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CBRN and the Trauma Victim
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Acute radiation syndrome describes the illnesses experienced in the first few hours to weeks of exposure to radiation. It typically follows the pattern of a prodrome, latent period and then manifest illness. The nature of the manifest illness can be considered as three sub-syndromes which occur as the absorbed dose increases.
A Series of Unfortunate Events
Published in Alan Perkins, Life and Death Rays, 2021
Two plant operators were killed as a result of the explosions. Other casualties included plant workers and fire fighters who climbed to the top of the turbine building to extinguish fires on the roof. Within 24 hours of the incident 28 workers including 6 firemen received what was estimated to be radiation doses of up to 20 Gy. All these workers developed symptoms of acute radiation syndrome including nausea, vomiting, diarrhoea, headaches, burns and fever and all died by the end of July. Underlying bone marrow failure was the main contributor to all deaths that occurred during the first 2 months. Another primary cause of death was considered to be due to infection from extensive skin burns from beta radiation. Around 1,000 workers were brought on site in the first few days, many of whom received high radiation doses. The operation continued to secure the site and shield the damaged reactor, so that the remaining three reactors could be restarted. Around 200,000 people, ‘liquidators’, were recruited from all over the Soviet Union between 1986 and 1987. They received high doses of radiation, averaging around 100 mSv. Some 20,000 liquidators received about 250 mSv, with a few receiving as high as 500 mSv. In all around 600,000 people were involved on site, but most of these received only low radiation doses more comparable with the background levels of around 3 mSv per year.
Management of Emergency Care for Radiation Accident Victims
Published in Kenneth L. Miller, Handbook of Management of Radiation Protection Programs, 2020
Mary Ellen Berger, Robert C. Ricks
Medical management of the patient with the acute radiation syndrome is directed to relief of symptoms, prevention and treatment of infection and bleeding, supportive care, and, when indicated, use of various growth factors and cytokines (i.e., G-CSF [granulocyte-colony-stimulating factor], GM-CSF [granulocyte/macrophage-colony-stimulating factor], interleukin-3 [IL-3]) to stimulate production of cells. With acute, uniform exposures greater than 8 or 9 Gy, bone marrow transplantation might be a consideration, although there are attendant risks in its use and limited experience to validate its usefulness in accident victims. Medical and nursing care in these cases is similar to that given any patient found to be in a profound state of hematologic depression.
The delayed effects of acute radiation exposure (DEARE): characteristics, mechanisms, animal models, and promising medical countermeasures
Published in International Journal of Radiation Biology, 2023
There is an urgent demand for effective medical countermeasures (MCM) in the event of high-dose radiation exposure (prompt exposures of >2 Gy; Coleman et al. 2015; Winters et al. 2023) ranging from nuclear plant disasters to nuclear warfare. Less than 24 hours after exposure to high-dose ionizing radiation, victims develop a continuum of multi-system symptoms referred to as acute radiation syndrome (ARS). Survivors of ARS are at risk for developing the delayed effects of acute radiation exposure (DEARE), a spectrum of chronic illnesses involving multiple organ systems and occurring months to years after radiation exposure. The DEARE are believed to result from some combination of oxidative stress, inflammation, senescence, fibrosis, and loss of stem cell self-renewal potential in the ARS survivors (Robbins and Zhao 2004; Zhao and Robbins 2009; Chua et al. 2012; Unthank et al. 2015; Wang et al. 2016; Al-Jumayli et al. 2022). DEARE remain an understudied area of radiation injury, with most knowledge gleaned from observing atomic bomb survivors and post-radiotherapy cancer survivors.
Gene expression for biodosimetry and effect prediction purposes: promises, pitfalls and future directions – key session ConRad 2021
Published in International Journal of Radiation Biology, 2022
Patrick Ostheim, Sally A. Amundson, Christophe Badie, Dimitry Bazyka, Angela C. Evans, Shanaz A. Ghandhi, Maria Gomolka, Milagrosa López Riego, Peter K. Rogan, Robert Terbrueggen, Gayle E. Woloschak, Frederic Zenhausern, Hanns L. Kaatsch, Simone Schüle, Reinhard Ullmann, Matthias Port, Michael Abend
Acute radiation syndrome (ARS) is caused by massive and sudden cell death and multiple radiation exposure characteristics (e.g. radiation quality, dose fractionation, dose rate, and partial/TBI) as well as biological processes (e.g. radiosensitivity, cell cycle dependency, and oxygenation) are known to contribute (Hall and Giaccia 2012). Examination of radiation-induced GE changes downstream of radiation exposure and upstream of the ARS event provide the basis of introducing radiation-related biomarkers for effect prediction (Abend and Port 2016; Port et al. 2018, 2021). Compared to dose estimation, this integrative approach appears more robust and easier to follow for clinicians, since GE changes are allocated to clinically defined ARS severity categories (see below) associated with certain treatment options.
A novel oral formulation of BIO 300 confers prophylactic radioprotection from acute radiation syndrome in mice
Published in International Journal of Radiation Biology, 2022
Vijay K. Singh, Oluseyi O. Fatanmi, Stephen Y. Wise, Alana Carpenter, Sara Nakamura-Peek, Artur A. Serebrenik, Michael D. Kaytor
Exposure to ionizing radiation due to a nuclear accident or incident may cause a spectrum of radiation syndromes known as acute radiation syndrome (ARS) (Gale et al. 2021). Radiation doses of 2 Gy or higher can lead to a multitude of tissue injuries resulting in various sub-syndromes of ARS such as hematopoietic, gastrointestinal, neurovascular, and cutaneous (Singh and Seed 2017). Hematopoietic ARS (H-ARS) in humans occurs following exposure to radiation doses of 2–6 Gy at a high dose rate and is characterized by the development of neutropenia, thrombocytopenia, and anemia. The hematopoietic system is particularly radiosensitive because stem and progenitor cells are actively dividing, increasing their susceptibility to DNA damage by radiation and free radicals generated by oxidative stress (Hall and Giaccia 2012; Heylmann et al. 2021). Surviving acute injury does not eliminate the risk of developing further radiation-induced health complications at a later date. The delayed effects of acute radiation exposure (DEARE) can manifest several months after the initial radiation exposure-induced injury and include a plethora of pathologies affecting multiple organs, particularly the lungs (DiCarlo et al. 2012; Unthank et al. 2015; MacVittie et al. 2019). DEARE-lung is characterized by a chronic inflammatory response to the initial radiological insult that progresses into potentially life-threatening pneumonitis and subsequent pulmonary fibrosis (Garofalo et al. 2014; Unthank et al. 2015).