Radiological assessment in beach sediment of coastline, Ghana.

The natural and artificial radioactivity in beach sediment sampled from the coastline of Ghana were analyzed using High Purity Germanium gamma ray detector. The overall average activity concentrations of 226Ra, 232Th, 40K and 137Cs were estimated to be 43 ± 6, 22 ± 1, 393 ± 74 and 8.4 ± 0.5 Bqkg-1, respectively. Apart from 226Ra the mean activity concentrations of the measured radionuclides were below the world averages of 32, 45, 412 and 18.2 Bqkg-1 respectively. High 137Cs mean concentration of 109.8 Bqkg-1 was observed for one of the locations, which might be due to the occurrence of a nuclear incidence or other factors. The evaluated radiological parameters also had values below world averages, except for some coastal areas which recorded Annual Gonadal Dose Equivalent (AGDE) values higher than the reference level of 300 µSvy-1. There was no significant risk associated with the radionuclide activities evaluated along the coast of Ghana. The correlation between the radionuclides and the radiological parameters were analyzed with the Pearson correlation matrix, cluster and PCA analysis, and they all showed similar outcomes. Spatial distribution maps were also created using ArcGIS software for a pictorial view of the distribution of radionuclides along the study area.

Radiological Assessment of Indoor Radon and Thoron Concentrations and Indoor Radon Map of Dwellings in Mashhad, Iran.

A comprehensive study was carried out to measure indoor radon/thoron concentrations in 78 dwellings and soil-gas radon in the city of Mashhad, Iran during two seasons, using two common radon monitoring devices (NRPB and RADUET). In the winter, indoor radon concentrations measured between 75 ± 11 to 376 ± 24 Bq·m-3 (mean: 150 ± 19 Bq m-3), whereas indoor thoron concentrations ranged from below the Lower Limit of Detection (LLD) to 166 ± 10 Bq·m-3 (mean: 66 ± 8 Bq m-3), while radon and thoron concentrations in summer fell between 50 ± 11 and 305 ± 24 Bq·m-3 (mean 115 ± 18 Bq m-3) and from below the LLD to 122 ± 10 Bq m-3 (mean 48 ± 6 Bq·m-3), respectively. The annual average effective dose was estimated to be 3.7 ± 0.5 mSv yr-1. The soil-gas radon concentrations fell within the range from 1.07 ± 0.28 to 8.02 ± 0.65 kBq·m-3 (mean 3.07 ± 1.09 kBq·m-3). Finally, indoor radon maps were generated by ArcGIS software over a grid of 1 × 1 km2 using three different interpolation techniques. In grid cells where no data was observed, the arithmetic mean was used to predict a mean indoor radon concentration. Accordingly, inverse distance weighting (IDW) was proven to be more suitable for predicting mean indoor radon concentrations due to the lower mean absolute error (MAE) and root mean square error (RMSE). Meanwhile, the radiation health risk due to the residential exposure to radon and indoor gamma radiation exposure was also assessed.

Nutritional assessment in surgical oncology: An ESSO-EYSAC global survey.

INTRODUCTION: The majority of cancer patients report malnutrition, with a significant impact on patient's outcome. This study aimed to compare how nutritional assessment is conducted across different surgical oncology sub-specialties. METHODS: Survey modules were designed for breast, hepato-pancreato-biliary (HPB), upper-gastrointestinal (UGI), sarcoma, peritoneal and surface malignancies (PSM) and colorectal cancer (CRC) surgeries to describe 4 domains: participants' setting, evaluation of clinical factors, use of screening tools and clinical practice. Results were compared among sub-specialties and according to human development index (HDI) in the largest cohorts. RESULTS: Out of 457 answers from 377 global participants (62% European), 35.0% were from breast and 28.9% were from CRC surgeons. Although MDTs management is consistently reported (64-88%), the presence of a nutritionist/dietician ranges from 14.1% to 44.2%. Breast surgeons seldom evaluate albumin (25.6%) and weight loss (30.6%), opposite to HPB, PSM and UGI groups (>70%, p 0.044). Overall, responders declared that the use of screening tools is largely neglected, that nutritional status is often assessed by the surgeons and that nutrition is not consistently modified according to risk factors (range among groups respectively: 1.9%-25.6%, 33.1%-51.4%, 33.1%-60.5%). Less than 20% of breast surgeons assess patients before/after surgery, comparing to >60% of PSM surgeons. However, no statistical differences were documented comparing groups for the majority of the items of the 4 domains. Nutritional evaluation is more often conducted by breast surgeons in medium/low HDI countries comparing very high/high HDI (p 0.04). CONCLUSIONS: Nutritional assessment is largely neglected. These results identify target-issues for the implementation of clinical practice.

Theoretical and practical knowledge curriculum for European Breast Surgeons.

The Breast Surgery theoretical and practical knowledge curriculum comprehensively describes the knowledge and skills expected of a fully trained breast surgeon practicing in the European Union and European Economic Area (EEA). It forms part of a range of factors that contribute to the delivery of high quality cancer care. It has been developed by a panel of experts from across Europe and has been validated by professional breast surgery societies in Europe. The curriculum maps closely to the syllabus of the Union of European Medical Specialists (UEMS) Breast Surgery Exam, the UK FRCS (breast specialist interest) curriculum and other professional standards across Europe and globally (USA Society of Surgical Oncology, SSO). It is envisioned that this will serve as the basis for breast surgery training, examination and accreditation across Europe to harmonise and raise standards as breast surgery develops as a separate discipline from its parent specialties (general surgery, gynaecology, surgical oncology and plastic surgery). The curriculum is not static but will be revised and updated by the curriculum development group of the European Breast Surgical Oncology Certification group (BRESO) every 2 years.

OCCUPATIONAL EXPOSURE ASSESSMENT AT A THERAPEUTIC RADON SPA FACILITY IN HUNGARY.

In order to estimate occupational exposure of workers in a therapeutic radon spa facility, radon concentration in the workplace air was investigated at Markhot Ferenc Hospital, Eger, Hungary. The investigated balneotherapeutic facility and its natural hot spa water are used for treatments and rehabilitations of rheumatic patients. Radon concentration, radon decay products at a bathhouse, treatment rooms and a consultation room were continuously measured in August and September 2018. In the present study, different levels of radon concentration among the observation sites and its clear temporal variations were found, though radon concentrations in the investigated sites were below 300 Bq m-3. Regarding such radon fluctuation and low equilibrium factor level (0.1), the annual effective doses of workers are estimated to be around 0.5 mSv year-1.

Intraoperative Assessment of Tumor Resection Margins in Breast-Conserving Surgery Using 18F-FDG Cerenkov Luminescence Imaging: A First-in-Human Feasibility Study.

In early-stage breast cancer, the primary treatment option for most women is breast-conserving surgery (BCS). There is a clear need for more accurate techniques to assess resection margins intraoperatively, because on average 20% of patients require further surgery to achieve clear margins. Cerenkov luminescence imaging (CLI) combines optical and molecular imaging by detecting light emitted by 18F-FDG. Its high-resolution and small size imaging equipment make CLI a promising technology for intraoperative margin assessment. A first-in-human study was conducted to evaluate the feasibility of 18F-FDG CLI for intraoperative assessment of tumor margins in BCS. Methods: Twenty-two patients with invasive breast cancer received 18F-FDG (5 MBq/kg) 45-60 min before surgery. Sentinel lymph node biopsy was performed using an increased 99mTc-nanocolloid activity of 150 MBq to facilitate nodal detection against the γ-probe background signal (cross-talk) from 18F-FDG. The cross-talk and 99mTc dose required was evaluated in 2 lead-in studies. Immediately after excision, specimens were imaged intraoperatively in an investigational CLI system. The first 10 patients were used to optimize the imaging protocol; the remaining 12 patients were included in the analysis dataset. Cerenkov luminescence images from incised BCS specimens were analyzed postoperatively by 2 surgeons blinded to the histopathology results, and mean radiance and margin distance were measured. The agreement between margin distance on CLI and histopathology was assessed. Radiation doses to staff were measured. Results: Ten of the 12 patients had an elevated tumor radiance on CLI. Mean radiance and tumor-to-background ratio were 560 ± 160 photons/s/cm2/sr and 2.41 ± 0.54, respectively. All 15 assessable margins were clear on CLI and histopathology. The agreement in margin distance and interrater agreement was good (κ = 0.81 and 0.912, respectively). Sentinel lymph nodes were successfully detected in all patients. The radiation dose to staff was low; surgeons received a mean dose of 34 ± 15 µSv per procedure. Conclusion: Intraoperative 18F-FDG CLI is a promising, low-risk technique for intraoperative assessment of tumor margins in BCS. A randomized controlled trial will evaluate the impact of this technique on reexcision rates.

[Epidemiology of dementia in Hungary]. / A dementia epidemiológiája magyarországon.

OBJECTIVE: To estimate the epidemiology and the distribution of disease severity of dementia in Hungary, using published data. To estimate the demented population of 2008 and to make a projection for 2050. METHODOLOGY: With an outlook for the international professional literature and the available Hungarian information we examine the epidemiology of dementia in Hungary by age-groups and disease severity (according to MMSE categories), then make our estimation for the entire population. RESULTS: Based on the estimation of the number of demented people in Hungary there is a noticeable difference between the domestic and the internationally published data. According to previous Hungarian studies, the number of the demented subjects vary between 530 and 917 thousand patients. Multiplying the elderly age-group's populations by the global prevalence data it results in 101 thousand of demented patients. Estimation by the domestic published data we remarkably overestimate the presumed value, whereas by using the global prevalence figures we underestimate. CONCLUSIONS: There is a strong need for a representative study to obtain exact figures on the prevalence of dementia in Hungary. Getting exact figures of the Hungarian prevalence of dementia it is a strong need an overall representative study. With the lack of it the health and social care systems are not able to prepare for providing the increasing number of patients.