Referred pain is frequently associated with misdiagnosis and unnecessary therapy directed to the pain location instead of its origin. When craniofacial pain is the sole symptom of myocardial ischemia, failure to recognize its cardiac source can endanger the patient. In particular, patients with acute myocardial infarction (AMI) who do not experience chest pain run a very high risk of misdiagnosis and death. Pain that is limited to the craniofacial region during myocardial ischemia has so far been described only in case reports and its overall prevalence is unknown. Experimental research in animals suggests a vagal involvement in the pathological mechanisms of cardiac pain referred to the face. The aim of this study was to gain knowledge about the prevalence, clinical characteristics and possible mechanisms of craniofacial pain of cardiac origin, in order to improve the clinician’s ability to make a correct diagnosis. It was hypothesized that the quality of craniofacial pain from cardiac versus dental origin would differ, implying a high diagnostic validity. It was also hypothesized that craniofacial pain can be the sole symptom of a prodromal (pre-infarction) angina episode and that this pain location would be especially associated with cardiac ischemia in the areas more densely innervated by vagal afferent fibres. The study group was comprised of consecutive patients who experienced craniofacial pain of a verified cardiac (n=326) or dental (n=359) origin. Demographic details on age, gender and pain characteristics (location, quality and intensity) were assessed in both groups. Cardiovascular risk factors, cardiac diagnosis and ECG signs of ischemia were also assessed in the cardiac pain group. Ethics approval and informed consent for each patient was obtained. Craniofacial pain was found to be the sole symptom of myocardial ischemia in 6% of patients and was the sole symptom of an AMI in 4% of patients; this craniofacial pain was more prevalent in women (p=0.031). In those patients without chest pain, it was the most frequent pain location and was the only symptom of prodromal angina in 5% of AMI patients. The craniofacial pain included the throat, the jaws, the temporomandibular joints/ears and the teeth, mainly bilaterally. The pain quality descriptors “pressure” and “burning” were statistically associated with pain of cardiac origin, while “throbbing” and “aching” were associated with an odontogenic cause (p<0.001). In myocardial ischemia patients, the occurrence of craniofacial pain was associated with an inferior localization of ischemia in the heart (p<0.001). In conclusion, this study showed that pain in the craniofacial region could be the sole symptom of cardiac ischemia and AMI, particularly in women. Craniofacial pain of cardiac origin was commonly bilateral, with the quality pain descriptors “pressure” and “burning”, and pain provocation with physical activity and pain relief at rest. The association between the presence of craniofacial pain and inferior wall ischemia suggests a vagal involvement in the mechanisms of cardiac pain referred to the craniofacial region. Since the possibility of misdiagnosis and death in this group of patients is high, awareness of this clinical presentation needs to be brought to the attention of researchers, clinicians and the general public.

Possible risks of using radioactive materials are a highly discussed topic nowadays. This work is dealing with this problem and it is focused on possible risks of using radioactive materials from the ex-treatment plant of uranium ores MAPE Mydlovary. In introductory chapters I am describing the current state of ex-treatment plant of uranium ores. I am dealing with the history of operation of MAPE, information about sludge lagoons and about stored sediments in them and other characteristics concerning this operation. For years, sediments in which radionuclides are contained have been stored in treatment plants and that is why I am dealing with ionizing radiation. Because the topic is the using of radioactive materials which can be used mainly by terrorists, I am also describing this worldwide phenomenon of recent years where I first of all focused on super-terrorism using radioactive weapons, namely so-called ?dirty bombs?. The target of this work is to find out possibilities of using radioactive materials from the ex-treatment plant. Therefore I measured values of radioactivity and exposition of radiation at some places with the help of exploratory research. That meant sampling of soils and water and also measurement of power of dose equivalent of radiation gamma. After gathering information of needed radiation values I carried out simulation of possible using of radioactive materials from the premises MAPE. By means of dirty bomb I used the programme TerEx at using radioactive material. Then I carried out several calculations which were focused on inhalation, ingestion or outdoor radiation from radioactive materials and also calculation how much it is necessary to gain a significant source of ionizing radiation. From these sources I have deduced impacts for individuals, society or environment. Based on analysis and evaluation of given problems, my set hypothesis ?By using radioactive materials from the ex-treatment plant of uranium ores MAPE Mydlovary a serious threat to people will not occur? was confirmed. Results of my work can be used as a study material for completing and broadening knowledge about risks resulting from using radioactive materials. Further an increase of foreknowledge and explanation of certain consequences of ionizing radiation on humans from materials from the ex-treatment plant of uranium ores MAPE Mydlovary, for inhabitants of Mydlovary and surrounding areas and also useful information for lay and professional society which is interested in these problems.

This thesis deals with the possibility of support of the integrated rescue system with assigned Army detachments. The theoretical part summarizes the transformation of the Ministry of Defence which had a major impact on the extent of the assistance provided. All rescue battalions were canceled and three engineer battalions and two separate rescue companies were created. Two rescue battalions were transformed into light motorized battalions and forwarded to the subordination of the Fourth and Seventh Mechanized Brigade. Organizational components of the ACR allocate a number of specialized teams for support intervening IRS. These include teams for ground and aerial radiation survey and decontamination detachments of people and technology, as well as some others, such as rescue detachment, detachment of transport humanitarian aid, a subunit of the earthwork, a subunit of the blasting and demolition, and more. Conditions requiring deployment of detachment vary according to the type of the assistance requested. They are primarily intended deployment Permanent Standby Force as planned assistance on request. This is the detachments in the central alarm plan and in accordance with the Act on the IRS ACR is required to provide such assistance. In providing assistance in dealing with radiological emergencies, ACR is equipped with a large number of devices, equipment and technologies. These are mainly radiometers, personal and group dosimeters. In the decontamination means is a habitat for decontamination of people and habitat for decontamination techniques LINE-82nd. The purpose of this thesis was to analyze whether the equipment ACR is still up-to-date with the times and that will be sufficient in comparison with similar Fire Rescue equipment. In the event of a radiation emergency is important to minimize the harmful effects of ionizing radiation on the population and the affected people. The lower limit of measurement was elected as the main comparing of the parameters measuring devices. In the case of decontamination of the equipment, attention was focused on the capacity of decontaminated people and technology. Carried out research revealed that earmarked detachments are equipped with measuring devices of varying ages and abilities. Some devices have been created at the time of the risk of nuclear war. This corresponds to their durable construction and a relatively high threshold, which is insufficient for the conditions solving a radiation accident in peaceful state. In addition, some of these instruments provide information and the measured value in the old, disused units, which can cause transmission of misleading information. Other devices are, however, modern, ergonomic, highly sensitive at low dose rate values, providing real-time information on the clear LCD display. Unique capabilities of the ACR give the possibility of performing aerial radiation survey, which greatly helps to keep the overview and assessment of future developments spread of radioactivity in the environment. The equipment ACR is quite outdated in the area of decontamination technology. Again, it originated at the time of the risk of nuclear war. The priority was a simple construction and operation, the ability of decontamination of large numbers of affected persons and equipment. However, there was practically no environmental solutions, separate showers for men and women and water consumption. On the other hand, the number of decontamination equipment of ACR virtually doubles the capacity of the firefighters equipment, which in terms of large accidental release of radioactive substances and decontaminated large number of people and technology is a distinct advantage. Overall, the Army units are able to qualitatively and quantitatively support the affecting IRS components and thus contribute significantly to dealing with radiological emergencies of any kind.

This diploma thesis deals with the analysis of preparedness of the Czech Republic for terrorist attack using radioactive material or source of ionizing radiation. The theoretical part of the thesis presents a basic introduction to the issue of terrorism, with a special emphasis on chemical, biological, radiological and nuclear terrorism, it describes the individual types of radiological weapons and represents the categorization of sources of ionizing radiation according to the International Atomic Energy Agency, together with radionuclides identified as potentially risky for terrorist abuse. The analysis in the research part was divided into several parts. It focuses independently on documentation that is being prepared in this area, on the exercise of the crisis management bodies and integrated rescue system units, which took place in several regions of Czech Republic, and on events related to the unauthorized use of radioactive material or sources of ionizing radiation. The last part of the research part is interviews with experts working in the field of preparedness of the Czech Republic for the risk of radiological terrorism. The purpose of the thesis was to collect information on how the Czech Republic is preparing for the risk of radiological terrorism and their subsequent evaluation through qualitative analysis. The results of this analysis show that Czech Republic is preparing for the risk of radiological terrorism in a way, that corresponds to the real risk. Conceptual and methodical materials are being elaborated in the subject area and exercises are carried out, which are attended both by the crisis management bodies and the integrated rescue system component. The technical and material equipment necessary for dealing with extraordinary event, that would arise due to radiological terrorism, is at perfect level. However, greater attention could be paid to the risk of abuse of the sources of ionizing radiation in the form of a radiological weapon of the RED kind (hidden emitter).

Cerebral angiography is radiological procedure to demonstrate areas of the vascular supply of the brain through the injection of a positive contrast where proper visualization of the blood stream is obtained. In this experiment, twenty adult dogs were submitted to a cerebral angiography. In the operation room, under general anesthesia, the left carotid artery was exposed and catheterized. The animals were then conducted to the Veterinary Radiological Sector for the cerebral angiography procedure. When good quality images where obtained, positive contrast was administrated and new x-rays were taken. The aim of this study was to evaluate this technique as a alternative radiographic technique in cases where alteration of the blood stream by occupying space such as may brain damages occure. The technique used was effective to obtain clear images, when determining the irrigation area of the brain. / A Angiografia Cerebral é um exame radiológico para demonstração da vascularização através da injeção de um meio de contraste positivo onde obtém-se adequada visualização do suprimento sangüíneo. Neste experimento vinte cães foram submetidos à Angiografia Cerebral, onde no bloco cirúrgico e sob anestesia geral, procedeu-se exposição e cateterização da artéria carótida comum esquerda. Os animais foram, então, conduzidos ao Setor de Radiologia Veterinária para realização do exame radiográfico simples e, após obtidas imagens satisfatórias, administrado o meio de contraste positivo, quando novas tomadas radiográficas foram realizadas. O objetivo foi avaliar a técnica como método complementar ao exame radiográfico simples, em casos de suspeita de alteração do fluxo sangüíneo, por lesões que ocupem espaço no cérebro, onde o primeiro não foi conclusivo. A técnica utilizada mostrou-se efetiva para a obtenção de imagens nítidas para determinação da área de irrigação sangüínea cerebral.

Les radiations sont omniprésentes. Elles ont de nombreuses applications dans des domaines variés: en médecine, elles permettent de réaliser des diagnostiques et de guérir des patients; en communication, tous les systèmes modernes utilisent des formes de rayonnements électromagnétiques; et en science, les chercheurs les utilisent pour découvrir la composition et la structure des matériaux, pour n'en nommer que quelques-unes. Concrètement, la radiation est un processus au cours duquel des particules ou des ondes voyagent à travers différents types de matériaux. La radiation peut être très énergétique, et aller jusqu'à casser les atomes de la matière ordinaire. Dans ce cas, on parlera de radiation ionisante. Il est communément admis que la radiation ionisante peut être bien plus nocif pour les êtres vivants que la radiation non ionisante. Dans cette dissertation, nous traiterons de la radiation ionisante. La radioactivité est le processus d'émission des radiations ionisantes. Elle existe sous forme naturelle, et est présente dans les sols, dans l'air et notre planète entière est bombardée en permanence de rayonnements cosmiques énergétiques. Depuis le début du XXe siècle, les chercheurs sont capables de créer artificiellement de la matière radioactive. Cette découverte a offert de multiples avancées technologiques, mais a eu également de lourdes conséquences pour l'humanité comme l'ont démontrés les évènements de Tchernobyl et de Fukushima ou d'autres accidents dans le monde médical. Cette dangerosité a conduit à l'élaboration d'un système de radioprotection. Dans la pratique, la radioprotection est principalement mise en œuvre en utilisant la méthode ALARA. Cette méthodologie consiste à justifier, optimiser et limiter les doses reçues. Elle est utilisée conjointement avec les limites légales. Le facteur d'optimisation est contraint par le fait que l'exposition volontaire d'un travailleur aux radiations lors d'une opération doit être plus bénéfique que si aucune intervention humaine n'était conduite dans une situation donnée. Dans le monde industriel et scientifique, il existe des infrastructures qui émettent des rayonnements ionisants. La plupart d'entre elles nécessitent des opérations de maintenance. Dans l'esprit du principe ALARA, ces interventions doivent être optimisées pour réduire l'exposition des travailleurs aux rayonnements ionisants. Cette optimisation ne peut pas être réalisée de manière automatique car la faisabilité des interventions nécessite dans tous les cas une évaluation humaine. La planification des interventions peut cependant être facilitée par des moyens techniques et scientifiques comme par exemple un outil informatique. Dans le contexte décrit ci-dessus, cette thèse regroupe des considérations techniques et scientifiques, et présente la méthodologie utilisée pour développer des outils logiciels pour la mise en œuvre de la radioprotection. / Radiation is omnipresent. It has many interesting applications: in medicine, where it allows curing and diagnosing patients; in communication, where modern communication systems make use of electromagnetic radiation; and in science, where it is used to discover the structure of materials; to name a few. Physically, radiation is a process in which particles or waves travel through any kind of material, usually air. Radiation can be very energetic, in which case it can break the atoms of ordinary matter (ionization). If this is the case, radiation is called ionizing. It is known that ionizing radiation can be far more harmful to living beings than non-ionizing radiation. In this dissertation, we are concerned with ionizing radiation. Naturally occurring ionizing radiation in the form of radioactivity is a most natural phenomenon. Almost everything is radioactive: there is radiation emerging from the soil, it is in the air, and the whole planet is constantly undergoing streams of energetic cosmic radiation. Since the beginning of the twentieth century, we are also able to artificially create radio-active matter. This has opened a lot of interesting technological opportunities, but has also given a tremendous responsibility to humanity, as the nuclear accidents in Chernobyl and Fukushima, and various accidents in the medical world have made clear. This has led to the elaboration of a radiological protection system. In practice, the radiological protection system is mostly implemented using a methodology that is indicated with the acronym ALARA: As Low As Reasonably Achievable. This methodology consists of justifying, optimizing and limiting the radiation dose received. This methodology is applied in conjunction with the legal limits. The word "reasonably" means that the optimization of radiation exposure has to be seen in context. The optimization is constrained by the fact that the positive effects of an operation might surpass the negative effects caused by the radiation. Several industrial and scientific procedures give rise to facilities with ionizing radiation. Most technical and scientific facilities also need maintenance operations. In the spirit of ALARA, these interventions need to be optimized in terms of the exposure of the maintenace workers to ionizing radiation. This optimization cannot be automated since the feasibility of the intervention tasks requires human assessment. The intervention planning could however be facilitated by technical-scientific means, e.g. software tools. In the context sketched above, this thesis provides technical-scientific considerations and the development of technical-scientific methodologies and software tools for the implementation of radiation protection.In particular, this thesis addresses the need for an interactive visual intervention planning tool in the context of high energy particle accelerator facilities.

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A manutenção dos níveis de dose abaixo dos limites exigidos pelas normas nacionais e internacionais é essencial em todas as aplicações das radiações ionizantes. Os níveis de restrição de dose no Brasil são estabelecidos utilizando a grandeza equivalente de dose ambiente, H* (10) e na prática de levantamentos radiométricos, os níveis de radiação são calculados por meio de medições com câmaras de ionização utilizando a grandeza kerma no ar convertidas para equivalente de dose ambiente por urn coeficiente constante. 0 presente trabalho tern por objetivo o estudo experimental das relações entre kerma no ar e a grandeza operacional equivalente de dose ambiente, pela medição de feixes de raios X transmitidos através de materiais utilizados em salas radiológicas dedicadas à exames de tórax. Uma metodologia experimental, baseada em técnicas de espectroscopia, foi desenvolvida para a medição dos espectros de raios X. Com os resultados, as estimativas da grandeza equivalente de dose ambiente, obtidas através de coeficientes de conversão entre o kerma no ar e esta grandeza, tornam-se mais realistas por levar em consideração as alterações espectrais decorrentes da atenuação dos feixes primários por objetos simuladores antropomórficos e por diferentes materiais atenuadores. Foi encontrada uma diferença máxima de 53,52% entre esses coeficientes e aquele adotado no Brasil por meio da ANVISA (1,14 Sv/Gy), o que indica uma subestimação desse valor. 0 comportamento espectral dos feixes de raios X transmitidos por barreiras primárias e atenuadores presentes em procedimentos radiológicos apresentou influencia sobre resultados relacionados a levantamentos radiométricos e procedimento de cálculos de barreiras. / The maintenance of dose levels below the limits required by national and international standards are essential in all applications of ionizing radiation. The dose constrains levels in Brazil are established in terms of the quantity ambient dose equivalent, H*(10), while the radiation levels in radiometric surveys are calculated by means of measurements with ion chambers using the quantity air-kerma converted to ambient dose equivalent by a constant factor. The present work aims the experimental study of the relationship between the air­ kerma and the operational quantity ambient dose equivalent, by measuring X-ray beams transmitted through materials used in dedicated chest radiographic facility. An experimental methodology, based on spectroscopic techniques was developed for the X-ray spectra measurements. With the results, estimates of ambient dose equivalent quantity through conversion factors between this quantity and the air-kerma, become more realistic by taking into account the spectral changes resulting from the attenuation of primary beams by anthropomorphic phantoms and different attenuating materials. The maximum difference founded between these coefficients and the one adopted in Brazil by ANVISA (1.14 Sv I Gy) was 53.52%, which indicates underestimation of the value. The spectral behavior of the X-ray beam transmitted by primary barriers and attenuators present in radiological procedures presented influences on results related to radiometric surveys and procedure calculations barriers.

Made available in DSpace on 2018-06-27T18:56:32Z (GMT). No. of bitstreams: 2 Marcel Zago Botelho.pdf: 6878925 bytes, checksum: 22ad774a47cc0769a99676eb64ea10fe (MD5) Marcel Zago Botelho.pdf.jpg: 3401 bytes, checksum: 2e13d66eded5ce0245644489e795b21f (MD5) Previous issue date: 2009-03-30 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The aim of this study is to evaluate the attenuation properties of the nanocomposites in the energy range between 20 and 120 keV. In order to evaluate the efficiency of nanostructured materials in the attenuation of radiation the results will be compared to data obtained with the same material in the non-nanostructured form. The nanostructured materials are characterized by having a size of crystallites less than 100nm, and shows different properties with respect to conventional materials. The nanocomposites used in this study were produced through the aggregation of nanoparticles of copper oxide (CuO) and zinc oxide (ZnO) to beeswax. The concentration of nanoparticles in the composite was varied between 5% and 10%. For comparison purpose the copper oxide and zinc oxide in a non-aggregated nanoparticles were also agregated in a nonnanoparticulated form to beeswax in the same proportion as for nanostructured materials. Samples were produced with dimensions 10 cm x 10 cm and 2 mm in thicknesses. The attenuation properties of the samples produced were evaluated at high energy X-ray beams, emmited by a X-ray equipment used in conventional radiology, and the low energy x-ray beams are produced by a clinical mammography equipment. The air kerma values, for different material thicknesses, were measured with an ionization chamber for x-ray beam produced at 60 kV and 102 kV. Results shows that the attenuation provided by the copper oxide is slighly higher for the nanoestrured materials compared with for the non-nanoestrutured ones. In the case of the zinc oxide, the material in the non-nanometric form shows an increasing of the attenuation relative to the nanoparticulates ones. In the mammography energy range the study was carried out for beams generated at 22, 26 and 30 kV. It is observed that the copper oxide in nanometric structure attenuate at about 23% more radiation than the same material in the non-nanoparticulate form. In the case of the zinc oxide the attenuation is higher at about 7% for the material in the non-nanometric form. This study suggest that nanostructured materials show great potential for application in radiological protection, because it can be easily incorporated into different compounds allowing the development of new materials for use in radiological protection. / Este estudo tem por objetivo determinar as propriedades de atenuação de nanocompósitos na faixa de energia entre 20 e 120 keV. Com o propósito de avaliar a eficiência dos materiais nanoestruturados na atenuação da radiação os resultados obtidos serão comparados aos dados obtidos com o mesmo material na forma não-nanoestruturada. Os materiais nanoestruturados são caracterizados por terem um tamanho de cristalito inferior a 100nm e apresentar propriedades diferenciadas em relação aos materiais convencionais. Os nanocompósitos utilizados neste trabalho foram obtidos a partir da agregação de nanopartículas de óxido de cobre (CuO) e óxido de zinco (ZnO) a cera de abelha alvejada. A concentração de nanopartículas nos compostos foi variada entre 5% e 10%. Para fins de comparação, o óxido de cobre e o óxido de zinco, na forma nãonanoparticulada também foram agregados na mesma proporção que os materiais nanoestruturados a cera de abelha alvejada. Foram produzidas amostras com dimensões 10 cm x 10 cm e 2 mm de espessura. As propriedades de atenuação destas amostras foram avaliadas em feixes de raios X produzidos por um equipamento de radiologia convencional, e por um equipamento clínico de mamografia. Na região de radiologia convencional foram realizadas medições de kerma no ar para diferentes espessuras de material para feixes de raios X gerados nas tensões de 60 e 102 kV. Os resultados obtidos mostraram uma leve tendência de maior atenuação da radiação pelo o óxido de cobre na forma nanométrica que o óxido de cobre na forma não-nanométrica. Observou-se uma tendência de maior atenuação pelo óxido de zinco na forma não-nanoparticulada. A atenuação da radiação para feixes de mamografia foi avaliada nas tensões de 22, 26 e 30 kV. Os dados obtidos mostraram que para o óxido de cobre na forma nanométrica a atenuação da radiação é maior em até 23% com relação às estruturas na forma não-nanométrica. Para o óxido de zinco a atenuação para o material não-nanométrico foi superior em até 7% relativo às estruturas na forma nanométrica. Os resultados obtidos neste trabalho sugerem que os materiais nanoestruturados mostram um grande potencial para aplicação em proteção radiológica, pois podem ser facilmente incorporados a diferentes compostos possibilitando o desenvolvimento de novos materiais.

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