acute radiation
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Author(s):  
Leif Stenke ◽  
Christel Hedman ◽  
Marita Lagergren Lindberg ◽  
Karin Lindberg ◽  
Jack Valentin

Abstract The major immediate and severe medical consequences in man following exposure to high doses of ionizing radiation can be summarized within the concept of the acute radiation syndrome (ARS). In a dose-dependent fashion, a multitude of organ systems can be affected by such irradiation, presenting considerable medical challenges to treating physicians. Accidents or malevolent events leading to ARS can provoke devastating effects, but they occur at a low frequency and in a highly varying manner and magnitude. Thus, it is difficult to make precise medical predictions and planning, or to draw conclusive evidence from occurred events. Therefore, knowledge from on-going continuous developments within related medical areas needs to be acknowledged and incorporated into the ARS setting, enabling the creation of evidence-based guidelines. In 2011 the WHO published a first global consensus on the medical management of ARS among patients subjected to nontherapeutic radiation. During the recent decade the understanding of and capability to counteract organ damage related to radiation and other agents have improved considerably. Furthermore, legal and logistic hurdles in the process of formally approving appropriate medical countermeasures have been reduced. We believe the time is now ripe for developing an update of internationally consented medical guidelines on ARS.


Life ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 99
Author(s):  
Weihong Li ◽  
Shixiang Zhou ◽  
Meng Jia ◽  
Xiaoxin Li ◽  
Lin Li ◽  
...  

Accurate dose assessment within 1 day or even 12 h after exposure through current methods of dose estimation remains a challenge, in response to a large number of casualties caused by nuclear or radiation accidents. P53 signaling pathway plays an important role in DNA damage repair and cell apoptosis induced by ionizing radiation. The changes of radiation-induced P53 related genes in the early stage of ionizing radiation should compensate for the deficiency of lymphocyte decline and γ-H2AX analysis as novel biomarkers of radiation damage. Bioinformatic analysis was performed on previous data to find candidate genes from human peripheral blood irradiated in vitro. The expression levels of candidate genes were detected by RT-PCR. The expressions of screened DDB2, AEN, TRIAP1, and TRAF4 were stable in healthy population, but significantly up-regulated by radiation, with time specificity and dose dependence in 2–24 h after irradiation. They are early indicators for medical treatment in acute radiation injury. Their effective combination could achieve a more accurate dose assessment for large-scale wounded patients within 24 h post exposure. The effective combination of p53-related genes DDB2, AEN, TRIAP1, and TRAF4 is a novel biodosimetry for a large number of people exposed to acute nuclear accidents.


2021 ◽  
Author(s):  
So-Yeon Park ◽  
Jong Min Park ◽  
Jung-in Kim ◽  
Chang Heon Choi ◽  
Minsoo Chun ◽  
...  

Abstract We applied a radiomics approach to skin surface images to objectively assess radiodermatitis in patients undergoing radiotherapy for breast cancer. A prospective cohort study of 20 patients was conducted. Skin surface images in normal, polarised, and UV modes were acquired using a skin analysis device before starting radiotherapy (‘before RT’), 7 days after the first treatment ('RT_D7'), on ‘RT_D14’, and 10 days after radiotherapy ended (‘after RT_D10’). Eighteen types of radiomic feature ratios were calculated. We measured skin doses in ipsilateral breasts using OSLDs on the first day of radiotherapy. Clinical evaluation of acute radiodermatitis was performed using the RTOG scoring criteria on ‘RT_D14’ and ‘after RT_D10’. Several statistical analysis methods were used to test the performance of radiomic features as indicators of radiodermatitis evaluation. As the skin was damaged by radiation, the energy for normal mode and sum variance for polarised and UV modes decreased significantly for ipsilateral breasts. The radiomic feature ratios at ‘RT_D7’ had strong correlations to skin doses and those at ‘RT_D14’ and ‘after RT_D10’ with statistical significance. The energy for normal mode and sum variance for polarised and UV modes demonstrated the potential to evaluate and predict acute radiation, which assists in its appropriate management.


Life ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 20
Author(s):  
Juras Kišonas ◽  
Jonas Venius ◽  
Olga Sevriukova ◽  
Mindaugas Grybauskas ◽  
Daiva Dabkevičienė ◽  
...  

Background: Up to 95% of irradiated patients suffer from ionizing radiation (IR) induced early skin reaction, acute radiation dermatitis (ARD). Some experts think that additional skin hydration can reduce acute skin reactions. Individual radiosensitivity (IRS) determined from lymphocytes may help to predict acute radiation toxicity. The purpose of this study is to evaluate the clinical manifestation of ARD in different skincare groups during whole breast radiotherapy depending on IRS and other risk factors. Methods: A total of 108 early-stage breast cancer patients were randomized into best supportive care (BSC) and additional skincare (ASC) groups. IRS was evaluated using a G2 assay modified with caffeine-induced G2 checkpoint arrest. All patients received a 50 Gy dose to the breast planning target volume (PTV). Clinical assessment of ARD symptoms according to the CTCAE grading scale was performed once a week. Results: IRS was successfully determined for 91 out of 108 patients. A total of 10 patients (11%) had normal IRS, 47 patients (52%) were categorized as radiosensitive, and 34 (37%) as highly radiosensitive. There was no significant difference in the manifestation of ARD between patient groups by skincare or IRS. According to logistic regression, patients with bigger breasts were prone to more severe ARD (p = 0.002). Conclusions: The additional skincare did not improve skin condition during RT. A total of 89% of patients had increased radiosensitivity. IRS determined before RT did not show the predictive value for the manifestation of ARD. Logistic regression revealed that breast volume was the most significant risk factor for the manifestation of ARD.


Author(s):  
Christina Beinke ◽  
Christian Siebenwirth ◽  
Michael Abend ◽  
Matthias Port

AbstractIn this review, we discuss the value of biological dosimetry and electron paramagnetic resonance (EPR) spectroscopy in the medical management support of acute radiation syndrome (ARS). Medical management of an ionizing radiation scenario requires significant information. For optimal medical aid, this information has to be rapidly (< 3 days) delivered to the health-care provider. Clinical symptoms may initially enable physicians to predict ARS and initiate respective medical treatment. However, in most cases at least further verification through knowledge on radiation exposure details is necessary. This can be assessed by retrospective dosimetry techniques, if it is not directly registered by personal dosimeters. The characteristics and potential of biological dosimetry and electron paramagnetic resonance (EPR) dosimetry using human-derived specimen are presented here. Both methods are discussed in a clinical perspective regarding ARS diagnostics. The presented techniques can be used in parallel to increase screening capacity in the case of mass casualties, as both can detect the critical dose of 2 Gy (whole body single dose), where hospitalization will be considered. Hereby, biological dosimetry based on the analysis of molecular biomarkers, especially gene expression analysis, but also in vivo EPR represent very promising screening tools for rapid triage dosimetry in early-phase diagnostics. Both methods enable high sample throughput and potential for point-of-care diagnosis. In cases of higher exposure or in small-scale radiological incidents, the techniques can be used complementarily to understand important details of the exposure. Hereby, biological dosimetry can be employed to estimate the whole body dose, while EPR dosimetry on nails, bone or teeth can be used to determine partial body doses. A comprehensive assessment will support optimization of further medical treatment. Ultimately, multipath approaches are always recommended. By tapping the full potential of all diagnostic and dosimetric methods, effective treatment of patients can be supported upon exposure to radiation.


2021 ◽  
Vol 66 (6) ◽  
pp. 45-49
Author(s):  
Nelya Metlyaeva ◽  
A. Bushmanov ◽  
I. Galstyan ◽  
A. Davtyan ◽  
M. Sukhova ◽  
...  

Purpose: Clinical and psychophysiological assessment of the adaptation of a patient who suffered from acute radiation sickness of moderate severity after the Chernobyl accident and acute leukemia, which began 30 years after the transferred ARS. Material and methods: A clinical and psychophysiological examination of a patient who suffered from acute radiation sickness of moderate severity after the Chernobyl accident and acute leukemia that occurred 30 years after the Chernobyl accident was carried out. The object of the study was the patient D.R.I., born in 1950, deputy. Head of the Chernobyl NPP workshop, participant in the liquidation of the consequences of the 1986 Chernobyl accident. On April 26, 1986, during an emergency, he underwent relatively uniform beta-gamma radiation with the development of ARS II (moderate) severity. Within 3.5 hours after the accident was in the premises of the Chernobyl nuclear power plant. In the structure of ARS, bone marrow syndrome of the second degree and oropharyngeal syndrome of the first degree of severity were observed. The radiation dose, according to a cytogenetic study, was 3.4 Gy. A psychophysiological study was carried out using the MMPI methodology, the Cattell’s 16 Personality Factors Test, the Expert automated software and methodological complex, designed to study the personality characteristics of a person, the cognitive and intellectual characteristics of a person, the Raven’s Progressive Matrices, simple and complex sensorimotor reactions and reactions to a moving object, 15 (2001) and 30 years (2016) after the Chernobyl radiation accident. Results: The clinical and psychophysiological assessment of the personality and the actual mental state made it possible to determine the demonstrative-hypochondriacal type of disturbance in the psychophysiological adaptation with the tendency for the anxiety-depressive behavior of the patient to progress to a state of increasing depression, more pronounced in dynamics. Conclusion: The psychophysiological assessment of the personality and current mental state of the patient who had ARS, moderate and, 30 years after the Chernobyl accident, acute leukemia showed a demonstrative-hypochondria type of adaptation disorder, as a variant of a disharmonious combination of hypochondria, anxiety-depressive and demonstrative tendencies with a predominance of demonstrativeness (the first, second and third scale of the MMPI methodology) with a significant decrease on the ninth scale in the form of an increase in depression in dynamics. The prevalence of demonstrativeness over growing depression in a person with high intellect, good figurative and logical thinking, and a lack of sensorimotor inhibition is a manifestation of optimism and resistance to a serious illness.


2021 ◽  
Vol 66 (6) ◽  
pp. 34-38
Author(s):  
T. Bichkova ◽  
I. Andrianova ◽  
O. Nikitenko ◽  
N. Stavrakova ◽  
I. Parfenova ◽  
...  

Purpose: Assessing the role of various factors in the formation of radioresistance is an important branch of radiobiology. The quality of drinking water, as it turned out, can significantly affect radioresistance. Against the background of studying the antiradiation properties of various types of water, differing in mineral and isotopic composition, the problem of the influence of tap water on the course of radiation injury remained underestimated. This circumstance determined the purpose of the work: to evaluate the modifying effect of tap water on the course of acute radiation sickness after X-ray irradiation of mice at an average lethal dose. Material and methods: Female ICR (CD-1) mice were irradiated with an average lethal dose once – 6.5 Gy of X-ray irradiation. After irradiation, half of the mice received tap water as drinking water, and the other half received artificially mineralized drinking water. Results: Keeping animals on tap water significantly reduced the survival rate of mice both with a single dose (log-rank test p=0.02, χ2=5.38) compared with animals receiving artificially mineralized distilled water. In addition, in the group of mice that received tap water, an increase in the rate of death of mice and a lower preservation of the group mass of animals during the development of acute radiation injury was noted. Conclusion: Tap water, used as drinking water, increases the damaging effect of radiation when X-rays are irradiated in mice.


2021 ◽  
Author(s):  
Qingfen Zhang ◽  
Ying Wang ◽  
Shuang Yang ◽  
Qian Wu ◽  
Wanmin Qiang

Abstract Purpose To determine the effect of various cleaning methods for skin with acute radiation dermatitis (RD) in patients treated for nasopharyngeal carcinoma (NPC). Methods A total of 168 NPC inpatients were randomized, while 152 patients completed the whole trial and the data were analyzed. Patients were randomly divided into non-washing group, washing with water alone group, and washing with water and soap group. All three groups received intensity modulated radiation therapy (IMRT) among other treatments. Follow-up from recruitment or the initial radiotherapy dose to 1 month after the final radiotherapy dose. CONSORT checklist was applied as the reporting guidelines for this study. Study evaluated a range of endpoints including incidence, timing, severity of acute RD and quality of life (QOL).Results There were no allergic reactions or aggravating in both washing groups during the whole treatment. The incidence of acute RD was 100% in all three groups, while the degree of severity differed among groups. Washing moderately reduced severity compared with patients without washing; washing also delayed the onset time of acute RD, reduced the incidence of moist desquamation and pruritus. There were no significant difference among groups with respect to pain or burning sensation. Washing improved QOL on physical, emotional, and social functional dimensions. Washing with water and soap was the most effective on reducing itching and improving QOL among three groups. Conclusion Washing irradiated skin reduces the occurrence and severity of acute radiation dermatitis.Clinical trial information ChiCTR2000038231, date of registration 09.18.2020


2021 ◽  
Author(s):  
W. June Brickey ◽  
Michael A. Thompson ◽  
Zhecheng Sheng ◽  
Zhiguo Li ◽  
Kouros Owzar ◽  
...  

Radiation can be applied for therapeutic benefit against cancer or may result in devastating harm due to accidental or intentional release of nuclear energy. In all cases, radiation exposure causes molecular and cellular damage, resulting in the production of inflammatory factors and danger signals. Several classes of innate immune receptors sense the released damage associated molecules and activate cellular response pathways, including the induction of inflammasome signaling that impacts IL-1β/IL-18 maturation and cell death. A previous report indicated inflammasomes aggravate acute radiation syndrome. In contrast, here we find that inflammasome components do not exacerbate gamma-radiation-induced injury by examining heterozygous and gene-deletion littermate controls in addition to wild-type mice. Absence of some inflammasome genes, such as caspase-1/11 and Nlrp3, enhance susceptibility of treated mice to acute radiation injury, indicating importance of the inflammasome pathway in radioprotection. Surprisingly, we discover that the survival outcome may be sex-dependent as more inflammasome-deficient male mice are susceptible to radiation-induced injury. We discuss parameters that may influence the role of inflammasomes as radioprotective or radioexacerbating factors in recovery from radiation injury including the use of littermate controls, the sex of the animals, differences in microbiota within the colonies and other experimental conditions. Under the conditions tested, inflammasome components do not exacerbate radiation injury, but rather provide protective benefit.


Author(s):  
Kasandra S. Hunter ◽  
Lisa S. Carnell ◽  
Andrea L. DiCarlo ◽  
Corey M. Hoffman ◽  
Shannon G. Loelius ◽  
...  

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