Search Results (136)

This study evaluated the activity concentrations of radionuclides in honey, bee pollen, bee bread, and propolis from multiple regions in Poland (Europe) to assess the levels of radiological contamination and their implications for public health. Furthermore, the work considers the use of bee products as bioindicators of the state of environmental contamination with radionuclides. The apiaries from which the samples were collected were selected in eight provinces in Poland, and are also complemented by reference data from soil contamination monitoring. Radionuclide measurements included both natural (e.g., ⁴⁰K, ²²⁶Ra) and anthropogenic isotopes (e.g., ¹³⁷Cs). The results show that although the overall activity concentrations were generally low, certain locations exhibited elevated levels of ¹³⁷Cs in bee products, likely reflecting historical deposition in soils. Propolis was best correlated with ¹³⁷Cs deposited in soil compared to the other products studied. The patterns observed substantiate the hypothesis that bee products, predominantly propolis, accurately reflect local radiological conditions, thereby providing a practical and non-intrusive approach to monitoring radionuclide contamination and informing risk management strategies. An assessment of potential health risks indicates that the effective dose is safe and ranges from 0.02 to 10.3 µSv per year, depending on the type of product and consumption. Full article

Chemical, biological, radiological, and nuclear (CBRN) incidents pose significant challenges requiring swift, coordinated responses to safeguard public health. This is especially the case in densely populated urban areas, where the public is not only at risk but can also be of assistance. Public cooperation is critical to the success of mass decontamination efforts, yet prior research has primarily focused on technical and procedural aspects, neglecting the psychological and social factors driving casualty behaviour. This paper addresses this gap through a narrative literature review, chosen for its flexibility in synthesising fragmented and interdisciplinary research across psychology, sociology, and emergency management. The review identified two primary pathways influencing casualty decision making: rational and affective. Rational pathways rely on deliberate decisions supported by clear communication and trust in responders’ competence, while affective pathways are shaped by emotional responses like fear and anxiety, exacerbated by uncertainty. Trust emerged as a critical factor, with effective —i.e., transparent, empathetic, and culturally sensitive— communication being proven to enhance public cooperation. Cultural and societal norms further shape individual and group responses during emergencies. This paper demonstrates the value of narrative reviews in addressing a complex, multifaceted topic such as casualty behaviour, enabling the integration of diverse insights. By emphasising behavioural, psychological, and social dimensions, the results of this paper offer actionable strategies for emergency responders to enhance public cooperation and improve outcomes during CBRN incidents. Full article

This study evaluates the accuracy of ²²²Rn exhalation rates from building materials using two standard experimental protocols, thus addressing the increasing importance of rapid radon assessment due to health concerns and regulatory limits. In detail, six types of natural stones frequently employed for the construction of buildings of historical-artistic relevance were analyzed using the closed chamber method (CCM) combined with the Durridge Rad7 system, by using two experimental protocols that differed in the measurement duration: 10 days (Method 1) versus 24 h (Method 2). Obtained results revealed that the radon exhalation rates ranged from 0.004 to 0.072 Bq h⁻¹, which are moderate to low if compared to studies in other regions. Statistical comparison using the u-test confirmed equivalence between protocols (u-test ≤ 2), thus supporting the validity of the faster Method 2 for practical applications. Furthermore, to estimate the potential indoor radon levels and determine the associated radiological risks to human health, for the investigated natural stones, the Markkanen room model was employed. As a result, simulated indoor radon concentrations remained well below regulatory thresholds (maximum value: 37.3 Bq m⁻³), thus excluding any significant health concerns under typical indoor conditions. Full article

Malignant diseases represent a major global health challenge and are among the leading causes of death worldwide. Accurate early diagnosis is essential for improving outcomes and combating these conditions effectively. Currently, the diagnosis of malignancies relies heavily on radiological imaging and pathological examinations, which are often invasive and not cost-effective. As such, there is a growing need for non-invasive and accessible methods to detect cancer in its early stages. Tumor markers—biomolecules whose levels increase in malignancy and can be measured in blood or other biological tissues and fluids—offer a promising tool. However, the sensitivity and specificity of currently available tumor markers are insufficient for early detection, limiting their use primarily to disease monitoring rather than diagnosis. While ongoing research continues to identify novel tumor markers, the development of more effective early detection strategies requires more than the discovery of new biomarkers. The continuous monitoring of patients and individuals with a high tumor risk and the personalization of tumor marker interpretation are also critical. In this review, we (i) summarize the most commonly used tumor markers, (ii) examine strategies for developing novel biomarkers, particularly through omics technologies, (iii) explore the potential of continuous monitoring using wearable biosensors for early tumor detection, and (iv) discuss approaches to personalizing tumor marker interpretation to support early diagnosis and improve treatment outcomes. Full article

Thyroid nodules are a common clinical finding, with their prevalence influenced by multiple environmental and occupational factors, including exposure to ionizing radiation. Healthcare workers, particularly those operating in radiology, nuclear medicine, interventional cardiology, and radiation oncology, are potentially at increased risk due to chronic low-dose radiation exposure. This review aims to evaluate the current evidence regarding the association between occupational radiation exposure and the development of thyroid nodules among healthcare professionals. The findings suggest a higher prevalence of thyroid nodules in radiation-exposed workers compared to the general population, although data heterogeneity and methodological limitations exist. Factors such as the duration of exposure, radiation protection practices, and frequency of monitoring play critical roles in modulating the individual risk. While some studies report no significant difference in malignancy rates, the increased detection of nodules underlines the need for regular thyroid surveillance in at-risk populations. Further longitudinal and multicentric studies are warranted to clarify the causality and guide preventive strategies. This review highlights the importance of occupational health protocols, including radiation shielding and periodic thyroid evaluation, in safeguarding the long-term endocrine health of healthcare workers. Full article

Lung cancer remains the leading cause of cancer-related mortality globally, largely due to late-stage diagnoses. While low-dose computed tomography (LDCT) has improved early detection and reduced mortality in high-risk populations, traditional screening strategies often adopt a one-size-fits-all approach based primarily on age and smoking history. This can lead to limitations, such as overdiagnosis, false positives, and the underrepresentation of non-smokers, which are especially prevalent in Asian populations. Precision medicine offers a transformative solution by tailoring screening protocols to individual risk profiles through the integration of clinical, genetic, environmental, and radiological data. Emerging tools, such as risk prediction models, radiomics, artificial intelligence (AI), and liquid biopsies, enhance the accuracy of screening, allowing for the identification of high-risk individuals who may not meet conventional criteria. Polygenic risk scores (PRSs) and molecular biomarkers further refine stratification, enabling more personalized and effective screening intervals. Incorporating these innovations into clinical workflows, alongside shared decision-making (SDM) and robust data infrastructure, represents a paradigm shift in lung cancer prevention. However, implementation must also address challenges related to health equity, algorithmic bias, and system integration. As precision medicine continues to evolve, it holds the promise of optimizing early detection, minimizing harm, and extending the benefits of lung cancer screening to broader and more diverse populations. This review explores the current landscape and future directions of precision medicine in lung cancer screening, emphasizing the need for interdisciplinary collaboration and population-specific strategies to realize its full potential in reducing the global burden of lung cancer. Full article

Several postmastectomy breast reconstruction techniques and procedures have been implemented, although with limited evaluation of benefits and adverse effects. We conducted a systematic review on the plane and timing of reconstruction, and on the use of nipple-sparing mastectomy, acellular dermal matrix, and autologous fat grafting as the evidence base for an updated clinical practice guideline on breast reconstruction for Ontario Health (Cancer Care Ontario). Both immediate and delayed reconstruction may be considered, with preferred timing depending on factors such as patient preferences, type of mastectomy, skin perfusion, comorbidities, pre-mastectomy breast size, and desired reconstructive breast size. Immediate reconstruction may provide greater psychological or quality of life benefits. In patients who are candidates for skin-sparing mastectomy and without clinical, radiological, and pathological indications of nipple-areolar complex involvement, nipple-sparing mastectomy is recommended provided it is technically feasible and acceptable aesthetic results can be achieved. Surgical factors including incision location are important to reduce necrosis by preserving blood supply and to minimize nerve damage. There is a role for both prepectoral and subpectoral implants; risks and benefits will vary, and decisions should be made during consultation between the patient and surgeons. In patients who are suitable candidates for implant reconstruction and have adequate mastectomy flap thickness and vascularity, prepectoral implants should be considered. Acellular dermal matrix (ADM) has led to an increased use of prepectoral reconstruction. ADM should not be used in case of poor mastectomy flap perfusion/ischemia that would otherwise be considered unsuitable for prepectoral reconstruction. Care should be taken in the selection and handling of acellular dermal matrix (ADM) to minimize risks of infection and seroma. Limited data from small studies suggest that prepectoral reconstruction without ADM may be feasible in some patients. Autologous fat grafting is recommended as a treatment for contour irregularities, rippling following implant-based reconstruction, and to improve tissue quality of the mastectomy flap after radiotherapy. Full article

Interventional radiology offers minimally invasive procedures guided by real-time imaging, reducing surgical risks and enhancing patient recovery. While beneficial to patients, these advancements increase occupational hazards for physicians due to chronic exposure to ionizing radiation. This exposure raises health risks like radiation-induced cataracts, cardiovascular disease, and cancer. Despite regulations like the European Council Directive 2013/59/EURATOM, which sets limits on whole-body and eye lens doses, no dose limits exist for the brain and meninges, since the brain has traditionally been considered a radioresistant organ. Recent studies, however, have highlighted radiation-induced brain damage, suggesting that meningeal exposure in interventional radiology may be underestimated. This study evaluates the entrance air Cumulative mean annual entrance air kerma to the skullull during interventional radiology procedures, using thermoluminescent dosimeters and controlled exposure simulations. Data were collected by varying the exposure time and analyzing the contribution to the entrance air kerma on each side of the head. The results indicate that, considering the attenuation of the cranial bone, the absorbed dose to the brain, obtained by averaging the head entrance air kerma for the right, front, and left sides of the operator’s head, could represent 0.81% to 2.18% of the annual regulatory limit in Italy of 20 mSv for the average annual effective dose of exposed workers (LD 101/2020). These results provide an assessment of brain exposure, highlighting the relatively low but non-negligible contribution of brain irradiation to the overall occupational dose constraint. Additionally, a correlation between entrance air kerma and the Kerma-Area Product was observed, providing a potential method for improved dose estimation and enhanced radiation safety for interventional radiologists. Full article

Background/Objectives: Necrotizing pneumonia (NP) is an uncommon, severe complication of community-acquired pneumonia (CAP) associated with increased hospital length of stay and high morbidity and mortality. Although this entity was described several decades ago, there is no consensus on radiological criteria for diagnosis, optimal antibiotic duration, or data on clinical outcomes in adults. Given the paucity of data on this entity, a retrospective cohort study was conducted at our institution to evaluate factors associated with all-cause mortality, hospital length of stay, and duration of antibiotics. Methods: An IRB-approved retrospective cohort analysis was conducted through electronic health record review at a tertiary academic center at the University of Florida—Jacksonville. The electronic health record was queried for a list of all hospitalizations from 1 January 2016 to 31 December 2023 with an International Classification of Diseases, 10th revision diagnosis code of J85.0 (gangrene and necrosis of the lung). The primary outcome was all-cause mortality, and secondary outcomes were hospital length of stay and duration of antibiotics. Results: A total of 57 patients met the definition of necrotizing pneumonia and were included in our study. Fourteen (24.6%) patients died while hospitalized. The mean length of hospital stay was 26.6 days, and the median duration of antibiotics was 28 days. The only statistically significant predictor in the model of all-cause mortality was the requirement of mechanical ventilation, with mortality being 27 times more likely in patients requiring mechanical ventilation (OR 27.6 (95% CI (2.6924, 671.9648)); p = 0.011). Conclusions: To our knowledge, this is the largest cohort of adult patients with NP in the literature. We found that mortality was 24.6%, with the requirement of mechanical ventilation associated with 27 times higher risk of mortality on multivariable logistic regression analysis. Full article

The combustion of hard coal and lignite in power and combined heat and power plants generates significant amounts of coal fly ash (CFA), a waste material with variable properties. CFA naturally contains radionuclides, specifically naturally occurring radioactive materials (NORMs), which pose potential radiological risks to the environment and human health during their storage and utilization, including their incorporation into building materials. Although global research on the radionuclide content in CFA is available, there is a clear gap in detailed and current data specific to Central and Eastern Europe and notably, a lack of a systematic analysis investigating the influence of installed power plant capacity on the concentration profile of these radionuclides in the generated ash. This study aimed to fill this gap and provide crucial data for the Polish energy and environmental context. The objective was to evaluate the concentrations of selected radionuclides (²³²Th, ²²⁶Ra, and ⁴⁰K) in coal fly ash samples collected between 2020 and 2023 from 19 Polish power and combined heat and power plants with varying capacities (categorized into four groups: S1–S4) and to assess the associated radiological risk. Radionuclide concentrations were determined using gamma spectrometry, and differences between groups were analyzed using non-parametric statistical methods, including PERMANOVA. The results demonstrated that plant capacity has a statistically significant influence on the concentration profiles of thorium and potassium but not radium. Calculated radiological hazard assessment factors (Ra_eq, H_ex, H_in, IAED) revealed that although most samples fall near regulatory limits (e.g., 370 Bq kg⁻¹ for Ra_eq), some exceed these limits, particularly in groups S1 (plants with a capacity less than 300 MW) and S4 (plants with a capacity higher than 300 MW). It was also found that the frequency of exceeding the annual effective dose limits (IAEDs) showed an increasing trend with the increasing installed capacity of the facility. These findings underscore the importance of plant capacity as a key factor to consider in the radiological risk assessment associated with coal fly ash. This study’s outcomes are crucial for informing environmental risk management strategies, guiding safe waste processing practices, and shaping environmental policies within the energy sector in Central and Eastern European countries, including Poland. Full article

The aim of this study was to explore diabetes mellitus type 2 as a risk factor in the prevalence of chronic apical periodontitis (CAP) in untreated and endodontically treated teeth. The second objective was to describe the correlation between the presence of periapical lesions and blood glucose/glycated hemoglobin levels among diabetic (DM) and non-diabetic patients with endodontically treated or untreated teeth with CAP. Materials and methods: This cross-sectional study was conducted on 90 patients (55 with DM, 35 without DM), admitted to the Oral and Maxillofacial Surgery Department of “St. Spiridon” Hospital in Iași, Romania. Endodontic and perapical status was evaluated using the Periapical Index (PAI) based on clinical and radiological evaluations with blood glucose levels and HbA1c analysis. Statistical analysis included data, correlations and regression analysis, and group comparisons using appropriate parametric or non-parametric tests. DM subjects had a higher mean value of untreated teeth with CAP (2.53 vs. 2.00) compared to the control group (p = 0.010) and a lower mean number of endodontically treated teeth without CAP (1.53 vs. 2.74) compared to the control group (p < 0.001). Diabetic patients also had a higher mean number of root-filled teeth with CAP (3.33 vs. 1.94; p < 0.001). Conclusions: There was a clear association between diabetes and oral pathology, with diabetic patients having fewer teeth, more untreated teeth, and a higher prevalence of periapical lesions. Elevated blood glucose and HbA1c levels indicated that poor metabolic control negatively impacts periapical healing and overall endodontic health. Full article

The introduction of COVID-19 vaccinations has significantly altered the course of the pandemic by markedly reducing the number of severe infection cases, hospitalizations, and deaths due to COVID-19. Elderly individuals constitute a particularly vulnerable group at risk of severe disease progression, which is often related to decreased immune system effectiveness and comorbidities. Severe infection outcomes in vaccinated individuals, though substantially rarer than in the unimmunized population, can still lead to death due to underlying health conditions. This analysis aims to describe the population of elderly individuals who, despite being vaccinated, died from interstitial pneumonia complicating SARS-CoV-2 infection. Data on the infection course and co-existing diseases were obtained from the database of the Józef Struś Multispecialty City Hospital in Poznań, which was converted into a dedicated facility during the pandemic. The inclusion criteria for the analysis were being over 60 years of age on the day of hospital admission, confirmed pneumonia in radiological examination, COVID-19 infection confirmed by PCR test, and an adverse disease course resulting in death. Patients admitted to the hospital from 1 June 2021 to 31 December 2021 were analyzed. Out of all hospitalizations, only 18 individuals met the inclusion criteria. Given the small number of patients, the authors employed descriptive methods to illustrate the clinical states of the individual patients, presenting SARS-CoV-2 infection in the context of co-existing diseases that significantly affect prognosis. The qualitative analysis employed highlights the complex and multidimensional courses of severely ill COVID-19 patients more emphatically. Full article

This study investigated the spatial distribution and radiological risks of naturally occurring radionuclides (²²⁶Ra, ²³²Th, ⁴⁰K) in 37 soil samples from Zacatecas, located in north-central Mexico, using high-resolution gamma spectrometry. Results revealed ⁴⁰K concentrations (mean: 736.81 Bq kg⁻¹), nearly double the global average, while ²²⁶Ra (29.96 Bq kg⁻¹) and ²³²Th (29.72 Bq kg⁻¹) aligned with worldwide norms. Geoaccumulation indices identified moderate ⁴⁰K accumulation at 22 sites, with El Capulín classified as moderately contaminated (I_geo = 1.07). Radiological risk indices showed absorbed dose rates (62.52 nGy h⁻¹) and excess lifetime cancer risk (0.330 × 10⁻³) exceeding global thresholds by 4% and 14%, respectively. Multivariate analyses demonstrated strong Spearman correlations (ρ = 0.75–1.00) among risk indices, while spatial interpolation identified southern/western regions as high-risk zones. These findings emphasize the necessity of integrating spatial analysis with multivariate statistical techniques in environmental radioprotection frameworks. While most of the study area complies with international safety standards, the identified zones exceeding dose thresholds warrant prioritized management to mitigate potential cumulative health risks. Full article

E-cigarette or vaping product use-associated lung injury (EVALI) is a critical and potentially fatal form of lung injury that gained considerable public health concern in 2019. The use of e-cigarettes and vaping products is causally associated with EVALI, a condition characterized by a constellation of respiratory symptoms, such as coughing, shortness of breath, and chest pain. This comprehensive narrative literature review explores the complexities of EVALI, including its association with the structure and composition of e-cigarettes and its epidemiology, pathogenesis, clinical and radiological manifestations, management strategies, and public health implications. Moreover, it uncovers the long-term repercussions of EVALI and underscores the ongoing research endeavors designed to mitigate and comprehend the risks associated with using e-cigarettes. Full article

Background: The clinical spectrum of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is broad; it can range from asymptomatic cases to mild upper respiratory tract illness, respiratory failure, and severe multiorgan failure resulting in death. Therefore, it is important to identify the clinical course of the disease and the factors associated with mortality. Objective: The aim of this study is to identify the risk factors associated with the severity of the disease, intensive care unit admission, and mortality in COVID-19 patients. Methods: A total of 1075 patients with clinical and radiological findings compatible with COVID-19 pneumonia and positive SARS-CoV-2 PCR were selected and retrospectively screened. All included patients were classified according to the 7th edition of the 2019 Coronavirus Disease Guidelines published by the National Health Commission of China. Results: It was observed that elevated white blood count (WBC) increased the severity of COVID-19 by 3.26 times and the risk of intensive care unit (ICU) admission by 3.47 times. Patients with high D-dimer levels had a 91% increased risk, and those with high fibrinogen levels had a 2.08 times higher risk of severe disease. High C-reactive protein (CRP) values were found to increase disease severity by 6.89 times, mortality by 12.84 times, and ICU admission by 3.37 times. Conclusions: Identifying the factors associated with disease severity, ICU admission, and mortality in COVID-19 patients could help reduce disability and mortality rates in pandemics. Full article