MOLDOVA - SYSTEMATIC PREPAREDNESS FOR MEDICAL RESPONSE TO RADIATION EMERGENCIES.

Under the conditions of a full-scale russian invasion of Ukraine, the danger of the development of radiation and nuclear emergency situations in the region has increased significantly. An external independent assessment of the ability of health care system of the Republic of Moldova to respond to emergency situations revealed the need to develop a training program for medical workers on the basics of responding to radiation and nuclear threats. In addition, the evaluation recommended the development of a standard for victims care taking into account the existing evidence base.

IMPLEMENTATION OF THE EDUCATIONAL MODULE «MANAGING EXPOSURE ASSESSMENT AND MEDICAL RESPONSE TO A RADIATION EMERGENCY IN UKRAINE».

The WHO educational module УДК «Ma naging exposure assessment and medical response to a radiation emergency in Ukraine» was developed and implemented. In total, 25 trainings were conducted for 377 healthcare professionals from 6 regions of Ukraine during 2023-2024.

SYNCHRONOUS COLON CANCER ASSOCIATED WITH IDIOPATHIC THROMBOCYTOPENIC PURPURA. CLINICAL CASE.

We present а rare clinical case of successful surgical treatment - combined left-sided hemicolectomy and cecal resection for colon cancer of two locations in a patient with idiopathic thrombocytopenic purpura, which, in our opinion, is due to radiation exposure is presented. It is shown that the biological effects of long-term ionizing radiation on critical organs can have a diverse nature both in terms of the time of occurrence and in their structure, which requires an individual approach, the involvement of related specialists and the necessary medical preoperative preparation for precise planning of surgical intervention taking into account all possible risks.

PATTERNS OF DEVELOPMENT OF CLINICAL AND FUNCTIONAL DISORDERS OF THE BRONCHOPULMONARY SYSTEM IN THE POST-ACCIDENT PERIOD IN PERSONS EXPOSED TO IONIZING RADIATION.

The objective was to study the relationship between clinical symptoms and the functional state of the bronchopulmonary system of clean-up workers of the Chornobyl Nuclear Power Plant accident with chronic obstructive pulmonary disease in the remote post-accident period.Materials and methods. A retrospective analysis of 824 cases of COPD in male patients who underwent inpatienttreatment in the radiation pulmonology department from 2014 to 2024 was conducted.

STRUCTURE AND CHARACTERISTICS OF THE CHORNOBYL NPP ACCIDENT SURVIVORS REASONS OF DEATH ACCORDING TO THE MATERIALS OF MEDICAL EXPERTISE FOR THE CAUSAL RELATIONSHIP OF DISEASES WITH THE EFFECT OF IONIZING RADIATION IN THE REMOTE POSTACCIDENTAL PERIOD (2024 year).

Unlabelled: Problem of the causal relationship of disease that became the reason of death with the effect of ionizing radiation and due to harmful influence of the Chornobyl Catastrophe during performance of professional, military or official duties and / or living on radiation-contaminated areas, additional exposure not through their own fault but due to a radiation accident, caused the development of a special form of medical expertise as part of the of medical social protection system for suffered contingents in the remote postaccidental period.

Objective: To study and characterize the structure of the survivor categories (clean-up workers and victims) of the Chernobyl Catastrophe in the remote post-accident period (2013-2024) regarding the causal relationship of disease that became the reason of death with the effect of ionizing radiation and due to harmful influence of the Chornobyl Catastrophe based on the materials of expert cases of the Central Interdepartmental Expert Commission of the Ministry of Health of Ukraine (CIEC).

Material And Methods: The work was performed in the design of a retrospective study that based on analysis of the structure of all categories of Chornobyl NPP accident (ChNPP) survivors during 2008-2024 years and studying of 58,137 medical expert cases, including 19,524 postmortem cases, which were considered by CIEC during 2013-2023 to establish a causal relationship between the disease and influence of radiation exposure and other harmful factors and conditions during ChNPP accident.

RELATIONSHIP OF THE PERCEIVED STRESS LEVEL, ANTHROPOMETRIC INDICATORS AND BODY COMPOSITION IN CHILDREN EXPERIENCING PERMANENT NEGATIVE IMPACT OF THE COVID-19 PANDEMIC AND THE WAR IN UKRAINE.

Objective: to assess the impact of stressful life events occuring with the period of restrictive measures introductionconnected to the COVID-19 pandemic and during the full-scale Russian aggression, on the anthropometric indicators and body composition of children aged 10-17 years.

Materials And Methods: The research group consisted of 56 boys and 70 girls aged 10-17 years who lived in radioactively contaminated areas of Zhytomyr, Rivne, and Kyiv regions with a soil contamination density of 137Cs from 18 kBq/m2 to 235 kBq/m2. The impact of stressful factors was assessed using the stress perception scale (PSS-10).

POST-RADIATION NEUROCOGNITIVE DEFICIT IN THE CHORNOBYL CLEAN-UP WORKERS: GERIATRIC ASPECTS (PART І).

Objective: to study the features of cognitive disorders in the remote period following exposure to ionizing radiation (IR) in the elderly participants of the liquidation of the consequences of the Chornobyl NPP accident (Chornobyl clean-up workers) with chronic cerebrovascular disorders.

Materials And Methods: The retrospective and prospective cohort study with the external and internal controlgroups. The randomized sample of the male elderly participants (attained age more than 60 years old) in liquidationof the consequences of the accident (Chornobyl clean-up workers, liquidators) at the Chornobyl nuclear power plant(ChNPP) in 1986-1987 (main group, n = 52) recruited from the Clinico-epidemiological registry (CER) of StateInstitution «National Research Center for Radiation Medicine, Hematology and Oncology of The National Academyof Medical Sciences of Ukraine» (NRCRMHO) with verified chronic cerebrovascular disorders (CVD) was examined.

DYSREGULATION OF AUTOPHAGY IN PERIPHERAL BLOOD LEUCOCYTES IS A FACTOR IN THE DEVELOPMENT OF INFLAMMAGING IN IMMUNOCOMPROMISED PERSONS ON THE EXAMPLE OF THE SERVICEMEN OF THE DEFENSE FORCES OF UKRAINE AND CLEAN-UP WORKERS OF THE CHORNOBYL ACCIDENT.

Objective: To assess the functional state and age-related characteristics of autophagy in peripheral blood leukocytes as a risk factor for the development of inflammaging using the example of the servicemen of the DefenseForces of Ukraine and clean-up workers of the Chornobyl accident.

Materials And Methods: A total of 103 male patients aged 28-77 (56,48 ∓ 9,05) years were examined. They included: the main group - 23 servicemen of the Defense Forces of Ukraine aged 44-59 (50,21 ∓ 5,13) years; the comparison group - 57 clean-up workers of the Chornobyl accident aged 56-63 (60,31 ∓ 1,78) years; and the control group -23 civilians aged 28-77 (53,26 ∓ 15,98) years.

IMPACT OF ASTAXANTHIN ON MANIFESTATIONS OF THE DIRECT AND RESCUE TUMOR-INDUCED BYSTANDER EFFECT.

Objective: to investigate the reciprocal impact on the genome of malignant and normal human peripheral bloodlymphocytes under their co-culture and the possibility to modify the effects by astaxanthin.

Methods: Separate and joint/separate culturing of peripheral blood lymphocytes (PBL) of the chronic lymphocyticleukemia (CLL) patients (n = 6) and conditionally healthy individuals (n = 6), Comet assay method, fluorescencemicroscopy with automated software for the analysis of results, statistical methods.

Results: Both direct and rescue tumour-induced bystander effects were observed under the joint/separate culturing of blood lymphocytes of conditionally healthy individuals (the bystander cells) and blood cells from CLL patients(the inducer cells).

ANALYSIS OF DNA METHYLATION CHANGES IN MANIFESTATION OF DIRECT AND RESCUE BYSTANDER EFFECTS.

Objective: to investigate changes in DNA methylation in bystander and inducer cells during the manifestation ofdirect and rescue bystander effects.

Methods: Separate and co-cultivation of peripheral blood lymphocytes (PBL) of 10 conditionally healthy individuals; γ-quantum irradiation (IBL-237C emitter); modified comet electrophoresis method (Comet assay) under neutralconditions using the methylation-sensitive restriction enzyme HpaII; fluorescence microscopy with an automatedcomputer software system for analyzing the results; statistical methods.

Results: The level of DNA methylation in PBL was quantitatively assessed using DNA migration parameters inagarose gel: the length of the comet tail (in μm), the percentage of DNA in the tail part of the comet, and TailMoment (TM), which simultaneously takes into account both the amount of DNA in the tail part of the comet andthe length of the tail.

METHODOLOGY OF RECONSTRUCTION OF INTERNAL DOSES FROM 137Cs AND 134Cs OF RESIDENTS OF RADIOACTIVELY CONTAMINATED SETTLEMENTS IN UKRAINE NOT COVERED BY WBC MONITORING.

Objective: Scientific justification of the methodology for calculating radiation internal doses from 137Cs and 134Cs intake for residents of Ukrainian settlements radioactively contaminated as a result of the Chornobyl (Chernobyl) accident in which measurements of incorporated radiocesium isotopes in humans using whole-body counters (WBC) were not carried out.

Materials And Methods: The paper presents a new methodology for reconstructing doses due to internal irradiation from Chornobyl fallout for both surface (in 1986) and root (in 1987-2023) contamination of vegetation with 137Cs and 134Cs and their transfer into the human body. The methodology for calculating the dose due to surface contamination of vegetation was based on the theoretical model of the transfer of radiocesium isotopes through the food chain with further adjustment of this model to the results of WBC measurements carried out between 15 July and 31 December 1986.

A RETROSPECTIVE STUDY OF DEATHS AMONG PARTICIPANTS IN THE LIQUIDATION OF THE CONSEQUENCES OF THE ACCIDENT AT THE CHORNOBYL NPP DUE TO INJURY, POISONING AND CERTAIN OTHER CONSEQUENCES OF EXTERNAL CAUSES (2000-2020).

Objective: To assess the dynamics of changes in the number of deaths due to injury, poisoning and certain other consequences of external causes and their structure among liquidators of the accident at the Chornobyl NPP (PACL) on the basis of the data of Ukraine's State Register of Persons Affected by the Chornobyl Disaster (SRU) for 2000-2020.

Materials And Methods: The study used information resources of the Ministry of Health of Ukraine for 2000-2020 regarding deaths among the PACL - databases of the SRU as a basis for monitoring their health status. Depersonalised information was selected for 2000-2020 regarding 5,124 deaths from injury, poisoning and certain other consequences of external causes (ICD codes S00-T98) among the PACL, who were monitored in healthcare facilitiesof the Ministry of Health of Ukraine.

STUDY OF DOSE FORMATION FOR THE POPULATION IN RADIOACTIVELY CONTAMINATED AREAS OF ZHYTOMYR REGION BASED ON COMPREHENSIVE RADIATION-HYGIENIC MONITORING.

Objective: the research is to determine the main radiation-hygienic factors influencing the formation of radiation doses among the population of radioactively contaminated territories (RCT) in Zhytomyr region in 2024 and to analyze the dynamics of internal radiation doses based on original experimental studies conducted in reference settlements from 2012 to 2024.

Materials And Methods: In 2024, a comprehensive radiation-hygienic monitoring program was conducted in 11 settlements of Narodychi Territorial Community (TC): the Narodychi and the villages of Selets, Bazar, Rudnya Bazarska, Khrystynivka (Zone 2), Motiyki, Zalissya, Davydky, Radcha, Nova Radcha, and Grezlya (Zone 3). The comprehensive radiation-hygienic monitoring included the following activities: mobile WBC monitoring: 817 measurements (562 adults and 255 children); collection and analysis of food samples: 39 milk samples, 61 potato samples, and 57 samples of wild foods, analyzed for radionuclide content, including 137Cs and 90Sr; assessment of external radiation exposure in these settlements; surveys: 194 individuals were surveyed regarding the consumption volumes of locally produced foods from their own households and purchased foods from commercial networks.

DIAGNOSTIC AND CLINICAL ASPECTS OF NORMOCALCEMIC PARATHYROID HYPERPLASIA AND NON-RENAL SECONDARY HYPERPARATHYROIDISM IN EXPOSED AND NON;EXPOSED TO IONIZING RADIATION INDIVIDUALS (LITERATURE REVIEW AND OWN RESEARCH DATA).

Parathyroids are the key regulators of calcium-phosphorus metabolism. By means of parathyroid hormone they respond to any changes in the serum level of calcium and phosphorus ions and determine the integrity of skeleton, affecting almost all systems and cells where calcium and phosphorus are involved in metabolism and/or signaling.Disorders of parathyroid function are associated with significant complications accompanying secondary hyperparathyroidism.

STATE INSTITUTION «NATIONAL RESEARCH CENTER FOR RADIATION MEDICINE, HEMATOLOGY AND ONCOLOGY OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE» - RESEARCH ACTIVITIES AND SCIENTIFIC ADVANCE IN 2023.

Research activities and scientific advance achieved in 2023 at the State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine» (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 institution has been reorganized and since December 2023 has been called the State Institution «National Research Center for Radiation Medicine, Hematology and Oncology» (NRCRM).

Thyroid doses for the Chornobyl Tissue Bank: improved estimates based on revised methodology and individual residence and diet history.

Increased thyroid cancer incidence has been one of the principal adverse health effects of the Chornobyl (Chernobyl) nuclear power plant accident. Accurate dose estimation is critical for assessing the radiation dose-response relationship. Current dosimetry estimates for individuals from the Chornobyl Tissue Bank (CTB) are based only on the limited information on their places of residence at the time of the accident and/or at the time of surgery for thyroid cancer.

Dose Reconstruction for Epidemiological Studies among Ukrainian Chernobyl Cleanup Workers.

The present paper provides an overview of the methods and summarizes the results of estimating radiation doses and their uncertainties for Ukrainian-American epidemiological studies among the Chernobyl (Chornobyl) cleanup workers. After the Chernobyl accident occurred on April 26, 1986, more than 300,000 Ukrainian cleanup workers took part between 1986 and 1990 in decontamination and recovery activities at the site of the Chernobyl Nuclear Power Plant. The U.

Prevalence of Thyroid Nodules in Residents of Ukraine Exposed as Children or Adolescents to Iodine-131 from the Chornobyl Accident.

Although childhood exposure to radioactive iodine-131 (I-131) is an established risk factor for thyroid cancer, evidence for an association with thyroid nodules is less clear. The objective of this study is to evaluate the association between childhood I-131 exposure and prevalence of ultrasound-detected thyroid nodules overall and by nodule histology/cytology (neoplastic/suspicious/non-neoplastic), size (<10 mm/≥10 mm), and number (single/multiple). This is a cross-sectional study of radiation dose (mean = 0.

IMMUNOPHENOTYPE OF LEUKEMIC CELLS IN CHRONIC LYMPHOCYTIC LEUKEMIA PATIENTS WITH NOTCH1 AND SF3B1 GENE MUTATIONS.

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.

ACUTE RADIATION SICKNESS IN HUMAN: ETIOPATHOGENESIS, CLINIC, DIAGNOSIS AND TREATMENT (LECTURE).

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.

STRUCTURE AND CHARACTERISTICS OF THE CHORNOBYL NPP ACCIDENT VICTIMS ACCORDING TO THE MATERIALS OF MEDICAL EXPERTISE OF THE CAUSAL RELATIONSHIP OF DISEASES WITH THE EFFECT OF IONIZING RADIATION IN THE REMOTE POSTACCIDENTAL PERIOD (2023 year).

Unlabelled: Loss of health and workability, as well as deaths due to harmful influence of the Chornobyl catastrophe (including radiation exposure) during performance of professional, military or official duties and / or living on radiation-contaminated areas, additional exposure not through their own fault but due to a radiation accident, caused the development of a special form of medical expertise as part of the of medical social protection system for these suffered contingents.

Objective: To study and characterize the structure of the affected categories (clean-up workers and victims) of the Chornobyl catastrophe based on the materials of expert cases of the Central Interdepartmental Expert Commission of Ministry of Health of Ukraine (CIEC) in the remote post-accidental period (2013-2023).

Material And Methods: The work was performed in the design of a retrospective study that based on analysis of the structure of all categories of Chornobyl NPP accident (ChNPP) victims during 2008-2023 years and studying of more 57 000 medical expert cases, which were considered by CIEC during 2013-2022 to establish a causal relationship between the disease and influence of radiation exposure and other harmful factors and conditions during ChNPP accident.

THE STRUCTURE OF THE INCIDENCE OF ONCOHEMATOLOGICAL DISEASES IN ECOLOGICALLY DISADVANTAGED REGIONS OF THE DNIPROPETROVSK REGION FOR THE PERIOD 2006-2017.

Objective: to conduct a comparative analysis of the incidence of malignant oncohematological diseases structure among the population of the 4 most ecologically disadvantaged cities of the Dnipropetrovsk region, taking into account the possible influence of various adverse environmental factors (radiation and chemical pollution of air, water and soil) for the period 2006-2017.

Materials And Methods: 1948 cases of acute myeloblastic and lymphoblastic leukemia, chronic myeloid and lymphocytic leukemia in residents of 4 cities of the Dnipropetrovsk region were analyzed, taking into account the possible influence of adverse environmental factors (radiation, air pollution, etc.).

SLEEP QUALITY OF SCHOOLCHILDREN - RESIDENTS OF RADIOACTIVELY CONTAMINATED AREAS DURING THE COVID-19 PANDEMIC.

Objective: to assess the sleep characteristics of middle school children during the COVID-19 pandemic.

Materials And Methods: Cross-sectional study of sleep characteristics of children - residents of radioactively contaminated areas of Zhytomyr and Rivne regions, who underwent a routine examination in June-July 2020, after their stay from March to June 2020 in conditions of home isolation due to quarantine restrictions during the COVID-19 pandemic. Ninety six students of comprehensive public schools, aged 10-16, took part in the study.

REVIEW OF THE NATURE OF ANTI/INFLAMMATORY AND PRO-INFLAMMATORY CYTOKINE REGULATION IN DIFFERENT PERIODS OF PLASMA CELL MYELOMA NATURAL HISTORY IN THE CHORNOBYL NPP ACCIDENT SURVIVORS.

Objective: identify the nature of anti-inflammatory and pro-inflammatory cytokine regulation in different periods of plasma cell myeloma (PCM) natural history with evaluation of its role as a prognostic criterion for the disease course in the Chornobyl NPP (ChNPP) accident survivors.

Materials And Methods: Levels of pro-inflammatory (IL-6, TNF-α) and anti-inflammatory (IL-10) cytokines both with their relationship were studied in the stage I-II and stage III PCM patients (n = 74) in different periods of the disease natural history i.e.

NEUROPHYSIOLOGICAL BASIS OF THE COMBINED EFFECTS OF ACUTE STRESS AND LOW DOSES OF IONIZING RADIATION ON HUMAN BRAIN.

Objective: to study the clinical and neurophysiological features in the Chornobyl clean-up workers with a verified chronic cerebrovascular disease/cerebral small vessels disease (SVD) exposed to low doses of ionizing radiation (IR), employees of the Chornobyl Nuclear Power Plant (SSE ChNPP), who were exposed to the stress factor of a full-scale war as a result of being held captive by the Russian military at their workplaces, and individuals of the non-irradiated comparison group.Design, object and methods. A cross-sectional clinical study with parallel external control groups.