[Development of an expert assessment of the quality of dental care]. / Razrabotka ekspertnoi otsenki kachestva stomatologicheskoi pomoshchi.

The article proposes a methodology for creating an assessment of the quality of dental care based on the use of the method of analysis of hierarchies and the theory of fuzzy logic. Approbation of the methodology was carried out on the assessment of the quality of dental services for the manufacture of metal-ceramic crowns. When conducting a new assessment, you can achieve a reduction in the time of its conduct by 6 times, increasing the number of evaluation criteria by 2 times and get results with a confidence factor (p=0.95). Evaluation allows you to combine existing descriptive, quantitative, radiological, functional assessments into a system and rank their significance for the final result. This allows assessing the quality of treatment more objectively.

Childhood leukaemia in Belarus, Russia, and Ukraine following the Chernobyl power station accident: results from an international collaborative population-based case-control study.

BACKGROUND: There is little evidence regarding the risk of leukaemia in children following exposure to radionuclides from the Chernobyl Nuclear Power Plant explosion on April 26, 1986. METHODS: This population-based case-control study investigated whether acute leukaemia is increased among children who were in utero or <6 years of age at the time of the Chernobyl accident. Confirmed cases of leukaemia diagnosed from April 26, 1986 through December 31, 2000 in contaminated regions of Belarus, Russia, and Ukraine were included. Two controls were matched to each case on sex, birth year, and residence. Accumulated absorbed radiation dose to the bone marrow was estimated for each subject. RESULTS: Median estimated radiation doses of participants were <10 mGy. A significant increase in leukaemia risk with increasing radiation dose to the bone marrow was found. This association was most evident in Ukraine, apparent (but not statistically significant) in Belarus, and not found in Russia. CONCLUSION: Taken at face value, these findings suggest that prolonged exposure to very low radiation doses may increase leukaemia risk as much as or even more than acute exposure. However the large and statistically significant dose-response might be accounted for, at least in part, by an overestimate of risk in Ukraine. Therefore, we conclude this study provides no convincing evidence of an increased risk of childhood leukaemia as a result of exposure to Chernobyl radiation, since it is unclear whether the results are due to a true radiation-related excess, a sampling-derived bias in Ukraine, or some combination thereof. However, the lack of significant dose-responses in Belarus and Russia also cannot convincingly rule out the possibility of an increase in leukaemia risk at low dose levels.

Chromatin image analysis provides new evidence of the relation of lymphocytes to cytokines and sCAM in the inflammatory nature of atherosclerosis.

Comparative analysis of cytokines and sCAM secretion within the lymphocyte chromatin state are possible evidence of inflammatory reactions in atherosclerosis. Two types of response were studied: coagulation and fibrinolysis (incubation of blood clot within 6 hours at 37 degrees C) and standardized viscosimetric flow using a rotational viscometer (shear rate 100 l/s, 60 seconds at 37 degrees C, and incubation within 6 hours at 37 degrees C). Cytokines IL-1alpha, IL-1beta, IL-6, IL-8, IL-10 (Immunotech, France), endothelin-1, and soluble cell adhesion molecules (sCAM) sP- and sE-selectin, sICAM-1, and sVCAM-1 (R&D, UK) have been determined using ELISA kits (photometer, Biomek-1000, Beckman, USA). The chromatin of lymphocyte nuclei was studied using the computer TV morphodensitometry system DiaMorph (Russia) and smears dyed specifically for DNA. Correlational changes in morphodensitometric (MDM) parameters and cytokine and sCAM levels in two tests were compared to initial levels. After rheologic testing, lymphocyte nuclei as a whole had not changed, but chromatin activity had decreased. Reorganization of nuclei after the coagulation test was observed. Endothelin-1 and sP- and sE-selectin levels were not related to function of lymphocytes (by MDM data) as seen in both tests; it is probable that another cell-cell communication mechanism had been switched on. We established a strong correlation between chromatin activity of lymphocytes and the serum concentration of IL-1beta, IL-6, and IL-10, which are the active participants in the pro- and anti-inflammatory program in atherogenesis. Results are evidence of the role of lymphocytes in pro- and anti-inflammatory cytokine reactions and cytokine-like sCAM activity in atherosclerosis.

A multilevel analysis of long-term psychological distress among Belarusians affected by the Chernobyl disaster.

BACKGROUND: Radiation contamination and sociopolitical instability following the Chernobyl nuclear power plant disaster have had a profound impact on Belarus. OBJECTIVE: To investigate the factors that impact long-term mental health outcomes of this population almost 20 years after the disaster. STUDY DESIGN: Cross-sectional study. METHODS: In-person interviews were conducted with 381 men and women from two geographic areas of differing radiation contamination within Belarus. Participants completed surveys of demographics, psychosocial factors and psychological distress. Individual-level characteristics were combined with household-level measures of radiation contamination exposure and family characteristics to create multilevel predictive models of psychological distress. RESULTS: Between-household effects accounted for 20% of variability in depression and anxiety scores, but only 8% of variability in somatization scores. Degree of chronic daily stressors showed a significant positive relationship with psychological distress, whereas mastery/controllability showed a significant inverse relationship with distress. At household level, perceived family problems, but not level of residential radiation contamination, was the best predictor of distress. CONCLUSIONS: Multilevel modelling indicates that long-term psychological distress among Belarusians affected by the Chernobyl disaster is better predicted by stress-moderating psychosocial factors present in one's daily life than by level of residential radiation contamination.