Screening for fetal chromosomal and subchromosomal disorders

Screening for fetal chromosomal disorders has evolved greatly over the last four decades. Initially, only maternal age-related risks of aneuploidy were provided to patients. This was followed by screening with maternal serum analytes and ultrasound markers, followed by the introduction and rapid uptake of maternal plasma cell-free DNA-based screening. Studies continue to demonstrate that cfDNA screening for common aneuploidies has impressive detection rates with low false-positive rates. The technology continues to push the boundaries of prenatal screening as it is now possible to screen for less common aneuploidies and subchromosomal disorders. The optimal method for incorporating cfDNA screening into existing programs continues to be debated. It is important that obstetricians understand the biological foundations and limitations of this technology and provide patients with up-to-date information regarding cfDNA screening.     

Reducing Variability of Radiation Dose in CT: The New Frontier in Patient Safety

PurposeAlthough reducing radiation dose in CT examinations is an important goal, also important in the management of radiation dose is ensuring consistency of dose administered for a given type of examination. We have implemented an approach to reducing variance in CT radiation dose by standardizing protocols and implementing software that decreases variance.MethodsA multifaceted approach to reducing variance in CT radiation dose was utilized: (1) establishment of the Radiation Dose Optimization Committee, (2) standardization of protocols, and (3) implementation of scanner software. Two periods of data were collected: pre-intervention (January 1, 2013, to July 31, 2014) and postintervention (January 1, 2016, to December 31, 2016). The period from August 1, 2014, to December 31, 2015, represented the time the major interventions were performed.ResultsThe average radiation dose for all CT exams performed during the pre-intervention period (n = 39,314) was 22.3 CTDIvol with an SD of 17.0. The average radiation dose for all CT exams performed during the postintervention period (n = 49,863) was 13.6 CTDIvol with an SD of 9.01. The postintervention variance was significantly decreased (P < .0001).ConclusionsA significant decrease in the variability of our network CT radiation dose was achieved as a result of a combination of standardizing protocols across the network and implementation of advanced software that effectively managed radiation dose, all overseen by the Radiation Dose Optimization Committee.     

Associations between Poor Sleep Quality,Obesity, and the Anthropometric Measurements of Women in Turkey

Recent studies have shown that poor sleep quality is significantly associated with obesity. The aim of this study is to examine the association of sleep quality with obesity and specific anthropometric measurements. A total of 105 women aged 20–55 years with no chronic diseases participated in this study. They filled out the Pittsburgh Sleep Quality Index (PSQI), their anthropometric measurements were taken, and their dietary data were collected with a food frequency questionnaire (FFQ). There was no significant relationship between sleep quality and BMI, waist circumference, triceps skinfold thicknesses, body fat ratio (%), and body fat mass (p > .05), but high bread consumption was significantly associated with poor sleep quality (p < .05). The women with poor sleep quality consumed significantly more bread, but not other foods, than the women with good sleep quality. Sleep quality can thus be related to eating habits.     

Effect of exposure factors on image quality in screening mammography

IntroductionThe aim of this research was to study the effect of exposure factors on image quality for digital screening mammography units in Kuwait which use Tungsten (W) targets with Rhodium (Rh) and Silver (Ag) as filters.MethodsMammography Accreditation Phantom Model 015 was imaged using a Hologic Selenia Digital mammography unit with W targets and Rh and Ag filters. Four images, each at 26, 28, 30, and 32 kVp, were obtained using each target-filter combination (W/Rh and W/Ag). The images were evaluated by five senior technologists for the number of specks, fibers and masses visible on each image. Statistical analysis was carried out using non-parametric tests at p = 0.05 level.ResultsThere were significant changes in the visibility of fibers and specks between different kVp values with W/Rh (p < 0.001). However, with W/Ag combination, significant differences were observed in the fibers only (p < 0.001). Among the kVp values used, 28 kV emerged as the optimal value. Comparison of images obtained with the two filter materials, led to significant differences in the visibility of fibers and specks (p < 0.008). At 32 kVp, there were significant differences in the visibility of specks only (p < 0.008).ConclusionA W/Rh target-filter combination provides better image quality than that provided by W/Ag. In particular, 30 and 32 kVp X-ray beams produce higher quality images than the lower kV values.