RESUMO
CASE PRESENTATION: A 34-year-old man presented to a community hospital with sudden-onset pleuritic chest pain on a background of a 12-month indolent history of progressive exertional dyspnea. He denied cough, fevers, night sweats, or weight loss. He reported some low back pain and ache. He had a history of gastroesophageal reflux and was a current smoker with a 20-pack year history. There were no known occupational or environmental exposures and there was no family history of any lung disease.
Assuntos
Osso e Ossos , Quilotórax , Pneumopatias/congênito , Linfangiectasia/congênito , Dor Musculoesquelética , Pleura , Derrame Pleural , Sirolimo/administração & dosagem , Toracentese/métodos , Adulto , Antibióticos Antineoplásicos/administração & dosagem , Biópsia , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/patologia , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Quilotórax/diagnóstico , Quilotórax/etiologia , Quilotórax/fisiopatologia , Diagnóstico Diferencial , Humanos , Imuno-Histoquímica , Pneumopatias/complicações , Pneumopatias/diagnóstico , Pneumopatias/fisiopatologia , Pneumopatias/terapia , Linfangiectasia/complicações , Linfangiectasia/diagnóstico , Linfangiectasia/fisiopatologia , Linfangiectasia/terapia , Masculino , Dor Musculoesquelética/diagnóstico , Dor Musculoesquelética/etiologia , Pleura/diagnóstico por imagem , Pleura/patologia , Derrame Pleural/diagnóstico , Derrame Pleural/etiologia , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoRESUMO
METHODS: Dose rates from 30 patients, treated over a 3-year period (2016-2018) were measured post therapy in contact with the patients' upper abdomen and at distances of 0.3â¯m and 1â¯m. Dose rates were compared with theoretical predictions and used as model inputs for calculating radiation doses received by family members and carers based on interaction patterns previously described in the literature. RESULTS: The average dose rate per activity from SIRT patients were:- In contact: 29⯱â¯23⯵Sv.h-1.GBq-1; 0.3â¯m: 4.1⯱â¯2.34⯵Sv.h-1.GBq-1 and 1â¯m: 0.59⯱â¯0.42⯵Sv.h-1.GBq-1. Dose rates measured at 0.3 and 1â¯m followed a predictable distribution. Estimated doses based on proximity models demonstrated restrictions to be advisable, depending on the administered activity, considering the dose constraint and limit of 0.3 and 1â¯mSv, respectively, employed within the EU. CONCLUSIONS: In accordance with local dose constraints, and depending on administered activities, radiation protection precautions may be necessary for those individuals in regular contact with patients who have receive 90Y SIRT. A radiation protection precautions calculator has been devised to offer personalised instructions taking into account the administered activity and proximity models.
