Health Blog

Paediatric Imaging in The Radiology Department

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Cardiac CT Angiography

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Shaping the face of medicine worldwide

For centuries, the healthcare system on our beautiful island home has been behind in developments that could possibly save lives. One such development that has been behind is that of non-invasive cardiac imaging. Radiology West however is pleased to remind western Jamaican doctors that they now have, at their disposal, state of the art cardiac imaging procedures that will help in their patient management,namely, calcium scoring and cardiac CT angiography. We therefore implore you to make use of these technologies as they have been helping the world to prove and help with the following:

  1. Diabetes mellitus is associated with more diffused and severe coronary artery disease than any other cardiovascualr risk factor.
    • In a study of 229 patients, composing of both diabetics and non- diabetics, diabetics were found to have coronary calcium in an average of 2.68 vessels, more significant stenosis and a higher odds ratio to have 2 or more vessels with over 50% occlusion. A diabetic patient who has a CAC score is at a higher risk for major cardiac events. Can you help prevent such events in the next diabetic patient you see?
  2. Patient sex modifies the association between Acute Coronary Syndrome and stenosis severity.
    • On baseline, cardiac CT angiograms, female Acute Coronary Syndrome (ACS) have comparable maximal % diameter stenosis severity compared to men. The association between the degree of distal stenosis and ACS is also significantly greater in women. How then will you treat the next female ACS patient that comes through your doors?
  3. Calcium Scoring is of great prognostic value in the Asian population, especially Indians.
    • In a large multi-ethnic Asian cohort study composing of Chinese, Indians and those of Malay descent, it was found that higher coronary calcification, being of Indian ethnicity, smoker, and having higher systolic blood pressure appeared to confer a higher chance of heart attack. Do you see Indian patients with similar risk factors in your practice? Could they benefit from a calcium score?
  4. Cardiac CT angiography is useful in the assessment of patients post heart transplant.
    • If not for cardiac CT angiography, researchers at Duke University would not have been able to accurately assess the lumen volume, wall volume including any plaque, volume of non-calcified, fibrocalcified and calcified plaque as well as the degree of lumina! narrowing for various heart transplant patients in a non invasive manner. Could your cardiology consults benefit in like manner?

All studies from which these facts were garnered can be found in: The Journal of Cardiovascular Computed Tomography. Volume 12, Issue 3S. May/June 2018. Abstracts of the 13th Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography


Do You Have a Testicular Abscess?

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Testicular abscesses are usually complications that are affiliated with inflammation of the epididymis (responsible for storing and carrying sperm) that extends to the testis, or epididymo-orchitis. As such, they usually carry pathogens (infectious agent), which can be divided into those that are sexually transmitted and those that are not.
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Testicular accesses are most commonly seen in young, sexually active males who usually have severe epidiymo-orchitis or have not treated it. Men with this type of abscess usually have testicular pain and sometimes fever and swelling for a few days.

Testicular abscesses, on a lesser scale can also be the result of a bacterial infection of an existing hematoma (due to testicular trauma). If the abscess ruptures through the fibrous covering of the testis then a scrotal abscess may develop.
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Testicular/scrotal ultrasounds can help men determine if they have a testicular abscess. Ask your doctor about a scrotal ultrasound to see if your testicles are in shape!


A CASE OF AUTISM IN THE IMAGING DEPARTMENT

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Junior* came in the radiology department about a week a go to get an x-ray of his chest done. He appeared to be a healthy 13-year-old boy with his mother. I called his name, his mom answered. He made a swift turn almost hitting her when he called out in a somewhat muffled manner. It was then that I realized something was not right.

Both came into the room. I was ready to do the test so I asked his mom to take his shirt off so as not to get the buttons on my image. He was so reluctant but could understand completely.

He finally allowed his extremely patient mom to take it off however it didn’t stop there. He proceeded to take his pants off too. His mom allowed him to go straight ahead. I had entered his name and set up all parameters for the study to be successful; now I was just waiting to position him for his x-ray. That took what seemed like forever.

You see a child that age and physical built is hard to sedate for a seemingly simple test as this and if sedated wouldn’t yield the resultant image quality needed for completion of his Canadian medical. Junior would not lie on the table as you can imagine (sometimes, we would allow this as an option ONLY when all else fails).

Junior’s mind is so different and so unique that we needed to try to think harder to see how he thinks. This requires so much patience. As I tried to help his mom I couldn’t help but be in amazement. The mind of an autistic child is just, well…. amazing.

I solicited the help of a college. After just around a half an hour of talking, maneuvering physically, singing between my colleague and I. …Nothing worked. That was until I noticed that Junior now kept wanting to hug his mother. I thought “That’s somewhat the PA position I needed him in. What if Mom was given a heavy lead shielding and asked to hold the cassette, maybe I could use an out of bucky technique.” We  tried just that.

ALAS!!! It worked perfectly! I say perfectly because the radiologist who had heard what was happening thought we were going to be unsuccessful. He gave me a high five and I sent them on their way.

I couldn’t help but think though? What would my fellow public sector radiographers have done with their extremely heavy workloads in the day? Would they have had the patience with a multitude of other people outside waiting in an area without air condition etc? It would be hard for them to, as I know it would have been hard for me if I were placed in the same position.

I had come to the realization that special children deserve special attention and as such need special resources for themselves sometimes. I wished the government could invest so much more in the special needs of our special ones as not everyone can afford private care as well as a facility with the psychology to understand these, our dear ones.

*Name has been changed.

Kamala Anderson, Radiographer


Our Children are Drinking!

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“I’ve been drinking on a regular for over five years!” stated the 19-year-old girl at a social gathering of her friends at the bar that I sat. Now my math isn’t too wonderful but this meant that she was drinking REGULARLY (provided she wasn’t lying) from the age of 14! Now this was a young lady who seemed extremely seasoned in her drinking as I sat having my drink. This got me thinking, “how many more kids are drinking like this? Do they know the risks?”.

Underage drinking in Jamaica is when anyone under the minimum legal drinking age of 18 drinks alcohol.

It is a risk that is extremely attractive to many adolescents and teens. When young adults drink alcohol, they don’t usually realize the potential damage drinking can have on their lives, the life of their families, and their communities on the overall sphere.

Under age drinking is illegal and is becoming a widespread public health problem posing many risks.

Then health minister, Dr. Fenton Ferguson said that alcohol remains the most widely used substance among adolescents.

“Approximately 10 per cent of the students interviewed reported getting drunk an average three times… and 12 per cent of the students reported consuming five or more alcoholic beverages,” said Dr. Ferguson. SIGH.

The government intends to reduce the harmful consumption of alcohol by 3% by 2018 from 2013 through a variety of methods. Through many stakeholders, they intend to implement the World Health Organization (WHO) recommendations for the reduction of the harmful use of alcohol as well as implement a social marketing campaign to discourage harmful use of alcohol and raise public awareness, especially amongst do the youth, about alcohol-related health risks, including cancer.

WOW!!! We need to our part however as parents, guardians, friends, families and well, just well wishers for a happy, healthy, society.

Kamala Anderson, Radiographer


Breast Cancer On The Rise For Younger Women

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Breast cancer is becoming more common in younger women, and the type they are getting is typically more aggressive. It is important that women become and stay aware of their body, and react quickly if they see or feel something unusual.

Click the video to learn more!
Breast Cancer On The Rise For Younger Women
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