Radiographic viewing conditions at Johannesburg Hospital

Purpose: To measure the luminance level of X-ray viewing boxes and ambient lighting levels in reporting rooms as a quality assurance procedure, and to compare the results with those recommended by the Directorate of Radiatio

A dose audit of fluoroscopy examinations at Charlotte Maxeke Johannesburg Academic Hospital: Analysis of preliminary results

Purpose: To retrospectively analyze the radiation doses delivered to patients undergoing fluoroscopy examinations in terms of the skin dose and the dose-area product (DAP). Materials and Methods: The subjects of this study were patients who underwent fluoroscopy examinations at Charlotte Maxeke Johannesburg Academic Hospital, South Africa during the period August 2007 to March 2008. The skin dose and dose-area product values were obtained from a built-in DAP-meter installed on a digital Philips Medical Systems MultiDiagnost Eleva fluoroscopy unit. The following cases were analyzed namely barium swallow, barium meal, barium enema, hexabrix swallow, gastrografin meal, voiding cystourethrogram, fistulogram, myelogram, nephrostomy and loopogram. Results: An analysis of three hundred and thirty one examinations is presented. From the recorded data the following quantities were deduced: the mean- and range of the skin doses and DAPs, mean screening time and mean fluoroscopy duration. An analysis of the screening time for the various examinations showed a weak correlation (r = 0.59) between skin dose and screening time, while a poor correlation (r = 0.42) was deduced between DAP reading and screening time. Conclusion: There is a wide spread in the radiation doses registered for any one given type of examination. The large variability in the radiation dose delivered proves that fluoroscopic examinations stand to gain from dose optimization. The usefulness and potential use of DAP meters with regards to dose optimization in radiology is shown. In line with efforts to optimize dose from diagnostic radiography examinations the authors recommend the establishment of diagnostic reference levels (DRLs) in South Africa for the most frequent examinations in general radiography, fluoroscopy, mammography and computed tomography. Keywords: patient dose, genetic risk, dose optimization, dose reference level

Suicídio entre pessoas idosas: revisão da literatura Suicidio entre personas ancianas: revisión de la literatura Suicide in elderly people: a literature review

Foi realizada revisão da literatura sobre os principais fatores associados à ideação, tentativas e suicídio propriamente dito de pessoas idosas. Foram pesquisadas as seguintes bases de dados: MEDLINE, PsychInfo, SciELO e Biblioteca Virtual em Violência e Saúde da BIREME, referentes ao período de 1980 a 2008. Foram selecionadas e analisadas 52 referências, que mostraram forte relação entre ideação, tentativas e efetivação do ato fatal em pessoas idosas, que resulta da interação de fatores complexos: físicos, mentais, neurobiológicos e sociais. O suicídio associado à depressão em idosos é prevenível desde que a pessoa esteja devidamente tratada. Há necessidade de investimento em pesquisa no Brasil, dado o crescimento persistente das taxas de suicídio entre idosos, sobretudo do sexo masculino.<br>Se realizó revisión de la literatura sobre los principales factores asociados con la formulación, intentos y suicidio propiamente dicho de personas ancianas. Las siguientes bases de datos fueron investigadas: MEDLINE, PsychInfo, SciELO y Biblioteca Virtual en Violencia y Salud de la BIREME, correspondientes al período de 1980 a 2008. Fueron seleccionadas y analizadas 52 referencias, que mostraron fuerte relación entre formulación, intentos y realización del acto fatal en personas ancianas, que resulta de la interacción de factores complejos: físicos, mentales, neurobiológicos y sociales. El suicidio asociado con la depresión en ancianos es prevenible siempre cuando la persona sea debidamente tratada. Hay necesidad de invertir en investigación en Brasil, dado el crecimiento persistente de las tasas de suicidio entre ancianos, sobretodo del sexo masculino.<br>A literature review was carried out focusing on the main factors associated with suicidal ideation, attempts and completed suicide in elders. The following databases were searched: MEDLINE, PsychINFO, SciELO and Biblioteca Virtual em Violência e Saúde da BIREME (BIREME's Violence and Health Virtual Library), referring to the period from 1980 to 2008. Fifty-two references were selected and analyzed. They showed a strong relationship among suicide ideation, attempt and completion in elderly individuals, which results from the interaction of complex physical, mental, neurobiological and social factors. Suicide associated with depression in the elderly can be prevented, provided the person is properly treated. In Brazil, it is necessary to invest in research, given the persistent increase in suicide rates among aged people, especially among males