ESS - MN - Comunicações em eventos científicos
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- O ensino da Medicina Nuclear durante a pandemia de COVID-19: reflexão após um ano de experiênciaPublication . Costa, Pedro Silva; Vieira, Domingos Manuel da Silva; Lemos, Joana Cristina da Costa; Costa, Pedro; Lemos, JoanaA Medicina Nuclear é uma especialidade médica na qual a formação de base dos Técnicos Superiores de Diagnóstico e Terapêutica está, actualmente, integrada na Licenciatura em Imagem Médica e Radioterapia. Devido à sua vertente tecnológica, mas também ao dinamismo do conhecimento neste domínio científico e à actualização constante das ferramentas disponíveis para uso em ambiente clínico e biomédico, o investimento num processo de ensino-aprendizagem moderno e baseado em evidência reveste-se de especial interesse neste contexto. Apesar da importância que tais práticas já mereciam, a Pandemia de COVID-19 e as implicações da mesma ao nível da limitação da leccionação de aulas em contexto presencial obrigou a alterações relativamente profundas no processo de ensino-aprendizagem. Esta comunicação pretende promover reflexão acerca das estratégias de adaptação do ensino para metodologias à distância e/ou mistas implementadas pela Área Técnico-Científica de Medicina Nuclear da ESS|P.Porto, desde Março de 2020, apresentar os desafios inerentes a esse processo e partilhar resultados verificados em mais de um ano de experiência acumulada, na perspectiva dos docentes e dos estudantes envolvidos. Para além de testemunhos individuais recolhidos junto de docentes e estudantes, através de feedback empírico informal, está em curso a recolha estruturada de perspectivas, percepções e opiniões através de inquérito dirigido aos estudantes da Licenciatura em Imagem Médica e Radioterapia da ESS|P.Porto inscritos nos anos lectivos 2019/2020 e 2020/2021. Os resultados obtidos permitem sustentar a reflexão acerca da validade e interesse do recurso a metodologias de ensino à distância e/ou misto, com foco na identificação das variáveis influenciadoras deste processo.
- Parameters optimization of filtered back projection in Myocardial Perfusion Imaging reconstructionPublication . Metelo, Luís Francisco; Cunha, L.; Vieira, Domingos; Fonseca, A.; Tavares, A.; Soares, S.; Amorim, I.; Castro, R.; Abrantes, A. M.; Botelho, M. F.Nowadays, even if it is noticed an increasingly wider use of Iterative Methods (IM), a significant number of NM Departments is still routinely using Filtered Backprojection (FBP) as the method of choice in what concerns image processing in MPI. Several authors recommend the use of same filter parameters, no matter what the patient physical characteristics are.
- Study of the influence of patient hydration in bone ScintigraphyPublication . Ferreira, S.; Cunha, L.; Fonseca, A.; Vieira, Domingos; Lemos, Joana; Matias, M.; Osorio, S.; Soares, S.; Silva, J. A.; Amorim, M. I.; Castro, R.; Metelo, Luís FranciscoBone Scintigraphy is a noninvasive and very sensitive Nuclear Medicine diagnostic method in detecting early bone lesions. Between the important technical details to consider when dealing with patient preparation there is the hydration level.
- Motion correction software in Myocardial Perfusion Imaging: is it useful?Publication . Cunha, L.; Lamego, J.; Ferreira, S.; Lemos, Joana; Vieira, Domingos; Fonseca, A.; Pires, L.; Neves, D.; João, M. Faria; Pereira, L.; Moreira, A. S.; Metelo, Luís FranciscoMyocardial Perfusion Imaging (MPI) is a very important tool in the assessment of Coronary Artery Disease (CAD) patients and worldwide data demonstrate an increasingly wider use and clinical acceptance. Nevertheless, it is a complex process and it is quite vulnerable concerning the amount and type of possible artefacts, some of them affecting seriously the overall quality and the clinical utility of the obtained data.
- Direct production of 99mTc-Technetium using low energy cyclotrons and radionuclidic purity: our results so far using natMo-MolybdenumPublication . Metelo, Luís Francisco; Costa, Pedro; Cunha, L.; Jonhson, R.; Matei, L.; Gelbart, W.; Obermair, J.; Artner, C.; Lass, P.; Currie, G.; Craciun, L.; Niculae, D.; Carmo, S.; Alves, F.; Botello, M.Despite the global crisis concerning 99mTc delivering to Nuclear Medicine Departments there isn’t yet a reliable solution. The cyclotron direct production of 99mTc, using the 100Mo(p,2n)99mTc nuclear reaction is our attempt to approach the problem, aiming to become efficient, reliable and sustainable from points of view as reducing drastically the radioactive waste being produced and becoming beneficial for all the involved parts. Between several critical factors, radionuclidic purity of cyclotron-produced 99mTc is being pointed as an issue of concern.
- Management of COVID-19 pandemic in Nuclear Medicine departments: A contribute for the Portuguese communityPublication . Costa, Pedro; Lemos, Joana; Vieira, Domingos; Arantes, N.Considering the infection with the new Coronavirus (SARS-CoV-2), which may evolve into CoronaVirus Disease 2019 (COVID-19), and the pandemic that is active, standards, guidelines and recommendations have been issued by diverse entities at the governmental, professional and scientific levels.
- Low dose ionizing radiation (LDIR) and the immune system: a reviewPublication . Martins, Ricardo; Ferraz, Ricardo; Costa, PedroIonizing radiation (IR) is unavoidable in medicine, whether it is in cancer treatment, through radiotherapy with high doses, or in imaging with low doses. While the effects of high dose ionizing radiation (HDIR) are well known, low dose effects are still shrouded in controversy. IR will act on cells either directly, altering DNA and protein structure, or through the creation offree radicals, affecting a cell’s functionality and ultimately, viability. This will affect the immune system, as IR not only induces an immune response, but also targets immune cells, which according to the law of Bergonie and Tribondeau are radiosensitive. While not consensual, it is theorized that IR might have an hormesis effect. LDIR has been defined in 2012 as any dose lower than 100 mGy. Despite this, multiple articles have different definitions of LDIR, and as a result, knowledge about the effects might be somewhat skewed. Through article and data analysis, our aim was to assess the knowledge of LDIR effects on the immune system and present a possible mechanism for their interaction. A literature review using a combination of keywords with Boolean search terms on the search engine of Web of Science™ was implemented. 100 articles were obtained and, after selection and filtering through inclusion and exclusion criteria, 45 articles had their data collected and compiled for complete analysis. LDIR showed activation ofpathways that induce immune activity. Acute LDIR was shown to increase pro-inflammatoryand decrease anti-inflammatory cytokine production, macrophage and natural killer cells’ proliferation and activity, while having a negative effect in splenocyte and T cell counts. Chronic LDIR showed reverse effects on cytokines, joined with a reduction of enzymes responsible forantioxidantdefenses. Results seem to show that acute LDIR induces a pro-inflammatory response and has anti-tumoral activity, where as chronic LDIR has anti-inflammatory properties
- Opening minds to Lean management in Nuclear MedicinePublication . Lemos, Joana; Vieira, Domingos; Arantes, N.; Costa, PedroNuclear Medicine (NM) is in constant technological evolution, challenging often professionals to be up to most recent standards and practices. In this sense, teaching NM should not be limited on the transmission of technical and scientific knowledge but also on opening minds to, for example, different management philosophies. Therefore, Nuclear Medicine students should be capable to change behaviours/practices and be concerned to search continuous improvement. To reach this standard, NM Department at our institution decided to implement the application of Lean Philosophy (management culture/philosophy focused on reducing various types of waste) in NM, in a process involving students, teachers and alumni.
- Practices in radiopharmacy: Is the use of a breathing needle a concern on the radiochemical purity of 99mTc radiopharmaceuticals?Publication . Oliveira, M.; Oliveira, T.; Rebelo, A.; Sousa, C.; Silva, A.; Nery, J.; Amorim, I.; Castro, R.The action of collecting the patient’s individual doses isn’t subjected to any followed protocol, unlike most practices in the Nuclear Medicine department. In certain departments, the individual doses are withdrawn by perforating the rubber septum at every dose while others choose to keep a needle in the kit to avoid multiple perforations. Radiochemical purity is typically the primary concern for 99mTc-radiopharmaceuticals so the potential presence of impurities will affect the radiochemical stability of the radiopharmaceutical and, after being injected to a patient, result in an altered biodistribution and poor image quality. Therefore, it’s important to verify every practice used on the product, which results in a need to learn if the needle kept in the kit at some departments is affecting the radiopharmaceutical’s stability. It is aimed to disseminate the results obtained on a large study performed to evaluate whether there is any correlation between keeping the needle in the kit, during the clinical practice and during the stability period of two different radiopharmaceuticals.
- Using low energy medical cyclotrons to produce 99mTc - TechnetiumPublication . Metello, L. F.; Gelbart, W.; Cunha, L.; Carmo, S.; Artner, C.; Alves, F.This paper refers to work in progress, addressing the global trouble in delivering 99mTc to Nuclear Medicine Departments, Aiming to develop an efficient, safe and economical way to directly produce Technetium 99metastable (99mTc) using lowenergy - so-called “medical” - cyclotrons. The present delivery strategy has intrinsic limitations because it is not only based on old nuclear reactors, but also limits the weekly agenda workflow. Our approach is distinct, and is based on the broad distribution network of the low energy cyclotrons and the accessibility of Molybdenum 100 (100Mo) as the target material, so the system here presented, is not based on the use of Nuclear Reactors and highly enriched (or even low enriched) Uranium 235 (235U), but entirely complying with the current international trends and directives, concerning the need to reduce the use of this potential highly critical target material. The direct production technique is based on the nuclear reaction 100Mo(p,2n)99mTc whose production yields have already been widely documented. The 99mTc is produced in a routine, reliable and efficient manner that, remaining always flexible, entirely blends with established protocols.