Problemy radiatsiinoi medytsyny ta radiobiolohii最新文献

Objective: to determine the incidence rates of malignant neoplasms (MNs) among residents of the most radionuclidecontaminated territories (RCT) with an assessment of the possible impact of force majeure circumstanceson the specified levels of indicatorsMaterials and methods. The object of the study was residents of the RCT of Zhytomyr and Kyiv regions, the totalnumber of which decreased from 173,198 persons in 2020 to 161,978 persons in 2023. The number of residentsof the most RCT by age group in 2021-2023 was determined in accordance with the structure observed in 2020.To estimate the number of cases of MNs diagnosed in residents of the RCT, the database of the National CancerRegistry of Ukraine (NCRU) was used. To eliminate the influence of force majeure circumstances on the assessment of the incidence rate of MNs among RCT residents in 2020-2023, the regression analysis method was substantiated and applied.

Results and conclusions: The obtained data provide grounds for concluding that the previous trends towards anincrease in the frequency of MNs and certain of their nosological forms, which are considered radiationassociated (MNs of lymphoid and hematopoietic tissue, thyroid cancer, breast cancer), will persist in 2020-2023, as wellas the need to take into account the likely impact of force majeure circumstances on the magnitude of the indicators.

Objective: determining the functioning features of health maintenance by the health care and health protectionfacilities of the NPP surveillance zone during epidemics, epidemic situations and manmade accidents under martial law and possible terrorist acts.

Methods: Quantitative and qualitative methods of sociological research were applied namely the analysis ofresource potential indicators, population surveys and method of expert assessments. When obtaining primary empirical data, the simple data sorting, their pairwise or sequential comparison, as well as procedures ensuring the identification of the measured variable were used. An informal analysis of legislative and regulatory documents wasapplied. The official sources of information, statistical data, scientific publications, legislative and regulatory actson health maintenance were the study subject.

Results: Analysis of the health maintenance parameters in the studied areas of the South Ukrainian NPP observation zone was conducted namely: values of the resource potential based on reporting of the Department of Healthof the Mykolaiv Regional State Administration for 2022-2023 and the first half of 2024 and study of public opinionregarding the activities of healthcare facilities' infrastructure, in particular the state of outpatient care, hospitalwork, energy, water and heat supply, attitude to introduction of the outofpocket medical services during martiallaw. An expert survey was conducted to assess the types of health care (emergency, primary, secondary, tertiary, medical rehabilitation), implementation of its basic principles, levels of preparedness of health care system for epidemics and epidemic situations, preparedness and response to emergencies (accidents, terrorist acts). Effectivenessof the medical information and communication system regarding health care and medical assistance to populationin healthcare facilities and provision of specialists with analytical and operational information were assessed.

Conclusion: Analysis of the data obtained on the issues of public health care under martial law indicated the insufficiently effective functioning of its separate components due to both shortage of personnel (doctors and nursingstaff) and the insufficiently effective implementation of healthcare information systems and eHealth technologiesin the practical activities of health care facilities. It is necessary to develop and implement the management decisions directed at ensuring the readiness of healthcare facilities for epidemics and epidemic situations and manmade emergencies, as well as training personnel through the specialized education and general system of trainingof working doctors.

Objective: to assess the relative levels of cytokines and the functional state of autophagy in peripheral blood lymphocytes of cleanup workers of the Chornobyl accident.

Materials and methods: A total of 42 male patients aged 51-77 (61,35 ± 5,21) years were examined. They included: the main group - 42 cleanup workers of the Chornobyl accident aged 56-63 (60,16 ± 1,73) years; and the control group - 11 persons aged 51-77 (64,72 ± 9,24) years, who did not participate in the liquidation of the consequences of the Chornobyl accident and did not live in radioactively contaminated areas. Analysis of relative levelsof cytokines, NFκB p65, and autophagy parameters in peripheral blood (PB) lymphocytes was performed using flowcytometry.

Results: The decrease in the relative levels of IL1β, IL2, and IFNγ and an increase in IL6, TNFα, and TGFβ in thePB lymphocytes of the cleanup workers of the Chornobyl accident were detected. Correlation analysis showed thepresence of a relationship between the levels of the studied cytokines. The relative level of NFκB p65, the basallevel of the key autophagy protein LC3B and after the addition of chloroquine diphosphate in the PB lymphocytesof the cleanup workers of the Chornobyl accident were similar to those in the control group. The decrease in thecapacity and responsiveness of the autophagic flux in the PB lymphocytes of the cleanup workers of the Chornobylaccident was noted. Direct correlations were found between the basal level of the LC3B protein and IL4 and IL6 inthe PB lymphocytes of the cleanup workers of the Chornobyl accident.

Conclusions: According to preliminary data, the detected changes in the cleanup workers of the Chornobyl accident may contribute to the activation of pathological inflammatory processes and autoimmune reactions due toimpaired lymphocyte function and inflammatory reactions due to a shift in the balance between cytokines and positive regulation of their synthesis.

Objective: the scientific analysis of the frequency of structural and functional changes in parathyroid glands (PTH)in different categories of the Chornobyl NPP (ChNPP) accident survivors (i.e. the irradiated individuals).

Materials and methods: The prospective study of 815 individuals and retrospective analysis of 3,849 case records(total 4,664 individuals) aged 19-75 years at the time of survey, in the range of 0.05-0.2 Gy external radiation dosesamong the ChNPP accident cleanup workers, was performed. Anthropometric, laboratory (parathyroid hormone,vitamin D, calcium, phosphorus, thyroid hormones, thyroid antibodies, and biochemical assays), instrumental (thyroid and parathyroid diagnostic ultrasound) and statistical methods were applied.

Results: There was a higher incidence of the ultrasound signs of parathyroid hyperplasia in the ChNPP accident survivors compared to controls (pooled RR ≈ 1.43; p < 0.001), with the highest values among evacuees and cleanupworkers workers. Incidence of nonrenal normocalcemic hyperparathyroidism (NRHPT) featured a trend to increasein survivors (RR ≈ 1.35; p ≈ 0.095) increasing with age. Level of parathyroid hormone was higher in females than inmales. Increase in the proportion of NRHPT was noted in the period 2019-2024 in both groups with more theincrease in survivors (slope difference ≈ +0.75 p.p./year; p ≈ 0.03). In subgroups of persons with comorbidities theproportion of NRHPT was higher in survivors, however not reaching a statistical significance in the study sample(crude estimates; p > 0.3).

Conclusions: The radiation factor of the ChNPP accident is associated with an increased risk of structural and functional parathyroid changes and normocalcemic NRHPT in particular. There is a higher incidence of ultrasound signsof parathyroid hyperplasia in the ChNPP accident survivors, especially the evacuees and local residents, than in subjects not exposed to extra exposure to ionizing radiation in their daily or practical activities (RR ≈ 1.43; p < 0.001).

Background: As is commonly known, cytokines have an ability to influence the inflammatory reactions, cytotoxiceffects, as well as the immune defense of the body. Study of the disease course depending on the ratio of pro andanti inflammatory cytokines is an urgent problem of contemporary oncohematology for the purpose of personalizedtreatment and improvement of the quality of life of patients with plasma cell myeloma who survived after theChornobyl NPP accident.

Objective: comparative analysis of the state of cytokine regulation in plasma cell myeloma patients at differentstages of therapy depending on a radiation component in the history to optimize the spectrum of clinicalhematological and immunological factors for the prognosis of disease course and assessment of therapy effectiveness.

Materials and methods: Content of cytokines (IL6, IL10, TNFα) in peripheral blood was assayed in the stage I-IIIplasma cell myeloma patients (n = 124) by the immunoenzymatic method using horseradish peroxidase as an indicator enzyme. The Multiskan EX 355 enzyme immunoassay analyzer (Termolabsystems, China) with a multichannelvertical scanning spectrophotometer was used.

Results: A significantly greater violations of cytokine balance and signs of formation of a «cytokine storm» i.e. anexcessive cytokine production were found in the Chornobyl NPP accident survivors, provoking a severe course oftumor process and occurrence of disease complications at all stages of the plasma cell myeloma.

Conclusion: Study of cytokine imbalance in plasma cell myeloma patients survived after the Chornobyl NPP accident is appropriate to predict the disease clinical course, prevent complications, increase effectiveness and prescribea personalized treatment.

Objective: investigation of the influence of mesenchymal stromal cells on the functioning of hematopoietic cellsof Balb/C mice after the exposure to ionizing radiation at a sublethal dose in cell culture in vitroand in vivo.

Methods: To study the influence of stromal microenvironment, a cocultivation model of hematopoietic cells of irradiated animals and mesenchymal cells forming feeder layers was used in the in vitro culture. Using the trypan bluedye, the number of hematopoietic cells with cytoplasmic membrane damage was assessed and the level of cell deathwas determined. Cell cultivation in the diffusion chambers culture in vivoallowed assessing the proliferative potential of bone marrow hematopoietic stem cells of irradiated animals.

Results: Investigation of the interaction between bone marrow stromal and hematopoietic cells of Balb/C miceallowed determining the modifying influence of the stroma on the level of progenitor cells' interphase and reproductive death due to ionizing radiation action at a sublethal dose. In particular, after 2 days the percentage of deadcells in suspension with direct contact with the stroma in vitro was reduced compared to hematopoietic cells wheresuch contact was absent: (40.5 ± 2.6) % vs (60.1 ± 2.8) %. The increase in cell aggregates number was also observedin the cultures of irradiated progenitors, which had previously interacted with mesenchymal stromal cells in vitro(25.2 ± 1.9 CFU), compared to the cells, which did not directly interact with the stroma (15.3 ± 2.8 CFU).

Conclusions: Cocultivation with stromal cells have significantly reduced the level of radiationinduced death ofbone marrow hematopoietic cells and increased their colonyforming activity, however, this required the direct contact with stroma in the in vitroculture.

Background: Incidental detection of pulmonary nodules remains a common diagnostic challenge in modern clinical practice. According to international guidelines, such findings often require repeated, longterm surveillanceusing followup imaging. Given the growing number of patients who need prolonged monitoring and the necessityto minimize cumulative radiation exposure, optimization of multislice computed tomography (MSCT) protocols hasbecome paramount. The development and implementation of targeted, ultralowdose scanning approaches enablethe acquisition of reproducible and highly informative diagnostic data while substantially reducing radiation dose.This is a key component in managing lowrisk patients and forms the basis for personalized followup strategies thatenhance safety in radiological imaging.

Objective: to scientifically validate, develop, and evaluate a targeted MSCT protocol for the monitoring of probablybenign pulmonary nodules, and to evaluate its diagnostic performance and radiation exposure against a standardfulldose protocol to determine its clinical utility for routine application.

Materials and methods: The study included 92 patients of the Mykolaiv Regional Oncology Center with incidentallydetected solitary pulmonary nodules up to 15 mm requiring dynamic followup. Inclusion criteria were probablybenign morphology and at least one previous followup imaging study. A known oncologic history or imaging suspicion of malignancy served as exclusion criteria.Scanning was performed on a 64slice Revolution Maxima CT scanner (GE, USA) in the supine position during a breathhold. A standard fulldose protocol (A) and a targeted protocol(B) were compared in terms of radiation exposure (CTDIvol, DLP) and diagnostic quality. Nodule dynamics wereassessed using identical reconstruction parameters (slice thickness 1.25 mm, interval 1 mm, lung and mediastinalwindows) with repeated measurements by two independent radiologists.

Results: The targeted protocol B reduced DLP by more than eight fold (27.8 vs. 229.5 mGy·cm) and lowered CTDIvolby approximately 40 %, resulting in an 85 % reduction of effective dose, while maintaining high image quality. Atotal of 88 % of nodules remained stable, 7.6 % showed minor changes, and 4.3 % required surgical intervention, alldemonstrating benign histology. Protocol B reliably differentiated stable incidentalomas from lesions requiringintervention, with minimal radiation exposure.

Conclusions: The developed targeted MSCT protocol is safe and effective for dynamic monitoring of probably benignpulmonary nodules. It significantly reduces cumulative radiation exposure without compromising diagnostic accuracy and should be integrated into routine radiological practice.

Objective: based on a comparative analysis of cardiovascular system clinical, structural, and functional state bothin emergency workers (EW) of the accident at the Chernobyl Nuclear Power Plant (ChNPP) and nоnirradiated individuals, to identify changes of cardiovascular system status that can be associated with COVID19 or the consequences of radiation, but not with the natural progression of cardiovascular diseases (CVD).

Materials and methods: The study included 46 EW and 21 unexposed patients (comparison group - CG) who survived COVID19 in 2020-2022 (groups EWC+ and CGC+ respectively), and EW and 21 unexposed individuals without a history of COVID19 (groups EWC and CGC respectively). All EW and CG individuals were male under longterm supervision, and underwent regular examination and treatment for cardiovascular diseases (CVD) in the cardiology department of the NRCRMHO in the pre and postCOVID period. During the examination of patients, generalclinical, laboratory, statistical methods, echocardiography, and daily electrocardiogram monitoring were used.

Results: During the comparable period of time between the pre and postCOVID examinations in the EW and nonirradiated individuals, regardless of whether they had COVID19 or not, a deterioration of cardiovascular system status was revealed, which consisted in the appearance of new cases of hypertensive heart disease, coronary heart disease, heart failure, rhythm and conduction disorders. Echocardiographic indicators, which characterize the structural and functional state of the left ventricle, did not have statistically significant difference both in each groupbetween the two examinations in pre and postCOVID period and between different groups.

Conclusions: The lack of the significant difference in clinical course of CVD and the structural and functional stateof myocardium between patients, who were sick with COVID19 or not, is more indicative of the natural progressionof cardiovascular system pathology. Hypothetically, it can be assumed that in elderly people (60-75 years old) having CVD, past radiation exposure does not significantly affect cardiovascular system status in the present.

The article examines the issues of a healthy lifestyle, nutritional culture, and the physiological needs for essentialnutrients and energy for the population living in areas radioactively contaminated as a result of the Chornobyl disaster. The radioactive substances will remain in the environment for several more generations, influencing theirhealth. Providing acceptable living conditions for the population in such territories is a relevant problem thatrequires studying and analyzing the impact on public health, as well as developing ways to correct nutrition as themain source of toxicant intake and establishing the needs for essential nutrients and energy for individuals whoconstantly live under the influence of a complex of anthropogenic factors. Technogenic and radioactive contamination of the environment cause severe and irreversible pathological changes and genetic deviations in the humanbody. Living in such conditions leads not only to an increase in morbidity but also to premature aging, loss of workcapacity, and an increase in early deaths. Solving the problem of optimizing nutrition is one of the most importanttasks of modern preventive medicine at the state level to preserve and improve human health.