RESUMO
Manganese (Mn), despite being a trace element necessary in small quantities for the correct functioning of the organism, at higher concentrations can induce health disorders, mainly in motor and cognitive functions, even at levels found in non-occupational environments. For this reason, US EPA guidelines define safe reference doses/concentrations (RfD/RfC) for health. In this study, the individualised health risk of exposure to Mn through different media (air, diet, soil) and routes of entry into the organism (inhalation, ingestion and dermal absorption) was assessed according to the procedure defined by the US EPA. Calculations related to Mn present in ambient air were made on the basis of data obtained from size-segregated particulate matter (PM) personal samplers carried by volunteers recruited in a cross-sectional study conducted in the Santander Bay (northern Spain), where an industrial source of airborne Mn is located. Individuals residing in the vicinity of the main Mn source (within 1.5 km) were found to have a hazard index (HI) higher than 1, indicating that there is a potential risk for these subjects to develop health alterations. Also, people living in Santander, the capital of the region, located 7-10 km from the Mn source, may have some risk (HI > 1) under some wind conditions (SW). In addition, a preliminary study of media and routes of entry into the body confirmed that inhalation of PM2.5-bound Mn is the most important route contributing to the overall non-carcinogenic health risk related to environmental Mn.
Assuntos
Poluentes Atmosféricos , Manganês , Humanos , Manganês/análise , Monitoramento Ambiental/métodos , Estudos Transversais , Exposição Ambiental/análise , Material Particulado/análise , Medição de Risco , Poluentes Atmosféricos/análiseRESUMO
Investigations regarding the feasibility, reliability, and accuracy of Fricke gel dosimeter layers for stereotactic radiosurgery are presented. A representative radiosurgery plan consisting of two targets has been investigated. Absorbed dose distributions measured using radiochromic films and gelatin Fricke Gel dosimetry in layers have been compared with dose distributions calculated by using a treatment planning system and Monte Carlo simulations. The different dose distributions have been compared by means of the gamma index demonstrating that gelatin Fricke gel dosimeter layers showed agreements of 100%, 100%, and 93%, with dose and distance tolerances of 2% and 2 mm, with respect to film dosimetry, treatment planning system and Monte Carlo simulations, respectively. The capability of the developed system for three-dimensional dose mapping was shown, obtaining promising results when compared with well-established dosimetry methods. The obtained results support the viability of Fricke gel dosimeter layers analyzed by optical methods for stereotactic radiosurgery.
Assuntos
Corantes Fluorescentes/química , Géis/química , Fenóis/química , Dosímetros de Radiação/normas , Radiocirurgia/métodos , Sulfóxidos/química , Estudos de Viabilidade , Humanos , Método de Monte Carlo , Imagens de Fantasmas , Reprodutibilidade dos TestesRESUMO
In this work, the benefits in terms of dose enhancement and dose sparing via radiation shielding are evaluated, for a combined irradiation scheme with sources of 241Am and tumor-infused with Gd agents, regarding conventional 192Ir treatment. Monte Carlo simulations using PENELOPE code were implemented for endocavitary brachytherapy geometries, configuring a pelvis phantom of 15 cm radius and 30 cm length. Inside, it was defined cylindrical tumor phantoms of 2 cm radius and 4 cm-6 cm length (simulating initial stages) as well as tumors of extensive volume (2.5 and 3.0 cm radius) and difficult coverage. Tumor phantoms were doped with 68 mM and 138 mM of Gd in order to assess the effects of enhancement and protection based on the concentration and emission energy of the isotope. Obtained results for the first tumor group, shown the feasibility of achieving dose enhancements of 94.3%-117% and 160%-194% for 68 mM and 138 mM of Gd infused into the tumor and irradiation with 241Am, respectively. Similarly, reduced dose enhancements of 3.5-5.7% y 8.9%-11.2% for 68 mM and 138 mM of Gd are attained with 192Ir. In terms of dose sparing outer the tumor, the radiation shielding and dose enhancement allowed a higher reduction in the dose by 241Am of 17%-24% for 68 mM and 21%-32% for 138 mM of Gd, and non-negligible dose sparing are produced too by 192Ir of 2% and 5% for the same concentration of Gd. For the second tumors group, the combined use of 241Am and Gd agents simultaneously allowed to improve coverage and reduce the healthy tissue dose, showing the obtained results the possibility of achieving coverage of 95% of the prescribed dose in 100% of tumor volume together with dose sparing factor of 6-21% reduction in isodose of the studied point and dose enhancements of 75%-158% at the prescription point.
Assuntos
Amerício/administração & dosagem , Braquiterapia/métodos , Gadolínio/administração & dosagem , Neoplasias/radioterapia , Dosagem Radioterapêutica , Humanos , Método de Monte Carlo , Imagens de FantasmasRESUMO
This work reports the experimental development of an integral Gd-infused dosimeter suitable for Gd dose enhancement assessment along with Monte Carlo simulations applied to determine the dose enhancement by radioactive and X-ray sources of interest in conventional and electronic brachytherapy. In this context, capability to elaborate a stable and reliable Gd-infused dosimeter was the first goal aimed at direct and accurate measurements of dose enhancement due to Gd presence. Dose-response was characterized for standard and Gd-infused PAGAT polymer gel dosimeters by means of optical transmission/absorbance. The developed Gd-infused PAGAT dosimeters demonstrated to be stable presenting similar dose-response as standard PAGAT within a linear trend up to 13â¯Gy along with good post-irradiation readout stability verified at 24 and 48â¯h. Additionally, dose enhancement was evaluated for Gd-infused PAGAT dosimeters by means of Monte Carlo (PENELOPE) simulations considering scenarios for isotopic and X-ray generator sources. The obtained results demonstrated the feasibility of obtaining a maximum enhancement around of (14⯱â¯1)% for 192Ir source and an average enhancement of (70⯱â¯13)% for 241Am. However, dose enhancement up to (267⯱â¯18)% may be achieved if suitable filtering is added to the 241Am source. On the other hand, optimized X-ray spectra may attain dose enhancements up to (253⯱â¯22) %, which constitutes a promising future alternative for replacing radioactive sources by implementing electronic brachytherapy achieving high dose levels.
Assuntos
Braquiterapia/métodos , Gadolínio/administração & dosagem , Dosagem Radioterapêutica , Amerício , Braquiterapia/estatística & dados numéricos , Simulação por Computador , Relação Dose-Resposta à Radiação , Estudos de Viabilidade , Géis , Humanos , Radioisótopos de Irídio , Método de Monte Carlo , Polímeros/administração & dosagem , Dosímetros de Radiação/estatística & dados numéricos , Radiometria/estatística & dados numéricos , Planejamento da Radioterapia Assistida por Computador/métodos , Planejamento da Radioterapia Assistida por Computador/estatística & dados numéricos , Raios XRESUMO
Conventional radiotherapy is mainly applied by linear accelerators. Although linear accelerators provide dual (electron/photon) radiation beam modalities, both of them are intrinsically produced by a megavoltage electron current. Modern radiotherapy treatment techniques are based on suitable devices inserted or attached to conventional linear accelerators. Thus, precise control of delivered beam becomes a main key issue. This work presents an integral description of electron beam deflection control as required for novel radiotherapy technique based on convergent photon beam production. Theoretical and Monte Carlo approaches were initially used for designing and optimizing device´s components. Then, dedicated instrumentation was developed for experimental verification of electron beam deflection due to the designed magnets. Both Monte Carlo simulations and experimental results support the reliability of electrodynamics models used to predict megavoltage electron beam control.
Assuntos
Elétrons/uso terapêutico , Planejamento da Radioterapia Assistida por Computador/métodos , Radioterapia de Alta Energia/métodos , Simulação por Computador , Humanos , Método de Monte Carlo , Aceleradores de Partículas , Imagens de Fantasmas , Fótons/uso terapêutico , Planejamento da Radioterapia Assistida por Computador/instrumentação , Planejamento da Radioterapia Assistida por Computador/estatística & dados numéricos , Radioterapia de Alta Energia/instrumentação , Radioterapia de Alta Energia/estatística & dados numéricosRESUMO
The present work investigates preliminary feasibility and characteristics of a new type of radiation therapy modality based on a single convergent beam of photons. The proposal consists of the design of a device capable of generating convergent X-ray beams useful for radiotherapy. The main goal is to achieve high concentrated dose delivery. The first step is an analytical approach in order to characterize the dosimetric performance of the hypothetical convergent photon beam. Then, the validated FLUKA Monte Carlo main code is used to perform complete radiation transport to account also for scattering effects. The proposed method for producing convergent X-rays is mainly based on the bremsstrahlung effect. Hence the operating principle of the proposed device is described in terms of bremsstrahlung production. The work is mainly devoted characterizing the effect on the bremsstrahlung yield due to accessories present in the device, like anode material and geometry, filtration and collimation systems among others. The results obtained for in-depth dose distributions, by means of analytical and stochastic approaches, confirm the presence of a high dose concentration around the irradiated target, as expected. Moreover, it is shown how this spot of high dose concentration depends upon the relevant physical properties of the produced convergent photon beam. In summary, the proposed design for producing single convergent X-rays attained satisfactory performance for achieving high dose concentration around small targets depending on beam spot size that may be used for some applications in radiotherapy, like radiosurgery.
Assuntos
Teleterapia por Radioisótopo/instrumentação , Estudos de Viabilidade , Método de Monte Carlo , Óptica e Fotônica , Fótons/uso terapêutico , Radiometria , Dosagem Radioterapêutica , Espalhamento de RadiaçãoRESUMO
Hematopoietic cell transplantation (HCT) is a highly specialized, expensive and resource-intense medical procedure that can be associated with racial disparities. We review the prevailing literature on racial disparities in HCT in the United States and describe areas for future research and interventions. We discuss the complexity of interpreting race as a biological and social determinant of disease in biomedical research, especially as it relates to HCT. In the United States, race is often a surrogate for socioeconomic, education and health insurance status. We also discuss some of the nuances to consider while reviewing the literature on racial disparities. Disparities by race exist in three areas related to HCT: donor availability, access to HCT and outcomes of HCT. African-Americans/Blacks have a lower likelihood of finding an unrelated donor. Race and ethnicity definitions are country-specific and reconciling race data can represent significant challenges to unrelated donor registries worldwide. African-Americans/Blacks do not have the same access to autologous and allogeneic HCT as Whites. Racial disparities in outcomes of HCT are more prevalent among allogeneic HCT than autologous HCT recipients. More research is required to understand the biological, social, cultural, medical and financial aspects of race that may influence access to HCT and survival after transplantation. Better understanding of racial disparities will minimize inequities, inform health policy, guide development of interventions targeted to eliminate disparities and ensure equitable access to HCT for all populations.