ABSTRACT Introduction: Every year more than 2.3 million cases of breast cancer are registered, making it the most common type of cancer among adults. The association between breast cancer and occupational factors is an issue that has been studied in the literature since the beginning of the 18th century. Technological developments have allowed a more in-depth study of the relationship between breast cancer and occupational factors such as exposure to chemicals, pesticides, metals and also sources of exposure to ionising and non-ionising radiation.The aim of the present literature review is to complete an update on the scientific knowledge about the relationship between occupational exposure to ionising radiation in healthcare workers and the development of breast cancer. Methodology: A research was carried using Medline with the PubMed search engine and Elsevier with the Science Direct search engine. The search words used were a combination of breast cancer, occupational exposure, ionizing radiation and healthcare workers. A research was also carried out in Revista Portuguesa de Saúde Ocupacional, using the terms “Breast Cancer” and “Ionizing Radiation”. Discussion/Conclusions: Current literature is not unanimous about the specific clinical and pathological features of breast cancer possibly linked to occupational settings. Healthcare professionals such as radiology technicians, nurses, orthopaedic surgeons and interventional cardiologists are especially vulnerable to this type of exposure, particularly to ionising radiation. However, some studies have pointed to a difficulty in establishing a causal relationship between these factors due to the number of variables involved, such as the duration and intensity of exposure and the influence of other risk factors. Changes in equipment, procedures and protective measures have resulted in lower doses in recent years, which means that the risk of breast cancer is low at current levels of occupational exposure to ionizing radiation.

RESUMO Introdução: Todos os anos são registados mais de 2,3 milhões de casos de cancro da mama, o que o torna o tipo cancro mais comum entre os adultos. A associação entre o cancro da mama e fatores ocupacionais é uma questão que tem vindo a ser estudada na literatura desde o início do século XVIII. Os desenvolvimentos tecnológicos permitiram um estudo mais aprofundado sobre a relação entre o cancro da mama e os fatores profissionais como a exposição a produtos químicos, pesticidas, metais e também fontes de exposição a radiação ionizante e não ionizante. O objetivo da presente revisão de literatura é incidir na relação entre a exposição ocupacional a radiação ionizante em trabalhadores da saúde e o desenvolvimento de cancro da mama. Metodologia: Foi efetuada uma pesquisa na Medline, com o motor de busca PubMed e na Elsevier, com o motor de busca Science Direct. As palavras de pesquisa usadas foram uma combinação dos termos breast cancer, occupational exposure, ionizing radiation e healthcare workers. Foi também realizada pesquisa na Revista Portuguesa de Saúde Ocupacional utilizando os termos “Cancro de mama” e “Radiação Ionizante”. Discussão/Conclusão: A literatura atual não é unânime quanto às características clínicas e patológicas específicas do cancro da mama possivelmente ligadas a contextos profissionais. Os profissionais de saúde, tais como técnicos de radiologia, enfermeiros, cirurgiões ortopédicos e cardiologistas de intervenção são especialmente vulneráveis a este tipo de exposição, nomeadamente à radiação ionizante. No entanto, alguns estudos apontaram para uma dificuldade em estabelecer uma relação causal entre estes fatores e o desenvolvimento de doença devido ao número de variáveis envolvidas, tais como a duração e intensidade da exposição e à influência de outros fatores de risco. As mudanças no equipamento, procedimentos e medidas de proteção resultaram em doses mais baixas nos anos mais recentes, o que significa que o risco de cancro da mama é baixo nos níveis atuais de exposição profissional à radiação ionizante.

ABSTRACT Background: Success rates in endourological procedures, notably percutaneous nephrolithotomy (PCNL) and ureteroscopy (URS), have demonstrated suboptimal outcomes, leading to more reinterventions and radiation exposure. Recently, the use of intraoperative computed tomography (ICT) scans has been hypothesized as a promising solution for improving outcomes in endourology procedures. With this considered, we conducted a comprehensive systematic review and meta-analysis encompassing all available studies that evaluate the impact of the use of intraoperative CT scans on surgical outcomes compared to conventional fluoroscopic-guided procedures. Methods: This systematic review was conducted in accordance with PRISMA guidelines. Multiple databases were systematically searched up to December of 2023. This study aimed to directly compare the use of an ICT scan with the standard non-ICT-guided procedure. The primary endpoint of interest was success rate, and the secondary endpoints were complications and reintervention rates, while radiation exposure was also evaluated. Data extraction and quality assessment were performed following Cochrane recommendations. Data was presented as an Odds ratio with 95%CI across trials and a random-effects model was selected for pooling of data. Results: A comprehensive search yielded 533 studies, resulting in the selection of 3 cohorts including 327 patients (103 ICT vs 224 in non-ICT). Primary outcome was significantly higher in the experimental group versus the control group (84.5% vs 41.4% respectively, 307 patients; 95% CI [3.61, 12.72]; p<0.00001; I2=0). Reintervention rates also decreased from 32.6% in the control to 12.6% in the ICT group (OR 0.34; 95%CI [0.12,0.94]; p =0.04; I2= 48%), whereas complication rates did not exhibit significant differences. Radiation exposure was also significantly reduced in two of the included studies. Conclusion: This meta-analysis highlights a favorable outcome with intraoperative CT scan use in PCNL procedures, showing a considerable increase in SFR when compared to standard fluoroscopy and nephroscopy. Despite limited studies, our synthesis underscores the potential of ICT scans to significantly reduce residual stones and their consequences for endourology patients, as reinterventions and follow-up ionizing radiation studies. Background procedures (PCNL URS, URS , (URS) Recently (ICT considered metaanalysis meta analysis fluoroscopicguided fluoroscopic guided Methods guidelines 2023 nonICTguided non procedure rate evaluated recommendations 95CI 95 randomeffects random effects data Results 53 32 103 (10 22 nonICT. nonICT . non-ICT) 84.5% 845 84 5 (84.5 414 41 4 41.4 respectively 30 3.61, 361 61 [3.61 12.72 1272 12 72 12.72] p<0.00001 p000001 0 00001 I2=0. I20 I I2=0 I2 I2=0) 326 6 32.6 126 12.6 OR 0.34 034 34 0.12,0.94 012094 94 [0.12,0.94] =0.04 004 04 48%, 48 48% 48%) differences Conclusion nephroscopy followup follow (URS 202 9 10 (1 2 non-ICT 84.5 8 (84. 41. 3.61 36 [3.6 12.7 127 1 7 p<0.0000 p00000 0000 32. 12. 0.3 03 0.12,0.9 01209 [0.12,0.94 =0.0 00 20 ( 84. (84 3.6 [3. p<0.000 p0000 000 0. 0.12,0. 0120 [0.12,0.9 =0. (8 3. [3 p<0.00 p000 0.12,0 012 [0.12,0. =0 [ p<0.0 p00 0.12, 01 [0.12,0 = p<0. p0 0.12 [0.12, p<0 0.1 [0.12 p< [0.1 [0. [0

ABSTRACT Introduction: medical applications, among all practices involving ionizing radiation, are responsible for the highest contribution to population exposure worldwide. Establishing quality assurance and radiation protection programs in radiology services contributes to achieving these objectives. Objective: to develop a web application prototype for assessing the quality of pediatric radiological exams at the Department of Imaging at "Pepe Portilla" Hospital in Pinar del Rio, aiming to improve the services provided and enhance protection for pediatric patients. Methods: applied research with a descriptive and technological innovation character, adopting a general dialectical materialist methodological approach at the Department of Imaging at "Pepe Portilla" Hospital in Pinar del Rio. This allowed the selection of both theoretical methods, such as Historical-Logical, Analysis-Synthesis, Induction-Deduction, and Modeling, and empirical methods, including scientific observation and interviews. Results: the web application prototype was developed to assess the fundamental quality indicators for obtaining medical images in pediatrics, adhering to global protection standards established by the quality assurance program. Conclusions: the web application prototype was developed as a tool for monitoring and evaluating the performance of the department. It establishes a basis for comparisons between healthcare institutions and facilitates internal and external audits of the service. Keywords: Prototype, quality, Imaging

RESUMEN Introducción: las aplicaciones médicas, de entre todas las prácticas que involucran radiación ionizante, son responsables de la más alta contribución a la exposición de la población a nivel mundial. El establecimiento de programas de garantía de la protección y calidad radiológica en los servicios de radiología contribuye a alcanzar estos objetivos. Objetivo: desarrollar un prototipo de aplicación Web para la evaluación de la calidad de los exámenes radiológicos de pediatría del Departamento de Imagenología del Hospital “Pepe Portilla” en Pinar del Rio, que favorezca la mejora del servicio prestado y protección a pacientes en edad pediátrica. Métodos: investigación aplicada, con carácter descriptivo y de innovación tecnológica, posee un enfoque metodológico general dialéctico materialista en el Departamento de Imagenología del Hospital “Pepe Portilla” en Pinar del Rio, lo que permitió la selección de los métodos, tanto teóricos: Histórico-Lógico, Análisis-Síntesis, Inducción-Deducción y Modelación; como empíricos, la observación científica y la entrevista. Resultados: se desarrolló el prototipo de aplicación web que evalúa los indicadores fundamentales de calidad para la obtención de la imagen médica en pediatría, con la ayuda de las normativas que establece el programa de garantía de la protección establecidas a nivel mundial. Conclusiones: se desarrolló el prototipo de aplicación web como instrumento para el control y evaluación del desempeño de la labor que se realiza en el departamento. Establece una base para cotejos entre las instituciones de salud y en la realización auditorías internas y externas al servicio.

Abstract Due to the need to achieve the principles of sustainable development and to understand the processes of formation of phytocenoses in areas that were adversely affected by the industrial impact, this study assessed the condition of the Grachevsky uranium mine (Kazakhstan), which underwent conservation procedures about 25 years ago. The purpose is to determine the level of water quality and phytocenosis of the shores of the reservoir accumulating natural effluents from reclaimed dumps and anthropogenic sites of a uranium mine, as well as quality indicators and toxicology. The assessment included a qualitative research method (analysis of documents) to determine agro-climatic conditions and empirical methods of collecting information. The authors studied the intensity of ionizing radiation of the gamma background of the water surface of the reservoir (and sections of the shoreline and territories adjacent to the reservoir), and hydrochemical parameters of the waters of the reservoir, and performed a description of the botanical diversity. The vegetation cover of the sections of the reservoir shore is at different stages of syngenesis and is represented by pioneer groupings, group thicket communities, and diffuse communities. Favorable ecological conditions for the settlement and development of plants develop within the shores of the reservoir. The intensity levels of ionizing radiation do not exceed the maximum permissible levels and practically do not affect the formation of phytocenoses. An anthropogenically modified dry meadow with the participation of plants typical of the steppe zone has been formed on the floodplain terrace. Concerning the indicators of quality and toxicology of this reservoir, the water can be used for household and drinking purposes under the condition of prior water treatment. It can be concluded that a high level of natural purification of the reservoir waters occurred within twenty years after the reclamation of the uranium mine. impact Kazakhstan, Kazakhstan , (Kazakhstan) 2 ago analysis documents agroclimatic agro climatic information reservoir) diversity groupings communities terrace treatment (Kazakhstan

Resumo Devido à necessidade de alcançar os princípios do desenvolvimento sustentável e de compreender os processos de formação de fitocenoses em áreas que foram negativamente afetadas pelo impacto industrial, este estudo avaliou o estado da mina de urânio de Grachevsky (Cazaquistão), que foi submetida a procedimentos de conservação há cerca de 25 anos. O objetivo é determinar o nível de qualidade da água e fitocenose das margens do reservatório que acumula efluentes naturais provenientes de depósitos recuperados e sítios antrópicos de uma mina de urânio, bem como indicadores de qualidade e toxicologia. A avaliação incluiu um método de investigação qualitativa (análise de documentos) para determinar as condições agroclimáticas e métodos empíricos de coleta de informação. Os autores estudaram a intensidade da radiação ionizante do fundo gama da superfície da água do reservatório (e seções da linha de costa e territórios adjacentes ao reservatório), bem como os parâmetros hidroquímicos das águas do reservatório, e fizeram uma descrição da diversidade botânica. A cobertura vegetal da seções da margem do reservatório encontra-se em diferentes estádios de singênese e é representada por agrupamentos pioneiros, comunidades de arbustos agrupados e comunidades difusas. Nas margens do resevatório desenvolvem-se condições ecológicas favoráveis à fixação e desenvolvimento das plantas. Os níveis de intensidade da radiação ionizante não ultrapassam os níveis máximos admissíveis e praticamente não afetam a formação de fitocenoses. No terraço da planície de inundação formou-se um prado seco modificado antropogenicamente com a participação de plantas típicas da zona de estepe. Em relação aos indicadores de qualidade e toxicologia deste reservatório, a água pode ser utilizada para fins domésticos e de consumo, desde que seja objeto de um tratamento prévio. Pode concluir-se que ocorreu um elevado nível de purificação natural das águas do reservatório nos vinte anos seguintes à recuperação da mina de urânio. industrial Cazaquistão, Cazaquistão , (Cazaquistão) 2 análise documentos informação reservatório) botânica encontrase encontra se pioneiros difusas desenvolvemse desenvolvem formouse formou estepe consumo prévio concluirse concluir (Cazaquistão

RESUMEN Objetivo: Evaluar las características de la piel y la calidad de vida de pacientes con cáncer de mama en tratamiento con radioterapia. Método: Estudio transversal con 60 mujeres. Se aplicaron la escala de clasificación de alteraciones cutáneas por exposición a radiaciones ionizantes (RTOG) y las versiones validadas en portugués de las que clasificaban tipos de piel (Fitzpatrick), síntomas (RISRAS) y calidad de vida (DLQI) en el período comprendido entre diciembre 2021 y octubre de 2022. Para el análisis de los datos se utilizaron el Test Exacto de Fisher, Chi-Cuadrado y el Test de Independencia General Asintótica. Resultados: El 100% de los pacientes evaluados sobre la piel. A medida que avanzaba el tratamiento y aparecía o empeoraba la radiodermatitis, hubo tendencia a aumentar la intensidad de los signos y síntomas, tales como: sensibilidad, malestar o dolor, visualización, ardor y calor, descamación seca y húmeda, que pudieron haber tenido una impacto en la calidad de vida y reflejado en otros aspectos, como: actividades de compra o salidas (p=0,0020), actividades sociales o de ocio (p=0,0420). Conclusión: La radiodermatitis es una afección común que afecta a mujeres con cáncer de mama, sometidas a radioterapia, las características de la piel y la calidad de vida de las pacientes afectadas durante este tratamiento. Objetivo radioterapia Método 6 RTOG (RTOG Fitzpatrick, Fitzpatrick , (Fitzpatrick) RISRAS (RISRAS DLQI (DLQI 202 2022 Fisher ChiCuadrado Chi Cuadrado Asintótica Resultados 100 como sensibilidad dolor visualización calor húmeda aspectos p=0,0020, p00020 p p=0,0020 0 0020 (p=0,0020) p=0,0420. p00420 p=0,0420 . 0420 (p=0,0420) Conclusión (Fitzpatrick 20 10 p0002 p=0,002 002 (p=0,0020 p0042 p=0,042 042 (p=0,0420 2 1 p000 p=0,00 00 (p=0,002 p004 p=0,04 04 (p=0,042 p00 p=0,0 (p=0,00 (p=0,04 p0 p=0, (p=0,0 p=0 (p=0, p= (p=0 (p= (p

ABSTRACT Objective: To evaluate the skin characteristics and quality of life of patients with breast cancer undergoing radiotherapy. Method: Cross-sectional study conducted with 60 women. The classification scales of skin changes resulting from exposure to ionizing radiation (RTOG) and the validated versions in Portuguese of those that classified skin types (Fitzpatrick), symptoms (RISRAS) and quality of life (DLQI) were applied. in the period between December 2021 and October 2022. For data analysis, Fisher’s Exact Test, Chi-Square and Asymptotic General Independence Test were used. Results: 100% of patients had skin irritation. As the treatment progressed and the radiodermatitis appeared or worsened, there was a tendency for the intensity of signs and symptoms to increase, such as: sensitivity, discomfort or pain, itching, burning and heat, dry and wet desquamation, which may have impacted the quality of life and reflected in other aspects, such as: shopping activities or outings (p=0.0020), social activities or leisure activities (p=0.0420). Conclusion: Radiodermatitis is a common condition that affects women with breast cancer undergoing radiotherapy, skin characteristics and quality of life of patients affected during this treatment. Objective radiotherapy Method Crosssectional Cross sectional 6 RTOG (RTOG Fitzpatrick, Fitzpatrick , (Fitzpatrick) RISRAS (RISRAS DLQI (DLQI applied 202 2022 analysis Fishers Fisher s ChiSquare Chi Square used Results 100 irritation worsened increase as sensitivity pain itching heat desquamation aspects p=0.0020, p00020 p p=0.0020 0 0020 (p=0.0020) p=0.0420. p00420 p=0.0420 . 0420 (p=0.0420) Conclusion (Fitzpatrick 20 10 p0002 p=0.002 002 (p=0.0020 p0042 p=0.042 042 (p=0.0420 2 1 p000 p=0.00 00 (p=0.002 p004 p=0.04 04 (p=0.042 p00 p=0.0 (p=0.00 (p=0.04 p0 p=0. (p=0.0 p=0 (p=0. p= (p=0 (p= (p

RESUMO Objetivo: Avaliar as características da pele e a qualidade de vida de pacientes com câncer de mama submetidas à radioterapia. Método: Estudo transversal com 60 mulheres. Foram aplicadas as escalas de classificação das alterações cutâneas decorrentes da exposição à radiação ionizante (RTOG) e as versões validadas em português das que classificaram os tipos de pele (Fitzpatrick), os sintomas (RISRAS) e a qualidade de vida (DLQI), no período entre dezembro de 2021 e outubro de 2022. Para a análise de dados, foram utilizados os Testes Exato de Fisher, Qui-Quadrado e Teste de Independência Geral Assintótica. Resultados: 100% das pacientes apresentaram irritação na pele. À medida que o tratamento avançou e que a radiodermatite surgiu ou se agravou, houve maior tendência de intensidade de sinais e sintomas, como: sensibilidade, desconforto ou dor, coceira, queimação e calor, descamação seca e úmida, o que pode ter impactado na qualidade de vida e refletido em outros aspectos, como: atividades de compras ou passeios (p=0,0020), programação social ou atividade de lazer (p=0,0420). Conclusão: A radiodermatite é uma condição comum que afeta as mulheres com câncer de mama submetidas à radioterapia, as características da pele e a qualidade de vida das pacientes são afetadas durante esse tratamento. Objetivo radioterapia Método 6 RTOG (RTOG Fitzpatrick, Fitzpatrick , (Fitzpatrick) RISRAS (RISRAS DLQI, DLQI (DLQI) 202 2022 dados Fisher QuiQuadrado Qui Quadrado Assintótica Resultados 100 agravou como sensibilidade dor coceira calor úmida aspectos p=0,0020, p00020 p p=0,0020 0 0020 (p=0,0020) p=0,0420. p00420 p=0,0420 . 0420 (p=0,0420) Conclusão (Fitzpatrick (DLQI 20 10 p0002 p=0,002 002 (p=0,0020 p0042 p=0,042 042 (p=0,0420 2 1 p000 p=0,00 00 (p=0,002 p004 p=0,04 04 (p=0,042 p00 p=0,0 (p=0,00 (p=0,04 p0 p=0, (p=0,0 p=0 (p=0, p= (p=0 (p= (p

ABSTRACT Objective: To compare cancer mortality among workers exposed to gamma and X radiation and the general population of the city of São Paulo, as well as that of the subgroup monitored with those not monitored for gamma and X radiation in a work unit with ionizing radiation based in the city of São Paulo. Methods: Between 2016 and 2021, a retrospective open cohort study was carried out with workers who were employed from 08/31/1956 to 12/31/2016 based on data collected at the company and in official institutions. Standardized mortality ratios (SMR) were calculated by sex, age and calendar period of cancers grouped according to type, risk factor and organ system in two analyses: in the external analysis, the mortality of the study population was compared with that of the general population of the city of São Paulo; In the internal analysis, the mortality of the monitored subgroup was compared with that of the subgroup not monitored for gamma and X radiation. Results: The external mortality analysis showed SMR=0.224 (95%CI 0.208–0.240) and the healthy worker effect, while the internal mortality analysis showed SMR=0.685 (95%CI 0.618–0.758). Conclusion: This study showed lower cancer mortality among exposed workers when compared to mortality in the general population and the healthy worker effect. Among workers monitored for gamma and X radiation, cancer mortality was lower when compared to those not monitored. Objective Paulo Methods 201 2021 08311956 08 31 1956 08/31/195 12312016 12 12/31/201 institutions SMR (SMR sex type analyses Results SMR0224 0 224 SMR=0.22 95%CI 95CI CI 95 0.208–0.240 02080240 208 240 effect SMR0685 685 SMR=0.68 0.618–0.758. 06180758 0.618–0.758 . 618 758 0.618–0.758) Conclusion 20 202 0831195 3 195 08/31/19 1231201 1 12/31/20 SMR022 22 SMR=0.2 9 0.208–0.24 0208024 24 SMR068 68 SMR=0.6 0618075 0.618–0.75 61 75 2 083119 19 08/31/1 123120 12/31/2 SMR02 SMR=0. 0.208–0.2 020802 SMR06 6 061807 0.618–0.7 7 08311 08/31/ 12312 12/31/ SMR0 SMR=0 0.208–0. 02080 06180 0.618–0. 0831 08/31 1231 12/31 SMR= 0.208–0 0208 0618 0.618–0 083 08/3 123 12/3 0.208– 020 061 0.618– 08/ 12/ 0.208 02 06 0.618 0.20 0.61 0.2 0.6 0.

RESUMO Objetivo: Comparar a mortalidade por câncer entre trabalhadores expostos à radiação gama e X e a população geral do município de São Paulo, bem como a do subgrupo monitorado com o não monitorado para radiação gama e X em uma unidade de trabalho sediada no município de São Paulo. Métodos: Entre 2016 e 2021 foi realizado estudo de coorte aberta retrospectiva com trabalhadores que tiveram vínculo empregatício desde 31/08/1956 até 31/12/2016 a partir de dados coletados na empresa e em instituições oficiais. Foram calculadas as razões de mortalidade padronizadas (RMP) por sexo, idade e período calendário de cânceres agrupados segundo o tipo, o fator de risco e o sistema orgânico em duas análises: na análise externa, comparou-se a mortalidade da população de estudo com a da população geral do município de São Paulo; já na análise interna, comparou-se a mortalidade do subgrupo monitorado com a do subgrupo não monitorado para radiação gama e X. Resultados: A análise externa de mortalidade mostrou RMP=0,224 (IC95% 0,208–0,240) e o efeito do trabalhador sadio, enquanto a análise interna de mortalidade mostrou RMP = 0,685 (IC95% 0,618–0,758). Conclusão: Este estudo mostrou menor mortalidade por câncer entre os trabalhadores expostos quando comparada com a mortalidade da população geral e o efeito do trabalhador sadio. Entre os trabalhadores monitorados para radiação gama e X, a mortalidade por câncer foi menor quando comparada com a dos não monitorados. Objetivo Paulo Métodos 201 202 31081956 31 08 1956 31/08/195 31122016 12 31/12/201 oficiais (RMP sexo tipo análises comparouse comparou se Resultados RMP0224 0 224 RMP=0,22 IC95% IC95 IC (IC95 0,208–0,240 02080240 208 240 sadio 0685 685 0,68 0,618–0,758. 06180758 0,618–0,758 . 618 758 0,618–0,758) Conclusão 20 3108195 3 195 31/08/19 3112201 1 31/12/20 RMP022 22 RMP=0,2 IC9 (IC9 0,208–0,24 0208024 24 068 68 0,6 0618075 0,618–0,75 61 75 2 310819 19 31/08/1 311220 31/12/2 RMP02 RMP=0, (IC 0,208–0,2 020802 06 6 0, 061807 0,618–0,7 7 31081 31/08/ 31122 31/12/ RMP0 RMP=0 0,208–0, 02080 06180 0,618–0, 3108 31/08 3112 31/12 RMP= 0,208–0 0208 0618 0,618–0 310 31/0 311 31/1 0,208– 020 061 0,618– 31/ 0,208 02 0,618 0,20 0,61 0,2

The ionizing radiation used in radiotherapy can break down deoxyribonucleic acid bonds, generate reactive oxygen and nitrogen species, alter intracellular proteins, and induce changes in the lipidome. This study delves into examining lipid classes and their spatial distribution in the brains of Wistar rats exposed to ionizing radiation. Healthy male isogenic Wistar rats (n = 15) were divided into a control group (CG, n = 3) and an irradiated group (IRG, n = 12). The individuals of the IRG group were subjected to total body irradiation (TBI) using a Co-60 source and a radiation dose of 5 Gy. The IRG group was subdivided into four subgroups corresponding to 168, 96, 48, and 24 h before sacrifice. The brains were sliced into the sagittal direction, and the slices were analyzed using the desorption electrospray ionization mass spectrometry imaging (DESI-MSI) approach. The mass spectrometry results and information from the Metabolite and Chemical Entity Database (METLINTM) and Lipid Metabolites and Pathways Strategy (LIPID MAPS) databases enabled the identification of lipids belonging to distinct classes. The DESI-MS images revealed distinctive spatial distributions of these lipids and the modulatory response induced by the radiation over time. bonds species proteins lipidome 15 CG, CG (CG 3 IRG, (IRG 12. 12 . 12) TBI (TBI Co60 Co 60 Co-6 Gy 168 96 48 2 sacrifice direction DESIMSI DESI MSI (DESI-MSI approach METLINTM (METLINTM LIPID MAPS DESIMS MS time 1 Co6 6 Co- 16 9 4

O uso de simulações computacionais que representam experimentos reais de física médica é uma alternativa para diminuir custos e proporcionar uma maior variedade de experimentos que utilizam radiações ionizantes. O laboratório virtual permite explorar uma série de conceitos de maneira semelhante aos abordados experimentalmente, possibilitando utilizar uma infinidade de fontes, materiais e detectores sem agregar custos. Além disso, as simulações computacionais permitem explorar aspectos inatingíveis com os experimentos reais. Este artigo descreve a implementação de um Laboratório Virtual de Física Médica que, através de interfaces gráficas intuitivas, roteiros guiados e contextualização histórica explora experimentos de física médica amplamente utilizados nas áreas da medicina nuclear, radiodiagnóstico e radioterapia. Como exemplo, apresentamos o experimento de atenuação da radiação (raios X e gama) com a matéria. Os experimentos foram implementados através da linguagem de programação Python. A interface gráfica foi desenvolvida através do framework Streamlit. O uso do Laboratório Virtual de Física Médica tem se mostrado uma ferramenta alternativa para alinhar o ensino prático ao teórico. ionizantes experimentalmente fontes disso intuitivas nuclear radioterapia exemplo raios gama matéria Python Streamlit teórico

The use of computer simulations that represent real experiments in medical physics is an alternative to reduce costs and provide a greater variety of experiments involving ionizing radiation. The virtual laboratory allows the exploration of a range of concepts in a similar manner to experimental approaches, enabling the utilization of a multitude of sources, materials, and detectors without incurring additional costs. Furthermore, computer simulations allow the exploration of aspects that are unattainable with real experiments. This article describes the implementation of a Virtual Medical Physics Laboratory that, through intuitive graphical interfaces, guided scripts, and historical context, explores widely used experiments in the areas of nuclear medicine, radiodiagnostics, and radiotherapy. As an example, we present the experiment on radiation attenuation (X-rays and gamma rays) with matter. The experiments were implemented using the Python programming language. The graphical interface was developed using the Streamlit framework. The use of the Virtual Medical Physics Laboratory has proven to be an alternative tool for bridging the gap between practical and theoretical teaching. approaches sources materials Furthermore interfaces scripts context medicine radiodiagnostics radiotherapy example Xrays X rays matter language framework teaching

ABSTRACT Objective: To compare cancer mortality among workers exposed to gamma and X radiation and the general population of the city of São Paulo, as well as that of the subgroup monitored with those not monitored for gamma and X radiation in a work unit with ionizing radiation based in the city of São Paulo. Methods: Between 2016 and 2021, a retrospective open cohort study was carried out with workers who were employed from 08/31/1956 to 12/31/2016 based on data collected at the company and in official institutions. Standardized mortality ratios (SMR) were calculated by sex, age and calendar period of cancers grouped according to type, risk factor and organ system in two analyses: in the external analysis, the mortality of the study population was compared with that of the general population of the city of São Paulo; In the internal analysis, the mortality of the monitored subgroup was compared with that of the subgroup not monitored for gamma and X radiation. Results: The external mortality analysis showed SMR=0.224 (95%CI 0.208–0.240) and the healthy worker effect, while the internal mortality analysis showed SMR=0.685 (95%CI 0.618–0.758). Conclusion: This study showed lower cancer mortality among exposed workers when compared to mortality in the general population and the healthy worker effect. Among workers monitored for gamma and X radiation, cancer mortality was lower when compared to those not monitored.

RESUMO Objetivo: Comparar a mortalidade por câncer entre trabalhadores expostos à radiação gama e X e a população geral do município de São Paulo, bem como a do subgrupo monitorado com o não monitorado para radiação gama e X em uma unidade de trabalho sediada no município de São Paulo. Métodos: Entre 2016 e 2021 foi realizado estudo de coorte aberta retrospectiva com trabalhadores que tiveram vínculo empregatício desde 31/08/1956 até 31/12/2016 a partir de dados coletados na empresa e em instituições oficiais. Foram calculadas as razões de mortalidade padronizadas (RMP) por sexo, idade e período calendário de cânceres agrupados segundo o tipo, o fator de risco e o sistema orgânico em duas análises: na análise externa, comparou-se a mortalidade da população de estudo com a da população geral do município de São Paulo; já na análise interna, comparou-se a mortalidade do subgrupo monitorado com a do subgrupo não monitorado para radiação gama e X. Resultados: A análise externa de mortalidade mostrou RMP=0,224 (IC95% 0,208–0,240) e o efeito do trabalhador sadio, enquanto a análise interna de mortalidade mostrou RMP = 0,685 (IC95% 0,618–0,758). Conclusão: Este estudo mostrou menor mortalidade por câncer entre os trabalhadores expostos quando comparada com a mortalidade da população geral e o efeito do trabalhador sadio. Entre os trabalhadores monitorados para radiação gama e X, a mortalidade por câncer foi menor quando comparada com a dos não monitorados.

Resumen Antecedentes: La eficacia de las máscaras faciales plomo-acrílicas atenuadoras de radiación utilizadas en cardiología intervencionista ha sido poco estudiada. Objetivo: Determinar la eficacia de la máscara facial plomo-acrílica en un contexto simulado. Método: Se realizó un estudio experimental que comparó las dosis de radiación ionizante secundaria recibida por un maniquí, que emuló al cardiólogo intervencionista, en la superficie de la órbita del ojo izquierdo, la boca y la superficie del lóbulo temporoparietal izquierdo. Se utilizaron dosímetros, dispuestos frontal y posterior a la máscara facial plomo-acrílica atenuadora de radiación. Las proyecciones fueron de 50° LAO y 60°/40° LAO. El voltaje fue de 73,8 ± 24,7 kV, la corriente de 582 ± 145 mA y el producto dosis-área de 50,4 ± 37,9 Gy/m2. Resultados: Las medianas de las dosis de radiación con y sin la máscara fueron 0,21 mSv (0,00-0,83) y 0,43 mSv (0,37-0,64), respectivamente, lo que corresponde a una atenuación de la radiación del 52%, y cuando la máscara se complementó con el escudo acrílico plomado suspendido del techo los niveles de radiación fueron indetectables. Conclusiones: La máscara facial plomo-acrílica atenuadora de radiación proporciona una atenuación moderada que, complementada con el escudo acrílico, consigue una atenuación óptima.

Abstract Background: The efficacy of radiation-attenuating lead-acrylic face masks used in interventional cardiology has been little studied. Objective: To determine the efficacy of lead acrylic face masks in a simulated environment. Method: An experimental study was performed to compare the secondary ionizing radiation doses received by a manikin simulating the interventional cardiologist at the surface of the left eye orbit, the mouth, and the surface of the left temporo-parietal lobe using dosimeters placed in front of and behind the radiation-attenuating lead acrylic face mask. The projections were 50° LAO and 60°/40° LAO. The voltage was 73.8 ± 24.7 kV, the current was 582 ± 145 mA, and the dose-area product was 50.4 ± 37.9 Gy/m2. Results: The median radiation doses with and without masks were 0.21 mSv (0.00-0.83) and 0.43 mSv (0.37-0.64), respectively, corresponding to a radiation attenuation of 52%, and when the mask was supplemented with the ceiling-suspended plumed acrylic shield, undetectable radiation levels were observed. Conclusions: The radiation-attenuating lead acrylic face mask provide moderate attenuation, which, when supplemented with the acrylic shield, achieves optimal attenuation.

Resumen: El presente artículo pretende realizar un breve recorrido de la historia de la Comisión Nacional de Energía Atómica que actualmente es una Institución dependiente de la Universidad Nacional de Asunción. Lleva trabajando en la promoción y el uso pacífico de la energía nuclear y de las radiaciones ionizantes en el país desde su creación. Se detalla sus funciones y los servicios especializados que brinda a la sociedad en la actualidad.

Abstract: This article is a brief overview of the history of the National Atomic Energy Commission, which is currently an institution under the National University of Asuncion. It has been working on the promotion and peaceful use of nuclear energy and ionizing radiation in the country since its creation. It details its functions and the specialized services it currently provides to society.

ABSTRACT Introduction: The use of radiographs as a complementary element for diagnosis is fundamental to the professional practice of every dental surgeon. Therefore, it is important to know not only the benefits of oral radiology and the fundamentals of radiological protection, but also to determine their level of application or adherence to compliance with the regulatory aspects that regulate the use of ionizing radiation in dentistry. Objective: To relate the knowledge of oral radiology care, the advantages and dangers in taking radiographs with compliance with the norms of radiological protection and ionizing radiation in dental students of a dental teaching clinic. Methods: The study population consisted of 180 fourth year dental students who used the radiological equipment in the teaching dental clinic during 2019 (second semester) and 2020 (first quarter). A representative sample of 104 students was taken, incorporated into the study by simple random sampling. Two data collection instruments were applied, one to evaluate knowledge (questionnaire) and the other to verify compliance with standards (checklist) on radiological protection and diagnostic imaging in dental practice. For the statistical analysis the chi-square statistical test was applied with a significance level of 95 %. Results: No statistically significant relationship was found (p = 0.30) between theoretical knowledge of radiological protection and diagnostic imaging with respect to compliance with the norms that regulate its application (p > 0.05). Ninety percent of participants have fair to excellent knowledge. However, only 32 % comply with the technical norms of ionizing radiation protection in their clinical practice. Conclusion: Dental students have sufficient knowledge of radiation protection and diagnostic imaging. However, this knowledge is not reflected in practices that adhere to the standards.

RESUMEN Introducción: El uso de radiografías como elemento complementario para el diagnóstico es fundamental para la práctica profesional de todo cirujano dentista. Por tanto, es importante conocer no solo los beneficios de la radiología oral y los fundamentos de protección radiológica, sino también determinar su nivel de aplicación o la adherencia frente al cumplimiento de los aspectos normativos que regulan el uso de la radiación ionizante en odontología. Objetivo: Relacionar el conocimiento sobre los cuidados en radiología bucal, las ventajas y los peligros en la toma de radiografías con el cumplimiento de las normas de protección radiológica y radiación ionizante en estudiantes de odontología de una clínica dental docente. Métodos: La población de estudio estuvo constituida por 180 estudiantes del cuarto año de la carrera de odontología, que emplearon los equipos radiológicos en la clínica docente asistencial durante los años 2019 (segundo semestre) y 2020 (primer trimestre). Se tomó como muestra representativa a 104 estudiantes, incorporados al estudio mediante muestreo aleatorio simple. Se aplicaron dos instrumentos de recolección de datos, uno para evaluar el conocimiento (cuestionario) y otro para verificar el cumplimiento de normas (lista de chequeo) sobre la protección radiológica y el diagnóstico por imágenes en la práctica odontológica. Para el análisis estadístico se aplicó la prueba estadística chi cuadrado con un nivel de significancia del 95 %. Resultados: No se encontró relación estadísticamente significativa (p = 0,30) entre el conocimiento teórico sobre la protección radiológica y el diagnóstico por imágenes, respecto el cumplimiento de las normas que regulan su aplicación (p > 0,05). El 90 % de participantes tienen conocimientos entre regulares y excelentes. Sin embargo, solo el 32 % cumple las normas técnicas de protección sobre radiación ionizante en su práctica clínica. Conclusión: Los estudiantes de odontología tienen suficiente conocimiento sobre protección radiológica y diagnóstico por imágenes. Sin embargo, este conocimiento no se refleja en prácticas adheridas a las normas.

Resumen Introducción : Una de las áreas de la farmacia vinculadas a la radiación ionizante es la Radiofarmacia que se refiere al estudio, preparación, control y dispensación de los radiofármacos a nivel industrial y hospitalaria. Se entiende como radiofármaco a cualquier producto que esté preparado para su uso con la finalidad diagnóstica y terapéutica que contenga uno o más radionucleidos (isótopos radioactivos) que son utilizados en combinación con moléculas o solos para ser administrados por vía oral o parenteral. El Instituto Nacional de Medicina Nuclear (INAMEN) a nivel nacional lidera ese campo desde 1962 al servicio de la población boliviana. Objetivo : Determinar el uso y diagnóstico de los radiofármacos que son utilizados con mayor frecuencia en medicina nuclear en el INAMEN en la gestión 2021. Metodología : Estudio descriptivo y retrospectivo donde se analizaron los reportes de solicitud de preparación y dispensación de radiofármacos en el laboratorio de Radiofarmacia del INAMEN. Estos datos fueron procesados para determinar que radiofármacos son los más demandados para el diagnóstico y terapia medica nuclear en nuestro departamento. Resultados . Se determinó que de las 2100 solicitudes presentadas al laboratorio de Radiofarmacia, el 42% corresponde al metilen difosfonato-99mTc, el 21% corresponde a los isotopos de 99mTc y el 11% corresponde al isotopo 131I. Conclusión . El análisis de los datos concluye que la principal demanda de radiofármacos es para radiotrazadores de tumores y para la yodoterapia.

Abstract Introduction : One of the areas of pharmacy linked to ionizing radiation is Radiopharmacy, which refers to the study, preparation, control and dispensing of radiopharmaceuticals at an industrial and hospital level. A radiopharmaceutical is understood as any product that is prepared for use for diagnostic and therapeutic purposes that contains one or more radionuclides (radioactive isotopes) that are used in combination with molecules or alone to be administered orally or parenterally. The National Institute of Nuclear Medicine (INAMEN) at the national level has led this field since 1962 at the service of the Bolivian population. Objective : Determine the use and diagnosis of the radiopharmaceuticals that are most frequently used in nuclear medicine in the INAMEN in the 2021 administration. Methodology : Descriptive and retrospective study where the reports requesting the preparation and dispensing of radiopharmaceuticals in the INAMEN Radiopharmacy laboratory were analyzed. These data were processed to determine which radiopharmaceuticals are the most in demand for nuclear medical diagnosis and therapy in our department. Results : It was determined that of the 2100 applications submitted to the Radiopharmacy laboratory, 42% correspond to methylene diphosphonate-99mTc, 21% correspond to 99mTc isotopes and 11% correspond to 131I isotopes. Conclution : The analysis of the data concludes that the main demand for radiopharmaceuticals is for tumor radiotracers and iodotherapy.

Resumen Los mecanismos de transporte de radiación ionizante en presencia de campos magnéticos pueden ser descritos mediante formulaciones basadas en la aplicación de la ecuación principal de Boltzmann. Sin embargo, cuando el transporte no es en vacío sino en medios materiales dispersores la dificultad en el cálculo analítico de la trayectoria de los electrones se incrementa considerablemente debido al carácter aleatorio de los procesos de interacción de la radiación con el medio dispersor. En este contexto, el presente trabajo propone y describe una metodología para caracterizar mediante técnicas numéricas, como la simulación Monte Carlo, el efecto de campos magnéticos intensos, presentes típicamente en los dispositivos de MRI-LINAC, sobre la trayectoria de partículas cargadas, propagándose en un medio material comúnmente presente en situaciones de radioterapia. Los resultados obtenidos para el aire como medio dispersor, indican que las variaciones de las trayectorias de los electrones dependen conjuntamente de la intensidad y dirección del campo magnético y de las interacciones por colisión con el medio material. El aumento de la intensidad de campo magnético incrementa la curvatura de las trayectorias y disminuye el desplazamiento, o corrimiento, en la dirección radial.

Abstrac Ionizing radiation transport mechanisms in presence of magnetic fields can be described in terms of formalisms based on the Boltzmann radiation transport equation. However, when the transport occurs not in vacuum but in scattering media the difficulty of its analytical calculation considerably increases because of the random character of the radiation interaction processes with the scattering medium. In this context, the present work proposes and describe a methodology to characterize effects due to strong magnetic fields on electron trajectories by means of numerical techniques, such as Monte Carlo simulation, to be applied to scattering media, typically present in MRI-LINAC devices in radiotherapy situations. The obtained results for air as the scattering material show that variations of the electrons' trajectories depend jointly on the magnetic field and the interactions with the scattering medium. Increasing the magnetic field intensity enhances the curvature of the trajectories while decreasing the displacement in the radial direction.

Resumen En el presente trabajo se estudia el efecto de la presencia de nanopartículas de cobre infundidas en un sistema dosi-métrico PAGAT, por medio de un abordaje basado en simulaciones Monte Carlo, empleando el código PENELOPE, de un sistema compuesto por nanopartículas de cobre estabilizadas y recubiertas con ácido ascórbico. Se caracterizó la respuesta del sistema al ser irradiado con un haz monoenergético de fotones de 150 keV, representativo de aplicaciones de ortovoltaje, y se evaluó el efecto de tres factores principales: el tamaño de la nanopartícula de cobre (de 10 a 300 nm), el espesor del recubrimiento (de 25 a 400 nm) y la densidad del recubrimiento (de 1.162 a 1.650 g/mL). Los resultados indican que existe un ligero aumento en el refuerzo de dosis absorbida en el material de gel dosimétrico PAGAT en función del tamaño de la nanopartícula, una disminución del refuerzo de dosis en el PAGAT a medida que aumenta el espesor del estabilizante, y un efecto competitivo, aunque comparativamente menos significativo, de cambios debido a la densidad del estabilizante. Finalmente, se analizó el espectro de fluencia de fotones para los tres casos estudiados con el fin identificar y evaluar las líneas de fluorescencia características del cobre confirmando la presencia de fotones de rayos X característicos derivados de la presencia de las nanopartículas de cobre, cuya presencia representa un potencial punto de partida para técnicas específicas de imaging.

Abstrac The present investigation is focused on the effect of copper nanoparticles infused in a PAGAT dosimetry system. Monte Carlo simulations using the PENELOPE code were employed to analyze a system composed of stabilized copper na-noparticles coated with ascorbic acid. The system was subjected to irradiation with a 150 keV monoenergetic photon beam, representative of orthovoltage applications. The study evaluated the influence of three key factors: the size of the copper nanoparticle (ranging from 10 to 300 nm), the coating thickness (ranging from 25 to 400 nm), and the coating density (ranging from 1.162 to 1.650 g/mL). The findings indicate a slight increase in dose enhancement with increasing nanoparticle size. Conversely, an increase in stabilizer thickness leads to a decrease in dose enhancement in the PAGAT system. The effect of changes in stabilizer density on dose enhancement is found to be less significant. Additionally, the photon fluence spectrum was analyzed for the three studied cases to identify and evaluate the characteristic fluores-cence lines of copper. This analysis confirms the presence of characteristic X-rays derived from the presence of copper nanoparticles, which could potentially serve as a foundation for specific imaging techniques.