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Medical Therapy of Patients Contaminated with Radioactive Cesium or Iodine

Research Department, Innlandet Hospital Trust, 2381 Brumunddal, Norway
IM Sechenov First Moscow State Medical University (Sechenov University), 119146 Moscow, Russia
Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, 09042 Monserrato-Cagliari, Italy
Department of Science, Systems and Models, Roskilde University, 4000 Roskilde, Denmark
Author to whom correspondence should be addressed.
Biomolecules 2019, 9(12), 856;
Received: 27 October 2019 / Revised: 6 December 2019 / Accepted: 9 December 2019 / Published: 11 December 2019
(This article belongs to the Special Issue Toxic and Essential Metals in Human Health and Disease)
Follow-up studies after the Chernobyl and Fukushima accidents have shown that 137Cs and 131I made up the major amount of harmful contaminants in the atmospheric dispersion and fallout. Other potential sources for such radionuclide exposure may be terrorist attacks, e.g., via contamination of drinking water reservoirs. A primary purpose of radionuclide mobilization is to minimize the radiation dose. Rapid initiation of treatment of poisoned patients is imperative after a contaminating event. Internal contamination with radioactive material can expose patients to prolonged radiation, thus leading to short- and long-term clinical consequences. After the patient’s emergency conditions are addressed, the treating physicians and assisting experts should assess the amount of radioactive material that has been internalized. This evaluation should include estimation of the radiation dose that is delivered and the specific radionuclides inside the body. These complex assessments warrant the reliance on a multidisciplinary approach that incorporates regional experts in radiation medicine and emergencies. Regional hospitals should have elaborated strategies for the handling of radiation emergencies. If radioactive cesium is a significant pollutant, Prussian blue is the approved antidote for internal detoxification. Upon risks of radioiodine exposure, prophylactic or immediate treatment with potassium iodide tablets is recommended. Chelators developed from calcium salts have been studied for gastrointestinal trapping and enhanced mobilization after strontium exposure. View Full-Text
Keywords: cesium; radioactive terrorism; radiation dosage; chelation therapy; iodine; strontium; Prussian blue cesium; radioactive terrorism; radiation dosage; chelation therapy; iodine; strontium; Prussian blue
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MDPI and ACS Style

Aaseth, J.; Nurchi, V.M.; Andersen, O. Medical Therapy of Patients Contaminated with Radioactive Cesium or Iodine. Biomolecules 2019, 9, 856.

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