National Radon Action Plans in Europe and Need of Effectiveness Indicators: An Overview of HERCA Activities.

Protection of the population and of workers from exposure to radon is a unique challenge in radiation protection. Many coordinated actions and a variety of expertise are needed. Initially, a National Radon Action Plan (NRAP) has been developed and implemented by some countries, while it is currently recommended by international organizations (e.g., World Health Organization) and required by international regulations, such as the European Council Directive 2013/59/Euratom and the International Basic Safety Standards on Radiation Protection and Safety of Radiation Sources, cosponsored by eight international organizations. Within this framework, the Heads of the European Radiological Protection Competent Authorities (HERCA) have organized activities aimed at sharing experiences to contribute toward the development and implementation of effective NRAPs. Two workshops were held in 2014 and 2015, the latter on radon in workplaces. As a follow-up to these, an online event took place in March 2021, and a second specific workshop on NRAP is planned for June 2022. These workshops were attended by experts from the competent authorities of European countries, relevant national and international organizations. The experience of several countries and the outcomes from these workshops have highlighted the need for adequate indicators of the effectiveness and progress of the actions of NRAPs, which could also be useful to implement the principle of optimization and the graded approach in NRAPs. In this paper, the activities of HERCA to support the development and implementation of effective NRAPs are described and some examples of effectiveness indicators are reported, including those already included in the NRAP of some European countries.

Indeterminate leprosy and lepromatous index case: four cases in the same family.

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, which primarily affects the skin and peripheral nerves. Brazil remains as the country with the second largest number of cases in the world. We report the case of three patients diagnosed with indeterminate leprosy in the same family. Two patients were HIV positive. An active search led to the discovery of the index case. It was crucial to persist in the search of the index case. This report shows how important it is to teach physicians and the general population about the signs and symptoms of leprosy. Early diagnosis and treatment are necessary to prevent sequelae and to eliminate the disease as a public health problem.

Indeterminate leprosy and lepromatous index case: four cases in the same family / Hanseniase indeterminada e caso indice virchowiano: 4 casos na mesma familia

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, which primarily affects the skin and peripheral nerves. Brazil remains as the country with the second largest number of cases in the world. We report the case of three patients diagnosed with indeterminate leprosy in the same family. Two patients were HIV positive. An active search led to the discovery of the index case. It was crucial to persist in the search of the index case. This report shows how important it is to teach physicians and the general population about the signs and symptoms of leprosy. Early diagnosis and treatment are necessary to prevent sequelae and to eliminate the disease as a public health problem.

A hanseníase é uma doença infecciosa crônica causada pelo Mycobacterium leprae, que afeta principalmente a pele e nervos periféricos. O Brasil continua sendo o segundo país do mundo com maior número de casos. Aqui relatamos três pacientes diagnosticados com hanseníase indeterminada, pertencentes à mesma família, cuja busca ativa levou à descoberta do caso índice. Dois pacientes eram HIV positivos. Foi de imensa importância a insistência na procura pelo caso índice. Este relato ilustra a importância do ensino sobre sinais e sintomas de hanseníase na formação médica e à população. O pronto reconhecimento e tratamento são necessários para prevenir sequelas e eliminar a doença como problema de saúde pública.

Radon ((222)Rn) concentration in indoor air near the coal mining area of Nui Beo, North of Vietnam.

Concentrations of radioactive radon gas ((222)Rn) were measured using passive monitors based on LR115 solid state track detectors during June-July 2010 in indoor air of dwellings in the Nui Beo coal mining area, mostly in Cam Pha and Ha Long coastal towns, Quang Ninh province, in the North of Vietnam. Global results of (222)Rn concentrations indoors varied from ≤6 to 145 Bq m(-3) averaging 46 ± 26 Bq m(-3) (n = 37), with a median value of 47 Bq m(-3). This was similar to outdoor (222)Rn concentrations in the region, averaging 43 ± 19 Bq m(-3) (n = 10), with a median value of 44 Bq m(-3). Indoor (222)Rn concentrations in the coastal town dwellings only were in average lower although not significantly different from indoor (222)Rn concentrations measured at the coal storage field near the harbor, 67 ± 4 Bq m(-3) (n = 3). Furthermore, there was no significant difference in the average (222)Rn concentration in indoor air measured in the coastal towns region and those at the touristic Tuan Chau Island located about 45 km south of the coal mine, in the Ha Long Bay. The indoor (222)Rn concentration in a floating house at the Bai Tu Long Bay, and assumed as the best estimate of the baseline (222)Rn in surface air, was 27 ± 3 Bq m(-3) (n = 3). Indoor average concentration of (222)Rn in dwellings at the Ha Noi city, inland and outside the coal mining area, was determined at 30 Bq m(-3). These results suggest that (222)Rn exhalation from the ground at the Nui Beo coal mining area may have contributed to generally increase (222)Rn concentration in the surface air of that region up to 1.7 times above the baseline value measured at the Bai Tu Long Bay and Ha Noi. The average indoor concentration of (222)Rn in Cam Pha-Ha Long area is about one-third of the value of the so-called Action Level set up by the US EPA of 148 Bq m(-3). Results suggest that there is no significant public health risk from (222)Rn exposure in the study region.

Hanseníase virchowiana históide de Wade: relato de três casos / Virchowian histoid leprosy of Wade: three cases report

Os autores descrevem três casos, não familiares, de acidentes com lesões nodulares na pele, características de hanseníase históide; de evolução crônica, principalmente da região extensora dos membros inferiores. Lesões estas que se assemelham a dermatofibromas. A avaliação clínica e histopatológica permitiram o diagnóstico de Hanseníase Virchowiana Históide de Wade. Tais relatos justificam-se pela raridade dos casos...

Case for diagnosis

Paciente de 29 anos, sexo masculino, branco, servente, natural e procedente de Palhoça, SC. Queixando-se de lesões de pele no tronco e membros há aproximadamente seis meses. Nega história de lesões semelhantes na família. Usa fenobarbital por epilepsia há, aproximadamente, 22 anos. Ao exame dermatológico, apresentava lesões papulonodulares eritematosas, de consistência endurecida, não dolorosa, variando de aproximadamente 0,5 a 2cm de diâmetro, com predomínio na região extensora dos membros inferiores. Realizada investigação laboratorial, biópsia de uma lesão com punch

Talidomida: indicaçöes e legislaçäo vigente / Thalidomide: indications and actual legislation

A talidomida, droga que tem ampla aplicaçäo clínica e potentes efeitos antiinflamatórios, qualifica-se como primeira escolha para tratamento de várias doenças. Seu efeito teratogênico, entretanto, limita seu uso clínico. Baseando-se neses conhecimentos, após estudo detalhado de cada um de seus efeitos, e avaliando-se cuidadosamente o risco/benefício de seu emprego, pretende-se indicar a talidomida para algumas situaçöes clínicas já bem estabelecidas. Säo elas: eritema nodoso hansênico, lúpus eritematoso discóide, estomatite aftosa recorrente, doença enxerto-verus-hospedeiro em sua fase crônica, úlceras dolorosas de mucosas em pacientes com HIV/Aids, prurigo nodular, síndrome de Behçet e prurigo actínico. A essas somam-se outras, em que seu uso só deve se indicado se outras drogas resultarem ineficazes. Complementando a avaliaçäo, foram consideradas as situaçöes nas quais a talidomida poderia ser eficaz, necessitando de estudo prévio das características da doença e do paciente para que se efetive sua utilizaçäo. O uso da talidomida deve sempre obedecer às portarias do Ministério da Saúde que regulamentam sua fabricaçäo, indicaçöes e dispensäo. Os principais pontos dessa legislaçäo seräo destacados, em especial a proibiçäo para uso em mulheres em idade fértil.