessments of possible detriment from such exposures. We continue to seek the necessary resources to follow our quest to improve radiation protection for the public!