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Ionizing Radiation Injury

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  1. Ionizing radiation occurs as electromagnetic waves of extremely short wavelength and as accelerated atomic particles
  2. Etiology
  3. Incidence, Prevalence, and Epidemiology
  4. Pathogenesis
  5. Clinical Manifestations
  6. Skin
  7. Bone marrow and lymphoid tissue
  8. Intestine
  9. Respiratory tract
  10. Whole body radiation injury
  11. Localized or regional radiation injury
  12. Diagnosis
  13. Treatment

Ionizing radiation occurs as electromagnetic waves of extremely short wavelength and as accelerated atomic particles (e.g., electrons, protons, neutrons, a-particles). The injuries caused by ionizing radiation include mutagenic, carcinogenic, and teratogenic effects and various acute and chronic tissue reactions, such as erythema, cataract of the lens, sterility, and depression of hematopoiesis.

[...] HERITABLE (GENETIC) EFFECTS OF RADIATION On the basis of the existing evidence, it is inferred that a dose of at least 1 Sv is required to double the rate of heritable mutations in human germ cells and that, consequently, less than of all genetically determined disease is attributable to natural background irradiation. CARCINOGENIC EFFECTS OF RADIATION Many but not all types of benign and malignant growths have been observed to be inducible by irradiation; however, the induced growths characteristically take years or decades to appear and possess no features to distinguish them from growths arising through other causes. [...]

[...] Clinical Manifestations Ionizing radiation injuries encompass a diversity of tissue reactions that vary markedly in dose-response relationships, manifestations, timing, and prognosis. Except for mutagenic and carcinogenic effects, the reactions generally result from the killing of sizable numbers of cells in the exposed tissues and are not detectable unless the dose of radiation exceeds a substantial threshold. Clinical Manifestations For this reason, the reactions are called nonstochastic (or deterministic) effects, in contrast to mutagenic and carcinogenic effects, which are presumed to have no thresholds and are considered to be stochastic in nature. [...]

[...] Although recovery is the rule after minor, acute reactions, delayed reactions tend to be irreversible and progressive. Recommendations Because the mutagenic and carcinogenic effects of ionizing radiation may have no thresholds, unnecessary exposure should be avoided, and any doses to radiation workers and patients should be kept as low as reasonably achievable, with particular care that they not exceed the relevant maximum permissible doses (e.g mSv/year occupational whole body radiation). Recommendations Facilities using radiation or radiation sources should be designed and equipped appropriately and should provide specialized training and supervision for all workers [...]

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