radpad daily dose newsletter

RADPAD Daily Dose Newsletter

 
 
 
 
 
Wrapped up tight and well in hand…Bottomed out with COVID…Rebounding! Oops…just kidding! The procedure yo yo continues to change directions. RTs, RNs and MDs in the interventional suites have seen the progression from full time…to part time…to no time. But slowly things started to open back up as the people were recalled and case logs began to grow. Then BAM! We were blind-sided by spikes in positive testing and hospitalized cases. Just like that, the labs were shut down again. More furloughs? More layoffs? Only time will clarify the confusing picture of managing ICU bed availability vs. cash flow lost with no elective procedures.
 
Dr. Donatella Marazitti

“Neuropsychological Testing Interventional Cardiology Staff After Long-Term Exposure to Ionizing Radiation”

 
Journal of International Neuropsychological Society – September 2015
 
Donatella Marazzati and Francesco Tomaiuolo
 

Cognitive damage has long been known and associated with direct cranial irradiation (Roguin, Goldstein & Bar, 2012 & 2013). However, a majority of the data available on the topic centers on the effects of high dose exposure rather than that in the low or moderate dose range. In this study, Dr. Donatella Marazitti and Dr. Francesco Tomaiuolo examine the impact that long term low-dose ionizing radiation has on the cognitive functioning of interventional workers in the Cath lab.

Eighty-three participants were selected from a group of cardiologists, technicians, and nurses who were attending the GISE meeting (Gruppo Italiano Studi Emodinamica) in Genoa, Italy in October of 2011 and 2012. They are referred to as the Exposed Group (EG). All EG participants had been working in catheterization laboratories for a period ranging between 2 and 35 years. The Exposed Group was compared to eighty-three physicians and RNs who worked in other areas of the hospital such as Psychiatry, Neurology and Gynecology in which they were not exposed to ionizing radiation.

None of the participants had any history of neurological or psychiatric disorders, suffered from chronic medical illness, or took psychtropic drugs. The educational profiles and years of service of the two groups were relatively the same. For all practical purposes, the two groups were identical except for the fact that one worked in radiation environments daily while the other didn’t.

Each participant was interviewed individually for an hour by a trained psychiatrist. During that hour, the psychiatrist administered a block of tests known as ENB (Esame Neuropsicologico Breve) that included:

  • Token Test – to assess subtle receptive language dysfunction
  • Digit Span Test (DST) – to evaluate short term memory
  • Trail-Making Tests A&B (TMA, TMB) – to measure visual attention
  • Word Fluency Phonemic and Semantic (WFP & WFS) – to evaluate lexical access
  • Immediate Recall Short Story (IRSS) & Delayed Recall Short Story (DRSS) – memory evaluation
  • Brown-Peterson Interference Test after 10 & 30 Units (IT10 & IT30) – to test short term memory
  • Clock Drawing Test – to estimate planning, motor programming and executing
  • Verbal Abstraction Test – to evaluate logical reasoning to extract verbal abstract concepts
  • Visuo-spatial Span Corsi test (CS) and Visuo-spatial Supraspan Corsi test (CSS) – to evaluate… visuo-spatial short-term and visuo-spatial learning memory
  • Superimposed Silhouettes test (SST) – testing ability to visually filter superimposed objects

 

Results

When comparing the test scores between the two groups, significant differences were detected mainly at the level of memory performance. Verbal long-term memory (DRSS) was significantly lower in the EG group. Visual short-term memory (CS)(IT10 & IT 30) and semantic lexical access abilities (WFS) were also lower in the EG group. These brain functions are mainly centered in the left hemisphere of the brain. No differences between the two groups were found when comparing language comprehension, verbal short-term memory, verbal fluency, selective and/or shifted and divided visual attention, praxic, visuagnosia, strategic planning and organized searching, extract verbal and non-verbal concepts. These functions are mainly centered in the right hemisphere of the brain.

Conclusions

“Taken all together, these findings suggest a significant reduction in memory abilities in interventional cardiology staff involving mainly verbal long-term memory and verbal fluency. These verbal performances have generally been attributed to left hemisphere abilities.” None of the right hemisphere associated skills/results were different across the two groups. Results for visually oriented testing; long-term visuo-spatial memory and constructive praxia were virtually identical. Work related radiation exposure for the Exposed Group is generally twice as high on their left than on the right hemisphere. Study results would make it seem logical that the left lobe and the functions attributed to it would be most impacted by radiation exposure.

The authors state, “In conclusion, our study shows that interventional cardiology personnel working in the cardiac cath lab and exposed to ionizing radiation from 2-35 years may show disturbances of some cognitive functions, in particular, verbal long-term memory… The results of this study highlight the fact that there is a great need of increasing awareness of IR-related problems among cardiologists, and more generally among medical professionals… In the meantime, targeted head protection is certainly a wise and convenient policy for all health professionals working in the cardiac catheterization laboratory.”

___________

 
 

TRUCK DRIVER OR CARDIOLOGIST?

 

Meet Newton Burn. Can you tell by looking at his face whether he is a truck driver or a cardiologist? “Of course not,” you say. Well, put on your detective hat and let’s look at some evidence to help us decide….Notice that the left side of Newton’s face looks very different from the right side. Why might that be? If he is a truck driver the damage to his face was caused by long term exposure to the sun through the driver’s side window of his truck. Over time, UV rays break down collagens and elastive fibers to cause wrinkles and sagging. Eventually, the attack on DNA strands destroys the body’s ability to create new cells and fight off mutant cells which eventually show up as cancers. Hmm…

“Very interesting,” you say, “so given this evidence why would I decide Newton is a cardiologist?”

Answer: A cardiologist is exposed to constant low dose radiation the source of which is on his left side. Like the sun, radiation also causes DNA damage. It triggers inflammatory reactions at the cell level which cause DNA double strands to break. This inhibits the body’s ability to produce healthy replacement cells while enhancing the production of mutant cells. Radiation also causes hardening of the arteries which leads to vascular aging and inability to regulate blood pressure.

We know that damage from the sun may eventually show up on the left side of a truck drivers face, but is damage from radiation reflected on a cardiologist’s face? The answer is “no”. Why? The damage to the truck driver occurs from the outside in and the result is visible. The damage to the cardiologist occurs from the inside out. It is not visible from the outside, but leaves its mark internally.

Now you know. Newton Burn is a truck driver and has been one for 28 years.

So what’s the point? UV rays and radiation. Neither one of them is good for you. One prematurely ages your skin to make you look older, and one prematurely ages your arteries to make your body perform like it’s older. Protect yourself!

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BET YOU DIDN’T KNOW THIS…

 

You no doubt know the answers to these questions:

1) What scientist discovered X-rays in 1895?

2) What Nobel prize winning French physicist conducted pioneering research on radioactivity bringing this new science into prominence at the turn of the century?

If you answered 1) Wilhelm Roentgen and 2) Madame Curie, you are right.

However, do you know the answer to this one?

What great inventor was active in the development and commercialization of X-ray technology for about five years and then pulled out of the field altogether?

Answer: Thomas Edison, the inventor of the fluoroscope. Good for you if you knew this answer, but do you know why he pulled out of the field?

As Paul Harvey would say, “Here is the rest of the story…”

Clarence Dally was Edison’s dedicated assistant in those early years. He was exposed to significant doses of radiation in his work and developed a skin disorder that eventually progressed to a carcinoma. After multiple amputations he died in 1905. Recognizing the dangers of X-ray and radiation, Edison packed up his equipment, stored it and left the field to pursue other interests. When asked years later about his work in X-ray development he replied, “Don’t talk to me about X-rays, I’m afraid of them.”

Radiation and the use of X-ray technology have come a long way in 120 years, but it is still dangerous to the uninformed and unprotected. Be smart and use everything available to you to protect yourself on every procedure.

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Match the left column term with the right column description by writing the correct number in the spot following the description.

Send us a picture of your answers to info@jessed72.sg-host.com to win your prize.

 

(Answers must be legible to win!)

 

 

Barbara Hamilton, MD is an interventional radiologist (IR) and blogger who has made it her mission to narrow the gender gap in procedurally-oriented and traditionally male-dominated fields like IR and surgery. Her new book, Save Lives, Enjoy Your Own: Finding Your Place in Medicine is written for budding physicians who are considering the surgically-oriented fields of medicine, but aren’t sure if they can (or should) pursue them. In Save Lives, Enjoy Your Own, join Dr. Hamilton and her colleagues as they outline their pathways into these fields, including some of the stumbling blocks and triumphs they encountered along the way. You can purchase a signed special edition of the book through her website, TiredSuperheroine.com.

 

 

Why waste a hook when you can just lie on the bank overhang and feel around for a big catfish with your bare hands? That’s exactly what RN Kelsey Thomas at Stillwater Oklahoma Medical Center did to snag this 55 lb. monster catfish. Kelsey broke her hand in the process, so friend Steven Henry assists with the hoist. Talk about your ultimate exotic hobby…

 

 

Don’t bet your health on anything less!

RADPAD was developed by physicians for physicians. Proven radiation protection during Cine and Digital Subtraction Angiography with 40+ independent clinical studies and over 600 citations in research publications including citations for efficacy by the International Commission on Radiological Protection (ICRP), the Society of Cardiovascular Angiography & Intervention (SCAI), the American College of Cardiology (ACC) Clinical Policy Approval Committee, the American Society of Echocardiography (ASE), and the Heart Rhythm Society (HRS).

See Radpad.com for more information; contact info@jessed72.sg-host.com for a free radiation evaluation and No-Brainer® radiation protection cap.

 

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