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INTRODUCTION: Total body irradiation (TBI) is part of the myeloablative conditioning for hematopoietic stem cell transplantation (HSCT) in malignant hematologic disorders. This therapy has recently shown improved survival in acute lymphoblastic leukemia (ALL) compared to chemotherapy-based regimens. However, side effects are a significant limitation, especially in the pediatric population. PATIENTS AND METHODS: We retrospectively analyzed the survival of patients with ALL who underwent an HSCT at a tertiary hospital between 1996 and 2009 (N = 69 HSCT in 57 patients). We differentiated a cohort that received TBI (N = 44) from another that did not (N = 25). Subsequently, we interviewed the survivors from the TBI group with a minimum of 10 years of follow-up (N = 18), asking about the presence of side effects. RESULTS: The overall survival (OS) at 2 and 5 years was 79.1% and 65.2% respectively for the TBI group and 66.2% and 55.8% for the non-TBI group, although this difference was not significant (P=.31). The event-free survival (EFS) at 2 and 5 years was 77.3% and 63.6% respectively for the TBI group and 56% and 32% for the non-TBI group (P=.02). The probability of relapse (PR) at 2 years for those who received TBI was 10% compared to 28.6% for those who did not receive TBI (P=.005). Survivors who received TBI developed secondary neoplasms (39%), dyslipidemia (67%), cognitive impairments affecting memory (44%), recurrent respiratory infections (39%), thyroid abnormalities (45%), premature ovarian failure (89%), cataracts (22%), and psychological problems (44%). However, the quality of life, as self-assessed by the patients, was considered good for 83% of the participants.. CONCLUSIONS: Patients who received TBI had significantly higher EFS and lower PR. However, adverse effects are frequent and significant, although they do not subjectively affect quality of life.
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Transplante de Células-Tronco Hematopoéticas , Leucemia-Linfoma Linfoblástico de Células Precursoras , Irradiação Corporal Total , Humanos , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Feminino , Estudos Retrospectivos , Irradiação Corporal Total/efeitos adversos , Masculino , Criança , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/métodos , Adolescente , Pré-Escolar , Resultado do Tratamento , Condicionamento Pré-Transplante/métodos , Condicionamento Pré-Transplante/efeitos adversos , Lactente , Seguimentos , Taxa de Sobrevida , Intervalo Livre de DoençaRESUMO
SUMMARY: The 12C6+ heavy ion beam irradiation can cause bystander effects. The inflammatory cytokines, endocrine hormones and apoptotic proteins may be involved in 12C6+ irradiation-induced bystander effects. This study characterized the protective effects and mechanisms of Huangqi decoction (HQD) against 12C6+ radiation induced bystander effects. Wistar rats were randomly divided into control, 12C6+ heavy ion irradiation model, and high-dose/medium-dose/low-dose HQD groups. HE staining assessed the pathological changes of brain and kidney. Peripheral blood chemical indicators as well as inflammatory factors and endocrine hormones were detected. Apoptosis was measured with TUNEL. Proliferating cell nuclear antigen (PCNA) expression was determined with real-time PCR and Western blot.Irradiation induced pathological damage to the brain and kidney tissues. After irradiation, the numbers of white blood cells (WBC) and monocyte, and the expression of interleukin (IL)-2, corticotropin-releasing hormone (CRH) and PCNA decreased. The damage was accompanied by increased expression of IL-1β, IL-6, corticosterone (CORT) and adrenocorticotropic hormone (ACTH) as well as increased neuronal apoptosis. These effects were indicative of radiation-induced bystander effects. Administration of HQD attenuated the pathological damage to brain and kidney tissues, and increased the numbers of WBC, neutrophils, lymphocyte and monocytes, as well as the expression of IL-2, CRH and PCNA. It also decreased the expression of IL-1β, IL-6, CORT and ACTH as well as neuronal apoptosis. HQD exhibits protective effects against 12C6+ radiation-induced bystander effects. The underlying mechanism may involve the promotion of the production of peripheral blood cells, inhibition of inflammatory factors and apoptosis, and regulation of endocrine hormones.
La irradiación con haz de iones pesados 12C6+ puede provocar efectos secundarios. Las citoquinas inflamatorias, las hormonas endocrinas y las proteínas apoptóticas pueden estar involucradas en los efectos secundarios inducidos por la irradiación 12C6+. Este estudio caracterizó los efectos y mecanismos protectores de la decocción de Huangqi (HQD) contra los efectos externos inducidos por la radiación 12C6+. Las ratas Wistar se dividieron aleatoriamente en grupos control, modelo de irradiación de iones pesados 12C6+ y grupos de dosis alta/media/baja de HQD. La tinción con HE evaluó los cambios patológicos del cerebro y el riñón. Se detectaron indicadores químicos de sangre periférica, así como factores inflamatorios y hormonas endocrinas. La apoptosis se midió con TUNEL. La expresión del antígeno nuclear de células en proliferación (PCNA) se determinó mediante PCR en tiempo real y transferencia Western blot. La irradiación indujo daños patológicos en los tejidos cerebrales y renales. Después de la irradiación, disminuyó el número de glóbulos blancos (WBC) y monocitos, y la expresión de interleucina (IL)-2, hormona liberadora de corticotropina (CRH) y PCNA. El daño estuvo acompañado por una mayor expresión de IL-1β, IL-6, corticosterona (CORT) y hormona adrenocorticotrópica (ACTH), así como un aumento de la apoptosis neuronal. Estas alteraciones fueron indicativas de efectos inducidos por la radiación. La administración de HQD atenuó el daño patológico a los tejidos cerebrales y renales, y aumentó el número de leucocitos y monocitos, así como la expresión de IL-2, CRH y PCNA. También disminuyó la expresión de IL-1β, IL-6, CORT y ACTH, así como la apoptosis neuronal. HQD exhibe mecanismos protectores contra los efectos externos inducidos por la radiación 12C6+. El mecanismo subyacente puede implicar la promoción de la producción de células sanguíneas periféricas, la inhibición de factores inflamatorios y la apoptosis y la regulación de hormonas endocrinas.
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Animais , Feminino , Ratos , Medicamentos de Ervas Chinesas , Substâncias Protetoras/administração & dosagem , Íons Pesados/efeitos adversos , Scutellaria baicalensis/química , Encéfalo/efeitos dos fármacos , Encéfalo/efeitos da radiação , Hormônio Liberador da Corticotropina , Ensaio de Imunoadsorção Enzimática , Ratos Wistar , Apoptose/efeitos dos fármacos , Apoptose/efeitos da radiação , Hormônio Adrenocorticotrópico , Antígeno Nuclear de Célula em Proliferação , Sistema Endócrino/efeitos dos fármacos , Sistema Endócrino/efeitos da radiação , Fatores Imunológicos/antagonistas & inibidores , Rim/efeitos dos fármacos , Rim/efeitos da radiaçãoRESUMO
Objetivo: Describir las aberraciones citogenéticas que pueden ser observadas por medio de la técnica Giemsa en fluorescencia y encontradas en pacientes con cáncer antes y después de ser sometidos a tratamiento con radioterapia. Métodos: Se analizó un mínimo de 200 metafases en primera división mitótica antes y después del tratamiento de radioterapia en nueve pacientes que asistieron a la sección de radioterapia del Hospital San Juan de Dios Costa Rica. En cada caso se contabilizó cada tipo de cromosomopatía por medio de la prueba de Giemsa en fluorescencia y utilizando bromodeoxiuridina y naranja de acridina. Resultados: Las cromosomopatías producidas por radioterapia se observaron tanto antes como después del tratamiento sin embargo destacó el incremento en la frecuencia de los cromosomas dicéntricos y anillos céntricos una vez finalizada la terapia. La frecuencia de fracturas cromatídicas de asociaciones satelíticas y de alteraciones morfológicas no se ve afectada por la radioterapia. Uno de los participantes presentó un recuento mitótico bajo. Conclusión: La radioterapia aumenta significativamente la frecuencia de los cromosomas dicéntricos y dicéntricos más anillos en la muestra en estudio. Este trabajo es relevante por ser el primer estudio en Costa Rica en el que se analizan los cromosomas dicéntricos como biomarcadores de exposición a radiaciones ionizantes mediante la prueba de Giemsa en fluorescencia y utilizando bromodeoxiuridina y naranja de acridina.
Aim: The objective of this study was to describe the before and after cytogenetic aberrations found in current patients of radiotherapy. This can be observed through the technique called "Giemsa in fluorescence" Methods: A minimum of 200 metaphases were analyzed in the first mitotic division in 9 patients. The patients where observed before and after radiotherapy treatment at the San Juan de Dios Hospital in Costa Rica. In each case any type of chromosomopathy was counted using the "Giemsa in fluorescence" test as well as Bromodeoxyuridine and acridine orange. Results: The chromosomopathies are observed before and after treatment with radiotherapy. The treatment seems to change the frecuency increasing the dicentric chromosomes and centric rings after the treatment. The frequency of chromatid fractures satellite associations and morphological alterations were not affected by radiotherapy. Conclusion: The chromosomopathies produced by radiotherapy were observed both before and after treatment with variations in their frequency. After radiotherapy dicentric chromosomes and dicentric chromosomes plus rings frequencies increased significantly. A low mitotic count was present this could have been the result of radiation on the bone marrow or by the cell repair and apoptosis system. The standardized " Fluorescence Plus Giemsa" test using Bromodesoxyuridine and acridine orange was used for the fiesta time in Costa Reica. This allowed for the measurement of radiation exposure used in the treatment or detection of diseases and cancer in pacients.
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Humanos , Radioterapia/estatística & dados numéricos , Cromossomos em Anel , Cobalto/análise , Neoplasias/radioterapia , Radiação , Costa RicaRESUMO
La pandemia por COVID-19 ha generado un impacto negativo en los sistemas de salud y la economía mundial. El agente etiológico de la COVID-19, el SARS-CoV2, puede permanecer de horas a días en superficies y aerosoles, representando un desafío en la descontaminación de objetos y ambientes cerrados. Agentes químicos como el alcohol, peróxido de hidrógeno, hipoclorito de sodio se han empleado con éxito para erradicar al coronavirus de superficies. Dado que estos agentes pueden causar daños en elementos de protección personal (como las máscaras), son irritantes y no parecen ser efectivos para la descontaminación de aerosoles, la luz ultravioleta ha sido explorada como una medida de mitigación para el desconfinamiento seguro. En este trabajo se realiza una revisión acerca de los principios físicos de la irradiación con luz ultravioleta y su interacción con la materia biológica. También se esboza un esquema de irradiación que podría ser útil para eliminar al SARS-CoV2 de superficies y aerosoles en ambientes cerrados(AU)
The COVID-19 pandemic has had a negative impact on health systems and the global economy. The etiological agent of COVID-19, SARS-CoV2, can remain from hours to days on surfaces and aerosols, representing a challenge in the decontamination of objects and closed environments. Chemical agents such as alcohol, hydrogen peroxide, sodium hypochlorite have been used successfully to inactivate the coronavirus on surfaces. Since these agents can damage personal protective equipment (such as masks), are irritants, and do not appear to be effective for aerosol decontamination, UV light has been explored as a mitigation measure for safe deconfinement. In this work, it is made a review about the physical principles of ultraviolet light and its interaction with biological matter. An irradiation scheme that could be useful to eliminate SARS-CoV2 from surfaces and aerosols in closed environments is also presented(AU)
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Humanos , Raios Ultravioleta , Descontaminação/métodos , Desinfecção/métodos , COVID-19 , Radiação , Hipoclorito de Sódio , Produtos Biológicos , Proteção Pessoal , Etanol , Peróxido de HidrogênioRESUMO
mILIB (Intravascular Laser Irradiation in the Modified Bloodstream) presents itself as one more photobiomodulation technique, among the many therapeutic possibilities we know. The advantage in this case is the possibility of making application in a systemic way in which the organism as a whole is benefited. The use of the red therapeutic laser in a transcutaneous way, has been a great option as an added therapeutic value to the treatment of several pathologies, providing systemic stimuli, similar to hemotherapy. Thus, mILIB presents itself as an effective and increasingly widespread technique for professionals working with photobiomodulation
mILIB (Irradiación láser intravascular en el torrente sanguíneo modificado) se presenta como una técnica de fotobiomodulación más, entre las muchas posibilidades terapéuticas que conocemos. La ventaja en este caso es la posibilidad de realizar una aplicación de forma sistémica en la que se beneficia al organismo en su conjunto.El uso del láser terapéutico rojo de forma transcutánea, ha sido una gran opción como valor terapéutico añadido al tratamiento. de varias patologías, proporcionando estímulos sistémicos, similar a la hemoterapia. Así, mILIB se presenta como una técnica eficaz y cada vez más extendida para los profesionales que trabajan con fotobiomodulación.
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Humanos , Doenças Vasculares/radioterapia , Terapia a LaserRESUMO
Las glándulas salivales humanas pueden ser gravemente lesionadas por la radioterapia utilizada contra neoplasias de cabeza y cuello, produciendo hiposialia y xerostomía, las cuales afectan la salud oral y sistémica, mermando la calidad de vida de la persona. Los tratamientos convencionales actuales están diseñados para disminuir los síntomas, sin actuar sobre los cambios fisiopatológicos que se dan a nivel glandular. Esta revisión intenta analizar aquellas terapias preventivas y/o curativas que están desarrollándose en el campo biomolecular y que tienen un futuro prometedor por sus características innovadoras: terapia génica, terapia con células madre y terapia con factores de crecimiento. Se evidencia un aporte adicional de la nanotecnología, la cual está mejorando las vías de aplicación de los tratamientos.
Human salivary glands can be seriously injured by the radiotherapy used against head and neck neoplasms, producing hyposialia and xerostomy, which affect oral and systemic health, diminishing the person's quality of life. Current conventional treatments are designed to reduce symptoms, without acting on the pathophysiological changes that occur at the glandular level. This review attempts to analyze those preventive and /or curative therapies that are developing in the biomolecular field and that have a promising future due to their innovative features: Gene therapy, stem cell therapy and growth factor therapy. An additional contribution of nanotechnology is evident, which is improving the routes of treatment application.
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Humanos , Radioterapia/efeitos adversos , Doenças das Glândulas Salivares/prevenção & controle , Células-Tronco/fisiologia , Terapia Genética/métodos , Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Lesões por Radiação/prevenção & controle , Protetores contra Radiação/uso terapêutico , Doenças das Glândulas Salivares/terapia , Glândulas Salivares/efeitos da radiação , Xerostomia/prevenção & controle , NanotecnologiaRESUMO
RESUMEN En el presente trabajo se expone la evolución del proceso de irradiación en Cuba, los principales resultados científico-técnicos e impactos alcanzados hasta la actualidad y las perspectivas de estas aplicaciones, así como la recuperación de las capacidades de irradiación existentes en el país, el control del proceso de irradiación, gestión de la calidad del proceso y los aspectos normativos establecidos.
ABSTRACTS The present paper deals with the evolution of radiation processing in Cuba, its main scientific results and impact up to now and the perspectives of these applications, as well as the recovery of the irradiation capacities existing in the country, the radiation process control, quality management in the mentioned radiation process and the established regulatory aspects.
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Resumen La radioterapia mediastínica es uno de los tratamientos fundamentales de las enfermedades malignas torácicas, pero también representa una causa potencial de complicaciones, tanto a corto como a largo plazo. Se presenta una serie de casos de rotura de vena innominada durante esternotomía media en pacientes con fibrosis mediastínica. Los tres casos descritos corresponden a pacientes intervenidos de cirugía cardiaca con antecedentes de radioterapia mediastínica, entre 15-30 años antes de la cirugía, por tres diferentes enfermedades malignas (linfoma de Hodgkin, timoma y cáncer de mama). En los tres casos se reporta rotura de la vena innominada, con desinserción de su origen en la vena cava superior debido a fibrosis mediastínica intensa.
Abstract Although mediastinal radiotherapy is one of the basic treatments of malignant thoracic diseases, it is also a potential cause of short and long-term complications. A series of cases of rupture of the innominate vein during sternotomy are presented in patients with mediastinal fibrosis. The three cases described correspond to patients intervened by cardiac surgery, with a history of mediastinal radiotherapy between 15 to 30 years before the surgery, due to three different malignant diseases (Hodgkin lymphoma, thymoma, and breast cancer). In the three cases, a rupture of the innominate vein is reported; with de-insertion of its origin in the superior vena cava sue to intense mediastinal fibrosis.
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Humanos , Feminino , Pessoa de Meia-Idade , Cirurgia Torácica , Fibrose , Veia Cava Superior , Neoplasias da Mama , Doença de Hodgkin , Veias BraquiocefálicasRESUMO
Abstract Total Body Irradiation (TBI) is a radiotherapy technique that consists of irradiating homogeneously the whole patient's body and it is characterized by an extended source to surface distances and the use of large irradiation fields. The limitations of the available input data and inherent problems with the calculation procedures make it very difficult to accurately determine the dose distributions in TBI. For these reasons, it is highly recommended to use In Vivo Dosimetry (IVD), to guarantee the quality of TBI treatments as a direct measurement of the delivered dose. An IVD QA system was implemented based on semiconductor diodes and radiochromic films. For the commissioning of the system, both detector types were calibrated independently, using as reference an ionization chamber with a valid certificate in terms of absorbed dose to water (Dw). This guarantees the traceability of the measurements. An experiment was carried out to simulate a clinical TBI procedure to a phantom. In this way, the calibration of the dosimetry system was confirmed.
Resumen La irradiación total del cuerpo (TBI) es una técnica de radioterapia que consiste en irradiar de manera homogénea todo el cuerpo del paciente y se caracteriza por una fuente extendida a distancias superficiales y el uso de grandes campos de irradiación. Las limitaciones de los datos de entrada disponibles y los problemas inherentes con los procedimientos de cálculo hacen que sea muy difícil determinar con precisión las distribuciones de dosis en TBI. Por estos motivos, es altamente recomendable utilizar la dosimetría in vivo (IVD), para garantizar la calidad de los tratamientos de TBI como una medida directa de la dosis administrada. Se implementó un sistema IVD QA basado en diodos semiconductores y películas radiocromáticas. Para la puesta en marcha del sistema, ambos tipos de detectores se calibraron de forma independiente, utilizando como referencia una cámara de ionización con un certificado válido en términos de dosis absorbida en agua (Dw). Esto garantiza la trazabilidad de las mediciones. Se llevó a cabo un experimento para simular un procedimiento clínico de TBI a un fantasma. De esta forma, se confirmó la calibración del sistema de dosimetría.
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Introducción El tratamiento estándar en estadios tempranos del cáncer de mama es la cirugía conservadora (cc) más radioterapia del volumen total mamario (wbi). Dado que la mayoría de las recidivas locales ocurren cercanas al sitio del tumor (85%) y existiendo la posibilidad de acortar tiempos de irradiación debido a que esta insume varias semanas, podría no ser necesario irradiar toda la mama, sino el área donde estaba situado el tumor más margen de seguridad, lo que insume un menor tiempo. Este el fundamento de la Irradiación Parcial Acelerada Mama (apbi). Consensos internacionales proporcionan guías para administrar apbi fuera de ensayos clínicos. Objetivos El objetivo principal de este trabajo es determinar y analizar las características clinico-anatomopatológicas e inmunohistoquímicas de las pacientes que fueron operadas y luego seleccionadas para ser irradiadas con técnica de apbi con radioterapia externa con intensidad modulada guiada por imágenes (imrt). Material y método Se trata de un trabajo prospectivo, no randomizado. La muestra está constituida por las primeras 20 pacientes ingresadas al protocolo apbi. El reclutamiento se realizó entre marzo de 2012 y julio de 2014. Se analizaron las características clínico-patológicas e inmunohistoquímicas de esas pacientes luego de cc más biopsia del ganglio centinela (bgc). Resultados Media de seguimiento en meses: 37,7 (r: 22-51); edad media: 65,7 años. Tamaño tumoral medio por anatomía patológica: 12,03 mm. Media de número de ganglios centinelas extirpados: 1,7. Todos los tumores fueron unifocales. Los márgenes quirúrgicos resultaron negativos en todos los casos. Tumores Luminal A: 19 pacientes; tumores Luminal B: 1 paciente. Hormonoterapia adyuvante en todas las pacientes. Control locorregional: 100%. Conclusiones A pesar del corto tiempo de seguimiento y del escaso número de pacientes, este análisis sugiere que la apbi en el lecho del tumor marcado intraoperatoriamente con fiduciales de titanio es factible para pacientes que reúnen los criterios estrictos clínico-patológicos e inmunohistoquímicos acordes con las guías internacionales.
Introduction The standard conservative treatment for early stage breast carcinomas is the breast conservative surgery plus whole breast irradiation. Because most local recurrences occur close to the site of the primary tumor (80- 90%) and the possibility of shortening the irradiation times because it takes several weeks, it may not be necessary to irradiate the entire breast, but the area where the tumor was located plus a margin of safety in less time. This is the basis of Accelerated Partial Irradiation of the Breast Objectives Determination and analysis of clinical-pathological and immunohistochemical characteristics in patients selected for Accelerated Partial Breast Irradiation (apbi) performed by imrt + igrt technique after breast conservative surgery plus sentinel node biopsy. Materials and method A prospective, non-randomized study of the first 20 patients performed apbi strictly following the recommendations of international consensus. It was initiated in March 2012 until July 2014. Clinical-pathological and immunohistochemical characteristics of these patients were analyzed to be selected for apbi, after breast conservative surgery plus sentinel node biopsy. Results Median follow up: 37.7 months (r: 22-51); average age: 65.7 years. Mean tumor size by pathological analysis: 12.03 mm. Mean number of sentinel nodes removed: 1.7. All tumors were unifocal. Negative surgical margins in all cases. Luminal A tumors: 19 patients; Luminal B tumors: 1 patient. Adjuvant hormone therapy in all patients. Loco-regional control: 100%. Conclusions Despite the short time of follow up and the small numbers of patients, this analysis suggests that apbi performed by imrt + igrt technique added to the placement of fiduciary marks at the time of surgery is feasible for highly selected patients who meet the clinical-pathological and immunohistochemical selection criteria according to international guidelines
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Humanos , Feminino , Neoplasias da Mama , Radioterapia , Titânio , Biópsia de Linfonodo Sentinela , GângliosRESUMO
BACKGROUND: Exposure of the nematophagous fungus Pochonia chlamydosporia to solar radiation and elevated temperatures before being incorporated into the soil can reduce its survival and efficiency as biocontrol agent. AIMS: A field experiment was carried out to assess the effect of the exposure period on the viability of P. chlamydosporia applied on the soil surface. METHODS: A commercial bionematicide based on P. chlamydosporia was sprayed on soil, and soil samples were collected before and at 0, 30, 60, 90, 120, and 150min after fungal application. Relative humidity (RH), the irradiance (IR), air temperature (AT), and soil temperature (ST) were recorded. The number of P. chlamydosporia colony forming units (CFUs) was evaluated after 20 days of incubation. RESULTS: P. chlamydosporia survival decreased over the time of exposure on the soil surface. Overall, the number of CFUs decreased by more than 90% at 150min after application. Exposure to RH ≥61%, ST and AT between 25-35°C and 19-29°C, and IR between 1172 and 2126µmol of photons m-2s-1 induced a negative exponential effect on the survival of the fungus over the time. CONCLUSIONS: Exposure to climatic conditions on the soil surface reduces P. chlamydosporia viability.
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Hypocreales/fisiologia , Microbiologia do Solo , Umidade , Hypocreales/crescimento & desenvolvimento , Hypocreales/efeitos da radiação , Controle Biológico de Vetores , Luz Solar , TemperaturaRESUMO
Se desarrolló una metodología para la validación y el control de rutina del proceso de irradiación que se realiza en un irradiador autoblindado con fuentes de 60Co. Esta metodología fue aplicada a un irradiador modelo ISOGAMMA LLCo con el objetivo de garantizar la correcta explotación del equipo, la eficiencia de los servicios brindados y la obtención, en forma consistente, de un producto que cumpla con los atributos de calidad y las especificaciones predeterminadas
A methodology was developed for the validation and routine control of the irradiation process performed in a self-shielding gamma irradiator with 60Co sources. This methodology was applied to an irradiator model ISOGAMMA LLCo in order to ensure the proper operation of the equipment, efficiency of services provided and to consistently obtain, , a product that meets the quality attributes and default specifications
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CLINICAL CASE: A 53-year old male presented with visual impairment in right eye after irradiation of right maxillary sinus carcinoma. Funduscopy shows radiation retinopathy: haemorrhages, exudates, macular oedema, and peripheral retinal ischaemia. A poor outcome was achieved despite laser treatment and intravitreal injections of bevacizumab, resulting in evisceration of the affected eye. DISCUSSION: Radiation retinopathy must be considered in any loss of vision after head and neck irradiation. Ophthalmological long-term follow-up of these patients is essential for an early diagnosis.
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Carcinoma/radioterapia , Neoplasias do Seio Maxilar/radioterapia , Lesões por Radiação/etiologia , Radioterapia/efeitos adversos , Retina/lesões , Inibidores da Angiogênese/uso terapêutico , Bevacizumab/uso terapêutico , Evisceração do Olho , Humanos , Isquemia/etiologia , Edema Macular/etiologia , Masculino , Pessoa de Meia-Idade , Hemorragia Retiniana/etiologiaRESUMO
The objective of this study was to determine the effects of coating nanoparticles of titanium dioxide (TiO2 NPs) and irradiation -UV on plates of titanium (Ti) for the adhesion and proliferation of human gingival fibroblasts (HGF). A total of 15 Ti plates were divided into three groups (n = 5); (i) control Ti, (ii) experimental: Ti+TiO2 NPs, (iii) experimental: Ti+TiO2 NPs+UV. The plates were analyzed with atomic force microscopy (AFM) and the roughness (Ra and Rmax) was determined. UV irradiation was performed for 20 min. HGF were subcultured in DMEM+10 % fetal bovine serum (FBS) at 37 °C with 5 % CO2. 2x106 cells/mL were inoculated on the plates and incubated for 1 h and washed with phosphate buffer saline (PBS). In the case of cell proliferation, cells were incubated for further 24 h more. Cell viability was determined with the MTT method, the formazan was dissolved with dimethylsulfoxide (DMSO) and analyzed at 540 nm. Experiments were performed of three independent experiments and data were analyzed by Kruskall-Wallis and multiple comparison of Mann-Whitney test. The surface topography of samples corresponded as follow: Ti (Ra= 0,492 µm y Rms= 0.640 µm), Ti+NPs TiO2, (Ra= 0.55 µm y Rms= 0.714 µm), respectively. The coating with TiO2 NPs significantly (p <0.05) increased the adhesion and proliferation of HGF compared with the group. The modification of Ti plates by coated with TiO2 NPs significantly increased adhesion and proliferation of HGF with the formation of a hydrophilic surface which favors the humectancy. This treatment may be reported here convenient to accelerate osseointegration of dental implants based titanium.
El objetivo fue determinar los efectos del recubrimiento con nanopartículas de dióxido de titanio (TiO2 NPs) e irradiación UV sobre placas de titanio (Ti) para la adhesión y proliferación de fibroblastos gingivales humanos (FGH). Un total de 15 placas de Ti se dividieron en tres grupos (n= 5); (i) control Ti, (ii) experimental Ti+NPs TiO2, (iii) experimental: Ti+NPs TiO2+UV. Las placas fueron analizadas en microscopía de fuerza atómica (MFA) y se determinó la rugosidad (Ra y Rmax). La irradiación con UV se realizó durante 20 min. FGH fueron subcultivados en DMEM+10 % de suero fetal bovino a 37 °C con 5 % de CO2. 2x106 células/mL fueron inoculadas sobre las placas e incubadas durante 1 h, se lavaron con solución salina de buffer fosfato. En el caso de la proliferación celular, las células se incubaron por 24 h más. La viabilidad celular se determinó con el método de MTT, el formazan fue disuelto con dimetilsulfoxido y se analizó a 540 nm. Los experimentos se realizaron a partir de tres experimentos independientes y los datos se analizaron por Kruskall-Wallis y por comparación múltiple de Mann-Whitney. La topografía de la superficie de las muestras correspondio de la siguiente manera: Ti (Ra= 0,492 µm y Rms= 0,640 µm), Ti+NPs TiO2, (Ra= 0,55 µm y Rms= 0,714 µm), respectivamente. El recubrimiento con NPs TiO2 aumentó significativamente la adhesión y proliferación de HGF en comparación con el grupo de Ti control (p <0,05). La modificación de la superficie de las placas de Ti recubiertas con NPs TiO2 aumentó significativamente la adhesión y proliferación de HGF con la formación de una superficie hidrófila que favorece la humectancia. Este tratamiento aquí informado tal vez sea un método conveniente para acelerar el proceso de la osteointegración de los implantes dentales a base de titanio.
Assuntos
Humanos , Proliferação de Células/fisiologia , Fibroblastos/metabolismo , Gengiva/metabolismo , Titânio , Raios Ultravioleta , Adesão Celular , NanopartículasRESUMO
O processo de deterioração do pescado é facilitado por suas características intrínsecas, como a proximidade da neutralidade que se encontra o pH; ação das enzimas autolíticas; elevada atividade de água e presença de nutrientes; além da elevada quantidade de gorduras insaturadas que auxiliam agilizando o processo de formação do ranço. Por isso, o emprego dos métodos de conservação deve ser realizado o mais prontamente possível, retardando a instalação da deterioração e mantendo o produto fresco por um período maior. Entre as tecnologias disponíveis para a conservação estão as radiações ionizantes. A irradiação de alimentos já é utilizada em vários países, sendo eficaz na extensão da validade comercial e até mesmo na melhora de alguns atributos sensoriais. Objetivou-se no presente trabalho contribuir para a avaliação da interferência da irradiação por feixe de elétrons nas características sensoriais de filés de corvina (M. furnieri) refrigerados, desembarcados no município de Niterói - RJ, Brasil. As amostras foram divididas em três grupos: controle; irradiado a 0,7 kGy; e irradiado a 1,0 kGy, os quais foram comparados sensorialmente entre si através de testes triangulares realizados com 30 provadores cada. Foram avaliados aroma, sabor, odor, textura e "outros". Os peixes inteiros foram adquiridos no cais de Itaipú, filetados no mercado, embalados a vácuo e mantidos à ±4°C. Foi encontrada diferença estatisticamente significativa (p<0,05) entre as amostras, quando confrontado o grupo irradiado a 1,0 kGy com os outros dois grupos. Concluiu-se portanto, que a dose de 1,0 kGy alterou as características sensoriais dos filés de corvina irradiados.(AU)
The process of spoilage of fish is facilitated by its intrinsic features, such as the proximity of neutrality of its pH; action of autolytic enzymes; high presence of water and nutrients; as well as a high amount of unsaturated fats that helps accelerate the process of rancidity. Therefore, preservation methods should be used as promptly as possible, delaying the installation of deterioration and keeping the product fresh for a longer period. Ionizing radiation is one of the technologies available for conservation. Food irradiation is already used in several countries, being effective for the improvement of some sensory attributes and even to extent the commercial validity. The objective of the present work is to contribute to the evaluation of the interference of electron beam irradiation on the sensory characteristics of chilled croaker (M. furnieri) fillets, unloaded in Niterói - RJ, Brazil. The samples were divided into three groups: control; irradiated at 0.7 KGy; and irradiated at 1.0 kGy, which were compared with each other through sensory tests with 30 triangular panelists each. They evaluated aroma, flavor, odor, texture and "other". Whole fish were purchased at Itaipú pier, were fillet in the market, vacuum packed and kept at ± 4 °C. Statistically significant differences were found (p<0,05) between samples when comparing the 1.0-kGy irradiated group with the other groups. It is therefore concluded that a 1.0-kGy dose alters the sensory characteristics of irradiated croaker fillets.(AU)
El proceso de deterioro de peces se facilita por sus características intrínsecas, tales como la proximidad de la neutralidad que se encuentra el PH; acción de las enzimas autolíticas; alta actividad de agua y presencia de nutrientes; además de la alta cantidad de grasas insaturadas que ayudan a acelerar el proceso de formación de rancidez. El uso de métodos de conservación debe realizarse lo más temprano posible, retardando la instalación de deterioro y manteniendo el producto fresco durante un largo espacio de tiempo. Entre las tecnologías disponibles para la conservación están las radiaciones ionizantes. Esta tecnología ya se utiliza en varios países y es muy eficaz en la ampliación de la validad comercial e incluso la mejora de algunos atributos sensoriales. El objetivo del presente trabajo ha sido evaluar el impacto de la irradiación por rayos de electrones en las características sensoriales de filetes de corvina (M. furnieri) refrigerados, desembarcados en el municipio de Niterói - RJ, Brasil. Las muestras se dividieron en tres grupos: control; irradiados a 0.7 kGy; e irradiados a 1,0 kGy, los cuales fueron comparados sensorialmente entre sí a través de pruebas triangulares realizadas con 30 panelistas. También, se evaluaron el aroma, sabor, olor, textura y "otros". Los pescados enteros fueron comprados en el muelle de Itaipú, fileteados en el mercado, envasados al vacío y mantenidos a ± 4°C. Se encontraron diferencias estadísticamente significativas (p<0,05) entre las muestras, cuando se compara el grupo irradiado a 1,0 kGy con los demás. Se concluye que una dosis de 1,0 kGy altera las características sensoriales de filetes de corvina irradiados.(AU)
Assuntos
Animais , Peixes/anatomia & histologia , Peixes/classificação , Radiação , Células Receptoras Sensoriais/classificaçãoRESUMO
Thyroid orbitopathy is the most prevalent non-thyroid symptom in Graves' syndrome. It has a high incidence and particularly affects young women. Smoking is clearly involved in its development and progress, and in its response to different treatments. This autoimmune condition usually has a benign course, independent from hyperthyroidism, but its severe, progressive forms represent a major therapeutic challenge. Clinical evaluation poses great difficulties, as there is no truly objective rating scale representing disease activity. New molecular or inflammation markers may prove to be useful in this regard. This review reports new findings about its pathophysiology and the different techniques used for treatment over time. Discussion particularly focuses on the immunomodulatory role of radiotherapy, as well as on its role together with corticosteroids.
Assuntos
Oftalmopatia de Graves/radioterapia , Corticosteroides/uso terapêutico , Terapia Combinada , Descompressão Cirúrgica , Método Duplo-Cego , Feminino , Oftalmopatia de Graves/imunologia , Oftalmopatia de Graves/fisiopatologia , Oftalmopatia de Graves/terapia , Humanos , Incidência , Masculino , Modelos Biológicos , Pentoxifilina/uso terapêutico , Lesões por Radiação/etiologia , Radioterapia de Alta Energia/efeitos adversos , Radioterapia de Alta Energia/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Selênio/uso terapêutico , Fumar/efeitos adversosRESUMO
La primera causa de irradiación de los seres humanos es la exposición a radiaciones ionizantes provocadas por procedimientos médicos. Los avances en la tecnología aplicada a diagnóstico por imágenes, la radioterapia y el aumento de intervenciones guiadas por rayos X, particularmente en los países desarrollados, ha aumentado de manera considerable la posibilidad de irradiar a pacientes y a trabajadores sanitarios. La situación es capaz de generar daños específicos. A partir de lecciones aprendidas al tratar algunos accidentes esta presentación pretende informar de los riesgos, recordar las particularidades de la protección radiológica y concientizar a la comunidad médica respecto de la importancia del entrenamiento y la capacitación en la protección radiológica. El compromiso ético por excelencia: "Primum non nocere", primero no dañar, resume la cuestión.
Exposure to ionizing radiation caused by medical procedures is the first cause of irradiation of human beings. Advances in technology applied to imaging diagnostic, radiotherapy and the increase of interventions guided by x-ray, particularly in developed countries, has increased considerably the possibility of irradiating patients and health workers. The situation is capable of generating specific damages. This presentation aims to report risks, to remember characteristics of radiation protection and to educate the medical community about the importance of training and training in radiation protection, from lessons learned treating some accidents The ethical commitment to excellence: "Primum non nocere", first not to damage, sums up the issue
A primeira causa de irradiação dos seres humanos é a exposição a radiações ionizantes provocadas por procedimentos médicos. Os avanços na tecnologia aplicada a diagnóstico por imagens, a radioterapia e o acréscimo das intervenções guiadas por raios X, notadamente nos países desenvolvidos, tem incrementado consideravelmente a possibilidade de irradiar pacientes e trabalhadores da saúde. Isto pode gerar danos específicos.Esta apresentação pretende informar respeito dos riscos na base de lições apreendidas por tratar alguns acidentes, lembrar as particularidades da proteção radiológica e conscientizar a comunidade médica respeito da importância do treinamento e o aperfeiçoamento na proteção radiológica. O compromisso ético por excelência: "Primum non nocere", primeiro não provocar danos, norteia a questão
Assuntos
Radiação , Radiação Ionizante , Proteção RadiológicaRESUMO
Comunicamos un caso de proliferación atípica vascular, en piel irradiada por cáncer de mama en una mujer de 69 años, de nueve años de control evolutivo sin terapia agresiva, sin complicaciones ni recidivas.
A 69 year-old woman with an atypical vascular proliferation due to irradiated brest cancer, are reported. The follow up is of nine years without local recurrences, after the electrodessications of the lesions.
RESUMO
INTRODUCTION: Accelerated partial breast irradiation (APBI) with multicatheters after lumpectomy for breast cancer (BC) may be an alternative to whole breast irradiation in selected patients. The aim is to show our 5 year experience. METHOD: Between June 2007 and June 2012, 87 BC patients have been evaluated for APBI. Inclusion criteria were: age over 40 years, unifocal tumour, infiltrating ductal or intraductal carcinoma, tumour size smaller than 3 cm and no lymph node involvement. Complications, cosmetic results and local and distant recurrences were evaluated. RESULTS: Treatment was completed in 48 patients and contraindicated in 39. The average age of treated patients was 59 years. Operating time was 123 min with 9 implanted catheters in each patient. No complications were observed during surgery or radiotherapy. Patients were discharged from hospital after 4 days. Tumour size was 11 mm. Of these, 35 were infiltrating ductal and 13 intraductal carcinomas. A total of 44 patients received adjuvant treatment. Mean follow-up was 22 months with no evidence of local or distant recurrence. The cosmetic outcome was good or excellent in 66% of cases. CONCLUSIONS: APBI with multicatheter placed after lumpectomy for BC is feasible and safe but requires a strict selection of patients.
Assuntos
Braquiterapia/instrumentação , Braquiterapia/métodos , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Mastectomia Segmentar , Catéteres , Terapia Combinada , Feminino , Humanos , Período Intraoperatório , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de TempoRESUMO
The aim was to study the effect of preconception gamma irradiation on the gross morphometry of the adult female mice and its embryo. Twenty-seven mice; 18 females and 9 males: subdivided into 3 groups namely (Control, Non-Irradiation and Radiation) containing 6 females and 3 male mice each in 2:1 ratio. A gamma irradiation dose of 1Gy/min was delivered to each batch of mice exposed by a Cobalt 60, Theratron 780c model, by Atomic Energy of Canada Limited (AECL) at the Radiotherapy department of the University College Hospital, Ibadan. All the animals were mated 1 week post irradiation. Vaginal plugs were confirmed, and the pregnant females were sacrificed on day 14 of gestation by chloroform inhalation. The gross morphology of the female mice and their harvested litters were assessed and statistically analysed. A total of 113 embryos were harvested in all groups; 54 for Control, 50 for Non-Irradiated and 9 for the irradiation group. The gross morphologic assessments of the fetuses were statistically significant at P value < 0.05 for all the 3 groups compared. These findings suggest that a preconception irradiation affects the morphology of the female mice and its progeny.
El objetivo fue estudiar el efecto de la irradiación gamma antes de la concepción sobre la morfometría macroscópica de ratones hembra adultos y los embriones de sus crías. Veinte y siete ratones, 18 hembras y 9 machos, divididos en 3 grupos (control, sin irradiación e irradiado) con 6 hembras y 3 machos cada uno en proporción 2:1. Una dosis de radiación gamma de 1 Gy/min fue aplicada a uno de los ratones expuestos por un equipo Cobalt 60, Theratron modelo 780c, Atomic Energy of Canada Limited (AECL) en el departamento de radioterapia del Hospital University College de Ibadan. Todos los animales se aparearon 1 semana después de la irradiación. Se confirmaron los tapones vaginales, y las hembras preñadas fueron sacrificadas en el día 14 de la gestación por inhalación de cloroformo. La morfología general de los ratones hembras y sus camadas fueron evaluadas y analizadas estadísticamente. Un total de 113 embriones se recolectaron en todos los grupos, 54 del grupo control, 50 del grupo no irradiados y 9 del grupo irradiado. Las evaluaciones morfológicas macroscópicas de los fetos fueron estadísticamente significativas (p<0,05) para los 3 grupos de comparación. Estos hallazgos sugieren que una irradiación previa a la concepción afecta a la morfología de los ratones hembra y su progenie.