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Radiation Protection of the Patient
Published in W. P. M. Mayles, A. E. Nahum, J.-C. Rosenwald, Handbook of Radiotherapy Physics, 2021
W. P. M. Mayles, Uwe Schneider
A particular problem arises when young patients are being treated. Examples in which there is good evidence of second cancers are patients treated with mantle fields for Hodgkin's disease, who have been found to have a significantly increased risk for solid cancers, including breast cancer (Bhatia et al. 1996; Dores et al. 2002), particularly if irradiated below the age of 30 (Aisenberg et al. 1997). Figure 61.2 illustrates the near-exponentially increasing risk as a function of decreasing age in terms of the age modifying function µ for breast cancer. Such a large second cancer risk for paediatric patients or young adults has also been observed for other solid cancers. It can be summarised, therefore, that the induction of second malignancies in paediatric patients is a major side effect and should be considered in the treatment planning process.
Introduction to Conditioning Agents for Hair and Skin
Published in Randy Schueller, Perry Romanowski, Conditioning Agents for Hair and Skin, 2020
Randy Schueller, Perry Romanowski
Another aspects of skin's condition related to compositional elements is pH. The skin's surface is slightly acid, with an inherent pH between 4 and 6. This value varies depending on the area of the body, however, and areas with higher moisture tend to have higher pH value (this includes the axilla, inguinal regions, and in between fingers and toes) (3). This "acid mantle," as it is referred to, assists the body in warding off infection. Therefore, proper pH is an indicator that skin is in good condition.
The Endocrine Pancreas
Published in George H. Gass, Harold M. Kaplan, Handbook of Endocrinology, 2020
The islet has a specialized capillary blood supply. Each islet is vascularized by one to three arterioles which penetrate to the core of the islet through breaches in the mantle. In the core, the capillaries are fenestrated and therefore highly permeable. The capillary network passes along the inside of the mantle before penetrating the mantle and draining into collecting venules. The endocrine cells seem to be aligned along vascular structures. Polyhedral β cells generally have two vascular borders with one face opposed to an “arterial” capillary and another face opposed to a “venous” capillary generally in a draining sinusoidal pattern. Adjacent β cells are joined by calcium-dependent and calcium-independent cell adhesion molecules as well as desmosomes with canalicular spaces formed where three or more β cells adjoin. It is believed that glucose uptake and “sensing” as well as a significant portion of insulin secretion occurs into these canaliculi where bulk flow of interstitial fluid occurs from the arterial to the venous side of the capillary web.
Personalized approaches for treatment-naïve mantle cell lymphoma
Published in Expert Review of Hematology, 2023
Sensitive techniques allow for the detection of minimal residual disease (MRD) in patients with mantle cell lymphoma. Techniques for these assays include flow cytometry and molecular-based analyses and may involve peripheral blood or bone marrow; details of these techniques and relative sensitivities are described elsewhere [80]. Importantly, the presence of MRD after induction is strongly associated with shorter progression-free survival in patients who went on to autologous transplant [81–83]. Similar findings have been reported in transplant-ineligible patients [84]. Given these findings, clinical trials are evaluating whether tailoring therapy based on MRD status can improve outcomes, either by intensifying therapy in patients with detectable MRD, or reducing therapy in patients already with undetectable MRD status. The ongoing ECOG-ACRIN phase 3 clinical trial (NCT03267433) enrolls transplant-eligible patients who responded to induction therapy and have undetectable MRD status after induction, randomizing them to ASCT vs no ASCT, with both groups receiving maintenance rituximab [22].
All for one, though not one for all: team players in normal tissue radiobiology
Published in International Journal of Radiation Biology, 2022
Marjan Boerma, Catherine M. Davis, Isabel L. Jackson, Dörthe Schaue, Jacqueline P. Williams
By the late 1950s, publications began reporting adverse cardiac effects following irradiation, seen not only in animal models (Kohn et al. 1957; Senderoff et al. 1959), but also in clinical subjects (Catterall 1960; Jones and Wedgwood 1960). By the early 1970s, the use of large thoracic fields, such as mantle or mediastinal irradiation, both of which involve high doses of radiation to the heart, was clearly seen as associated with late cardiac disease (Landberg et al. 1972; Martin et al. 1975; McReynolds et al. 1976). Indeed, since that time, systematic analyses of cardiac disease risk in survivors of Hodgkin’s disease have provided unequivocal proof of RIHD, including the influence of other cardiovascular risk factors (Hancock et al. 1993a; Darby et al. 2005; Hooning et al. 2007; Taylor et al. 2007; Henson et al. 2013; van Nimwegen et al. 2016). Futhermore, for several decades, radiation therapy for breast cancer, especially of the left breast, included all or part of the heart. Retrospective analyses of large cohorts of long-term breast cancer survivors, looking at cardiac morbidity and mortality, have provided insight into the radiation sensitivity of substructures in the heart, as well as determining the risk of delayed cardiac disease from even low radiation doses (Darby et al. 2005).
Cortical thickness and gyrification index measuring cognition in Parkinson’s disease
Published in International Journal of Neuroscience, 2021
Shefali Chaudhary, S. Senthil Kumaran, Vinay Goyal, G. S. Kaloiya, M. Kalaivani, N. R. Jagannathan, Rajesh Sagar, Nalin Mehta, A. K. Srivastava
We also observed surface mantle correlates to clinical scores. Progressive cortical thinning in temporo-parietal region with H&Y stage was observed. This signifies regional thinning with disease progression. For GI, no such correlation was observed. Interestingly, UPDRS-II negative correlation to frontal precentral and parietal postcentral GI were observed. UPDRS-II signifies ‘activities of daily living’ though not a direct measure of motor symptoms, but gets affected by tremor, rigidity, bradykinesia, and freezing [41]. Pre and postcentral GI was related to UPDRS-III (motor) score in an earlier study, which we did not observe [36]. However, a similar pattern for UPDRS-II may actually be reflecting the underlying motor condition and/or PD pathology and needs further investigation.