Acute radiation syndrome is caused by exposure to high doses of radiation over a short period of time. There are three main syndromes that develop based on the absorbed radiation dose: hematopoietic syndrome from 1-10 Gy affecting bone marrow, gastrointestinal syndrome from 10-50 Gy, and central nervous syndrome above 50 Gy. Symptoms develop in the prodromal phase within hours, followed by a latent phase with no symptoms for weeks. The critical phase sees a relapse of severe symptoms that can cause death within days depending on the radiation dose. Outcomes depend on factors like radiation type, dose, and rate of exposure.
This power-point presentation is very important for radiology resident radiologist and radiographers and technician. this includes principles, technique , biological effects of radiation and how to protect, whats should normal radiation dose with latest update. This slide also includes ALARA PRINCIPLE thanks.
Effects of radiation
Signs and symptoms of radiation
Infected period of radiation
Dosage
Calculation of dosage
Units and SI units used
Diseases caused by radiation
Radioresistant
This power-point presentation is very important for radiology resident radiologist and radiographers and technician. this includes principles, technique , biological effects of radiation and how to protect, whats should normal radiation dose with latest update. This slide also includes ALARA PRINCIPLE thanks.
Effects of radiation
Signs and symptoms of radiation
Infected period of radiation
Dosage
Calculation of dosage
Units and SI units used
Diseases caused by radiation
Radioresistant
Acute radiation syndrome (ARS) or acute radiation sickness is an acute illness caused by irradiation of the entire body (or most of the body) by a high dose penetrating radiation in a very short period of time (usually a matter of minutes). The major cause of this syndrome is depletion of immature parenchymal stem cells in specific tissues.
Classically, acute radiation syndrome is subdivided into three sub-syndromes:
the hematopoietic syndrome,
the gastrointestinal syndrome,
the cerebrovascular syndrome
others include :
pulmonary syndrome, cutaneous radiation injury
radiation-induced multi organ dysfunction (failure) syndrome.
Acute Radiation Syndrome (ARS) (sometimes known as radiation toxicity or radiation sickness) is an acute illness caused by irradiation of the entire body (or most of the body) by a high dose of penetrating radiation in a very short period of time (usually a matter of minutes). The major cause of this syndrome is depletion of immature parenchymal stem cells in specific tissues.Examples of people who suffered from ARS are the survivors of the Hiroshima and Nagasaki atomic bombs, the firefighters that first responded after the Chernobyl Nuclear Power Plant event in 1986, and some unintentional exposures to sterilization irradiators.
BIOLOGICAL EFFECTS OF RADIATION USHA YADAV.pptxSubamProjects
Basic of human body
What is biological effect of radiation
How radiation can cause biological damage
Factors affecting biological effects
What are classes different biological effects caused by radiation
Acute radiation syndrome
Partial body effects
Cancer and genetic risk
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
2. • “Acute Radiation Syndrome (ARS) is an acute illness caused by
irradiation of the entire body (or most of the body) by a high dose of
penetrating radiation in a very short period of time (usually a matter
of minutes). The major cause of this syndrome is depletion of
immature parenchymal stem cells in specific tissues”- CDC
3. Radiation Sickness
• Accidental exposure to Ionizing
radiation
• whole body irradiation
• surface contact
• ingestion or
• inhalation of radioactive material
• Dependent on two factors:
• Absorbed dose (Gy)
• Rate of dose
4. TIMINGS OF EVENTS OF RADIATION
RESPONSE
10-6
10
-12
10-9
10-15
10-3
1 second
1 hour
1 day
1 year
100 years
1 ms
10
0
109
106
103
Energy deposition
Excitation/ionization
Initial particle tracks
Radical formation
PHYSICAL INTERACTIONS
PHYSICO-CHEMICAL INTERACTIONS
BIOLOGICAL RESPONSE
MEDICAL EFFECTS
Diffusion, chemical reactions
Initial DNA damage
DNA breaks / base damage
Repair processes
Damage fixation
Cell killing
Promotion/completion
Teratogenesis
Cancer
Hereditary defects
Proliferation of "damaged" cells
Mutations/transformations/aberrations
TIME(sec)
5. Factors affecting ARS
• Type of radiation eg Alpha,beta, Gamma, neutrons.
• Type of Exposure : Contamination & Irradiation ,
• Contamination may be internal contamination or external contamination
• Radiation Dose
• Duration of exposure
• Tissue radiosensitivity
6. The required conditions for Acute Radiation
Syndrome (ARS) are
• The radiation dose must be large (i.e., greater than 0.7 Gray (Gy) or
70 rads).
• Mild symptoms may be observed with doses as low as 0.3 Gy or 30
rads.
• The dose usually must be external ( i.e., the source of radiation is
outside of the patient’s body).
• Radioactive materials deposited inside the body have produced
some ARS effects only in extremely rare cases.
• The radiation must be penetrating (i.e., able to reach the internal
organs).
• High energy X-rays, gamma rays, and neutrons are penetrating
radiations.
7. • The entire body (or a significant portion of it) must have
received the dose.
• Most radiation injuries are local, frequently involving the
hands, and these local injuries seldom cause classical signs
of ARS.
• The dose must have been delivered in a short time (usually a
matter of minutes).
• Fractionated doses are often used in radiation therapy.
These are large total doses delivered in small daily amounts
over a period of time. Fractionated doses are less effective
at inducing ARS than a single dose of the same magnitude.
8. Dosage ;
• Threshold Dose : Depend on dose delivery mode:
• single high dose most effective
• fractionation increases threshold dose in most cases
significantly
• decreasing the dose rate increases threshold in most cases
• Threshold may differ in different persons
• Criteria of dose
• < 1 Gy: LOW DOSE
• 1-10 Gy: MODERATE DOSE
• > 10 Gy: HIGH DOSE
Lethal Dose
• It is an expression of the per cent lethal dose as a
function of time.
• It means: “Dose which would cause death to 50%
of the population in 30 days”.
• Its value is about 2-3 Gy for humans for whole body
irradiation
9. Sources of Data on Human Exposures
• Atomic bomb denonation and fall-out –survivors and there off springs
• Medical Exposures- such as patients receiving radiation therapy, prenatal X-ray
exposures
• Occupational Exposures- uranium miners, radium dial painters (1920’s), nuclear
dockyard workers, scientific researchers, nuclear material enrichment and
processing workers, diagnostic and therapeutic radiation workers.
10.
11. Whole Body Exposure
ABSORBED DOSE (Gy) SYNDROME OR TISSUE
INVOLVED
SYMPTOMS
1-10 Bone Marrow syndrome Leucopenia,
thrombopenia,
hemorrhage, infections
10-50 GastroIntestinal
Syndrome
Diarrhoea, fever,
electrolytic imbalance
>50 Central Nervous
syndrome
Cramps, tremor, ataxia,
lethargy, impaired vision,
coma
12. Phases of Radiation Injury
Dose
(Gy)
Prodromal
Phase
Manifest Phase
Prognosis without
Supportive Care
0.5–1.0 Mild Modest decline in blood counts Survival
1.0–2.0 Mild–moderate Some bone marrow damage Survival >90%
2.0–3.5 Moderate
Moderate–severe bone marrow
damage
Probable survival
3.5–5.5 Severe
Severe bone marrow damage;
modest GI damage
Death within 3.5–6
wk (50% of victims)
5.5–7.5 Severe
Pancytopenia and moderate GI
damage
Death probable
within 2–3 wk
7.5–10.0 Severe
Severe GI and bone marrow
damage
Death probable
within 2 wk
10 Severe
Severe GI damage, radiation-
induced lung injury, altered mental
status; at higher doses (>20.0 Gy),
cardiovascular collapse, fever,
shock
Death within 2 wk
Ann Intern Med. 2004;140:1037–1051.
13. Phases of Radiation Sickness
• Prodromal Phase (N-V-D stage):
• Initial appearance of symptoms (nausea, vomiting, fatigue,
diarrhea, shock, ataxia, disorientation, etc.)
• Within a few hours and up to a week
• Latent Phase:
• Complete lack of illness/ symptoms for 1-4weeks
• Manifest illness/ Critical Phase:
• A relapse into severe symptomatology (GI, hematopoetic and
CNS syndromes)
• In extremely high doses (2-6 Gy), death within a few days.
• Recovery or death
14. Prodromal Syndrome
• Depends on size of dose
• Symptoms vary with respect to time of onset, maximum severity,
duration of exposure.
• Severe prodromal phase means poorer outcomes.
• Symptoms can be gastro intestinal nausea, vomiting, intestinal
cramps, diarrhea or neuro muscular such as easy fatigability, fever,
head ache and hypotension.
• At 50% Lethal dose gastrointestinal symptoms are commin while at
supra lethal dose neuromuscular symptoms prevail.
15. Hematopoietic Syndrome
• LD 50 -2.5-5 Gy , death , if it occurs, is a result of
radiation damage to hematopoietic system.
• Occurs upon irradiation of bone marrow inflicting
irreversible damage to the proliferative capacity of the
spleen and bone marrow
• Prodormal Phase nausea, vomiting and anorexia within
a few hours at the higher dose levels, or after 6 to 12
hours at the lower dose levels. Lasts 24 to 48 hours.
• Latent Phase : can last upto one month, depending on
dose received. Usually asymptomatic except for fatigue
and weakness.
• Manifestation : usually after 3 weeks, infections,
neutropenic fevers, bleeding, petechial hemorrhages.
16. • The number of circulating granulocytes, platelets and erythrocytes
decreases rapidly.
• Death occurs unless the bone marrow begins to regenerate.
Infections is an important cause of death.
• Peak incidence of deaths from HPS occurs 30 days after exposure,
although deaths continue till 60 days.
17.
18. Typical hematologic course and clinical stages after sublethal (~3 Gy) exposure to total-body
irradiation
19. Gastrointestinal syndrome
• Lethal dose 50 7-15 Gy
• immediate, prompt and profuse onset of nausea,
vomiting and diarrhea, followed by a short latent
period.
• Death occurs due to destruction of intestinal villi ,
basal epithelial cells.
• The surface gets rapidly infected; combined with
Hematopoietic syndrome, septicemia and death
occur invariably
20.
21. • Dose of radiation in magnitude of 10Gy sterilizes large population of
dividing cells in the crypts
• Vili and differentiated cells are not affected in a dose of this order
• As the vili get sloughed off, no replacement cells produced in the
crypt, consequently intestine is denuded of vili.
• GI mucosa becomes increasingly atrophic, Plasma and electrolytes are
lost into the intestines, hemorrhages and ulcerations occur, resulting
in marked dehydration and vascular effects
23. • Death in humans usually after 9-10 days following irradiation.
• All individuals who receives a dose large enough for gastrointestinal
to result in death have already received far more than enough
radiation to result in hematopoetic death.
24. Cardiovascular Syndrome
• >30 Gy
• Always fatal, there is immediate nausea,
vomiting, anorexia and prostration, and
irreversible hypotension; blood pressure will
be markedly unstable.
• Within hours after exposure, the victim will
be listless, drowsy, tremulous, convulsive,
and ataxic.
• Death most likely will occur within a matter
of days.
25. CNS syndrome
• > 50 Gy
• Increased pressure in the confining cranial
vault as the result of increased fluid content
caused by edema, vasculitis, and meningitis
• Uncoordinated movements, disorientation
and convulsions
• Due to damage to the neurons and brain
vasculature
• Death occurs in 1-2 days.
26. • Chronology of events:
• Severe nausea vomiting with matterof minutes
• Disorientation, loss of co-ordination of muscular movements,
• Respiratory distress, diarrhea, convulsive seizures,coma and death
28. • Radiation injury to skin caused by non penetrating beta particles or
low energy photons. Injury may b also seen in absence of ARS.
• Can occur at doses of 2Gy
• Sources : contact with unsecured radiation sources from food
irradiators, radiotherapy equipment, or well depth gauges. In
addition, cases of CRI have occurred in people who were overexposed
to x-radiation from fluoroscopy units.
• Symptoms include tingling to itching
• Signs : erythema, epilation, edema, dry desquamation to wet
desquamation, ulceration and necrosis as dose increased.
29. • Prodromal stage (within hours of exposure)—This stage is
characterized by early erythema (first wave of erythema), heat
sensations, and itching that define the exposure area. The duration of
this stage is from 1 to 2 days.
• Latent stage (1–2 days postexposure)—No injury is evident.
Depending on the body part, the larger the dose, the shorter this
period will last. The skin of the face, chest, and neck will have a
shorter latent stage than the skin of the palms of the hands or the
soles of the feet.
30. • Manifest illness stage (days to weeks postexposure)—The basal layer
is repopulated through proliferation of surviving clonogenic cells. This
stage begins with erythema (second wave), a sense of heat, and slight
edema, which are often accompanied by increased pigmentation. The
symptoms that follow vary from dry desquamation or ulceration to
necrosis, depending on the severity of the CRI .
• Third wave of erythema (10–16 weeks postexposure, especially after
beta exposure)—The exposed person experiences late erythema,
injury to blood vessels, edema, and increasing pain. A distinct bluish
color of the skin can be observed. Epilation may subside, but new
ulcers, dermal necrosis, and dermal atrophy (and thinning of the
dermis layer) are possible.
32. SPECIFIC ORGAN SYSTEMS
& RELATED DAMAGE
HIGH RS MIDDLE RS LOW RS
•Bone Marrow
•Spleen
•Thymus
•Lymphatic nodes
•Gonads
•Eye lens
•Lymphocytes
•Skin
•Mesoderm organs
(liver, heart,
lungs…)
•Muscle
•Bones
•Nervous system
Editor's Notes
External Irradiation
External irradiation occurs when all or part of the body is exposed to penetrating radiation from an external source
Contamination
The second type of radiation injury involves contamination with radioactive materials. Contamination means that radioactive materials in the form of gases, liquids, or solids are released into the environment and contaminate people externally, internally, or both.
Incorporation
The third type of radiation injury that can occur is incorporation of radioactive material. Incorporation refers to the uptake of radioactive materials by body cells, tissues, and target organs such as bone, liver, thyroid, or kidney.
Threshold response:
An increase in radiation dose may not produce an observable effect until the tissue has received a minimal level of exposure called the threshold dose.
Once the threshold dose has been exceeded, increasing dose will demonstrate exceeding observable tissue damage.
Cataract and erythema of skin are well-known threshold responses
Highly sensitive to radiation killing are the cells of the hematopoietic system and related lymphoid system.
Most sensitive are the stem cells of the bone marrow, which give rise to all circulating blood cells and platelets, as well as the lymphoid tissues found in the spleen, liver, lymph nodes and thymus
Circulating lymphocytes are quite sensitive to radiation and a measurable drop in the normal titre (about 21,000/dl) can meter radiation exposure and indicate dose levels.
As little as 10 cGy can show a measurable drop in the circulating small lymphocyte population.
Of particular resistance are the mature circulating red blood cells and platelets; this is probably due to their lack of a nucleus.
Radiosensitivity- cell kill: RS = Probability of a cell, tissue or organ of suffering an effect per unit of dose.
Bergonie and Tribondeau (1906): “RS LAWS”: RS will be greater if the cell:
Is highly mitotic.
Is undifferentiated
Factors affecting RS: P
Physical
LET (linear energy transfer): RS
Dose rate: RS
Temperature RS
Chemical
Increase RS: OXYGEN, cytotoxic drugs.
Decrease RS: SULFURE (cys, cysteamine…)
Biological
Cycle status:
RS: G2, M
RS: S
Repair of damage (sub-lethal damage may be repaired e.g. fractionated dose