Internal dosimetric analyser to assist routine, confirmatory and special radiobioassays.

The IAEA Radiation Safety Technical Services Laboratory has developed and validated an Internal Dosimetric Analyser (IDA) software tool to facilitate access to dosimetric data and perform calculations related to individual monitoring for intakes of radionuclides and occupational radiation protection. IDA serves to correlate measurements from routine, confirmatory and special internal monitoring with data obtained from the Occupational Intakes of Radionuclides series of recommendations published by the International Commission on Radiological Protection. The purpose of IDA is to keep the internal dosimetry data in the background and allow the dosimetrist to make the necessary calculations to be able to decide (1) whether the bioassay method and monitoring period are appropriate for routine, confirmatory or special monitoring; (2) whether the method and period will allow the recording level to be detected; (3) whether previous intakes are contributing to the current measurement; and (4) whether measurement uncertainties affect the dose assessment.

Características de pacientes adultos con cáncer y su atención en el Hospital Universitario San José de Popayán, Colombia / Characteristics of adult cancer patients and their care at the San José University Hospital, Popayán, Colombia

Resumen Objetivo: Describir las características sociodemográficas y clínicas de los pacientes adultos con diagnóstico de cáncer atendidos en el Hospital Universitario San José (HUSJ) de Popayán, Colombia. Métodos: Estudio observacional con datos rutinarios de cáncer que incluyó pacientes mayores de 18 años atendidos entre 2012 y 2017 en los servicios de urgencias y hospitalización con diagnóstico de cáncer, según el Manual CIE 10 (Clasificación Internacional de Enfermedades, décima versión) en el HUSJ. Se aplicó una estrategia de muestreo aleatorio simple con afijación proporcional por años y se analizaron de forma descriptiva y gráfica. Resultados: Se incluyeron 245 pacientes. El 51% de los cuales correspondió al género femenino y la mediana de edad fue de 64 años. El cáncer más frecuente en ambos sexos fue el de estómago, seguido por el cáncer de ovario y cérvix en mujeres y por el cáncer de próstata, de tejido sanguíneo y de médula ósea en hombres. Los tipos histológicos de cáncer registrados en la mayoría de los pacientes fueron los carcinomas y adenocarcinomas. En el 36,7% de los pacientes se documentó la presencia de metástasis. La mortalidad durante la última hospitalización fue del 20% y el 12% de los pacientes requirieron remisión a otro nivel de atención superior. Conclusión: Los resultados de este estudio muestran similitudes con el comportamiento de la enfermedad en el país, con excepción del cáncer ginecológico. Adicionalmente, aporta información valiosa tanto a nivel regional como a la institución y crea conciencia de la necesidad de la implementación y mantenimiento de registros hospitalarios de cáncer.

Abstract Objective: To describe the socio-demographic and clinical characteristics of adult cancer patients who received treatment at the San José University Hospital (HUSJ) in Popayán, Colombia. Methods: Observational study with routine cancer data, which included patients aged over 18 years, who received treatment between 2012 and 2017 in the emergency and hospitalization departments, with cancer diagnosis according to the ICD Manual 10 (International Statistical Classification of Diseases, tenth revision) in the HUSJ. It was applied a simple random sampling strategy, with proportional allocation by years, and they were analyzed descriptively and graphically. Results: 245 patients were included, 51% of which corresponded to female gender; median age, 64 years. The most frequent cancer in both sexes was stomach cancer, followed by ovary cancer and cervix cancer in women; and cancer of the prostate, blood tissue, and bone marrow in men. The histological types of cancer registered in most of the patients were carcinomas and adenocarcinomas. The presence of metastases was documented in 36.7% of the patients. The mortality during the last hospitalization was 20%; and 12% of patients required referral to another higher level of care. Conclusion: The results of this study show similarities with the behavior of the disease in the country, with the exception of gynecological cancer. Additionally, it provides valuable information both regionally and at institution level, as well as it raises awareness of the need for the implementation and maintenance of hospital cancer records.

Porcine Small Intestinal Submucosa Mitral Valve Material Responses Support Acute Somatic Growth.

Background: Conceptually, a tissue engineered heart valve would be especially appealing in the pediatric setting since small size and somatic growth constraints would be alleviated. In this study, we utilized porcine small intestinal submucosa (PSIS) for valve replacement. Of note, we evaluated the material responses of PSIS and subsequently its acute function and somatic growth potential in the mitral position. Methods and Results: Material and mechanical assessment demonstrated that both fatigued 2ply (∼65 µm) and 4ply (∼110 µm) PSIS specimens exhibited similar failure mechanisms, but at an accelerated rate in the former. Specifically, the fatigued 2ply PSIS samples underwent noticeable fiber pullout and recruitment on the bioscaffold surface, leading to higher yield strength (p < 0.05) and yield strain (p < 0.05) compared to its fatigued 4ply counterparts. Consequently, 2ply PSIS mitral valve constructs were subsequently implanted in juvenile baboons (n = 3). Valve function was longitudinally monitored for 90 days postvalve implantation and was found to be robust in all animals. Histology at 90 days in one of the animals revealed the presence of residual porcine cells, fibrin matrix, and host baboon immune cells but an absence of tissue regeneration. Conclusions: Our findings suggest that the altered structural responses of PSIS, postfatigue, rather than de novo tissue formation, are primarily responsible for the valve's ability to accommodate somatic growth during the acute phase (90 days) following mitral valve replacement. Impact Statement Tissue engineered heart valves (TEHVs) offer the potential of supporting somatic growth. In this study, we investigated a porcine small intestinal submucosa bioscaffold for pediatric mitral heart valve replacement. The novelty of the study lies in identifying material responses under mechanical loading conditions and its effectiveness in being able to function as a TEHV. In addition, the ability of the scaffold valve to support acute somatic growth was evaluated in the Baboon model. The current study contributes toward finding a solution for critical valve diseases in children, whose current prognosis for survival is poor.

GHSI EMERGENCY RADIONUCLIDE BIOASSAY LABORATORY NETWORK - SUMMARY OF THE SECOND EXERCISE.

The Global Health Security Initiative (GHSI) established a laboratory network within the GHSI community to develop collective surge capacity for radionuclide bioassay in response to a radiological or nuclear emergency as a means of enhancing response capability, health outcomes and community resilience. GHSI partners conducted an exercise in collaboration with the WHO Radiation Emergency Medical Preparedness and Assistance Network and the IAEA Response and Assistance Network, to test the participating laboratories (18) for their capabilities in in vitro assay of biological samples, using a urine sample spiked with multiple high-risk radionuclides (90Sr, 106Ru, 137Cs, and 239Pu). Laboratories were required to submit their reports within 72 h following receipt of the sample, using a pre-formatted template, on the procedures, methods and techniques used to identify and quantify the radionuclides in the sample, as well as the bioassay results with a 95% confidence interval. All of the participating laboratories identified and measured all or some of the radionuclides in the sample. However, gaps were identified in both the procedures used to assay multiple radionuclides in one sample, as well as in the methods or techniques used to assay specific radionuclides in urine. Two-third of the participating laboratories had difficulties in determining all the radionuclides in the sample. Results from this exercise indicate that challenges remain with respect to ensuring that results are delivered in a timely, consistent and reliable manner to support medical interventions. Laboratories within the networks are encouraged to work together to develop and maintain collective capabilities and capacity for emergency bioassay, which is an important component of radiation emergency response.

EURADOS intercomparison on emergency radiobioassay.

Nine laboratories participated in an intercomparison exercise organised by the European Radiation Dosimetry Group (EURADOS) for emergency radiobioassay involving four high-risk radionuclides ((239)Pu, (241)Am, (90)Sr and (226)Ra). Diverse methods of analysis were used by the participating laboratories for the in vitro determination of each of the four radionuclides in urine samples. Almost all the methods used are sensitive enough to meet the requirements for emergency radiobioassay derived for this project in reference to the Clinical Decision Guide introduced by the NCRP. Results from most of the methods meet the requirements of ISO 28218 on accuracy in terms of relative bias and relative precision. However, some technical gaps have been identified. For example, some laboratories do not have the ability to assay samples containing (226)Ra, and sample turnaround time would be expected to be much shorter than that reported by many laboratories, as timely results for internal contamination and early decisions on medical intervention are highly desired. Participating laboratories are expected to learn from each other on the methods used to improve the interoperability among these laboratories.

An unusual anomaly of the radial artery with potential significance to the forearm free flap. Case report.

INTRODUCTION: The radial forearm free flap has become the favourite transplant for microsurgical repair of small-to-medium sized soft tissue defects of the oral cavity. This flap derives its blood supply from perforators of the radial artery. As the radial forearm flap gains ever more popularity, it is likely that anomalous forearm vascular patterns will be encountered by more surgeons. PURPOSE: In this paper, a rare anomaly found in a patient during flap elevation is described. This 63-year-old male had a squamous cell carcinoma of the floor of the mouth and a radial forearm free flap was harvested to repair the defect. During this procedure an aberrant duplication of the radial artery was found which could have significance in harvesting such a flap in other patients. CONCLUSION: There are anomalies of the radial artery that may jeopardize the vascular supply to the radial forearm free flap. Surgeons performing this flap must be aware of the most common variants of the vascular anatomy of the forearm.

Coexistencia de tres diferentes patologias tiroideas / Coexistence of three different thyroid diseases

The case of a 53 year old woman, coming from a goitrogenous area, who developed a clinical picture of subacute thyroiditis is reported. The 99m Technetium scan was normal and a needle aspiration cytology showed multinucleated giant cells; the patient underwent total thyroidectomy. The histological examination revealed the association of multinodular goiter, papillary invasive multicentric carcinoma and granulomatous thyroiditis. The coexistence of these 3 different diseases in a single patient and the role of cancer as a possible etiologic factor of granulomatous changes of the thyroid gland are discussed.