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1.
Minerva Pediatr ; 72(3): 226-235, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32613821

RESUMO

Although medical literature shows that children are minimally susceptible to 2019-Corona virus disease (COVID-19), they are hit the hardest by psychosocial impact of this pandemic. Being quarantined in homes and institutions may impose greater psychological burden than the physical sufferings caused by the virus. School closure, lack of outdoor activity, aberrant dietary and sleeping habits are likely to disrupt children's usual lifestyle and can potentially promote monotony, distress, impatience, annoyance and varied neuropsychiatric manifestations. Incidences of domestic violence, child abuse, adulterated online contents are on the rise. Children of single parent and frontline workers suffer unique problems. The children from marginalized communities are particularly susceptible to the infection and may suffer from extended ill-consequences of this pandemic, such as child labor, child trafficking, child marriage, sexual exploitation and death etc. Parents, pediatricians, psychologists, social workers, hospital authorities, government and non-governmental organizations have important roles to play to mitigate the psychosocial ill-effects of COVID-19 on children and adolescents. To provide the basic amenities, social security, medical care, and to minimize the educational inequities among the children of the different strata of the society are foremost priorities.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Quarentena/psicologia , Estresse Psicológico/etiologia , Atividades Cotidianas , Adolescente , Criança , Maus-Tratos Infantis/psicologia , Socorristas/psicologia , Acesso aos Serviços de Saúde , Humanos , Deficiência Intelectual/psicologia , Acontecimentos que Mudam a Vida , Fatores de Risco , Instituições Acadêmicas , Isolamento Social/psicologia , Marginalização Social , Fatores Socioeconômicos , Estresse Psicológico/prevenção & controle , Populações Vulneráveis/psicologia
3.
J Emerg Manag ; 18(3): 237-245, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32441040

RESUMO

The network of international urban search and rescue (USAR) teams, International Search and Rescue Advisory Group (INSARAG), has started its unique classification system called INSARAG External Classification (IEC) since 2005. In IEC, teams are classified into Heavy or Medium category, and as of the end of 2018, more than 50 teams have been classified. It seems that, through IEC, INSARAG successfully implements the standards such as the IN-SARAG Guidelines although the document is nonbinding. This article analyzes why IEC has got strong support from international USAR teams and what are the keys to successful implementation of standards in international emer-gency management. It concludes that it has been successful because, for example, INSARAG carefully gains a con-sensus from the member states when creating the standards, reiterates the minimum standards instead of the best practices, and sets the clear goal. The endorsement at the UN General Assembly Resolution also contributed to gaining support. Although there are some issues which need to be considered to maintain the system in the future, the lessons of the IEC model can be used for other fields of international disaster and emergency management.


Assuntos
Desastres , Serviços Médicos de Emergência/normas , Socorristas , Humanos , Internacionalidade , Reforma Urbana
4.
J Emerg Manag ; 18(3): 267-273, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32441043

RESUMO

Anthrax was widely discussed in the media several years ago during the American Anthrax attacks. Despite a lessened interest in the subject today, anthrax still poses a threat to the United States government and its people. This article looks at publically available data and resources in an effort to combine current information into one easy to ready document. It can be used as an informational reference for first responders when learning about the anthrax threat.


Assuntos
Antraz , Bioterrorismo , Socorristas , Humanos , Estados Unidos
6.
West J Emerg Med ; 21(2): 365-373, 2020 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-32191195

RESUMO

INTRODUCTION: Since 2013, the First Care Provider (FCP) model has successfully educated the non-medical population on how to recognize life-threatening injuries and perform interventions recommended by the Committee for Tactical Emergency Casualty Care (C-TECC) and the Hartford Consensus in the disaster setting. Recent programs, such as the federal "Stop The Bleed" campaign, have placed the emphasis of public training on hemorrhage control. However, recent attacks demonstrate that access to wounded, recognition of injury, and rapid evacuation are equally as important as hemorrhage control in minimizing mortality. To date, no training programs have produced a validated study with regard to training a community population in these necessary principles of disaster response. METHODS: In our study, we created a reproducible community training model for implementation into prehospital systems. Two matched demographic groups were chosen and divided into "trained" and "untrained" groups. The trained group was taught the FCP curriculum, which the Department of Homeland Security recognizes as a Stop the Bleed program, while the untrained group received no instruction. Both groups then participated in a simulated mass casualty event, which required evaluation of multiple victims with varying degree of injury, particularly a patient with an arterial bleed and a patient with an airway obstruction. RESULTS: The objective measures in comparing the two groups were the time elapse until their first action was taken (T1A) and time to their solution of the simulation (TtS). We compared their times using one-sided t-test to demonstrate their responses were not due to chance alone. At the arterial bleed simulation, the T1A for the trained and untrained groups, respectively, were 34.75 seconds and 111 seconds (p-value = .1064), while the TtS were 3 minutes and 33 seconds in the trained group and eight minutes in the untrained groups (physiologic cutoff) (p-value = .0014). At the airway obstruction simulation, the T1A for the trained and untrained groups, respectively, were 20.5 seconds and 43 seconds (p-value = .1064), while the TtS were 32.6 seconds in the trained group and 7 minutes and 3 seconds in the untrained group (p-value = .0087). Simulation values for recently graduated nursing students and a local fire department engine company (emergency medical services [EMS]) were also given for reference. The trained group's results mirrored times of EMS. CONCLUSION: This study demonstrates an effective training model to civilian trauma response, while adhering to established recommendations. We offer our model as a potential solution for accomplishing the Stop The Bleed mission while advancing the potential of public disaster response.


Assuntos
Serviços Médicos de Emergência , Socorristas , Tratamento de Emergência , Hemorragia/terapia , Incidentes com Feridos em Massa , Consenso , Educação , Serviços Médicos de Emergência/métodos , Tratamento de Emergência/normas , Humanos
7.
Accid Anal Prev ; 138: 105466, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32087394

RESUMO

INTRODUCTION: Accident risk is increased for emergency responders driving with warning lights and sirens compared to other road users' driving. Currently no standards for education of ambulance drivers exist. Research shows that high order understanding trainings focusing on insight to avoid critical driving situations might be more helpful than trainings focusing on car handling. The present controlled intervention study evaluates a one-day simulator-based high order training program specifically designed for ambulance drivers. METHODS: In a longitudinal design with three measurement times multiple methods were used to evaluate the training holistically targeting the levels of reaction to training, learning, behavior and results of training. Questionnaire, knowledge test and driving profile data were analyzed with repeated measures analysis of variance controlling for age and sex. Data of two intervention groups and one control-waiting group was collected between 2014 and 2017 in two German federal states. RESULTS: 183 German paramedics (age: M = 33.1, SD = 9.4, 21.9 % female) participated in the study. 147 participants (80.3 %) completed post-training tests, and 30 participants (16.4 %) completed follow-up measurements six months after training. Participants' reaction to training was positive directly after the training, and dropped slightly over time. Intervention group participants gained traffic-relevant knowledge compared to control group participants. Risk sensitivity of regular driving situations was the only attitude variable positively affected by training. This effect was not sustained six months after training. Training led to a decrease of average and maximum speed in short- as well as long-term measurements but did not affect drivers' acceleration. Although speed was lower in post-tests, emergency response times did not differ. CONCLUSION: The simulator-based training for paramedics has small but notable effects on drivers' knowledge, attitudes and real driving behavior. Although only very few measured variables showed positive training effects, no negative training effects were found. Speed was reduced in the long term which underlines the importance of such a training. More research is needed to determine effects on different types of participants and to elicit framework conditions for training integration in formal education.


Assuntos
Acidentes de Trânsito/prevenção & controle , Ambulâncias , Condução de Veículo/educação , Socorristas/educação , Adulto , Atitude , Feminino , Alemanha , Humanos , Conhecimento , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Treinamento por Simulação , Inquéritos e Questionários , Adulto Jovem
9.
Arch Prev Riesgos Labor ; 23(1): 52-67, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-31991077

RESUMO

AIM: To analyze catharsis techniques used with professionals assisting victims of emergencies and disasters. METHODS: Systematic review carried out in seven bibliographic databases: MEDLINE-Pubmed, Web of Science, Cochrane Library, CINAHL, Scopus, PsycINFO, and other secondary sources, for articles published between 2008 and 2017, with the terms "catharsis", "emergencies", "debriefing" y "post-traumatic stress". Publication and selection biases were taken into account. RESULTS: Five reviews met the study inclusion criteria. Distress and traumatic experiences following an emergency or disaster are very common among health professionals, with adverse repercussions at the physical, psychological and cognitive levels. Some authors find that debriefing offers an opportunity for emotional release and toreduce the impact of stress on the lives of emergency responders, acting as a support network where they can reconstruct their experiences, express their thoughts and feelings, and reduce the impact on their lives. For other authors, however, this technique is not always effective for all professionals and may lead to negative consequences. CONCLUSIONS: Debriefing is a common intervention that promotes catharsis. However, there is considerable controversy over its implementation and effectiveness. This study identified a diversity of catharsis techniques applied to staff responding to emergencies and disasters.


Assuntos
Catarse , Desastres , Socorristas , Transtornos de Estresse Pós-Traumáticos , Emergências , Socorristas/psicologia , Emoções , Humanos , Transtornos de Estresse Pós-Traumáticos/psicologia
12.
Toxicol Lett ; 321: 90-94, 2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-31881244

RESUMO

Potent opioids are increasingly responsible for morbidity and mortality in the Western world. Fentanyl and fentanyl derivatives are increasingly prevalent as adulterants or substitutes for opioid drugs of abuse in Europe and in North America. Trafficking and distribution of these chemicals evolve continuously and are poorly characterized at this time. Rescue and emergency personnel are increasingly concerned with the possibility of unintentional environmental exposures that might occur in the course of their operational duties. There is evidence that opioid agonists have been broadcast or applied directly in an offensive manner as incapacitating agents. Defending against toxicity from such agents requires a thoughtful plan for protection, decontamination, and treatment.


Assuntos
Analgésicos Opioides/efeitos adversos , Substâncias para a Guerra Química/efeitos adversos , Tráfico de Drogas , Socorristas , Fentanila/efeitos adversos , Exposição Ocupacional/efeitos adversos , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Trabalho de Resgate , Descontaminação , Fentanila/análogos & derivados , Humanos , Exposição Ocupacional/prevenção & controle , Medição de Risco , Fatores de Risco
13.
MMWR Recomm Rep ; 68(4): 1-14, 2019 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-31834290

RESUMO

This report updates the 2009 recommendations from the CDC Advisory Committee on Immunization Practices (ACIP) regarding use of anthrax vaccine in the United States (Wright JG, Quinn CP, Shadomy S, Messonnier N. Use of anthrax vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices [ACIP)], 2009. MMWR Recomm Rep 2010;59[No. RR-6]). The report 1) summarizes data on estimated efficacy in humans using a correlates of protection model and safety data published since the last ACIP review, 2) provides updated guidance for use of anthrax vaccine adsorbed (AVA) for preexposure prophylaxis (PrEP) and in conjunction with antimicrobials for postexposure prophylaxis (PEP), 3) provides updated guidance regarding PrEP vaccination of emergency and other responders, 4) summarizes the available data on an investigational anthrax vaccine (AV7909), and 5) discusses the use of anthrax antitoxins for PEP. Changes from previous guidance in this report include the following: 1) a booster dose of AVA for PrEP can be given every 3 years instead of annually to persons not at high risk for exposure to Bacillus anthracis who have previously received the initial AVA 3-dose priming and 2-dose booster series and want to maintain protection; 2) during a large-scale emergency response, AVA for PEP can be administered using an intramuscular route if the subcutaneous route of administration poses significant materiel, personnel, or clinical challenges that might delay or preclude vaccination; 3) recommendations on dose-sparing AVA PEP regimens if the anthrax vaccine supply is insufficient to vaccinate all potentially exposed persons; and 4) clarification on the duration of antimicrobial therapy when used in conjunction with vaccine for PEP.These updated recommendations can be used by health care providers and guide emergency preparedness officials and planners who are developing plans to provide anthrax vaccine, including preparations for a wide-area aerosol release of B. anthracis spores. The recommendations also provide guidance on dose-sparing options, if needed, to extend the supply of vaccine to increase the number of persons receiving PEP in a mass casualty event.


Assuntos
Vacinas contra Antraz/uso terapêutico , Antraz/prevenção & controle , Adolescente , Adulto , Comitês Consultivos , Idoso , Antraz/epidemiologia , Vacinas contra Antraz/efeitos adversos , Centers for Disease Control and Prevention, U.S. , Criança , Socorristas , Feminino , Humanos , Esquemas de Imunização , Masculino , Pessoa de Meia-Idade , Profilaxia Pós-Exposição , Profilaxia Pré-Exposição , Gravidez , Estados Unidos/epidemiologia , Adulto Jovem
14.
Probl Radiac Med Radiobiol ; 24: 350-366, 2019 Dec.
Artigo em Inglês, Ucraniano | MEDLINE | ID: mdl-31841479

RESUMO

The objective of this investigation is to determine features of hypertensive heart disease (HHD) and coronary heart disease (CHD) development in emergency workers (EW) of Chornobyl Nuclear Power Plant (ChNPP) in dependence on gender, occupation, duration of stay under radiation and the nature of performed job. MATERIALS AND METHODS: During the period from 2012 to 2018, 483 male EW (EW-m) and 134 female EW (EW-f), who worked in the accident zone over 1986-1987, were examined. All EW of both gender at the time of emergency works had no signs of cardiac pathology. The diagnosis of cardiovascular disease was established in accordance with the diagnostic standards adopted in Ukraine [2964], on the basis of clinical and laboratory examination. RESULTS: EW could be divided into the following categories according to their occupational membership and nature of performed job: (1) ChNPP staff, (2) persons engaged in construction works (builders), (3) drivers, (4) engineers and technicians, (5) Soviet Army (SA) personnel, policemen and firemen served in Ministry of Internal Affairs (MIA), officers of Interior Troops (IT), (6) low skilled laborers (LSL), (7) medical staff (doctors, nurses, paramedics) and (8) service staff. Among all examined men and women who took part in emergency work, the overwhelming majority stood in the accident area from the end of April to the end of December 1986: 440 men and 111 women. Others were involved to work during 1987. Most men and women worked on liquidation of the accident from April 26, 1986 to the end of May (349 and 71 persons respectively), with the proportion of men was significantly higher. In the rest months of 1986 and the beginning of 1987, on the contrary, the relative number of women involved in the accident exceeded the proportion of men.The EW-m of all occupations were in the risk zone of the cardiovascular diseases, and the HHD development truly correlated with service in MIA, SA and IT, CHD development with profession of engi- neer and technician, and builder as well, and MI development with driver job. The risk of HHD development during the first 10 years after the accident was 4.6 times higher among officers of MIA, SA and IT who had non-shift work in Prypiat and/or at the ChNPP comparing with persons of other occupations and working conditions. The risk of CHD development during the first 15 years was 8.2 times higher in the engineers and technicians who worked in the 30-km zone, compared with other EW and risk of MI throughout the observation period was 6.4 times higher in the drivers, who had shift work in a 30-km zone. In EW-f the risk of HHD developing during the first 10 years after the accident was 2.1 times lower than those who worked in the service sector (kitchen, trade, economists and account- ants, communications, etc.) compared with the representatives of any other profession, and the risk of CHD devel- oping during the first 15 years after the accident was higher in medical staff and EW of other occupational cate- gories that had shift work. Women who worked with shifts had a 4.8-fold higher risk of MI developing than those who had limited terms of work with the subsequent withdrawal from the accident area. CONCLUSIONS: For more accurately assess the radiation effects on the cardiovascular system of persons who took part in the emergency works at the ChNPP, it should not be limited by comparing the effects of unexposed populations, but to take into account the EW professional affiliation, the terms of stay in the accident area and the nature of performed work.


Assuntos
Acidente Nuclear de Chernobyl , Socorristas , Hipertensão/fisiopatologia , Isquemia Miocárdica/fisiopatologia , Exposição à Radiação/efeitos adversos , Adulto , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Hipertensão/patologia , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/epidemiologia , Isquemia Miocárdica/etiologia , Isquemia Miocárdica/patologia , Ocupações/classificação , Fatores Sexuais , Fatores de Tempo , Ucrânia/epidemiologia
15.
Probl Radiac Med Radiobiol ; 24: 380-394, 2019 Dec.
Artigo em Africano, Ucraniano | MEDLINE | ID: mdl-31841481

RESUMO

OBJECTIVE: Study of the status of parathyroid glands in individuals exposed to ionizing radiation as a result of the ChNPP accident and comparison with the general population of Ukraine. MATERIALS AND METHODS: Subjects exposed as a result of the ChNPP accident (n = 1,348) and people from the general population of Ukraine (n=655) were examined. Diagnostic ultrasound scan of thyroid and parathyroid glands (PTG) was conducted in all study subjects. The technique of parathyroid ultrasound screening was developed, which led to an increase in the efficiency of their imaging. Additionally, the 25-hydroxyvitamin D (25(OH)D), parathyroid hor- mone, ionized calcium and some other parameters were selectively assayed in serum. RESULTS: High incidence of parathyroid hyperplasia was detected 27-32 years after the irradiation in persons ex- posed as a result of the ChNPP accident, especially in evacuees from the 30-km exclusion zone (71.4%; χ2Yates' = 24.1; р = 0) and residents of radilogically contaminated territories (41.7%; χ2Yates' = 6.45; p < 0.01) having no primary hyperparathyroidism. High prevalence of vitamin D insufficiency and deficiency was revealed in all study subgroups, namely in 83.1 % of the general population of Ukraine along with a bit better vitamin D status in the ChNPP acci- dent survivors i.e. the vitamin insufficiency and deficiency was found in 78.7 % of them. Incidence of hyperparathy- roidism, predominantly of the secondary (normocalcemic) one, was 33.8 % among persons exposed as a result of the ChNPP accident (p > 0.3) being somewhat higher than in the general population of Ukraine (26.1%), despite above- mentioned better supply of vitamin D. CONCLUSIONS: There is a widespread insufficiency or deficiency of vitamin D (over 78.7%) in the population of Ukraine in general providing an unfavorable background for the higher prevalence of health disorders associated with calcium and phosphorus metabolism. The latter features parathyroid hyperplasia and musculosceletal, immune, cardiovascular, and endocrine system comorbidities. Such disorders should exacerbate with a secondary increase in parathyroid hormone secretion (26.1 %). Higher incidence of normocalcemic hyperparathyroidism (33.8% versus 26.1%) against a background of better vitamin D status among irradiated individuals indicates the existence of other factors, where the past combined effects of Chornobyl radioactive fallout and external parathyroid exposure are most likely to be involved. This could explain the greater number of cases of parathyroid hyperplasia and hyper- parathyroidism among the exposed subjects. However the additional precise studies are required here with clarifi- cation of the personal data in population groups of the ChNPP accident survivors. Participants of the ChNPP acci- dent clean-up work in the «iodine period¼ of 1986 are of especial concern here. Besides that, the study population should be expanded with inclusion of subjects exposed in prenatal period.


Assuntos
Acidente Nuclear de Chernobyl , Socorristas , Hiperparatireoidismo Primário/fisiopatologia , Glândulas Paratireoides/efeitos da radiação , Glândula Tireoide/efeitos da radiação , Deficiência de Vitamina D/fisiopatologia , Adolescente , Adulto , Idoso , Cálcio/sangue , Estudos de Casos e Controles , Feminino , Humanos , Hiperparatireoidismo Primário/sangue , Hiperparatireoidismo Primário/diagnóstico por imagem , Hiperparatireoidismo Primário/etiologia , Masculino , Pessoa de Meia-Idade , Glândulas Paratireoides/diagnóstico por imagem , Glândulas Paratireoides/metabolismo , Glândulas Paratireoides/patologia , Hormônio Paratireóideo/sangue , Doses de Radiação , Exposição à Radiação/efeitos adversos , Sobreviventes , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/metabolismo , Glândula Tireoide/patologia , Ucrânia , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue
16.
Probl Radiac Med Radiobiol ; 24: 465-479, 2019 Dec.
Artigo em Inglês, Ucraniano | MEDLINE | ID: mdl-31841488

RESUMO

OBJECTIVE: to retrospectively characterize changes in the hepatobiliary system in liver cirrhosis (LC) in the clean-up workers of the Chornobyl NPP accident and to determine the factors of disease progression according to the expert materials of the Central Interagency Expert Commission on Establishing the Causal Relationship of the Diseases with the influence of factors of Chornobyl NPP accident. MATERIALS AND METHODS: Based on the data of 60 cases of the Central Interagency Expert Committee on establishing the causal link of diseases with the impact of the Chornobyl NPP accident, the factors of development, concomitant pathology and indicators of the hepatobiliary system status in 49 deceased and 11 alive clean-up workers with LC were investigated. RESULTS: A retrospective study of the morphological changes of the hepatobiliary system in the clean-up workers with LC showed that the main pathologic anatomical diagnosis in 37.8 % of cases was small-nodal LC, in 8.9 % - micromacronodular, in 4.4 % - large-nodal, in 2.2 % - primary biliary LC, in the other 40 % of cases - LC with uncer- tain nodal structure, as well as 2 (4.4 %) cases of fatty liver and 1 case (2.2 %) of portal cirrhosis against the back- ground of fatty liver. Pathomorphological changes were characterized by expressed growth of fibrous tissue with replacement of the liver parenchyma (fields of fibrosis), increase in size and impaired structure of the liver, thick- ening and tightening of its capsule, fibrotic changes in other organs - gastric mucosa, pancreas, spleen, lungs, heart. Histological examination revealed lobe structure abnormalities, false lobules, periportal fibrosis, lymphoid-lympho- cytic infiltration, diffuse fatty small-sized and large-drop dystrophy, and hepatocyte atrophy. Common inflammato- ry processes and fibrotic changes of other organs and systems: cardiovascular, urinary, bronchopulmonary, stomach, pancreas and spleen made the course of the LC more severe. The most frequent were cardiovascular diseases, signi- ficantly more frequent among the deceased than alive patients: hypertension - 67.3 % and 45.5 %, p < 0.05, coro- nary heart disease - 57.1 % and 18 %, p < 0.05. In most cases, the cause of death in the clean-up workers with LC was hepatic and cellular failure (53.3 %), which together with hepatic-renal failure (17.8 %) made 71.1 %. CONCLUSION: Changes in the hepatobiliary system of change in in the clean-up workers with LC were characterized by marked growth of fibrotic tissue with replacement of the parenchyma and impaired liver structure, fibrotic changes in other organs, diffuse fatty small and large droplet dystrophy and atrophy of hepatocytes. The severe course of the LC with the manifestation of the disease at the stage of decompensation was due to a vague clinical picture, lack of subjective symptoms of liver disease, slow, steadily progressing development, lack of or inadequate examination and treatment, a significant number of concomitant pathology of other organs and systems. The fac- tors of the development of LC in the clean-up workers were the long course of chronic liver disease, numerous con- comitant pathology, long stay in the accident zone, the effect of ionizing radiation, as well as the lack of dispensa- ry supervision and adequate treatment.


Assuntos
Doenças Cardiovasculares/patologia , Acidente Nuclear de Chernobyl , Socorristas , Fígado Gorduroso/patologia , Cirrose Hepática/patologia , Lesões por Radiação/patologia , Adulto , Ductos Biliares/patologia , Ductos Biliares/efeitos da radiação , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/fisiopatologia , Progressão da Doença , Fígado Gorduroso/etiologia , Fígado Gorduroso/mortalidade , Fígado Gorduroso/fisiopatologia , Feminino , Mucosa Gástrica/patologia , Mucosa Gástrica/efeitos da radiação , Coração/fisiopatologia , Coração/efeitos da radiação , Humanos , Fígado/patologia , Fígado/efeitos da radiação , Cirrose Hepática/etiologia , Cirrose Hepática/mortalidade , Cirrose Hepática/fisiopatologia , Pulmão/patologia , Pulmão/efeitos da radiação , Masculino , Pessoa de Meia-Idade , Pâncreas/patologia , Pâncreas/efeitos da radiação , Exposição à Radiação/efeitos adversos , Lesões por Radiação/etiologia , Lesões por Radiação/mortalidade , Lesões por Radiação/fisiopatologia , Estudos Retrospectivos , Baço/patologia , Baço/efeitos da radiação , Análise de Sobrevida , Fatores de Tempo , Ucrânia
17.
Probl Radiac Med Radiobiol ; 24: 493-502, 2019 Dec.
Artigo em Inglês, Ucraniano | MEDLINE | ID: mdl-31841490

RESUMO

OBJECTIVE: to describe the clinical types of cataracts in the remote period after acute radiation sickness (ARS). MATERIALS AND METHODS: Twenty four - thirty three years after the emergency exposure, a complete ophthalmolog- ic examination of 53 reconvalescents of ARS conducted. The average age of patients at the time of the examination was (64.6 ± 1.2) years, the average radiation dose of the examined patients was (2.39 ± 0.17) Gy. Ophthalmologic examination included visometry with and without correction, tonometry, autorefractokeratometry, biomicroscopy on a slit lamp, retroillumination photography (infrared and color) of a lens. To evaluate the results of surveys used statistical methods: calculation of average values of quantitative indicators, estimation of probability difference by Student's method. RESULTS: In 10 patients (17 eyes) of the 53 reconvalescents of ARS in the remote period after irradiation artifakia after surgical treatment was recognized. In all other patients, changes in the transparency of the lens were detect- ed, and most patients had combined changes. Radiation cataract with it's characteristic clinical picture was detect- ed in 32 people, and in one more case, it's first signs were recorded. But 14 reconvalescents of ARS in the remote period after irradiation had not radiation cataract. CONCLUSIONS: Radiation cataract has not been detected in 14 reconvalescents of ARS in the remote period after irra- diation; the radiation doses of these patients significantly exceeds the threshold levels. Therefore, the absence of it's signs in the remote period in individuals exposed to doses above 2 Gy may indicate that this well-known radia- tion-induced effect is stochastic. Further analysis of the clinical features of the len's pathology in the reconvales- cents of ARS is promising for the study of the mechanism of damage to the lens in this category of victims of the Chornobyl accident.


Assuntos
Catarata/patologia , Acidente Nuclear de Chernobyl , Socorristas , Exposição à Radiação/efeitos adversos , Lesões por Radiação/patologia , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Catarata/classificação , Catarata/etiologia , Extração de Catarata , Humanos , Cristalino/patologia , Cristalino/efeitos da radiação , Cristalino/cirurgia , Pessoa de Meia-Idade , Doses de Radiação , Lesões por Radiação/etiologia , Sobreviventes , Fatores de Tempo , Ucrânia
18.
Probl Radiac Med Radiobiol ; 24: 503-515, 2019 Dec.
Artigo em Inglês, Ucraniano | MEDLINE | ID: mdl-31841491

RESUMO

OBJECTIVE: The objective was to study the relationship between functional status of bronchopulmonary system and telomere length in clean-up workers of Chornobyl NPP accident in a remote post-accident period. MATERIALS AND METHODS: A study was performed in 113 clean-up workers of Chornobyl NPP accident. Individual do- cumented doses of irradiation in clean-up workers ranged from 1,0 to 880 mSv (330.4 ± 317.7 (M ± SD)). The aver- age age of the Chornobyl NPP participants was (62.21 ± 6.99) years. A complex of functional pulmonary tests (spirometry, body plethysmography, examination of lung diffusion capacity) was performed. Relative telomere length (RTL) was analysed by flow-FISH. RESULTS: There was a tendency to decrease the relative telomere length in clean-up workers with COPD I-II stage and COPD III-IV, compared with patients with the absence of bronchopulmonary diseases (RTL 15,2 ± 2,7). Significantly shorter telomeres were observed in patients with COPD who were exposed to radiation at a dose of more than 500 mSv (13.6 ± 2.5) compared with COPD patients who were exposed at a dose <10 mSv (RTL 15.3 ± 2.3). When analyzing the correlation relationships of the studied indicators, no significant associations were found with the relative telomere length. At this stage of the study no association of relative telomere length with age, body mass index, and functional criteria (FEV1 (l), intrathoracic pressure (ITGV), total lung capacity (TLC), diffusion lung capac- ity (DLCO)) was detected. CONCLUSIONS: The analyzed telomere length relationship from liquidators of the Chernobyl found no direct associa- tion with indicators of lung function tests, however, showed a trend towards reducing the relative telomere length in clean-up workers who suffer from COPD and exposed to doses from 100 to 500 mSv and above 500 mSv.


Assuntos
Acidente Nuclear de Chernobyl , Socorristas , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Exposição à Radiação/efeitos adversos , Lesões por Radiação/fisiopatologia , Telômero/ultraestrutura , Idoso , Relação Dose-Resposta à Radiação , Humanos , Pulmão/patologia , Pulmão/efeitos da radiação , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/etiologia , Doença Pulmonar Obstrutiva Crônica/genética , Doses de Radiação , Lesões por Radiação/etiologia , Lesões por Radiação/genética , Testes de Função Respiratória , Sobreviventes , Encurtamento do Telômero , Fatores de Tempo , Ucrânia
19.
Probl Radiac Med Radiobiol ; 24: 516-521, 2019 Dec.
Artigo em Inglês, Ucraniano | MEDLINE | ID: mdl-31841492

RESUMO

A clinical case of cutaneous T-cell lymphoma is presented in this paper - Mycosis fungoides, a tumorous stage that developed in a patient who suffered as a result of the Chornobyl accident. The most likely development of this di- sease is due to the influence of the radiation factor, which led to the affection of lymphoid cells. This disease has characteristic staging with a typical morphological pattern only in later stages, therefore, the diagnosis usually occurs in evident clinical and histological changes of the mycotic and tumorous stages, when treatment is ineffec- tive. The features of the disease and treatment are described.


Assuntos
Acidente Nuclear de Chernobyl , Socorristas , Linfoma Cutâneo de Células T/patologia , Micose Fungoide/patologia , Lesões por Radiação/patologia , Neoplasias Cutâneas/patologia , Diagnóstico Tardio , Dexametasona/uso terapêutico , Feminino , Humanos , Linfoma Cutâneo de Células T/diagnóstico , Linfoma Cutâneo de Células T/etiologia , Linfoma Cutâneo de Células T/terapia , Pessoa de Meia-Idade , Micose Fungoide/diagnóstico , Micose Fungoide/etiologia , Micose Fungoide/terapia , Estadiamento de Neoplasias , Doses de Radiação , Exposição à Radiação/efeitos adversos , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia , Lesões por Radiação/terapia , Pele/patologia , Pele/efeitos da radiação , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/terapia , Sobreviventes , Terapia Ultravioleta
20.
Probl Radiac Med Radiobiol ; 24: 522-536, 2019 Dec.
Artigo em Inglês, Ucraniano | MEDLINE | ID: mdl-31841493

RESUMO

OBJECTIVE: to study the hirudotherapy efficacy in presbyacuzis praecox in clean-up workers (CUWs) of the Chornobyl disaster (ChD) during the post-accident years. MATERIALS AND METHODS: From archive data of previously examined 8,136 males' CUWs we selected among them 129 persons with the determined presbyacuzis praecox during the post-accident years. According to the physical dosime- try data the individual radiation of received by CUWs during the work on a rotational scheme in the Chornobyl exclu- sion zone from the end of 1986 to 1992-1994 amounted to 0.21-0.50 Gy. The examinations were carried out using a modern standard set of audiometric, vestibulometric and electrophysiological methods. Two forms of sensory and neural hearing loss in the elderly were distinguished, namely the presbyacuzis and presbyacuzis praecox. Prior to work in the exclusion zone, patients' auditory and vestibular functions were within normal range. Among 129 patients, 68 ones with presbyacuzis praecox were included in two main age groups (aged 40-49 and 50-59 yrs) and were treated using hirudotherapy, taking into consideration their coagulation hemostasis. Other 61 patients of analogical age groups were treated by allopathotherapy. For the analysis of results obtained, techniques of variational statistics were used. RESULTS: Direct correlation (r = 0.71) between inhibitory processes in central areas of the auditory analyzer in pres- byacuzis praecox in CUWs was established by electrophysiology and by speech audiometry data obtained before the treatment. Hyperacusis signs were detected in CUWs of two main and two control groups. Following the use of two treatment schemas, a significant improving of auditory functions was found (p < 0.05) according to tone and speech audiometries. The positive hirudotherapy effect concerning hearing functions was registered in 88% cases (in 59 CUWs among 68 ones); if allopathotherapy had been used, such effect was found in 65% cases (in 45 control patients among 61 ones of control group). The duration of allopathotherapy effect reached 6-9 months comparing to 12-18 months of hiruditherapy one, being twice longer. Improving the patients' coagulation hemostasis, hirudotherapy activated cardiovascular activity favoring the increase of social adequacy in CUWs with presbyacuzis praecox. CONCLUSIONS: It has been shown that hirudotherapy as a kind of naturopathy has significant advantages over alopa- totherapy by the absence of side effects, 23.0% higher and twice as long as improvement of auditory functions. Hirudotherapy, as an effective therapeutic and recreational measures, should be more widely implemented in clini- cal practice in order to minimize the development and progression of diseases in the special population of people who have been exposed to ionizing radiation due to the Chornobyl catastrophe to continue their vitality.


Assuntos
Acidente Nuclear de Chernobyl , Socorristas , Perda Auditiva Neurossensorial/terapia , Aplicação de Sanguessugas/métodos , Lesões por Radiação/terapia , Adulto , Audiometria da Fala , Coagulação Sanguínea/fisiologia , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Reconhecimento Fisiológico de Modelo/fisiologia , Equilíbrio Postural/fisiologia , Doses de Radiação , Exposição à Radiação/efeitos adversos , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia , Lesões por Radiação/fisiopatologia , Sobreviventes , Resultado do Tratamento , Ucrânia
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