Initial healthcare to pediatric population under the radiation events. / MEDYChNA DOPOMOGA DYTIaChOMU NASELENNIu PRY RADIATsIY̆NYKh PODIIaKh NA PERShYKh ETAPAKh.

The objective of this paper is to analyze the data from scientific literature and available recommendations for health professionals on healthcare providing to pediatric population in the events associated with risk of radiation exposure. Over the past sixty years there were several large scale radiological events with a large number of chil dren affected, namely the atomic bombing of Hiroshima and Nagasaki, accident at the Chornobyl nuclear power plant, contact to 137Cs radiation source unutilized at the hospital shutdown in Brazil etc. Further research has crys tallized injuries and health disorders in the survived children in all cases being much more significant vs. other pop ulations. Analysis of circumstances and features of a number of emergency situations or incidents in the nuclear industry for several decades has shown a high probability of radioactive materials release into the environment. The danger of terrorism with the use of ionizing radiation sources resulting in a considered inevitable hazard to the chil dren is estimated as serious in recent years and deserves an especial mention here.

Non cancer thyroid and other endocrine disease in children and adults exposed to ionizing radiation after the ChNPP accident. / NEZLOIaKISNA TYREOIDNA TA INShA ENDOKRYNNA PATOLOGIIa U DOROSLYKh I DITEY, OPROMINENYKh VNASLIDOK AVARII NA ChAES.

STUDY OBJECTIVE: To summarize the verified clinical and epidemiological data on the natural history of non cancer endocrine disease in remote period after the ChNPP accident in survivors of adult and children age. MATERIALS AND METHODS: Retrospective estimation was carried out of data on 24,588 adult persons and 20,087 chil dren survived after the ChNNP accident and being healthy or having any diseases. Data were retrieved from database of the Clinical Epidemiological Registry (CER), NRCRM for the 23 years (1992-2014) of survey. Average total external radiation dose in adults was 0.187 Gy, range of thyroid dose in children was 0.1-1.55 Gy. These data were verifies in a separate clinical study. Anthropometric, laboratory biochemical and hormonal assay values, thyroid ultrasound imaging patterns and radiation dose values were retrieved for the study. RESULTS: Retrospective data review for the 1992-2014 period indicated that incidence of thyroid disease in all per sons survived after the ChNPP accident run at 40.29% with 35.37% among the clean up workers, 27.24% among evac uees, and 28.6% among population of contaminated territories that all is significantly (p < 0.0001) higher vs. the entire population of Ukraine (3.9%). Following non cancer endocrine diseases were most prevalent in the ChNPP acci dent survivors: nodular goiter (14.35%), chronic autoimmune thyroiditis (~8%), pre obesity and obesity (41.9% and 36.8% respectively), prediabetes and diabetes mellitus (15.5% and 21.4% respectively). Nodular goiter (21.8%), chronic autoimmune thyroiditis (12.95%), pre obesity and obesity (41.71% and 33.61% respectively), and predia betes and diabetes mellitus (8.6% and 12.15% respectively) were most often diagnosed in the ChNPP accident clean up workers. Children evacuated from the 30 kilometer exclusion zone were a critical population group. They were diagnosed diffuse non toxic goiter in 43.68%, chronic autoimmune thyroiditis in 1.74%, primary hypothyroidism in 0.96%, and nodular goiter in 2.57%. Peak prevalence of chronic autoimmune thyroiditis occurred in 2001-2003 i.e. in a period of their intensive pubertal maturation. In children (first generation) of exposed parents the thyroid dis ease was revealed in 42.64%, that exceeded the incidence in control group, chronic autoimmune thyroiditis was found rarer i.e. in 0.45%, diffuse non toxic goiter in 9.5-13.8%, nodular goiter in 1.7%. CONCLUSIONS: Non cancer endocrine disease in children and adults exposed to ionizing radiation is frequent and reg istered in 3 53% of persons. It occurs in most of survivors 10-15 years upon the impact of radiation factor as a result of man made accident and continues to grow slowly in 30 years.

Morbidity pattern of non-cancer endocrine disease in ChNPP accident emergency workers (1992-2013 Clinical/Epidemiological Registry data). / Struktura nezlojakisnoi' endokrynnoi' patologii' v uchasnykiv likvidacii' naslidkiv avarii' na ChAES (za danymy Kliniko-Epidemiologichnogo Rejestru 1992-2013 rr.).

Objective. The study examined the morbidity pattern of non-cancer endocrine disease in ChNPP accident emergency workers (AEW) versus the entire population of Ukraine. Materials and methods. The study included a retrospective estimation of the examination data from 10,771 ChNPP AEW of the so-called iodine and non-iodine periods (main study group). Data were received from the RCRM Clinical/Epidemiological Registry for the survey period of 22 years (1992-2013) on persons been either healthy or having a range of endocrine disease. Anthropometric measures both with biochemical and hormonal assay data and external radiation dose values were taken into account. Diagnostic thyroid ultrasound was applied. Results. There is a significant (2-10-fold) and reliable (p < 0.01) increase of the incidence of non-cancer endocrine disease in the ChNPP AEW, namely by 23.20 % of nodular goiter (0.53 % in control, χ2 = 9602, р < 0.0001), by 13.37 % of autoimmune thyroiditis (0.35 % in control; χ2 = 5381, р < 0.0001), by 11.89 % in average and by 16.29 % in last years of type 2 diabetes mellitus (χ2 = 2527, р < 0.0001), by 41.67 % of pre-obesity (χ2 = 10.92, р < 0.01), and by 38.12 % of obesity (χ2 = 41.50, р < 0.01) compared to the entire population. Conclusions. Effects of ionizing radiation and other hazardous factors on endocrine system in the ChNPP AEW appeared upon 15-25 years. There was a significant (2-10-fold) and reliable (p < 0.01) increase of the incidence of the nodular goiter, autoimmune thyroiditis, obesity, type 2 diabetes mellitus. And there is a trend to further increase.

[Treatment of the muscles in primary amputation of the lower extremity]. / Ob obrabotke myshts pri pervichnoi amputatsii nizhnei konechnosti.

Histological and histochemical investigations of muscles in 18 patients have shown that when performing primary amputations of lower extremities according to the type of surgical treatment in the wound stump there necessarily remains muscular tissue of lower viability with necrotic areas.

[Resection of the pancreas in necrotic pancreatitis]. / O rezektsii podzheludochnoi zhelezy u bol'nykh nekroticheskim pankreatitom.

The grounds for expediency of pancreatic resection in various periods of the necrotic pancreatitis clinical course are presented together with the description of a simplier technique of a left-side resection of the gland combined with spleenectomy. The left-side resection of the pancreas was carried out in 74 cases, pancreatoduodenal resection--in 1 patient. 4 patients died.