title: Clinical evaluation of a radio-protective cream for the hands of the pediatric interventional cardiologist.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effectiveness of UltraBLOX™ radiation attenuating hand cream during lengthy cardiac catheterization procedures in children.
  
  
  BACKGROUND
  The hands of interventional cardiologists receive high doses of radiation due to their proximity to the X-ray beam. Radiation attenuating gloves have about a 26% attenuation rate, but reduce dexterity and tactile sensation. The UltraBLOX™ cream is a new FDA-approved X-ray attenuating cream that can be applied to the operator's hands for radio-protection.
  
  
  METHODS
  Two nanoDot™ dosimeters were secured side by side on the dorsum of the operator's (n = 2) left hand close to the wrist. One dosimeter and the rest of the hand were covered with 0.2 mm layer of the cream. The other dosimeter was unshielded. Procedures were performed using 110 kVp fluoroscopy at 15 pulses/sec. The measurements were categorized into four groups dependent on the duration of the procedure. The patients in all four groups were well matched for age and size.
  
  
  RESULTS
  Procedural and cumulative hand radiation doses were higher with longer procedural duration. The overall % attenuation by the cream was 39.7% (28.6-51.5) and was unaffected by the length of the procedure (median: 40.9% at 30 min and 41.4% at 180 min; P = 0.66) or the dose of radiation. The kappa statistic for interobserver agreement for good tactile sensitivity was 0.82.
  
  
  CONCLUSIONS
  UltraBLOX™ cream provides a new option for radio-protection for the hands of interventional cardiologists without impairing tactile sensitivity. There was no decrease in attenuation up to 180 min. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.
authors.forename: Saradha
authors.initials: S
authors.lastname: Subramanian
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.
authors.forename: B Rush
authors.initials: BR
authors.lastname: Waller
authors.forename: Natasha
authors.initials: N
authors.lastname: Winders
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.
authors.forename: Lindsey E
authors.initials: LE
authors.lastname: Bird
authors.affiliation: Department of Radiology, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.
authors.forename: Vijaykumar
authors.initials: V
authors.lastname: Agrawal
authors.affiliation: Department of Biostatistics, Harvard Medical School, Boston, Massachusetts.
authors.forename: David
authors.initials: D
authors.lastname: Zurakowski
authors.affiliation: Toshiba America Medical Systems, Tustin, California.
authors.forename: Andrew
authors.initials: A
authors.lastname: Kuhls-Gilcrist
authors.affiliation: BLOXR, Salt Lake City, Utah.
authors.forename: Ashok
authors.initials: A
authors.lastname: Khandkar
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.
authors.forename: Shyam K
authors.initials: SK
authors.lastname: Sathanandam
mesh_terms: D000293:Adolescent; D006328:Cardiac Catheterization / Q000379:methods*; D000072096:Cardiologists; D002648:Child; D002675:Child, Preschool; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects*; D005500:Follow-Up Studies; D006225:Hand / Q000528:radiation effects; D006801:Humans; D007223:Infant; D008297:Male; D016273:Occupational Exposure / Q000517:prevention & control; D011446:Prospective Studies; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000517:prevention & control*; D011835:Radiation Protection / Q000295:instrumentation*; D015641:Radiography, Interventional / Q000009:adverse effects*; D063465:Skin Cream
keywords: dosimeter; radio-protection; ultrablox