Novos Rumos da Política de Controle do Câncer no Brasil / New Trends of the Cancer Control Policy in Brazil / Nuevas Direcciones de la Política de Control del Cáncer en Brasil

As últimas estimativas mundiais de incidência e mortalidade relacionadas ao câncer apontam para a necessidade de adoção de medidas sustentáveis de prevenção e controle do câncer, especialmente nos países com baixo nível de desenvolvimento econômico e naqueles em desenvolvimento, onde se inclui o Brasil1. Essas estratégias perpassam, necessariamente, pela adoção e fortalecimento de políticas públicas que apoiem o planejamento e a priorização de medidas de controle do câncer

Sustainable measures for cancer prevention and control are deemed necessary as the recent world estimates of cancer-related incidence and mortality indicate, mostly for low economic income countries and in development as Brazil1. Necessarily, these strategies beget the adoption and strengthening of supportive public policies for planning and prioritization of cancer control

Impactos del cuidado de personas con cáncer en la vida del cuidador y la dinámica familiar / Impacts of Caring for Persons with Cancer on the Caregiver and Family Dynamics

Introducción: La existencia de un paciente con cáncer en el seno de la familia implica varios retos y conduce a una necesidad de reorganización de toda la familia para la prestación de cuidados a este individuo, dejando, a veces, de cuidar de sí mismo, generando nuevas demandas a menudo descuidadas. Objetivo: Comprender, desde la perspectiva de los familiares cuidadores, cómo el proceso de cuidar de la persona con cáncer impacta en la vida del cuidador y la dinámica familiar. Métodos: Estudio descriptivo y exploratorio, con enfoque cualitativo realizado con los familiares cuidadores de personas con cáncer de la ciudad de Viçosa, Minas Gerais, Brasil, desde diciembre de 2016 hasta enero de 2017. La recopilación de datos se realizó con 7 cuidadores familiares, por medio de una guía con preguntas abiertas, estructurada sobre la base de la escala de Zarit, que se interrumpió cuando hubo la saturación de los datos. El análisis se realizó mediante la técnica de análisis de contenido. Resultados: Los familiares cuidadores mostraron alteraciones en las necesidades humanas básicas relacionadas con los dominios: psicobiológico, psicosocial y psicoespiritual. Tales aspectos orientan las acciones de los profesionales de salud y validan la importancia de una asistencia holística y humanitaria para el cuidador, que también necesita de cuidados. Conclusiones: Los profesionales de enfermería deben actuar en la planificación de acciones que se centran en el apoyo educativo, psicológico, humanizado, empático e integral y en la promoción de la salud, agregados al plan de atención el núcleo familiar, a fin de minimizar el desgaste físico, psicológico y social del cuidador(AU)

Introduction: The existence of a cancer patient within any family implies several challenges and leads to a necessity for reorganization of the whole family in order to provide care for this individual, sometimes ceasing to take care of themselves and generating new demands, often neglected. Objective: To understand, from the perspective of family caregivers, how the process of caring for the person with cancer impacts the caregiver's life and family dynamics. Methods: Descriptive and exploratory study, with a qualitative approach, carried out, from December 2016 to January 2017, with family caregivers of people with cancer, in Viçosa City, Minas Gerais, Brazil. Data collection was carried out with seven family caregivers, using a guide with open questions and structured on the basis of the Zarit scale, which was interrupted when the data was saturated. The analysis was carried out using the content analysis technique. Results: Family caregivers showed alterations in basic human needs related to the psychobiological, psychosocial and psychospiritual domains. Such aspects guide the actions of health professionals and validate the importance of holistic and humanitarian assistance for the caregiver, who also needs care. Conclusions: Nursing professionals must act in planning actions that focus on educational, psychological, humanized, empathic and comprehensive support and health promotion, added to the family nucleus care plan, in order to minimize the physical, psychological and social exhaustion of the caregiver(AU)

Immunodeficiencies: non-infectious manifestations

Abstract Objectives: Classical immunodeficiencies are mainly characterized by infectious conditions. In recent years, manifestations related to allergy, inflammation, autoimmunity, lymphoproliferation, and malignancies related to this group of diseases have been described. The text intends to make an update on the non-infectious manifestations of the primary defects of the immune system. Source of data: Searches were carried out in the PubMed database for review articles published in the last five years, in English, French, or Spanish, using the terms "allergy," "inflammation," "autoimmunity," "lymphoproliferation," "cancer," AND "immunodeficiency" or "primary immunodeficiency" or "inborn errors of immunity" NOT "HIV". Synthesis of data: Non-infectious manifestations characterize the primary defects in which there is dysregulation of the immune system. The most common manifestations of autoimmunity in this group of diseases are autoimmune cytopenias. Exacerbated inflammatory processes, benign lymphoproliferation, and propensity to malignancy of the lymphoreticular system are related to several diseases in this group. Severe manifestations of atopy or food allergy characterize some immunodeficiencies. Disorders of inborn immunity of the autoinflammatory type are characterized by an aseptic inflammatory process in the absence of autoimmunity, with fever and recurrent manifestations in different organs. Conclusions: Not only infectious conditions should raise the suspicion of immunodeficiencies, but also manifestations of allergy, inflammation, autoimmunity, lymphoproliferation, or cancer, especially if they are recurrent, associated to each other, affecting young patients, or in severe and/or difficult to treat conditions.

Atlas do Câncer Relacionado ao Trabalho no Brasil: Análise Regionalizada e Subsídios para a Vigilância em Saúde do Trabalhador / Atlas of Work-Related Cancer in Brazil: Regionalized Analysis and Subsidies for Occupational Health Surveillance

Considerando a responsabilidade da gestão pública em saúde de auxiliar na formulação de políticas públicas alinhadas aos princípios básicos dos direitos humanos, cidadania e ao trabalho seguro ­ espera-se que esse documento possa subsidiar ações de vigilância, prevenção e controle do CRT que priorizem os trabalhadores de setores e atividades econômicas mais vulneráveis à ocorrência dessas doenças, indiferentemente do vínculo empregatício e forma de inserção no mercado de trabalho, conforme definido na Política Nacional de Saúde do Trabalhador e da Trabalhadora (PNSTT).

Exposição ao uso da lenha para cocção no Brasil e sua relação com os agravos à saúde da população / Exposure to the use of firewood for cooking in Brazil and its relation with the health problems of the population

Resumo A poluição do ar em ambientes fechados é agravada pela queima de lenha em fogões rústicos e ambientes pouco ventilados. A exposição aos poluentes emitidos por este tipo de combustível resulta no aumento da morbidade e da mortalidade. No Brasil, os estudos e as estimativas são escassos. Visando entender esta problemática, o objetivo deste trabalho foi investigar o uso de lenha utilizando as séries de dados das agências governamentais para estimar o número de pessoas expostas. Os resultados apontam que a lenha é o segundo combustível mais usado para cozinhar, sendo utilizada por uma parcela significativa da população, em torno de 30 milhões de brasileiros. Um fator decisivo no maior uso deste combustível é o nível socioeconômico da população associada ao preço do gás liquefeito de petróleo (GLP). Os estudos realizados no país registraram concentrações altas de partículas durante a queima da lenha, excedendo os limites sugeridos pela Organização Mundial da Saúde (OMS). Também foram observadas associações entre a exposição aos poluentes gerados pela queima e o agravamento dos mais diversos problemas de saúde, dentre eles doenças respiratórias e câncer. A substituição da lenha e outros combustíveis sólidos por combustíveis mais limpos deve ser a meta do governo para minimizar custos com a saúde.

Abstract Indoor air pollution is exacerbated by the burning of firewood in rustic stoves and poorly ventilated environments. Exposure to the pollutants emitted by this type of fuel results in increased morbidity and mortality. In Brazil, studies and estimates regarding these conditions are scarce. In order to understand this problem, the objective of this work was to investigate the use of firewood using the data series of government agencies to estimate the number of exposed people. The results indicated that firewood is the second most used fuel for cooking, being used by a significant portion of the population, more than 30 million Brazilians. A decisive factor in the increased use of this fuel is the socioeconomic level of the population associated with the price of liquefied petroleum gas (LPG). The studies carried out in the country recorded high concentrations of particles during firewood burning, exceeding the limits suggested by the World Health Organization (WHO). Associations were also observed between the exposure to the pollutants generated by the burning and the aggravation of health problems, among them respiratory diseases and cancer. Replacing fuelwood and other solid fuels with cleaner fuels should be the government's goal to minimize health costs.

Autoanticuerpos en miopatías inflamatorias idiopáticas: enfoque en la práctica clínica / Autoantibodies in idiopathic inflammatory myopathies: focus on clinical practice

Las miopatías inflamatorias idiopáticas (MII) conforman un grupo diverso de en-fermedades caracterizadas por lesiones musculares inmunomediadas, que pue-den estar acompañadas de manifestaciones extramusculares.La identificación de autoanticuerpos específicos de miositis (AEM) y asociados a miositis (AAM) se ha convertido en una herramienta relevante en el diagnóstico, clasificación y pronóstico en este grupo de enfermedades.Adquieren relevancia en el diagnóstico y determinación de pronóstico de la Enfer-medad Pulmonar Intersticial (EPI), en el diagnóstico diferencial entre subgrupos de MII, especialmente en entidades de comportamiento atípico como la Miopatía Necrotizante Inmuno Mediada (MNIM) y la Miositis por Cuerpos de Inclusión, y permiten el enfoque y seguimiento estricto en pacientes con autoanticuerpos asociados a cáncer. En el último tiempo se ha planteado su utilidad tanto en la determinación de actividad de la enfermedad como en predecir la respuesta al tratamiento inmu-nosupresor.

Idiopathic inflammatory myopathies (IIM) comprise a heterogenous group of ill-nesses characterized by immune mediated muscular injuries that may be accom-panied by extra-muscular manifestations.The identification of myositis-specific autoantibodies MSAs and myositis-associ-ated autoantibodies (MAA) has become a relevant tool in the diagnose, classifica-tion, and prognosis in this group of illnesses.They become relevant in the diagnose and determination of a prognosis for Inter-stitial Lung Disease (ILD), in the differentiated diagnose among sub-groups of MII, especially in entities of an atypical behavior, such as Immune Mediated Necrotiz-ing Myopathy (IMNM) and Inclusion Body Myositis, and they enable a strict focus and follow-up on patients with cancer-associated autoantibodies. Lately, its usefulness has been stated both to determine disease activity and to forecast the response to the immunosuppressive treatment.

Cuidados médicos en EII: más allá de la terapia convencional / Medical care in IBD: more than conventional therapy

The management of Inflammatory Bowel Disease has progressed over the years largely due to better therapeutic options. These current management is guided by the primary goal in achieving clinical and endoscopic remission (deep remission), thus improving the quality of life of patients. In order to achieve these objectives however, there are risks associated which must always be considered. It is important to recognize that IBD patients are at risk of infection and neoplastic lesions for the natural history of the disease or the therapies that we used. Prevention of possible complications must be carried out. Options in therapeutic management not only include pharmacological therapy, but also include an adequate nutritional setting and an optimal correction of nutritional deficits. These alternative nutritional strategies can and should be considered as an effective therapeutic strategy aimed at improving the quality of life of IBD patients.

El manejo de la enfermedad inflamatoria intestinal ha progresado con el paso de los años dado a mayores opciones terapéuticas. El manejo actual se guía por objetivos para lograr remisión clínica y endoscópica (remisión profunda) mejorando así la calidad de vida de estos pacientes. Sin embargo, para lograr estos objetivos, se debe considerar siempre los riesgos asociados a las nuevas terapias. Es importante reconocer que los pacientes con EII son personas en riesgo tanto de infecciones como de lesiones neoplásicas por la historia natural de la enfermedad y/o por las terapias utilizadas, por lo tanto, la prevención de posibles complicaciones debe ser realizada en forma periódica. Por otro parte, el manejo terapéutico, no solo incluye la terapia farmacológica, sino también una adecuada optimización nutricional y una adecuada corrección de los déficit nutricionales secundarios. En este mismo sentido terapias alternativas, pueden ser consideradas como estrategia terapéuticas complementarias destinadas a mejorar la calidad de vida de estos pacientes.

Farmacogenética, tabaco, alcohol y su efecto sobre el riesgo de desarrollar cáncer / Pharmacogenetics, tobacco, alcohol and its effect on the risk development cancer

El cáncer es la segunda causa de muerte en el mundo, según datos de la Organización Mundial de la Salud (OMS) en el año 2015 ocasionó 8,8 millones de muertes. Dentro de los factores de riesgo para el desarrollo de cáncer se encuentran el tabaquismo y el consumo de alcohol. En Chile el 33,6% de la población fuma y un 21,2 % de los jóvenes. El consumo de alcohol en la población chilena es de 74,5 % y en los jóvenes de un 12,2 %. Entre los factores fisiológicos que influyen en el desarrollo de cáncer, el factor genético juega un rol relevante, habiéndose demostrado que la presencia de polimorfismos genéticos alteran la capacidad del organismo de eliminar contaminantes y aumentan el riesgo de desarrollar cáncer. Lo mismo ocurre con polimorfismos que impiden la reparación de ADN debido a daños producidos por efecto de contaminantes ambientales como el humo de cigarrillo. El objetivo de esta revisión es analizar el estado del arte de la relación entre farmacogenética, tabaco y alcohol como factores de riesgo para el desarrollo de cáncer. Los resultados sugieren que la presencia de po limorfismos que alteran la función de enzimas de biotransformación fase I (CYP1A1, CYP1E1) y fase II (GST), además de polimorfismos en enzimas de reparación del ADN (ERCC1/ERCC2) aumentan el riesgo de cáncer inducido por el hábito tabáquico y alcohólico. Esta asociación es importante, si consideramos que en la población chilena el hábito de fumar y beber alcohol es altamente prevalente.

Cancer is the second leading cause of death in the world, causing 8.8 million deaths in 2015 according to the World Health Organization (WHO). Risk factors for cancer include smoking and alcohol con sumption. In Chile, 33.6% of the population and 21.2% of young people smokes. Alcohol consump tion in the Chilean population is 74.5% and 12.2% in young people. Among the physiological factors that influence the development of cancer, the genetic factor plays a relevant role. It has been shown that the presence of genetic polymorphisms that alter the ability of the body to eliminate contami nants increase the risk of developing cancer. The same applies to polymorphisms that prevent DNA repair due to damage caused by environmental pollutants such as cigarette smoke. The objective of this review is to analyze the state of the art of the relationship between pharmacogenetics, smoking, and alcohol consumption as risk factors for the development of cancer. In conclusion, the results suggest that the presence of polymorphisms that alter the function of biotransformation enzymes phase I (CYP1A1, CYP1E1) and phase II (GST), as well as polymorphisms in DNA repair enzymes (ERCC1 / ERCC2), increase the risk of cancer induced by smoking and alcohol consumption. This association is important considering that smoking and drinking alcohol are highly prevalent among the Chilean population.

Roles of flotillins in tumors / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The identification and use of molecular biomarkers have greatly improved the diagnosis and treatment of malignant tumors. However, a much deeper understanding of oncogenic proteins is needed for the benefit to cancer patients. The lipid raft marker proteins, flotillin-1 and flotillin-2, were first found in goldfish retinal ganglion cells during axon regeneration. They have since been found in a variety of cells, mainly on the inner surface of cell membranes, and not only act as a skeleton to provide a platform for protein-protein interactions, but also are involved in signal transduction, nerve regeneration, endocytosis, and lymphocyte activation. Previous studies have shown that flotillins are closely associated with tumor development, invasion, and metastasis. In this article, we review the functions of flotillins in relevant cell processes, their underlying mechanisms of action in a variety of tumors, and their potential applications to tumor molecular diagnosis and targeted therapy.

A Nexus model of cellular transition in cancer

The exact cause of cancer is one of the most immutable medical questions of the century. Cancer as an evolutionary disease must have a purpose and understanding the purpose is more important than decoding the cause. The model of cancer proposed herein, provides a link between the cellular biochemistry and cellular genetics of cancer evolution. We thus call this model as the "Nexus model" of cancer. The Nexus model is an effort to identify the most apparent route to the disease. We have tried to utilize existing cancer literature to identify the most plausible causes of cellular transition in cancer, where the primary cancer-causing agents (physical, chemical or biological) act as inducing factors to produce cellular impeders. These cellular impeders are further linked to the Nexus. The Nexus then generates codes for epigenetics and genetics in cancer development.

Prevalência de distúrbios da comunicação, deglutição e motricidade orofacial em crianças e adolescentes no momento da matrícula em um hospital oncológico / Prevalence of communication, swallowing and orofacial myofunctional disorders in children and adolescents at the time of admission at a cancer hospital

RESUMO Objetivo Descrever a prevalência dos distúrbios da comunicação, deglutição e motricidade orofacial em um grupo de crianças e adolescentes, no momento da matrícula hospitalar em um instituto oncológico. Método Estudo transversal, com a inclusão de crianças com dois anos ou mais e adolescentes de ambos os gêneros, matriculados na Seção de Oncologia Pediátrica do Instituto Nacional de Câncer José de Alencar Gomes da Silva (INCA) no período de março de 2014 a abril de 2015 para investigação e/ou tratamento de tumores sólidos. Foi utilizado um protocolo para registro das informações sociodemográficas e clínicas e os achados da avaliação clínica fonoaudiológica, que contemplava aspectos do sistema sensório-motor oral, deglutição, fala, linguagem, voz e audição. Resultados Oitenta e oito crianças/adolescentes (41,3%) avaliados apresentavam algum tipo de distúrbio fonoaudiológico. As alterações fonoaudiológicas mais frequentes foram o distúrbio miofuncional orofacial, a disfonia e os transtornos de linguagem. Os menos frequentes foram a disacusia, a paralisia de língua e o trismo. A variável clínica que teve associação estatisticamente significante com a presença de alterações fonoaudiológicas foi o local da lesão. Conclusão O estudo demonstrou uma alta prevalência de alterações fonoaudiológicas em crianças e adolescentes no momento da matrícula hospitalar em um hospital oncológico. A ocorrência de transtornos fonoaudiológicos foi maior nos grupos de participantes com lesões localizadas no sistema nervoso central e na região da cabeça e pescoço.

ABSTRACT Purpose Describe the prevalence of communication, swallowing and orofacial myofunctional disorders in a group of children and adolescents at the time of registration at a cancer hospital. Methods A cross-sectional study conducted with children aged ≥2 and adolescents, of both genders, admitted to the Pediatric Oncology Section of the Instituto Nacional de Câncer José de Alencar Gomes da Silva (INCA) from March 2014 to April 2015 for investigation and/or treatment of solid tumors. A protocol was used to record the sociodemographic and clinical information and findings of the speech-language pathology clinical evaluation, which included aspects of the oral sensorimotor system, swallowing, speech, language, voice, and hearing. Results Eighty-eight children/adolescents (41.3%) presented some type of speech-language disorder. The most frequent speech-language disorders were orofacial myofunctional disorder, dysphonia, and language impairments, whereas the less frequent ones were dysacusis, tongue paralysis, and trismus. Site of the lesion was the clinical variable that presented statistically significant correlation with presence of speech-language disorders. Conclusion High prevalence of speech-language disorders was observed in children and adolescents at the time of admission at a cancer hospital. Occurrence of speech-language disorders was higher in participants with lesions in the central nervous system and in the head and neck region.

Historia del primer artículo científico argentino sobre cáncer y tabaco / History of the first Argentine scientific article on cancer and tobacco

Se revisa la historia del primer artículo científico argentino sobre cáncer y tabaco, de tipo experimental, realizado por el Dr Ángel Roffo en la década del 30.

The history of the first Argentine scientific article on cancer and tobacco, experimental, conducted by Dr. Angel Roffo in the 30s is reviewed.

Mortalidade e incapacidade por doenças relacionadas à exposição ao tabaco no Brasil, 1990 a 2015 / Mortality and disability from tobacco-related diseases in Brazil, 1990 to 2015

RESUMO: Introdução: A epidemia global do tabaco já assumiu proporções de pandemia, com cerca de 1,3 bilhão de usuários e 6 milhões de mortes anuais. Objetivo: Este trabalho teve como objetivo analisar as tendências de mortalidade por doença pulmonar obstrutiva crônica (DPOC) e câncer de pulmão, lábios, cavidade oral, faringe e esôfago, no Brasil, entre 1990 e 2015. Métodos: O estudo foi viabilizado mediante parceria entre o Instituto Métricas e Avaliação em Saúde (IHME), da Universidade de Washington, Ministério da Saúde e o grupo técnico GBD Brasil, utilizando análise de estimativas do estudo Carga Global de Doenças 2015. Resultados: As taxas de mortalidade por DPOC caíram, já que, em 1990, foi de 64,5/100.000 habitantes e, em 2015, 44,5, queda de 31%. Para os vários tipos de câncer relacionados ao tabaco, a queda foi em menor proporção do que a verificada para DPOC. A mortalidade por câncer de pulmão permaneceu estável, com taxa de 18,7/100.000 habitantes, em 1990, e 18,3/100.000 habitantes, em 2015. Entre as mulheres, observa-se curva ascendente, com aumento de 20,7%. Discussão: O estudo aponta o tabaco como fator de risco para mortalidade prematura e incapacidades por DPOC e câncer. A importante redução da prevalência do tabaco nas últimas décadas poderia explicar reduções nas tendências de doenças relacionadas com o tabaco. A maior mortalidade por câncer de pulmão em mulheres pode expressar o aumento tardio do tabagismo nesse sexo. Conclusão: Ações nacionais nas últimas décadas têm tido grande efeito na diminuição da mortalidade de doenças relacionadas ao tabaco, mas ainda há grandes desafios, principalmente quando se trata de mulheres e jovens.

ABSTRACT: Introduction: The global tobacco epidemic has taken pandemic proportions, with about 1.3 billion users and 6 million annual deaths. This study aimed to analyze the trends in mortality from chronic obstructive pulmonary disease (COPD) and lung, lips, oral cavity, pharynx, and esophagus cancer in Brazil between 1990 and 2015. Methods: The study was made possible through a partnership between the Metrics and Health Assessment Institute (IHME), University of Washington, Ministry of Health and the GBD Brazil technical group, using estimates from the Global Disease Charge 2015 study. Results: The mortality rates due to COPD fell; in 1990, it was 64.5/100,000 inhabitants and in 2015, 44.5, a decrease of 31%. For the various types of cancer related to smoking, the decrease was in a lower proportion than for COPD. For lung cancer, rates were 18.7/100,000 inhabitants in 1990 to 18.3 in 2015. For women, there is an upward curve for lung cancer from 1990 to 2015, with an increase of 20.7%. Discussion: The study points to smoking as a risk factor for premature mortality and disability due to COPD and cancer. The significant reduction in tobacco prevalence in recent decades could explain reductions in tobacco-related disease trends. The higher mortality from lung cancer in women may express the delayed increase in smoking in this gender. Conclusion: Nationwide actions taken in the last decades have had a great effect on reducing mortality from tobacco-related diseases, but there are still major challenges, especially when it comes to women and young people.

Childhood cancer and environmental integrity: a commentary and a proposal

ABSTRACT Improvements in the health standards of developed and developing societies depend primarily on the relationships between economy and environment. Recent long-term changes in the chemical composition of man-made environments may be linked to changes in the biology of human beings. Here we argue that children are at the greatest risk of being affected by the dangerous effects of these changes, with particular reference to cancer. The concept of cancer risk must be extended to new contexts. Considering the increasing rates of chemical pollution and its spreading in the environment, we illustrate a proposal aiming to protect the human health, in an intra- and intergenerational perspective. A surveillance system of occupational and residential exposures should be implemented to prevent cancer risk in embryos and children.

Neoplasias extra-colónicas en pacientes con enfermedad inflamatoria intestinal / Extra-intestinal malignancies in patients with inflammatory bowel disease

Patients with inflammatory bowel disease (IBD) have shown to be at increased risk of developing extraintestinal malignancies. Immunomodulators (immunosuppressant and anti-tumor necrosis factor) diminish the mucosal inflammatory response changing the evolution of the disease, especially when these strategies are introduced earlier. However, therapies that alter the immune system may also promote carcinogenesis. Treatment of IBD in patients with prior malignancy is challenging and the final decision regarding therapeutic strategy should be made on a case-by-case basis. The purpose of this review is to show the characteristics of extra-colonic cancer in patients with IBD, including risks, pathogenesis and management of IBD after cancer diagnosis, the effect of neoplasm treatment on IBD, and the effect of IBD and its treatments on cancer outcomes.

Los pacientes con enfermedad inflamatoria intestinal (EII) presentan un mayor riesgo de desarrollar neoplasias extraintestinales. Los inmunomoduladores (inmunosupresores y terapia biológica anti-TNF) disminuyen la respuesta inflamatoria a nivel de la mucosa, modificando la evolución de la enfermedad, especialmente cuando son introducidos precozmente. Sin embargo, estas terapias pueden alterar el sistema inmune y promover la carcinogénesis. El tratamiento de la EII en pacientes con antecedentes de cáncer es un desafío y la decisión final sobre la estrategia terapéutica debe ser determinada caso a caso. Esta revisión tiene como objetivo mostrar las características de las neoplasias extra-intestinales en pacientes con EII, incluyendo los riesgos, patogénesis y manejo de la EII posterior al diagnóstico del cáncer, el efecto de la neoplasia sobre el tratamiento de la EII y el efecto de la EII y su tratamiento sobre el cáncer.

Radionuclide concentrations and excess lifetime cancer risk due to gamma radioactivity in tailing enriched soil around Maiganga coal mine, Northeast Nigeria

Background: Human activities such as mining enhance the radioactivity levels above normal background which can lead to an incremental increase in the radiation risk to the population

Materials and Methods: 20 tailing enriched soil samples collected around Maiganga coal mine, Gombe, Northeast Nigeria were assessed for their[226]Ra,[232]Th and [40]K contents using HPGe gamma-ray detector

Results: The mean activity values of 11.9013.0, 17.72+/-3.6 and 70.44+/-20.4 Bq kg[-1] were obtained for [226]Ra, [232]Th and [40]K respectively. These values were below the world average values documented by UNSCEAR. The ratio of [232]Th:[226]Ra obtained was 1.5, which showed that [232]Th activity was higher than the activity of [226]Ra while [40]K recorded the highest activity concentration in the studied samples. Statistical analysis identified strong positive relationships among all radiological parameters and confirmed that [225]Ra,[232]Th and [40]K were the major contributors to radiation dose. Radium equivalent activity [Ra[eg]], absorbed gamma dose rate [D[r]], annual effective dose [AEDE], activity utilization index [AUI], external and internal hazard indices [H[ex]] and H[in], gamma representative index [l[vr]], annual gonadal dose [AGDE] and excess lifetime cancer risk [ELCR] were calculated to quantify the radiation risk to the public from exposure to[226]Ra, [232]Th and [40]K in the studied samples. The mean values of these hazard parameters were within the acceptable limits provided for human safety and environmental protection

Concfusfon: The use of the raffing enrfcnecf soff sampfes of Maiganga coaf mine for any purpose whatsoever does not therefore pose any immediate radiological risk to the coaf workers or the general pubfic