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1.
Regul Toxicol Pharmacol ; 128: 105093, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34864125

RESUMO

The European Commission's Green Deal is a major policy initiative aiming to achieve a climate-neutral, zero-pollution, sustainable, circular and inclusive economy, driving both the New Industrial Strategy for Europe and the Chemicals Strategy for Sustainability. Innovative materials can help to reach these policy goals, but they need to be safe and sustainable themselves. Thus, one aim is to shift the development of chemicals to Safe- and Sustainable-by-Design, and define a new systems approach and criteria for sustainability to achieve this. An online workshop was organised in September 2020 by the Joint Research Centre and the Directorate-General Research and Innovation of the European Commission, with participants from academia, non-governmental organisations, industry and regulatory bodies. The aims were to introduce the concept of Safe- and Sustainable-by-Design, to identify industrial and regulatory challenges in achieving safer and more sustainable Smart Nanomaterials as an example of innovative materials, and to deliver recommendations for directions and actions necessary to meet these challenges. The following needs were identified: (i) an agreed terminology, (ii) a common understanding of the principles of Safe- and Sustainable-by-Design, iii) criteria, assessment tools and incentives to achieve a transition from Safe-by-Design to Safe- and Sustainable-by-Design, and (iv) preparedness of regulators and legislation for innovative chemicals/nanomaterials. This paper presents the authors' view on the state of the art as well as the needs for future activities, based on discussions at the workshop and further considerations. The case of Smart Nanomaterials is used to illustrate the Safe- and Sustainable-by-Design concept and challenges for its implementation. Most of the considerations can be extended to other advanced materials and to chemicals and products in general.


Assuntos
Química/normas , Meio Ambiente , Regulamentação Governamental , Nanoestruturas/química , Nanotecnologia/organização & administração , Desenvolvimento Sustentável/tendências , União Europeia , Humanos , Nanotecnologia/normas , Políticas
2.
Radiol Med ; 124(4): 315-322, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30554376

RESUMO

AIMS: To evaluate the use of radiotherapy (RT) for oligometastatic cancer (OMC) among radiation oncologists in Lombardy, Italy. METHODS AND STUDY DESIGN: A survey with 12 items regarding data of 2016 was sent to all 34 Lombardy RT centers. The survey included six general items and six specific items regarding patient/disease/treatment characteristics. RESULTS: Thirteen centers answered the survey (38%). All centers responded to general items and 12 centers submitted patient/disease/treatment data. General items The majority of centers (8/13) consider OMC if metastases number is less than 5. The most commonly prescribed dose/fraction is 5-10 Gy (8/13) using schedules of 3-5 fractions (11/13). Patient data items A total of 15.681 patients were treated in 2016 with external beam RT in 12 responding centers, and 1.087 patients were treated for OMC (7%). Primary tumor included lung, prostate, breast, colorectal and other malignancies in 33%, 21%, 12%, 9% and 25% of all OMC patients, respectively. Brain, lymph node, lung, bone, liver and others were the most common treated sites (24%, 24%, 22%, 17%, 8% and 5%, respectively). One and more than one metastasis were treated in 75 and 25% of patients, respectively. The vast majority of patients (95%) were treated with image-guided intensity-modulated RT or stereotactic RT. CONCLUSIONS: Seven percent of all RT patients in Lombardy are treated for OMC. Extreme hypofractionation and high-precision RT are commonly employed. The initiative of multicenter and multidisciplinary collaboration has been undertaken in order to prepare the platform for prospective and/or observational studies in OMC.


Assuntos
Metástase Neoplásica/radioterapia , Padrões de Prática Médica/estatística & dados numéricos , Radio-Oncologistas/estatística & dados numéricos , Fracionamento da Dose de Radiação , Feminino , Humanos , Itália , Masculino , Doses de Radiação , Inquéritos e Questionários
3.
Regul Toxicol Pharmacol ; 73(1): 463-76, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26169479

RESUMO

Nanotechnology has the potential to innovate the agricultural, feed and food sectors (hereinafter referred to as agri/feed/food). Applications that are marketed already include nano-encapsulated agrochemicals or nutrients, antimicrobial nanoparticles and active and intelligent food packaging. Many nano-enabled products are currently under research and development, and may enter the market in the near future. As for any other regulated product, applicants applying for market approval have to demonstrate the safe use of such new products without posing undue safety risks to the consumer and the environment. Several countries all over the world have been active in examining the appropriateness of their regulatory frameworks for dealing with nanotechnologies. As a consequence of this, different approaches have been taken in regulating nano-based products in agri/feed/food. The EU, along with Switzerland, were identified to be the only world region where nano-specific provisions have been incorporated in existing legislation, while in other regions nanomaterials are regulated more implicitly by mainly building on guidance for industry. This paper presents an overview and discusses the state of the art of different regulatory measures for nanomaterials in agri/feed/food, including legislation and guidance for safety assessment in EU and non-EU countries.


Assuntos
Qualidade de Produtos para o Consumidor/legislação & jurisprudência , Alimentos/normas , Legislação sobre Alimentos/normas , Nanoestruturas/normas , Nanotecnologia/legislação & jurisprudência , Setor Privado/legislação & jurisprudência , Agricultura/legislação & jurisprudência , Agroquímicos/normas , Animais , Anti-Infecciosos/normas , União Europeia , Embalagem de Alimentos/legislação & jurisprudência , Humanos , Medição de Risco , Segurança/legislação & jurisprudência
4.
Part Fibre Toxicol ; 11: 9, 2014 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-24521051

RESUMO

BACKGROUND: To assess the risk of all nanomaterials (NMs) on a case-by-case basis is challenging in terms of financial, ethical and time resources. Instead a more intelligent approach to knowledge gain and risk assessment is required. METHODS: A framework of future research priorities was developed from the accorded opinion of experts covering all major stake holder groups (government, industry, academia, funders and NGOs). It recognises and stresses the major topics of physicochemical characterisation, exposure identification, hazard identification and modelling approaches as key components of the current and future risk assessment of NMs. RESULTS: The framework for future research has been developed from the opinions of over 80 stakeholders, that describes the research priorities for effective development of an intelligent testing strategy (ITS) to allow risk evaluation of NMs. In this context, an ITS is a process that allows the risks of NMs to be assessed accurately, effectively and efficiently, thereby reducing the need to test NMs on a case-by-case basis.For each of the major topics of physicochemical characterisation, exposure identification, hazard identification and modelling, key-priority research areas are described via a series of stepping stones, or hexagon diagrams structured into a time perspective. Importantly, this framework is flexible, allowing individual stakeholders to identify where their own activities and expertise are positioned within the prioritisation pathway and furthermore to identify how they can effectively contribute and structure their work accordingly. In other words, the prioritisation hexagon diagrams provide a tool that individual stakeholders can adapt to meet their own particular needs and to deliver an ITS for NMs risk assessment. Such an approach would, over time, reduce the need for testing by increasing the reliability and sophistication of in silico approaches.The manuscript includes an appraisal of how this framework relates to the current risk assessment approaches and how future risk assessment could adapt to accommodate these new approaches. A full report is available in electronic format (pdf) at http://www.nano.hw.ac.uk/research-projects/itsnano.html. CONCLUSION: ITS-NANO has delivered a detailed, stakeholder driven and flexible research prioritisation (or strategy) tool, which identifies specific research needs, suggests connections between areas, and frames this in a time-perspective.


Assuntos
Nanotecnologia , Pesquisa , Segurança , Testes de Toxicidade/normas , Exposição Ambiental , Humanos , Informática , Legislação Médica , Modelos Estatísticos , Nanopartículas/química , Nanopartículas/toxicidade , Nanotecnologia/legislação & jurisprudência , Pesquisa/legislação & jurisprudência , Medição de Risco , Segurança/legislação & jurisprudência , Testes de Toxicidade/tendências
5.
iScience ; 26(5): 106736, 2023 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-37216095

RESUMO

In our increasingly interconnected world, natural hazards and their impacts spread across geographical, administrative, and sectoral boundaries. Owing to the interrelationships between multi-hazards and socio-economic dimensions, the impacts of these types of events can surmount those of multiple single hazards. The complexities involved in tackling multi-hazards and multi-risks hinder a more holistic and integrative perspective and make it difficult to identify overarching dimensions important for assessment and management purposes. We contribute to this discussion by building on systemic risk research, especially the focus on interconnectedness, and suggest ways forward for an integrated multi-hazard and multi-risk framework that should be beneficial in real-world applications. In this article, we propose a six-step framework for analyzing and managing risk across a spectrum ranging from single-to multi- and systemic risk.

6.
NanoImpact ; 21: 100297, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33738354

RESUMO

The European Green Deal, the European Commission's new Action Plan for a Circular Economy, the new European Industrial Strategy and the Chemicals Strategy for Sustainability launched in October 2020 are ambitious plans to achieve a sustainable, fair and inclusive European Union's economy. In line with the United Nations Sustainable Development Goals 2030, these policies require that any new material or product should be not only functional and cost-effective but also safe and sustainable to ensure compliance with regulation and acceptance by consumers. Nanotechnology is one of the technologies that could enable such a green growth. This paper focuses on advanced nanomaterials that actively respond to external stimuli, also known as 'smart nanomaterials', and which are already on the market or in the research and development phase for non-medical applications such as in agriculture, food, food packaging and cosmetics. A review shows that smart nanomaterials and enabled products may present new challenges for safety and sustainability assessment due to their complexity and dynamic behaviour. Moreover, existing regulatory frameworks, in particular in the European Union, are probably not fully prepared to address them. What is missing today is a systematic and comprehensive approach that allows for considering sustainability aspects hand in hand with safety considerations very early on at the material design stage. We call on innovators, scientists and authorities to further develop and promote the 'Safe- and Sustainable-by-Design' concept in nanotechnology and propose some initiatives to go into this direction.


Assuntos
Nanoestruturas , Agricultura , União Europeia , Nanoestruturas/efeitos adversos , Nanotecnologia , Desenvolvimento Sustentável
7.
Cancers (Basel) ; 13(11)2021 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-34070797

RESUMO

BACKGROUND AND PURPOSE: Two previous "Patterns Of Practice" surveys (POP I and POP II), including more than 4000 patients affected by prostate cancer treated with radical external beam radiotherapy (EBRT) between 1980 and 2003, established a "benchmark" Italian data source for prostate cancer radiotherapy. This report (POP III) updates the previous studies. METHODS: Data on clinical management and outcome of 2525 prostate cancer patients treated by EBRT from 2004 to 2011 were collected and compared with POP II and, when feasible, also with POP I. This report provides data on clinical presentation, diagnostic workup, radiation therapy management, and toxicity as collected within the framework of POP III. RESULTS: More than 50% of POP III patients were classified as low or intermediate risk using D'Amico risk categories as in POP II; 46% were classified as ISUP grade group 1. CT scan, bone scan, and endorectal ultrasound were less frequently prescribed. Dose-escalated radiotherapy (RT), intensity modulated radiotherapy (IMRT), image guided radiotherapy (IGRT), and hypofractionated RT were more frequently offered during the study period. Treatment was commonly well tolerated. Acute toxicity improved compared to the previous series; late toxicity was influenced by prescribed dose and treatment technique. Five-year overall survival, biochemical relapse free survival (BRFS), and disease specific survival were similar to those of the previous series (POP II). BRFS was better in intermediate- and high-risk patients treated with ≥ 76 Gy. CONCLUSIONS: This report highlights the improvements in radiotherapy planning and dose delivery among Italian Centers in the 2004-2011 period. Dose-escalated treatments resulted in better biochemical control with a reduction in acute toxicity and higher but acceptable late toxicity, as not yet comprehensively associated with IMRT/IGRT. CTV-PTV margins >8 mm were associated with increased toxicity, again suggesting that IGRT-allowing for tighter margins-would reduce toxicity for dose escalated RT. These conclusions confirm the data obtained from randomized controlled studies.

8.
Nanoscale ; 12(7): 4695-4708, 2020 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-32049073

RESUMO

Grouping and read-across has emerged as a reliable approach to generate safety-related data on nanomaterials (NMs). However, its successful implementation relies on the availability of detailed characterisation of NM physicochemical properties, which allows the definition of groups based on read-across similarity. To this end, this study assessed the availability and completeness of existing (meta)data on 11 experimentally determined physicochemical properties and 18 NMs. Data on representative NMs were mainly extracted from existing datasets stored in the eNanoMapper database, now available on the European Observatory on Nanomaterials website, while data on case-study NMs were provided by their industrial manufacturers. The extent of available (meta)data was assessed and data gaps were identified, thereby determining future testing needs. Data completeness was assessed by using the information checklists included in the templates for data logging developed by the EU-funded projects NANoREG and GRACIOUS. A completeness score (CS) between 0 and 1 was calculated for each (meta)data unit, template section, property, technique and NM. The results show a heterogeneous distribution of available (meta)data across materials and properties, with none of the selected NMs fully characterised. The average CS calculated for representative NMs (0.43) was considerably lower than for case-study NMs (0.68). The low CS was largely caused by missing information on sample preparation and standard operating procedures, and was attributed to a lack of harmonised data reporting and entry procedure. This study therefore suggests that a persistent use of well-defined and harmonised reporting schemes for experimental results is a useful tool to increase (meta)data completeness and ensure their integration and reuse.

9.
NanoImpact ; 12: 18-28, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30505982

RESUMO

Legislation addressing environmental, health and safety aspects of nanomaterials in consumer products and ensuring their safe use is being continuously updated in the European Union and globally. This leads to a growing need for tools to implement this developing legislation. A freely accessible inventory of ready-to-use and publicly available tools that together cover the tasks within a nanomaterial safety assessment process was built in the presented work. This inventory is a unique metadata set in Excel® format: the 'NANoREG Toolbox', which assembles information needed for selecting and accessing instruments that meet specific goals. The recorded tools are categorised according to their purpose, type and regulatory status. The Toolbox covers an unprecedented and broad range of over 500 current tools, developed in Europe and beyond. While NANoREG focussed on safety assessment under the EU Regulation on Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH), the instruments in the Toolbox are relevant and useful for nanomaterial safety assessments worldwide.

10.
Nanotoxicology ; 10(9): 1215-28, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-26853193

RESUMO

Several tools to facilitate the risk assessment and management of manufactured nanomaterials (MN) have been developed. Most of them require input data on physicochemical properties, toxicity and scenario-specific exposure information. However, such data are yet not readily available, and tools that can handle data gaps in a structured way to ensure transparent risk analysis for industrial and regulatory decision making are needed. This paper proposes such a quantitative risk prioritisation tool, based on a multi-criteria decision analysis algorithm, which combines advanced exposure and dose-response modelling to calculate margins of exposure (MoE) for a number of MN in order to rank their occupational risks. We demonstrated the tool in a number of workplace exposure scenarios (ES) involving the production and handling of nanoscale titanium dioxide, zinc oxide (ZnO), silver and multi-walled carbon nanotubes. The results of this application demonstrated that bag/bin filling, manual un/loading and dumping of large amounts of dry powders led to high emissions, which resulted in high risk associated with these ES. The ZnO MN revealed considerable hazard potential in vivo, which significantly influenced the risk prioritisation results. In order to study how variations in the input data affect our results, we performed probabilistic Monte Carlo sensitivity/uncertainty analysis, which demonstrated that the performance of the proposed model is stable against changes in the exposure and hazard input variables.


Assuntos
Técnicas de Apoio para a Decisão , Manufaturas/toxicidade , Modelos Teóricos , Nanoestruturas/toxicidade , Exposição Ocupacional/análise , Benchmarking , Humanos , Indústrias , Método de Monte Carlo , Nanotubos de Carbono/toxicidade , Medição de Risco/métodos , Local de Trabalho/normas , Óxido de Zinco/toxicidade
11.
Environ Int ; 95: 36-53, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27523267

RESUMO

Commercialization of nanotechnologies entails a regulatory requirement for understanding their environmental, health and safety (EHS) risks. Today we face challenges to assess these risks, which emerge from uncertainties around the interactions of manufactured nanomaterials (MNs) with humans and the environment. In order to reduce these uncertainties, it is necessary to generate sound scientific data on hazard and exposure by means of relevant frameworks and tools. The development of such approaches to facilitate the risk assessment (RA) of MNs has become a dynamic area of research. The aim of this paper was to review and critically analyse these approaches against a set of relevant criteria. The analysis concluded that none of the reviewed frameworks were able to fulfill all evaluation criteria. Many of the existing modelling tools are designed to provide screening-level assessments rather than to support regulatory RA and risk management. Nevertheless, there is a tendency towards developing more quantitative, higher-tier models, capable of incorporating uncertainty into their analyses. There is also a trend towards developing validated experimental protocols for material identification and hazard testing, reproducible across laboratories. These tools could enable a shift from a costly case-by-case RA of MNs towards a targeted, flexible and efficient process, based on grouping and read-across strategies and compliant with the 3R (Replacement, Reduction, Refinement) principles. In order to facilitate this process, it is important to transform the current efforts on developing databases and computational models into creating an integrated data and tools infrastructure to support the risk assessment and management of MNs.


Assuntos
Nanoestruturas/efeitos adversos , Medição de Risco/métodos , Simulação por Computador , Meio Ambiente , Saúde Ambiental , Humanos , Nanotecnologia , Gestão de Riscos
12.
Head Neck ; 37(5): 677-84, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-24596075

RESUMO

BACKGROUND: Intestinal-type adenocarcinoma (ITAC) is a rare and locally aggressive occupation-related tumor. Currently, endoscopic-assisted resection and advances in irradiation modalities (3D conformal radiotherapy/intensity-modulated radiation therapy [IMRT]) are emerging as an alternative to traditional open surgery and conventional radiotherapy. METHODS: Retrospective analysis of 30 consecutive patients affected with sinonasal ITAC, primarily treated by an endoscopic approach followed by 3D conformal radiotherapy/IMRT at a single institution, from 2003 to 2010. RESULTS: The 5-year overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), and recurrence-free survival (RFS) were 72.7% ± 9.6%, 78% ± 9.5%, 67.9% ± 10.7%, and 69.2% ± 9.4%, respectively (mean follow-up, 48 months). No major complications or serious toxicities were observed. Prognostic factors were stage of disease at diagnosis, development of recurrences, status of surgical margins, grading, tumoral pattern of growth, and proliferative index (Ki-67). CONCLUSION: The low morbidity of endoscopic approaches, the acceptable toxicity of modern irradiation modalities, and these promising survival rates, indicate that this treatment strategy might be considered a safe, minimally invasive, and maximally effective option for treating selected sinonasal ITAC.


Assuntos
Adenocarcinoma/patologia , Adenocarcinoma/terapia , Endoscopia/métodos , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/terapia , Adenocarcinoma/mortalidade , Adulto , Idoso , Análise de Variância , Estudos de Coortes , Terapia Combinada , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Neoplasias Intestinais/patologia , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Neoplasias dos Seios Paranasais/mortalidade , Modelos de Riscos Proporcionais , Radioterapia Adjuvante , Estudos Retrospectivos , Medição de Risco , Análise de Sobrevida , Resultado do Tratamento
13.
Int J Environ Res Public Health ; 12(12): 15007-21, 2015 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-26633430

RESUMO

An engineered nanomaterial (ENM) may actually consist of a population of primary particles, aggregates and agglomerates of various sizes. Furthermore, their physico-chemical characteristics may change during the various life-cycle stages. It will probably not be feasible to test all varieties of all ENMs for possible health and environmental risks. There is therefore a need to further develop the approaches for risk assessment of ENMs. Within the EU FP7 project Managing Risks of Nanoparticles (MARINA) a two-phase risk assessment strategy has been developed. In Phase 1 (Problem framing) a base set of information is considered, relevant exposure scenarios (RESs) are identified and the scope for Phase 2 (Risk assessment) is established. The relevance of an RES is indicated by information on exposure, fate/kinetics and/or hazard; these three domains are included as separate pillars that contain specific tools. Phase 2 consists of an iterative process of risk characterization, identification of data needs and integrated collection and evaluation of data on the three domains, until sufficient information is obtained to conclude on possible risks in a RES. Only data are generated that are considered to be needed for the purpose of risk assessment. A fourth pillar, risk characterization, is defined and it contains risk assessment tools. This strategy describes a flexible and efficient approach for data collection and risk assessment which is essential to ensure safety of ENMs. Further developments are needed to provide guidance and make the MARINA Risk Assessment Strategy operational. Case studies will be needed to refine the strategy.


Assuntos
Exposição Ambiental/efeitos adversos , Nanopartículas/efeitos adversos , Nanoestruturas/efeitos adversos , Medição de Risco/métodos , Gestão de Riscos/métodos , Coleta de Dados , Humanos , Modelos Teóricos
14.
Int J Environ Res Public Health ; 12(10): 13415-34, 2015 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-26516872

RESUMO

Physicochemical properties of chemicals affect their exposure, toxicokinetics/fate and hazard, and for nanomaterials, the variation of these properties results in a wide variety of materials with potentially different risks. To limit the amount of testing for risk assessment, the information gathering process for nanomaterials needs to be efficient. At the same time, sufficient information to assess the safety of human health and the environment should be available for each nanomaterial. Grouping and read-across approaches can be utilised to meet these goals. This article presents different possible applications of grouping and read-across for nanomaterials within the broader perspective of the MARINA Risk Assessment Strategy (RAS), as developed in the EU FP7 project MARINA. Firstly, nanomaterials can be grouped based on limited variation in physicochemical properties to subsequently design an efficient testing strategy that covers the entire group. Secondly, knowledge about exposure, toxicokinetics/fate or hazard, for example via properties such as dissolution rate, aspect ratio, chemical (non-)activity, can be used to organise similar materials in generic groups to frame issues that need further attention, or potentially to read-across. Thirdly, when data related to specific endpoints is required, read-across can be considered, using data from a source material for the target nanomaterial. Read-across could be based on a scientifically sound justification that exposure, distribution to the target (fate/toxicokinetics) and hazard of the target material are similar to, or less than, the source material. These grouping and read-across approaches pave the way for better use of available information on nanomaterials and are flexible enough to allow future adaptations related to scientific developments.


Assuntos
Nanoestruturas/toxicidade , Meio Ambiente , Humanos , Medição de Risco/métodos , Segurança
15.
Tumori ; 101(2): 174-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25744865

RESUMO

AIMS AND BACKGROUND: Bladder preservation is a treatment option in muscle-invasive bladder carcinoma. The most investigated approach is a trimodality schedule including maximum transurethral resection of bladder tumor (TURBT) followed by chemoradiotherapy. Our aim was to evaluate the use of bladder preservation by radiation oncologists of the Lombardy region in Italy. METHODS AND STUDY DESIGN: A survey with 13 items regarding data of 2012 was sent to all 32 radiotherapy centers within the collaboration between the Lombardy Oncological Network and the Lombardy Section of the Italian Society of Oncological Radiotherapy. RESULTS: Thirteen centers (41%) answered the survey; the presented data come from 11 active centers. In these centers, 11,748 patients were treated with external-beam radiotherapy in 2012, 100 of whom having bladder cancer (0.9%). 74/100 patients received radiotherapy as palliative treatment for T, N or M lesions. A further 9 and 5 patients received radiotherapy for oligometastatic disease (ablative doses to small volumes) and postoperatively, respectively. Bladder preservation was performed in 12 cases and included trimodality and other strategies (mainly TURBT followed by radiotherapy). A multidisciplinary urology tumor board met regularly in 5 of 11 centers. All responders declared their interest in the Lombardy multicenter collaboration on bladder preservation. CONCLUSIONS: Our survey showed that bladder preservation is rarely used in Lombardy despite the availability of the latest radiotherapy technologies and the presence of an urology tumor board in half of the centers. The initiative of multicenter and multidisciplinary collaboration was undertaken to prepare the platform for bladder preservation as a treatment option in selected patients.


Assuntos
Carcinoma de Células de Transição/patologia , Carcinoma de Células de Transição/radioterapia , Tratamentos com Preservação do Órgão/métodos , Padrões de Prática Médica/estatística & dados numéricos , Radioterapia (Especialidade) , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/radioterapia , Adulto , Feminino , Humanos , Comunicação Interdisciplinar , Itália , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Inquéritos e Questionários , Recursos Humanos
16.
Nanotoxicology ; 8(2): 117-31, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23244341

RESUMO

Substantial limitations and uncertainties hinder the exposure assessment of engineered nanomaterials (ENMs). The present deficit of reliable measurements and models will inevitably lead in the near term to qualitative and uncertain exposure estimations, which may fail to support adequate risk assessment and management. Therefore it is necessary to complement the current toolset with user-friendly methods for near-term nanosafety evaluation. This paper proposes an approach for relative exposure screening of ENMs. For the first time, an exposure model explicitly implements quantitative weight of evidence (WoE) methods and utilises expert judgement for filling data gaps in the available evidence-base. Application of the framework is illustrated for screening of exposure scenarios for nanoscale titanium dioxide, carbon nanotubes and fullerenes, but it is applicable to other nanomaterials as well. The results show that the WoE-based model overestimates exposure for scenarios where expert judgement was substantially used to fill data gaps, which suggests its conservative nature. In order to test how variations in input data influence the obtained results, probabilistic Monte Carlo sensitivity analysis was applied to demonstrate that the model performs in stable manner.


Assuntos
Carbono/toxicidade , Modelos Teóricos , Nanoestruturas/toxicidade , Exposição Ocupacional , Titânio/toxicidade , Humanos , Medição de Risco , Testes de Toxicidade
17.
Nanotoxicology ; 8(3): 334-48, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-23641967

RESUMO

Bringing together topic-related European Union (EU)-funded projects, the so-called "NanoSafety Cluster" aims at identifying key areas for further research on risk assessment procedures for nanomaterials (NM). The outcome of NanoSafety Cluster Working Group 10, this commentary presents a vision for concern-driven integrated approaches for the (eco-)toxicological testing and assessment (IATA) of NM. Such approaches should start out by determining concerns, i.e., specific information needs for a given NM based on realistic exposure scenarios. Recognised concerns can be addressed in a set of tiers using standardised protocols for NM preparation and testing. Tier 1 includes determining physico-chemical properties, non-testing (e.g., structure-activity relationships) and evaluating existing data. In tier 2, a limited set of in vitro and in vivo tests are performed that can either indicate that the risk of the specific concern is sufficiently known or indicate the need for further testing, including details for such testing. Ecotoxicological testing begins with representative test organisms followed by complex test systems. After each tier, it is evaluated whether the information gained permits assessing the safety of the NM so that further testing can be waived. By effectively exploiting all available information, IATA allow accelerating the risk assessment process and reducing testing costs and animal use (in line with the 3Rs principle implemented in EU Directive 2010/63/EU). Combining material properties, exposure, biokinetics and hazard data, information gained with IATA can be used to recognise groups of NM based upon similar modes of action. Grouping of substances in return should form integral part of the IATA themselves.


Assuntos
Nanoestruturas , Medição de Risco , Testes de Toxicidade , Animais , Linhagem Celular , União Europeia , Humanos , Nanoestruturas/normas , Nanoestruturas/toxicidade
18.
Nanotoxicology ; 6: 880-98, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22229953

RESUMO

It has been largely recognised that substantial limitations and uncertainties make the conventional risk assessment (RA) of chemicals unfeasible to apply to engineered nanomaterials (ENMs) today, which leaves the regulators with little support in the near term. The aim of this paper is to discuss the state of the art in the area of the RA of nanomaterials, focusing on the available data and approaches. There is a paucity of reliable information in the online safety databases and the literature is dominated by (eco)toxicity studies, while the nano-exposure research lags behind. Most of the reviewed nano-RA approaches are designed to serve as preliminary risk screening and/or research prioritisation tools and are not intended to support regulatory decision making. In this context, we recommend to further study the possibilities to apply complementary/alternative tools for near-term RA of ENMs in order to facilitate their timely regulation, using the data that are currently available in the literature.


Assuntos
Nanoestruturas/toxicidade , Bases de Dados de Compostos Químicos , Medição de Risco
19.
Int J Environ Res Public Health ; 8(2): 435-55, 2011 02.
Artigo em Inglês | MEDLINE | ID: mdl-21556195

RESUMO

A model-based prioritisation exercise has been carried out for the Water Framework Directive (WFD) implementation. The approach considers two aspects: the hazard of a certain chemical and its exposure levels, and focuses on aquatic ecosystems, but also takes into account hazards due to secondary poisoning, bioaccumulation through the food chain and potential human health effects. A list provided by EU Member States, Stakeholders and Non-Governmental Organizations comprising 2,034 substances was evaluated according to hazard and exposure criteria. Then 78 substances classified as "of high concern" where analysed and ranked in terms of risk ratio (Predicted Environmental Concentration/Predicted No-Effect Concentration). This exercise has been complemented by a monitoring-based prioritization exercise using data provided by Member States. The proposed approach constitutes the first step in setting the basis for an open modular screening tool that could be used for the next prioritization exercises foreseen by the WFD.


Assuntos
Exposição Ambiental , Poluentes Químicos da Água/toxicidade , Poluição da Água/prevenção & controle , Algoritmos , Europa (Continente) , Medição de Risco
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