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The external radiation hazard
Published in Alan Martin, Sam Harbison, Karen Beach, Peter Cole, An Introduction to Radiation Protection, 2018
Alan Martin, Sam Harbison, Karen Beach, Peter Cole
Another material that can be used to assess medical X-ray doses is lithium borate, which has a ‘tissue-equivalent’ effective atomic number and as such does not affect the image quality. Also, calcium sulphate has a very high sensitivity and can be used for environmental dose measurements.
Thermoluminescent Dosimetry
Published in Gad Shani, Radiation Dosimetry, 2017
Thermoluminescent dosimetry is used in many scientific and applied fields such as radiation protection, radiotherapy clinic, industry, and environmental and space research, using many different materials. The basic demands of a thermoluminescent dosimeter (TLD) are good reproducibility, low hygroscopicity, and high sensitivity for very low dose measurements or good response at high doses in radiotherapy and in mixed radiation fields. LiF is used for dose measurements in radiotherapy since the effective atomic number of 8.3 is close to that of water or tissue. Lithium tetraborate is more tissue-equivalent than LiF, but it is deliquescent (absorbs moisture from the atmosphere) and its stored signals fade rapidly. Its use is therefore only worthwhile for x-rays, where the closeness of its effective atomic number of 7.3 to tissue outweighs the disadvantages. Calcium sulphate has an effective atomic number of 15.6 and is therefore much less tissue-equivalent, but its effective atomic number is quite close to that of bone. It is very sensitive and therefore can be used for protection dosimetry. Calcium fluoride has an effective atomic number of 16.9 and is also used for protection dosimetry, as it is also very sensitive.
Principles of fracture fixation
Published in Sebastian Dawson-Bowling, Pramod Achan, Timothy Briggs, Manoj Ramachandran, Stephen Key, Daud Chou, Orthopaedic Trauma, 2014
Stephen Tai, Panagiotis Gikas, David Marsh
Used when the fracture pattern is deemed stable, or in patients in whom operative treatment is contraindicated, casting is the mainstay of treatment. The two materials used mostly are as follows: Plaster of Paris – hemihydrated calcium sulphate. In contact with water, it reacts to form hydrated calcium sulphate. This reaction is exothermic. Plaster is pliable and slow to set, allowing time for moulding of the cast.Fibreglass – knitted fibreglass is impregnated with a resin that polymerizes and hardens when immersed in water. Fibreglass is lighter in weight and more radiolucent than plaster of Paris; however, moulding is more difficult.
Advances in pharmacotherapy for diabetic foot osteomyelitis
Published in Expert Opinion on Pharmacotherapy, 2021
Raju Ahluwalia, Jose Luiz Lázaro-Martínez, Ines Reichert, Nicola Maffulli
The principal types of biodegradable ceramics available for antibiotic delivery are based on either calcium sulfate or calcium phosphate (Tables 4 and 5). Within the calcium phosphate group, two main types exist: tricalcium phosphate and hydroxyapatite. Calcium sulfate has also been used as a bone graft material since 1892 [90], having a compressive strength equivalent to that of cancellous bone [91]. However, it is brittle and quickly loses its strength as it is hydrolyzed on its own and needs to be combined with another ceramic. Its use in DFO showed that 20 of 323 patients required further debridement before wound healing occurred [92], and another 20 patients required an amputation, 6 being below knee. Jogia et al. reported no recurrence or amputation following debridement of forefoot ulcers in 20 patients at 12-month follow-up with routine use of calcium sulfate impregnated with antibiotics [93]. Krause et al. found that 13 of 49 feet treated by trans-metatarsal amputation with calcium sulfate and tobramycin experienced a reduction in below knee amputation rates at an average follow-up of 28 months (8–52 months) [94].
Single-stage debridement with implantation of antibiotic-loaded calcium sulphate in 34 cases of localized calcaneal osteomyelitis
Published in Acta Orthopaedica, 2020
Nan Jiang, Xing-qi Zhao, Lei Wang, Qing-rong Lin, Yan-jun Hu, Bin Yu
Calcium sulphate (CS), a novel local antibiotic vehicle, has been widely used for the treatment of chronic osteomyelitis with satisfying outcomes (Gauland 2011, Ferguson et al. 2014, Andreacchio et al. 2019). Compared with polymethylmethacrylate (PMMA), CS can carry a wider range of antibiotics and is completely biodegradable, thus not requiring second surgery for removal (Inzana et al. 2016). Although previous studies had reported local antibiotic-loaded CS implantation for CO treatment, their strategies differed, including a 2-stage surgery of debridement followed by autologous bone graft (Papagelopoulos et al. 2006), the Silo technique with CS/hydroxyapatite (Drampalos et al. 2018), and even calcanectomy (Walsh and Yates 2013). Nonetheless, the clinical experience of bone-preserving strategy for CO treatment remains limited.
The role of bioactive glass in the management of chronic osteomyelitis: a systematic review of literature and current evidence
Published in Infectious Diseases, 2020
Yashwant Singh Tanwar, Nando Ferreira
One of the most common complications of synthetic bone void filler agents is a persistent post-operative serous discharge from the wound. This has been seen with both calcium sulphate preparations and bioactive glass. In the present study, 24 patients (12.5%) had prolonged serous discharge from the wound which eventually settled either with or without flap coverage. It was noted that the majority of these patients had either tibial or calcaneal involvement. The increased rate of wound complications over these two sites seems explicable owing to the poor soft tissue coverage and the delicate vascular supply. A low threshold for a flap coverage post debridement especially in vulnerable areas like the calcaneum and tibia might avoid such complications. Placement of bioactive glass in subcutaneous areas in direct contact with the skin should be avoided.