ABSTRACT
Breast cancer (BC) is one of the urgent problems of health care, which is due to a constant trend of growth. One of the risk factors for the development of breast cancer is ionizing radiation (IR). Numerous epidemiological and experimental studies have shown the high sensitivity of the mammary gland (MG) to this factor. Consideration of models of absolute and relative risks of the occurrence of radio-induced tumors of the MG in irradiated persons showed the importance of such factors as age at the time of irradiation, multiplicity. frequency of exposure, dose level and concomitant non-neoplastic diseases of the mammary and thyroid gland (TG). Excess radiation-induced cases of cervical cancer were found among irradiated women after the atomic bombings of Hiroshima and Nagasaki.Epidemiological features of the development of breast cancer under the influence of IV are presented in detail, which is one of the environmental factors involved in the formation of the modern carcinogenic situation. In con-nection with the significant sensitivity of the MG to the carcinogenic effect of IR, this form of neoplasms attracted special attention after the Chornobyl accident. The effect of small doses of radiation after the Chornobyl disaster led to a wave-like change in the incidence of breast cancer in certain periods of the year, and the radiation-induced incidence of this pathology can occur spontaneously.
Subject(s)
Breast Neoplasms , Chernobyl Nuclear Accident , Neoplasms, Radiation-Induced , Humans , Female , Breast Neoplasms/epidemiology , Breast Neoplasms/etiology , Breast Neoplasms/pathology , Radiation, Ionizing , Thyroid Gland/pathology , Risk Factors , Neoplasms, Radiation-Induced/epidemiology , Neoplasms, Radiation-Induced/etiology , Radiation DosageABSTRACT
Research activities and scientific advance achieved in 2022 at the State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine¼ (NRCRM) concerning medical problems of the Chornobyl disaster, radiation medicine, radiobiology, radiation hygiene and epidemiology in collaboration with the WHO network of medical preparedness and assistance in radiation accidents are outlined in the annual report. The report presents the results of fundamental and applied research works of the study of radiation effects and health effects of the Chornobyl accident. The report also shows the results of scientificorganizational and health care work, staff training. The Scientific Council meeting of NAMS approved the NRCRM Annual Report.
Subject(s)
Chernobyl Nuclear Accident , Radiation Injuries , Radioactive Hazard Release , Humans , Ukraine , Research ReportABSTRACT
Prerequisite. In the conditions of a full-scale invasion, the issue of radiation safety and anti-radiation protection in the Armed Forces of Ukraine (AFU) occupies a special place, since the aggressor country violated global geopolitical international decisions, occupied civilian nuclear facilities, in the process of their liberation servicemen mayhave to act in conditions of increased radiation risk, the possibility of using tactical nuclear weapons also is not excluded. OBJECTIVE: to investigate the state of the current national regulatory framework for ensuring radiation safety and anti-radiation protection of military personnel during the period of martial law. METHODS: bibliographic, analytical, historical, systematic approach. RESULTS: The main normative document on the organization of radiation safety and anti-radiation protection of both personnel and the population in Ukraine, as well as military personnel, currently in everyday conditions and in case of radiation accidents since 1998 and until now, are the State Hygienic Standards «Radiation Safety Standards of Ukraine (NRBU-97)¼. But neither in this document, nor in the transition to NRBU-2021-P, the issue of exposure to such a category as military personnel during the performance of combat (special) tasks is considered. The system of monitoring the radiation situation in Ukraine, documents on the organization of medical support for military personnel, including the Guidelines on the Medical Support of the Armed Forces of Ukraine for a Special Period (2019)and the Guidelines on the Organization of Radiation Safety in the Armed Forces of Ukraine (2020), were analyzed.modules of radiation safety principles in the Armed Forces of Ukraine were proposed. CONCLUSION: The unsolved problem of normalization of the radiation factor in the case of man-made and socio-political emergencies can create significant problems in the organization of anti-radiation protection of troops and the population in the case of the use of nuclear weapons or radiation accidents in a special period and requires anurgent solution. It is obvious that there is a need to develop regulatory documents regarding the response and planning of continuous activities to respond to potential nuclear and radiation threats during martial law, including relationships at all levels of the management vertical and methods of communication in the event of a threat.
Subject(s)
Military Personnel , Radiation Protection , Radioactive Hazard Release , Humans , UkraineABSTRACT
OBJECTIVE: scientific substantiation of the new methodology for estimation of passport doses of the settlementswhich belong to Zone of Unconditional (obligatory) Resettlement, or 2nd zone and Zone of Granted VoluntaryResettlement, or 3rd zone in the framework of dosimetric passportization in accordance with the legislation ofUkraine. MATERIALS AND METHODS: 37 years after the accident, radioactive contamination of the environment has significantly decreased. However, it is still necessary to carry out ecological and dosimetric monitoring and apply countermeasures in certain territories of Ukraine affected by the accident at the Chornobyl Nuclear Power Plant: restriction of the consumption of locally produced milk, forest products, etc. The methodology, which was since 1996 used to estimate the passport doses of Ukrainian settlements, no longer corresponds to the current level of scientific knowledge about radioactive contamination of environment. The new methods of passport doses calculating presented in the work involves the use of a model whose parameters are determined by the types, quality and completeness of radio-ecological and dosimetric monitoring carried out on the radioactively contaminated territories in 1986-2013. The methodology takes into account the specific of radioactive contamination of each settlement. The passport dose of external exposure is reconstructed only from 137Cs radionuclide, because the contributions of other Chornobyl radionuclides influence the radiation dose only in the first years after the accident. The passport dose of internal exposure is formed as a result of the consumption of 137Cs contaminated food products. It is calculated depending on the availability in the settlement in the current year of the results of measurements of the 137Cs radionuclide activity incorporated in the human body using a whole body counter (WBC) and the activity of 137Cs in the private milk. At the same time, priority is given precisely to the results of WBC measurements of 137Cs. RESULTS AND CONCLUSIONS: A new methodology (Methodology-2023) for passport doses calculation of Ukrainian settlements was substantiated. A comparison of passport doses based on the results of radioecological and dosimetric monitoring in 2011 calculated by Methodology-2023 and passport doses calculated by Methodology-96 was made.Passport doses calculated by Methodology-2023 increased by 40 % on average compared to doses calculated by Methodology-96. At the same time, passport doses of internal radiation calculated by the new methodologyincreased by 1.5 times, and passport doses of external radiation increased by 1.7 times. The passport dose of 2011, calculated by Methodology-2023, exceeds the legally established limit of 1 mSv in 71 settlements, most of which are located in Korostenkyi raion of Zhytomyr Oblast.
Subject(s)
Chernobyl Nuclear Accident , Food Contamination, Radioactive , Radiation Monitoring , Humans , Radiation Dosage , Cesium Radioisotopes/analysis , Body Burden , Food Contamination, Radioactive/analysis , Ukraine , Radiation Monitoring/methodsABSTRACT
OBJECTIVE: to estimate the risk of thyroid cancer incidence in the population of Ukraine in connection with its exposure to radioactive iodine fallout of Chornobyl origin and the use of pesticides in agricultural production in the country. OBJECT OF STUDY: Incidence rates of thyroid cancer in the population of Ukraine in 2001-2019, average regional radiation doses absorbed by the thyroid because of the Chornobyl accident, the volume of use of various groups of pesticides in the regions of Ukraine. RESEARCH METHODS: statistical, mathematical and cartographic. RESULTS: The study covering the period of 2001-2019, revealed significant temporal and regional differences in the thyroid cancer incidence in the population of the Ukraine regions in 2001-2019. The existence of a significant correlation between the thyroid cancer incidence and the amount of radiation exposure to the thyroid associated with the Chornobyl accident was established. The existence of a significant correlation between the thyroid cancer incidence and the degree of pesticide use intensity in agriculture in the Ukraine regions was established. A significant value of multiple correlation r = 0.5866 (p < 0.05) was found between the thyroid cancer incidence in Ukraine andthe average regional radiation doses and the pesticide use intensity in agricultural production in the country. CONCLUSIONS: A reliable value of the multiple correlation between the value of the average regional radiation exposure doses to the thyroid associated with the Chornobyl accident and the degree of pesticide use intensity in the national economy of Ukraine and the thyroid cancer incidence in the population was determined.
Subject(s)
Chernobyl Nuclear Accident , Endocrine Disruptors , Pesticides , Thyroid Neoplasms , Humans , Thyroid Neoplasms/epidemiology , Thyroid Neoplasms/etiology , Radiation Dosage , Incidence , Endocrine Disruptors/adverse effects , Ukraine/epidemiology , Iodine Radioisotopes/analysis , Radiation, IonizingABSTRACT
OBJECTIVE: identification of clinical and metabolic characteristics of osteogenesis and factors affecting bone mineral density (BMD) in children living in radioactively contaminated territories (RCT) after the ChNPP accident for the use of therapeutic and preventive measures aiming to reduce the incidence of disorders. MATERIALS AND METHODS: Children aged 4 to 18 years old (n = 539) were involved in the study within 4 age groups, namely under 7 years old, 7-10 years old, 10-14 years old, older than 14 years old. Studied parameters in children with a reduced BMD (85-65 relative units and under 65 relative units) were estimated vs. the normative BMD (100-85 relative units) cases. Diagnosis of osteopenia and osteoporosis in children was established according to the BMD T-index. Family history of the relatives of children was studied. Body weight at birth, fractures of the long bones, complaints of osalgia, jaw anomalies, dental caries, presence of obesity, and hypermobility syndrome (HMS) were assessed. Peripheral blood biochemical tests were performed featuring the serum total protein, alkaline phosphatase (APh), calcium, vitamin D, creatinine, serum iron (SI), ferritin, cortisol, pituitary thyroid-stimulating hormone (TSH), and free thyroxine (FT4) assay. BMD was measured and radiation doses in children were reconstructed. RESULTS: BMD depended on the age of children. A direct correlation was established between the cholelithiasis and urolithiasis incidence (Ñ < 0.01), cancer and endocrine diseases (Ñ < 0.05) in the relatives of children that had BMD under 65 relative units. Dental caries developed more often (Ñ < 0.05), while obesity was less frequent (Ñ < 0.05) in the subjects with BMD < 65 relative units. A direct correlation was established between the level of serum creatinine and BMD (Ñ < 0.01), and there was an inverse correlation between the serum APh level and BMD (Ñ < 0.001).Every third child had a vitamin D deficiency. Fractures of long bones and increased content of SI and TSH were characteristic for the children having got osteopenia (BMD within 85-65 relative units), while besides a predisposition to bone fractures the higher levels of SI, APh, cortisol both with calcium deficiency were found in children with osteoporosis (BMD < 65 relative units) compared to the general group with a similar BMD. An increased incidence of HMS was characteristic too. Radiation doses in children with osteopenia were higher than in those with osteoporosis: (1.17 ± 0.09) mSv and (0.92 ± 0.06) mSv respectively (Ñ < 0.05). No correlation was found between the radiation doses and clinical signs, blood biochemistry or BMD. CONCLUSIONS: Study of the functional mechanisms of bone structures in children, depending on their metabolism, had made it possible to reveal the factors that affect bone formation in children living in RCT after the ChNPP accident, and to form the population groups for the timely application of therapeutic and preventive measures aiming to reduce the incidence of disorders of musculoskeletal system.
Subject(s)
Bone Diseases, Metabolic , Dental Caries , Fractures, Bone , Osteoporosis , Child , Infant, Newborn , Humans , Child, Preschool , Adolescent , Thyroid Gland/diagnostic imaging , Thyroid Gland/metabolism , Calcium , Hydrocortisone , Bone and Bones/diagnostic imaging , Osteoporosis/diagnostic imaging , Osteoporosis/epidemiology , Osteoporosis/etiology , Bone Diseases, Metabolic/diagnostic imaging , Bone Diseases, Metabolic/epidemiology , Bone Diseases, Metabolic/etiology , Thyrotropin , ObesityABSTRACT
OBJECTIVE: To study the state of cardiovascular system in servicemen (SM) of Ukraine Armed Forces (UAF), who took part in the fight against russian military aggression, and the factors of military service that could cause the occurrence of circulatory system diseases. MATERIALS AND METHODS: The study included 110 men of UAF, who were undergoing examination and treatment at the NRCRM. The average age of the examinees was (46.4 ± 8.8) years. The checkup included an examination by a cardiologist and different diseases experts (as indicated), electrocardiography, Doppler echocardiography, daily monitoring of the electrocardiogram and other necessary studies. RESULTS: Hypertensive heart disease (HHD) was diagnosed in 83.6 % of patients, coronary heart disease (CHD) in 52.8 % ones, including 7.3 % of persons who survived an acute myocardial infarction, heart failure (HF) in 80.9 % of patients. Before the war, 51.8 and 7.3 % of SM suffered from HHD and CHD, respectively. Seven SM sustained a missile wound of extremities and subsequently developed HHD, suggesting a possible association between the two events (Pearson's χ2 = 4.148 with Ñ = 0.042, but Ñ = 0.081 using Fisher's exact test). Out of 18 SM without signs of HHD, 8 had normal body weight and 10 had obesity, when in SM with HHD it was 7 and 15 persons, respectively.Obesity I degree discovered in 10, and II degree in 2 SM. Excess body weight and the degree of obesity had a significant relationship with HHD development (χ2 = 8.995; Ñ = 0.029). The age of patients with CHD (50 persons) was significantly greater than that of patients without CHD (52 persons): (50.1 ± 5.4) vs. (42.0 ± 9.5) years at Ñ = 0.000. CONCLUSIONS: Among circulatory system diseases in SM of UAF HHD and CHD were the most common ones. More than half of the SM were sick with HHD before being drafted into the army. During the period of taking part in the war the development of HHD new cases was observed in 35 SM, and CHD in 50 SM. The onset of HHD new cases can be associated with missile wound of extremities and obesity, and new CÐD cases with age factor.
Subject(s)
Cardiovascular System , Coronary Disease , Hypertension , Military Personnel , Male , Humans , Adult , Middle Aged , Ukraine/epidemiology , Hypertension/epidemiology , Hypertension/etiology , Obesity/epidemiologyABSTRACT
Objective - to investigate the course of B-cell chronic lymphocytic leukemia (CLL) in patients after SARS-CoV-2 virus infection taking into account anamnestic exposure to the ionizing radiation (IR).Methods. The study was performed in a group of 51 CLL patients who were admitted to the Department of Radiation hematology of the National Research Center for Radiation Medicine of NAMS of Ukraine, Kyiv, from January 2020 (the beginning of SARS-CoV-2 epidemic) to August 2023. The group included 19 (37.3 %) clean-up workers of the Chornobyl NPP accident, 15 (29.4 %) inhabitants of radionuclide contaminated areas and 17 (33.3 %) IR non-exposed patients. The diagnosis of CLL was based on clinical history, lymphocyte morphology, and immunophenotypic criteria. Statistical studies were performed using the SPSS software package, version 20.0.Results. The diagnosis of CLL was established for the first time in 14 patients, in seven of them, CLL was diagnosed after 2-17 months after SARS-CoV-2 infection. In contrast to patients who did not suffer from a coronavirus infection, they had pronounced lymphadenopathy, which in some cases was accompanied by hyperleukocytosis, and needed early treatment. Thirteen patients with a previously established CLL were diagnosed with COVID-19 by PCR test. In seven of them (53.8 %) starting treatment was needed, or CLL has progressed. Seven of 51 patients (13.5 %) were vaccinated against SARS-CoV-2. Then, four of them were diagnosed with SARS-CoV-2 infection, confirmed by a positive PCR test, and two patients had a relapse of CLL within 1-2 months after vaccination. Most of patients with signs of the influence of SARS-CoV-2 infection on CLL belonged to sufferers of the Chornobyl NPP accident Conclusions. The clinical features of CLL that developed after SARS-CoV-2 were characterized firstly. The negative impact of SARS-CoV-2 infection on previously established CLL was established. The question about vaccination of CLL patients remains debatable.
Subject(s)
COVID-19 , Chernobyl Nuclear Accident , Leukemia, Lymphocytic, Chronic, B-Cell , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/etiology , SARS-CoV-2 , LymphocytesABSTRACT
OBJECTIVE: assessment of clinical-hematological and metabolic-biochemical parameters of the of bone tissue and hormonal regulation depending on the serum iron content and radiation dose values in children living on radiologically contaminated territories after the ChNPP accident in Ukraine. MATERIALS AND METHODS: Children (n = 271) living on radiologically contaminated territories (RCT) of Ukraine were involved in the study. Three study groups were formed according to the serum iron level (SIL), namely group I with SIL 10.0-22.0 µmol/l (n = 92), group II with SIL 23.0-34.0 µmol/l (n = 144), and group III with SIL above 35.0 µmol/l (n = 35). Diseases in the family tree, bodyweight at birth, complaints on osalgia, bone fractures, jaw anomalies, dental caries, and obesity were accounted. Morphometric parameters of erythrocytes and hemogram elements were analyzed. Creatinine, alkaline phosphatase, calcium, total protein, iron, cholesterol, bilirubin, and transaminases were assayed in blood serum. The urine content of the 19 free amino acids, serum content of the free thyroxine (FT4), pituitary thyroid-stimulating hormone (TSH), and cortisol were assayed both with bone tissue density. Individual radiation doses were calculated. RESULTS: In 12.9 % of cases the SIL was > 35.0 µmol/l. Relatives with endocrine diseases were often present in the family tree of children with SIL > 23.0 µmol/l. There were increased urine content of the free amino acids (p < 0.05) and signs of protein degradation under high SIL. Contents of amino acids involved in collagen synthesis and antioxidant status (alanine, serine, glutamine, aspartic acid) and iron metabolism (arginine, leucine) were assayed at the highest levels (p < 0.05). Urinary levels of valine, lysine, and methionine, which are associated with iron metabolism, were decreased (p < 0.05). An inverse correlation (rs = -0.58; p < 0.01) was established between the serum TSH and cortisol levels regardless of the SIL. Serum TSH level directly correlated with urine content of amino acids involved in collagen synthesis. An inverse correlation (rs = -0.55; p < 0.001) was established between the serum TSH level and urine content of tyrosine that is essential for the thyroid hormone (triiodothyronine and thyroxine) synthesis.Cortisol was found having a negative effect on protein synthesis. Inverse correlation was established between the serum cortisol level and urine content of the free amino acids essential for collagen synthesis. There was no dependence of the average radiation dose values on the SIL. An inverse correlation was determined between the patient's radiation dose and SIL > 35.0 µmol/l (rs = -0.29; p < 0.05). CONCLUSIONS: The increased SIL in children living on RCT may occur due to both a genetic predisposition and the acquired factors driving protein and mineral metabolism of bone and their hormonal regulation.
Subject(s)
Hydrocortisone , Thyroxine , Child , Infant, Newborn , Humans , Ukraine , Thyrotropin , Iron , Amino Acids , CollagenABSTRACT
OBJECTIVE: to evaluate the subpopulation structure of peripheral blood leukocytes as a component of inflammaging in the servicemen of the Armed Forces of Ukraine and clean-up workers of the accident at the Chornobyl nuclear power plant. MATERIALS AND METHODS: Three hundred ninety-seven males aged 30-82 (54.99 ± 8.85) years examined. Among them: clean-up workers of the accident at the Chornobyl nuclear power plant, aged 54-64 (59.95 ± 1.88) years, who were examined before the beginning and during the Russian military invasion of Ukraine; 24 civilians of the control group, aged 50-77 (58.87 ± 7.18) years and 15 persons of the age control group, aged 42-49 (46.00 ± 2.26) years, who examined before the war has started; the comparison group-W - 27 civilians (age: 51-82 (65.44 ± 9.13)) and the age control group-W - 14 civilians (age: 31-49 (40.64 ± 5.59)) who examined after the war has started; 73 servicemen of the Armed Forces of Ukraine aged 30-49 (42.20 ± 5.35) years and 54 servicemen aged 50-59 (54.07 ± 2.86) years. The subpopulation distribution of peripheral blood leukocytes was analyzed using flow cytometry. RESULTS: A decrease in the relative number of CD45+ 14- granulocytes, CD3+ HLA-DR+ T-lymphocytes, and CD3-57+ NK against the background of an increase in the number of CD45+ 14+ monocytes, CD3-HLA-DR+ B-lymphocytes found in the majority of people in the examination groups, the study of which conducted after the beginning of the war, CD4+ T-lymphocytes and CD3+ 57+ NKT. The relative number of CD45+ 14- granulocytes increased against the background of a decrease in CD45+ 14- lymphocytes was noted in clean-up workers who were examined before the war started.About 30% of civilians over 50 years of age who were examined before the war started had a decrease in CD19+ B- lymphocytes, CD4+ and CD8+ T-lymphocytes, CD3-57+ NK, CD3+ 57+ NKT, and the CD4+ / CD8+ ratio. Conducted correlation analysis revealed a weak to moderate inverse correlation between the relative number of CD19+ B-lymphocytes and age in civilians, regardless of when they were examined, and the servicemen of the Armed Forces of Ukraine.Inverse correlations of HLA-DR+ B-lymphocytes, CD45+ 14+ monocytes, CD4+ T-lymphocytes, CD4+ / CD8+ ratio, and CD3-57+ NK and CD3+ 57+ NKT with age were noted in civilians who were examined after the war has started. A direct correlation between CD3+ 57+ NKT and age was found in the servicemen of the Armed Forces of Ukraine. CONCLUSIONS: The immunological profile of both clean-up workers in the Chornobyl nuclear power plant and the servicemen of the Armed Forces of Ukraine or civilians was similar compared to the group with reference indicators. Anintergroup study revealed changes in the subpopulation distribution of peripheral blood leukocytes, which may be associated with both aging and changes in living conditions during military operations. Specific changes in cellular immunity can either tip the balance towards inflammaging or indicate already existing immunopathologicalreactions.
Subject(s)
Chernobyl Nuclear Accident , Military Personnel , Radiation Injuries , Male , Humans , Middle Aged , Aged , Aged, 80 and over , Adult , Lymphocytes , HLA-DR Antigens , UkraineABSTRACT
INTRODUCTION: The victims of the Chornobyl accident, as well as whole population of Ukraine, have become the object of the COVID-19 pandemic in today's conditions. As of 01.01.2020, 108,898 victims had documented permanent disability (persons with disabilities) and, as a rule, suffered from 4-6 types of non-tumor chronic diseases of internal organs, primarily the circulatory system, as well as oncological and endocrine pathology, that significantly affect the course of COVID-19 in a severe scenario and contribute to death. This determines the relevance of the issue of the impact of comorbid pathology in fatal cases due to coronavirus disease (COVID-19) in victims of the Chornobyl accident.The Objective of the study was to study the nature and significance of comorbid pathology in the victims of the Chernobyl accident who died from COVID-19.Design, object and methods of the study - a retrospective non-randomized, comparative comprehensive analysis of the materials of 134 medical expert cases of male clean-up workers of the Chornobyl accident who died from COVID-19 in 2020-2022 during the pandemic was carried out. The analysis of the materials of expert cases included the study of clinically significant and morphologically confirmed pathological processes. The source of the data was the materials of the Central Interdepartmental Expert Commission of the Ministry of Health of Ukraine on the establishment of causal relationship of diseases, disability and death with the action of ionizing radiation and other harmful factors as a result of the Chernobyl accident. RESULTS: In the structure of comorbid pathology in the clean-up workers of the Chornobyl accident who died due to COVID-19 during 2020-2022, diseases of the circulatory system dominate, which occurred in 86.57% of cases of consideration of medical expert cases. AH complicated the course and contributed to the development of fatal consequences in 52.24% of cases, ChIHD - in 34.32% of cases. The consequences of acute vascular events in the form of post-infarction cardiosclerosis in patients with ChIHD contributed to death in COVID-19 in 29 (21.64%) cases.Cerebrovascular pathology represented by cerebral atherosclerosis was detected in 76 (56.72%) cases of death from COVID-19. Acute vascular cerebral events in the cerebral basin (ischemic and hemorrhagic strokes) contributed to fatal outcomes in 19 (14.18%) cases. The presence and course of diabetes mellitus also had a significant impact on the course and fatal mortality of COVID-19 - 24.63% (33 cases). Chronic respiratory diseases (COPD) influenced the course of COVID-19 and contributed to death in 6.72% (9) of cases, nephrological pathology (ChTIN) - in 2.98% (4) of cases, peptic ulcer disease of the duedenum - in 2.24% (3) of cases. More than half of the clean-up workers of the Chornobyl NPP accident who died due to COVID-19 had more than two severe chronic diseases of the comorbid component and their complications. CONCLUSIONS: Сlean-up workers of the Chornobyl accident who died from COVID-19 had another severe comorbid chronic disease, or several diseases that influenced the course of coronavirus disease and each other and contributed to the development of fatal consequences. Death from COVID-19 is much more common in clean-up workers of the Chornobyl accident suffering from severe disabling non-oncological diseases of the cardiovascular system (arterial hypertension, coronary heart disease), cerebrovascular diseases with consequences of acute vascular events, as well as diabetes mellitus. Victims of the Chornobyl catastrophe, especially clean-up workers of the Chornobyl NPP accident, are at special risk for severe coronavirus disease and death from COVID-19.
Subject(s)
COVID-19 , Chernobyl Nuclear Accident , Diabetes Mellitus , Radiation Exposure , Humans , Male , Retrospective Studies , Radiation Dosage , Pandemics , COVID-19/epidemiology , Diabetes Mellitus/epidemiology , Chronic Disease , Ukraine/epidemiologyABSTRACT
Under the conditions of war in Ukraine, there remains a high probability that russia will use nuclear weapons or commit terrorist acts against nuclear power plants, which will lead to exposure of the population in doses that cause acute radiation sickness (ARS). In this regard, our medical service must be ready for the treatment of ARS of various degrees of severity under a mass influx of victims. In peacetime, ARS is a rather infrequent pathology, so most doctors lack experience in its treatment. This article, having the form of a lecture, presents material on the pathogenesis, classification, clinic, diagnosis and treatment of ARS, taking into account the modern achievements of radiation medicine. Treatment of ARS is based on the use of pharmaceutical drugs that are licensed in Ukraine. The article will be useful for doctors and medical workers of all branches and levels of health care, who will have to deal with irradiated persons in order to timely identify patients with ARS and provide them with effective treatment.
Subject(s)
Acute Radiation Syndrome , Humans , Acute Radiation Syndrome/diagnosis , Acute Radiation Syndrome/etiology , Acute Radiation Syndrome/therapy , UkraineABSTRACT
BACKGROUND: The typical chronic lymphocytic leukemia (CLL) immunophenotype is vital for diagnosis, but the expression of some antigens varies and has prognostic value. There are data that reduced CD20 expression is associated with NOTCH1 and SF3B1 gene mutations. AIM: To determine a high-risk group of CLL patients for prediction of unfavorable NOTCH1 and SF3B1 gene mutations based on immunophenotyping of leukemic cells. MATERIALS AND METHODS: Flow cytometric and molecular-genetic analysis (mutations of NOTCH1, SF3B1, and TP53 genes using the polymerase chain reaction followed by direct sequencing) was performed in a group of 86 previously untreated CLL patients. RESULTS: The immunophenotype of leukemic cells of all examined patients met the criteria of CLL diagnosis. NOTCH1 gene mutations were found in 21 patients (24.4%), and SF3B1 gene mutations - in 7 patients (8.1%). There were no TP53 gene mutations among the examined patients. A decreased number of CD20+CD5+ cells and a downward trend in the relative index of mean fluorescence intensity (iMFI) of CD20+ cells were found in patients with NOTCH1 and SF3B1 gene mutations. Based on the iMFI level (higher and/or lower than 3.0) and the number of CD20+CD5+ cells among all B-cells (higher and/or lower than 50%), we distinguished CLL cases with low and relatively high levels of CD20 antigen expression. Using ROC analysis and the parameter of low CD20 antigen expression, we could predict the presence of NOTCH1 and SF3B1 gene mutations in 73.3 ± 0.06% of patients (p = 0.001). The risk of NOTCH1 and SF3B1 gene mutations in cases with low CD20 antigen expression was 6.96 (95% CI = 2.53-19.18; p = 0.0001). The revealed regularities were statistically significant for patients in whom the diagnosis was established in all Binet - Rai stages except A0-AI. CONCLUSION: Our data confirmed a reduced CD20 expression in CLL patients with NOTCH1 and SF3B1 mutations. In addition, an approach was proposed to identify high-risk CLL patients for prediction of such mutations: previously untreated CLL patients at advanced Binet - Rai stages (BII, CIII, CIV) with a reduced number of double-positive CD20+CD5+ cells in peripheral blood and/or low iMFI of CD20+ cells.
Subject(s)
Leukemia, Lymphocytic, Chronic, B-Cell , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis , Leukemia, Lymphocytic, Chronic, B-Cell/genetics , Antigens, CD20 , Immunophenotyping , B-Lymphocytes , Transcription Factors , Mutation , Receptor, Notch1/genetics , RNA Splicing Factors/genetics , Phosphoproteins/geneticsABSTRACT
Despite current research in the development of drugbased cytostatic and targeted therapies in the treatment of breast cancer, radiation therapy (RT) is an important component in the treatment of this pathology in the postoperative period. At the same time, an important problem is the development of pathological changes in the heart in the longterm period, which worsen the quality of life and increase the risk of cardiac death 10 or more years after RT The problem of heart damage due to RT is gaining new significance due to the existing increase in the number of cancer patients requiring radiation exposure in the modern world. RT of malignant tumors of the breast and organs of the chest cavity causes damage to all structures of the heart, including the coronary arteries, valves, conducting system, pericardium. The frequency of heart damage increases in proportion to the time that has passed after RT. According to some authors, the prevalence of clinically significant radiationinduced heart diseases 5-10 years after RT is 10-30%, and the frequency of asymptomatic lesions is 88%. The duration of the latent period can reach 15-20 years. The work has an analysis of longterm studies of the presence of pathological changes that are found in the heart tissues of patients with breast cancer, as a result of radiation therapy.
Subject(s)
Breast Neoplasms , Heart Injuries , Female , Humans , Breast Neoplasms/pathology , Quality of Life , Heart , Coronary VesselsABSTRACT
Any collection of objects of study needs some arrangement, i. e. classification. The existing numerous classifications of antiradiation agents are built on the basis of their antiradiation effects of an integrated or differentiated nature. The work presents the chronology of the main classifications of chemical compounds that are able to protect against the shortterm and longterm effects of ionizing radiation when they are introduced into the body both before and after exposure. The change of views, trends and paradigms regarding radioprotective compounds is shown. These classifications of antiradiation medicines include radioprotectors, means of stimulating the radioresistance of the body, means of prevention and suppression of the primary reaction to irradiation, means of prevention and treatment of lesions from exposure to incorporated radionuclides, means of treatment of acute bone marrow syndrome, means of treatment of local radiation lesions. It is shown that modern concepts of radiation protection are based on fundamentally different «points of application¼ of groups of radioprotective agents and depend on the stage of radiation damage.
Subject(s)
Radiation Injuries , Radiation Protection , Radiation-Protective Agents , Humans , Radiation-Protective Agents/pharmacology , Radiation-Protective Agents/therapeutic use , Radiation Injuries/etiology , Radiation Injuries/prevention & control , Radiation, IonizingABSTRACT
Research activities and scientific advance achieved in 2021 at the State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine¼ (NRCRM) concerning medical problems of the Chornobyl disaster, radiation medicine, radiobiology, radiation hygiene and epidemiology in collaboration with the WHO network of medical preparedness and assistance in radiation accidents are outlined in the annual report. The report presents the results of fundamental and applied research works of the study of radiation effectsand health effects of the Chornobyl accident.The report also shows the results of scientific-organizational and health care work, staff training. The Scientific Council meeting of NAMS approved the NRCRM Annual Report.
Subject(s)
Chernobyl Nuclear Accident , Radiation Injuries , Radioactive Hazard Release , Humans , Ukraine , Research ReportABSTRACT
Studies of the longterm oncological consequences after the Chornobyl accident show a significant impact of radiation exposure on the cancer incidence rate in affected population in Ukraine. This is supported by the increased radiation risk of leukaemia in liquidators, which exceeds national population rates, and its value is comparable to the data on hibakushi, who were subjected to Abombings. For the first time in the cleanup workers cohort the radiation dependence of chronic lymphoid leukaemia was established. There are radiation associated risks of leukemia in children who have been exposed to radiation from the Chornobyl accident. There has been registered an increase of thyroid cancer incidence in children and adults (liquidators, evacuees from the 30km exclusion zone and residents of the most contaminated territories). There is an excess of breast cancer in female liquidators. The frequency of all forms of malignant neoplasms decreases over time but still exceeds national rates. Further monitoring of malignant neoplasms in the groups of affected population will allow evaluating the radiation risks of cancer forms whose radiationassociated manifestation is already known from previous studies or can be expected in the future.
Subject(s)
Breast Neoplasms , Chernobyl Nuclear Accident , Radiation Exposure , Thyroid Neoplasms , Adult , Child , Humans , Female , Radiation Exposure/adverse effects , Thyroid Neoplasms/epidemiology , Thyroid Neoplasms/etiology , Ukraine/epidemiology , Radiation DosageABSTRACT
OBJECTIVE: to determine which changes of cardiovascular system clinical, and structural, and functional state in emergency workers (EW) of the accident at the Chornobyl nuclear power plant (CNNP) can be associated with COVID-19 they suffered from and not with the natural progression of coronary heart disease (CHD). MATERIALS AND METHODS: The study included 16 male EW who fell ill with mild and medium-severe COVID-19 (EWC group) in 2020-2021, which was confirmed by a PCR test (polymerase chain reaction). All these patients were observed in the NRCRM cardiology department before infection with the coronavirus. The comparison group consisted of 32 EW who did not suffer from COVID-19 and their age and examination dates corresponded to EWC. General clinical, laboratory, statistical methods and Doppler echocardiography were used for patients examination. RESULTS: In the post-covid period, EW-C observed a worsening of CHD clinical course, which consisted in an increase in the number of patients with severe functional class angina pectoris, with ventricular and supraventricular extrasystoles, as well as with more severe heart failure (HF). Since similar changes in the state of the cardiovascular system were found among EW who did not suffer from COVID-19, they can be attributed to the natural progression of CHD. In the EW-C group, there was an increase in the number of patients with atrial fibrillation (AF) by 4 times (up 37.5 %), while in the comparison group EW only by 1.1 times (up 3.1 %). The progression of CHD and HF in the examined patients was accompanied by an increase in the end-diastolic and end-systolic volumes of the left ventricle and the mass of the myocardium, the severity of which was not significantly different in patients with and without COVID-19. The number of post-covid patients with reduced ejection fraction (EF) during examination after COVID-19 increased by 31.3 %, and in the group of EW, which were examined at the same time, by 6.32 %. CONCLUSIONS: A significant increase in the number of patients with AF and a reduced EF in the EW-C compared with the EW can be attributed to the results of the SARS-CoV-2 virus influence on cardiovascular system.
Subject(s)
COVID-19 , Chernobyl Nuclear Accident , Coronary Disease , Humans , SARS-CoV-2 , Coronary Disease/epidemiology , Coronary Disease/etiology , MyocardiumABSTRACT
OBJECTIVE: to establish cellular immunity in clean-up workers of the Chornobyl accident compared to patients with malignant neoplasms of the oral cavity, oral and laryngeal parts of the pharynx according to the subpopulation organization of peripheral blood leukocytes. MATERIALS AND METHODS: We examined 112 males, age (56,92 ± 6,17) years (M ± SD), including 26 male clean-up workers exposed at the radiation dose 10-500 mSv; 20 male clean-up workers exposed at the dose range 504-990mSv; 33 patients with malignant neoplasms of the oral cavity, oral and laryngeal parts of the pharynx and 33 non-exposed subjects of the control group. Immune cell subsets analysis was performed by the expression of differential and activation antigens of peripheral blood leukocytes using flow cytometry. RESULTS: In assessing each group's cellular immunity, there was a decrease in the number of CD19+ B-lymphocytes, CD3+ HLA-DR+ T- and CD3- HLA-DR+ B-lymphocytes, CD3- 16+ 56+ natural killer cells, combined with an increase in the number of CD8+ T-lymphocytes. An increase in the relative number of CD4+ CD8+ T-lymphocytes was determined in clean-up workers (D < 500 mSv) and cancer patients. An increase in the number of CD8+ T-lymphocytes and a decrease in the number of CD4+ T-lymphocytes were observed in clean-up workers (D > 500 mSv), as well as in cancer patients. In addition, a decrease of monocytes, CD3+ 16+ 56+ , and CD3+ TCRαß+ T-lymphocytes was determined in patients with oncological pathology. CONCLUSIONS: The obtained results show the unidirectionality of changes in cellular immunity in the participants of the liquidation of the consequences of the accident at the Chornobyl nuclear power plant and patients with the investigated oncological pathology, which indicates the formation of persistent violations of antitumor protection in the participants of the liquidation of the consequences of the accident as the basis of oncogenesis. Determining changes in the number of lymphocytes, monocytes, granulocytes, CD4+ T-lymphocytes, CD4+ CD8+ immature T-lymphocytes, the immunoregulatory ratio CD4+ / CD8+, CD3+TCRαß+ T-lymphocytes and CD3+ 16+ 56+ CTL can have an additional effect on the effectiveness antitumor protection and the probability of oncogenesis risk in immunocompromised individuals.
Subject(s)
Chernobyl Nuclear Accident , Immunity, Cellular , Mouth Neoplasms , Pharyngeal Neoplasms , Humans , Male , Carcinogenesis , HLA-DR Antigens , Mouth Neoplasms/epidemiology , Pharynx , Middle Aged , Pharyngeal Neoplasms/epidemiologyABSTRACT
OBJECTIVE: to determine the causes of increased bone mineral density (BMD) based on case history, clinical and laboratory data, including the assay of hormones involved in ossification processes in children, living on radiologically contaminated territories (RCT) after the accident at the ChNPP, compared to the normative BMD patterns. MATERIALS AND METHODS: There were 289 children involved in the study. The 1st group included persons with a BMD above 100 IU, 2nd group - with normative BMD (100-85 IU). Family history of diseases was assessed featuring cancer and endocrine diseases, cholelithiasis, and urolithiasis. Weight of the child at birth, frequency of bone fractures, complaints about osalgia, jaw abnormalities, dental caries, presence or absence of obesity, peripheral blood count, blood biochemical parameters (total protein, creatinine, iron, alkaline phosphatase, calcium), serum pituitary thyroid-stimulating hormone and cortisol were accounted. Children's radiation doses were calculated according to the materials of the «General dosimetric certification of settlements of Ukraine that were exposed to radioactive contamination after the Chornobyl accident¼. RESULTS: Higher than normative BMD values were found in children after puberty, while normative ones - in puberty (Ñ < 0.001), regardless of gender. A direct correlation between the bone fractures frequency was established in children with increased BMD (Ñ < 0.01). Jaw anomalies and dental caries occurred at that significantly less often than in normative BMD (Ñ > 0.05). A direct correlation was established between the obesity and BMD (Ñ < 0.001).Increased alkaline phosphatase activity was inversely correlated with BMD (rs = -0.21; Ñ < 0.05). In children with elevated BMD a direct correlation was established between the level of iron and endocrine disorders in the family history (Ñ > 0.001). Serum level of cortisol was directly correlated with dental caries (Ñ < 0.05). In children, regardless of BMD value, a direct correlation was established between the radiation dose, age and obesity (Ñ < 0.001). CONCLUSIONS: Higher than normative BMD is accompanied by an increased frequency of bone fractures, jaw abnormalities, metabolic changes in bone tissue and bone tissue hormonal regulation in children, which requires application of pathogenetic therapy for the osteogenesis.
