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1.
Bull Cancer ; 106(10): 903-914, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31495441

RESUMO

Germ-cell tumors are the most common solid tumors in young men. The follow-up of these patients is very important in their management. In stage I testicular cancer, surveillance is the standard for low-risk disease. In addition to the early detection of relapse, follow-up should be directed towards prevention, detection and treatment of late toxicity, and secondary malignancies. Follow up consists in physical examination, laboratory analysis and radiological imaging. Recently, guidelines recommend risk-adapted surveillance strategy, with a reduction of CT scans numbers, due to the recognition of the risk of ionizing radiation exposure. However, efforts to maintain adequate compliance with follow up are required.


Assuntos
Recidiva Local de Neoplasia/prevenção & controle , Neoplasias Embrionárias de Células Germinativas/prevenção & controle , Segunda Neoplasia Primária/diagnóstico , Neoplasias Testiculares/prevenção & controle , Adulto , Humanos , Masculino , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/patologia , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Induzidas por Radiação/diagnóstico , Neoplasias Induzidas por Radiação/prevenção & controle , Cooperação do Paciente , Exposição à Radiação/prevenção & controle , Prevenção Secundária , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/patologia , Tomografia Computadorizada por Raios X , Adulto Jovem
2.
Oncology ; 96(4): 173-178, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30836369

RESUMO

Firstly used in the early 90s to generate 3-dimensional projections of X-ray images, cone beam computed tomography (CBCT) has resulted in a large application in dentomaxillofacial imaging, even in children. CBCT uses ionizing radiation that may cause damage to the DNA, and children are at the greatest carcinogenesis risk due to their higher tissue radiosensitivity and their longer life expectancy compared to adults. The questions of whether the cancer risk is really increased after repeated dental CBCT in childhood and of what the underlying biological basis is have become hot topics in the field of dentistry and radiobiology. We performed an overview of the current literature to assess an acceptable role of CBCT in pediatric dentistry.


Assuntos
Tomografia Computadorizada de Feixe Cônico/efeitos adversos , Dano ao DNA , Neoplasias Induzidas por Radiação/etiologia , Odontopediatria , Exposição à Radiação/efeitos adversos , Radiografia Dentária/efeitos adversos , Fatores Etários , Humanos , Neoplasias Induzidas por Radiação/diagnóstico , Neoplasias Induzidas por Radiação/genética , Odontopediatria/métodos , Radiografia Dentária/métodos , Medição de Risco , Fatores de Risco , Fatores de Tempo
3.
Cancer Sci ; 110(2): 817-827, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30548366

RESUMO

Thyroid ultrasound screening of young residents in Fukushima Prefecture, Japan, showed a high detection rate of papillary thyroid carcinoma (PTC). Detailed morphological analysis of these tumors was not presented to date. This study sets out to evaluate changes in histopathological and invasive characteristics of Fukushima PTC with time after the nuclear accident of March 2011 in all available cases and in different age subgroups. Histological specimens of 115 PTCs from patients aged 18 years or younger at the time of the Fukushima Dai-ichi Nuclear Power Plant accident, who underwent surgical resection at Fukushima Medical University during 2012-2016, were reviewed. Patients were divided into those treated during the first 4 years after the accident (n = 78, shorter-onset) or later (n = 37, longer-onset). The whole group and 3 age subgroups: children (aged less than 15 years), adolescents (aged from 15 to less than 19 years), and young adults (aged from 19 years) at surgery were analyzed. No statistically significant time-related changes in tumor structure or invasiveness were found in the whole group or in age-matched subgroups. Statistically significant age-related downtrend was observed for intrathyroid spread in the whole group of patients. The absence of temporal changes in tumor morphological characteristics and tumor invasiveness strongly suggests common etiology of the shorter- and longer-onset Fukushima PTCs, which are unlikely related to the effect of exposure to very low doses of radiation.


Assuntos
Carcinoma/patologia , Neoplasias Induzidas por Radiação/patologia , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Adolescente , Adulto , Feminino , Acidente Nuclear de Fukushima , Humanos , Japão , Masculino , Programas de Rastreamento/métodos , Neoplasias Induzidas por Radiação/diagnóstico , Doses de Radiação , Ultrassonografia/métodos , Adulto Jovem
4.
J Vasc Surg ; 69(6): 1776-1785.e2, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30583890

RESUMO

OBJECTIVE: Endovascular aneurysm repair (EVAR) has increasingly been used as the primary treatment approach for abdominal aortic aneurysm (AAA). This study examined the hypothesis that EVAR leads to an increased risk of abdominal cancer within the radiation field compared with open AAA repair. METHODS: The nationwide English Hospital Episode Statistics database was used to identify all patients older than 50 years who received an AAA repair in 2005 to 2013. EVAR and open AAA repair groups were compared for the incidence of postoperative cancer using inverse probability weights and G-computation formula to adjust for selection bias and confounding. RESULTS: Among 14,150 patients who underwent EVAR and 24,645 patients who underwent open AAA repair, follow-up was up to 7 years. EVAR was associated with an increased risk of postoperative abdominal cancer (hazard ratio [HR], 1.14; 95% confidence interval [CI], 1.03-1.27) and all cancers (HR, 1.09; 95% CI, 1.02-1.17). However, there was no difference between the groups in the risk of lung cancer (HR, 1.04; 95% CI, 0.92-1.18) or obesity-related nonabdominal cancer (HR, 1.12; 95% CI, 0.69-1.83). Within the EVAR group, use of computed tomography surveillance was not associated with any increased risk of abdominal cancer (HR, 0.94; 95% CI, 0.71-1.23) or all cancers (HR, 0.97; 95% CI, 0.81-1.17). CONCLUSIONS: This study suggests an increased risk of abdominal cancer after EVAR compared with open AAA repair. The differential cancer risk should be further explored in alternative national populations, and radiation exposure during EVAR should be measured as a quality metric in the assessment of EVAR centers.


Assuntos
Neoplasias Abdominais/epidemiologia , Aneurisma da Aorta Abdominal/cirurgia , Aortografia/efeitos adversos , Implante de Prótese Vascular/efeitos adversos , Angiografia por Tomografia Computadorizada/efeitos adversos , Procedimentos Endovasculares/efeitos adversos , Neoplasias Induzidas por Radiação/epidemiologia , Radiografia Intervencionista/efeitos adversos , Neoplasias Abdominais/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/epidemiologia , Bases de Dados Factuais , Inglaterra/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/diagnóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
5.
Circ Cardiovasc Interv ; 11(11): e006765, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30571202

RESUMO

Background Children treated with cardiac catheterization procedures have now a long life expectancy and consequently potential long-term radiation-induced risks. We projected lifetime attributable risks (LARs) of cancer incidence from the most frequent procedures in pediatrics: atrial septal defect closure, patent ductus arteriosus occlusion, or pulmonary valvuloplasty. Methods and Results Organ equivalent doses were estimated for 1251 procedures performed in children aged ≤15 years at 2 reference catheterization centers in France from 2009 to 2013. Sex-specific LARs were projected in lifelong nonsmokers using extended Committee on Biological Effects of Ionizing Radiation VII risk models and considering various sources of risk projection uncertainties and dose variability (Radiation Risk Assessment Tool software). Median LARs ranged between 0.3 and 1.4 (atrial septal defect closure), 0.6 and 5.0 (patent ductus arteriosus occlusion), and 1.0 and 12.0 (pulmonary valvuloplasty) per 1000 procedures, depending on patient sex and age at treatment. These radiation-related risks would represent 0.4% to 6.0% of children's total lifetime cancer risk. For the 10% of procedures (all types combined) with highest exposures, LARs reached 4.2 per 1000 (95% uncertainty interval, 0.8-13.1) in boys and 22.2 per 1000 (95% uncertainty interval, 7.4-45.6) in girls. In boys, lung cancer accounted for 70% to 80% of the projected LARs, whereas in girls it accounted for 20% to 60% and breast cancer for 30% to 80% of the excess risks, depending on the type of procedure and patient age. Conclusions Radiation exposure may lead to substantial radiation doses and increased cancer risks in some cases. This suggests the need for dose reporting to support recommendations for long-term surveillance and prevention strategies when it is necessary.


Assuntos
Cateterismo Cardíaco/efeitos adversos , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/terapia , Neoplasias Induzidas por Radiação/epidemiologia , Exposição à Radiação/efeitos adversos , Radiografia Intervencionista/efeitos adversos , Adolescente , Idade de Início , Feminino , Fluoroscopia/efeitos adversos , França/epidemiologia , Cardiopatias Congênitas/epidemiologia , Humanos , Incidência , Masculino , Neoplasias Induzidas por Radiação/diagnóstico , Doses de Radiação , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
6.
Cell Physiol Biochem ; 49(5): 1959-1969, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30235449

RESUMO

BACKGROUND/AIMS: Primary splenic angiosarcoma is an aggressive malignancy originating from endothelial cells with a particularly poor outcome despite radical therapy. Owing to its extremely low incidence, available data for splenic angiosarcoma are limited. The present study aimed to address this limitation by presenting a thorough retrospective analysis of Chinese primary splenic angiosarcoma patients over a 53-year period (1963-2016). METHODS: To determine the characteristics of Chinese primary splenic angiosarcoma and identify factors that impact the outcomes of this histology, we retrospectively retrieved reports of 110 Chinese primary splenic angiosarcoma cases published between 1963-2012. RESULTS: In total, 61 males and 49 females diagnosed with primary splenic angiosarcoma were included in the present study. The median age at diagnosis was 50 years (range 2.5-76 years). Of these patients, 25.5% had received prior radiotherapy. The rate of splenic rupture was 59.11%. The 1-year overall survival rate was 19.1% with a median overall survival time of 8.1 months. Age, gender, and radiation history showed no correlation with survival rate. However, by univariate analysis, we found that significant adverse predictors of survival were splenic rupture before surgery and large tumor size (> 5 cm), while adjuvant chemotherapy was a favorable predictor. Furthermore, multivariate analysis revealed that splenic rupture and adjuvant chemotherapy were independent adverse and favorable predictors, respectively. CONCLUSION: Our large series describes and confirms the characteristics and poor prognosis of Chinese primary splenic angiosarcoma, thus indicating a critical role for early diagnosis and surgical intervention (prior to rupture) in management, and highlights the promising potential of adjuvant chemotherapy for improving the outcome in these cases.


Assuntos
Hemangiossarcoma/diagnóstico , Neoplasias Esplênicas/diagnóstico , Adolescente , Adulto , Idoso , Quimioterapia Adjuvante , Criança , Pré-Escolar , China , Bases de Dados Factuais , Feminino , Hemangiossarcoma/tratamento farmacológico , Hemangiossarcoma/mortalidade , Hemangiossarcoma/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/diagnóstico , Neoplasias Induzidas por Radiação/patologia , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Neoplasias Esplênicas/tratamento farmacológico , Neoplasias Esplênicas/mortalidade , Neoplasias Esplênicas/patologia , Taxa de Sobrevida , Adulto Jovem
8.
Dig Dis Sci ; 63(9): 2451-2455, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29855768

RESUMO

BACKGROUND: Cancer survivors treated with abdominal or pelvic radiation therapy (RT) for childhood cancer have an increased risk of colorectal cancer. However, clinical guidelines are inconsistent on recommendations regarding the early initiation of screening in these patients due to the lack of supporting evidence that these patients pass through a pre-invasive phase, in which adenomatous polyps can be detected and removed. AIMS: To determine the prevalence of adenomatous polyps in cancer survivors treated with RT for childhood cancer; the prevalence in average-risk patients aged 17-49; and the prevalence in average-risk patients aged 50-75. METHODS: We conducted a retrospective study comparing the prevalence of adenomatous polyps among three patient groups: childhood cancer survivors aged 17-49 with prior RT who underwent colonoscopy screening from 2006 to 2017; age- and gender-matched patients in the average-risk population; and average-risk patients aged 50-75. RESULTS: One hundred and forty-five patients were included in the study. The proportion of patients with adenomatous polyps in the cancer survivor group was significantly higher than that in the age- and gender-matched average-risk group (58.6 vs 17.2%, p = 0.00) and higher than the average-risk group aged 50-75 (58.6 vs 27.6%, p = 0.009). The prevalence of adenomas with high-risk features was higher in the survivor group compared to patients aged 50-75 (20.7 vs 3.5%, p = 0.015). CONCLUSIONS: Cancer survivors treated with RT for childhood cancer have a higher prevalence of adenomatous polyps compared to the average-risk population. These findings support the early initiation of colonoscopy screening 10 years after radiation therapy, even in patients who have received RT doses below 30 Gy.


Assuntos
Pólipos Adenomatosos/epidemiologia , Sobreviventes de Câncer , Pólipos do Colo/epidemiologia , Neoplasias Colorretais/epidemiologia , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias/radioterapia , Pólipos Adenomatosos/diagnóstico , Adolescente , Adulto , Distribuição por Idade , Idade de Início , Idoso , Colúmbia Britânica/epidemiologia , Pólipos do Colo/diagnóstico , Colonoscopia , Neoplasias Colorretais/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias Induzidas por Radiação/diagnóstico , Prevalência , Radioterapia/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
9.
Med Hypotheses ; 116: 124-131, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29857896

RESUMO

There were many anecdotal reports of injuries to humans, animals and plants following the Three Mile Island, Chernobyl and Fukushima accidents that were indicative of radiation exposures that delivered a dose of at least 0.5 Sieverts, but studies that attempted to relate observed increases of cancer rates and other injuries with exposure to the radioactive releases from these accidents have failed to find an association. To resolve this dissonance, it was assumed that an analysis of knowledge about accident releases and health effects gathered from one of these accidents could lead to the identification of an unrecognized exposure that could be inferred to have caused a specific observed injury that required a dose of at least 0.5 Sieverts. Because there is considerably more useful knowledge of reactor releases of radionuclides and observed health effects related to the Three Mile Island accident, that knowledge is analyzed. A relationship is inferred to exist between exposure to particulates in plumes released from the station vent stack and severe prolonged immunosuppression, a known effect of an exposure that delivers a dose of at least 0.5 Sieverts. More than ninety percent of the particulates were comprised of Strontium 89 nuclides, essentially pure beta emitters. Because Strontium is a metal, the nuclides in the particulates were configured as stable crystals which, when coming to rest in body tissue, functioned as intense point sources of chronic beta irradiation. The inference led to the hypothesis "particulates comprised of Strontium 89 nuclides provided the exposure that caused the health effects that were observed following the Three Mile Island accident". The hypothesis was tested for validity against two requirements; that only the humans beneath the plumes, who would have inhaled the particulates, expressed the abrupt and persistent rise in the health parameter Deaths from all Causes that would result from the severe prolonged immunosuppression that follows a 0.5 Sievert dose, and that they expressed the excess cancers that would be expected following organ doses of 0.5 or more Sieverts. These effects were found. The Hypothesis is therefore valid and leads to knowledge of the heretofore unknown mechanisms and effects of low LET beta irradiation by a particulate.


Assuntos
Neoplasias Induzidas por Radiação/diagnóstico , Liberação Nociva de Radioativos , Radioisótopos de Estrôncio/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Exposição Ambiental/efeitos adversos , Raios gama , Humanos , Imunossupressão , Lactente , Recém-Nascido , Transferência Linear de Energia , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/epidemiologia , New York , Pennsylvania , Doses de Radiação , Medição de Risco , Fatores de Tempo , Adulto Jovem
10.
Health Phys ; 115(1): 161-169, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29787442

RESUMO

This article summarizes the results of 30 y of follow-up of cancer and noncancer effects in Ukrainian cleanup workers after the Chornobyl accident. The number of power plant employees and first responders with acute radiation syndrome under follow-up by the National Research Center for Radiation Medicine decreased from 179 in 1986-1991 to 105 in 2011-2015. Cancers and leukemia (19) and cardiovascular diseases (21) were the main causes of deaths among acute radiation syndrome survivors (54) during the postaccident period. Increased radiation risks of leukemia in the Ukrainian cohort of 110,645 cleanup workers exposed to low doses are comparable to those among survivors of the atomic bomb explosions in Japan in 1945. Additionally, an excess of chronic lymphocytic leukemia was demonstrated in the cleanup workers cohort for 26 y after the exposure. A significant excess of multiple myeloma incidence [standardized incidence rate (SIR) 1.61 %, 95% confidence interval (CI) 1.01-2.21], thyroid cancer (SIR 4.18, 95% CI 3.76-4.59), female breast cancer (SIR 1.57 CI 1.40-1.73), and all cancers combined (SIR 1.07; 95% CI 1.05-1.09) was registered. High prevalence was demonstrated for cardio- and cerebrovascular diseases and mental health changes. However, the reasons for the increases require further investigation. To monitor other possible late effects of radiation exposure in Chornobyl cleanup workers, analytical cohort and case-control studies need to include cardiovascular pathology, specifically types of potentially radiogenic cancers using a molecular epidemiology approach. Possible effects for further study include increased rates of thyroid, breast, and lung cancers and multiple myeloma; reduction of radiation risks of leukemia to population levels; and increased morbidity and mortality of cleanup workers from cardio- and cerebrovascular pathology.


Assuntos
Síndrome Aguda da Radiação/epidemiologia , Acidente Nuclear de Chernobyl , Neoplasias Induzidas por Radiação/epidemiologia , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Vigilância da População , Exposição à Radiação/efeitos adversos , Síndrome Aguda da Radiação/diagnóstico , Síndrome Aguda da Radiação/etiologia , Síndrome Aguda da Radiação/mortalidade , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/diagnóstico , Neoplasias Induzidas por Radiação/etiologia , Neoplasias Induzidas por Radiação/mortalidade , Doenças Profissionais/diagnóstico , Doenças Profissionais/etiologia , Doenças Profissionais/mortalidade , Doses de Radiação , Medição de Risco , Fatores de Risco , Ucrânia/epidemiologia , Adulto Jovem
11.
Radiat Environ Biophys ; 57(2): 163-168, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29550923

RESUMO

The Chernobyl reactor accident in 1986 has caused significant exposure to ionizing radiation of the Ukrainian population, in particular clean-up workers and evacuees from the exclusion zones. A study aiming at the discovery of radiation markers of the breast cancer was conducted from 2008 to 2015 within a collaborative project by HZM, LMU, and NRCRM. In this study, post-Chernobyl breast cancer cases both in radiation-exposed female patients diagnosed at age less than 60 from 1992 to 2014 and in non-exposed controls matched for residency, tumor type, age at diagnosis, TNM classification as well as tumor grading were investigated for molecular changes with special emphasis to copy number alterations and miRNA profiles. Cancer registry and clinical archive data were used to identify 435 breast cancer patients among female clean-up workers and 14 among evacuees from highly contaminated territories as candidates for the study. Of these, 129 breast cancer patients fit study inclusion criteria and were traced for individual reconstruction of the target organ (breast) doses. The doses were estimated for 71 exposed cases (clean-up workers and evacuees from which biomaterial was available for molecular studies and who agreed to participate in a dosimetric interview) by the use of the well-established RADRUE method, which was adjusted specifically for the assessment of breast doses. The results of 58 female clean-up workers showed a large inter-individual variability of doses in a range of about five orders of magnitude: from 0.03 to 929 mGy, with median of 5.8 mGy. The study provides the first quantitative estimate of exposures received by female clean-up workers, which represent a limited but very important group of population affected by the Chernobyl accident. The doses of 13 women evacuated after the accident who did not take part in the clean-up activities (from 4 to 45 mGy with median of 19 mGy) are in line with the previous estimates for the evacuees from Pripyat and the 30-km zone.


Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Acidente Nuclear de Chernobyl , Recuperação e Remediação Ambiental , Neoplasias Induzidas por Radiação/diagnóstico , Neoplasias Induzidas por Radiação/epidemiologia , Exposição Ocupacional/efeitos adversos , Adulto , Neoplasias da Mama/etiologia , Relação Dose-Resposta a Droga , Relação Dose-Resposta à Radiação , Feminino , Humanos , Neoplasias Induzidas por Radiação/etiologia , Ucrânia/epidemiologia
13.
Dermatol Online J ; 24(1)2018 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-29469762

RESUMO

Anaplastic large cell lymphoma (ALCL) is a rare type of non-Hodgkin lymphoma that can involve the skin primarily or secondarily. Our case describes an unusual presentation of eruptive tumors localized to the leftbreast region several years following breast cancer surgery and radiation for carcinoma of the breast. This report highlights the challenges in reachingthe diagnosis of an aggressive systemic lymphoma presenting on the skin.


Assuntos
Neoplasias da Mama/radioterapia , Linfoma Anaplásico de Células Grandes/diagnóstico , Neoplasias Induzidas por Radiação/diagnóstico , Neoplasias Cutâneas/diagnóstico , Idoso de 80 Anos ou mais , Mama/patologia , Neoplasias da Mama/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Linfoma Anaplásico de Células Grandes/patologia , Neoplasias Induzidas por Radiação/patologia , Neoplasias Cutâneas/patologia
14.
Health Phys ; 114(4): 386-397, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29481529

RESUMO

Mallinckrodt Chemical Works was the earliest uranium processing facility in the Manhattan Project, beginning in 1942. Even then, concern existed about possible health effects resulting from exposure to radiation and pitchblende dust. This concern was well founded as the facility processed Belgian Congo pitchblende ore that was up to 60% pure uranium with high U content and up to 100 mg of radium per ton. Workers were exposed to external gamma radiation plus internal radiation from inhalation and ingestion of pitchblende dust (uranium, radium, and silica). Multiple sources of exposure were available for organ dose reconstruction to a degree unique for an epidemiologic study. Personal film badge measures available from 1945 captured external exposures. Additional external exposure included 15,518 occupational medical x-rays and 210 radiation exposure records from other facilities outside of Mallinckrodt employment. Organ dose calculations considered organ-specific coefficients that account for photon energy and job-specific orientation of workers to the radiation source during processing. Intakes of uranium and radium were based on 39,451 uranium urine bioassays and 2,341 breath radon measurements, and International Commission on Radiological Protection (ICRP) Publication 68 biokinetic models were used to estimate organ-specific radiation absorbed dose. Estimates of exposure to airborne radon and its short-lived progeny were based on radon measurements in work areas where radium-containing materials were handled or stored, together with estimated exposure times in these areas based on job titles. Dose estimates for radon and its short-lived progeny were based on models and methods recently recommended in ICRP Publication 137. This comprehensive dosimetric approach follows methods outlined by the National Council on Radiation Protection Scientific Committee 6-9 for the Million Worker Study. Annual doses were calculated for six organs: lung, brain, heart, kidney, colon and red bone marrow. Evaluation and adjustment for individual cumulative measures of pitchblende dust inhalation were made for lung and kidney diseases.


Assuntos
Poluentes Radioativos do Ar/análise , Neoplasias Induzidas por Radiação/diagnóstico , Reatores Nucleares , Exposição Ocupacional/análise , Exposição à Radiação/análise , Proteção Radiológica/normas , Radiometria/métodos , Poluentes Radioativos do Ar/efeitos adversos , Estudos Epidemiológicos , Humanos , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Induzidas por Radiação/etiologia , Exposição Ocupacional/efeitos adversos , Doses de Radiação , Exposição à Radiação/efeitos adversos , Medição de Risco , Estados Unidos/epidemiologia
15.
Int J Surg Pathol ; 26(5): 469-474, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29336183

RESUMO

Synovial sarcoma is a ubiquitous neoplasm predominantly affecting soft tissues of young adults of any gender; few cases have been described in the digestive system, mostly in the stomach. The (X;18)(p11.2; q11.2) translocation yields unique SS18-SSX fusion genes. Synovial sarcoma has been related to radiotherapy, but no synovial sarcoma has been associated with the digestive system. This article describes the case of a synovial sarcoma arising along the extrahepatic biliary tree, 10 years after the application of an abdominal radiotherapy schedule due to a retroperitoneal metastatic seminoma in a male who developed progressive obstructive jaundice. Ninety percent of the analyzed cells carried the SS18 gene with separation of sequences, thus denoting a translocation. There are only 8 post-radiotherapy synovial sarcomas that have been reported previously, and this is the first report of a radiotherapy-related synovial sarcoma arising from the extrahepatic biliary tree, and the second case described in this anatomic region.


Assuntos
Neoplasias do Ducto Colédoco/patologia , Ducto Colédoco/patologia , Neoplasias Induzidas por Radiação/patologia , Sarcoma Sinovial/patologia , Seminoma/radioterapia , Adulto , Colangiopancreatografia Retrógrada Endoscópica , Ducto Colédoco/diagnóstico por imagem , Ducto Colédoco/efeitos da radiação , Ducto Colédoco/cirurgia , Neoplasias do Ducto Colédoco/diagnóstico , Neoplasias do Ducto Colédoco/genética , Neoplasias do Ducto Colédoco/terapia , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Masculino , Microscopia Eletrônica de Transmissão , Neoplasias Induzidas por Radiação/diagnóstico , Neoplasias Induzidas por Radiação/cirurgia , Proteínas de Fusão Oncogênica , Cuidados Paliativos/métodos , Sarcoma Sinovial/diagnóstico , Sarcoma Sinovial/genética , Sarcoma Sinovial/terapia , Tomografia Computadorizada por Raios X , Ultrassonografia
16.
Risk Anal ; 38(7): 1474-1489, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29211917

RESUMO

Complex statistical models fitted to data from studies of atomic bomb survivors are used to estimate the human health effects of ionizing radiation exposures. We describe and illustrate an approach to estimate population risks from ionizing radiation exposure that relaxes many assumptions about radiation-related mortality. The approach draws on developments in methods for causal inference. The results offer a different way to quantify radiation's effects and show that conventional estimates of the population burden of excess cancer at high radiation doses are driven strongly by projecting outside the range of current data. Summary results obtained using the proposed approach are similar in magnitude to those obtained using conventional methods, although estimates of radiation-related excess cancers differ for many age, sex, and dose groups. At low doses relevant to typical exposures, the strength of evidence in data is surprisingly weak. Statements regarding human health effects at low doses rely strongly on the use of modeling assumptions.


Assuntos
Neoplasias Induzidas por Radiação/epidemiologia , Guerra Nuclear , Liberação Nociva de Radioativos , Medição de Risco/métodos , Idoso , Estudos de Coortes , Exposição Ambiental , Feminino , Política de Saúde , Humanos , Incidência , Japão , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Neoplasias Induzidas por Radiação/diagnóstico , Armas Nucleares , Probabilidade , Radiação Ionizante , Fatores de Risco , Estatística como Assunto , Sobreviventes , II Guerra Mundial
18.
Virchows Arch ; 472(3): 361-368, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28983701

RESUMO

The diagnosis of radiation-associated angiosarcoma is challenging and there are overlapping clinicopathological features between radiation-associated benign, atypical and malignant vascular lesions. It has been shown convincingly, that the majority of radiation-associated angiosarcomas are characterised by amplification and subsequent overexpression of MYC in contrast to benign and atypical vascular lesions. Given the fact that epigenetic changes play an important role in carcinogenesis and loss of histone H3K27 trimethylation (H3K27me3) has been found in a number of malignant neoplasms including malignant peripheral nerve sheath tumours, especially when associated with previous radiotherapy, we evaluated the immunohistochemical reaction pattern for H3K27me3 in 49 vascular lesions and control cases: normal skin and benign vascular lesions not associated with previous radiotherapy, radiation-associated benign, atypical and malignant vascular lesions and angiosarcomas not associated with previous radiotherapy. We found loss of H3K27me3 expression in most cases of radiation-associated angiosarcomas, whereas endothelial cells in benign and atypical vascular lesions arising after previous radiotherapy stained positively for H3K27me3. The sporadic angiosarcomas stained inconsistently for H3K27me3. Loss of H3K27me3 is typically seen in radiation-associated angiosarcomas, representing an additional diagnostic tool and raises questions in regard to the carcinogenesis of malignant vascular neoplasms.


Assuntos
Neoplasias da Mama/metabolismo , Mama/metabolismo , Células Endoteliais/patologia , Hemangiossarcoma/metabolismo , Histonas/metabolismo , Neoplasias Induzidas por Radiação/diagnóstico , Neoplasias Induzidas por Radiação/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Mama/patologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Diagnóstico Diferencial , Feminino , Hemangiossarcoma/diagnóstico , Hemangiossarcoma/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Adulto Jovem
20.
An Bras Dermatol ; 92(3): 395-397, 2017 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29186257

RESUMO

Lymphangioma is a rare benign disease of the lymphatic vessels. Typically, they are primary conditions but may be acquired secondarily, such as those caused by irradiation during radiotherapy for the treatment of breast cancer. The local lymphatic obstruction provoked by irradiation causes the appearance of asymptomatic hyaline vesicles on the irradiated skin. The present report describes a 78-year-old female patient, who initially presented hyaline vesicles that progressed into multiple papules with serous exudation of a yellowish and odorless secretion on the area of chronic radiodermitis in right breast. Despite the rarity of the case, we emphasize the importance of knowledge regarding dermatological disease for early diagnosis and proper medical conduct.


Assuntos
Neoplasias da Mama/radioterapia , Linfangioma/diagnóstico , Neoplasias Induzidas por Radiação/diagnóstico , Idoso , Neoplasias da Mama/cirurgia , Feminino , Humanos , Linfangioma/etiologia , Mastectomia
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