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Background: In the Computer Tomography imaging, examinations for the diagnosis of lesions of the upper abdomen currently use water-soluble, iodinated, non-ionic contrast agents with low molecular weight. One possibility to reduce the time of the examination and X-ray exposure is to increase the injection rate. However, higher injections rates lead to increased hypersensitivity reactions and extravasation rates. Furthermore, cardiac pump function does not always allow for the transportation of such a large volume within one heartbeat. With a contrast agent of higher iodine concentration, the injection rate may be reduced without decreasing the iodine delivery rate while reducing the volume load of the heart.
Aim: to compare the performance and image quality of two injection protocols of contrast medium for multiphasic CT imaging of malignant hepatic lesions; one using Imeron 300 at an injection rate of 5 ml/ sec and the second using Imeron 400 at an injection rate of 3,7 ml/ sec, for multiphasic CT imaging of malignant hepatic lesions, in order to optimise the iodine concentration and injection rate of the contrast agent Imeron in the Multislice Spiral-CT of the upper abdomen.
Materials and methods: the current prospective, single centre, double-blinded, randomised and interindividual comparison study included 50 patients (29 males and 21 females) with a mean age of 63,3 years. Patients were randomised to one of the two injection protocols. Image evaluation included qualitative assessment (technical quality, presence of artefacts and overall contrast quality) and quantitative assessment (measuring the difference in HU between the lesion and the surrounding hepatic tissue). The difference between both protocols was tested for statistical significance using the Wilcoxon-Mann-Whitney test and the Two-Sample t-test.
Results: there was no statistically significant difference between both protocols regarding the technical quality of images, both in the AP (p = 0,46) and in the venous phase (p = 0,48). Additionally, no statistically significant difference was found regarding the presence of artefacts related to the contrast medium, both in the AP (p = 0,46) and in the venous phase (p = 0,46), as well as regarding the overall contrast quality of images both in the AP (p = 0,50) and in the venous phase (p = 0,48). Quantitative assessment showed no statistically significant difference regarding the difference in HU measurement between the hepatic lesion and the surrounding hepatic tissue, both in the AP (p = 0,36) and in the venous phase (p = 0,92).
Conclusion: in the multiphasic CT imaging of the liver, reducing the injection rate of the contrast medium Imeron from 5 ml/ sec to 3,7 ml/ sec while increasing the iodine strength of the agent from 300 to 400 mg/ml, respectively, and thus keeping the iodine injection flow rate constant, produces similar signal intensities and results in similar technical, image and overall contrast qualities..
Keywords: Contrast-medium, injection rate, iodine concentration, hepatic malignancy, multiphasic CT
Animal agriculture is responsible for at least 16.5% of global yearly CO2e (carbon dioxide equivalent) emissions (Twine 2021: 3) and thus partially causal for the corresponding climate change, and its disastrous consequences for millions (Romanello et al. 2023: 1-2). At the same time, animal agriculture restricts and damages the bodily autonomy of animals regularly (Hampton et al. 2021: 28) which could be unethical depending on the underlying ethical theory. The policy option of veganism by law is, nevertheless, rarely considered. The definitions of veganism range from an individual ethic of the abstention from consuming animal products to a political philosophy calling for the abolition of animal agriculture (Mancilla 2016: 1-3). Because veganism through the cessation of animal agriculture could be the policy solution to the aforementioned issues concerning the rights of present and future generations affected by climate change and the rights of animals, I explore arguments for and against the implementation of veganism by law.
Although a veganized agriculture would provide 52% of the required emission reductions for the 2°C target of the Paris climate accord (Eisen and Brown 2022: 6), and could allow for greater animal welfare, current policies of many governments promote the opposite. For example, 82% of the subsidies of the European Union’s Common Agricultural Policy are routed towards the production of animal products and animal feed (Kortleve et al. 2024: 1-2). Moreover, for American adults the U.S. Department of Agriculture and the U.S. Department of Health and Human Services (2020: 96) promotes the consumption of 720ml of cow milk or other dairy per day and recommends a protein intake through meat and eggs between 652 g and 936 g per week.
In this bachelor thesis I outline the current state of animal agriculture, its emissions and the associated harm towards animals and humans. The empirical findings are dissected ethically with a consequentialist approach and a deontological approach. The ethical analysis concerning the decisions of individuals is then converted into a political philosophy regarding the duties of states towards present and future generations and animals including corresponding policy implications.
The normative argument is mainly based on the example of industrialized animal agricul-ture, the area where most of the interaction between animals and humans occurs. Nevertheless, other sectors where animals are used for human consumption or entertainment are discussed in less detail, in order to analyze the arguments for veganism by law.
In short, using the recommended political argument structure of Abel et al. (2021: 6) the following hypothesis acts as the basis for the political and philosophical discussion and is revised where necessary:
Moral claims: The state should protect present and future generations and animal rights.
Empirical claims: Animal agriculture is a major contributor to climate change and its corresponding effects and violates the wellbeing of animals regularly.
Conclusion: The state should enforce veganism by law.