The document discusses the biological effects of ionizing radiation. It covers early observations of radiation effects from 1895 onwards. It describes direct and indirect cellular damage from radiation and outlines deterministic and stochastic effects. Deterministic effects have a threshold dose and include skin burns, cataracts and sterility. Stochastic effects have no threshold and include cancer and genetic mutations. Sensitive organs include the breast, lungs, bone and thyroid. Radiation exposure during pregnancy can cause lethal effects or malformations in the embryo/fetus.
Radiation protection, also known as radiological protection, is defined by the International Atomic Energy Agency (IAEA) as "The protection of people from harmful effects of exposure to ionizing radiation, and the means for achieving this". Exposure can be from a source of radiation external to the human body or due to internal irradiation caused by the ingestion of radioactive contamination.
Ionizing radiation is widely used in industry and medicine, and can present a significant health hazard by causing microscopic damage to living tissue. There are two main categories of ionizing radiation health effects. At high exposures, it can cause "tissue" effects, also called "deterministic" effects due to the certainty of them happening, conventionally indicated by the unit gray and resulting in acute radiation syndrome. For low level exposures there can be statistically elevated risks of radiation-induced cancer, called "stochastic effects" due to the uncertainty of them happening, conventionally indicated by the unit sievert.
Fundamental to radiation protection is the avoidance or reduction of dose using the simple protective measures of time, distance and shielding. The duration of exposure should be limited to that necessary, the distance from the source of radiation should be maxi mised, and the source shielded wherever possible. To measure personal dose uptake in occupational or emergency exposure, for external radiation personal dosimeters are used, and for internal dose to due to ingestion of radioactive contamination, bioassay techniques are applied.
Radiation protection, also known as radiological protection, is defined by the International Atomic Energy Agency (IAEA) as "The protection of people from harmful effects of exposure to ionizing radiation, and the means for achieving this". Exposure can be from a source of radiation external to the human body or due to internal irradiation caused by the ingestion of radioactive contamination.
Ionizing radiation is widely used in industry and medicine, and can present a significant health hazard by causing microscopic damage to living tissue. There are two main categories of ionizing radiation health effects. At high exposures, it can cause "tissue" effects, also called "deterministic" effects due to the certainty of them happening, conventionally indicated by the unit gray and resulting in acute radiation syndrome. For low level exposures there can be statistically elevated risks of radiation-induced cancer, called "stochastic effects" due to the uncertainty of them happening, conventionally indicated by the unit sievert.
Fundamental to radiation protection is the avoidance or reduction of dose using the simple protective measures of time, distance and shielding. The duration of exposure should be limited to that necessary, the distance from the source of radiation should be maxi mised, and the source shielded wherever possible. To measure personal dose uptake in occupational or emergency exposure, for external radiation personal dosimeters are used, and for internal dose to due to ingestion of radioactive contamination, bioassay techniques are applied.
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.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
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.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Radiation emitted from Cell Phones, Cell phone towers, Wi-Fi, TV and FM towers, microwave ovens, etc are called Electromagnetic radiations and are known to cause significant Biological effects on the human body and health of animals. Children are more prone to these effects as their skulls are thinner and still developing. This report summarizes the various studies done in reputed institutions of US, Germany, Sweden, Australia etc. Also, several news reports on the same have been accounted. In addition, some advise tips for the use of these devices have been mentioned. With the rapid advent in technology, avoidance of these radiations is almost close to impossible. It is due to this reason a solution, "Radiation Shield" has been invented by Prof. Girish Kumar of IIT Bombay, India, to absorb the excess radiation emitted from these sources
discusses about the effect of radiation that is hazardous to man and other living beings, how does these effects occur, and the necessity of minimizing the exposure to harmfull radiation
Chromosomes contains the genetic material, it means that when any alteration happens in the number and chromosomes structure can cause genetics illness, for example: ADS, cognition problems or some changes in the genome that can represent a benefit or damage for an individual or a specie like the protection of XX chromosome.
Its a lecture 8 in the series and it explains how noise and radiation in our environment could affect our health and how we can prevent and control the bad effects
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
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
3. • 1895 X-rays discovered by Roentgen
• 1896 First skin burns reported
• 1896 First use of x-rays in the treatment of cancer
• 1896 Becquerel: Discovery of radioactivity
• 1897 First cases of skin damage reported
• 1902 First report of x-ray induced cancer
• 1911 First report of leukaemia in humans and lung
cancer from occupational exposure
• 1911 94 cases of tumour reported in Germany
(50 being radiologists)
Early Observations of the Effects
of Ionising Radiation
4. Information comes from:
studies of humans (epidemiology)
studies of animals and plants (experimental radiobiology)
fundamental studies of cells and their components
(cellular and molecular biology)
The key to understanding the health effects of radiation
is the interaction between these sources of information
Effects of Radiation Exposure
5. CELL
• IS THE BASIC UNIT OF
LIFE
• MAKES ORGANS
AND TISSUES
• HUMAN BODY CONSISTS
OF 1014
SUCH CELLS
• BIOLOGICAL TISSUES
COMPRIZE OF 70% OF
WATER
CELL MEMBRANE: CONTROL
INTAKE & OUTPUT OF SOLUBLE
SUBSTANCE
NUCLEAR
MEMBRANE
NUCLEUS
CONTAINS DNA,
CHROMOSOME,
GENES ETC.
CYTOPLASM
FLUID LIKE SUBSTANCE THAT
CONTAINS MANY SEPARATE
CONSTITUENTS
6. DIRECT ACTION ON
CELLS
• IN DIRECT ACTION,THE
SENSITIVE VOLUME OF
THE CELL IS AFFECTED
BY DIRECT TRANSFER
OF ENERGY FROM
RADIATION TO THE
CELL AND SENSITIVE
VOLUME CAN BE
INACTIVATED
INDIRECT ACTION
ON CELLS
• IN INDIRECT ACTION,
THE SENSITIVE
VOLUME OF THE CELL
IS INACTIVATED BY
TRANSFER OF ENERGY
FROM ANOTHER
VOLUME THAT HAS
ABSORBED ENERGY
FROM RADIATION
8. Biological Effects of Radiation
Deterministic Effects Stochastic Effects
Due to large doses of radiation
exposure during short period of
time
Due to large short term doses, or
smaller doses received over a long
period of time.
9. Deterministic effects
(Short term biological effects)
Dose
Severity
..
threshold
• lots of cells killed in a given tissue or organ
– high dose
• cell replacement (if able to happen) will tend to offset cell
killing
10. Stochastic effects
Long Term Biological Effects (Chronic Radiation Effects)
Cancer
Hereditary Effects
Probability
ofeffect
Dose
•
All radiation induced cancers have a long latent period
before they are detected.
• The shortest latent period is about 5-10 year for
Leukemia, and about 20 - 30 years for solid tumors.
11. SOMATIC EFFECTS
• ARISE FROM DAMAGE TO CELLS IN A
PARTICLLAR TISSUE AND AFFECT
ONLY TO THE IRRADIATED PERSON
• CAN BE EITHER STOCHASTIC EFFECT
OR DETERMINISTIC EFFECT
12. HERIDITORY EFFECTS
• OCCUR IN CHILDREN OR FUTURE
GENERATIONS OF IRRIDIATED
PERSON DUE TO A ALTERED GERM
CELL
• ARE STOCHASTIC EFFECTS
14. Indirect Actions
When water is irradiated with Ionizing
radiation, the following reactions take
place.
H2O H2O+
+ e -
1.1
Positive ion dissolves immediately.
H2O+
H+
+ OH 1.2
15. Electron is picket up by a neutral water
molecule.
H2O + e-
H2O-
1.3
This also dissolves immediately.
H2O-
H + OH-
1.4
H and OH are free radicals and are highly
reactive.
(The reactions 1.1 1.4 last only about
10-6
s)
16. The free radicals H & OH may recombine
or react with other molecules.
If OH radicals are in close proximity, they
can recombine to form H2O2
OH + OH H2O2
If irradiated water contains dissolved O2
the following reaction will take place.
H + O2 HO2
17. Since this hydroperoxyl radical has longer
life time which allows.
H + HO2 H2O2
Since H2O2is a relatively stable oxydizing
agent, H2O2 can affect molecules or cells .
23. Damages to the DNA
Three major types can be discussed.
• DNA Base Damage
- This is the most common damage to
the DNA molecules.
- If the cell remain unprepared it can
survive and reproduce as a altered
cell.
26. Damages to Stands
Single strand break.
• Braking of a one strand
• Can be quickly repaired.
Double strand break
• Braking of both strands either by
single event or two separate event.
Single event Two separate event
27. DAMAGE TO THE CELLS BY
RADIATION CAN CAUSE:
• DELAY IN CELL REPRODUCTION
• CHROMOSOME ABERATION
• CELL DEATH
• GENE MUTATION ETC.
31. 31
Deterministic effects
• Due to cell killing
• Have a dose
threshold
• Specific to
particular tissues
• Severity of harm is
dose dependent
Radiation injury from an industrial source
32. Examples for deterministic
effects
• Skin breakdown
• Cataract of the lens of the eye
• Sterility
• Kidney failure
• Acute radiation syndrome (whole body)
34. Threshold Doses for Deterministic
Effects
• Cataracts of the lens of the eye 2-10 Gy
• Permanent sterility
– males 3.5-6 Gy
– females 2.5-6 Gy
• Temporary sterility
– males 0.15 Gy
– females 0.6 Gy dose
Severity of
effect
threshold
35. Note on threshold values
• 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
36. Threshold doses for deterministic
effects
Organ doses for adults
typically > 50 Gy
37. Absorbed dose (Gy) Syndrome or Tissues
involved
Symptoms
1 - 2 Bone marrow Mild leucopenia and
thrombopenia
2 - 10 Bone marrow syndrome Leucopenia, thrombopenia,
hemorrhage, infections
10 - 15 Intestinal syndrome Diarrhoea, fever, electrolytic
imbalance
> 15 Neurological syndrome Cramps, tremor, ataxia,
lethargy, impaired vision,
coma
Absorbed dose
(Gy)
Therapy Prognosis Lethality
1 – 2 Symptomatic Excellent 0-10 %
2 – 10 Transfusions of
leucocytes and
platelets. Bone
marrow
transplantation.
Growth stimulating
factors
Uncertain 0-90%
10-15 Palliative Very poor 90 - 100 %
> 15 Symptomatic Hopeless 100 %
Whole body exposureWhole body exposure
38. Radiation induced skin injuries
Effect
Typical
threshold
dose (Gy)
Fluoroscopic
on time
(minutes) to
reach
threshold at a
dose rate of
50 mGy per
min
Fluoroscopic
on time
(minutes) to
reach
threshold at
a dose rate
of 100 mGy
per min
Time to
onset of the
effect
Early transient erythema 2 40 20 hours
Temporary epilation 3 60 30 ~3 weeks
Main erythema 6 120 60 ~10 days
Permanent epilation 7 140 70 ~3 weeks
Dry desquamation 10 200 100 ~4 weeks
Invasive fibrosis 10 200 100 ------------
Dermal atrophy 11 220 110 >14 weeks
Telangiectasia 12 240 120 >52 weeks
Moist desquamation 15 300 150 ~4 weeks
Late erythema 15 300 150 ~6-10 weeks
Dermal necrosis 18 360 180 >10 weeks
Secondary ulceration 20 400 200 >6 weeks
39. RADIOSENSITIVITY
High RS Medium RS Low RS
Bone Marrow
Spleen
Thymus
Lymphatic nodes
Gonads
Eye lens
Lymphocytes
(exception to the
RS laws)
Skin
Mesoderm organs
(liver, heart,
lungs…)
Muscle
Bones
Nervous system
41. STOCHASTIC EFFECTS
• MAY BE DUE TO EITHER A SINGLE
LARGE OVER EXPOSURE OR
CONTINUING LOW LEVEL OVER
EXPOSURE
• RESULTS FROM :
CHROMOSOME ABERATIONS AND,
GENE MUTATIONS
43. Chromosome Aberration and Gene
Mutation
If the stands broken are not repaired, the end of
the breaks can attach to the broken or unbroken
chromosomes (healthy ones) and result
chromosome aberrations, and gene mutations etc.
44.
45. Stochastic effects
• Due to cell changes (DNA) and proliferation
towards a malignant disease
• Severity (i.e. cancer) independent of the dose
• No dose threshold (they are presumed to occur at
any dose however small)
• Probability of effect increases with dose
46. Cancer
Over proliferation of viable cells which
have received damages to their control
systems in the form of gene mutations or
chromosome aberrations.
47. … order of magnitudes
• 1cm3
of tissue = 109
cells
• 1 mGy --> 1 in 1000 or 106
cells hit
• 999 of 1000 lesions are repaired - leaving 103
cells
damaged
• 999 of 1000 damaged cells die (not a major
problem as millions of cells die every day in every
person)
• 1 cell may live with damage (could be mutated)
48. RADIOSENSITIVITY
High RS Medium RS Low RS
Bone Marrow
Spleen
Thymus
Lymphatic nodes
Gonads
Eye lens
Lymphocytes
(exception to the
RS laws)
Skin
Mesoderm organs
(liver, heart,
lungs…)
Muscle
Bones
Nervous system
49. SENSITIVE ORGANS TO RADIATION INDUCED
CANCERS
• Female breast
• Lungs
• Bone
• Thyroid and
• Skin
• Current best estimate of the fatality risk from
radiation induced cancer is 5 per 100 person – Sievert.
This means that, if 20000 people were each given 1.0
mSv, one of them may die 20 – 30 years later due to a
cancer induced by that dose. However in that
population of 20000 people, about 3200 of them would
die from normal cancer in 20 – 30 years.
51. Radiation effects on the
embryo/foetus
• lethal effects
• malformations/growth anomalies
• mental retardation
• cancer
– childhood, adulthood
• hereditary effects
• For a dose of 10 mSv, probability of the above is
less than 0.2%, compared with about 6% natural
incidence of the same.
52. Effects of Antenatal Exposure
• The effects on the embryo/fetus depend on the time of
exposure relative to conception.
• Lethal effects can be induced in experimental animal by
relatively low doses (such as 100 mSv) before or immediately
after implantation of the embryo into the uterine wall.
• They may also be induced after higher doses during all stages
of intra-uterine development.
• Exposure of the embryo in the first three weeks following
conception is not likely to result in deterministic or stochastic
effects in the live-born child, despite the fact that the central
nervous system and the heart are beginning to develop in the
third week. It is thought that any cellular damage at this stage
is much more likely to cause the death of the embryo/fetus than
to result in stochastic effects expressed in the live-born.
54. Pre-implant stage (up to 10 days) Only lethal effect, all or none
Embryo contains only few cells which are
not specialized
If too many cell are damaged-embryo is
resorbed
If only few killed-remaining pluripotent
cells replace the cells loss within few cell
divisions
Atomic Bomb survivors - high incidence of
both - normal birth and spontaneous
abortion
55.
56. Effects of Antenatal Exposure
Malformation
• During the period of major organogenesis, conventionally
from the start of the third week after conception, malformations
may be caused in the organ under development at time of
exposure. These effects are deterministic in character with a
threshold in man, estimated from animal experiments, to be
about 0.1 Gy.
• Throughout the period from 3 weeks after conception until the
end of pregnancy, it is likely that radiation exposure can cause
stochastic effects resulting in an increased probability of cancer
in the live-born. The available data are not consistent and
considerable uncertainty exists. However, the ICRP assumes
that the nominal fatality probability coefficient is, at most, a
few times that for the population as a whole. Irradiated fetus
seem to be susceptible to childhood leukemia and other
childhood cancers which expressed approximately during the
first decade of life.
57. Effects of Antenatal Exposure
Loss of Intelligence
• Values of intelligence quotient (IQ) lower than expected reported in some
children exposed in utero.
• Mental retardation was not observed to be induced by radiation prior to 8
weeks from conception ,or after 25 weeeks. The period 8-15 weeks are more
sensitive than the period 16-25 weeks. During the most sensitive period, the
fraction of those exposed which became severely mentally retarded increased
by approximately 0.4 per Sv. During weeks 16-25, it increased by about 0.1 per
Sv.
• Observed a gneral downward shift in the distribution of IQ with increasing
dose. the shift is proportional to dose. Small shifts cannot be clinically
identified. A coefficient of about 30 IQ points per Sv relates exposure from 8
weeks to 15 weeks after conception. A similar, but smaller shift, is detectable
exposure in the period from 16 weeks to 25 weeks.
At doses of the order of 0.1 Sv, no effect would be detectable in the general
distribution of IQ, but at somewhat large doses the effect might be sufficient to
show an increase in the number of children classified as severely retarded. All
the observations on IQ and severe mental retardation relate to high dose.
58. Radiation-Induced Malformations
• Malformations have a threshold of 100-200
mGy or higher and are typically associated
with central nervous system problems
• Fetal doses of 100 mGy are not reached even
with 3 pelvic CT scans or 20 conventional
diagnostic x-ray examinations
• These levels can be reached with
fluoroscopically guided interventional
procedures of the pelvis and with radiotherapy
59. Central Nervous System
Effects
• During 8-25 weeks post-conception the
CNS is particularly sensitive to radiation
• Fetal doses in excess of 100 mGy can
result in some reduction of IQ
(intelligence quotient)
• Fetal doses in the range of 1000 mGy can
result in severe mental retardation
particularly during 8-15 weeks and to a
lesser extent at 16-25 weeks
60. Leukemia and Cancer
• Radiation has been shown to increase the
risk for leukemia and many types of cancer
in adults and children
• Throughout most of pregnancy, the
embryo/fetus is assumed to be at about the
same risk for carcinogenic effects as
children
61. Leukemia and Cancer
• The relative risk may be as high as 1.4
(40% increase over normal incidence) due
to a fetal dose of 10 mGy
• Individual risk, however, is small with the
risk of cancer at ages 0-15 being about 1
excess cancer death per 1,700 children
exposed “in utero” to 10 mGy
63. How do we know about radiation
induced cancer?
• epidemiological studies
– A bomb survivors (Life Span Study)
– Medical exposures
(eg Ankylosing Spondylitis Study)
– Occupational exposures
(eg. UK National Register for
Radiation Workers)
• molecular biology studies
64. Epidemiological studies - features
• Large population size
– Up to 100 000
• Years of follow-up
– Often 30 or more years
• Mix of ages, sex, ethnic groups
• Setting
– War, medical, occupational
• Organs irradiated
– All, through to specific organs
• Dose range
– Mainly medium to high
• Dose rate
– Mainly high
65. Cancer risk estimates
• Estimated lifetime fatal cancer risk for the general
population with exposure to low LET radiation at high
doses and dose rates
– ICRP 60 risk estimate
– 10% per Sv
• It is assumed there is NO threshold
• Allowance is made for low doses/dose rates
– ICRP 60 used a factor of 2
– 5% per Sv at low doses/dose rates
– for workers the risk is assessed at 4% per Sv at low
doses/dose rates
66. Lifetime fatal cancer risks - low dose/rate
• Risk per 100 person Sv
Organ ICRP 26 ICRP 60
Bone marrow 0.20 0.50
Bone surfaces 0.05 0.05
Lung 0.20 0.85
Thyroid 0.05 0.08
Breast 0.25 0.20
Colon 0.85
Oesophagus 0.30
Stomach 1.10
Liver 0.15
Urinary bladder 0.30
Skin 0.02
Ovaries 0.10
Remainder 0.50 0.50
TOTAL 1.25 5.00
67. Hereditary effects of radiation
• effects associated with gene mutations and
chromosomal aberrations induced in parental germ
cells and transmitted to progeny
• radiation does not produce new, unique mutations
• information for humans is inconclusive - no direct
evidence
• probability of hereditary effects is proportional to
the gonadal dose
68. Hereditary Effects of Radiation
• Ionising radiation is known to cause heritable
mutations in many plants and animals
BUT
• intensive studies of 70,000 offspring of the
atomic bomb survivors have failed to identify an
increase in congenital anomalies, cancer,
chromosome aberrations in circulating
lymphocytes or mutational blood protein
changes.Neel et al. Am. J. Hum. Genet. 1990, 46:1053-1072Neel et al. Am. J. Hum. Genet. 1990, 46:1053-1072
69. Estimating risks of hereditary effects
• hereditary effects are stochastic in nature, with the
amount of radiation exposure determining the
probability of occurrence
• current risk estimates for hereditary effects over all
generations
– 2.4 x 10-2
per Sv - dose to gonads, reproductive pop
– 1.0 x 10-2
per Sv - dose to gonads, general pop
• A derived figure to assess the risks of occupational
exposures
– 0.6 x 10-2
per Sv - dose to gonads, worker population
70. HIROSHIMA 1945 :
Total Population : 330000
Deaths : 110000
Injured : 80000
NAGASAKI 1945 :
Total Population : 210000
Deaths : 70000
Injured : 28000
71. HIROSHIMA 1945 :
70000 new born children 1946 – 1953
showed no genetic effects.
(Parents were survivors of Hiroshima
or Nagasaki atomic bomb explosion)
72. HIROSHIMA 1945 :
No. of monitored pregnancies
1945 / 46 : ca. 2800
No effect :
0 – 8 weeks
after 25 weeks
73. HIROSHIMA 1945 :
Findings :
• Decrease of IQ
(foetus exposed)
• Delayed growth and development
(exposed at young
age)
• Leukemia
74. STOCHASTIC EFFECTS OF
IONIZING RADIATION
Thyroid cancer diagnosed up to 1998 among
children 0-17 years at the time of the Chernobyl
accident
0
50
100
150
200
250
300
1990 1991 1992 1993 1994 1995 1996 1997 1998
Year
Number
Belarus
Russian Federation
Ukraine
Total
75. Comparison of Radiation Worker Risks
to Other Workers
Mean death rate 1989
(10-6
/y)
Trade 40
Manufacture 60
Service 40
Government 90
Transport/utilities 240
Construction 320
Agriculture 400
Mines/quarries 430
Safe industries
≡ 2 mSv/y (100 mSv over
a lifetime)
≡ max permissible exposuremax permissible exposure
(20 mSv/year or 1000 mSv(20 mSv/year or 1000 mSv
over a lifetimeover a lifetime
76. The following activities are associated with
a risk of death that is 1/1000000
•10 days work in a nuclear medicine department
• smoking 1.4 cigarette
• living 2 days in a polluted city
• traveling 6 min in a canoe
• 1.5 min mountaineering
• traveling 480 km in a car
• traveling 1600 km in an airplane
• living 2 months together with a smoker
• drinking 30 cans of diet soda
RISKS
77. In Perspective
• Loss of Life in Days
– Unmarried Male – 3500 (~10 yr)
– Unmarried Female – 2250 (~5 yr)
– Smoking(1 pk/day) – 2250 (~ 7 yr)
– 25% Overweight – 777 (~ 2 yr)
– Alcohol Consumption – 465 (~ 1 yr)
– Driving a motor vehicle - 207
– Radiation (1 mSv/yr for 70 years) - 10
This slide can be used with a powerpoint effect - each mouseclick will bring up one event. Alternatively, the effect can be turned off.
The fisure illustrates the concept of threshold dose. The threshold dose is the absorbed dose that is needed to create a clinically observed injury in the most rediosensitive individual. Example of threshold doses are given. The magnitude of these doses should be discussed. Give some example illutrating high dose rate activities in medicine e.g. Handling unshielded radioactive material etc.
Note also tumor cure is in this context a deterministic effect
This slide is useful to recap the concept of deterministic effects. Below a certain threshold there is no effect and beyond the threshold the effect becomes noticeable. There can be an increase in severity of the effect with dose, however, the notion of risk is not really applicable to deterministic effects.
When discussing threshold values it is important to state the points given on the next slide.
The second point can be compared to drug effects
These are obviously only rough estimates - however they may illustrate the magnitude of the problem. It could be pointed out that 1mGy is of the order of magnitude of the annual exposure of humans. Therefore the whole discussion above could be made for 1 year of life.
The diagram gives the number of thyroid cancers diagnosed in children 0-17 y the years following the Chernobyl accident. The various frequencies for the different regions is related to the exposure of the populations due to the fallout.