CADORmed: a tool for internal dose assessment.

CADORmed is a free bespoke Excel® tool for committed effective dose assessment using latest dose coefficients from ICRP OIR publications. The field of application of CADORmed is special monitoring, and it is not available for the dose assessment of chronic exposure. Calculations are made according to EURADOS guidelines and principles (EURADOS report 2013-1). The Chi-squared test for the goodness of fit is made with a scattering factor for type A and type B errors according to the EURADOS report. The Intake is calculated with the maximum likelihood method. Measurements that are below the detection limit are incorporated by the use of an allocated value equal to one-half or one-quarter of the detection limit. The Identification of rogue data can easily be achieved. Advanced options may also be used: mixed ingestion and inhalation, mixture of default absorption types, correction for DTPA treatment, calculation with a new intake and adjustment when the date of intake are unknown. The validation of the tool has been included in the work plan of EURADOS WG 7. The validation plan has been defined and the validation tests completed. All changes are traced in a Quality Assurance document.

Bioassay and alpha spectrometry in indirect monitoring of Spanish workers exposed to enriched uranium.

Workers at risk of exposure to uranium compounds should be monitored and their internal exposure quantified in terms of committed effective dose E(50) in mSv. In vitro bioassay methods can quantify uranium in urine and faeces at low activity levels. Alpha spectrometry (AS) is the most common method used for monitoring alpha-emitting radionuclides in internal dosimetry services. It provides isotopic information and low minimum detectable activity (MDA) values (≤0.50 mBq per sample). This study reports the results of a five-year monitoring of workers exposed to uranium at a Spanish Juzbado facility, which produces nuclear fuel elements enriched with up to 5 % of 235U. Monitoring included about 100 workers per year, most of whom had worked at the facility for more than 10 years before the individual monitoring programme was established. We analysed nearly 550 samples of more than 200 workers over five years. The obtained results indicate that workers were adequately protected from uranium exposure through inhalation and had an acceptably low chronic intake at the facility.

GHSI EMERGENCY RADIONUCLIDE BIOASSAY LABORATORY NETWORK - SUMMARY OF THE SECOND EXERCISE.

The Global Health Security Initiative (GHSI) established a laboratory network within the GHSI community to develop collective surge capacity for radionuclide bioassay in response to a radiological or nuclear emergency as a means of enhancing response capability, health outcomes and community resilience. GHSI partners conducted an exercise in collaboration with the WHO Radiation Emergency Medical Preparedness and Assistance Network and the IAEA Response and Assistance Network, to test the participating laboratories (18) for their capabilities in in vitro assay of biological samples, using a urine sample spiked with multiple high-risk radionuclides (90Sr, 106Ru, 137Cs, and 239Pu). Laboratories were required to submit their reports within 72 h following receipt of the sample, using a pre-formatted template, on the procedures, methods and techniques used to identify and quantify the radionuclides in the sample, as well as the bioassay results with a 95% confidence interval. All of the participating laboratories identified and measured all or some of the radionuclides in the sample. However, gaps were identified in both the procedures used to assay multiple radionuclides in one sample, as well as in the methods or techniques used to assay specific radionuclides in urine. Two-third of the participating laboratories had difficulties in determining all the radionuclides in the sample. Results from this exercise indicate that challenges remain with respect to ensuring that results are delivered in a timely, consistent and reliable manner to support medical interventions. Laboratories within the networks are encouraged to work together to develop and maintain collective capabilities and capacity for emergency bioassay, which is an important component of radiation emergency response.

EURADOS intercomparison on emergency radiobioassay.

Nine laboratories participated in an intercomparison exercise organised by the European Radiation Dosimetry Group (EURADOS) for emergency radiobioassay involving four high-risk radionuclides ((239)Pu, (241)Am, (90)Sr and (226)Ra). Diverse methods of analysis were used by the participating laboratories for the in vitro determination of each of the four radionuclides in urine samples. Almost all the methods used are sensitive enough to meet the requirements for emergency radiobioassay derived for this project in reference to the Clinical Decision Guide introduced by the NCRP. Results from most of the methods meet the requirements of ISO 28218 on accuracy in terms of relative bias and relative precision. However, some technical gaps have been identified. For example, some laboratories do not have the ability to assay samples containing (226)Ra, and sample turnaround time would be expected to be much shorter than that reported by many laboratories, as timely results for internal contamination and early decisions on medical intervention are highly desired. Participating laboratories are expected to learn from each other on the methods used to improve the interoperability among these laboratories.

Hipocalcemia neonatal de inicio tardío: factor revelador de un hiperparatiroidismo primario materno desconocido / Late-onset neonatal hypocalcemia: Revealing unknown maternal primary hyperparathyroidism

Fundamento y objetivos. Describir el caso clínico de una hipocalcemia neonatal tardía secundaria a un hiperparatiroidismo materno previamente desconocido, poniendo de relieve la importancia de las pruebas de laboratorio, tanto en el diagnóstico como en el tratamiento del recién nacido y su madre. Caso clínico. Recién nacido varón a término de un embarazo y parto normales que en el 9.° día de vida presenta numerosas crisis convulsivas. En la primera analítica urgente se observa una hipocalcemia asociada a hipomagnesemia, que precisa una terapia correctora de ambos iones, siendo necesario el uso de tratamiento antiepiléptico para el cese de las crisis. Tras un estudio analítico completo y descartadas otras causas por la exploración, anamnesis y pruebas complementarias, se le diagnostica un hipoparatiroidismo neonatal. A partir de este diagnóstico se investiga a la madre, detectándole mediante las pruebas de laboratorio e imagen un posible adenoma paratiroideo izquierdo causante de un hiperparatiroidismo primario no diagnosticado con anterioridad, y confirmado tras su intervención. Conclusiones. Ante la presencia de una hipocalcemia neonatal es preciso investigar un posible hiperparatiroidismo materno (AU)

Background and objectives. To describe a case of late-onset neonatal hypocalcemia, secondary to previously unknown maternal hyperparathyroidism. In particular, highlighting the relevance of the lab tests, in both the diagnosis and the treatment of the newborn and his mother. Clinic case. A full term newborn male with a normal pregnancy and delivery presented at nine days suffering from multiple seizures. Emergency blood biochemistry showed hypocalcemia associated with a low blood magnesium that required corrective ion therapy and anticonvulsives in order to stop the seizures. After a full physical examination and biochemical studies which ruled out other etiologies, a diagnosis of neonatal hypoparathyroidism was reached. Thereafter, the mother was investigated, and laboratory tests and imaging of the parathyroids showed a feasible left parathyroid adenoma causing primary hyperparathyroidism which was previously undiagnosed and confirmed after surgery. Conclusions. In any presentation of neonatal hypocalcemia, the mother should be investigated for possible hyperparathyroidism (AU)