Radiology Hints

Increasing voltage (kV) decreases contrast and increases exposure, making the film darker. Increasing milliampere-seconds (mAs) increases exposure, making the film darker.

 

Biochemistry Notes - Scanned

These scans are from my notes which ended at the beginning itself....may be of some help.

Screening for Lp(a)

Patients at high to moderate risk of cardiovascular disease should be screened for elevated levels of lipoprotein(a) (Lp[a]) and take niacin to bring their Lp(a) level under 50 mg/dL, according to a consensus statement from the European Atherosclerosis Society.

Lp(a) is a plasma lipoprotein consisting of a cholesterol-rich LDL particle with one molecule of apolipoprotein B-100 and a molecule of apolipoprotein A. About 20% of people are thought to have plasma Lp(a) levels over 50 mg/dL; there are no gender differences in Lp(a) concentrations, but racial differences have been observed, with whites and Asians having lower levels while black and Hispanics generally have somewhat higher levels.
Since lifestyle appears to have little impact on an individual's Lp(a) level, the EAS consensus panel recommends that 1 to 3 g of niacin (nicotinic acid) daily is the best treatment for lowering Lp(a) levels. However, the group acknowledges that there have not been randomized, controlled trials selectively targeting plasma levels of Lp(a) and calls for further studies in both primary- and secondary-prevention settings to better define which patients should be targeted for treatment and what the target level of Lp(a) should be.

Kerala Medical PG Allotment Notice

The final round allotment process for the PG Medical Courses
2010 which is scheduled on 26.06.2010 and 29.06.2010 is postponed, in
the light of the judgement dated 24.06.2010 of the Hon’ble High Court
in WP(c) 13474/2010. Further information regarding the allotment
process shall be published in the website later.
Since the cut-off date for admission process is 30.06.2010, as
prescribed in the time schedule approved by the Hon’ble Supreme
Court, there may even be a chance of conducting the allotment
process on 29th and 30th of June 2010 for service and non-service
candidates respectively. Therefore the candidates are advised to have
a close watch on the information provided through the website from
28.06.2010 onwards.

Brain Tumour Risk in Relation to Mobile Telephone Use: Results of the INTERPHONE International Case–Control Study

Abstract

Background The rapid increase in mobile telephone use has generated concern about possible health risks related to radiofrequency electromagnetic fields from this technology.
Methods An interview-based case–control study with 2708 glioma and 2409 meningioma cases and matched controls was conducted in 13 countries using a common protocol.
Results A reduced odds ratio (OR) related to ever having been a regular mobile phone user was seen for glioma [OR 0.81; 95% confidence interval (CI) 0.70–0.94] and meningioma (OR 0.79; 95% CI 0.68–0.91), possibly reflecting participation bias or other methodological limitations. No elevated OR was observed ≥10 years after first phone use (glioma: OR 0.98; 95% CI 0.76–1.26; meningioma: OR 0.83; 95% CI 0.61–1.14). ORs were <1.0 for all deciles of lifetime number of phone calls and nine deciles of cumulative call time. In the 10th decile of recalled cumulative call time, ≥1640 h, the OR was 1.40 (95% CI 1.03–1.89) for glioma, and 1.15 (95% CI 0.81–1.62) for meningioma; but there are implausible values of reported use in this group. ORs for glioma tended to be greater in the temporal lobe than in other lobes of the brain, but the CIs around the lobe-specific estimates were wide. ORs for glioma tended to be greater in subjects who reported usual phone use on the same side of the head as their tumour than on the opposite side.
Conclusions Overall, no increase in risk of glioma or meningioma was observed with use of mobile phones. There were suggestions of an increased risk of glioma at the highest exposure levels, but biases and error prevent a causal interpretation. The possible effects of long-term heavy use of mobile phones require further investigation. 


http://www.medscape.com/viewarticle/723258?src=mp&spon=34&uac=126137EG

Yttrium-90 (90Y) RadioMicrosphere Therapy

June 16, 2010 (Salt Lake City, Utah) — Scintigraphy using single
photon emission computed tomography with an integrated x-ray computed
tomography scanner (SPECT/CT) to detect extrahepatic shunting could
help boost the safety of yttrium-90 (90Y) radiomicrosphere therapy in
the liver, according to a Cleveland Clinic study presented here at the
Society of Nuclear Medicine (SNM) 2010 Annual Meeting.

Microsphere technology has gained popularity among surgeons and
interventional radiologists as an effective organ-preserving method of
individually treating hepatic malignancies, noted lead investigator
and presenter Ron Young, technologist and manager of the nuclear
medicine department at the Cleveland Clinic in Ohio.

Mr. Young described how, in a typical procedure, the 20 to 40 μm glass
spheres imbedded with 90Y are injected into hepatic artery circulation
where they selectively embolize the tumor's microvasculature. Beta
particles emitted by the isotope kill cells in a 2.4 mm diameter
region around the tumor and spare healthy liver tissue.

Hepatic radiomicrosphere therapy is considered safe, with a
complication rate of less than 5%, Mr. Young reported. But he added
that many adverse events arise from the incomplete embolization of the
hepatic vessels under angiographic guidance before the procedure. It
can lead to severe pulmonary, gastrointestinal, and pancreatic
radiation burns after the 90Y particles are shunted from the liver.
Other complications include pancreatitis, cholestitis, and gastritis,
he told Medscape Radiology in an interview.

To minimize risk, technetium-99m (99mTc) microaggregated albumin (MAA)
imaging is performed to simulate extrahepatic shunting in the presence
of incomplete hepatic vessel embolization before the surgeon moves on
to the actual procedure, Mr. Young explained.

With guidance from staff interventional radiologist Abraham Levitin,
MD, Mr. Young and colleagues found that 99mTc-MAA SPECT/CT was 2.5
times more accurate than planar imaging in this role.

In 99 consecutive patients who underwent both imaging procedures,
extrahepatic shunting was detected in 23 patients with SPECT/CT and in
9 patients with the planar approach. The investigators did not perform
a detailed statistical analysis.

SPECT/CT also detected a hepatic thrombosis that was not observed on
planar images, Mr. Young noted. The finding led the surgical team to
minimize the lumen of the thrombosis in the inferior vena cava before
turning their attention back to liver treatment, he added.

The findings promise a significant improvement over the standard
technology, said Peter S. Conti, MD, professor of radiology, pharmacy,
and biomedical engineering at the University of Southern California in
Los Angeles. Dr. Conti was not involved with the study.

"The broader implications are that the use of SPECT/CT improves the
ability of the clinician to determine if patients are good candidates
for therapy," he said during an SNM-sponsored media briefing.

Hooman Kabiri, MD, who performs 90Y microsphere procedures at the Ohio
State University Medical Center in Columbus, said in a phone interview
that a shift to SPECT/CT would give him and other interventionist
radiologists more peace of mind.

"It can add to the sensitivity of detecting our ability to embolize
the communications between the hepatic and nonhepatic arteries. It is
a valuable tool in that respect," he told Medscape Radiology.

But shifting to SPECT/CT could also lead to unnecessary treatment
delays because of possible false positives, he cautioned. The 3%
adverse incident rate at Ohio State suggests that the actual rate of
extrahepatic shunting is much lower than the 23% rate identified with
SPECT/CT in the Cleveland Clinic study, he said about the trial.

A larger prospective study testing the relative clinical efficacy and
accuracy of the 2 imaging techniques is planned, Mr. Young told SNM
meeting attendees.

The study did not receive commercial support. Mr. Young, Dr. Conti,
and Dr. Kabiri have disclosed no relevant financial relationships.

Society of Nuclear Medicine (SNM) 2010 Annual Meeting: Abstract 2023.
Presented June 7, 2010.

Italian Scientists Find a Viral Link to Type 1 Diabetes

Italian researchers have found a link between a common virus and type
1 diabetes that may open the door to answers about what triggers the
disease in children.

Scientists at the University of Insurbia in Varese, Italy, tested the
blood of 112 children between two and 16 years of age immediately
after they had been diagnosed with type 1. The researchers were
looking for the presence of DNA left over from infection by an
enterovirus, a common, very mild virus that usually produces either no
symptoms or mild ones, such as aching muscles or rashes.

The scientists knew that previous studies have shown a possible link
between enteroviruses and the onset of type 2. Their study results
confirmed the link: 83 percent of the children with type 1 had
low-level enterovirus infection, compared to 7 percent of children
without the disease.

http://www.diabeteshealth.com/read/2010/06/17/6724/italian-scientists-find-a-viral-link-to-type-1-diabetes/