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Medical management of acute radiation syndrome and associated infections in a high-casualty incident

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 he...

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Autor principal: Dainiak, Nicholas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5941165/
https://www.ncbi.nlm.nih.gov/pubmed/29509947
http://dx.doi.org/10.1093/jrr/rry004
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author Dainiak, Nicholas
author_facet Dainiak, Nicholas
author_sort Dainiak, Nicholas
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description 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.
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spelling pubmed-59411652018-05-15 Medical management of acute radiation syndrome and associated infections in a high-casualty incident Dainiak, Nicholas J Radiat Res Supplement Paper 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. Oxford University Press 2018-04 2018-03-02 /pmc/articles/PMC5941165/ /pubmed/29509947 http://dx.doi.org/10.1093/jrr/rry004 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Supplement Paper
Dainiak, Nicholas
Medical management of acute radiation syndrome and associated infections in a high-casualty incident
title Medical management of acute radiation syndrome and associated infections in a high-casualty incident
title_full Medical management of acute radiation syndrome and associated infections in a high-casualty incident
title_fullStr Medical management of acute radiation syndrome and associated infections in a high-casualty incident
title_full_unstemmed Medical management of acute radiation syndrome and associated infections in a high-casualty incident
title_short Medical management of acute radiation syndrome and associated infections in a high-casualty incident
title_sort medical management of acute radiation syndrome and associated infections in a high-casualty incident
topic Supplement Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5941165/
https://www.ncbi.nlm.nih.gov/pubmed/29509947
http://dx.doi.org/10.1093/jrr/rry004
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