Radioepidemiological studies in the Urals: outcomes and future directions

The paper presents the key milestones and outcomes of 65-year studies of the carcinogenic consequences of accidental radiation exposure of the population of the Urals region. The radioactive contamination of the Techa River and the 1957accident at the Mayak PA were the reasons for the long-term exposure of the population at a wide range of doses. The most important tasks of the study were the reconstruction of individual doses, follow-up of the health and life status of cohort members. The research results have shown that chronic human exposure, in comparison to acute exposure, does not reduce the risk of developing malignant tumors and leukemias, and the value of the dose-rate factor does not exceed “one”. Thus, according to our data, the current recommendations of the International Commission on Radiological Protection underestimate the radiation risk of malignant tumors and leukemias in case of chronic exposure of the population by a factor of two. Prospects for further radio-epidemiological studies in the Urals are associated with the analysis of the cohort of Southern Urals Populations Exposed to Radiation (SUPER), which includes about 63 thousand exposed people and makes it possible to assess the radiation risk of solid cancers of certain localizations, certain types of leukemia, and non-cancer effects.

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Correctable biliary atresia and cholangiocarcinoma: a case report of a 63-year-old patient

Surgical Case Reports ◽

10.1186/s40792-019-0748-9 ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Masaki Nio ◽

Motoshi Wada ◽

Hideyuki Sasaki ◽

Hiromu Tanaka ◽

Masatoshi Hashimoto ◽

...

Keyword(s):

Biliary Atresia ◽

Liver Tumors ◽

Malignant Tumors ◽

Porta Hepatis ◽

Case Presentation ◽

Cancer Occurrence ◽

Long Term Survivors ◽

Near Future

Abstract Background Although cancer occurrence following surgery for biliary atresia has gradually increased, the development of cholangiocarcinoma in a native liver survivor of biliary atresia is extremely rare. Case presentation A 3-month-old female patient with the correctable type of biliary atresia underwent a cystoduodenostomy. At 16 years of age, she underwent multiple surgeries including lysis of intestinal adhesions, ileostomy, and gastrojejunostomy at another hospital. At 54 years of age, she underwent lithotomy at the porta hepatis, resection of the residual cystic bile duct with gallbladder, and hepaticojejunostomy in Roux-en-Y fashion. As she approached the age of 63, her computed tomography scan showed no liver tumors. In the following year, she developed cholangiocarcinoma at the porta hepatis and underwent chemotherapy. However, the cancer progressed, and she died before she reached the age of 64 years. Conclusions Cholangiocarcinoma is extremely rare in patients with biliary atresia. However, physicians should follow up patients with biliary atresia as closely as possible, as malignant tumors secondary to biliary atresia may increase in number in the near future because of the growing number of long-term survivors with biliary atresia.

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Serving Students With Acquired Brain Injury: Understanding Long-Term Need and Outcomes After the BrainSTEPS Program

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2021_persp-21-00059 ◽

2021 ◽

pp. 1-14

Author(s):

Jessica Salley Riccardi ◽

Libby Crook ◽

Brenda Eagan-Johnson ◽

Monica Vaccaro ◽

Angela H. Ciccia

Keyword(s):

Brain Injury ◽

Regular Education ◽

Acquired Brain Injury ◽

Transition Services ◽

Student Outcome ◽

Severe Injuries ◽

School Based ◽

Wide Range

Purpose: The purpose of this study was to inform school-based services for children with acquired brain injury (ABI) by describing and analyzing functional student-outcome data from a state-wide, school-based, school re-entry consultation program, BrainSTEPS (Strategies Teaching Educators, Parents, and Students), in Pennsylvania. Method: A nonexperimental, retrospective analysis was conducted with data collected during a pilot follow-up survey for BrainSTEPS. Caregivers reported on 337 students with ABI participating in BrainSTEPS. Results: Most students post-ABI who were participating in BrainSTEPS were enrolled in regular education and reported no ongoing symptoms, as well as no parent perception of need for additional BrainSTEPS consultation during the time period of the follow-up survey. Current receipt of therapy was significantly associated with injury type, χ 2 (1, n = 329) = 16.72, p < .001. A multiple logistic regression was significant ( p < .001) in predicting the need for additional BrainSTEPS consultation. More severe injuries, educational placement postinjury of regular education with a 504 plan (compared to regular education), and current receipt of therapy significantly increased the odds of need for consultation. Conclusions: Due to the wide range of experiences of students in this sample, hospital-to-school transition services, educational supports and services, and long-term follow-up must be individualized for children with ABI. Speech-language pathologists are critical members of the school-based academic team for students with ABI to decrease long-term unmet needs.

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Tracing Long- and Short-term Migrants for Participation in Demographic and Epidemiological Studies: Evidence from Senegal

Field Methods ◽

10.1177/1525822x19879892 ◽

2019 ◽

Vol 32 (1) ◽

pp. 38-57

Author(s):

Mufaro Kanyangarara ◽

Laetitia Douillot ◽

Gilles Pison ◽

Cheikh Tidiane Ndiaye ◽

Valerie Delaunay ◽

...

Keyword(s):

Rural Areas ◽

Statistical Power ◽

Epidemiological Studies ◽

Adult Mortality ◽

Short Term ◽

Middle Income ◽

Middle Income Countries ◽

Contact Information

Migration of participants in demographic and epidemiological studies results in missing data. One approach to reduce resulting losses in statistical power and potential biases is to follow up migrants at their new residence. We describe the follow-up of migrants who were eligible for participation in a trial of a new questionnaire to measure adult mortality in Niakhar, Senegal. We conducted a short inquiry in the migrant’s last known household to obtain contact information and then attempted to contact and interview 661 migrants who resided in Dakar, Mbour, and rural areas close to Niakhar. About two-thirds of migrants were successfully enrolled in the study. Having a contact phone number and knowing the name of the head of compound at destination increased the likelihood of successful enrollment. Following up migrants in demographic studies is feasible in low- and middle-income countries, including long-term migrants who have not been contacted for extended periods of time.

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The Milan System for Reporting Salivary Gland Cytopathology: Assessment of Cytohistological Concordance and Risk of Malignancy

Acta Cytologica ◽

10.1159/000510720 ◽

2020 ◽

pp. 1-13

Author(s):

Shilpy Jha ◽

Suvradeep Mitra ◽

Suvendu Purkait ◽

Amit Kumar Adhya

Keyword(s):

Salivary Gland ◽

Predictive Value ◽

Malignant Tumors ◽

Minor Salivary Gland ◽

Treatment Protocol ◽

Needle Aspiration ◽

Histopathological Diagnosis ◽

Wide Range ◽

Risk Of Malignancy

Introduction: The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was proposed by the American Society of Cytopathology and the International Academy of Cytology to bring uniformity in the reporting system and the treatment protocol. A wide range of risk of malignancy for each category has been reported by various authors by applying the system. Aim: We intend to study the cytohistological concordance and the ROM for each of the diagnostic categories of the Milan system. Materials and Methods: The study included 292 cases of fine-needle aspiration cytology (FNAC) of salivary gland lesions over a period of 3 years. The diagnosis of these cases was reclassified into the 6 categories of the Milan system. The cytohistological concordance and ROM for each category of the Milan system were calculated based on the clinical and histopathological follow-up. Results: The patients’ age ranged from 3 to 81 years with the mean of 42.65 ± 16.3 years. The cases included 189 (64.7%) parotid, 82 (28.1%) submandibular, and 21 (7.2%) cases of minor salivary gland swellings. Follow-up histopathological diagnosis for 102 cases was available. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated to be 64.28, 97.01, 90, 86.67, and 87.37%, respectively. After reclassification, the number of cases in each category was as follows: category I: 31 (10.62%), category II: 80 (27.4%), category III: 2 (0.68%), category IVA: 143 (48.97%), category IVB: 1 (0.34%), category V: 13 (4.45%), and category VI: 22 (7.53%). The calculated ROM was as follows: category I: 42.86%, category II: 26.67%, category III: 100% category IVA: 10.17%, category IVB: 0%, category V: 71.42%, category VI: 100%. Conclusion: FNAC is an excellent procedure to differentiate benign from malignant tumors, and MSRSGC is a useful system for risk assessment and deciding the further treatment protocol. Our findings also suggest that in addition to the surgical follow-up, inclusion of the clinical and radiological follow-up may be a better strategy for calculation of ROM, especially for categories I and II.

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Long-term follow-up after prosthetic replacement of the superior vena cava combined with resection of mediastinal-pulmonary malignant tumors

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/s0022-5223(19)36558-4 ◽

1991 ◽

Vol 102 (2) ◽

pp. 259-265 ◽

Cited By ~ 99

Author(s):

Philippe G. Dartevelle ◽

Alain R. Chapelier ◽

Ugo Pastorino ◽

Pierre Corbi ◽

Bernard Lenot ◽

...

Keyword(s):

Superior Vena Cava ◽

Malignant Tumors ◽

Superior Vena ◽

Vena Cava ◽

Prosthetic Replacement ◽

Long Term Follow Up

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Long-term outcome of indigenous 177Lu-DOTATATE PRRT in patients with Metastatic Advanced Neuroendocrine Tumours: a single institutional observation in a large tertiary care setting

British Journal of Radiology ◽

10.1259/bjr.20201041 ◽

2021 ◽

Vol 94 (1117) ◽

pp. 20201041

Author(s):

Keerti Sitani ◽

Rahul V Parghane ◽

Sanjay Talole ◽

Sandip Basu

Keyword(s):

Primary Tumour ◽

Univariate Analysis ◽

Tertiary Care ◽

Previous History ◽

Term Outcome ◽

Long Term Outcome ◽

Wide Range ◽

Grade 3

Objectives: Assessment of long-term outcome and toxicity of indigenous 177Lu-DOTATATE PRRT in patients of metastatic/advanced NETs in a large tertiary-care PRRT setting. Methods: A total of 468 metastatic/advanced NET patients (wide range of primary sites including CUP-NETs), who underwent at least two cycles of 177Lu-DOTATATE PRRT with available follow-up information, were included and analysed retrospectively in this study. In-house labelling of DOTATATE with 177Lu (direct route produced) was carried out in the hospital radiopharmacy and treatment administered in cycles (dose: 5.55 to 7.4 GBq per patient), at 10–12 weeks interval. The assessment of long-term outcome was undertaken under three broad headings: (a) Therapeutic response, (b) Survival outcome and (c) Toxicity assessment. The median point estimate with 95% CI for progression free survival (PFS) and overall survival (OS) were calculated by Kaplan–Meier method. Prognostic covariates for association with PFS and OS was investigated by Cox proportional hazards model (univariate and multivariate Hazard Ratios) and with disease control rate (DCR) by Chi-square test, with significant P value defined as <0.05. Results: Long-term outcome (follow-up ranging from 4 to 97.6 months; median period:46 months following first 177Lu-DOTATATE PRRT) results showed, (i) on symptomatic response evaluation scale, complete response (CR) in 214 patients (45.7%), partial response (PR) in 108 (23.1%), stable disease (SD) in 118 (25.2%), progressive disease (PD) in 28 (6%). (ii) Biochemical response evaluation showed CR in 52 (12%), PR in 172 (40%), SD in 161 (38%), and PD in 42 patients (10%). (iii) Molecular imaging response (by PERCIST criteria) showed CR in 29 (6%), PR in 116 (25%), SD in 267 (57%) and PD in 56 (12%) patients. (iv) On RECIST 1.1 criteria, CR was observed in 14 patients (3%), PR in 126 patients (27%), SD in 282 patients (60%) and PD in 46 patients (10%). The median PFS and OS were not reached at a median follow-up of 46 months. Observed PFS and OS at 7 years were 71.1% 95% CI (62.4–79.7%) and 79.4% 95% CI (71.4–86.9%) respectively. PFS was dependent on previous history of chemotherapy, baseline 68Ga-DOTATATE and 18F-FDG uptake, site of primary tumour, total cumulative dose and number of PRRT cycles on univariate analysis, whereas multivariate analysis showed significant association for previous history of chemotherapy, baseline 68Ga-DOTATATE and 18F-FDG uptake and number of PRRT cycles. The OS was dependent on baseline 68Ga-DOTATATE uptake, site of primary tumour, presence of bony metastatic disease, total cumulative dose and number of PRRT cycles on univariate analysis, whereas multivariate analysis showed significant association for bony metastatic disease and number of PRRT cycles. Transient haematological toxicity of Grade 1, Grade 2, and Grade 3 was found in 8 (1.7%), 1 (0.2%) and one patient (0.2%), respectively. Nephrotoxicity of Grade 1, Grade 2, Grade 3, and Grade 4 were seen in 16 (3.5%), 3 (0.6%), 2 (0.4%) and one patient (0.2%), respectively. On a separate sub-analysis of 322 NET patients with progressive disease at the initiation point of PRRT, overall response rates (CR + PR + SD) were 93.5%, 88.5%, 89.1 and 87.9% on symptomatic, biochemical, RECIST 1.1 and PERCIST criteria and PFS and OS at 7 years 68.3% and 79.2%, respectively. Conclusions: The present results demonstrate that 177Lu-DOTATATE PRRT improved symptoms and biochemical markers substantially in most of the NET patients, with disease stabilisation on both anatomical and molecular imaging in majority and response in a sizeable fraction. Additionally, the therapeutic protocol with lesser dose per cycle (mean 5.92 GBq/cycle) and prolonged duration (over 5 cycles and 1.5 years) in a metastatic NET setting proved equally efficacious (with superior PFS and OS rates) and relatively better tolerated with minimal toxicity. Advances in knowledge: The present work critically examines the long-term results, survival outcome and toxicity profile of the indigenous 177Lu-DOTATATE (produced through direct neutron activation of enriched 176Lu) in metastatic progressive NETs across a wide range of primary sites and malignancies. Such long-term outcome data establishes the favourable impact of PRRT in a wide patient base and also the therapeutic efficacy of the product.

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Depressive symptoms, emotional support and activities of daily living disability onset: 15-year follow-up of the Bambuí (Brazil) Cohort Study of Aging

Cadernos de Saúde Pública ◽

10.1590/0102-311x00141917 ◽

2018 ◽

Vol 34 (7) ◽

Cited By ~ 4

Author(s):

Juliana Lustosa Torres ◽

Erico Castro-Costa ◽

Juliana Vaz de Melo Mambrini ◽

Sérgio William Viana Peixoto ◽

Breno Satler de Oliveira Diniz ◽

...

Keyword(s):

Cohort Study ◽

Social Network ◽

Depressive Symptoms ◽

Activities Of Daily Living ◽

Psychosocial Factors ◽

Emotional Support ◽

Daily Living ◽

Wide Range

Psychosocial factors appear to be associated with increased risk of disability in later life. However, there is a lack of evidence based on long-term longitudinal data from Western low-middle income countries. We investigated whether psychosocial factors at baseline predict new-onset disability in long term in a population-based cohort of older Brazilians adults. We used 15-year follow-up data from 1,014 participants aged 60 years and older of the Bambuí (Brazil) Cohort Study of Aging. Limitations on activities of daily living (ADL) were measured annually, comprising 9,252 measures. Psychosocial factors included depressive symptoms, social support and social network. Potential covariates included sociodemographic characteristics, lifestyle, cognitive function and a physical health score based on 10 self-reported and objectively measured medical conditions. Statistical analysis was based on competitive-risk framework, having death as the competing risk event. Baseline depressive symptoms and emotional support from the closest person were both associated with future ADL disability, independently of potential covariates wide range. The findings showed a clear graded association, in that the risk gradually increased from low emotional support alone (sub-hazard ratio - SHR = 1.11; 95%CI: 1.01; 1.45) to depressive symptoms alone (SHR = 1.52; 95%CI: 1.13; 2.01) and then to both factors combined (SHR = 1.61; 95%CI: 1.18; 2.18). Marital status and social network size were not associated with incident disability. In a population of older Brazilian adults, lower emotional support and depressive symptoms have independent predictive value for subsequent disability in very long term.

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Prospective long-term follow-up analysis of the cardiovascular system in marathon runners: study design of the Pro-MagIC study

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2020-000786 ◽

2020 ◽

Vol 6 (1) ◽

pp. e000786

Author(s):

Julia Schoenfeld ◽

Michael Johannes Schindler ◽

Bernhard Haller ◽

Stefan Holdenrieder ◽

David Christopher Nieman ◽

...

Keyword(s):

Cardiovascular System ◽

Cardiopulmonary Exercise Testing ◽

Strenuous Exercise ◽

Ventricular Ejection Fraction ◽

Cardiovascular Changes ◽

Link Type ◽

Wide Range ◽

Exercise Induced

IntroductionProlonged strenuous exercise training may result in structural, functional and electrical cardiac remodelling, as well as vascular and myocardial injuries. However, the extent to which high-volume, intense exercise is associated with arrhythmias, myocardial fibrosis, coronary heart disease and pathological alterations of the vasculature remains unknown. In addition, there is no clear consensus on the clinical significance of these exercise-induced changes. Previous studies typically used cross-sectional designs and examined exercise-induced cardiovascular changes in small cohorts of athletes for up to 3–7 days of recovery. Long-term longitudinal studies investigating cardiovascular changes induced by prolonged strenuous exercise in large cohorts of athletes are needed to improve scientific understanding in this area.Methods and analysisIn this prospective observational monocenter study, 277 participants of the Beer, Marathon, Genetics, Inflammation and the Cardiovascular System (Be-MaGIC) study (ClinicalTrials.gov: NCT00933218) will be invited to participate in this 10-year follow-up study. A minimum target sample size of 130 participants will be included in the study. Participating athletes will be examined via the following: anthropometry, resting electrocardiography and echocardiography, blood sampling, retinal vessel diameters, carotid sonography and cardiopulmonary exercise testing, including exercise electrocardiography.DiscussionThis longitudinal study will provide comprehensive data on physiological changes in the cardiovascular system and the development of pathologies after a 10-year period of prolonged and strenuous endurance exercise. Since the participants will have engaged in a wide range of training loads and competitive race events, this study will provide useful risk factor determinants and training load cut-off values. The primary endpoint is the association between the exercise-induced increase in cardiac troponin during the Munich marathon 2009 and the decline in right ventricular ejection fraction over the next 10 years.Trial registration numberNCT04166903.

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Increased incidence of solid malignant tumors after bone marrow transplantation for severe aplastic anemia [see comments]

Blood ◽

10.1182/blood.v78.2.277.277 ◽

1991 ◽

Vol 78 (2) ◽

pp. 277-279 ◽

Cited By ~ 109

Author(s):

G Socie ◽

M Henry-Amar ◽

JM Cosset ◽

A Devergie ◽

T Girinsky ◽

...

Keyword(s):

Bone Marrow ◽

Bone Marrow Transplantation ◽

Aplastic Anemia ◽

Marrow Transplantation ◽

Malignant Tumors ◽

Conditioning Regimen ◽

Severe Aplastic Anemia ◽

Male Patients

Abstract From May 1980 to December 1989, 107 consecutive patients with non- constitutional severe aplastic anemia underwent bone marrow transplantation at our institution using cyclophosphamide and thoraco- abdominal irradiation as conditioning regimen. During the same period, 40 patients with Fanconi anemia were also grafted after a similar conditioning, giving a total series of 147 patients. With a mean follow- up of 64 months, four male patients developed a solid malignant tumor, a number that leads to an 8-year cumulative incidence rate of 22% (eg, relative risk to general population = 41, P less than .001). These results should be considered as a warning to clinicians who follow these successfully grafted long-term patients.

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Pets and Health

Psychological Reports ◽

10.2466/pr0.1998.83.3.1011 ◽

1998 ◽

Vol 83 (3) ◽

pp. 1011-1024 ◽

Cited By ~ 10

Author(s):

James Robert Brasić

Keyword(s):

Adverse Effects ◽

Objective Assessment ◽

Wide Range ◽

Follow Up Studies ◽

Long Term Follow Up

Beneficial and adverse effects of pets for individuals in a wide range of circumstances have been reported. Nevertheless, well-designed unbiased experiments and long-term follow-up studies are needed. Pets appear to be therapeutic for some individuals and deleterious for others. The controversies concerning the effects of pets on health merit objective assessment by unbiased researchers.

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