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Journal articles on the topic 'Effectice dose'

Author: Grafiati

Published: 4 June 2021

Last updated: 12 February 2022

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1

MARUYAMA, Takashi, Kazuo IWAI, Kanae NISHIZAWA, Yutaka NODA, and Yoshikazu KUMAMOTO. "Organ or Tissue Doses, Effective Dose and Collective Effective Dose from X-Ray Diagnosis, in Japan." RADIOISOTOPES 45, no. 12 (1996): 761–73. http://dx.doi.org/10.3769/radioisotopes.45.12_761.

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Andersson, Martin, Lennart Johansson, Sören Mattsson, David Minarik, and Sigrid Leide-Svegborn. "ORGAN DOSES AND EFFECTIVE DOSE FOR FIVE PET RADIOPHARMACEUTICALS." Radiation Protection Dosimetry 169, no. 1-4 (March 13, 2016): 253–58. http://dx.doi.org/10.1093/rpd/ncw033.

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3

Huda, Walter. "Computing Effective Doses from Dose-Length Product in CT." Radiology 248, no. 1 (July 2008): 321–22. http://dx.doi.org/10.1148/radiol.2481080042.

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4

Martin, C. J. "Effective dose in medicine." Annals of the ICRP 49, no. 1_suppl (November 4, 2020): 126–40. http://dx.doi.org/10.1177/0146645320927849.

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The International Commission on Radiological Protection (ICRP) developed effective dose as a quantity related to risk for occupational and public exposure. There was a need for a similar dose quantity linked to risk for making everyday decisions relating to medical procedures. Coefficients were developed to enable the calculation of doses to organs and tissues, and effective doses for procedures in nuclear medicine and radiology during the 1980s and 1990s. Effective dose has provided a valuable tool that is now used in the establishment of guidelines for patient referral and justification of procedures, choice of appropriate imaging techniques, and providing dose data on potential exposure of volunteers for research studies, all of which require the benefits from the procedure to be weighed against the risks. However, the approximations made in the derivation of effective dose are often forgotten, and the uncertainties in calculations of risks are discussed. An ICRP report on protection dose quantities has been prepared that provides more information on the application of effective dose, and concludes that effective dose can be used as an approximate measure of possible risk. A discussion of the way in which it should be used is given here, with applications for which it is considered suitable. Approaches to the evaluation of risk and methods for conveying information on risk are also discussed.

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5

Kiljunen, T., A. Tietäväinen, T. Parviainen, A. Viitala, and M. Kortesniemi. "Organ doses and effective doses in pediatric radiography: Patient-dose survey in finland." Acta Radiologica 50, no. 1 (February 2009): 114–24. http://dx.doi.org/10.1080/02841850802570561.

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6

Kulseng, Carl Petter Skaar, and Jon Christoffer Sandstrøm. "Effective doses to staff and dose rates emitted from patients undergoing positron emission tomography utilizing 18F- Fluorodeoxglucose." Radiography Open 2, no. 1 (November 30, 2015): 1–14. http://dx.doi.org/10.7577/radopen.1526.

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IntroductionThe purpose of this two--folded quantitative study was to determine the radiation doses received by staff during 2014 at the PET--department at St. Olavs Hospital in Trondheim, Norway. Although studies show that the doses received by staff performing such examinations are far beneath the limits set by regulation, there was a need to determine how much radiation the staff at this clinic actually was exposed to. We investigated in detail both dose rates emitted by 18 F from different parts of the body to the surroundings along with effective doses to staff during 2014.MethodPart one - Dose rates from 20 patients undergoing FDG-PET/CT--scans were measured with dosimeter RadEye B20 (Thermo Scientific, USA) from five measuring points at three different stages of a standard whole body PET-scan utilizing 18 F-FDG.Part two - Effective doses to five radiographers and four bioengineers were registered daily during 2014. The effective dose measurements were done daily by the staff with personal dosimeter RadEye EPD MK2+ (Thermo Scientific, USA). The dosimeter was worn at chest level. The automatic injector Medrad Intego (Bayer, Germany) administrate the radioactive doses.ResultsPart one - Dose rates emitted from different parts of patients show significant differences. The highest dose rate was measured from the head and sternum of the patients. The knees emit the least dose rate of all body parts and was considerably lower from one meterdistance.Part two - The average effective doses were far below the recommended limits for occupational radiation. The total average effective dose per member of staff was 0.13 mSv in 2014 and the daily average dose was 4.91 μSv/day.ConclusionPart one - 18 F-FDG showed irregular distribution in the body, the lowest dose rates originated from the lower extremities and reflects the metabolism of glucose in the body at rest.Part two - We found significant differences between staff working with both CT and the radioisotope injection compared to the staff working solely with one of these tasks. Nevertheless, all effective- doses were safely within the guideline limits for occupational radiation.

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7

Taylor, David. "Establishing a dose–response relationship for haloperidol decanoate." Psychiatric Bulletin 29, no. 3 (March 2005): 104–7. http://dx.doi.org/10.1192/pb.29.3.104.

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Aims and MethodThe aim of this literature analysis was to establish the range of doses of haloperidol decanoate effective in preventing relapse in schizophrenia. Studies reporting relapse rates in patients treated for longer than 6 months were included. Relapse rate was then plotted against dose or log dose to allow drawing of dose–response curves.ResultsFifteen publications reporting 13 individual studies were identified. of these, 6 studies met inclusion criteria and were analysed. Dose–response curves indicated limited effect at 25 mg/4 weeks but near maximal effect at doses of 50 mg/4 weeks. There was no clear evidence that increasing the dose above 100 mg/4 weeks provided additional benefit in preventing relapse.Clinical ImplicationsThe recommended dose range for haloperidol decanoate (50–300 mg/ 4 weeks) does not reflect the findings of this study. Optimally effective doses appear to be around 50–100 mg/4 weeks. The use of doses above 100 mg/4 weeks is difficult to support given data available.

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8

Tsai, H. Y., C. J. Tung, C. C. Yu, and Y. S. Tyan. "Survey of computed tomography scanners in Taiwan: Dose descriptors, dose guidance levels, and effective doses." Medical Physics 34, no. 4 (March 14, 2007): 1234–43. http://dx.doi.org/10.1118/1.2712412.

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9

Opreanu, Razvan C., Ranji Samaraweera, and John P. Kepros. "Effective Dose to Dose-Length Product Coefficients for Calculation of CT Effective Dose." Radiology 252, no. 1 (July 2009): 315–16. http://dx.doi.org/10.1148/radiol.2521090245.

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10

Gupta, M. M., and A. Nagaratnam. "Effective dose equivalent and effective dose for some selected radiopharmaceuticals." Journal of Radiological Protection 16, no. 4 (December 1996): 263–68. http://dx.doi.org/10.1088/0952-4746/16/4/005.

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11

Pritz, Jakub, Kenneth M. Forster, Amarjit S. Saini, Matthew C. Biagioli, and Geoffrey G. Zhang. "Calculating prescription doses for new sources by biologically effective dose matching." Brachytherapy 11, no. 6 (November 2012): 521–27. http://dx.doi.org/10.1016/j.brachy.2012.02.003.

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12

Drexler, G., W. Panzer, N. Petoussi, and M. Zankl. "Effective dose ? how effective for patients?" Radiation and Environmental Biophysics 32, no. 3 (September 1993): 209–19. http://dx.doi.org/10.1007/bf01209771.

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13

Pritts, Elizabeth A., Alexander K. Yuen, Shefaali Sharma, Robert Genisot, and David L. Olive. "The Use of High Dose Letrozole in Ovulation Induction and Controlled Ovarian Hyperstimulation." ISRN Obstetrics and Gynecology 2011 (November 17, 2011): 1–4. http://dx.doi.org/10.5402/2011/242864.

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Letrozole, an aromatase inhibitor, has been demonstrated to be effective as an ovulation induction and controlled ovarian hyperstimulation agent. However, dose administration has generally been limited to 5 days at 2.5 to 7.5 mg daily. We undertook a retrospective review of over 900 treatment cycles using letrozole in doses as high as 12.5 mg per day. Results indicate that such doses do indeed offer benefit to patients; in that there is increased follicular growth and a higher number of predicted ovulations with higher doses of the drug. However, increasing doses does not produce a detrimental effect upon endometrial thickness. High-dose letrozole may be of value in women who fail to respond adequately to lower doses. Furthermore, randomized trials are needed to determine whether high-dose letrozole might actually be optimal as a starting dose for certain treatment groups.

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14

Orlovskaya, V. I., and I. G. Trifonov. "Dose assessment for NPP staff for beyond design basis accident taking into account typical site infrastructure." Proceedings of the National Academy of Sciences of Belarus, Physical-Technical Series 64, no. 4 (January 11, 2020): 485–90. http://dx.doi.org/10.29235/1561-8358-2019-64-4-485-490.

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Assessment of radiation effect on nuclear power plant staff was made for beyond design basis accident (4 hours period). The considered accident scenario includes emergency radionuclide emission through containment bypass. Assessment of radiation effect on NPP staff was done on the basis of radionuclide concentration distribution on site considering typical infrastructure. Concentration mapping was calculated by developed program module for COMSOL 3.5a application. The obtained data included average volume radionuclide activities in lower air layer, total inhalation dose, effective dose of external exposure, equivalent and effective dose in thyroid and total effective dose for NPP staff during beyond design basis accident. Doses from radioactive cloud (external exposure) and from inhalation (internal exposure) were estimated for the following radionuclides: 137Cs, 134Cs, 131I, 133I, 90Sr. In the case of selected beyond design basis accident the total effective dose of staff is 61,98 mSv for the first 4 hours after the accident beginning. This number is slightly above the threshold of the allowable annual dose limit for personnel in emergency situations (50 mSv). Taking into account that short-lived iodine radionuclides 131I и133I give the main contribution in the dose (50.23 mSv including 27.23 mSv for thyroid), such emergency actions as respiratory protection and iodine prophylaxis for the staff can significantly decrease the received doses.

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15

Ouwehand, A. C. "A review of dose-responses of probiotics in human studies." Beneficial Microbes 8, no. 2 (April 26, 2017): 143–51. http://dx.doi.org/10.3920/bm2016.0140.

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The probiotic definition requires the administration of an ‘adequate amount’ in order to obtain a health benefit. What that amount should be is not indicated. Here, an overview is given of studies that investigated the dose-response relation of probiotics in human interventions. Studies were divided in; meta-analyses, meta-analyses on specific probiotic strains, and studies testing two or more doses of a probiotic (combination) in the same study. Meta-analyses on the effect of probiotics on antibiotic associated diarrhoea (AAD) suggest a dose-response effect; for Clostridium difficile-associated diarrhoea on the other hand no dose-response was observed. For other end-points; such as necrotising enterocolitis, prevention of atopic dermatitis and slow intestinal transit, no dose-response relation was identified in meta-analyses. For prophylaxis in colorectal cancer and relief of irritable bowel syndrome, no dose-response relation was determined. However, for blood pressure, a meta-analysis observed that higher doses (greater than 1011 cfu) were more effective than lower doses. Meta-analyses of specific strains suggest a break-point for effectiveness of Lactobacillus rhamnosus GG in the treatment of acute gastroenteritis in children; no dose-response was observed for two other probiotics assessed. Studies comparing two or more doses indicate that faecal recovery and risk reduction of AAD follow a positive dose-response relationship. Other end-points such as immune markers, general health, and bowel function did not exhibit clear dose-response relations. For AAD, the findings are very compelling; both meta-analyses and dedicated dose-response studies observe a positive correlation between dose and AAD risk. These findings do not allow for extrapolation, but suggest that studying higher doses for this end-point would be worthwhile. The lack of a clear dose-response for other end-points, does not mean it does not exist; present data does just not allow drawing any conclusions.

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16

Warrell, R. P., C. J. Coonley, and T. S. Gee. "Homoharringtonine: an effective new drug for remission induction in refractory nonlymphoblastic leukemia." Journal of Clinical Oncology 3, no. 5 (May 1985): 617–21. http://dx.doi.org/10.1200/jco.1985.3.5.617.

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Homoharringtonine (HHT) is a new plant alkaloid originally isolated in the People's Republic of China. Preliminary studies have suggested antitumor activity in several neoplastic diseases. We treated 49 patients with relapsed or resistant acute leukemia with escalating doses of homoharringtonine administered by continuous infusion. Three dose levels were examined: 5 mg/m2 for seven days, 7 mg/m2 for seven days, and 5 mg/m2 for nine days. Of 28 patients with acute nonlymphoblastic leukemia who received cumulative doses of 45 to 49 mg/m2, seven patients (25%) achieved complete remission. Four of these remissions occurred in a subset of ten patients previously resistant to two or more induction attempts with conventional chemotherapy. There were no remissions in three patients with secondary leukemia or in seven patients with acute lymphoblastic leukemia. Reversible hypotension, fluid retention, diarrhea, and tumor lysis syndrome were the major toxic effects of this treatment. Our results indicate that homoharringtonine is an effective new drug for the treatment of acute nonlymphoblastic leukemia and that this drug does not share cross-resistance with conventional antileukemic agents. The recommended dose is 5 mg/m2/d administered by continuous infusion for nine days.

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17

Mavroidis, P., N. Papanikolaou, and B. Lind. "COMPARISON OF THE BIOLOGICALLY EFFECTIVE UNIFORM DOSE, EQUIVALENT UNIFORM DOSE, EFFECTIVE DOSE AND GENERALIZED EQUIVALENT UNIFORM DOSE CONCEPTS." Radiotherapy and Oncology 92 (August 2009): S239—S240. http://dx.doi.org/10.1016/s0167-8140(12)73233-4.

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18

Mahmoodi, Maede, and Ali Chaparian. "Organ Doses, Effective Dose, and Cancer Risk From Coronary CT Angiography Examinations." American Journal of Roentgenology 214, no. 5 (May 2020): 1131–36. http://dx.doi.org/10.2214/ajr.19.21749.

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19

Nishizawa, Kanae, Takashi Maruyama, Makoto Takayama, Minoru Okada, Jun-ichi Hachiya, and Yoshiro Furuya. "Determinations of organ doses and effective dose equivalents from computed tomographic examination." British Journal of Radiology 64, no. 757 (January 1991): 20–28. http://dx.doi.org/10.1259/0007-1285-64-757-20.

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20

Bushberg, Jerrold T. "Uses of Effective Dose." Health Physics 116, no. 2 (February 2019): 129–34. http://dx.doi.org/10.1097/hp.0000000000001014.

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21

Harrison, J. D., M. Balonov, C. J. Martin, P. Ortiz Lopez, H.-G. Menzel, J. R. Simmonds, R. Smith-Bindman, and R. Wakeford. "Use of effective dose." Annals of the ICRP 45, no. 1_suppl (March 15, 2016): 215–24. http://dx.doi.org/10.1177/0146645316634566.

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22

McCollough, Cynthia H., and Beth A. Schueler. "Calculation of effective dose." Medical Physics 27, no. 5 (May 2000): 828–37. http://dx.doi.org/10.1118/1.598948.

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23

Qiang, Wang, Fu Qiang, and Lin Lin. "ESTIMATION OF EFFECTIVE DOSE OF DENTAL X-RAY DEVICES." Radiation Protection Dosimetry 183, no. 4 (August 31, 2018): 418–22. http://dx.doi.org/10.1093/rpd/ncy159.

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Abstract This study aims to estimate the effective doses of dental X-ray devices under common scanning protocols. After putting TLDs in the Alderson Radiation Therapy Phantom, we exposed the phantom under common scanning protocols of three dental X-ray devices, namely CBCT, dental panoramic machine and intraoral round cone device. Then effective doses were calculated using the measured absorbed doses of organs and tissues. Tissue weighting factors recommended by the ICRP were adopted in the calculation. Effective doses under common scanning protocols of three Dental X-ray devices were obtained. The effective dose of dental CT was 0.20 mSv, and that of dental panoramic machine and intraoral radiography were 0.013 and 0.0050 mSv, respectively. The tissue absorbed doses of dental CT scan were 0.63 mGy of brain, 7.7 mGy of salivary glands, 8.7 mGy of thyroid and 4.0 mGy of the lens of the eye. The tissue absorbed doses from dental panoramic machine are 0.62 mGy of salivary glands and 0.25 mGy of thyroid. And finally the tissue absorbed dose of intraoral radiography was 0.80 mGy of salivary gland. Among the three dental X-ray devices studied, dental CBCT scan can cause much higher effective dose than the other two. Brain, salivary glands, thyroid and the lens of the eye are tissues receiving relatively higher absorbed doses.

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24

Nikonova, T. V. "NPH insulin. Effective mixing - effective dose regimen." Problems of Endocrinology 57, no. 4 (August 15, 2011): 56–60. http://dx.doi.org/10.14341/probl201157456-60.

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Insulin therapy, a corner stone of the treatment of diabetes mellitus, both type 1 and type 2, has undergone substantial modification since the manufacture of the first insulin preparations 90 years ago up to the present time. Human insulins, such as neutral protamin Hagedorn (NPH) insulins, remain a major instrument of therapy of diabetes mellitus despite rapid developments in this field of knowledge and the wide availability of insulin analogs. When prescribing these preparations, the attending physician should be absolutely confident that the patient has a minimum background of knowledge and skills indispensable for efficacious and safe treatment. Such skills include the habit of mixing NPH insulin suspensions by 20-fold turning the vial or the cartridge upside-down or rolling them between the palms in order to ensure the uniform distribution of insulin in the suspension and its accurate dosing. The manufactures place from one to three glass or metal bullets inside the vials and cartridges for more homogeneous mixing of their contents. P. Kaiser et al. undertook the study of several pharmaceutical forms of NPH insulin manufactured by different companies to estimate the accuracy of dosing (variability of the insulin dose depending on the number of turns of the cartridge for homogeneous mixing). The insulin concentration in a single dose was measured by high-performance liquid chromatography. Marked variability of the insulin dose after less than ten (three or six) turns was documented for all cartridges with the exception of Insuman Basal insulin cartridges ("Sanofi"). It may be expected that the accuracy of dosing will not deteriorate using these cartridges owing to the presence in them of three heavy metal bullets even if the patient does not perform the necessary mixing procedure for one or another reason.

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25

Farhan, Ahmed. "RADON GAS AND EFFECTIVE DOSE IN GROUNDWATER IN ABU- JIR VILLAGE IN ANBAR, WESTERN IRAQ." Iraqi Geological Journal 53, no. 2C (September 30, 2020): 26–33. http://dx.doi.org/10.46717/igj.53.2c.3rs-2020.09.03.

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In the present study, radon gas concentration in the shallow groundwater samples of the Abu-Jir region in Anbar governorate was measured by using Rad-7 detector. The highest radon gas level in the samples is up to 9.3 Bq/L, while the lowest level is 2.1 Bq/L, with an average of 6.44±1.8 Bq/L. The annual effective dose is varied from 33.945 μSv/y to 7.66 μSv/y, with an average of 0.145±0.06 μSv/y. Consequently, the radon level in the groundwater studied is lower than the standard recommended value (11 Bq/L) reported by the United States Environmental Protection Agency (USEPA). The potential source of radon is uranium-rich hydrocarbons that are leakage to the surface along the Abu-Jir Fault. This research did not indicate any risk that radon gas concentrations may occur in the groundwater in the study area, and despite this, the research strongly recommends to propose a new Iraqi specification that defines the permissible level of radon gas concentrations in the groundwater and air to avoid harm to human health and will be an Iraqi standard that will be applied for the first time in Iraq.

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26

Gutiérrez-Barrios, Alejandro, Hugo Camacho-Galán, Francisco Medina-Camacho, Dolores Cañadas-Pruaño, Antonio Jimenez-Moreno, German Calle-Perez, and Rafael Vázquez-García. "Effective Reduction of Radiation Exposure during Cardiac Catheterization." Texas Heart Institute Journal 46, no. 3 (June 1, 2019): 167–71. http://dx.doi.org/10.14503/thij-17-6548.

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Exposure to ionizing radiation during cardiac catheterization can have harmful consequences for patients and for the medical staff involved in the procedures. Minimizing radiation doses during the procedures is essential. We investigated whether fine-tuning the radiation protocol reduces radiation doses in the cardiac catheterization laboratory. In January 2016, we implemented a new protocol with reduced radiation doses in the Hospital de Jerez catheterization laboratory. We analyzed 170 consecutive coronary interventional procedures (85 of which were performed after the new protocol was implemented) and the personal dosimeters of the interventional cardiologists who performed the procedures. Overall, the low-radiation protocol reduced air kerma (dose of radiation) by 44.9% (95% CI, 18.4%–70.8%; P=0.001). The dose-area product decreased by 61% (95% CI, 30.2%–90.1%; P <0.001) during percutaneous coronary interventions. We also found that the annual deep (79%, P=0.026) and shallow (62.2%, P=0.035) radiation doses to which primary operators were exposed decreased significantly under the low-radiation protocol. These dose reductions were achieved without increasing the volume of contrast media, fluoroscopy time, or rates of procedural complications, and without reducing the productivity of the laboratory. Optimizing the radiation safety protocol effectively reduced radiation exposure in patients and operators during cardiac catheterization procedures.

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27

Muchão, Fabio Pereira, Juliana Miguita e. Souza, Hélida Conceição Cavalcante Torres, Isabella Batista De Lalibera, Andréa Vieira de Souza, Joaquim Carlos Rodrigues, Claudio Schvartsman, and Luiz Vicente Ribeiro Ferreira da Silva Filho. "Albuterol via metered-dose inhaler in children: Lower doses are effective, and higher doses are safe." Pediatric Pulmonology 51, no. 11 (May 12, 2016): 1122–30. http://dx.doi.org/10.1002/ppul.23469.

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28

Gaul, Charly, and Alain Eschalier. "Dose Can Help to Achieve Effective Pain Relief for Acute Mild to Moderate Pain with Over-the-Counter Paracetamol." Open Pain Journal 11, no. 1 (September 28, 2018): 12–20. http://dx.doi.org/10.2174/1876386301811010012.

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Background:Paracetamol (acetaminophen) is one of the most widely used Over-The-Counter (OTC) analgesics for the self-treatment of mild to moderate acute pain. Different dosages are used in different countries and, in some of them, a large proportion of adults are using low doses (325 mg to 500 mg).Objectives:The objective of the study was to review information from published research studies to answer the question: is there a dose-dependent analgesic effect of paracetamol in the treatment of mild to moderate acute pain?Methods:A detailed assessment of available systematic reviews, meta-analyses and single randomised trials was undertaken based on an electronic literature search focusing on studies comparing higher and lower doses of paracetamol in the management of mild to moderate acute pain.Results:Reviews and comparative trials generally showed greater efficacy with higher dose paracetamol (1000 mg) than with lower doses (500 mg or 650 mg) in achieving clinically significant pain relief with comparable tolerability in different types of pain.ConclusionsThe nature and intensity of the pain are two key elements of the therapeutic choice.Higher dose immediate-release paracetamol (1000 mg), used for a short duration of time (4-5 days) and adhering to recommendations within the label for risk groups, delivers safe and more effective analgesia than lower doses for adults with mild to moderate acute pain.Strengths and Limitations of this Study:• Paracetamol is one of the most widely used OTC analgesics for the self- treatment of mild to moderate acute pain and this study aims to explore the practical question of whether the use of low doses, which is common in some countries, provides suboptimal pain relief.• This review provides an overview of previous studies focusing on comparing the analgesic efficacy of different doses of paracetamol rather than comparing the effect of different OTC analgesics.• This review details a narrative assessment of available systematic reviews, meta-analysis and randomised trials but does not offer a quantitative analysis of pain relief achieved with different doses of paracetamol.• The review does not provide an overview of studies focusing on different forms of paracetamol.• The focus for this review is immediate release paracetamol. Combined and slow release paracetamol formulations were not considered of relevance. The latter are in the process of being suspended across the European Union due to safety concerns with overdosing [1].

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29

Kawasaki, Toshio, Masami Sakakubo, Kanako Ito, and Ai Kitagawa. "ESTIMATION OF ORGAN DOSES AND EFFECTIVE DOSES BASED ON IN-PHANTOM DOSIMETRY FOR PAEDIATRIC DIAGNOSTIC CARDIAC CATHETERISATION." Radiation Protection Dosimetry 185, no. 2 (January 9, 2019): 215–21. http://dx.doi.org/10.1093/rpd/ncy298.

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Abstract The present study evaluated the organ doses, effective doses and conversion factors from the dose–area product to effective dose in pediatric diagnostic cardiac catheterization performed by in-phantom dosimetry and Monte Carlo simulation. The organ and effective doses in 5-y-olds during diagnostic cardiac catheterizations were evaluated using radiophotoluminescence glass dosemeters implanted into a pediatric anthropomorphic phantom and PCXMC software. The mean effective dose was 3.8 mSv (range: 1.8–7.5 mSv). The conversion factors from the dose–area product to effective dose were 0.9 and 1.6 mSv (Gy cm2)−1 for posteroanterior and lateral fluoroscopy, respectively, and 0.9 and 1.5 mSv (Gy cm2)−1 for posteroanterior and lateral cineangiography, respectively. Effective doses evaluated using the pediatric dosimetry system agreed with those obtained using PCXMC software within 12%. The dose data and conversion factors evaluated may guide the estimation of exposure doses in children undergoing diagnostic cardiac catheterization.

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30

Cohen, Jay S. "Why Aren't Lower, Effective, OTC Doses Available Earlier by Prescription?" Annals of Pharmacotherapy 37, no. 1 (January 2003): 136–42. http://dx.doi.org/10.1345/aph.1a487.

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BACKGROUND Many popular oral over-the-counter (OTC) drugs were originally available only by prescription, but not at the low doses contained in their OTC counterparts. Yet, if OTC doses are effective for treating mild symptoms, why weren't these low, often safer doses made available at least by prescription when the drugs were first approved? OBJECTIVE To examine issues surrounding the delayed approval of OTC doses by the Food and Drug Administration (FDA). METHODS Information reviewed included package inserts, data obtained from manufacturers, and articles published in MEDLINE (1966 to December 2001). Medications examined included presently available and potentially approved OTC antiinflammatory, gastrointestinal, and antihistamine drugs. RESULTS Considerable data demonstrate the effectiveness of ibuprofen, naproxen, ranitidine, famotidine, nizatidine, diphenhydramine, and clemastine at OTC doses. Published studies also show the effectiveness of celecoxib, omeprazole, and fexofenadine at doses 33–50% lower than currently recommended for prescription use. CONCLUSIONS OTC doses are effective for many patients with mild symptoms and for some with serious symptoms. However, OTC-like doses are usually not offered when drugs are approved for prescription use because new drugs are usually studied in patients with serious conditions requiring higher doses; manufacturers and the FDA seem to prefer a middle-dose approach; >75% of subjects in premarketing dose studies are male; and averaging the responses of study subjects may obscure a wide range of interindividual variation in drug response. Simplistic dosage guidelines make therapeutic decisions easier. Because dose-related adverse effects frequently diminish quality-of-life and reduce adherence, the early availability of OTC-like doses, at least by prescription, would allow healthcare professionals greater flexibility in matching medication doses to patients’ widely differing needs.

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31

Shrimpton, Paul C., and Barry F. Wall. "Effective Dose and Dose-Length Product in CT." Radiology 250, no. 2 (February 2009): 604–5. http://dx.doi.org/10.1148/radiol.2502081340.

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32

Clark, M. J., J.-L. Chartier, B. R. L. Siebert, and M. Zankl. "Comparison of Personal Dose Equivalent and Effective Dose." Radiation Protection Dosimetry 78, no. 2 (July 2, 1998): 91–99. http://dx.doi.org/10.1093/oxfordjournals.rpd.a032349.

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33

Sutherland, SR, and DR Lindsay. "Ovariectomized does do not require progesterone priming for oestrous behaviour." Reproduction, Fertility and Development 3, no. 6 (1991): 679. http://dx.doi.org/10.1071/rd9910679.

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Ewes need to be primed with progesterone in order to achieve sensitivity to oestrogen. This relationship was examined in goats. In experiment 1 the median effective dose of oestradiol benzoate (ODB) required to induce oestrus during the breeding season (July) in progesterone-primed ovariectomized does was 15 micrograms, a dose similar to that reported to be required in ewes. In experiment 2 (initiated in March) the requirement for progesterone priming before injection of ODB to induce oestrus after a period without any exogenous hormone treatment, was compared in goats and sheep. Without progesterone priming, ovariectomized does were sensitive to doses of ODB between 20 and 80 micrograms, whereas ewes were not. This indicates that, unlike sheep, goats may not require progesterone priming in order to exhibit oestrus at the beginning of the breeding season. After being primed with progesterone, ewes were more sensitive to ODB than were does. In primed ewes the median effective dose of ODB was 12 micrograms whereas in does it was 27 micrograms. These differences may be due to a seasonal effect on oestrous behaviour or differences in sensitivity to oestrogen between the species.

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34

Kicken, P. J. H., M. Zankl, and G. J. Kemerink. "Patient Dosimetry in Arteriography of the Lower Limbs. Part II: Dose Conversion Coefficients, Organ Doses and Effective Dose." Radiation Protection Dosimetry 81, no. 1 (January 1, 1999): 37–45. http://dx.doi.org/10.1093/oxfordjournals.rpd.a032568.

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IWAI, Satoshi. "Current Issues on Effective Dose and Effective Dose Equivalent Used in Radiological Protection." Japanese Journal of Health Physics 37, no. 3 (2002): 245–48. http://dx.doi.org/10.5453/jhps.37.245.

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Xu, X. George. "THE EFFECTIVE DOSE EQUIVALENT AND EFFECTIVE DOSE FOR HOT PARTICLES ON THE SKIN." Health Physics 89, no. 1 (July 2005): 53–70. http://dx.doi.org/10.1097/01.hp.0000156961.73455.0e.

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37

Sharma, B. Arunkumar, Th Tomcha Singh, L. Jaichand Singh, Y. Indibor Singh, and Y. Sobita Devi. "Biological effective doses in the intracavitary high dose rate brachytherapy of cervical cancer." Journal of Contemporary Brachytherapy 4 (2011): 188–92. http://dx.doi.org/10.5114/jcb.2011.26469.

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38

Suliman, I. I., H. M. Khamis, T. H. Ombada, K. Alzimami, M. Alkhorayef, and A. Sulieman. "Radiation exposure during paediatric CT in Sudan: CT dose, organ and effective doses." Radiation Protection Dosimetry 167, no. 4 (November 4, 2014): 513–18. http://dx.doi.org/10.1093/rpd/ncu321.

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39

Uselmann, Adam J., and Bruce R. Thomadsen. "On effective dose for radiotherapy based on doses to nontarget organs and tissues." Medical Physics 42, no. 2 (January 29, 2015): 977–82. http://dx.doi.org/10.1118/1.4906190.

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40

Pelliccioni, Maurizio, Marco Silari, and Luisa Ulrici. "Effective dose and organ doses due to gas bremsstrahlung from electron storage rings." Nuclear Instruments and Methods in Physics Research Section A: Accelerators, Spectrometers, Detectors and Associated Equipment 457, no. 3 (January 2001): 438–46. http://dx.doi.org/10.1016/s0168-9002(00)00780-4.

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41

Leborgne, Felix, Jack F. Fowler, Jose H. Leborgne, Eduardo Zubizarreta, and Rick Chappell. "Biologically effective doses in medium dose rate brachytherapy of cancer of the cervix." Radiation Oncology Investigations 5, no. 6 (1997): 289–99. http://dx.doi.org/10.1002/(sici)1520-6823(1997)5:6<289::aid-roi5>3.0.co;2-u.

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42

Anabah, T., A. Olufolabi, J. Boyd, and R. George. "Low-dose spinal anaesthesia provides effective labour analgesia and does not limit ambulation." Southern African Journal of Anaesthesia and Analgesia 21, no. 1 (January 2, 2015): 19–22. http://dx.doi.org/10.1080/22201181.2015.1013322.

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43

BUCKLE, A. H., and J. LEWIS. "Biologically effective dose using reciprocal repair for varying fraction doses and fraction intervals." British Journal of Radiology 81, no. 962 (February 2008): 137–42. http://dx.doi.org/10.1259/bjr/14479917.

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44

Osei, Ernest K., and Johnson Darko. "A Survey of Organ Equivalent and Effective Doses from Diagnostic Radiology Procedures." ISRN Radiology 2013 (September 6, 2013): 1–9. http://dx.doi.org/10.5402/2013/204346.

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The quantification of radiation risks associated with radiological examinations has been a subject of interest with the increased use of X-rays. Effective dose, which is a risk-weighted measure of radiation to organs in the body associated with radiological examination, is considered a good indicator of radiological risk. We have therefore investigated patient effective doses from radiological examinations. Organ and effective doses were estimated for 94 patients who underwent computed tomography examinations and for 338 patients who had conventional radiography examinations. The OrgDose (version 2) program was used for the estimation of effective doses. The tube potential ranges: 57 kVp to 138 kVp depending on the examination and patient size. The entrance surface doses have a wide range even for the same examination: 0.44–10.31 mGy (abdomen) and 0.66–16.08 mGy (lumbar spine) and the corresponding effective dose ranges 0.025–0.77 mSv and 0.025–0.95 mSv respectively. Effective dose for adult abdomen-pelvic CT examinations ranges 5.4–19.8 mSv with a mean of 13.6 mSv and for pediatrics ranges 2.1–5.5 mSv with a mean of 2.7 mSv. The mean effective dose for adult chest and head CT examinations are 7.9 and 1.8 mSv respectively and for pediatrics are 1.7 and 1.1 mSv.

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45

Plante, Elena, Heidi M. Mettler, Alexander Tucci, and Rebecca Vance. "Maximizing Treatment Efficiency in Developmental Language Disorder: Positive Effects in Half the Time." American Journal of Speech-Language Pathology 28, no. 3 (August 9, 2019): 1233–47. http://dx.doi.org/10.1044/2019_ajslp-18-0285.

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Purpose When a behavioral treatment is generally efficacious, the central research questions shift to optimized dose delivery. In this study, we determine whether a validated treatment method can be made more effective or efficient by increasing the dose density employed. Method Twenty children were treated with Enhanced Conversational Recast methods to treat morphological errors. Half received 24 doses per session within a half hour (approximately 1 dose/1.25 min), and the other received the same number of doses within 15 min (approximately 1 dose/38 s). Generalization of morpheme use was probed throughout treatment and at a 6-week follow-up. Spontaneous use of treated morphemes was also tracked. Results Although the treatment was effective overall, there were no significant differences between treatment conditions on any of the outcome measures. Follow-up performance correlated significantly with performance at the end of the treatment period. Conclusion Minimal between-groups differences suggest that performance does not suffer when dose rates are compressed into half the time during treatment, making the high-density dose delivery method a more efficient delivery method. This could make time available within a treatment session to address other goals or allow for more classroom instructional time for the child. Supplemental Material https://doi.org/10.23641/asha.8968559

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Trifilio, S., M. Tallman, S. Singhal, L. Gordon, A. Evens, and J. Mehta. "Low-Dose Recombinante Urate Oxidase (Rasburicase) Is Effective in Hyperuricemia." Blood 104, no. 11 (November 16, 2004): 3312. http://dx.doi.org/10.1182/blood.v104.11.3312.3312.

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Abstract Hyperuricemia is a feature of tumor lysis syndrome (TLS), and is treated with hydration, urine alkalinization, and allopurinol. Allopurinol inhibits the conversion of hypoxanthine to xanthine, and xanthine to uric acid (UA) by inhibiting xanthine oxidase. It has no direct effect on existing UA. Rasburicase lowers UA rapidly to very low levels at the labeled dose of 0.15–0.2 mg/kg daily for 5 days by converting UA to allantoin which is rapidly excreted. Despite this dramatic effect on UA, rasburicase has not been shown to have any beneficial impact on survival. We administered 0.2 mg/kg ideal body weight rasburicase to an obese hyperuricemic patient (actual 120 kg, ideal 60 kg). Serum UA declined from 11 mg/dL to 1.4 mg/dL in 3 h and 0.4 mg/dL in 11 h. The serum UA level remained low for several days and a second dose was not needed. After seeing this dramatic and sustained response, low rasburicase doses were used in patients with malignant diseases with close monitoring of biochemical parameters. No dose level was systematically explored and the doses used ranged from 1.5 mg to 12 mg. This analysis is a retrospective review of all patients who received low-dose rasburicase. 23 adults (39–78 y) with cancer and hyperuricemia received a single low dose of rasburicase at 12 mg (n=1; index case), 6 mg (n=2), 4.5 mg (n=1), 3 mg (n=18), and 1.5 mg (n=1). 6 patients received 1 and 1 patient received 2 more doses of 3 mg each. Allopurinol and other supportive therapy including hydration were administered. UA levels (baseline 7.4–19 mg/dL, median 11.6) declined by 4–96% (median 40%) within 24 h of rasburicase administration (Fig 1; the dashed lines show patients receiving more than 1 rasburicase dose). Figure Figure The decline was 31–68% (median 46%) amongst the 12 patients receiving a single 3 mg dose (Fig 2). Figure Figure The baseline serum creatinine was 0.9–8.4 mg/dL (median 2.4), and the minimum and maximum values in the week following rasburicase were 0.7–5.8 (median 1.8) and 1.0–8.8 (median 2.6) respectively. No clinically significant renal dysfunction developed in any patient. The total rasburicase dose administered, 3–12 mg (median 3 mg), was 3–12% (median 5%) of the recommended dose. Based on the Red Book rasburicase cost of $387 for a 1.5 mg vial, the amount of money saved ranged from $11,000 to $29,000 per patient; for a total saving of between $373,000 and $507,000. While this was not a systematic dose-reduction study and patients were treated by multiple physicians and pharmacists on clinical grounds, the data suggest that rasburicase is effective at a fraction of the recommended dose. While a formal investigation of low doses is warranted, we recommend using rasburicase at a standard dose of 3 mg in hyperuricemic patients, checking UA levels frequently, and repeating rasburicase administration if needed. This approach has the potential for substantial cost saving while providing appropriate therapy to lower UA.

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47

Kendall, G. M., J. W. Stather, and A. W. Phipps. "Effectance, committed effective dose equivalent and annual limits on intake: what are the changes?" Journal of Radiological Protection 10, no. 2 (June 1, 1990): 83–93. http://dx.doi.org/10.1088/0952-4746/10/2/001.

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Nicholls, H. "Low-dose HRT is effective." Trends in Endocrinology and Metabolism 12, no. 6 (August 1, 2001): 241. http://dx.doi.org/10.1016/s1043-2760(01)00448-9.

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49

Heron, John C. Le. "Remaining problems with effective dose?" Physics in Medicine and Biology 37, no. 4 (April 1, 1992): 1012–15. http://dx.doi.org/10.1088/0031-9155/37/4/016.

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50

Falcone, A., JW Darnowski, RM Ruprecht, SH Chu, I. Brunetti, and P. Calabresi. "Different effect of benzylacyclouridine on the toxic and therapeutic effects of azidothymidine in mice." Blood 76, no. 11 (December 1, 1990): 2216–21. http://dx.doi.org/10.1182/blood.v76.11.2216.2216.

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Abstract It has been reported that in vitro uridine (Urd) can reverse azidothymidine (AZT) cytotoxicity without decreasing anti-human immunodeficiency virus (HIV) activity. Our studies in mice have shown that daily oral doses of benzylacyclouridine (BAU), an inhibitor of Urd breakdown, also reduces AZT hematologic toxicity, presumably by elevating the plasma concentration of Urd. We now extend these murine studies and report the effect of various doses of exogenous Urd, various doses of BAU, or the combination of BAU and Urd, administered daily, on AZT-induced toxicity. In mice receiving concomitant AZT, daily doses of Urd of 1,000 to 2,000 mg/kg increase peripheral reticulocytes and slightly reduce AZT-induced hematologic toxicity. However, the range of effective doses is narrow, and higher doses of Urd (greater than 3,000 mg/kg/d) significantly enhance hematologic toxicity. At its most effective dose, (2,000 mg/kg/d), Urd produces 28% mortality. In contrast, BAU doses up to 300 mg/kg/d reduced AZT-related hematologic toxicity in a dose-dependent manner without mortality. Higher daily doses of BAU and the combination of BAU with low doses of Urd were not more effective. Studies conducted in mice infected with the Rauscher murine leukemia virus (RLV) indicate that BAU does not impair the antiretroviral effect of AZT when administered at doses that reduce AZT-induced anemia and leukopenia. These findings may be significant for the treatment of patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex.

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