Early Dose Assessment in Criticality Accidents

Goans, Ronald E.; Holloway, Elizabeth; Berger, Mary Ellen; Ricks, Robert C.

doi:10.1097/00004032-200110000-00009

Cited by 87 publications

(51 citation statements)

References 4 publications

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“…The hematopoietic system is known to be the most radiosensitive system (Thoma and Wald 1959;Guskova and Baysogolov 1971;Wald 1998;Guskova et al 2001;Guskova 2001a;Selidovkin et al 2001;Goans et al 2001). Patterns of the peripheral blood counts (number of neutrophils, lymphocytes, platelets, and erythrocytes, L Ϫ1 ) were analyzed in Mayak PA workers with different degrees of severity of ARS starting with the initial pre-accidental level and extending through the first seven days after acute exposure.…”

Section: Resultsmentioning

confidence: 99%

Predictability of Acute Radiation Injury Severity

Azizova¹,

Osovets²,

Day

et al. 2008

Health Physics

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Results of dose-response analyses for different clinical symptoms of acute radiation syndrome (ARS) are reported here. The analyses were performed on dosimetric and clinical data from a group of ARS patients (59 cases) exposed to gamma and neutron or gamma radiation alone due to nuclear accidents at Mayak Production Association (Mayak PA). Findings suggested the possibility of prediction of injury severity within the first hours or days after acute exposure based on clinical symptoms and signs such as the onset of vomiting, neutrophil count abnormalities in the peripheral blood within the first 2-3 hours after acute exposure, and lymphocyte count abnormalities in the peripheral blood within the first 24-48 h after acute exposure.

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Section: Resultsmentioning

confidence: 99%

Predictability of Acute Radiation Injury Severity

Azizova¹,

Osovets²,

Day

et al. 2008

Health Physics

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“…Following radiation accidents or intentional exposure, it is critically important to estimate rapidly the level of exposure in (31). Microarray studies of exposed cell cultures have led to the discovery of GADD45 and CDKN1a as potential biomarkers of radiation exposure.…”

Section: Discussionmentioning

confidence: 99%

Discovering Clinical Biomarkers of Ionizing Radiation Exposure with Serum Proteomic Analysis

et al. 2006

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In this study, we sought to explore the merit of proteomic profiling strategies in patients with cancer before and during radiotherapy in an effort to discover clinical biomarkers of radiation exposure. Patients with a diagnosis of cancer provided informed consent for enrollment on a study permitting the collection of serum immediately before and during a course of radiation therapy. High-resolution surfaceenhanced laser desorption and ionization-time of flight (SELDI-TOF) mass spectrometry (MS) was used to generate high-throughput proteomic profiles of unfractionated serum samples using an immobilized metal ion-affinity chromatography nickel-affinity chip surface. Resultant proteomic profiles were analyzed for unique biomarker signatures using supervised classification techniques. MS-based protein identification was then done on pooled sera in an effort to begin to identify specific protein fragments that are altered with radiation exposure. Sixty-eight patients with a wide range of diagnoses and radiation treatment plans provided serum samples both before and during ionizing radiation exposure. Computer-based analyses of the SELDI protein spectra could distinguish unexposed from radiation-exposed patient samples with 91% to 100% sensitivity and 97% to 100% specificity using various classifier models. The method also showed an ability to distinguish high from low dose-volume levels of exposure with a sensitivity of 83% to 100% and specificity of 91% to 100%. Using direct identity techniques of albuminbound peptides, known to underpin the SELDI-TOF fingerprints, 23 protein fragments/peptides were uniquely detected in the radiation exposure group, including an interleukin-6 precursor protein. The composition of proteins in serum seems to change with ionizing radiation exposure. Proteomic analysis for the discovery of clinical biomarkers of radiation exposure warrants further study. (Cancer Res 2006; 66(3): 1844-50)

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“…If there is a significant decrease in lymphocytes in the first 6 to 48 hours, prolonged and intense medical treatment will likely be required (Table 4). 11 At dose levels greater than 30 Gy (3,000 rad) of whole-body penetrating radiation, the cardiovascular/central nervous system syndrome occurs primarily as a result of hypotension and cerebral edema. There is almost immediate nausea, vomiting, prostration, hypotension, ataxia, and convulsions.…”

Section: Whole-body Radiation Exposurementioning

confidence: 99%

Medical Treatment of Radiological Casualties: Current Concepts

Koenig¹,

Goans²,

Hatchett³

et al. 2005

Annals of Emergency Medicine

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176

156

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The threat of radiologic or nuclear terrorism is increasing, yet many physicians are unfamiliar with basic treatment principles for radiologic casualties. Patients may present for care after a covert radiation exposure, requiring an elevated level of suspicion by the physician. Traditional medical and surgical triage criteria should always take precedence over radiation exposure management or decontamination. External contamination from a radioactive cloud is easily evaluated using a simple Geiger-Muller counter and decontamination accomplished by prompt removal of clothing and traditional showering. Management of surgical conditions in the presence of persistent radioactive contamination should be dealt with in a conventional manner with health physics guidance. To be most effective in the medical management of a terrorist event involving high-level radiation, physicians should understand basic manifestations of the acute radiation syndrome, the available medical countermeasures, and the psychosocial implications of radiation incidents. Health policy considerations include stockpiling strategies, effective use of risk communications, and decisionmaking for shelter-in-place versus evacuation after a radiologic incident.

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Early Dose Assessment in Criticality Accidents

Cited by 87 publications

References 4 publications

Predictability of Acute Radiation Injury Severity

Predictability of Acute Radiation Injury Severity

Discovering Clinical Biomarkers of Ionizing Radiation Exposure with Serum Proteomic Analysis

Medical Treatment of Radiological Casualties: Current Concepts

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