Abstract Background: High-risk Human Papillomaviruses (HR-HPVs) are the etiological agents of cervical cancer and its preneoplastic lesions. HPV16 and 18 are the most frequent HR-HPV genotypes detected in cervical cancer. HR-HPV genome integration into the host cell is an important event in the carcinogenic process. However, it remains uncertain which stage of cervical carcinogenesis HPV16 and 18 integration occurs in the Chilean population. Aim: The goal of this study was to evaluate HPV16 and HPV18 integration in preneoplastic lesions of the cervix. Methods: DNA was extracted from 108 cervical scrape samples with preneoplastic lesions. HPV was genotyped using PCR and non-radioactive hybridization. The integration status of HPV16 and HPV 18 was determined by evaluating the E2 gene presence through PCR. Results: HPV16 and HPV18 tested positive in 36.1% and 12.0% of samples, respectively. HPV16 was found integrated in 23.1% of HPV 16 cases, while HPV 18 in 100% of samples positive for this viral genotype. Conclusions: HR-HPV integration is an early event in cervical carcinogenesis, occurring in nearly half of preneoplastic lesions and being more frequent in HPV18 than in HPV16. The evaluation of HR-HPV integration can be utilized as a complementary tool for detecting HPV in the Chilean population.

Resumen Introducción: El virus del papiloma humano de alto riesgo (VPH-AR) es responsable del cáncer de cuello uterino y sus lesiones preneoplásicas. Los genotipos VPH16 y VPH18 son los más frecuentes en este cáncer. La integración del VPH-AR en el genoma de la célula hospedera es crucial en la carcinogénesis cervical, pero la etapa en que ocurre en la población chilena es incierta. Objetivo: Evaluar la integración de VPH16 y VPH18 en lesiones pre-neoplásicas de cuello uterino. Métodos: Se analizaron 108 muestras de raspados cervicales. El VPH se genotipificó mediante reacción de polimerasa en cadena (RPC) e hibridación no radiactiva. La integración de VPH16 y VPH18 se determinó por presencia del gen E2 mediante RPC. Resultados: VPH16 y VPH18 se detectaron en 36,1% y 12,0% de las muestras, respectivamente. El VPH16 se integró en 23,1% de los casos de VPH16, mientras que VPH18 se integró en 100% de las muestras positivas para este genotipo. Conclusiones: La integración VPH-AR es un evento temprano en la carcinogénesis cervical que ocurre en casi la mitad de las lesiones pre-neoplásicas y es más frecuente en VPH18 que en VPH16. La evaluación de la integración VPH-AR puede ser una herramienta útil para detectar el virus en la población chilena.

ABSTRACT BACKGROUND: The efficacy of anti-thyroid drugs in conjunction with radioactive iodine therapy in the management of Graves’ disease is still controversial. OBJECTIVE: To compare the efficacy of pretreatment with methimazole before the administration of radioactive iodine for the treatment of Graves’ disease. DESIGN AND SETTING: A systematic review and meta-analysis was conducted at a teaching/tertiary hospital in Ibadan, Nigeria. METHODS: A systematic search of the PubMed, Embase, Cochrane Library, and Web of Science databases was performed from inception to December, 2021. RESULTS: Five studies with 297 participants were included. There was no difference in the risk of persistent hyperthyroidism when radioactive iodine was used in conjunction with methimazole compared with when radioactive iodine was used alone (relative risk: 1.02, 95% confidence interval, CI: 0.62–1.66; P = 0.95, I2 = 0%). Subgroup analysis based on the duration between discontinuation of methimazole and the administration of radioactive iodine showed a lower risk of persistent hyperthyroidism when methimazole was discontinued within 7 days before radioactive iodine use, although this did not reach statistical significance (risk ratio: 0.85, CI: 0.28–2.58). CONCLUSIONS: The use of methimazole before radioactive iodine administration was not associated with an increased risk of persistent hyperthyroidism. Concerns about medication toxicity and adverse effects should be considered when clinicians make decisions on combination therapies for the treatment of Graves’ disease. PROSPERO REGISTRATION: CRD42020150013, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=150013. BACKGROUND antithyroid anti thyroid Graves controversial OBJECTIVE SETTING metaanalysis meta teachingtertiary teaching tertiary Ibadan Nigeria METHODS PubMed Embase Library December 2021 RESULTS 29 included relative 102 1 02 1.02 95 interval CI 0.62–1.66 062166 0 62 66 095 0.95 I 0%. 0% . 0%) ratio 085 85 0.85 0.28–2.58. 028258 0.28–2.58 28 2 58 0.28–2.58) CONCLUSIONS REGISTRATION CRD42020150013 CRD https//www.crd.york.ac.uk/prospero/display_record.phpRecordID=150013. httpswwwcrdyorkacukprosperodisplayrecordphpRecordID150013 httpswwwcrdyorkacukprosperodisplayrecordphpRecordID https //www.crd.york.ac.uk/prospero/display_record.php RecordID=150013. www crd york ac uk prospero display record php RecordID 150013 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=150013 202 10 1.0 9 0.62–1.6 06216 6 09 0.9 08 8 0.8 02825 0.28–2.5 5 CRD4202015001 phpRecordID https//www.crd.york.ac.uk/prospero/display_record.phpRecordID=150013 httpswwwcrdyorkacukprosperodisplayrecordphpRecordID15001 wwwcrdyorkacukprosperodisplayrecordphp RecordID150013 RecordID=150013 15001 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=15001 20 1. 0.62–1. 0621 0. 0282 0.28–2. CRD420201500 https//www.crd.york.ac.uk/prospero/display_record.phpRecordID=15001 httpswwwcrdyorkacukprosperodisplayrecordphpRecordID1500 RecordID15001 RecordID=15001 1500 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1500 0.62–1 062 028 0.28–2 CRD42020150 https//www.crd.york.ac.uk/prospero/display_record.phpRecordID=1500 httpswwwcrdyorkacukprosperodisplayrecordphpRecordID150 RecordID1500 RecordID=1500 150 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=150 0.62– 06 0.28– CRD4202015 https//www.crd.york.ac.uk/prospero/display_record.phpRecordID=150 httpswwwcrdyorkacukprosperodisplayrecordphpRecordID15 RecordID150 RecordID=150 15 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=15 0.62 0.28 CRD420201 https//www.crd.york.ac.uk/prospero/display_record.phpRecordID=15 httpswwwcrdyorkacukprosperodisplayrecordphpRecordID1 RecordID15 RecordID=15 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1 0.6 0.2 CRD42020 https//www.crd.york.ac.uk/prospero/display_record.phpRecordID=1 RecordID1 RecordID=1 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID= CRD4202 https//www.crd.york.ac.uk/prospero/display_record.phpRecordID= RecordID= https://www.crd.york.ac.uk/prospero/display_record.php?RecordID CRD420 https//www.crd.york.ac.uk/prospero/display_record.phpRecordID CRD42 CRD4

ABSTRACT BACKGROUND: The efficacy of anti-thyroid drugs in conjunction with radioactive iodine therapy in the management of Graves’ disease is still controversial. OBJECTIVE: To compare the efficacy of pretreatment with methimazole before the administration of radioactive iodine for the treatment of Graves’ disease. DESIGN AND SETTING: A systematic review and meta-analysis was conducted at a teaching/tertiary hospital in Ibadan, Nigeria. METHODS: A systematic search of the PubMed, Embase, Cochrane Library, and Web of Science databases was performed from inception to December, 2021. RESULTS: Five studies with 297 participants were included. There was no difference in the risk of persistent hyperthyroidism when radioactive iodine was used in conjunction with methimazole compared with when radioactive iodine was used alone (relative risk: 1.02, 95% confidence interval, CI: 0.62–1.66; P = 0.95, I2 = 0%). Subgroup analysis based on the duration between discontinuation of methimazole and the administration of radioactive iodine showed a lower risk of persistent hyperthyroidism when methimazole was discontinued within 7 days before radioactive iodine use, although this did not reach statistical significance (risk ratio: 0.85, CI: 0.28–2.58). CONCLUSIONS: The use of methimazole before radioactive iodine administration was not associated with an increased risk of persistent hyperthyroidism. Concerns about medication toxicity and adverse effects should be considered when clinicians make decisions on combination therapies for the treatment of Graves’ disease. PROSPERO REGISTRATION: CRD42020150013, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=150013. BACKGROUND antithyroid anti thyroid Graves controversial OBJECTIVE SETTING metaanalysis meta teachingtertiary teaching tertiary Ibadan Nigeria METHODS PubMed Embase Library December 2021 RESULTS 29 included relative 102 1 02 1.02 95 interval CI 0.62–1.66 062166 0 62 66 095 0.95 I 0%. 0% . 0%) ratio 085 85 0.85 0.28–2.58. 028258 0.28–2.58 28 2 58 0.28–2.58) CONCLUSIONS REGISTRATION CRD42020150013 CRD https//www.crd.york.ac.uk/prospero/display_record.phpRecordID=150013. httpswwwcrdyorkacukprosperodisplayrecordphpRecordID150013 httpswwwcrdyorkacukprosperodisplayrecordphpRecordID https //www.crd.york.ac.uk/prospero/display_record.php RecordID=150013. www crd york ac uk prospero display record php RecordID 150013 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=150013 202 10 1.0 9 0.62–1.6 06216 6 09 0.9 08 8 0.8 02825 0.28–2.5 5 CRD4202015001 phpRecordID https//www.crd.york.ac.uk/prospero/display_record.phpRecordID=150013 httpswwwcrdyorkacukprosperodisplayrecordphpRecordID15001 wwwcrdyorkacukprosperodisplayrecordphp RecordID150013 RecordID=150013 15001 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=15001 20 1. 0.62–1. 0621 0. 0282 0.28–2. CRD420201500 https//www.crd.york.ac.uk/prospero/display_record.phpRecordID=15001 httpswwwcrdyorkacukprosperodisplayrecordphpRecordID1500 RecordID15001 RecordID=15001 1500 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1500 0.62–1 062 028 0.28–2 CRD42020150 https//www.crd.york.ac.uk/prospero/display_record.phpRecordID=1500 httpswwwcrdyorkacukprosperodisplayrecordphpRecordID150 RecordID1500 RecordID=1500 150 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=150 0.62– 06 0.28– CRD4202015 https//www.crd.york.ac.uk/prospero/display_record.phpRecordID=150 httpswwwcrdyorkacukprosperodisplayrecordphpRecordID15 RecordID150 RecordID=150 15 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=15 0.62 0.28 CRD420201 https//www.crd.york.ac.uk/prospero/display_record.phpRecordID=15 httpswwwcrdyorkacukprosperodisplayrecordphpRecordID1 RecordID15 RecordID=15 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1 0.6 0.2 CRD42020 https//www.crd.york.ac.uk/prospero/display_record.phpRecordID=1 RecordID1 RecordID=1 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID= CRD4202 https//www.crd.york.ac.uk/prospero/display_record.phpRecordID= RecordID= https://www.crd.york.ac.uk/prospero/display_record.php?RecordID CRD420 https//www.crd.york.ac.uk/prospero/display_record.phpRecordID CRD42 CRD4

Resumen Introducción: Durante el 21o. Congreso Mundial de Epidemiología, organizado por la Asociación Internacional de Epidemiología (IEA) en Saitama-Japón en agosto de 2017, se aceptó invitación de los organizadores para visitar la Planta Nuclear # 1 de Fukushima. Objetivo: Explorar la situación operacional y de salud pública en el área de la prefectura de Fukushima y su planta nuclear #1, sitio afectado por el terremoto y tsunami de 2011. Métodos: Salida de inspección de campo (Inspection Tour) y encuentro con representantes de TEPCO (Tokyo Energy Power Company) en área de control; explicación didáctica de antecedentes y situación actual zonal, e instrucciones (briefing) para acceso. Visita con explicación de zonas de atención de salud y trabajos realizados. Recorrido en autobús especialmente adaptado al perímetro de cada reactor, portando dosímetro individual. Reunión final para resolución de dudas e inquietudes y lecciones del caso. Resultados: Visita y reuniones ejecutadas; exposición personal = 0,01 mSv/h. Radiación por zonas de reactor: central=230 mSv/h; paredes=40 mSv/h; planta=0,26 mSv/h, periferia=0,26 mSv/h. Zona de exclusión=20 km. Políticas de salubridad basadas en limpieza y remoción de fuentes de contaminación; aislamiento de aguas y bombeo de fuentes subterráneas; prevención y contención de escapes. Conclusión: La prevención lo es todo en asuntos industriales, sean nucleares o no; la colaboración interpersonal e interagencias es esencial en el manejo a muy largo plazo de desastres similares; debe evitarse incorporar técnicas o tecnologías industriales desconocidas o foráneas sin antes valorar su costo, alcance y posibles riesgos de salud individual, pública o medio-ambiental.

Abstract Introduction. During the 21st. International Epidemiology Association (IEA) World Congress of Epidemiology at Saitama (Japan), celebrated in August 2017, an invitation from its organizers to visit Fukushima Nuclear Plant # 1 was accepted. Objective: To explore operational and public health situation at the area of the Fukushima Prefecture and its nuclear plant #1, place affected by the 2011 earthquake and tsunami. Methods. Inspection tour and appointment with representatives of TEPCO (Tokyo Energy Power Company) at the control area; explanation on background and actual situation, and briefing before access. Guided visit to areas dedicated to healthcare and workers’ attention, and work done. Tour by specially adapted autobus to the perimeter of each reactor, using individual dosimeter. Final meeting to solve questions and lessons of this case. Results. Visit and meetings were executed; individual exposure = 0,01 mSv. Radioactivity by reactor zones: central (inside) =230 mSv/h; walls =40 mSv/h; plant =0,26 mSv/h, perimeter =0,26 mSv/h. Exclusion zone =20 km. Public Health policies in place based upon cleansing and removal of sources of contamination; water isolation and subterranean sources pumping; prevention and containment of leaks. Conclusion. About industrial issues, prevention is everything, whether they be nuclear or not; interpersonal / interagencies’ cooperation is paramount when dealing with similar disasters at a very long term; unknown or poorly understood industrial techniques or technologies should be avoided before a proper evaluation of their risk/benefit balance, scope and possible health risks to subjects, communities or environment.

SUMMARY Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. On the contrary, primary thyroid lymphoma (PTL) is a rare disease, accounting for 2% to 5% of all thyroid malignancies. Despite several cases in which both PTC and PTL arise in the setting of Hashimoto's thyroiditis (HT), the coexistence of both tumors in HT patients is very rare. Herein we report the case of a 66-year-old woman with long-standing nodular HT under replacement therapy, who presented with a fast, painless enlargement in the right anterior side of the neck. Thyroid ultrasonography demonstrated increased growth of a hypoechoic nodule in the right lobe measuring 32 × 20 mm. A total thyroidectomy was performed, and histology revealed a diffuse large B-cell lymphoma (DLBCL) on a background of florid HT. Moreover, a unifocal papillary microcarcinoma, classical variant (7 mm, pT1aNxMx), was discovered. The patient was then treated with chemotherapy for the PTL, but she did not undergo radioactive iodine ablation treatment for the microPTC as per guidelines. Two years after surgery, the patient had no evidence of recurrence of either malignancy. This rare case highlights the importance of monitoring HT patients with nodular lesions, especially if they have long-standing disease. In addition, PTL should be considered for differential diagnosis in elder HT patients who present with sudden thyroid enlargement.

OBJETIVO: Investigar o equipamento nacional de detecção gama intra-operatória na identificação de linfonodo sentinela. MÉTODOS: Foram utilizados 30 ratos machos, adultos jovens. Depois de anestesiados, os animais foram distribuidos em dois grupos de 15 animais cada. O grupo A recebeu radiofármaco dextran 500 - Tc99 e azul patente V e o grupo B, somente azul patente V para realização do mapeamento linfático. Foi realizada a medição da captação radioativa da região de fundo, do sítio de injeção e do linfonodo sentinela ex vivo do grupo A. Após a exérese, cada linfonodo do grupo A e do grupo B foram misturados formando uma nova seqüência aleatória e procedeu a leitura da radioatividade de cada linfonodo com os dois equipamentos. RESULTADOS: O linfonodo sentinela hipercaptante foi identificado pelo equipamento nacional durante as medições da captação radioativa na região do sítio de injeção e linfonodo sentinela ex vivo. O equipamento nacional detectou radiação mesmo nos linfonodos que não receberam o radiofármaco, causando falso positivo, verificado na aplicação dos testes de Mann-Whitney e t pareado de Student. O alfa de Cronbach mostrou alta consistência interna dos dados (0,9416). CONCLUSÕES: O equipamento nacional de detecção gama intra-operatória identifica o linfonodo sentinela e mostra falsos positivos e necessita de aprimoramento.

PURPOSE: To investigate a national equipment of intraoperatory gamma detection in the identification of sentinel lymph node. METHODS: Thirty young adult male rats were used. After anesthetized, animals were divided into two groups of 15 animals each. Animals from group A received dextram 500 - Tc99 radiopharmaceutical and patent blue V and those from group B received only patent blue V to map the lymphatic drainage. The presence of radiation in the background area, in the area of injection and of the ex vivo sentinel lymph node of group A were measured. After the exeresis, each lymph node in group A and in group B was mixed forming a new random sequence and the radioactive reading of each lymph node was carried out, using both pieces of equipment. RESULTS: The hottest sentinel lymph node was identified by the national equipment when radiation was measured in the area of limphatic drainage after the Dextran 500 was injected. Also, the ex vivo sentinel lymph node. The national equipment has also detected radiation in the lymph nodes that had not received radiopharmaceutical, leading to false positive, checked by the application of Mann-Whitney tests and Student's paired t-tests. The Cronbach alpha has shown high internal consistency of data 0,9416. CONCLUSIONS: The national equipment of intraoperatory gamma detection identifies the LS and showed false positives LS and needs improvement.

OBJETIVO: Determinar exposições decorrentes da radioiodoterapia ambulatorial do carcinoma diferenciado da tireoide (CDT) sobre os familiares dos pacientes e o meio ambiente. MÉTODOS: Administraram-se 100 a 150 mCi de (131I)NaI para tratamento ambulatorial de 20 pacientes com CDT. Monitorizaram-se com dosímetros termoluminescentes as doses de radiação recebidas por familiares (n = 27) e potenciais de dose nas residências. Também foram monitorizadas contaminação de superfície e rejeitos radioativos. RESULTADOS: Registraram-se doses < 1,0 mSv em 26 acompanhantes e 2,8 mSv em um caso, inferiores ao aceitável para exposições médicas (5,0 mSv/procedimento). Excetuando-se o quarto dos pacientes (média = 0,69 mSv), determinou-se potencial de dose nas residências < 0,25 mSv. A contaminação de superfícies (4,2 Bq.cm-2) não ultrapassou níveis de liberação, sem representar riscos mesmo em simulações do pior cenário. Os rejeitos radioativos tiveram volume de 2,5 litros e atividade estimada em 90 µCi (média = 4,5 µCi/paciente). CONCLUSÕES: Não foi constatado impacto radiológico ao meio ambiente ou aos familiares de pacientes tratados ambulatorialmente com 100 a 150 mCi de iodo-131 e acompanhados por profissionais qualificados.

PURPOSE:To evaluate exposure and dosimetry to family members and environment due to outpatient radioiodine therapy of differentiated thyroid carcinoma. METHODS: Twenty patients were treated with 100-150mCi of iodine-131 on an out-patient basis. Family members dosimetry (n = 27) and potential doses inside the house were measured with thermoluminescent dosimeters. Surface contamination and radioactive wastes were also monitored. RESULTS: Less than 1.0 mSv doses were found in 26 co-habitants and 2.8 mSv in a single case (inferior to the acceptable value of 5.0 mSv/procedure). Potential doses in the houses were inferior to 0.25 mSv, excluding the patients bedroom (mean value = 0.69 mSv). Surface contamination (mean = 4.2 Bq.cm-2) were below clearance levels. Radioactive wastes generated had a volume of 2.5 liters and a total activity estimated in 90 µCi, with a calculated exposure close to the background radiation levels. CONCLUSIONS: No radiological impact was detected after iodine therapy with 100-150 mCi on an out-patient basis followed by experienced professionals.

210Po concentrations have been determined in one green alga and in five freshwater plants grown in a pond of the Carapebus restinga (State of Rio de Janeiro). The alga Chara sp showed elevated concentration of 210Po, similar to that observed for marine algae. All the other plants had the lowest concentration of 210Po in the stems and the highest in the roots. Intermediate values were observed in the leaves. The unexpected high concentration of 210Po in the roots, even superior to reported values for roots of plants from high radioactive background areas, must be due to the elevated levels of this radionuclide in associated soils that are known to be rich in humic organic material. There seem to have been no translocation of this radionuclide from the roots to the other parts of the plants.