The purpose of this study is to support retrospective dose estimation for epidemiological studies by providing estimates of historical absorbed organ doses to the brain, lens of the eye, salivary ...glands, and thyroid from intraoral dental radiographic examinations performed from 1940 to 2009. We simulated organ doses to an adult over 10 y time periods from 1940 to 2009, based on commonly used sets of x-ray machine settings collected from the literature. Simulations to estimate organ dose were performed using personal computer x-ray Monte Carlo software. Overall, organ doses were less than 1 mGy for a single intraoral radiograph for all decades. From 1940 to 2009, doses to the brain, eye lens, salivary glands, and thyroid decreased by 86, 96, 95, and 89%, respectively. Of these four organs, the salivary glands received the highest doses, with values decreasing from about 0.23 mGy in the 1940s to 0.025 mGy in the 2000s for a single intraoral radiograph. Based on simulations using collected historical data on x-ray technical parameters, improvements in technology and optimization of the technical settings used to perform intraoral dental radiography have resulted in a decrease in absorbed dose to the brain, eye lens, salivary glands, and thyroid over the period from 1940 to 2009.
•Reviewed evidence indicates potential effects of low doses of IR on cognition.•Gaps in our understanding of radiation induced cognitive deficit were identified.•Childhood cancer, A-bomb survivors ...and occupational cohorts may be informative to study radiation cognitive changes.•Animal models may elucidate the mechanism of radiation induced cognitive effects.
The last decades have seen increased concern about the possible effects of low to moderate doses of ionizing radiation (IR) exposure on cognitive function.
An interdisciplinary group of experts (biologists, epidemiologists, dosimetrists and clinicians) in this field gathered together in the framework of the European MELODI workshop on non-cancer effects of IR to summarise the state of knowledge on the topic and elaborate research recommendations for future studies in this area.
Overall, there is evidence of cognitive effects from low IR doses both from biology and epidemiology, though a better characterization of effects and understanding of mechanisms is needed.
There is a need to better describe the specific cognitive function or diseases that may be affected by radiation exposure. Such cognitive deficit characterization should consider the human life span, as effects might differ with age at exposure and at outcome assessment.
Measurements of biomarkers, including imaging, will likely help our understanding on the mechanism of cognitive-related radiation induced deficit. The identification of loci of individual genetic susceptibility and the study of gene expression may help identify individuals at higher risk.
The mechanisms behind the radiation induced cognitive effects are not clear and are likely to involve several biological pathways and different cell types.
Well conducted research in large epidemiological cohorts and experimental studies in appropriate animal models are needed to improve the understanding of radiation-induced cognitive effects. Results may then be translated into recommendations for clinical radiation oncology and imaging decision making processes.
IARC periodically convenes such advisory groups to ensure that the agents evaluated in the Monographs are selected on the basis of the latest scientific evidence relevant to carcinogenicity.1 A ...detailed report of the Advisory Group recommendations will be published in due course.2 The Advisory Group assessed the response to a public call for nominations and considered more than 200 candidate agents, including the recommended priority agents remaining from a similar Advisory Group meeting convened in 2019.3 The Advisory Group comprised scientists with expertise across the spectrum of topics relevant to carcinogenicity. In drawing their conclusions, the members appraised, for each nominated agent, the evidence regarding human exposure, cancer in humans, cancer in experimental animals, and carcinogen mechanisms according to precepts described in the Preamble to the IARC Monographs.1 Systematic literature searches were complemented by a text mining and database fusion approach to identify relevant studies, document the relative abundance of literature for the different evidence streams, and map chemical similarity4 in support of decisions on prioritisation for individual agents and groups of agents. Monographs Advisory Group Members A Berrington de González (UK)—Meeting Chair; S A Masten (USA)—Meeting Vice Chair; P Bhatti (Canada); R T Fortner (Norway); S Peters (Netherlands); T Santonen (Finland); M G Yakubovskaya (Russian Federation)—Subgroup Meeting Chairs; R Barouki (France); S B M Barros (Brazil); D Barupal (USA); L E Beane Freeman (USA); G M Calaf (Chile); J Dillner (Sweden); K El Rhazi (Morocco); L Fritschi (Australia); S Fukushima (Japan); L Godderis (Belgium); M Kogevinas (Spain); D W Lachenmeier (Germany); D Mandrioli (Italy); M M Muchengeti (South Africa); R T Niemeier (USA); J J Pappas (Canada); J Pi (China); M P Purdue (USA); E Riboli (UK unable to attend); T Rodríguez (Nicaragua); V Schlünssen (Denmark) Declaration of interests All Monographs Advisory Group members declare no competing interests Invited Specialists None Representatives Y Choi, Division of Cancer Prevention, National Cancer Control Institute (South Korea);B Kim, Division of Cancer Prevention, National Cancer Control Institute (South Korea) Declaration of interests YC and BK declare no competing interests Observers R Bars, Regulatory Science Ltd (France); J Britt, ToxStrategies (USA) Declaration of interests RB is a a salaried employee of Regulatory Science Associates and CropLife International sponsored his travel to and attendance at the Advisory Group meeting. Rationale Agents not previously evaluated by IARC Monographs Disinfection byproducts in water, including haloacetic acids; sleep disruption; hair straightening products; metalworking fluids; obesity*; platinum-based chemotherapies as mechanistic class†; dibutyl phthalate; nitrogen dioxide‡; artificial light at night‡; sugar-sweetened beverage consumption‡; GLP-1 analogues‡; Fonofos‡ Relevant human cancer, animal cancer, and mechanistic evidence Fusobacterium nucleatum; human cytomegalovirus; sedentary behaviour; ultraprocessed food consumption; anthracyclines as mechanistic class†; BRAF inhibitors—dabrafenib, encorafenib, vemurafenib; epirubicin; tetracycline; tofacitinib and other Janus kinase inhibitors; perfluorohexanesulfonic acid; cannabis smoking‡; ultrafine particles‡; assisted reproductive techniques‡; chlorpyrifos‡ Relevant human cancer and mechanistic evidence Electronic nicotine delivery systems; estragole; carbadox; alachlor; cyfluthrin; cypermethrin; mancozeb; neonicotinoid insecticides; tebuconazole; vinclozolin; bisphenol A; bisphenol S; bisphenol F; 2,3-butanedione; carbon disulfide; diisononyl phthalate; glycidamide; hexafluoropropylene oxide dimer acid; methanol; ozone; pentabromodiphenyl ethers; triclosan; zearalenone‡ Relevant animal cancer and mechanistic evidence Hepatitis D virus; Salmonella typhi; taconite; terbufos‡ Relevant human cancer evidence Metyltetraprole; proquinazid; butyraldehyde; chlorinated paraffins; tris(chloropropyl)phosphate Relevant animal cancer evidence Methamphetamine; Congo red; cumyl hydroperoxide; 2,4-dihydroxybenzophenone; parabens; electronic waste work‡; polyhexamethyleneguanidine‡ Relevant mechanistic evidence Agents previously evaluated by IARC Monographs§ Hair colouring products (personal use of); coal dust; paracetamol (acetaminophen); textured implants (breast and buttock); carbaryl; ethylenedithiocarbamates; permethrin; pyrethrins and pyrethroids New human cancer, animal cancer, and mechanistic evidence to warrant re-evaluation of the classification Non-ionising radiation (radiofrequency)‡ New human cancer and animal cancer evidence to warrant re-evaluation of the classification Human papillomavirus β; Opisthorchis felineus; indoor combustion of biomass; textile manufacturing industry work; inorganic lead compounds; daunorubicin; doxorubicin; methotrexate; atrazine and other triazine pesticides; acetaldehyde; acrylamide; Merkel cell polyomavirus‡; clomiphene citrate‡; progestogen-only contraceptives‡; chlordecone‡ New human cancer and mechanistic evidence to warrant re-evaluation of the classification Multiwalled carbon nanotubes; butyl benzyl phthalate; 5-nitro-o-toluidine; 4-nitrotoluene; p-phenylenediamine New animal cancer and mechanistic evidence to warrant re-evaluation of the classification Metallic nickel; very hot beverages and food¶; carbon tetrachloride‡; tetrachloroethylene‡ New human cancer evidence to warrant re-evaluation of the classification Piperonyl butoxide New animal cancer evidence to warrant re-evaluation of the classification Schistosoma japonicum; Schistosoma mansoni; patulin; safrole; anaesthetics, volatile—isoflurane, sevoflurane, and desflurane; malathion; bromate compounds; 3,3′-dimethoxybenzidine; 3,3′-dimethylbenzidine; isoprene; fluoranthene‡ New mechanistic evidence to warrant re-evaluation of the classification Helicobacter pylori‡; aflatoxins‡; outdoor air pollution‡; tobacco smoking and second-hand smoke‡; silica dust‡; asbestos‡; hormone replacement therapy‡; radon and its decay products‡; ethylene oxide‡; formaldehyde† Group 1 carcinogen with evidence for new cancer sites (see section 3 of the Preamble to the IARC Monographs1) Table 1 Agents recommended for evaluation by the IARC Monographs with high priority Previous evaluation status Toxoplasma gondii; black cohosh extracts; outdoor combustion of biomass; tattoos and permanent make up; anatase-type nano-TiO2; neonatal phototherapy; anti-thymocyte globulin; bifenthrin; biphenyl; pendimethalin; α-pinene; sulfolane Agents not previously evaluated by the IARC Monographs Fumonisin B1; pyrrolizidine alkaloids; ingested nitrate; selenium and selenium compounds; xylenes Agents previously evaluated by the IARC Monographs* Table 2 Agents recommended for evaluation by the IARC Monographs with medium priority Rationale Chronic circadian dysfunction; diabetes; insomnia; reduction of sex hormones with human aging; violation of tissue renewal or regeneration with human aging; alefacept No evidence of exposure, or not an exogenous exposure Dysbiotic microbiota; poor oral hygiene; nitrate-reducing bacteria in tobacco; SARS-CoV-2; cleaning products; long working hours; social isolation and loneliness; phosphorescent paints; laboratory work and occupation as a chemist; occupation as a pesticide applicator; semiconductor industry work; acrylonitrile-butadiene-styrene particles emitted by three-dimensional printers; engineered stone fabrication; microplastics and nanoplastics; aluminium; rare earth elements; intense pulsed light; artificially sweetened beverage consumption; dietary salt intake; indole-3-carbinol; isoflavones; sucralose; gadolinium-based contrast agents; gene or cell therapy or vectors; glucocorticoids; glutathione; reversible acetylcholinesterase inhibitors; allyl alcohol; ametryn; atraric acid; boscalid; o-benzyl-p-chlorophenol; cinidon ethyl; p-cresol; 1,2-cyclohexanedicarboxylic acid, diisononyl ester; 2,4-dichlorophenol; 2,4-dimethylphenol; ethyl anthranilate; S-ethyl-N,N-dipropylthiocarbamate; furmecyclox; hexythiazox; 2-hydroxy-4-methoxybenzophenone; menthyl anthranilate; methyl anthranilate; palmitic acid; phosmet; red dye number 3 (erythrosine); styrene-acrylonitrile (SAN) trimer; 2,4,6-tribromophenol
Objective: To determine the role of health status, personality and coping style, on self-report health-related quality of life (QoL). Methods: Participants were HIV seropositive individuals at all ...disease stages from three samples (a) gay/bisexual men from the UK, (b) injecting drug users from the UK, (c) injecting drug users from Italy. All participants completed questionnaires evaluating QoL, personality, coping style and social support. Explicit models of the relationships between the measured variables based on a review of the literature were tested using structural equation modelling. Results: Health status was modestly associated with the physical but not the psychological aspects of QoL (β = 0.44). Neuroticism was strongly associated with psychological QoL (β = -0.73) but only weakly with physical QoL (β = -0.21). The samples did not differ in either the pattern or the magnitude of these relationships. Mediating factors such as coping style, social support and other personality variables had only a weak influence on the role of Neuroticism. Conclusions: Neuroticism had a strong influence on health-related QoL that was independent of health status. Neuroticism was more strongly associated with the psychological aspects of QoL than health status. Coping styles and the other psychological variables assessed had only a weak mediating influence on this relationship.
A great number of locoregional treatments are currently carried out to treat a variety of locoregional neoplastic diseases. Indications are the treatment of primary and metastatic liver tumors, ...peritoneal mesotheliomas, peritoneal spread of ovarian carcinomas, peritoneal recurrences of gastrointestinal cancers, peritoneal spread of retroperitoneal sarcomas, melanomas and sarcomas of the limbs, some primary tumors of the brain, breast, kidney, lung, bladder. But to deal with locoregional therapy demands to clarify some features of these malignancies. At this regard, the knowing of their natural history can be crucial to guide the choice of the correct locoregional treatment. For instance peritoneal carcinomatosis is considered as a main step of disease progression for ovarian cancer and often for gastrointestinal tumors as well. However when the tumors are confined on the surface of the peritoneum, basing on their own natural history, they can be considered as localized diseases. Selected patients with peritoneal neoplastic seeding, previously considered in a preterminal condition, can be considered as candidates for curative treatment, using cytoreductive surgical tecniques (16) and hyperthermic intraperitoneal chemotherapy (19). The same can be thought about others primary or metastatatic tumors when the neoplastic deposits are confined within a definite site or region of the body. In this paper the main aspects of liver metastases and peritoneal carcinomatosis natural history, two of the most frequently recognized indications for locoregional therapy, are presented.
Locoregional chemotherapy in the 80's was considered an effective palliative treatment for unresectable hepatic metastases. With the advent of new drugs supporting effective systemic chemotherapy it ...was disregarded for many years. Recently, following the advent of new drugs and the developing of new association scheme, it has regained interests also for its adjuvant and neoadjuvant role to hepatic resections. Current schemes of locoregional and systemic chemotherapy for liver metastases are based on continuous infusions using implantable pumps but confirmation, in term of tissue drug concentration, that continuous infusions do better than bolus infusions is still lacking. To address this specific aspect we have experimentally compared these two different administration modalities using an anthracyclin, Epiadryamicin (EPI), with high plasmatic clearance and main biliary escretion (8,16) and infused through arterial, portal and systemic routes. The most high EPI concentration within the tumour was obtained after bolus-arterial infusion but also for continuous infusions the artery resulted better than other routes. Differently the most high EPI liver concentration resulted after portal infusion both if infused with a bolus or in 5 minutes time. This experiment may therefore legitimate the clinical use of this drug with bolus repeated infusions through the hepatic artery.
PDF
