Pregnancy and ionising radiation.
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Biomedical subjects
Publications and source records attributed to J G Russell.
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A calculation is made of the cost for an ultrasound screening programme for abdominal aortic aneurysm. From this is derived the cost of a QALY (Quality Adjusted Life Year) for different ages and sex. The cost of a QALY in this programme compares well with other types of screening programme. It is found that a screening programme should include both men and women.
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The epidemiology of Hepatitis B infection is used to show that dental health care workers are at greater risk of acquiring serious infective diseases than is the population at large. The significance of this greater risk is that dental employers must take the proper steps to protect their employees' health. A five fold strategy is put forward to achieve this end. The law governing a (dental) employer's duty in this regard is examined. Failure to take appropriate action leaves the dental employer open to legal action in the event that an employee acquires a serious infection in the course of his work. The similarity is stressed between Irish and British law in protecting the needs of authority and established bodies such as for instance the dental profession. However, the developments in Irish law are mentioned which show that following established practice in a profession does not guarantee protection from legal suit.
The effects are described of xerostomia on the oral mucosa and dental structures. The various conditions which give rise to extreme dryness are listed; a rough estimate is made on the prevalence of these conditions. The contribution of drug induced xerostomia, of post irradiation mouth dryness and of autoimmune associated salivary disorders are dealt with. Reference is made to studies of xerostomia in various subpopulations. The prevalence of diseases known to be associated with mucosal dryness, and the yearly patterns of drug prescription in Ireland are used to justify an estimate of 2.1% to 3.3% of the population to be the incidence of xerostomia in the Republic of Ireland.
As culture-bound syndromes, Japanese shinkeishitsu ("constitutional neurasthenia") and taijinkyofusho ("anthropophobia") have received considerable attention in the Japanese literature. While these disorders are viewed as diagnostically distinct from Western psychiatric categories, recent studies by the Japanese suggest some affinity with Western social phobias, depression, and schizophrenia. The paper reviews this literature and offers suggestions for further cross-cultural research.
A plea is made for a significant input on AIDS to the dental undergraduate curriculum by medical teachers. The suspicion is that in some schools the teaching of medicine to dental students is not treated seriously. Figures are quoted depicting the worldwide spread of AIDS. The risk of dentists acquiring HIV in the health care setting is discussed. Mention is made of infection control in the dental environment. The objectives are given of a medical curriculum for dental students. Some of the oral manifestations of AIDS are named. Symptoms and signs (which a dentist should be able to recognize) are given for pulmonary, neurological, gastrointestinal or neoplastic complications that may be found in HIV infection. The role of the dentist is stressed in continuing surveillance of patients with HIV infection.
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Reasons are offered as to why it is imperative that the dental undergraduate is familiar with all aspects of AIDS. The epidemiology of the disease is discussed, as are methods of transmission of the virus. A classification is given of the clinical presentation of HIV infection. The classification is based on the system put forward by the Centers for Disease Control, Atlanta. A brief résumé is given of laboratory diagnosis in HIV infection, and of the risk of health care workers contracting the disease. The precautions recommended for use in dentistry as proposed by the Centers for Disease Control are quoted in full. Finally mention is made of the treatment and control of AIDS.
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We indicate the principles which can be used to apply cost-benefit analysis to radiation protection of staff in an X-ray department. The cost of saving radiation exposure to staff by varying the lead equivalence of lead gowns and lead protective screens is calculated. The cost is compared with the financial values of the detriment as assessed by the National Radiological Protection Board. The expenditure required to avoid a man-Sv for staff protection in diagnostic departments is suggested. In the examples we take, it is found that the larger staff dose reductions, and often the cheaper reductions, can be obtained by reducing the radiation dose to the patient. There are, of course, major additional advantages to the patient in reducing this dose.