Purpose: To compare the image quality of the low-dose to the standard-dose protocol of MDCT scanning of the paranasal sinuses, based on subjective assessment and determine the radiation doses to the eyes and thyroid gland and dose reduction between these two protocols. Materials and Methods: 31 adult patients were scanned. Prior to scanning, thermoluminescent dosimeters (TLDs) were placed at 4 sites: outer canthus of right eye, outer canthus of left eye, inner canthus and anterior neck (thyroid gland). Every patient was scanned twice using the standard-dose protocol (100mAs) followed by the low-dose protocol (40mAs). The images were reviewed by 3 radiologists. Wilcoxon test was used as the test of significance for the image quality assessments. The paired sample t-test was used as the test of significance for the analysis of the radiation doses measured by the TLDs. Results: Of the 30 patients selected for analysis, this study showed no significant difference in the scores for the diagnostic image quality and the anatomical structures assessments between the two protocols. The average calculated mean entrance surface doses and standard deviation for the standard-dose and low-dose protocols were 12.40±1.39 mGy and 5.53±0.82 mGy respectively to the lens and 1.03±0.55 mGy and 0.63±0.53 mGy respectively to the thyroid gland. Conclusion: The reduction of mAs from 100 to 40 resulted in a significant reduction of the radiation doses to the lens and thyroid gland by 55.4% and 38.8% respectively without causing any significant effect to the diagnostic image quality and assessment of the anatomical structures.

OBJECTIVETo study the relative risk (RR) of mortalities of cerebro-cardiovascular diseases (CVD) in Guangzhou workers with hypertension.

METHODProspective cohort study was conducted in 78,379 workers, aged >or= 35, from 399 factories. Cox regression model were mainly used for data analysis.

RESULTS(1) There were 48,705 male and 29,674 female workers in the cohort. All workers were followed-up for 8 years. 363 CVD deaths (male 305, female 58) mainly died of stroke, coronary heart disease and hypertension. The crude mortalities were 78.58/100,000 person years in male and 24.55/100,000 person years in female. (2) Compared with the optimal or normal blood pressure (ONBP), the RR (95%) of CVD deaths with high blood pressure (HBP) were 6.19 (4.85 - 7.91) in male and 2.78 (1.59 - 4.85) in female. In male, compared with ONBP, the RR of CVD deaths without illness but with 1st-grade HBP at baseline, and of those suffered non-CVD but with 1st-grade HBP at baseline, and of those suffered CVD with 2nd-grade HBP at baseline were 3.98, 3.25 and 3.15 respectively (P < 0.01). (3) After stratifying of age, smoking, drinking, educational levels and occupational exposure, the RR of CVD deaths was higher in those who were younger, or ever-smoking, non-drinking, higher educational level, exposed to occupational hazards and with hypertension.

CONCLUSIONThere is relationship between BP levels and CVD mortality. High BP may affect CVD deaths at younger age. Comprehensive measures should be used to reduce the risk of CVD deaths.

Adult ; Aged ; Blood Pressure ; Cardiovascular Diseases ; mortality ; Cerebrovascular Disorders ; mortality ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies

INTRODUCTION: Our study aimed to identify the factors associated with successful first-time radioactive iodine (RAI) treatment in patients with Graves' disease (GD). MATERIALS AND METHODS: This is a restrospective study of patients with GD who were treated with RAI. Treatment success was defined as onset of permanent hypothyroidism or euthyroidism after 1 dose of RAI at 1-year follow-up. RESULTS: There were 388 GD patients who underwent RAI treatment between January 2014 and December 2015. Of these, 74% achieved treatment success. Median time to achieve permanent hypothyroidism was 2 months. Male gender, smoking, higher antithyroid drug dosage, lower thyroid stimulating hormone (TSH) level, large goitre size and TSH receptor antibody (TRAb) titre at time of RAI were significantly associated with treatment failure. Multivariate analysis showed that larger goitre size and higher TRAb titre were associated with lower first-time RAI success. CONCLUSION Larger goitre size and higher TRAb titre predict lower success of RAI therapy in GD patients. Treatment decisions and strategies should be customised for patients who present with these characteristics.

OBJECTIVE: This study aimed to assess the health workforce's service capacities within a health Service Delivery Network (SDN) of an urban poor and a rural poor setting.

METHODS: This is a concurrent mixed-methods study implemented in Navotas and Masbate, an urban poor and a rural poor area, respectively. Health needs of the residents were assessed through records review, qualitative methods and a household survey. Health facilities in the identified SDN were assessed using the Service Availability and Readiness Assessment (SARA) tool. Training data of Human Resource for Health (HRH) were also obtained.

RESULTS: SDN in the two areas are different in terms of formality where memoranda of agreement were prepared between Masbate facilities but not in Navotas. Health worker to population ratios were 12.1 per 10,000 in Navotas and 2.7 in Masbate, respectively. The primary care facilities in the two sites met the recommended level of trainings for health workers in obstetric care, immunization, childhood nutrition and tuberculosis. There was a lack of post-graduate training in non-communicable diseases in all facilities. Poverty and geography were significant factors affecting health service delivery.

CONCLUSION: In terms of human resources, both sites have limited number of health workers and the ratios fall far below WHO guideline. Recommendations include: Primary health care staff complement should be increased in the two SDNs. HHRDB should conduct a study to settle the issue of continuing medical education requirements that are not congruent with WHO recommendations. The SDNs should include the access of medicines and commodities by poor patients in private facilities during times of stock outs. Also, during stock outs or unavailability of government health personnel, transportation should be made available via the SDN to transport poor patients to private or nongovernment facilities with the needed personnel. The DOH and HHRDB should investigate innovative strategies for telehealth services that do not require continuous electricity, nor telephone or cellphone signal.

Human ; Community Health Services ; Health Services Accessibility ; Delivery Of Health Care ; Quality Of Health Care