Search Results (57)

Hydrogen-rich water (HRW) has shown neuroprotective effects in acute brain injury, but its role in chronic radiation-induced brain injury (RIBI) remains unclear. This study investigated the long-term efficacy of HRW in mitigating cognitive impairment and neuronal damage caused by chronic RIBI. Fifty male Sprague Dawley rats were randomly divided into five groups: control, irradiation (IR), IR with memantine, IR with HRW, and IR with combined treatment. All but the control group received 20 Gy whole-brain X-ray irradiation, followed by daily interventions for 60 days. Behavioral assessments, histopathological analyses, oxidative stress measurements, ¹⁸F-FDG PET/CT imaging, transcriptomic sequencing, RT-qPCR, Western blot, and serum ELISA were performed. HRW significantly improved anxiety-like behavior, memory, and learning performance compared to the IR group. Histological results revealed that HRW reduced neuronal swelling, degeneration, and loss and enhanced dendritic spine density and neurogenesis. PET/CT imaging showed increased hippocampal glucose uptake in the IR group, which was alleviated by HRW treatment. Transcriptomic and molecular analyses indicated that HRW modulated key genes and proteins, including CD44, CD74, SPP1, and Wnt1, potentially through the MIF, Wnt, and SPP1 signaling pathways. Serum CD44 levels were also lower in treated rats, suggesting its potential as a biomarker for chronic RIBI. These findings demonstrate that HRW can alleviate chronic RIBI by preserving neuronal structure, reducing inflammation, and enhancing neuroplasticity, supporting its potential as a therapeutic strategy for radiation-induced cognitive impairment. Full article

Radiation therapy serves as a fundamental treatment for primary and metastatic brain tumors, whether used alone or combined with surgery and chemotherapy. Despite its oncological efficacy, this treatment paradigm frequently induces radiation-induced brain injury (RBI), a progressive neuropathological condition characterized by structural and functional damage to healthy cerebral parenchyma. Patients with RBI frequently develop affective disorders, particularly major depressive disorder and generalized anxiety disorder, which profoundly impair psychosocial functioning and quality of life. The pathophysiology involves complex mechanisms such as neuroinflammation, oxidative stress, blood–brain barrier disruption, and white matter damage. Current management strategies include antidepressants, corticosteroids, and neuroprotective agents, while emerging therapies targeting neuroinflammation and neural repair show promise. This review comprehensively examines the pathogenesis of RBI-related affective disorders and evaluates both conventional and novel treatment approaches. By synthesizing current evidence, we aim to provide insights for developing more effective interventions to improve patient outcomes and quality of life. Full article

Alzheimer’s disease (AD) is one of the primary causes of disability and dependency among aging populations worldwide. Neuroinflammation may be a potential therapeutic target in AD. Moreover, ionizing radiation may be a tool for modulating neuroinflammation. Here, we used three mouse lines—C57Bl/6 and the transgenic AD models 5xFAD and Tau P301S—to investigate the effects of combined ionizing radiation (γ-rays and carbon-12 nuclei) on emotional state, cognitive abilities, and markers of microglial activation. The obtained data show that combined irradiation results in enhanced exploratory behavior and spatial learning in the C57Bl/6 mice. The same changes, as well as a decrease in anxiety, were found in the Tau P301S mice. Irradiation of the 5xFAD mice resulted in improved welfare and ability to discriminate odors. At the same time, irradiation led to an increase in the level of pro- and anti-inflammatory cytokines in the prefrontal cortex and, to a lesser extent, in the hippocampus of the C57Bl/6 and Tau P301S mice. An increase in macrophage inflammatory protein-1α in the prefrontal cortex and a decrease in interleukin 2β in the hippocampus were found in the 5xFAD mice. Taken together, our data indicate that ionizing radiation exposure is an adequate tool to modulate microglial activity in the brain and may provide cognitive and non-cognitive behavioral benefits in neurodegenerative disease conditions. Full article

Objectives: In healthy young adults, thoracic kyphosis can be attributed to a number of factors, including a sedentary lifestyle, stress, poor posture, activity and daily habits, muscle pain, fatigue, and anxiety. In regard to clinical diagnosis and evaluation methods, high-cost radiological measurements and a variety of non-radiological clinical methods are employed. In this study, a decision support system that performs automatic thoracic kyphosis angle measurements has been developed with the objective of avoiding exposure of the human body to radiation and reducing the time required for measurements. Methods: The features were determined with reference to the thoracic kyphosis measurements that were manually marked by the expert on the subjects. The kyphosis angle was calculated by automatically identifying the T1 and T12 points through image segmentation using a convolutional neural network (CNN), which is a type of deep learning algorithm. Results: Intra-class consistency of ICC > 0.95 (p < 0.05) and internal consistency reliability of Cronbach’s α = 0.947 are obtained. Conclusions: The results demonstrate that the proposed algorithm exhibits high intra-class consistency and high internal consistency reliability to provide an automated thoracic kyphosis angle measurement system. Full article

Thyroid ultrasonography (US) usage has risen significantly over the past two decades, with annual increases of up to 21% in some healthcare systems. This review examines patterns in thyroid US usage, factors driving potential misuse, and strategies to mitigate overuse. While thyroid US provides valuable information on thyroid morphology and structure without radiation exposure, inappropriate use—estimated at 10–50% of exams—leads to adverse consequences, including patient anxiety, unnecessary procedures, and potential overdiagnosis of thyroid cancer. The widespread adoption of US has coincided with increased thyroid cancer diagnoses, yet mortality rates remain unchanged, suggesting overdiagnosis rather than actual disease increase. Clinical guidelines consistently recommend selective US use not for routine evaluation of thyroid dysfunction (hyper/hypothyroidism) without palpable abnormalities, but for the anatomical assessment of palpable nodules. For thyroid incidentalomas (ITNs), evidence suggests negligible malignancy risk for nodules < 1 cm, arguing against further investigation. The paper proposes a rational approach to thyroid US, emphasizing that patients with thyroid dysfunction without palpable abnormalities, euthyroid patients without palpable nodules, and patients with subcentimetric ITNs should not undergo thyroid US. Addressing this overutilization requires a better understanding of contributing factors and targeted interventions. By restricting US to appropriate clinical scenarios, healthcare resources can be optimized without compromising patient outcomes, ensuring that rare cases of clinically significant thyroid cancer receive proper diagnosis and treatment. Full article

In recent years, high-power microwave (HPM) technology has developed rapidly. However, the current research mainly focuses on how to improve its performance and its impact on electronic devices, and there has been relatively little research on its effects on organisms. In particular, the research on the biological effects of HPMs in the X-band is even more limited. The purpose of this paper is to conduct a study on the effects of HPMs in the X-band with a frequency of 9.375 GHz on mood, learning, and cognitive abilities, as well as the antioxidant defense system. Upon observation, it was noted that the mice in the exposed groups, when compared to the control group, did not display significant signs of depression or anxiety. Furthermore, their learning capabilities, memory retention, and cognitive functions remained intact and were not adversely affected. The results of oxidative-stress-related indicators in serum and brain tissue showed increased levels of antioxidant enzymes including superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px), reduced levels of protein carbonyl (PCO) and malondialdehyde (MDA), and no significant changes in reactive oxygen species (ROS). In summary, acute exposure to 9.375 GHz HPM did not cause significant damage to the organisms, and the body could defend against the acute stress caused by HPMs through its own antioxidant system. This investigation provides substantial theoretical foundations and robust experimental evidence for establishing safety parameters and potential biomedical applications of microwave radiation within defined exposure limits. Full article

Background: Music intervention (MI) is a promising complementary therapy for alleviating psychological distress in patients with cancer undergoing radiotherapy. This systematic review and meta-analysis assessed the efficacy of MI in reducing anxiety, depression, and fatigue in these patients. Methods: A comprehensive search was conducted in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and the International Clinical Trials Registry Platform from inception to 9 January 2025. We included randomized controlled trials (RCTs) and cohort studies investigating MI’s impact on psychological outcomes in patients with cancer receiving radiotherapy in this review. The study quality was appraised using the Cochrane Risk of Bias 2.0 for RCTs and the ROBINS-I tool for cohort studies. A meta-analysis was performed using a random-effects model in Review Manager 5.4. Results: A total of 13 studies (11 RCTs and 2 cohort studies) with 1073 participants were included. The pooled analysis revealed a significant reduction in anxiety (mean difference [MD]: −3.53, 95% confidence interval [CI]: −5.98 to −1.07, p = 0.003), a non-significant effect on depression (MD: −1.12, 95% CI: −3.25 to 1.01, p = 0.29), and a significant improvement in fatigue (MD: −15.88, 95% CI: −28.19 to −3.57, p = 0.01). A subgroup analysis based on intervention type indicated that music medicine (MM) was more effective in reducing anxiety compared to music therapy (MT). Conclusions: The findings of this study suggest that MI, particularly MM, may be beneficial in alleviating anxiety and fatigue in patients with cancer undergoing radiotherapy, but its impact on depression remains inconclusive. Future studies should employ standardized methodologies and rigorous RCT designs to validate these findings. Full article

Background/Objectives: Lumbar disk herniation (LDH) significantly affects quality of life due to lower back and radiating leg pain. Surgical intervention, such as discectomy, is effective for symptom relief when conservative measures fail; however, psychological factors like anxiety, depression, and maladaptive coping strategies may negatively impact surgical outcomes. This study aims to assess the role of preoperative psychological evaluations in predicting postoperative recovery and to identify key psychological and functional predictors of surgical success. Methods: A prospective study was conducted on 888 patients undergoing microdiscectomy for LDH at Mater Olbia Hospital between December 2020 and December 2023. Preoperative evaluations included the Visual Analog Scale, Symptom Checklist 90-R, Oswestry Disability Index, and Short Form 36. Logistic regression models and ROC curve analysis were used to identify significant predictors of outcomes and evaluate model accuracy. Results: Preoperative pain levels and emotional well-being emerged as the strongest determinants of postoperative improvement in the Oswestry Disability Index. The predictive model demonstrated high specificity (90.2%) in identifying patients likely to benefit from surgery. Clinically significant improvements were achieved by 69% of patients, highlighting the importance of psychological and functional assessments. Conclusions: Preoperative psychological assessment is critical in predicting outcomes of lumbar disk herniation surgery. Addressing psychological factors preoperatively enhances recovery, supports personalized treatment planning, and improves patient education. These findings advocate for an integrated care model that considers both physical and psychological health, optimizing surgical outcomes and patient satisfaction. Full article

Background/Objectives: The Fukushima Daiichi Nuclear Power Station accident underscored the critical role of public health nurses (PHNs) in managing evacuees during nuclear emergencies. Despite their importance, PHNs often lack sufficient knowledge and experience, which may make them anxious about this role. This study aimed to investigate the factors associated with PHNs’ anxiety about accepting evacuees and identify strategies to alleviate this anxiety. Methods: A cross-sectional survey was conducted among 100 PHNs working in Oita Prefecture, Japan, a region designated to receive evacuees in the event of a nuclear disaster. Data were collected via an online questionnaire assessing radiation knowledge, workplace characteristics, and anxiety about accepting evacuees. Univariate and multivariate logistic regression analyses were performed to identify the predictors of anxiety. Results: PHNs working in prefectural offices were 3.4 times more likely to feel anxious about accepting evacuees than those in municipal offices (OR = 3.488, 95% CI = 1.236–10.963, p = 0.023). Awareness of evacuation site responsibilities significantly reduced anxiety (OR = 0.412, 95% CI = 0.134–1.211, p = 0.110). Overall, knowledge of radiation was low, with only 8% correctly identifying the differences between stochastic and deterministic effects. Online training was the preferred format for education. Conclusions: Workplace characteristics and knowledge of evacuation responsibilities significantly influence PHNs’ anxiety levels. Addressing knowledge gaps through tailored, accessible training programs, particularly in online formats, is essential. Strengthening preparedness among PHNs could enhance their confidence and ability to manage evacuees effectively during nuclear disasters. Full article

Our previous study demonstrated that the acute high-dose-rate (3.3 Gy/min) γ-ray irradiation (γ-irradiation) of postnatal day-3 (P3) mice with 5 Gy induced depression and drastic neuropathological changes in the dentate gyrus of the hippocampus of adult mice. The present study investigated the effects of chronic low-dose-rate (1.2 mGy/h) γ-irradiation from P3 to P180 with a cumulative dose of 5 Gy on animal behaviour, hippocampal cellular change, and miRNA and mRNA expression in the hippocampus and blood in female mice. The radiation exposure did not significantly affect the animal’s body weight, and neuropsychiatric changes such as anxiety and depression were examined by neurobehavioural tests, including open field, light-dark box, elevated plus maze, tail suspension, and forced swim tests. Immunohistochemical staining did not detect any obvious loss of mature and immature neurons (NeuN and DCX) or any inflammatory glial response (IBA1, GFAP, and PDGFRα). Nevertheless, γH2AX foci in the stratum granulosum of the dentate gyrus were significantly increased, suggesting the chronic low-dose-rate irradiation induced persistent DNA damage foci in mice. miRNA sequencing and qRT-PCR indicated an increased expression of miR-448-3p and miR-361-5p but decreased expression of miR-193a-3p in the mouse hippocampus. Meanwhile, mRNA sequencing and qRT-PCR showed the changed expression of some genes, including Fli1, Hs3st5, and Eif4ebp2. Database searching by miRDB and TargetScan predicted that Fli1 and Hs3st5 are the targets of miR-448-3p, and Eif4ebp2 is the target of miR-361-5p. miRNA/mRNA sequencing and qRT-PCR results in blood showed the increased expression of miR-6967-3p and the decreased expression of its target S1pr5. The interactions of these miRNAs and mRNAs may be related to the chronic low-dose-rate radiation-induced persistent DNA damage. Full article

Deep Inspiratory Breath Hold (DIBH) has become a valuable technique in left-breast cancer radiotherapy, offering the possibility to reduce radiation exposure to organs at risks (OARs) and minimize the risk of cardiac complications. This treatment method involves stopping the breathing of patients during irradiation in order to temporarily distance the heart from the radiation field, which reduces potential cardiac risks and other complications. To identify factors that may affect the effectiveness of DIBH treatment, we analyzed the most important 5-year studies published in the PubMed database. Research shows that DIBH reduces the radiation dose to the heart and lungs. However, the effectiveness of DIBH is determined by a variety of factors, including the patient’s training, cooperation, anatomical features, age, and choice of radiotherapy technique. Additionally, cardiovascular risk factors, such as diabetes, smoking, and hypertension, can be impactful to the effectiveness and potential complications of DIBH. Moreover, if a patient has a substantial level of depression or anxiety, then they may be potentially disqualified from the DIBH treatment method. In addition to this, a lack of consent and/or fear may also disqualify a patient from DIBH treatment. Careful patient selection, comprehensive training, and optimization of treatment parameters are essential to maximize the benefits of DIBH whilst minimizing any potential side effects. DIBH enhancement techniques, such as IMRT and VMAT, also have an important role to play. The purpose of this narrative review article is to summarize the factors affecting the efficacy and side effects of DIBH in radiation therapy for left-breast cancer, with the aim of optimizing its clinical application while minimizing side effects. Patients who are likely to benefit most from DIBH are young women in good medical condition, able to cooperate with the procedure, and with smaller breasts. The increase in the estimated 10-year patient survival is significantly influenced by cardiovascular problems, so patients without diabetes and metabolic syndrome, and non-smokers, will benefit the most. An estimated 50–70% of breast cancer patients are likely to benefit from DIBH, and in the best case, it can result in a 50% reduction in the risk of cardiac problems after photodynamic therapy (PDT). Full article

This study clarified the negative aspects of the self-imposed evacuation of mothers of small children seeking to avoid radiation exposure from the Fukushima Daiichi Nuclear Power Station accident on 11 March 2011. We conducted semi-structured interviews with 27 mothers, employing open-ended inquiries based on an interview guide. Our analysis of their responses using the Ka-Wakita-Jiro (KJ) method categorized the results into eight distinct groups comprising 142 labels. These categories included continued anxiety about the health effects of radiation, differences in risk perception, changes in spousal relationships, the inability to make friends and find support, living as a single parent, financial concerns, the unfamiliar feel of the area to which they evacuated, and uncertainty about the future. Despite their hardships, the mothers continued their self-imposed evacuation to avoid radioactivity. Our findings underscore that their anxieties about radiation exposure persisted even after self-imposed evacuation, leading to deteriorated relationships with key individuals who would have been involved in raising their children. These results offer valuable insights into the challenges experienced by the indirect victims of the nuclear accident, such as the mothers of small children. Full article

Similar to invasive breast cancer, ductal carcinoma in situ is also going through a phase of changes not only from a technical but also a conceptual standpoint. From prescribing radiotherapy to everyone to personalized approaches, including radiotherapy omission, there is still a lack of a comprehensive framework to guide radiation oncologists in decision making. Many pieces of the puzzle are finding their place as high-quality data mature and are disseminated, but very often, the interpretation of risk factors and the perception of risk remain very highly subjective. Sharing the therapeutic choice with patients requires effective communication for an understanding of risks and benefits, facilitating an informed decision that does not increase anxiety and concerns about prognosis. The purpose of this narrative review is to summarize the current state of knowledge to highlight the tools available to radiation oncologists for managing DCIS, with an outlook on future developments. Full article

Patient report outcomes are commonly collected during oncology visits to elicit symptom burden and guide management. We aimed to determine the frequency of intervention for patients undergoing radiotherapy with high symptom complexity scores and identify which factors are associated with being offered an intervention. A retrospective chart audit was completed of adult patients with cancer who had at least one radiotherapy appointment and were assigned a high symptom complexity. A total of 200 patients were included; 150 (75.0%) patients were offered an intervention for the main symptom. The most offered intervention was medications. Multivariable logistic regression showed factors associated with being offered an intervention were the following: symptom score of 9 (OR = 9.56, 95% CI 1.64–62.8) and 10 (OR = 7.90, 95% CI 1.69–38.2); palliative intent radiation (OR 3.87, 96% CI 1.46–11.1); and last review appointment (OR 6.22, 95% CI 1.84–23.3). Symptoms associated with being offered an intervention included pain (OR 22.6, 95% CI 6.47–91.1), nausea (OR 15.7, 95% CI 1.51–412), shortness of breath (OR 7.97, 95% CI 1.20–63.7), and anxiety (OR 6.69, 95% CI 1.58–31.6). This knowledge will help guide clinical practice to understand symptom burden and how we can improve our management of patients’ symptoms. Full article

As cancer patients often suffer from fear of cancer progression (FoP), valid screening for FoP is of high relevance. The aims of this study were to test psychometric properties of two FoP questionnaires, to determine their relationship to other anxiety-related constructs, and to analyze the impact of sociodemographic and clinical factors on the FoP. Our sample consisted of n = 1733 patients with mixed cancer diagnoses. For measuring FoP, the Fear of Progression questionnaire (FoP-Q-12) and the Concerns About Cancer Recurrence Questionnaire (CARQ-4) were used. The mean scores of the FoP-Q-12 and the CARQ-4 were 30.0 ± 10.4 and 16.1 ± 10.8, respectively, indicating relatively high levels of FoP. Both questionnaires showed excellent internal consistency coefficients, α = 0.895 and α = 0.915, respectively. The correlation between the two FoP questionnaires was r = 0.72. Female patients reported more FoP than male patients (d = 0.84 and d = 0.54, respectively). There was a nonlinear age dependency of FoP, with an increase found in the age range from 18 to 50 years and a decrease in the older age range. Radiation, chemotherapy, and antibody therapy, but not surgery, lead to an increase in FoP. Both questionnaires show good psychometric properties and can be recommended for use in an oncological routine. Female patients and patients in the middle-age range deserve special attention from healthcare providers. Full article