Results 1 - 10 of 1892
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[en] The growing knowledge on nature and effects of ionizing radiations have allowed their use in a safety form in many countries for several decades. However, despite it, radiologic accidents are not an exception. The purpose of this paper is to offer an up-to-date information on the most important clinical aspects of the acute radiation syndrome (ARS) on which there are no case reports in Cuba. The ARS is produced if an individual has received an irradiation in the whole body, more or less uniform. In order to manage these patients it is necessary to consider some physical aspects such as type irradiation, if there is radioactive contamination, results of dosimetry and data on the accident. The clinical picture and hematologic examinations should be the main support of the physician for the classifying and evolutive evaluation of the patients. If it is necessary, studies of bone marrow should be included. Finally, physicoclinical correlation ought to be established with the elements of biologic dosimetry offered by the cytogenetic and biochemical studies. The therapeutical behaviour will depend on the type and conditions of the patient, his or her clinical evolution and, in particular, of the complications present in each case. 12 refs
[en] The prevention of complications of a disease through suitable medical (clinical) measures and the therapy of the complications as practised in haematological and oncological institutions for patients with severe haematopoietic insufficiency are effective means of dealing with serious forms of the radiation syndrome. Early medical differentiation of the victims of radiation accidents on the basis of prognostic criteria permits grouping according to the therapeutic requirements. The paper is above all concerned with those diagnostic procedures which are at the disposal of any physician. (DG)
[de]Die Praevention von Verlaufskomplikationen durch geeignete aerztliche (klinische) Massnahmen und die Therapie der Komplikationen, wie sie in haematologisch-onkologisch arbeitenden Einrichtungen fuer Patienten mit schwerer haemopoetischer Insuffizienz praktiziert werden, sind zur Behandlung schwerer Formen des Strahlensyndroms wirksam. Die fruehzeitige medizinische Differenzierung aufgrund prognostischer Kriterien erlaubt eine Gruppierung der Strahlenunfallopfer nach den Behandlungsbeduerfnissen. Im Vordergrund stehen diagnostische Verfahren, wie sie jedem Arzt zur Verfuegung stehen. (DG)
[en] Abdominal obesity with visceral fat accumulation have been known to be intimately associated with the development of metabolic syndrome. Therefore, it is important to estimate the precise amount of visceral fat. Ultrasonography has been reported that it is a simple and noninvasive method for visceral fat evaluation. Purpose of this study is to evaluate the association of ultrasonographic visceral fat thickness, anthropometric indexes, and risk factor of metabolic syndrome, and to investigate the cut-off value of abdominal visceral fat thickness leading to increased risk of metabolic syndrome. The subject included 200 men and 200 women who visited D healthcare center in Daejeon from January to April 2008. The subcutaneous fat thickness and visceral fat thickness were measured by ultrasonograph. As anthropometric index, we measured body mass index, waist circumference and waist/height ratio. As for the risk factor of metabolic syndrome, we measured blood pressure, high density lipoprotein cholesterol, triglyceride and fasting serum glucose. VFT was significantly correlated with waist circumference, (r=0.683/M, r=0.604/F), waist to height ratio (r=0.633/M, r=0.593/F) and BMI (r=0.621/M, r=0.534/F) in both men and women. In addition it was significantly correlated with Systolic blood pressure (r=0.229/M, r=0.232/F), Diastolic blood pressure ((r=0.285/M, r=0.254/F), high density cholesterol (r=-0.254/M, r=-0.254/F), Triglyceride (r=0.475/M, r=0.411/F), and Fasting blood sugar (r=0.158/M, r=0.234/F) in both men and women. The cut-off value of visceral fat thickness leading to the increased risk of metabolic syndrome was 4.58 cm (sensitivity 89.2%, specificity 71.2%) in men and 3.50 cm (sensitivity 61.2% specificity 80.8%) in women respectively. The odds ratio of the risk of metabolic syndrome was dramatically increased with the abdominal visceral fat thickness level over 6 cm in men and 5 cm in women. The visceral fat thickness using ultrasonography was significantly correlated with anthropometric indexes and risk factors of metabolic syndrome in both men and women. The cut-off value of visceral fat thickness leading to the increased risk of metabolic syndrome was 4.58 cm in men and 3.50 cm in women.
[en] Domperidone was administered to 95 patients with radiation sickness following radiotherapy for various cancers. The chest and the mediastinum were irradiated in 43 patients, the upper and lower abdomen in 40 patients, and the head, neck, and supraclavicular region in 12 patients. As to radiation source, x-ray was used for 46 patients, γ-ray for 41 patients, electron beam for 3 patients, and radiation source more than one were used for 5 patients. The dose given before the onset of radiation sickness totaled 3000 rad in 20 patients, 1000 rad -- 3000 rad in 41, and less than 1000 rad in 34. Domperidone was given to the patients one tablet (5 mg or 10 mg) P.O., 3 times per day before meals, for 1 -- 2 weeks. The overall effective rate of the drug was 68.4%. The 10 mg tablets were slightly more effective than the 5 mg ones. In the patients who were given the drug in a dose of 10 mg, the ameliorating rate of subjective symptoms was 68.1% for nausea, 88.9% for vomiting, 44.6% for anorexia, 17.5% for general fatigue, and 69.2% for dizziness. Laboratory findings showed no abnormal effects of the drug. One patient had itching with eruptions, which, however, was mild and disappeared immediately after withdrawal of the medication. (Ueda, J.)
[en] A high-casualty incident may result in a significant human toll due to the inability of a community to meet the health care demands of the population. A successful medical response requires health care facilities to not only communicate and integrate medical services, meet surge capacity, protect health care workers and implement triage and treatment protocols, but also to provide the venue for clinical management of acute radiation injuries and their associated infections. Today, clinical management is primarily guided by the recommendations of a Consultancy that were made at the World Health Organization (WHO). This international consensus was reached on evidence-based, clinical management of each of the four sub-syndromes that compose acute radiation syndrome (ARS), including the hematopoietic subsyndrome (HS), gastrointestinal subsyndrome (GIS), neurovascular subsyndrome (NVS) and cutaneous subsyndrome (CS). Major findings in studies meeting inclusion criteria for management strategies for HS were that (i) no randomized controlled studies of medical countermeasures have been (or will likely ever be) performed for ARS cases, (ii) the data for management of HS are restricted by the lack of comparator groups, and (iii) reports of countermeasures for management of injury to non-hematopoietic organs are often incompletely described. Here, (i) recommendations made in Geneva are summarized; (ii) the analysis of countermeasures for HS is updated by review of two additional cases and extended to published reports not meeting inclusion criteria; and (iii) guidelines are provided for management of microbial infections based upon patient risk for prolonged immunosuppression.