Exposição ocupacional em cardiologia intervencionista por meio de dosimetria computacional – uma análise do IMC do paciente
Notice bibliographique
Résumé
With the growing number of obese people around the world, the incidence of obesity-related diseases, such as cardiovascular diseases, is also increasing. An alternative for treating some of these diseases is through interventional cardiology (IC), which uses ionizing radiation to visualize and treat these conditions in a minimally invasive manner. Therefore, the treatment of obese patients through IC procedures has been very common. One of these procedures is coronary angiography (CA), discussed in this work. As X-rays are activated in real time during these procedures, the doses received by workers present in the room are of great concern. Since occupational exposures are proportional to the doses received by the patient and these tend to be higher in obese patients due to the need of more energetic radiation, it is assumed that professionals receive higher doses the larger the patient's size. The goal of this work is to analyze the influence of patient’s body mass index (BMI) on occupational doses. Thus, effective and equivalent doses were obtained for two professionals, a main physician and an assistant, for three different patient sizes, from computer simulations using the Monte Carlo method. A common IC room was simulated with PA, LAO45, RAO30 and RLAT projections. The voltages used were 80 kV and 100 kV, with the spectra generated by the SpekCalc software with additional filtration of 1.5 mmAl, anode angle of 12º and tungsten target. It was observed that the doses in the professionals were very close for the different sizes of patients when dealing with the same tube voltage, in all projections. Higher occupational doses were associated with obese patients only when they were examined at higher tube voltage than leaner patients. The projection considered most critical was RLAT. In it, the two professionals received the highest effective doses, that is 3.04 μSv for the main physician and 2.85 μSv for the assistant. Considering the different parameters studied, professionals were more exposed in the situation in which the smaller patient was examined at 100 kV in the RLAT projection, a situation in which workers receive both scattered and primary radiation. It was possible to conclude that the main parameter affecting occupational doses, when analyzing different patients, was tube voltage. As for equivalent doses, it was found that the eye lens was one of the organs that received the highest dose, in both professionals, even with the use of lead glasses. The results found emphasize the need for the use of individual and collective protective equipment by all professionals working in CA procedures.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,003 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».