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Background: During radiation therapy for breast cancer, healthy tissues are damaged, leading to both systemic and local reactions, including radiation dermatitis with such symptoms as erythema, dryness, peeling, and pain. Disturbances of the microcirculation lead to hypoxia and fibrosis. The use of low-temperature argon plasma is a promising method for preventing acute radiation-induced skin damage, which is crucial for maintaining quality of life, preventing complications, and minimizing long-term effects. Aim: To evaluate the effectiveness of low-temperature argon plasma used in the complex medical rehabilitation of patients undergoing external radiation therapy for breast cancer. Materials and methods: A prospective, randomized interventional study was conducted involving 60 breast cancer patients undergoing radiation therapy. All patients received a course of medical rehabilitation, including general magnetic therapy, exercise therapy, balance response training on a biofeedback simulator, nutritional support, and sessions with a medical psychologist. In the main group (n = 30), rehabilitation included low-temperature argon plasma treatment. Outcomes were assessed using the RTOG scale for acute complications of radiation therapy and laser Doppler flowmetry. Results: After completing radiation therapy and complex medical rehabilitation, statistically significant differences were observed between the main group and the comparison group (which did not receive low-temperature argon plasma treatment) in the severity of radiation reactions on the RTOG scale (p = 0.016) and in peripheral blood flow parameters. Conclusion: Low-temperature argon plasma supports nutritional blood flow and active mechanisms for microcirculatory regulation, preserving skin blood supply and preventing severe acute radiation dermatitis.
Ocular surface temperature (OST) is affected by changes in eye physiology caused by normal homeostasis, environmental changes, or systemic and local disease. OST can help a physician diagnose eye disease with improved accuracy and provide useful information for eye research. This paper presents a novel system, including novel hardware design and novel algorithms, capable of automatically measuring and tracking OST from the cornea over any period of time. The system uses an infrared (IR) camera and a visible (VIS) camera to capture synchronous thermal and visible videos, respectively, from the eye surface. The frames for each camera video sequence are then registered together (video registration) using two sets of control points. The points are manually selected on the first pair of timestamped IR/VIS frames and tracked over all subsequent frames using the Lucas–Kanade (LK) optical flow algorithm (point tracking). A mean square error (MSE) of 5.43±2.01 pixels was reported for salient point tracking of the IR video and 6.81±2.32 pixels for tracking of the VIS video. Overall MSE for registration was 5.03 ±1.82 pixels. The corneal area was segmented in the VIS images and localized on the IR images using the semantic segmentation method (corneal segmentation). A mean Intersection over Union (IoU) of 94.6% was found, representing the accuracy of corneal segmentation. A system for measuring and tracking eye surface temperature over time was developed. The system is able to localize the cornea on both VIS and IR images, and report temperature profiles of the cornea over the period of measurement. Experimental results show that the system can work as a tool for measuring and tracking OST over time.
At the present time, the studies carried out to improve the radiotherapy of tumors using accelerated heavy ions are of great interest, since they give off the main energy at the end of the run at the Bragg peak, which increases the severity of radiation damage to the tumor and minimizes damage to surrounding healthy tissues. In this work, the levels of lymphocyte lactate dehydrogenase (LDH) and succinate dehydrogenase (SDH) activity, the ratio of LDH/SDH, induced reactive oxygen species (ROS) of neutrophils, and leukocytes DNA damage (%TDNA) in blood 1 day after accelerated carbon ions irradiation of mice with an energy of 450 MeV/nucleon in doses of 0.2-2 Gy in the Bragg peak were determined. Found: SDH activity increased at doses of 0.2-1 Gy and sharply decreased at a dose of 1.5 Gy in all mice. With a decrease in SDH activity, glycolysis (LDH activity) increased compensatory, which, apparently, is associated with the developing mitochondrial dysfunction of immune cells. The %TDNA of leukocytes increased depending on the dose and was accompanied by a decrease in the functional activity of neutrophils - the zymosan-induced ROS production decreased. Thus, against the background of an increased %TDNA and a decrease in SDH activity, glycolysis becomes of great importance. The applied methods are highly sensitive and can be used to detect individual differences in animals that are biological models in preclinical studies.
Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem, 2023.
BACKGROUND: Testing for carcino-embryonic antigen (CEA) in the blood is a recommended part of follow-up to detect recurrence of colorectal cancer following primary curative treatment. There is substantial clinical variation in the cut-off level applied to trigger further investigation. OBJECTIVES: To determine the diagnostic performance of different blood CEA levels in identifying people with colorectal cancer recurrence in order to inform clinical practice. SEARCH METHODS: We conducted all searches to January 29 2014. We applied no language limits to the searches, and translated non-English manuscripts. We searched for relevant reviews in the MEDLINE, EMBASE, MEDION and DARE databases. We searched for primary studies (including conference abstracts) in the Cochrane Central Register of Controlled Trials (CENTRAL), in MEDLINE, EMBASE, and the Science Citation Index & Conference Proceedings Citation Index - Science. We identified ongoing studies by searching WHO ICTRP and the ASCO meeting library. SELECTION CRITERIA: We included cross-sectional diagnostic test accuracy studies, cohort studies, and randomised controlled trials (RCTs) of post-resection colorectal cancer follow-up that compared CEA to a reference standard. We included studies only if we could extract 2 x 2 accuracy data. We excluded case-control studies, as the ratio of cases to controls is determined by the study design, making the data unsuitable for assessing test accuracy. DATA COLLECTION AND ANALYSIS: Two review authors (BDN, IP) assessed the quality of all articles independently, discussing any disagreements. Where we could not reach consensus, a third author (BS) acted as moderator. We assessed methodological quality against QUADAS-2 criteria. We extracted binary diagnostic accuracy data from all included studies as 2 x 2 tables. We conducted a bivariate meta-analysis. We used the xtmelogit command in Stata to produce the pooled estimates of sensitivity and specificity and we also produced hierarchical summary ROC plots. MAIN RESULTS: In the 52 included studies, sensitivity ranged from 41% to 97% and specificity from 52% to 100%. In the seven studies reporting the impact of applying a threshold of 2.5 µg/L, pooled sensitivity was 82% (95% confidence interval (CI) 78% to 86%) and pooled specificity 80% (95% CI 59% to 92%). In the 23 studies reporting the impact of applying a threshold of 5 µg/L, pooled sensitivity was 71% (95% CI 64% to 76%) and pooled specificity 88% (95% CI 84% to 92%). In the seven studies reporting the impact of applying a threshold of 10 µg/L, pooled sensitivity was 68% (95% CI 53% to 79%) and pooled specificity 97% (95% CI 90% to 99%). AUTHORS' CONCLUSIONS: CEA is insufficiently sensitive to be used alone, even with a low threshold. It is therefore essential to augment CEA monitoring with another diagnostic modality in order to avoid missed cases. Trying to improve sensitivity by adopting a low threshold is a poor strategy because of the high numbers of false alarms generated. We therefore recommend monitoring for colorectal cancer recurrence with more than one diagnostic modality but applying the highest CEA cut-off assessed (10 µg/L).
Introduction. The paper presents the results of research on the influence of IR sources on the health of professionally and accidentally exposed personnel. Particular emphasis is placed on: identifying the relationships between the level of radiation dose and the development of oncological diseases; use of contemporary biological dosimetry methods for retrospective analysis of irradiation doses; the impact of parental irradiation on the health of the offspring; the structure of morbidity, including oncological diseases in patients exposed to IR sources. Material and methods. The study material was used by subjects professionally and accidentally exposed to IR sources: medical staff and PMCCNA born in the Republic of Moldova, Ukraine and the Russian Federation, as well as their descendants, victims of the accident at the Fukushima Daiichi nuclear power plant (Japan) and residents of the region. Chelyabinsk. Clinical, immunological and cytogenetic methods were used. Results. A wide range of mental pathologies was observed at PMCCNA, at the victims of the accident at the Fukushima Daiichi nuclear power plant, etc. The structure of immune deficiency syndromes was dominated by allergic and autoimmune syndromes. Based on the analysis of stable chromosomal aberrations, exposure doses were established. Conclusions. In the absence of dose information received by staff professionally/accidentally exposed to IR sources, assessment of stable chromosomal aberrations makes it possible to reconstruct the radiation dose for PMCCNA exposed to low doses of IR.
Electromagnetic hyperthermia remains experimental treatment after 40 years of research and application in view of its “temperature concept” based on the belief that temperature is the only parameter of the efficacy. Initial “extreme hyperthermia” concept was based on the wrong premise of much higher thermal susceptibility of malignant cells and broad therapeutic range of hyperthermia, allowing to kill tumor cells by above-threshold (>43°C) temperature without damaging healthy tissues. Indeed, this therapeutic gap is minor or absent which makes the extreme hyperthermia impossible. The next concept of “thermal dose” was based on the ungrounded extrapolation of the biochemical Arrhenius relationship onto the living matter and formed the basis of “moderate hyperthermia” concept, believing that it could enhance tumor oxygenation and radio- and chemosensitivity, ignoring the special features of tumor blood flow. Both concepts have not been confirmed; “thermal dose” is currently proven to be not connected with any clinical outcome. Analysis of randomized trials with respect to biases has not confirmed hyperthermia efficacy. The growing evidence of athermal effects and their broad application has caused development of some athermal cancer treatments. Hyperthermia concept should be cardinally reevaluated now with respect to obvious bankruptcy of the temperature concept and development of the athermal concept.
OBJECTIVE: To examine the current state of epidemiology in Russia. DESIGN: The structure of clinical research and statistical methods was used to shed light on the epidemiology in Russia. The frequencies of specific study designs were evaluated using Medline data for 1970-1997. To determine the proportion of advanced design clinical studies the frequency of cohort, prospective, follow up, or longitudinal studies, and controlled trials was evaluated. All diagnosis related studies were found to determine the usage of advanced statistical technique (ROC analysis). The adequacy of Medline information was checked by hand search of journals. All dissertations in epidemiology defended in Russia in 1995 and 1996 were evaluated for their methodology. The curriculum recommended by Ministry of Health to Medical Universities was evaluated. Available literature and library indexing of epidemiological terms examined. MAIN RESULTS: Russian medical research uses less frequently advanced study designs and methods of data analysis. Medical students are taught epidemiology as a science of spread of infectious diseases. There is no department of epidemiology in Russian universities where epidemiology is taught in the modern sense and no epidemiological and biostatistical periodicals available in Russia. CONCLUSION: Epidemiology in Russia remains in an archaic state of science of the spread of infectious diseases and it is detrimental to methodology of medical research in Russia.
Ischemic heart disease (CHD) is one of the most common diseases of the circulatory system, which is the main cause of death in Ukraine. The purpose of this study was to analyze the incidence, disability, mortality from ischemic heart disease, its individual nosological forms in the adult population evacuated from the 30 km zone of the Chernobyl nuclear power plant in the post-accident period, taking into account the age at the date of the accident, sex and time after the accident for further improving the system of dispensary observation evacuees and reducing the risk of cardiovascular complications. The study used epidemiological surveillance data (1988-2016) for the category of the adult evacuated population (18-60 years old as of the date of the accident) with a population of 42 982 people, of which 58.7% are women according to the data of the State Register of Ukraine of persons injured in as a result of the Chernobyl disaster (GRU). The research results were assessed both in general for ischemic heart disease and the main nosological forms according to ICD-9 and ICD-10. In the study, epidemiological, analytical, mathematical and statistical methods were used, as well as the method of internal comparison (with indicators of 1988-1992). As the results of the study have shown, in the structure of the causes of morbidity, disability and mortality of the adult evacuated population from diseases of the circulatory system, IHD takes a leading place. The statistically significant influence of age, calendar observation period, gender was established. Among nosological forms, chronic CHD is in the lead. Evacuees at the age of 18–39 years show an increase in the incidence of coronary artery disease with a maximum rate after 17 years, and at the age of 40-60 years – at the beginning of the observation with a subsequent noticeable decrease since 2003. In recent years (2013-2016), there has been a significant decrease in the incidence of coronary artery disease at the age of 40-60 years by 9.3 times, and at the age of 18-39 years, on the contrary, an increase by 3.8 times. During the post-accident period, the level of disability and mortality of the studied contingents from ischemic heart disease has significantly increased. High rates of growth of disability in recent years in persons aged 18-39 at the date of the accident. The mortality rate of the evacuees in recent years has increased in comparison with the early observation period by 5.8 times, higher mortality rates in men compared to women. Further more in-depth studies are required to assess the contribution of non-cancer diseases to the total radiation damage to human health.
Abstract Since the early 40s when the first research related to the development of the atomic bomb began for the Manhattan Project, actinides (An) and their association with the use of nuclear energy for civil applications, such as in the generation of electricity, have been a constant source of interest and fear. In 1962, the first Society of Toxicology (SOT), led by H. Hodge, was established at the University of Rochester (USA). It was commissioned as part of the Manhattan Project to assess the impact of nuclear weapons production on workers’ health. As a result of this initiative, the retention and excretion rates of radioactive heavy metals, their physiological impact in the event of acute exposure and their main biological targets were assessed. In this context, the scientific community began to focus on the role of proteins in the transportation and in vivo accumulation of An. The first studies focused on the identification of these proteins. Thereafter, the continuous development of physico-chemical characterization techniques has made it possible to go further and specify the modes of interaction with proteins from both a thermodynamic and structural point of view, as well as from the point of view of their biological activity. This article reviews the work performed in this area since the Manhattan Project. It is divided into three parts: first, the identification of the most affine proteins; second, the study of the affinity and structure of protein-An complexes; and third, the impact of actinide ligation on protein conformation and function.
Intelligence agencies routinely use surveillance technology to perform surveillance on digital data. This practice raises many questions that feed a societal debate, including whether the surveillance technology is effective in achieving the given security goal, whether it is cost-efficient, and whether it is proportionate. Oversight bodies are important actors in this debate, overseeing budgets, legal and privacy matters, and the performance of intelligence agencies. This paper examines how oversight bodies evaluate the questions above, using documents produced by American and British oversight mechanisms.
It is known that the hematopoietic system, through its associated functional cells, transports oxygen in the blood and provides immune regulations, ensures coagulation of blood, and sustains intact blood vessels This system includes bone marrow (a major blood-forming system) and mature cells that circulate in the blood vessels
The goal of this PhD is to develop and validate an independent dose calculation method in order to support the intense commissioning work of a Light Ion Beam Therapy (LIBT) facility, and to validate the Treatment Planning System (TPS) dose calculation. The work focuses on proton therapy treatments and is held as a collaboration between the CREATIS laboratory (Lyon, France) and the MedAustron - Vienna - Austria Ion Therapy Center (Wiener Neustadt, Austria). At MedAustron - Vienna - Austria, in order to exploit a sharp lateral penumbra for the proton beam as well as to improve the accuracy of the TPS dose calculation algorithms, the air gap between the treatment head window and the patient is reduced by moving the patient towards the treatment head. Therefore, non-isocentric treatments have to be accurately taken into consideration during modeling as well as validation phase as moving the target away from the room isocenter may lead to reduced treatment accuracy. In this study, the parametrization of the proton pencil beam follows the recommendations provided in Grevillot et al. (2011), but including a full nozzle description. Special care is taken to model the pencil beam properties in non-isocentric conditions, including the use of a Range Shifter (RaShi). The characterization of the pencil beam is based solely on fluence profiles measured in air and depth dose profile acquired in water. In addition, the presented model is calibrated in absolute dose based on a newly formalism in dose-area-product presented in Palmans and Vatnitsky (2016). Eventually, a detailed validation is performed in water, for three-dimensional regular-shaped dose distributions. Several parameters commonly exploited in proton dosimetry such as range, distal penumbra, modulation, field sizes and lateral penumbra for proton dosimetry are evaluated for validation purposes. The pencil beam optics model reached an accuracy within the clinical requirement of 1mm/10% and it is not affected by the complexity of non-isocentric treatments and the use of a RaShi. Ranges are reproduced within 0.2 and 0.35 mm (max deviation) without and with range shifter, respectively. The dose difference in reference conditions is within 0.5%. The 3D dose delivery validation in water was within 1.2% at maximum. The agreement of distal and longitudinal parameters is mostly better than 1 mm. The obtained results will be used as a reference for the future clinical implementation of the MedAustron - Vienna - Austria independent dose calculation system. As an example of the potential clinical outcome of the presented work, the patient specific quality assurance measurements performed in water have been successfully reproduced within the clinical requirement of 5% accuracy for a few patients.
Purpose. Penile cancer rarely gives symptomatic skeletal metastases. Methods. We present 2 patients with squamous carcinoma of the penis who were surgically treated for metastases in the femur. Results. Both patients had pathological fractures and were operated on. In one case, the skeletal metastasis preceded any lymphatic spread of the disease, suggesting early haematogenous dissemination. Conclusions. Endoprosthetic reconstruction resulted in pain relief and restored the ambulatory capacity. Clinicians should be aware of the possibility for symptomatic bone metastases with a risk for pathological fracture in patients with penile cancer.
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Background: The unavoidable links between the benefits of conventional systemic treatment of cancer and the side effects such as lymphopenia. Objective: To analyze this phenomenon in view of the newly discovered trophic function of circulating hematopoietic stem cells (HSC) and their lymphocyte descendants. Method: We used population statistics and recent current research involving natural aging and preliminary aging with cancer, its cytotoxic therapy, eclampsia at pregnancy, and radiation hormesis. Results: In contrast to immune-defense interpretations of these health conditions, the trophic influence of HSC and morphogenic lymphocytes on natural tissue renewal and regeneration after sublethal injuries eliminates the majority of covered inconsistencies, which are inherent to the dominating idea of cellular immunity. Conclusion: Our examination led to the feeding influence of lymphopoiesis on tumor progression, an indirect mechanism of tumor growth control by systemic therapy via either destruction of trophic cells, or by competitive distraction from malignant tissue via reparation of sublethal injuries in normal tissues. Analyses also involved similarities of the mechanisms of systemic chemotherapy and total body/half body radiotherapy in low doses, as well as the futility of the theoretical opposition of the radiation hormesis phenomenon to the linear non-threshold model, dominant in radiobiology.
The measurement of circulating blood volume (CBV) is crucial in various medical conditions including surgery, iatrogenic problems, rapid fluid administration, transfusion of red blood cells, or trauma with extensive blood loss including battlefield injuries and other emergencies. Currently, available commercial techniques are invasive and time-consuming for trauma situations. Recently, we have proposed high-speed multi-wavelength photoacoustic/photothermal (PA/PT) flow cytometry for in vivo CBV assessment with multiple dyes as PA contrast agents (labels). As the first step, we have characterized the capability of this technique to monitor the clearance of three dyes (indocyanine green, methylene blue, and trypan blue) in an animal model. However, there are strong demands on improvements in PA/PT flow cytometry. As additional verification of our proof-of-concept of this technique, we performed optical photometric CBV measurements in vitro. Three label dyes—methylene blue, crystal violet and, partially, brilliant green—were selected for simultaneous photometric determination of the components of their two-dye mixtures in the circulating blood in vitro without any extra data (like hemoglobin absorption) known a priori. The tests of single dyes and their mixtures in a flow system simulating a blood transfusion system showed a negligible difference between the sensitivities of the determination of these dyes under batch and flow conditions. For individual dyes, the limits of detection of 3×10–6 M‒3×10–6 M in blood were achieved, which provided their continuous determination at a level of 10–5 M for the CBV assessment without a priori data on the matrix. The CBV assessment with errors no higher than 4% were obtained, and the possibility to apply the developed procedure for optical photometric (flow cytometry) with laser sources was shown.