RESUMO
OBJECTIVE: assessment of impact of operation of the Pivdennoukrainska Nuclear Power Plant (PUNPP) on the environment of surveillance zone (SZ) based on parameters of radiation monitoring within 2015-2021 period. METHODS: socio-hygienic (analysis of the radiation monitoring parameters), analytical, statistical. RESULTS: The environmental radiation impact associated with emissions and discharges of radioactive substances originated in the production cycle of the PUNPP in everyday conditions was found as insignificant. The gas-aerosol atmospheric emissions of inert radioactive gases, long-lived nuclides, and 131I did not exceed the established permissible levels (PL) and amounted to a hundredth of a percent of the emission limit (EL) for the inert radioactive gases and long-lived nuclides, and a thousandth of a percent for radioactive iodine. Total atmospheric emissions of the 51Cr, 54Mn, 59Fe, 58Co, 60Co, 90Sr, 95Zr, 95Nb, 134Cs, 137Cs, and 3Ð radionuclides by the PUNPP power units (actual and % of EL) did not exceed the established PL. Maximum average values of atmospheric air concentration of 137Cs in SZ forthe 2015-2021 period ranged from 2.858 µBq/m3 (PUNPP industrial site) to 1.986 µBq/m3 (Riabokoneve village, 33.5 km distance), and maximum average values of the 90Sr air concentration were from 1.310 µBq/m3 to 0.566 µBq/m3, respectively. According to radionuclide monitoring no significant change of the quality of surface water occurred upon the PUNPP discharges to the Pivdennyi Bug River. Specific activity of the 137Сs in agricultural products in the PUNPP SZ was insignificant and not exceeding the PL of the content in food products. Content of 137Cs in the samples from the PUNPP SZ did not exceed 1.0 % of the total activity. CONCLUSION: Average concentration of radionuclides in atmospheric air of the settlements in the PUNPP SZ was several orders of magnitude lower than that established by regulatory documents. The PUNPP discharges to the Pivdennyi Bug River, according to radionuclide parameters that are monitored, have not significantly changed the quality of surface water. The content of 90Sr and 137Cs was uniform in all observation radii of distance from the NPP, confirming the very low level of 90Sr and 137Cs environmental emission by the PUNPP. The content of 137Cs in agricultural products within the PUNPP SZ was significantly lower than PL.
Assuntos
Neoplasias da Glândula Tireoide , Poluentes Radioativos da Água , Humanos , Radioisótopos de Césio/análise , Radioisótopos do Iodo/análise , Radioisótopos de Estrôncio/análise , Manganês/análise , Poluentes Radioativos da Água/análise , Água/análise , Gases/análiseRESUMO
OBJECTIVE: to assess the state of information needs of the population and its provision by local governments on the safety of nuclear energy facilities and community preparedness for emergencies at nuclear power plants (NNP). MATERIALS AND METHODS: To determine the information needs of the population, a survey of the working population of the surveillance zone (SZ) of the NPP was conducted using unique probability sampling, where the sample was 322 people and the sampling error was 5.4 % with a confidence interval of 95.0 %. The issues of population behavior in case of emergencies at NPPs were studied. The assessment of the quality of the information content of the official websites of the executive authorities and local governments of various levels on radiation safety issues was carried out. RESULTS: The population of the SZ NPP considers the most effective information at the place of work, through neighbors, friends, from State Emergency Service specialists. Among information channels, the first place in terms of efficiency is occupied by Internet resources and social networks; the press and television occupy the second position, but remain convenient for the majority of the population. The most popular information related to NPP activities are: radiation status, environmental impact, benefits and subventions, such as compensation for the risk of living near NPPs, conditions of storage and disposal of radioactive waste. The preparedness of communities and the behavior of the population, in case of an emergency at the nuclear power plant, has been practiced in the satellite city and partially in the cities, but the rural population understands the sequence of actions much worse. CONCLUSION: Information support in NPP satellite cities is significantly better compared to rural areas of SZ. Bodies of executive power and local selfgovernment of the NPP SZ do not perform their function of informing the population on radiation safety and community readiness for emergencies through their official websites. The problem of information support of territorial communities is one of the most important to prevent the consequences of emergencies.
Assuntos
Emergências , Energia Nuclear , Humanos , Meio Ambiente , Centrais NuclearesRESUMO
OBJECTIVE: to determine the place of health in the system of values of the population of the surveillance zone (SZ)of nuclear power plants (NPPs) and its importance in the perception of emergency risks (ER). MATERIALS AND METHODS: To determine the place of health in the value system, a survey of the able-bodied popula-tion of satellite cities of Rivne (RNPP) and South Ukrainian (SUNPP) nuclear power plants was conducted using non-repetitive sampling, where the sampling error does not exceed 7,0 %. The motivational and behavioral componentthat determined health in the individual hierarchy of values of the subject according to the questionnaireBerezovskaya R. A. was studied. Statistical and mathematical methods were used in the research process. RESULTS: The array of respondents was conditionally divided into 4 groups according to their attitude to humanhealth. And the group where a person's life position is focused exclusively on health is the most common - 77,0 %.Group IV, which wants to live without limiting itself, is 8,1 %. The component integrity of values-goals and values-means among the urban population of the SZ of both nuclear power plants is the same: the main goal in life is health,happy family life, and as a means - perseverance, diligence and health. Goal values in groups I and IV have somedifferences: in the first group of respondents the main goal in life is health, and in the fourth, where a person's lifeguidelines exclude any restrictions - a happy family life. Values for these populations have some differences, but inboth groups health appears to be the main means to an end. There is a close correlation between the core of termi-nal values and the average indicators of the state of concern about the risk of emergencies. CONCLUSIONS: Identified hierarchy of values: a group of stable dominant values; average status values; group of leastsignificant values. The values of the highest status among the values-goals are - health, happy family life and inte-resting work. Most respondents plan to achieve them through values such as «health¼, «perseverance and hardwork¼. There is a close correlation between the core of terminal values and the average indicators of the state ofconcern about the risk of emergencies.
Assuntos
Atitude Frente a Saúde , Monitoramento Ambiental/estatística & dados numéricos , Inquéritos Epidemiológicos/estatística & dados numéricos , Centrais Nucleares/estatística & dados numéricos , Exposição à Radiação/estatística & dados numéricos , Medição de Risco/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Ucrânia , Adulto JovemRESUMO
The authors report a rare case of combination of chromophobe renal cell carcinoma Grade 2 pT2aN0 with multiple hepatocellular adenomas in a 31-year-old bodybuilder who received anabolic androgenic steroids at high doses for 8 years. According to MRI data, over 15 liver adenomas and tumor in the lower segment of the right kidney were detected. The patients underwent laparascopic resection of the right kidney and liver segments 2, 3 and 4 with large adenomas. Histological study and immunohistochemistry revealed no malignancy signs in hepatocellular adenomas. Nuclear ß-catenin expression was absent. Kidney tumor had a structure of chromophobe renal cell carcinoma. The patient is currently being followed-up due to residual small liver adenomas. In our opinion, liver adenomatosis and renal cancer have the same cause in this case (chronic toxic effect of androgens).
Assuntos
Adenoma de Células Hepáticas , Anabolizantes , Carcinoma Hepatocelular , Carcinoma de Células Renais , Neoplasias Renais , Neoplasias Hepáticas , Adulto , Anabolizantes/efeitos adversos , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/cirurgia , Humanos , Neoplasias Renais/induzido quimicamente , Neoplasias Renais/diagnóstico , Neoplasias Renais/cirurgia , Neoplasias Hepáticas/diagnóstico , EsteroidesRESUMO
OBJECTIVE: Evaluation of the key environmental determinants that shape the response of the social environment tothe activities of nuclear power plants. MATERIALS AND METHODS: The poll was conducted in the observation zone (OZ) of the South-Ukrainian NPP (SUNPP).A repetition-free probabilistic selection was used in the population survey. The sample of respondents from the population of the SUNPP OZ was 322 people with the sampling error of 5.4 % and confidence interval of 95.0%. An ordinal 5-point measurement scale was used to assess the quality of life and anxiety, and nominal measurement scaleswere used for other issues. All the age groups of population from 20 to 65 years were taken into account. The sociohygienic, sociological, statistical and mathematical research methods were applied in the process of work (relativevalues, averages, reliability of paired differences according to Student's t test). RESULTS: The level of perception of radiation risk by the population of the NPP OZ was the lowest among respondentsof satellite cities of Rivne NPP (RNPP) and SUNPP compared to the population of rural settlements and cities of theOZ. Storage and shipment of radioactive waste are the determinant among the factors that form an environmentalthreat to the population of OZ as a result of NPP activities. Social factors that determine the assessment of environmental safety of NPP activities are employment at the NPP, place of residence, gender, age, level of education of thepopulation, etc. The «Ch-image¼ of the ecological catastrophe formed in the population of Ukraine as a result of theChNPP accident , regardless of the place of residence on the territory of Ukraine, influences behavior, formation ofplans and assessments, especially in population living near the ionizing radiation sources. CONCLUSION: The current legislation governing the relationship between functioning NPPs and the communities inwhich they are located needs to be improved, guided by the basic principle of environmental public health - socialjustice, i.e. the human right to a healthy environment. It means that the settlements of the OZ (communities)receive funds to compensate for risk living in compliance with certain safety rules to maintain health. Legal regulation and constant awareness of population are the main directions for the formation of adequate assessments.
Assuntos
Ansiedade/psicologia , Energia Nuclear/ética , Centrais Nucleares/ética , Qualidade de Vida/psicologia , Adulto , Ansiedade/epidemiologia , Segurança Química/métodos , Acidente Nuclear de Chernobyl , Escolaridade , Meio Ambiente , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Centrais Nucleares/provisão & distribuição , Resíduos Radioativos/legislação & jurisprudência , Fatores Sexuais , Inquéritos e Questionários , Ucrânia/epidemiologiaRESUMO
OBJECTIVE: To assess an impact of the Rivne Nuclear Power Plant (RNPP) activity on the control area (CA) environ- ment according to environmental and radiation monitoring data over time of 2011-2017 as a component of the radiation safety system. MATERIALS AND METHODS: Review of geographical and natural features of the territory of the «Rivne NPP¼ manufac- turing facility was carried out to assess its CA environment. Assessment of environmental and radiation situation of the CA was carried out according to the data of RNPP monitoring systems and a number of state institutions of Rivne oblast over time of 2011-2017. Opinion of the CA population about the RNPP environmental impact was studied. The sampled population of respondents was calculated based on the total population living in CA. The sampling error no more that 7.0%. Data from sociological survey of population were calculated using the statistical programs. RESULTS: The radiation impact of RNPP on environment is related to emissions and discharges of radioactive sub- stances generated in the production cycle. Over time the total index of radionuclide discharge to the Styr River since 2011 is of a marked downward trend from 2.11 % to 0.18 %. The maximum concentrations of 60Co and 137Cs radionuclides at the three sampling points along the Styr River over time of 2011-2016 were about one thousandth of a percent, and of 131I - one hundredth of a permissible value according to the Radiation Safety Standards of Ukraine (RSSU). Emissions of inert radioactive gases and long-lived nuclides into the atmosphere were less than 0.2 % and iodine emissions were 0.01 % to the emission limit. Average radionuclide concentrations in the natural air of the RNPP CA settlements did not exceed the admissible concentration limit (ACL). Concentrations of chem- ical pollutants in discharges of the RNPP to the Styr River over time of 2012-2017 did not exceed the ACL. Integral wastewaters of municipal enterprises of the CA and RNPP result in an increased index of biochemical oxygen uti- lization and ammonium salt content in the Styr River, exceeding the ACL in fishery reservoir water. No exceedance of ACL of repugnant substances in the open air of settlements was observed regarding the pollutants under study. According to population survey the radiation contamination of territories as a result of the ChNPP accident and RNPP activities, which cause anxiety, are the key factors determining an environmental situation at the place of residence. The correlation coefficients between anxiety index and public estimates of environmental situation are established. CONCLUSIONS: Content of radionuclides in emissions and discharges generated in the RNPP production cycle under everyday conditions does not exceed the allowed RSSU-97 values. The combined discharges of collective enterpri- ses and RNPP are the main sources of chemical pollution of surface waters in CA. There is a higher correlation coef- ficient between the anxiety and somatization rates and environmental sphere parameter in rural population com- pared to urban one. The combined effect of environmental, radiation and psychological factors on the RNPP CA population makes the health studies necessary in the latter.
Assuntos
Poluentes Radioativos do Ar/análise , Centrais Nucleares , Exposição à Radiação/análise , Monitoramento de Radiação/métodos , Poluentes Radioativos da Água/análise , Radioisótopos de Césio/análise , Radioisótopos de Cobalto/análise , Humanos , Radioisótopos do Iodo/análise , Rios/química , UcrâniaRESUMO
OBJECTIVE: Comparative review of integral variables of mortality rates in children aged 0-17 years and adult popu-lation of the surveillance zone (SZ) of the Rivne NPP (RNPP) with the morbidity level in respective populationgroups of the radiologically contaminated areas (RCA). MATERIALS AND METHODS: Morbidity rates were studied in population of the RNPP SZ (Volodymyretskyi andManevytskyi regions, Varash city) and RCT (Bereznivskyi and Kamin-Kashirskyi regions) according to the official sta-tistical data for 2016. The data set included data on the morbidity rates (from all diseases) and by the classes of dis-eases in children and adults in conversion to the 1000 persons of respective population in Rivne and Volyn oblasts.Morbidity review in children and adults was also carried out according to the «percentile-profile¼ methodology, themethod taking into account the age-related factors of morbidity, and the method of the sum of places.Mathematical, statistical, and programmatic capabilities of Microsoft Office Excel 2007 software were used for cal-culations. RESULTS: Morbidity review in children of the RNPP SZ in 2016 indicates the lowest incidence level in children of theVarash city. Incidence rates in children aged 0-17 years living in the RCA are higher compared with the incidencerates of children of the RNPP SZ. Comparative review of the morbidity rates in adult population of the RNPP SZ indi-cates lower incidence rates by the classes of diseases in adults in Manevytskyi region compared with theVolodymyretskyi region and the city of Varash. The adult morbidity indices are higher in RCT than in RNPP SZ. CONCLUSIONS: According to the results of «percentile-profile¼ approach, the studied areas were selected into the twogroups by a level of overall morbidity below and above the average level. Morbidity levels in children and adults inthe place of residence were distributed in different ways. Method of using the age coefficients of morbidity alloweddetermining the proportions that are related to childhood and adult morbidity in the studied areas. Disease inci-dence in children in the Varash city comprised a lowest share (21.0%) in the RNPP SZ general morbidity. The high-est share was made by children in Volodymyretskyi region of the SZ (49.0%). The highest morbidity level (from alldiseases) in adult population was observed in the Kamin-Kashirskyi region (RCT), in children it was the highest onein Bereznovskyi region (RCT). The lowest general morbidity in adult population was observed in the Volodymyretskyiregion, and in children it was the lowest one in the city of Varash (RNPP SZ).
Assuntos
Acidente Nuclear de Chernobyl , Monitoramento Epidemiológico , Raios gama/efeitos adversos , Exposição à Radiação/efeitos adversos , Adolescente , Adulto , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/patologia , Criança , Pré-Escolar , Exposição Ambiental/efeitos adversos , Feminino , Gastroenteropatias/epidemiologia , Gastroenteropatias/etiologia , Gastroenteropatias/patologia , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Neoplasias/epidemiologia , Neoplasias/etiologia , Neoplasias/patologia , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/etiologia , Doenças do Sistema Nervoso/patologia , Doses de Radiação , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/etiologia , Doenças Respiratórias/patologia , Dermatopatias/epidemiologia , Dermatopatias/etiologia , Dermatopatias/patologia , Ucrânia/epidemiologia , Doenças Urológicas/epidemiologia , Doenças Urológicas/etiologia , Doenças Urológicas/patologiaRESUMO
The paper describes a case of solitary epithelioid hemangioendothelioma concurrent with nodular parenchymal AL amyloidosis of the lung and Rosai-Dorfman disease in a 70-year-old woman. The core of the tumor was represented by bone tissue with dendriform ossification, as well as by amyloid that showed green apple birefringence at polarized light microscopy. The peripheral portions of the tumor and the myxohyaline stroma exhibited slit-like structures, epithelioid and fusiform cells with small cytoplasmic vacuoles. These cells expressed CD31, CD34, factor VIII, and cytokeratins 7 and 18. The Ki-67 proliferation index was 10%. S100- and CD68-positive histiocytes with the phenomenon of emperipolesis were revealed in the tumor and in the lymph nodes of the mediastinum and lung hilum. There was a positive reaction to immunoglobulin lambda light chains in the lymphocytic infiltration around amyloid clumps. The frequency of epithelioid hemangioendothelioma was less than 1 case per million people annually. We found only one case of its concurrence with pulmonary amyloidosis in the English-language literature. No relationship could be revealed between this tumor and Rosai-Dorfman disease.
Assuntos
Amiloidose , Hemangioendotelioma Epitelioide , Histiocitose Sinusal , Idoso , Amiloidose/complicações , Amiloidose/diagnóstico , Citocinas/análise , Feminino , Hemangioendotelioma Epitelioide/complicações , Hemangioendotelioma Epitelioide/diagnóstico , Histiócitos , Histiocitose Sinusal/complicações , Histiocitose Sinusal/diagnóstico , Humanos , LinfonodosRESUMO
OBJECTIVE: To study the contentment of population of NPP surveillance areas i.e. monitoring zones with specific components of quality of life, namely the social security, medical care, and socio economic compensation of risk. MATERIALS AND METHODS: A sociological study of public opinion about the specific components of quality of life has been conducted in population of the NPP monitoring zone. A questionnaire with independent question blocks was developed. A non repeatable probabilistic selection was applied in population opinion poll. The sampled population was calculated on the basis of the total population living in the NPP monitoring zone. Sample error not exceeded 7.0%. A comparative assessment of the responses of various groups of the able bodied population on issues of social security, medical care, socio economic compensation of risk and analysis of statistical data for 2011-2015 on the resource potential of medical facility of the nuclear power plant overspill town has been conducted. RESULTS: The safety and security status is rated at below the average. Documents regulating the life safety of pop ulation of NPP monitoring zone provide them no confidence in their security. Probability estimates of man made accidents are higher in urban population and depend on education level. The socialized health care is assessed on low and average levels according to the studied parameters. Among the types of medical care the providing of nec essary medical goods, preventive examinations, scheduled medical examination service, ambulance activity, and medical psychological aid need to be improved. There was no significant change in resource potential of special ized healthcare infirmary of NPP overspill town for the last 5 years. CONCLUSION: Low rating by the monitoring zone population of work efficiency of health facilities is determined by a set of factors, some of which lies in the plane of state socio economic problems. Choice priority of the direct sub ventions in population of monitoring zone depends on the place of residence and occupation. Provisions on social security, protection and medical care of population of the NPP monitoring zones in Ukraine do not correspond to European standards and require a revision.
Assuntos
Atenção à Saúde/estatística & dados numéricos , Centrais Nucleares , Qualidade de Vida/psicologia , Monitoramento de Radiação/métodos , Radiometria/métodos , Segurança , Adulto , Idoso , Atenção à Saúde/organização & administração , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Pública/estatística & dados numéricos , Opinião Pública , Monitoramento de Radiação/legislação & jurisprudência , População Rural , Fatores Socioeconômicos , Inquéritos e Questionários , Ucrânia , População UrbanaRESUMO
AIM: Тo compare morphological changes and results of immunohistochemical (IHC) identification of viruses (polyomaviruses, adenoviruses, and herpesviruses) in the biopsy specimens with their clinical manifestations in recipients of renal transplants. MATERIAL AND METHODS: Morphological and IHC studies were conducted using 71 needle renal transplant biopsy specimens from patients in the study group and 10 renal biopsy specimens from those in the control group. A number of clinical indicators were estimated. RESULTS: IHC examination revealed the expression of adenoviral antigens more commonly in patients with posttransplant nephritis than in recipients without nephritis or in control individuals (p<0.05). The association of patient age and time after kidney transplantation with the severity of viral damage was confirmed: graft loss in children occurred within the first months of surgery (p<0.05). Polyomavirus was detected by PCR in patients with the morphological patterns of polyomavirus nephropathy. Determination of HSV-1 and HSV-2 in the biopsy specimens showed no significant associations with morphological changes. CONCLUSION: By taking into account a variety of factors that influence the development of viral nephritis, morphological and IHC examinations should be combined with evaluation of clinical findings.
Assuntos
Rim/virologia , Nefrite/virologia , Transplantes/virologia , Adenoviridae/isolamento & purificação , Adenoviridae/patogenicidade , Adolescente , Adulto , Biópsia , Criança , Pré-Escolar , DNA Viral/isolamento & purificação , Feminino , Herpesviridae/isolamento & purificação , Herpesviridae/patogenicidade , Humanos , Rim/patologia , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Imagem Molecular/métodos , Nefrite/patologia , Polyomavirus/isolamento & purificação , Polyomavirus/patogenicidade , Transplantes/transplante , Adulto JovemRESUMO
AIM: To define the effect of donor and recipient gender on the results of kidney transplantation from living related donor. MATERIAL AND METHODS: Group of 271 patients who underwent kidney transplantation from living related donor was analyzed. There were 115 women and 156 men. Age varied from 1 to 63 years (mean 21.30±12.32). There were 127 children aged 1-18 years (mean 11.28±4.63) and 144 adults aged 19-63 years (mean 29.81±11.24). Donors included 162 women and 109 men. Overall survival was calculated using Kaplan-Mayer. Mortality and incidence of transplants failure were determined using Fisher's exact test. RESULTS: All patients were divided into 2 groups depending on recipients' gender and then into 4 subgroups depending on gender of donors and recipients. Comparative statistical analysis showed that transplants survival was higher in women vs. men (T=2.7, p=0.007). Survival of patients was similar in both groups. Moreover it was the best in subgroup of recipients-women with kidneys from donors-men. Difference was statistically significant (T=2.16, p=0.03). There was no significant difference in all other cases. CONCLUSION: The results of kidney transplantation are better in recipients-women than in men.
Assuntos
Função Retardada do Enxerto , Rejeição de Enxerto , Falência Renal Crônica/cirurgia , Transplante de Rim , Doadores Vivos , Adolescente , Adulto , Fatores Etários , Criança , Função Retardada do Enxerto/etiologia , Função Retardada do Enxerto/prevenção & controle , Feminino , Rejeição de Enxerto/etiologia , Rejeição de Enxerto/prevenção & controle , Sobrevivência de Enxerto , Humanos , Estimativa de Kaplan-Meier , Rim/patologia , Rim/cirurgia , Transplante de Rim/efeitos adversos , Transplante de Rim/métodos , Transplante de Rim/mortalidade , Doadores Vivos/classificação , Doadores Vivos/estatística & dados numéricos , Masculino , MoscouRESUMO
AIM: To clarify whether cytomegalovirus (CMV) infection can affect the results of living related donor kidney transplantation. SUBJECTS AND METHODS: A study group included 17 (7.27%) patients (10 men and 7 women; 8 children and 9 adults) aged 3 to 51 years who had developed resistant CMV infection. For comparative analysis, a control group was formed from 113 patients (61 men and 52 women; 40 children and 73 adults) aged 1 to 61 years, whose CMV polymerase chain reaction (PCR) had always been negative, i.e. CMV DNA was absent. The duration of CMV infection episodes was 44 to 232 days. RESULTS: The patients were given valganciclovir in a dose of 450 mg/day. CMV PCR was negative in all the patients at the end of therapy. None of the patients died; one graft was lost. In the control (negative CMV PCR) group, 6 grafts were lost in 113 patients lost and 4 patients died. Statistical analysis showed that the results of related donor kidney transplantation were virtually equal. CONCLUSION: Suppression of resistant CMV infection can be achieved with the longer use of valganciclovir or its higher dose. CMV infection fails to affect the results of related donor kidney transplantation.
Assuntos
Infecções por Citomegalovirus , Citomegalovirus/efeitos dos fármacos , Ganciclovir/análogos & derivados , Falência Renal Crônica/cirurgia , Transplante de Rim , Doadores Vivos , Adolescente , Antivirais/administração & dosagem , Pré-Escolar , Citomegalovirus/isolamento & purificação , Infecções por Citomegalovirus/tratamento farmacológico , Infecções por Citomegalovirus/etiologia , Infecções por Citomegalovirus/mortalidade , DNA Viral/análise , Resistência à Doença/imunologia , Relação Dose-Resposta a Droga , Feminino , Ganciclovir/administração & dosagem , Humanos , Imunossupressores/administração & dosagem , Imunossupressores/efeitos adversos , Transplante de Rim/efeitos adversos , Transplante de Rim/métodos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/virologia , Federação Russa/epidemiologia , Fatores de Tempo , Transplante Homólogo , Resultado do Tratamento , ValganciclovirRESUMO
AIM: To evaluate the results of kidney transplantation from alive related donor in patients with Alport syndrome and to compare with those in patients with kidney hypoplasia. MATERIAL AND METHODS: We have analyzed 8 and 27 medical records of patients with Alport syndrome and kidney hypoplasia respectively. Following parameters were used - Kaplan-Meier survival analysis, Wilcox overall risk, percentage of transplants loss and mortality (Fisher's exact test calculation). RESULTS: It is concluded that percentage of transplants loss and mortality rate as well as overall survival and risk were similar in both groups. CONCLUSION: Despite risk of anti-GBM nephritis development in patients with Alport syndrome results are comparable with those after transplatation for chronic renal failure caused by other reasons.
Assuntos
Autoanticorpos/imunologia , Falência Renal Crônica/cirurgia , Transplante de Rim , Rim , Nefrite Hereditária/cirurgia , Nefrite , Adolescente , Adulto , Feminino , Humanos , Estimativa de Kaplan-Meier , Rim/patologia , Rim/cirurgia , Transplante de Rim/efeitos adversos , Transplante de Rim/métodos , Doadores Vivos , Masculino , Nefrite/diagnóstico , Nefrite/etiologia , Nefrite/imunologia , Nefrite/mortalidade , Avaliação de Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/imunologia , Complicações Pós-Operatórias/mortalidade , Análise de SobrevidaRESUMO
The paper describes a case of von Hippel--Lindau-related pancreatic neuroendocrine tumor and adrenal myelolipoma in a 44-year-old woman. The pancreatic tumor and a left retroperitoneal mass were removed in the women in July 2014 and May 2015. Histological examination of the pancreatic tumor revealed that the latter consisted of clear cells forming tubular and tubercular structures showing the expression of chromogranin A, synaptophysin, and cytokeratins 18 and 19 and a negative response to CD10 and RCC. The adrenal medullary mass presented as clear-cell alveolar structures with inclusions of adipose tissue mixed with erythroid, myeloid, and lymphoid cells. The clear-cell component of the adrenal gland expressed neuroendocrine markers with a negative response to cytokeratins, CD10, and RCC. Molecular genetic examination yielded a signal corresponding to two copies of the VHL gene. No deletions or amplifications of the gene were detected. Cases of von Hippel--Lindau disease concurrent with adrenal pheochromocytoma and myelolipoma and simultaneous pancreatic involvement were not found in the literature.
Assuntos
Neoplasias das Glândulas Suprarrenais/patologia , Mielolipoma/patologia , Tumores Neuroendócrinos/patologia , Doença de von Hippel-Lindau/patologia , Neoplasias das Glândulas Suprarrenais/complicações , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/genética , Adulto , Aberrações Cromossômicas , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Mielolipoma/complicações , Mielolipoma/diagnóstico , Mielolipoma/genética , Proteínas de Neoplasias/biossíntese , Proteínas de Neoplasias/genética , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/genética , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/patologia , Patologia Molecular , Feocromocitoma/complicações , Feocromocitoma/diagnóstico , Feocromocitoma/genética , Feocromocitoma/patologia , Doença de von Hippel-Lindau/complicações , Doença de von Hippel-Lindau/diagnóstico , Doença de von Hippel-Lindau/genéticaRESUMO
Due to the development of organ transplantation and its accompanying immunosuppression, recent years have been marked by the higher incidence of opportunistic viral infections that are of considerable importance among posttransplantation complications. A variety of viral infections, the possibility of their concomitant or subtle course, and the ability to cause life-threatening complications in recipients make relevant the description of existing diagnostic methods. The article summarizes the data available in the literature on the etiology, clinical symptoms, and morphological manifestations of viral infections, such as polyomaviruses, adenoviruses, herpesviruses, including HSV-1, HSV-2, cytomegalovirus (CMV), and Epstein-Barr virus. It describes the principles of differential diagnosis of kidney transplant damage caused by these viruses and that with acute cellular and humoral rejection, which plays an important role due to opposite approaches to treating these diseases.
Assuntos
Infecções por Herpesviridae/patologia , Transplante de Rim , Rim/patologia , Rim/virologia , Rejeição de Enxerto/virologia , Humanos , Terapia de ImunossupressãoRESUMO
The aim of investigation is analysis of factors forecasting the results of kidney transplantation from living-related donors. This research is based on the analysis of 272 kidneys' transplantation from living-related donors. It was analyzed such parameters as recipients' age, donors' age, donors' sex, degree of relationship between donor and recipient, degree of HLA-compatibility, type of inductive immunosuppression (monoclonal antibodies, corticosteroids, polyclonal antibodies), recipient's sex, presence or absence of rejection episodes for whole postoperative period. We recognized that far not all above-mentioned parameters could predict the results of kidney transplantation from living-related donors.
Assuntos
Rejeição de Enxerto/prevenção & controle , Terapia de Imunossupressão/métodos , Transplante de Rim , Doadores Vivos , Medição de Risco/métodos , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Feminino , Rejeição de Enxerto/epidemiologia , Sobrevivência de Enxerto , Humanos , Incidência , Lactente , Falência Renal Crônica/cirurgia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Federação Russa/epidemiologia , Taxa de Sobrevida/tendências , Adulto JovemRESUMO
AIM: To clarify whether vaccination provokes renal graft rejection. SUBJECTS AND METHODS: A total of 131 vaccinations were performed in 92 patients with chronic kidney failure (CKF), including 7 and 85 patients vaccinated before and in different periods after kidney transplantation, respectively. The patients were examined using needle graft biopsy, measurement of proteinuria, and estimation of changes in blood creatinine levels and glomerular filtration rate. RESULTS: Vaccination was not fount to provoke rejection, as suggested by the results of needle biopsy of renal allografts and examination of their function. CONCLUSION: Vaccination is safe for patients with CKF as it causes no rejection episodes.
Assuntos
Rejeição de Enxerto/imunologia , Falência Renal Crônica/imunologia , Falência Renal Crônica/cirurgia , Transplante de Rim , Vacinação/efeitos adversos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Rejeição de Enxerto/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Adulto JovemRESUMO
To understand whether the presence of cytomegalovirus in blood influences the results of kidney transplantation from live relative donors, we analysed materials from 258 recipients divided into 2 groups. Group 1 included 113 patients with negative results of PCR for cytomegalovirus, group 2 contained 139 patients with positive PCR. We evaluated lethality, the loss of transplanted kidneys, frequency of rejection and infectious complications. Statistical treatment of the data obtained included Kaplan-Meier survival analysis, the Wilcoxon test showing the cumulative hazard risk, and comparative analysis by Fisher's and Student's tests. It was shown that cytomegalovirus present in blood increases lethality and the frequency of infectious complications in recipients of transplanted kidneys but does not influence their rejection. The cumulative survival rate was significantly higher and cumulative risk lower in group 1 than in group 2.
Assuntos
Citomegalovirus/patogenicidade , Rejeição de Enxerto/virologia , Transplante de Rim , Complicações Pós-Operatórias/virologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Objective. The purpose of this study was to determine the key factors of social well-being of the population in surveillance zone Rivne NPP. Materials and methods. Sociological, hygienic and mathematical methods i.e. comparison of generalized performance characteristics such as relative and average values, expression of interactions between factors using a pairwise correlation (r) were used in the paper. A questionnaire was developed for the public opinion polls with independent blocks of issues: the study of living environment/conditions through the assay of adequacy of ten major areas of life, assessment of satisfaction with the quality of life in household sphere and components and cost items of family budget, satisfaction level of medical care, "Integral Index of Social Well-being" Test (IISW). The sample was representative by age and gender for population of the surveillance zone of Rivne NPP (n=220, 6.7% sampling error). Results. According to opinion polls there is a negative impact on social well-being of low sufficiency in issues of socio-political life, social security and social relations. More than a half of population feels no any socio-economic compensation for the risk of Rivne NPP function in their daily lives. The overall satisfaction index in recreational and cultural sphere is close to the national average value, which may indirectly indicate to a positive impact of subventions to the social infrastructure of surveillance zone. However, satisfaction of population in the required medical care is extremely low, as is the case throughout Ukraine, due to several factors, such as lack of specialists, poor providing with essential medicines, and high cost of medicines. Conclusions. The list of benefits and compensations associated with living near the functioning NPP needs improvement and coordination with opinion of local communities. Their implementation at that needs a permanent information support. Some links are established between areas that are important in shaping of social feelings and assessment of environmental situation, perception of radiation situation, possibility of socio-political, man-made and natural emergencies. The more confident respondents in welfare of ecological state of residence, the higher level is in their social comfort.
RESUMO
AIM: To elucidate whether and how tacrolimus affects the cumulative survival of patients after living related kidney donor transplantation. SUBJECTS AND METHODS: The clinical materials of 246 related kidney transplant recipients, including 108 patients in whom tacrolimus (Prograf and Advagraf) Astellas Pharma US, Inc) was included in the immunodepression protocol (Group 1) and 138 patients who did not receive the agent (Group 2), were analyzed. Comparative analysis used the following tests: the Kaplan Meier test estimating the cumulative survival of recipients and transplants; the Cox test assessing the cumulative risk; and the log-rank test. Allorenal graft losses and mortality rates were also calculated. RESULTS: Mathematical analysis of the above indicators demonstrated that the allograft and survival rates were far higher (p < 0.05) and the cumulative risk was much less in Group 1 (p < 0.02). Graft losses and the recipients' deaths were higher in Group 2. CONCLUSION: The analysis suggests that the incorporation of tacrolimus into the immunodepression therapy protocol positively impacts the results of lung related kidney donor transplantation.