The review highlights current ideas about the mechanisms of radiation-induced genome instability formation. Based on the results of a search in the abstract medical and biological database PubMed/MEDLINE, Google Scholar and a manual search of relevant information sources, data on the use of some cytogenetic and molecular genetic methods as biomarkers of the effects of low-dose acute and prolonged radiation are analyzed and summarized. The effectiveness of the use of natural radioprotectors under various radiation conditions (emergency, professional, radiotherapy, etc.) is considered. The search results confirm the feasibility of studying the radiation-induced effect at the cytogenetic, genomic and epigenomic levels, which will contribute to solving an important problem in radiobiology, radiation genetics and radiation protection to improve methods for assessing, predicting and preventing the negative effects of radiation on human health. Key words: ionizing radiation, genome stability, epigenetic
OBJECTIVE:evaluation of the frequency and type of bacterial fungal complications and outcome of acute lymphoblastic leukemia (ALL) taking into account the serum ferritin content in children, residing in radiologically contaminated territories (RCT) of Ukraine after the ChNPP accident. MATERIALS AND METHODS:Pediatric ALL patients (n = 146), residing in RCT of Ukraine, were the study subjects within a survey period of 15 years. The ALL diagnosis and distribution of patients by the disease variants were heldaccording to the FAB classification and results of immunophenotyping of the bone marrow blast cells. Chemotherapy(CT) was prescribed according to the BerlinFrankfurtMunster group (BFM) protocols. Patients were examined afterthe remission induction therapy. Incidence and type of the bacterial fungal and toxic complications were assessed.The number of deaths was taken into account depending on the age, ALL variant and serum ferritin (SF) content.Radiation doses to the bone marrow were calculated for the entire period of stay in RCT after the accident.Processing of the obtained materials was carried out using the mathematical statistical methods (Student's andSpearman's correlation coefficients, χ2 Pearson test). RESULTS:Study subjects were distributed according to the ALL variants, namely proB (n = 21, 14.4 %), «general»type (n = 97, 66.4 %), preB (n = 12, 8.2 %), and TALL (n = 16, 11.0 %). Three groups were formed taking intoaccount the SF levels: Group I (n = 53) - SF up to 200 ng/ml, Group II (n = 49) - SF from 200 ng/ml to 500 ng/ml,Group III (n = 44) - SF above 500 ng/ml. The blood hemoglobin level and RBC count were decreased along theincrease in SF content (p < 0.05). A direct correlation was found between the SF content and RBC average volume(r = 0.45; р < 0.05). Anemia was of a normocytic type. The lowest number of cases with iron overload was among thechildren with preBHLL disease variant (1 out of 12). An inverse correlation was established between the transferrin concentration and average hemoglobin content in RBC (r = 0.6; р < 0.05). Sepsis and infections of the anal areawere more often observed in the patients with SF level above 200 ng/ml. The course of pneumonia was complicated in case of SF level above 500 ng/ml. The oral cavity and intestinal mucositis did not depend on SF level.Incidence of the systemic toxic effects after chemotherapy was increased under SF level above 500 ng/ml. The number of deaths in children with SF levels above 500 ng/ml was almost doubled. Most of the deaths occurred in thepatients with proBALL (15 out of 21) and TALL (8 out of 16) disease variants. Fewer children had died having the«common» ALL type (14 out of 97, 14.4 %). The number of deaths in case of preBALL variant not depended on SF levels. The «common» type and TALL patients having got iron overload died more often. The average radiationdoses to the bone marrow were (4.9 ± 0.4) mSv and did not affect the remaining parameters. CONCLUSIONS:Iron excess in the body affects the incidence and type of infectious complications both with the outcome of ALL in children, which requires timely diagnosis and preventive measures.
INTRODUCTION:The full scale war in Ukraine has created unprecedented psychosocial stress for children, leading toincreased anxiety. An additional adverse factor may be living in radiationcontaminated areas. At the same time,individual genetic vulnerability (5-HTTLPR polymorphism of the serotonin transporter gene) can modulate theresponse to chronic stress. This study aimed to determine how war and radiation stressors affect the level of traitanxiety in children and whether this relationship is modulated by the 5HTTLPR genotype. OBJECTIVE:to assess the interaction between war related stress factors and variants of the 5-HTTLPR polymorphismof the serotonin transporter gene ( SLC6A4) on anxiety levels in schoolage children. METHODS:A crosssectional survey included 231 children aged 10-17 from three regions of Ukraine that had beenaffected by military operations (some of the participants lived in radioactively contaminated areas). The questionnaire covered data on war stressors (forced displacement, occupation, frequency of air raid alerts, etc.) and psychometric scales, in particular STAI (trait ity anxiety). Genotyping of 5-HTTLPR was performed using allelespecific PCR.The data were analysed using regression methods to assess associations and gene x environment (G x E) interactions. RESULTS:Children who experienced intense war stressors or were regularly exposed to air raid sirens had significantly higher levels of trait anxiety (p < 0.01). The strongest predictor of high anxiety was a high level of response toair raid sirens (OR ≈ 31; p < 0.001). Living in a radiation control zone had no significant effect on anxiety (p = 0.48).The effect of cumulative stress on anxiety was almost twice as strong in children carrying the S allele of 5-HTTLPRthan in those carrying the L/L genotype (G x E effect, p < 0.001). CONCLUSIONS:Chronic war stressors significantly increase children's anxiety levels, with genetically vulnerable individuals (carriers of the S allele of 5-HTTLPR) responding much more strongly to stress. The results emphasise theneed to take into account genetic factors in psychosocial assistance to children experiencing war, with a focus onthe most vulnerable (displaced persons, military families).
OBJECTIVE:to investigate the psychophysiological characteristics of cognitive disorders in the long term after exposure to ionizing radiation in the elderly participants in the liquidation of the Chornobyl Nuclear Power Plant accident (Chornobyl cleanup workers). MATERIALS AND METHODS:Prospective clinical study with external and internal control. A randomized sample of elderly participants (attained age over 60 years) in the liquidation of the consequences of the accident at theChernobyl NPP (ChNPP) in 1986-1987 (Chornobyl cleanup workers) was examined from the Clinical andEpidemiological Registry (CER) of the National Research Center for Radiation Medicine (NRCRM) (main group, n = 52)with verified chronic cerebrovascular pathology. Comparison group (n = 13) - unexposed outpatients and inpatients/examinees of the Department of Radiation Psychoneurology of the Institute for Clinical Radiology (ICR) ofthe NRCRM. Internal control - cleanup workers, exposed at doses < 0.05 Sv (n = 12). Psychophysiological methods(auditory event related potentials (ERPs) P300 with topographic mapping), descriptive and variational statistics,parametric and nonparametric criteria, regressioncorrelation analysis were used. RESULTS:According to P300, diffuse impairment of information and cognitive processes of the brain lateralized tothe left temporal region with a tendency to spread to the right frontal central region was detected in the maingroup. A significant dosedependent decrease in the amplitude of the cognitive component P300 in the left frontaltemporal region (r= - 0.65; p= 0.02) was found in the elderly cleanup workers exposed at doses exceeding 0.5 Sv.For the first time, a dosedependent increase in the P300 was detected was detected in the main group of cleanupworkers in the right temporal and posterior temporal regions: T4 (r= 0.31; p= 0.01), T6 (r= 0.28; p= 0.03). CONCLUSIONS:The auditory ERPs P300 technique is informative for detecting and monitoring neurocognitive disorders in the elderly victims of the Chornobyl disaster. The use of modern, inexpensive, accessible, and noninvasivepsychophysiological methods for diagnosing neurocognitive disorders is advisable both in scientific research and inroutine clinical practice. Objective psychophysiological markers of post radiation neurocognitive deficits in the elderly have been identified for the first time. Initially, dosedependent changes in the temporal characteristics of theP300 component in the right (subdominant) hemisphere in the elderly Chornobyl accident survivors have been identified. These trends require further observation and study.
The review highlights current ideas about the mechanisms of radiationinduced genome instability formation.Based on the results of a search in the abstract medical and biological database PubMed/MEDLINE, Google Scholarand a manual search of relevant information sources, data on the use of some cytogenetic and molecular geneticmethods as biomarkers of the effects of lowdose acute and prolonged radiation are analyzed and summarized. Theeffectiveness of the use of natural radioprotectors under various radiation conditions (emergency, professional,radiotherapy, etc.) is considered. The search results confirm the feasibility of studying the radiationinduced effectat the cytogenetic, genomic and epigenomic levels, which will contribute to solving an important problem in radiobiology, radiation genetics and radiation protection to improve methods for assessing, predicting and preventing thenegative effects of radiation on human health.
OBJECTIVE:to assess the relative levels of cytokines and the functional state of autophagy in peripheral blood lymphocytes of cleanup workers of the Chornobyl accident. MATERIALS AND METHODS:A total of 42 male patients aged 51-77 (61,35 ± 5,21) years were examined. They included: the main group - 42 cleanup workers of the Chornobyl accident aged 56-63 (60,16 ± 1,73) years; and the control group - 11 persons aged 51-77 (64,72 ± 9,24) years, who did not participate in the liquidation of the consequences of the Chornobyl accident and did not live in radioactively contaminated areas. Analysis of relative levelsof cytokines, NFκB p65, and autophagy parameters in peripheral blood (PB) lymphocytes was performed using flowcytometry. RESULTS:The decrease in the relative levels of IL1β, IL2, and IFNγ and an increase in IL6, TNFα, and TGFβ in thePB lymphocytes of the cleanup workers of the Chornobyl accident were detected. Correlation analysis showed thepresence of a relationship between the levels of the studied cytokines. The relative level of NFκB p65, the basallevel of the key autophagy protein LC3B and after the addition of chloroquine diphosphate in the PB lymphocytesof the cleanup workers of the Chornobyl accident were similar to those in the control group. The decrease in thecapacity and responsiveness of the autophagic flux in the PB lymphocytes of the cleanup workers of the Chornobylaccident was noted. Direct correlations were found between the basal level of the LC3B protein and IL4 and IL6 inthe PB lymphocytes of the cleanup workers of the Chornobyl accident. CONCLUSIONS:According to preliminary data, the detected changes in the cleanup workers of the Chornobyl accident may contribute to the activation of pathological inflammatory processes and autoimmune reactions due toimpaired lymphocyte function and inflammatory reactions due to a shift in the balance between cytokines and positive regulation of their synthesis.
BACKGROUND:As is commonly known, cytokines have an ability to influence the inflammatory reactions, cytotoxiceffects, as well as the immune defense of the body. Study of the disease course depending on the ratio of pro andanti inflammatory cytokines is an urgent problem of contemporary oncohematology for the purpose of personalizedtreatment and improvement of the quality of life of patients with plasma cell myeloma who survived after theChornobyl NPP accident. OBJECTIVE:comparative analysis of the state of cytokine regulation in plasma cell myeloma patients at differentstages of therapy depending on a radiation component in the history to optimize the spectrum of clinicalhematological and immunological factors for the prognosis of disease course and assessment of therapy effectiveness. MATERIALS AND METHODS:Content of cytokines (IL6, IL10, TNFα) in peripheral blood was assayed in the stage I-IIIplasma cell myeloma patients (n = 124) by the immunoenzymatic method using horseradish peroxidase as an indicator enzyme. The Multiskan EX 355 enzyme immunoassay analyzer (Termolabsystems, China) with a multichannelvertical scanning spectrophotometer was used. RESULTS:A significantly greater violations of cytokine balance and signs of formation of a «cytokine storm» i.e. anexcessive cytokine production were found in the Chornobyl NPP accident survivors, provoking a severe course oftumor process and occurrence of disease complications at all stages of the plasma cell myeloma. CONCLUSION:Study of cytokine imbalance in plasma cell myeloma patients survived after the Chornobyl NPP accident is appropriate to predict the disease clinical course, prevent complications, increase effectiveness and prescribea personalized treatment.
The article studies the historical experience of ensuring food security for the population of radioactively contaminated territories (RCTs) of Ukraine after the Chornobyl catastrophe of 1986 and analyzes the modern challengescaused by the full scale martial law. Based on the analysis of archival materials, regulatory legal acts, and scientific publications, it was established that in the first years after the accident, the government implemented a comprehensive protection system which included: centralized supply of clean products, production of safe agriculturalproducts, use of radioprotectors, organization of balanced nutrition for children, and largescale information andeducational work. However, chronic underfunding and the liquidation of specialized services led to the gradualdestruction of this system. Surveys conducted showed that, despite being aware of the radiation contamination, asignificant part of the RCT residents continue to consume local products, especially «gifts of the forest» (wildfoods), which is the main source of internal irradiation. This is due to a low level of material wellbeing and localdietary traditions. Under conditions of full scale war, where critical infrastructure is being destroyed and logisticalchains are disrupted, the issue of food security in RCTs becomes particularly acute. The authors conclude that historical experience demonstrates the need for constant funding and coordination of efforts for effective populationprotection. Modern conditions require the development of new approaches that will consider not only radiation risksbut also the challenges associated with martial law, including infrastructure destruction, economic instability, andlimited access to safe products.
The review presents literature data on the incidence and mechanisms of acute lymphoblastic leukemia (ALL) inadults and children, taking into account the role of genetic changes, chromosomal aberrations, and epigenetic disorders that occur pre and postnatally as a result of exposure to ionizing radiation in a wide range of doses. The possibility of developing a set of preventive measures for the occurrence of radiationassociated ALL is discussed basedon the determination of individual variability of patients and the role of the disease's modifying risk factors.
Research activities and scientific advance achieved in 2024 at the State Institution «National Research Center for Radiation Medicine, Hematology and Oncology of the National Academy of Medical Sciences of Ukraine» (NRCRMHO) concerning medical problems of the Chornobyl disaster, radiation medicine, radiobiology, radiation hygiene and epidemiology, hematology and oncology, 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 NRCRMHO Annual Report.
OBJECTIVE:determining the functioning features of health maintenance by the health care and health protectionfacilities of the NPP surveillance zone during epidemics, epidemic situations and manmade accidents under martial law and possible terrorist acts. METHODS:Quantitative and qualitative methods of sociological research were applied namely the analysis ofresource potential indicators, population surveys and method of expert assessments. When obtaining primary empirical data, the simple data sorting, their pairwise or sequential comparison, as well as procedures ensuring the identification of the measured variable were used. An informal analysis of legislative and regulatory documents wasapplied. The official sources of information, statistical data, scientific publications, legislative and regulatory actson health maintenance were the study subject. RESULTS:Analysis of the health maintenance parameters in the studied areas of the South Ukrainian NPP observation zone was conducted namely: values of the resource potential based on reporting of the Department of Healthof the Mykolaiv Regional State Administration for 2022-2023 and the first half of 2024 and study of public opinionregarding the activities of healthcare facilities' infrastructure, in particular the state of outpatient care, hospitalwork, energy, water and heat supply, attitude to introduction of the outofpocket medical services during martiallaw. An expert survey was conducted to assess the types of health care (emergency, primary, secondary, tertiary, medical rehabilitation), implementation of its basic principles, levels of preparedness of health care system for epidemics and epidemic situations, preparedness and response to emergencies (accidents, terrorist acts). Effectivenessof the medical information and communication system regarding health care and medical assistance to populationin healthcare facilities and provision of specialists with analytical and operational information were assessed. CONCLUSION:Analysis of the data obtained on the issues of public health care under martial law indicated the insufficiently effective functioning of its separate components due to both shortage of personnel (doctors and nursingstaff) and the insufficiently effective implementation of healthcare information systems and eHealth technologiesin the practical activities of health care facilities. It is necessary to develop and implement the management decisions directed at ensuring the readiness of healthcare facilities for epidemics and epidemic situations and manmade emergencies, as well as training personnel through the specialized education and general system of trainingof working doctors.
OBJECTIVE:to investigate chromosome abnormalities resulting from the tumor induced bystander effect (TIBE) andto assess the ability of astaxanthin to modify TIBE in nonirradiated and in vitro irradiated peripheral blood lymphocytes of glioblastoma patients. METHODS:Peripheral blood lymphocytes (PBLs) from 30 individuals (20 glioblastoma patients and 10 healthy volunteers)were cultured. Some samples were exposed to γ rays at a dose of 1.0 Gy prior to cultivation. Astaxanthin was added tothe culture medium at a final concentration of 20.0 μg/ml before PBL incubation. Chromosomal preparations wereobtained using standard protocols. Cytogenetic analysis included both chromatid and chromosometype aberrations. RESULTS:In the analysis of baseline cytogenetic parameters in nonirradiated peripheral blood lymphocytes ofglioblastoma patients, the mean frequency of aberrant metaphases was (5.91 ± 0.74) %, which was statistically significantly higher than that of the control group (p < 0.05). The mean frequency of chromosome aberrations was6.21 ± 0.87 per 100 cells, indicating the presence of TIBE. Following exposure to ionizing radiation, the level of chromosomal damage was also significantly higher in glioblastoma patients compared with healthy volunteers (p < 0.05).Treatment with astaxanthin in both irradiated and nonirradiated peripheral blood lymphocytes resulted in a significant reduction in the frequency of chromosome aberrations (p < 0.01), primarily due to a decrease in chromosometype aberrations. In irradiated cultures, the frequency of chromosomal aberrations decreased from 23.99 ± 2.24 to12.01 ± 1.21 per 100 cells on average. Notably, astaxanthin did not affect the frequency of single fragments. CONCLUSION:Astaxanthin at a concentration of 20.0 μg/ml significantly reduces the manifestation of the tumorinduced bystander effect at the cytogenetic level in cultures of both nonirradiated and irradiated peripheral bloodlymphocytes from glioblastoma patients.
OBJECTIVE:investigation of the influence of mesenchymal stromal cells on the functioning of hematopoietic cellsof Balb/C mice after the exposure to ionizing radiation at a sublethal dose in cell culture in vitroand in vivo. METHODS:To study the influence of stromal microenvironment, a cocultivation model of hematopoietic cells of irradiated animals and mesenchymal cells forming feeder layers was used in the in vitro culture. Using the trypan bluedye, the number of hematopoietic cells with cytoplasmic membrane damage was assessed and the level of cell deathwas determined. Cell cultivation in the diffusion chambers culture in vivoallowed assessing the proliferative potential of bone marrow hematopoietic stem cells of irradiated animals. RESULTS:Investigation of the interaction between bone marrow stromal and hematopoietic cells of Balb/C miceallowed determining the modifying influence of the stroma on the level of progenitor cells' interphase and reproductive death due to ionizing radiation action at a sublethal dose. In particular, after 2 days the percentage of deadcells in suspension with direct contact with the stroma in vitro was reduced compared to hematopoietic cells wheresuch contact was absent: (40.5 ± 2.6) % vs (60.1 ± 2.8) %. The increase in cell aggregates number was also observedin the cultures of irradiated progenitors, which had previously interacted with mesenchymal stromal cells in vitro(25.2 ± 1.9 CFU), compared to the cells, which did not directly interact with the stroma (15.3 ± 2.8 CFU). CONCLUSIONS:Cocultivation with stromal cells have significantly reduced the level of radiationinduced death ofbone marrow hematopoietic cells and increased their colonyforming activity, however, this required the direct contact with stroma in the in vitroculture.
OBJECTIVE:Assessment of thyroid doses among participants of the Chornobyl Tissue Bank (CTB) enrolled in the study of the genomic landscape of thyroid follicular carcinomas and follicular adenomas, using updated methodologies and data on residential history and dietary patterns collected during the study through personal dosimetry interviews. MATERIALS AND METHODS:This study presents an assessment of thyroid doses in 140 participants of the Chornobyl Tissue Bank (CTB) with pathologically confirmed diagnoses of follicular adenoma and follicular thyroid carcinoma.Thyroid doses from 131I intake were estimated using the substantially revised 'Thyroid Dosimetry System 2020 for Ukraine' (TDU20). In addition, the data on residential and dietary history have been obtained through personal interviews with 85 individuals for whom dosimetryrelated data were limited. Radiation doses to the thyroid were also estimated for the following minor exposure pathways: (a) intake of short lived radionuclides (132Te+132I and 133I) via inhalation and ingestion; (b) external irradiation from radionuclides deposited on the ground; and (c) ingestion of 134Cs and 137Cs with contaminated foodstuffs. RESULTS:The arithmetic mean of thyroid doses estimated in this study from all exposure pathways combined was 445 mGy, while the median dose was 71 mGy. Among study participants, a broad range of thyroid doses was observed, from 0.23 mGy to 14 Gy. The major exposure pathway was 131I intake, which accounted for a median contribution of 92 % to the thyroid dose. Among individuals who were interviewed in the study, thyroid doses from 131I intake that were calculated using TDU20 and individual questionnaire data were lower than doses that did not include the interview data: 105 mGy vs. 150 mGy for the arithmetic mean and 46 mGy vs. 98 mGy for the median, respectively.Uncertainties in dose estimates from 131I intake were characterized using the geometric standard deviation of 1,000 individual stochastic dose realizations. As a result, the geometric standard deviation ranged from 1.3 to 6.1, with an overall arithmetic mean of 3.1 and a median of 3.3 across all study participants. CONCLUSIONS:This study demonstrated that the use of individual questionnaire data in dose assessment for participants who completed personal dosimetric interviews had an impact on the estimated thyroid doses. In conducting specialized studies aimed at identifying potential associations between thyroid dose and key demographic, clinical, pathological, and moleculargenetic indicators, it is valuable to carry out personal dosimetric interviews to obtain detailed residential and dietary histories of study participants. Incorporating such information allows for more realistic individual dose estimates.
OBJECTIVE:To assess the impact of neoadjuvant chemotherapy on the size and spread of the tumor process and indicators of proliferative activity in breast cancer patients who suffered from the Chornobyl accident. MATERIALS AND METHODS:The 96 patients with breast cancer (BC) who were exposed to ionizing radiation as a resultof the Chernobyl accident were examined. Clinical, radiological, instrumental, morphological, and immunohistochemical research methods were used. RESULTS AND CONCLUSIONS:Before neoadjuvant cytostatic therapy, criteria T0, Tis, T1 was not diagnosed in anypatient. As a result of treatment, complete clinical and morphological regression of the tumor was established in16.7 % of patients. A decrease in staging criteria after neoadjuvant chemotherapy (NCT) was diagnosed in 60.4 %of patients. Analysis of patients with breast cancer by stage grouping before and after NCT showed that there wereno patients at all in the study before the start of treatment. After neoadjuvant therapy, in 29.2 % of women, tumorsin the breast gland were classified as stage I by their criteria. Only 2.1 % of women started treatment with stage IIA. After NCT, the prevalence of the primary tumor met the criteria for stage II A in 20.8 % of patients. 53.1 % ofpatients started treatment with stage II B, and after neoadjuvant therapy, this stage was in 14.6 % of patients. StageIII A was detected in 22.9 % of patients before treatment, after therapy the number of patients with this stagedecreased to 14.6 % of patients. 14.6 % of women started treatment with stage III B, after treatment only 3.1 % ofpatients were classified as this stage. Stage III C was detected in 6.2 % of patients at the beginning of treatment,after NCT, no patients with criteria related to this stage were identified. Stage IV was detected in 1.04 % of patients,both before and after NCT. A decrease in Ki67 values under the influence of NCT was observed in 76 % of patients,and in another 16.7 % of patients complete clinical and pathomorphological regression of the tumor was observed.Thus, according to the values of proliferative activity, positive dynamics for neoadjuvant cytostatic chemotherapywas recorded in 92.7 % of patients.
OBJECTIVE:To assess the level of psychological stress in children affected by war and living in regions with radioecological burden, as well as to determine possible associations with the SOD2 polymorphism (Val16Ala, rs4880),using quartile stratification as an approach to the interpretation of the PSM25 scale. MATERIALS AND METHODS:The study involved 42 children aged 10 to 17 years living in regions with different levelsof radiation exposure and affected by military events. The psychoemotional state was assessed using the PSM25psychological stress scale. A quartile approach was used to stratify the level of stress: Q1 (low), Q1-Q3 (intermediate) and Q3 (high). DNA samples were examined to detect the rs4880 polymorphism of the SOD2 gene. Statisticalanalysis was performed using nonparametric criteria and logistic regression models. RESULTS:The level of psychological stress in the sample ranged from 29 to 182 points, indicating heterogeneity ofindividual reactions. About 26 % of children demonstrated values exceeding the conditional clinical thresholds onthe PSM25 scale. The quartile stratification allowed us to identify three subgroups with different stress severity.Analysis of sociodemographic characteristics revealed a statistically significant association between gender andstress levels: girls had higher scores than boys (p = 0.041), which was also confirmed in the binary logistic model.Although children from areas with elevated radiation backgrounds did not score significantly higher on nonparametric tests, the regression model revealed a trend towards an increased risk of high stress in this group (p = 0.063).Genetic analysis showed a potential protective role of the Ala allele of the SOD2 polymorphism (rs4880). Althoughthe χ2 test did not reveal significant differences in the distribution of genotypes between quartile groups, bothbinary and ordinal logistic regression showed a consistent trend: carriers of Val/Ala and Ala/Ala genotypes had alower probability of high stress levels compared to the Val/Val reference group. CONCLUSION:There is a significant variation in the level of psychoemotional stress in children exposed to war, whichindicates the heterogeneity of individual reactions. The quartile stratification of the PSM25 scale provided aneffective adaptation to the lack of standards for the pediatric population and allowed to identify clinically significant subgroups by stress level. Male gender was associated with a lower level of stress, and living in areas withchronic radiation background was associated with a tendency to increased risk, indicating the influence of socioenvironmental factors. The association analysis indicated a possible protective role of the Ala allele of the SOD2gene (rs4880), which is manifested in a reduction in the risk of high stress in children. This hypothesis requires further confirmation in larger samples.
The Chornobyl disaster - a largescale nuclear accident that caused significant radiation exposure to large populations of people. The work of ophthalmologists who studied its consequences radically changed scientists' understanding of the effects of ionizing radiation on the organ of vision. Before the Chornobyl accident, it was widely believed that the organ of vision was relatively resistant to the effects of ionizing radiation. It was thought that the most likely effect of radiation exposure was radiation cataracts, which were considered a deterministic effect.The objective of this study is analyze epidemiological, clinical, and experimental data on the ophthalmologicaleffects of radiation obtained after the Chоrnobyl disaster. Materials and methods. The criteria for inclusion in the analytical review were peer reviewed publications in the scientometric databases PubMed/MEDLINE, Scopus, Web of Science, and manually selected works devoted to the study of the ophthalmological consequences of the Chornobyl disaster, other radiation incidents, and the consequences of occupational radiation exposure, published in the period after the Chornobyl disaster.Results. Studies conducted after the Chornobyl disaster have significantly changed the understanding of theeffects of ionizing radiation on the vision organ. It has been shown that the eye is extremely sensitive to radiation exposure and is one of the most vulnerable structures of the body. Analyzing the results of longterm post-Chornobyl studies, we can distinguish four groups of ophthalmological diseases that occur in people affected by the Chornobyl disaster: the first group is specific radiation damage to the eye, the appearance of which is possible only as a result of ionizing radiation exposure; the second group is diseases that under normal conditions occur mainly in elderly people and the development of which is accelerated as a result of radiation exposure; the third group is functional changes that were detected in radiationexposed people; and the fourth group includes effects that occurred in people irradiated in utero.
BACKGROUND:Incidental detection of pulmonary nodules remains a common diagnostic challenge in modern clinical practice. According to international guidelines, such findings often require repeated, longterm surveillanceusing followup imaging. Given the growing number of patients who need prolonged monitoring and the necessityto minimize cumulative radiation exposure, optimization of multislice computed tomography (MSCT) protocols hasbecome paramount. The development and implementation of targeted, ultralowdose scanning approaches enablethe acquisition of reproducible and highly informative diagnostic data while substantially reducing radiation dose.This is a key component in managing lowrisk patients and forms the basis for personalized followup strategies thatenhance safety in radiological imaging. OBJECTIVE:to scientifically validate, develop, and evaluate a targeted MSCT protocol for the monitoring of probablybenign pulmonary nodules, and to evaluate its diagnostic performance and radiation exposure against a standardfulldose protocol to determine its clinical utility for routine application. MATERIALS AND METHODS:The study included 92 patients of the Mykolaiv Regional Oncology Center with incidentallydetected solitary pulmonary nodules up to 15 mm requiring dynamic followup. Inclusion criteria were probablybenign morphology and at least one previous followup imaging study. A known oncologic history or imaging suspicion of malignancy served as exclusion criteria.Scanning was performed on a 64slice Revolution Maxima CT scanner (GE, USA) in the supine position during a breathhold. A standard fulldose protocol (A) and a targeted protocol(B) were compared in terms of radiation exposure (CTDIvol, DLP) and diagnostic quality. Nodule dynamics wereassessed using identical reconstruction parameters (slice thickness 1.25 mm, interval 1 mm, lung and mediastinalwindows) with repeated measurements by two independent radiologists. RESULTS:The targeted protocol B reduced DLP by more than eight fold (27.8 vs. 229.5 mGy·cm) and lowered CTDIvolby approximately 40 %, resulting in an 85 % reduction of effective dose, while maintaining high image quality. Atotal of 88 % of nodules remained stable, 7.6 % showed minor changes, and 4.3 % required surgical intervention, alldemonstrating benign histology. Protocol B reliably differentiated stable incidentalomas from lesions requiringintervention, with minimal radiation exposure. CONCLUSIONS:The developed targeted MSCT protocol is safe and effective for dynamic monitoring of probably benignpulmonary nodules. It significantly reduces cumulative radiation exposure without compromising diagnostic accuracy and should be integrated into routine radiological practice.
OBJECTIVE:the scientific analysis of the frequency of structural and functional changes in parathyroid glands (PTH)in different categories of the Chornobyl NPP (ChNPP) accident survivors (i.e. the irradiated individuals). MATERIALS AND METHODS:The prospective study of 815 individuals and retrospective analysis of 3,849 case records(total 4,664 individuals) aged 19-75 years at the time of survey, in the range of 0.05-0.2 Gy external radiation dosesamong the ChNPP accident cleanup workers, was performed. Anthropometric, laboratory (parathyroid hormone,vitamin D, calcium, phosphorus, thyroid hormones, thyroid antibodies, and biochemical assays), instrumental (thyroid and parathyroid diagnostic ultrasound) and statistical methods were applied. RESULTS:There was a higher incidence of the ultrasound signs of parathyroid hyperplasia in the ChNPP accident survivors compared to controls (pooled RR ≈ 1.43; p < 0.001), with the highest values among evacuees and cleanupworkers workers. Incidence of nonrenal normocalcemic hyperparathyroidism (NRHPT) featured a trend to increasein survivors (RR ≈ 1.35; p ≈ 0.095) increasing with age. Level of parathyroid hormone was higher in females than inmales. Increase in the proportion of NRHPT was noted in the period 2019-2024 in both groups with more theincrease in survivors (slope difference ≈ +0.75 p.p./year; p ≈ 0.03). In subgroups of persons with comorbidities theproportion of NRHPT was higher in survivors, however not reaching a statistical significance in the study sample(crude estimates; p > 0.3). CONCLUSIONS:The radiation factor of the ChNPP accident is associated with an increased risk of structural and functional parathyroid changes and normocalcemic NRHPT in particular. There is a higher incidence of ultrasound signsof parathyroid hyperplasia in the ChNPP accident survivors, especially the evacuees and local residents, than in subjects not exposed to extra exposure to ionizing radiation in their daily or practical activities (RR ≈ 1.43; p < 0.001).
BACKGROUND:Alcohol abuse is one of the public health problems in the world and Ukraine, but with significantattention to the health status of Chornobyl NPP accident cleanup workers (ACWs), studies on their mortality anddisability from toxic effect of alcohol have not been found. OBJECTIVE:retrospective analysis of data from Ukraine's State Register of Persons Affected by the Chornobyl Disaster(SRU) for 1987-2017 on mortality and disability from toxic effect of alcohol (ICD10 codes T51.0-T51.9; ICD9codes 980.0-980.9) among the ACWs who were under medical supervision at healthcare facilities of the Ministry ofHealth of Ukraine.Study object and methods. OBJECT:deaths from toxic effect of alcohol among the ACWs and the level of disabilityof the deceased. METHODS:general scientific, demographic, mathematical and statistical, graphical. RESULTS:In the structure of external causes of deaths in the ACWs for the period 1987-2017, 18.2 % (1 411 cases)account for deaths from toxic effect of alcohol. The mortality of the ACWs from toxic effect of alcohol had the following features: 98.7 % of the deceased were men; the main cause of death was the toxic effect of ethyl alcohol(70.1 %); the highest levels were in 2001-2005; the duration of life for men was 26-75 years, and for women 36-68 years; the peak of mortality was at the age of 45-49 years (26.1 %); 93.0 % of men and 72.2 % of womendied at working ages; 98.6 % of men and 77.8 % of women died prematurely (before the age of 65); the average lifeduration for the cohort was (47.79 ± 2.49) years; 31.47 thousand personyears of potential life were lost (an average of 22.3 years per person). The period of healthy life (from the date of the first involvement in works for the remediation of the consequences of the Chornobyl NPP accident to the establishment of a fact of loss of health and theappointment of a disability pension) was from 1 to 27 years. The peak of health deterioration falls on 5-7 years afterthe start of works in the ACWs who were involved in works in 1986 (46.7 %), 5-6 years - in 1987 (39.0 %), 3-4, 6and 10 years (more than 10 % each, and a total of 46.6 %) - in 1988 and subsequent years of involvement. At thetime of death of the ACWs, 285 people or 20.2 % had a disability status (group III - 183 people (64.2 %), group II 89 people (31.2 %), group I - 13 people (4.6 %). Disability pensions due to loss of health resulting from injury orillness as a result of the Chornobyl disaster were awarded to 206 people (72.3 % of all disability pensions). The vastmajority were people who were involved in works in 1986 (46.7 %) and 1987 (39.0 %). CONCLUSIONS:The paper focuses on sociodemographic aspects of mortality from toxic effect of alcohol among theACWs and its structure. We see prospects for further research in conducting epidemiological studies of health problems of the ACWs resulting from alcohol abuse.
