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Efstathios P. Efstathopoulos

Other affiliations: University of Patras
Bio: Efstathios P. Efstathopoulos is an academic researcher from National and Kapodistrian University of Athens. The author has contributed to research in topics: Medicine & Imaging phantom. The author has an hindex of 28, co-authored 148 publications receiving 2684 citations. Previous affiliations of Efstathios P. Efstathopoulos include University of Patras.


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TL;DR: The purpose of this article is to define wall shear stress, to introduce relevant concepts of fluid mechanics to nonexperts, and to critically review the various methods that have been used for the assessment of wallShear stress in animal and human blood circulation, paying special attention to the case of coronary arteries.

239 citations

Journal ArticleDOI
TL;DR: The objective of the present project was the determination of the dose received by patients during cardiac procedures, such as coronary angiography, percutaneous transluminal coronary angioplasty (PTCA) and stent implantation, which showed the contribution of cinefluorography to the total DAP was higher than that of fluoroscopy.
Abstract: The objective of the present project was the determination of the dose received by patients during cardiac procedures, such as coronary angiography, percutaneous transluminal coronary angioplasty (PTCA) and stent implantation. Thermoluminescent dosemeters (TLDs), suitably calibrated, were used for the measurement of the dose received at four anatomical locations on the patient's skin. A dose-area product (DAP) meter was also used. The contribution of cinefluorography to the total DAP was higher than that of fluoroscopy. A DAP to effective dose conversion factor equal to 0.183 mSv Gy-1 cm-2 was estimated with the help of a Rando phantom. Thus, the effective dose received by the patients could be assessed. Mean values of effective dose equal to 5.6 mSv, 6.9 mSv, 9.3 mSv, 9.0 mSv and 13.0 mSv were estimated for coronary angiography, PTCA, coronary angiography and ad hoc PTCA, PTCA followed by stent implantation and coronary angiography and ad hoc PTCA followed by stent implantation, respectively.

171 citations

Journal ArticleDOI
TL;DR: This article review the derived doses at non-pediatric patients from 72 relevant studies published during the last 22 years in international scientific literature indicate that patient radiation doses vary widely among the different interventional cardiology procedures but also among equivalent studies.
Abstract: Interventional cardiology procedures result in substantial patient radiation doses due to prolonged fluoroscopy time and radiographic exposure. The procedures that are most frequently performed are coronary angiography, percutaneous coronary interventions, diagnostic electrophysiology studies and radiofrequency catheter ablation. Patient radiation dose in these procedures can be assessed either by measurements on a series of patients in real clinical practice or measurements using patient-equivalent phantoms. In this article we review the derived doses at non-pediatric patients from 72 relevant studies published during the last 22 years in international scientific literature. Published results indicate that patient radiation doses vary widely among the different interventional cardiology procedures but also among equivalent studies. Discrepancies of the derived results are patient-, procedure-, physician-, and fluoroscopic equipmentrelated. Nevertheless, interventional cardiology procedures can subject patients to considerable radiation doses. Efforts to minimize patient exposure should always be undertaken.

130 citations

Journal ArticleDOI
TL;DR: Calculation of the dose burden for interventionists considering the actual number of procedures performed annually revealed that dose limits for the extremities and the lenses of the eyes were not exceeded, however, there are cases in which high doses have been recorded and this can lead to exceeding the dose limits when bad practices are followed and the radiation protection tools are not properly used.
Abstract: Objectives: The aim of this study was to determine occupational dose levels in interventional radiology and cardiology procedures. Methods: The study covered a sample of 25 procedures and monitored occupational dose for all laboratory personnel. Each individual wore eight thermoluminescent dosemeters next to the eyes, wrists, fingers and legs during each procedure. Radiation protection shields used in each procedure were recorded. Results: The highest doses per procedure were recorded for interventionists at the left wrist (average 485 μSv, maximum 5239 μSv) and left finger (average 324 μSv, maximum 2877 μSv), whereas lower doses were recorded for the legs (average 124 μSv, maximum 1959 μSv) and the eyes (average 64 μSv, maximum 1129 μSv). Doses to the assisting nurses during the intervention were considerably lower; the highest doses were recorded at the wrists (average 26 μSv, maximum 41 μSv) and legs (average 18 μSv, maximum 22 μSv), whereas doses to the eyes were minimal (average 4 μSv, maximum 16 μSv...

118 citations

Journal ArticleDOI
TL;DR: The correlation between the degree of hepatic, splenic, pancreatic, vertebral bone marrow, and myocardial siderosis, as expressed by relaxation rate (R2 = 1/T2) values, in patients with thalassemia is investigated.
Abstract: Purpose To investigate the correlation between the degree of hepatic, splenic, pancreatic, vertebral bone marrow (VBM), and myocardial siderosis, as expressed by relaxation rate (R2 = 1/T2) values, in patients with thalassemia. Materials and Methods R2 relaxation rate values of liver, spleen, VBM, pancreas, and myocardium were estimated in 68 consecutive transfusion-dependent patients with β-thalassemia major and 10 healthy controls using a respiratory triggered 16-echo Carr-Purcell-Meiboom-Gill (CPMG) spin echo sequence. Results Hepatic R2 values were significantly increased in all 68 patients; VBM, pancreatic, and myocardial R2 values were increased in 67/68, 35/47, and 47/61 patients, whereas five patients showed decreased pancreatic R2 attributed to fatty degeneration. Of the 39 nonsplenectomized patients, splenic R2 values were decreased in 30 and normal in nine patients. Hepatic R2 values correlated with splenic (r = 0.63, P < 0.001), VBM (r = 0.52, P < 0.001), but not with myocardial and pancreatic R2 values. Conclusion Despite positive correlations between the degree of hepatic, splenic, and VBM siderosis, as expressed by respective R2 values, there was variability of iron distribution patterns in thalassemic patients. Unpredictable patterns of iron distribution may be seen, such as normal signal of the spleen in the presence of siderotic liver, resembling primary hemochromatosis. Fatty degeneration of the pancreas was not uncommon. J. Magn. Reson. Imaging 2009;29:853–859. © 2009 Wiley-Liss, Inc.

92 citations


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08 Dec 2001-BMJ
TL;DR: There is, I think, something ethereal about i —the square root of minus one, which seems an odd beast at that time—an intruder hovering on the edge of reality.
Abstract: There is, I think, something ethereal about i —the square root of minus one. I remember first hearing about it at school. It seemed an odd beast at that time—an intruder hovering on the edge of reality. Usually familiarity dulls this sense of the bizarre, but in the case of i it was the reverse: over the years the sense of its surreal nature intensified. It seemed that it was impossible to write mathematics that described the real world in …

33,785 citations

01 Jan 2000
TL;DR: This annex is aimed at providing a sound basis for conclusions regarding the number of significant radiation accidents that have occurred, the corresponding levels of radiation exposures and numbers of deaths and injuries, and the general trends for various practices, in the context of the Committee's overall evaluations of the levels and effects of exposure to ionizing radiation.
Abstract: NOTE The report of the Committee without its annexes appears as Official Records of the General Assembly, Sixty-third Session, Supplement No. 46. The designations employed and the presentation of material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries. The country names used in this document are, in most cases, those that were in use at the time the data were collected or the text prepared. In other cases, however, the names have been updated, where this was possible and appropriate, to reflect political changes. Scientific Annexes Annex A. Medical radiation exposures Annex B. Exposures of the public and workers from various sources of radiation INTROdUCTION 1. In the course of the research and development for and the application of atomic energy and nuclear technologies, a number of radiation accidents have occurred. Some of these accidents have resulted in significant health effects and occasionally in fatal outcomes. The application of technologies that make use of radiation is increasingly widespread around the world. Millions of people have occupations related to the use of radiation, and hundreds of millions of individuals benefit from these uses. Facilities using intense radiation sources for energy production and for purposes such as radiotherapy, sterilization of products, preservation of foodstuffs and gamma radiography require special care in the design and operation of equipment to avoid radiation injury to workers or to the public. Experience has shown that such technology is generally used safely, but on occasion controls have been circumvented and serious radiation accidents have ensued. 2. Reviews of radiation exposures from accidents have been presented in previous UNSCEAR reports. The last report containing an exclusive chapter on exposures from accidents was the UNSCEAR 1993 Report [U6]. 3. This annex is aimed at providing a sound basis for conclusions regarding the number of significant radiation accidents that have occurred, the corresponding levels of radiation exposures and numbers of deaths and injuries, and the general trends for various practices. Its conclusions are to be seen in the context of the Committee's overall evaluations of the levels and effects of exposure to ionizing radiation. 4. The Committee's evaluations of public, occupational and medical diagnostic exposures are mostly concerned with chronic exposures of …

3,924 citations

Journal ArticleDOI
TL;DR: Effective dose provides an approximate indicator of potential detriment from ionizing radiation and should be used as one parameter in evaluating the appropriateness of examinations involving ionizing Radiation.
Abstract: Medical uses of radiation have grown very rapidly over the past decade, and, as of 2007, medical uses represent the largest source of exposure to the U.S. population. Most physicians have difficulty assessing the magnitude of exposure or potential risk. Effective dose provides an approximate indicator of potential detriment from ionizing radiation and should be used as one parameter in evaluating the appropriateness of examinations involving ionizing radiation. The purpose of this review is to provide a compilation of effective doses for radiologic and nuclear medicine procedures. Standard radiographic examinations have average effective doses that vary by over a factor of 1000 (0.01-10 mSv). Computed tomographic examinations tend to be in a more narrow range but have relatively high average effective doses (approximately 2-20 mSv), and average effective doses for interventional procedures usually range from 5-70 mSv. Average effective dose for most nuclear medicine procedures varies between 0.3 and 20 mSv. These doses can be compared with the average annual effective dose from background radiation of about 3 mSv.

1,736 citations

Journal ArticleDOI
TL;DR: The health care system must treat illness, alleviate suffering and disability, and promote health, but the whole system needs to work to improve the health of populations.
Abstract: 1. Health care is a human right. 2. The care of the individual is at the center of health care, but the whole system needs to work to improve the health of populations. 3. The health care system must treat illness, alleviate suffering and disability, and promote health. 4. Cooperation with each other, those served, and those in other sectors is essential for all who work in health care. 5. All who provide health care must work to improve it. 6. Do no harm.

801 citations