Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-08-07T14:15:11Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Tese doutorado Keyla Mendonça.pdf: 1892604 bytes, checksum: 11d46f4a20b26b6f0556122ab34f0316 (MD5) / Made available in DSpace on 2017-08-07T14:15:12Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Tese doutorado Keyla Mendonça.pdf: 1892604 bytes, checksum: 11d46f4a20b26b6f0556122ab34f0316 (MD5) Previous issue date: 2016-08-05 / CNPQ / A radioiodoterapia (RIT) para hipertireoidismo é feita ambulatorialmente há cerca de 70 anos, com poucas restrições quanto à segurança radiológica dos familiares de convívio domiciliar. Diante disso, o objetivo do estudo foi avaliar o impacto radiológico da RIT para hipertireoidismo por meio de levantamento das exposições no ambiente domiciliar destes pacientes nos primeiros seis dias pós-tratamento, para servir como um parâmetro real na tomada de decisões relacionadas com a conduta terapêutica e estabelecimento de novas recomendações práticas e seguras desta terapia. Dosímetros termoluminescentes TLD-100 foram colocados nos acompanhantes e nos ambientes domiciliares de 25 pacientes hipertireóideos tratados com atividades de 555 MBq (n=9), 740 MBq (n=7) e 1110 MBq (n=9). Além disso, foram verificadas as contaminações superficiais de objetos e materiais desses pacientes. As doses efetivas obtidas por meio dos TLDs-100 foram de 0,9 mSv, 0,6 mSv e 0,2 mSv, para atividades administradas de 555 MBq, 740 MBq e 1110 MBq, respectivamente. Os valores médios de equivalente de dose ambiental dos locais mais frequentados dos pacientes, como quarto, cozinha, banheiro e sala foram de: 2,11; 0,15; 0,20 e 0,44 mSv, respectivamente. A monitoração de objetos e materiais de âmbito domiciliar para cada grupo de atividade 555, 740 e 1110 MBq variaram de valores indetectáveis até próximos a 150 Bq.cm-2. No Brasil, a norma 3.05 da Comissão Nacional de Energia Nuclear estabelece que pacientes tratados com 131I possam realizar terapia com atividades até 1850 MBq, em regime ambulatorial, sem nenhuma restrição de isolamento. Além disso, a norma 3.01da Comissão nacional de energia Nuclear estabelece os limites de dose efetiva para indivíduos do público e acompanhantes/voluntários, como sendo de 1 mSv e 5 mSv por ano, respectivamente. Comparando a população estudada com a norma vigente, apenas duas acompanhantes de pacientes ultrapassaram o limite estabelecido. Pressupõe-se que o contato físico próximo e constante delas aos pacientes, em consequência da exiguidade do espaço domiciliar, resultou nessas doses efetivas. Conclui-se que o tratamento do hipertireoidismo em regime ambulatorial com atividades de até 1.110 MBq, foi realizado de forma segura e forneceu informações úteis sobre a proteção e exposição dos familiares e acompanhantes de pacientes. / The radioiodine therapy (RIT) for hyperthyroidism is done on an outpatient basis for about 70 years, with few restrictions on radiological safety of household living family. Thus, the objective of the study was to evaluate the radiological impact of RIT for hyperthyroidism through survey of exposures in the home environment of these patients in the first six days after treatment, to serve as an actual parameter in making decisions related to the therapeutic approach and establishment of new practices and safe recommendations of this therapy. TLD-100 thermoluminescent dosimeters were placed in the accompanying domestic environments and 25 hyperthyroid patients treated with 555 MBq Activity (n = 9), 740 MBq (n = 7) and 1110 MBq (n = 9). Furthermore, the surface contamination of objects and materials of these patients were checked. The effective doses obtained through the TLDs-100 were 0.9 mSv 0.6 mSv and 0.2 mSv for administered activity of 555 MBq 740 MBq and 1110 MBq, respectively. The average values of ambient dose equivalent of the busiest places of the patients, such as bedroom, kitchen, bathroom and living room were: 2,11; 0.15; 0.20 and 0.44 mSv, respectively. Monitoring objects and home environment of materials for each activity group 555, 740 and 1110 MBq ranged from undetectable to near 150 Bq.cm-2. In Brazil, the standard 3:05 of the National Nuclear Energy Commission established that patients treated with 131I can perform therapy activities up to 1850 MBq, in an outpatient setting, without any isolation restriction. In addition, the standard 3.01da National Nuclear Energy Commission shall establish the effective dose limits for individuals from the public and chaperones / volunteers, as of 1 mSv to 5 mSv per year, respectively. Comparing the study population with the current regulations, only two companions of patients exceeded the limit. It is assumed that the close physical contact and constant them to patients as a result of the paucity of home space, resulted in these effective doses. We conclude that treatment of hyperthyroidism on an outpatient basis with up to 1,110 MBq activities was carried out safely and provided useful information on the protection and exposure of family members and patients companions.

The aim of my thesis was to evaluate radiation consequences in patients, and to evaluate unusual occurrences stemming from radiation at the department of nuclear medicine in hospital Ceske Budejovice. In the theory part, I worked with professional literature, applicable laws and internal documentation provided by the department of nuclear medicine in hospital Ceske Budejovice Plc The thesis reacted to the need of the department of nuclear medicine (dept. NM) in hospital Ceske Budejovice to evaluate the optimisation of doses for the patients and set local diagnostic levels. Different organisations worldwide deal with the question of optimising radiation protection, and their recommendations and standards are used in the Czech Republic. For this purpose, it is necessary to know the real activity of radiopharmaceuticals applied in each examination and to conduct a forecast resulting in effective doses also based on CT scans. The thesis also evaluates the occurrence of special radiation events really experienced at the department of NM (nuclear medicine) in the hospital mentioned above, the reasons for these events happening and precautions preventing them from happening in future. The owner of the permission for this activity, meaning the use of the source of ionizing radiation, has the duty to keep all documentation and paperwork in accordance with the law regulating nuclear power, abide by the rules of good practices and the real state of allowed practice. The occurrence of unusual events is closely connected with the documentation - internal emergency plan and monitoring program. (Law 263/2016) Therefore, it was recommended to compare these to the actual state and to review them based on the facts found. The values of applied activities and effective doses found were compared to the values published in the last report from UNSCEAR in 2016 and national referential values published in the bill about radiation protection no 422/ 2016. All results were inputted into tables and graphs. It was found that the applied activities at the department of NM in hospital Ceske Budejovice are in agreement with the values presented in UNSCEAR report and that they are lower than the national referential levels, which shows that there is optimised state of radiation protection for patients. The occurrence of concrete unusual radiation events at the department of NM in hospital Ceske Budejovice and their analysis revealed certain shortcomings in the process and the absence of security elements needed while holding radioactive liquid waste in storage at the hospital. It was necessary to find and implement such precautions, which will prevent similar type of events in future. The thesis will be handed in to the person tending to the radiation protection for the use of evaluation and providing the protection at the department of NM at the hospital Ceske Budejovice and to enable the documentation to be completed for the allowed activity.