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The article discusses the features and development of poultry farming in the Republic of Kazakhstan. Various points of view of domestic and foreign scientists and researchers on the issue of the specifics and further development of this industry in the country and in the region are analyzed. For analysis, the authors selected such indicators as the number of poultry, the production of poultry meat, the production of eggs, the consumption rate per capita: eggs, meat and meat products, the price of products. On the basis of statistical data, the state of poultry farming in the Republic of Kazakhstan and the North Kazakhstan region over the past 5 years was analyzed. Wh en writing the article, the authors took data from poultry enterprises in the North Kazakhstan region for 2017 -2021, namely, the share of egg production by poultry farms in the region, total per capita consumption and the average price per year of poultry products were calculated in detail. As a result, there is a strong demand for poultry products in the country's market, so poultry farms will need to find all opportunities to increase the volume of production and increase its competitiveness.

Aim. To characterize patients receiving PCSK9 inhibitors, and assess the efficiency of their treatment in a specialized lipid center.Material and methods. A retrospective analysis of the medical records of patients who visited the Lipid clinic of the National Medical Research Center for Therapy and Preventive Medicine (Moscow, Russia), receiving PCSK9 inhibitor and having lipid profile in dynamics, was carried out (n=77). Cardiovascular risk (CVR) and low-density lipoprotein cholesterol (LDL-C) target levels were evaluated in accordance with the Russian guidelines for the diagnostics and correction of dyslipidemias 2020.Results. Of 77 patients taking PCSK9 inhibitors (44.2% males, the median of age 56 [47; 66] years), the majority (64.0%) had a probable or definite familial hypercholesterolemia (FH). The proportion of other lipid metabolism disorders, pure hypercholesterolemia and combined hyperlipidemia was 21% and 15%. More than half of the patients (68.8%) had a very high CVR, mainly due to the presence of coronary heart disease (84.9%). The proportion of patients receiving PCSK9 inhibitors as monotherapy was 7.8%, in combination with high-intensity statin therapy – 33.8%, as part of triple lipid-lowering therapy (high-intensity statin, ezetimibe, PCSK9 inhibitors) – 50.6%. Addition of PCSK9 inhibitors to combined lipid-lowering therapy enabled to reduce the LDL-C level to 1.02 [0.62; 1.39] mmol/l with its total decrease from the baseline by 87.3%. While taking PCSK9 inhibitors, LDL-C Conclusion: In a specialized lipid center, PCSK9 inhibitors are prescribed to patients with high or very high CVR, most of whom are FH patients. The effectiveness of the use of PCSK9 inhibitors in real-world practice is comparable to the results of clinical trials.

Background. Endocrine comorbidity, a concomitant radiation injury of several endocrine glands, is a topical issue in radiation medicine. The purpose of the study was to establish a correlation of secondary hyperparathyroidism with thyroid and pancreatic disorders among the Chornobyl nuclear power plant (NPP) accident survivors. Materials and methods. A blind sample (n = 60) of subjects treated at the radiation endocrinology department in 2019 was selected for the study. Study sample included the Chornobyl NPP accident survivors (group 1, n = 40) and patients not exposed to radiation (group 2, n = 20). The average age of people was 60.2 ± 9.8 years. Decompensation of type 2 diabetes was the most common cause for hospital admission (48.3 %), decompensation of hypothyroidism was in second place (46.7 %). Research methods: clinical, instrumental, laboratory, statistical. Results. Incidence of the increased risk of vitamin D deficiency and excessive parathyroid hormone production in the Chornobyl NPP accident survivors was somewhat higher than in individuals not exposed to radiation (81.08 and 78.12 %; χ2 = 0.257, p = 0.612; 31.12 and 28.08 %; χ2 = 0.462, p = 0.319, respectively). Using a multivariate analysis, the reliable model was obtained confirming the relationship of increased parathyroid hormone level and early subclinical signs of the target organ damage (F = 4.294; p = 0.042), which proves the relevance of using clinical questionnaires. A reliable positive correlation was found between the vitamin D and free thyroxine levels (r = 0.729; p = 0.001), and negative one was found with the thyroid-stimulating hormone content (r = –0.803; p = 0.001). In the Chornobyl NPP accident survivors with type 2 diabetes, a decreased vitamin D concentration correlated with an increased duration of metformin therapy (r = –0.421; p = 0.001) and body mass index (r = –0.787; p = 0.001). It was found that the parathyroid hormone level increases along with the duration of type 2 diabetes and an increase in creatinine clearance (r = 0.724; p = 0.001, and r = 0.799; p = 0.001). Conclusions. Vitamin D deficiency has a negative effect on the course of comorbid disorders (type 2 diabetes and hypothyroidism) and excessive production of parathyroid hormone.

Prerequisite. Since the advent of nuclear energy, industry and weapons, a possibility of radiation events i.e. incidents and accidents had emerged. Given the presence of radioactive iodine as part of environmental contamination, the response of authorities and medical services consists, in particular, in carrying out the emergency iodine prophylaxis among specialists and general population. And along with the fact that emergency iodine prophylaxis is a generally accepted measure in radiation events accompanied by the release of radioactive iodine, some methods of its implementation were and remain in certain sources and instructions/recommendations contradictory and even false. Such inconsistency increases the potential risks of health effects of radioactive iodine and exacerbates the sense of fear and uncertainty among the population involved in the incident.to consider and review the essence of emergency iodine prophylaxis during radiation events, physiological aspects of iodine metabolism in the body, properties of individual iodine prophylaxis agents that are recommended, and to justify the rationality of using some of them along with absurdity/inadmissibility of others; substantiate the creation of a unified preventive information strategy regarding the event in order to reduce anxiety and other negative psychological consequences among the affected population.The review was performed by searching the abstract and scientometric databases and printed publications.In the event of serious radiation events at nuclear power plants and industry facilities, radioactive iodine is highly likely to enter the environment. With the threat of radioactive iodine incorporation or with its incorporation that has already begun, it is absolutely necessary to carry out the emergency iodine prophylaxis. Such prevention should be carried out with stable iodine preparations such as potassium iodide or potassium iodate in special pharmaceutical formulas. Dosing of drugs in age and population groups should be carried out by specialists in radiation medicine and radiation safety in accordance with internationally recognized guidelines. The use of iodinecontaining food additives, iodine solution for external use and Lugol's solution is categorically unacceptable due to complete ineffectiveness, impracticality of implementation, and sometimes due to the threat of serious harm to health.Clear preparedness plans for possible radiation accidents and incidents, as well as successfullyimplemented appropriate preventive measures, including emergency iodine prophylaxis, are crucial for the effective and successful response to such events. Emergency iodine prophylaxis during radiation events should be carried out exclusively under the guidance of specialists in radiation medicine and radiation safety using special pharmaceutical formulas of potassium iodide or potassium iodate in doses recognized by the international scientific community. Other means of emergency iodine prophylaxis, including «handicraft»/home preparations, are absolutely unacceptable. Implementation of this protective measure should be accompanied by a coordinated information campaign in order to minimize purely radiation risks and to preserve the psychological well-being of the population.Peredumova. Z momentu poiavy iadernoï energetyky, promyslovosti ta zbroï isnuie ĭmovirnist' radiatsiĭnykh podiĭ - intsydentiv ta avariĭ. Za umovy naiavnosti radioaktyvnogo ĭodu u skladi ekologichnykh zabrudnen' reaguvannia organiv vlady i medychnykh sluzhb poliagaie, zokrema, u provedenni sered fakhivtsiv ta naselennia v tsilomu avariĭnoï ĭodnoï profilaktyky. I poriad z tym, shcho avariĭna ĭodna profilaktyka ie zagal'novyznanym zakhodom pry radiatsiĭnykh podiiakh, shcho suprovodzhuiut'sia vykydom radioaktyvnogo ĭodu, deiaki metody ïï provedennia buly ĭ zalyshaiut'sia u pevnykh dzherelakh i nastanovakh rekomendatsiiakh superechlyvymy i navit' khybnymy. Podibna neuzgodzhenist'zbil'shuie potentsiĭni ryzyky medychnykh efektiv radioaktyvnogo ĭodu i pidvyshchuie pochuttia strakhu i nevyznachenosti sered zaluchenogo do intsydentu naselennia.Meta: rozglianuty sutnist' avariĭnoï ĭodnoï profilaktyky pry radiatsiĭnykh podiiakh, fiziologichni aspekty obminu ĭodu v organizmi, vlastyvosti okremykh zasobiv ĭodnoï profilaktyky, iaki rekomenduiut'sia, ta obґruntuvaty ratsional'nist' zastosuvannia odnykh z nykh i bezgluzdist' neprypustymist' inshykh; obgruntuvaty stvorennia iedynoï preventyvnoï informatsiĭnoï strategiï shchodo zakhodu z metoiu zmenshennia tryvozhnosti ta inshykh negatyvnykh psykhologichnykh naslidkiv sered postrazhdalogo naselennia.Materialy ta metody. Ogliad vykonano shliakhom poshuku u referatyvnykh ĭ naukometrychnykh bazakh ta drukovanykh vydanniakh. Rezul'taty. Pry serĭoznykh radiatsiĭnykh podiiakh na pidpryiemstvakh iadernoï energetyky ta promyslovosti u navkolyshnie seredovyshche z vysokoiu ĭmovirnistiu nadkhodyt' radioaktyvnyĭ ĭod. Pry zagrozi inkorporatsiï radioaktyvnogo ĭodu abo pry ĭogo inkorporatsiï, iaka vzhe pochalasia, neodminno neobkhidne provedennia avariĭnoï ĭodnoï profilaktyky. Taku profilaktyku slid provodyty preparatamy stabil'nogo ĭodu u vygliadi kaliiu ĭodydu abo kaliiu ĭodatu u spetsial'nykh farmatsevtychnykh formakh vypusku. Dozuvannia preparativ u vikovykh i populiatsiĭnykhgrupakh zdiĭsniuiet'sia vidpovidno do mizhnarodnovyznanykh nastanov spetsialistamy z radiatsiĭnoï medytsyny ta radiatsiĭnoï bezpeky. Zastosuvannia ĭodovmisnykh kharchovykh dobavok, rozchynu ĭodu dlia zovnishn'ogo zastosuvannia i rozchynu Liugolia kategorychno neprypustyme cherez povnu neefektyvnist', nereal'nist' vykonannia, a inkoly - z ogliadu na zagrozu tiazhkoï shkody zdorov’iu.Vysnovky. Chitki plany gotovnosti shchodo mozhlyvykh radiatsiĭnykh avariĭ ta intsydentiv, a takozh vdalo provedeni vidpovidni preventyvni zakhody, vkliuchaiuchy avariĭnu ĭodnu profilaktyku vyrishal'no vazhlyvi dlia efektyvnogo ĭ uspishnogo reaguvannia pry takykh podiiakh. Avariĭna ĭodna profilaktyka pry radiatsiĭnykh podiiakh maie zdiĭsniuvatysia vykliuchno pid kerivnytstvom fakhivtsiv z radiatsiĭnoï medytsyny ta radiatsiĭnoï bezpeky z vykorystanniam spetsial'nykh farmatsevtychnykh form kaliiu ĭodydu abo kaliiu ĭodatu u vyznanykh mizhnarodnoiu naukovoiu spil'notoiu dozakh. Inshi zasoby avariĭnoï ĭodnoï profilaktyky, vkliuchaiuchy «kustarnogo» pobutovogo prygotuvannia, absoliutno neprypustymi. Zdiĭsnennia ts'ogo zakhysnogo zakhodu maie suprovodzhuvatys' uzgodzhenoiu informatsiĭnoiukampaniieiu zadlia minimizatsiï iak suto radiatsiĭnykh ryzykiv, tak i dlia zberezhennia psykhologichnogo blagopoluchchia naselennia.

Despite significant progress in the development of novel methods for the prevention and treatment of cardiovascular diseases, their prevalence remains high, which is largely due to low adherence of patients to drug and non-drug preventive interventions. Motivational counseling (MC) is a unique technology that makes it possible to activate the patient’s desire to change their behavior towards a healthy one. The review presents an analysis of the literature on MC technology and the possibilities of its application in cardiology practice. Research data show the effectiveness of MC in improving the nutrition profile, physical activity, weight loss, smoking cessation, control of glycated hemoglobin in patients with diabetes, improving outcomes in patients with heart failure, increasing adherence to therapy, etc. Conducting MC using telemedicine technologies seems promising. The training of specialists is of paramount importance, since the effectiveness of this type of counseling largely depends on the accuracy of the consultant’s adherence to the essence and technologies of MC.

Aim. To analyze the structure of clinical data, as well as the principles of collecting and storing related data of the biobank of the National Medical Research Center for Therapy and Preventive Medicine (hereinafter Biobank).Material and methods. The analysis was carried out using the documentation available in the Biobank, as well as the databases used in its work. The paper presents clinical data on biosamples available in the Biobank as of August 18, 2021.Results. At the time of analysis, the Biobank had 373547 samples collected from 54192 patients within 37 research projects. The article presents the analysis of data representation and quantitative assessment of the presence/absence of common diagnoses in clinical projects. Approaches to documenting clinical information associated with biological samples stored in the Biobank were assessed. The methods and tools used for standardization and automation of processes used in the Biobank were substantiated.Conclusion. The Biobank of the National Medical Research Center for Therapy and Preventive Medicine is the largest research biobank in Russia, which meets all modern international requirements and is one of the key structures that improve the research quality and intensify their conduct both within the one center and in cooperation with other biobanks and scientific institutions. The collection and systematic storage of clinical abstracts of biological samples is an integral and most important part of the Biobank’s work.

Intensive investigation of cardiovascular disease (CVD) risk factors (RFs), both traditional (smoking, dyslipidemia, diabetes, etc.) and non-traditional, which are a component of the so-called exposome, as well as their non-drug and drug correction provide wide prospects for effective cardiovascular prevention. Prevention becomes the dominant trend in cardiology and in medicine in general. The aim of the article was to describe cardiovascular prevention in young, middle, elderly and senile age. Due to the multifaceted nature of cardiovascular RFs, an integrated biopsychosocial approach, individual and population-based prevention, cumulative risk assessment of all CVDs, intersectoral collaboration and the involvement of decision-makers, are key to the success and effectiveness of prevention measures. It is important to note that, on the one hand, preventive measures should be started as early as possible due to cumulative effect of RFs, on the other hand, most of the preventive interventions for CVD are extremely relevant at all life stages.

to investigate the clinical, hormonal-metabolic and structural features of parathyroid injuries in sur-vivors exposed to ionizing radiation after the Chornobyl NPP accident in adulthood and childhood, both with theirconnections to other non-cancerous endocrine disorders, and to establish the respective interhormonal and dys-metabolic relationships.Clinical effects of ionizing radiation on the endocrine system in persons affected by theChornobyl NPP accident (n = 224) and their descendants (n = 146), compared with the general population sample(n = 70) were the study object. All patients underwent the ultrasound thyroid and parathyroid examination. Thegenerally recognized clinical, anthropometric (body weight, height, thigh volume, body mass index), instrumental(ultrasound examination of thyroid and parathyroid glands), laboratory (biochemical, hormonal), and statisticalmethods were applied. Parametric and nonparametric statistical methods were used in data processing. The value ofp0.05 was considered a statistically significant.No significant difference was found in the incidence of carbohydrate metabolic disorders in the ChornobylNPP (ChNPP) accident consequences clean-up workers (ACCUW), evacuees from the NPP 30-km exclusion zone, res-idents of radiologically contaminated areas and in the control group in whom the parathyroid hyperplasia wasdetected. There was a significant increase in the incidence of arterial hypertension among ACCUW who had parathy-roid hyperplasia (76.9%) vs. the control group (51.2%). In cases of parathyoid hyperplasia the vitamin D levels weresignificantly lower than without it. Vitamin D insufficiency/deficiency was found in 94% of the surveyed subjects.The average level of parathyroid hormone in blood serum was significantly higher in the ACCUW of «iodine» period withdiagnosed parathyroid hyperplasia than in the control group: (57.2 ± 2.87) pg / ml against (32.74 ± 3.58) pg / ml,p0.05. Results of multivariative analysis indicated a strong association of vitamin 25(OH)D insufficiency/defi-ciency with development of thyroid disease, carbohydrate metabolic disorders, cardiovascular disease, osteo-penia/osteoporosis. parathyroid ultrasound scan was at that an effective diagnostic method for primary screeningfor parathyroid hyperplasia and regular monitoring of the treatment efficiency. When examining children bornto parents irradiated after the ChNPPA the parathyroid hyperplasia (58%) and low serum content of vitamin D(11.6 ± 3.5) nmol / l were most often found in children living on radiologically contaminated territories (RCT).A strong correlation was established between the HOMA insulin resistance index and serum content of vitamin D(r = 0.65), parathyroid hormone (r = 0.60), and free thyroxine (r = 0.68) in the group of children born to parents irra-diated after the ChNPPA, having got chronic autoimmune thyroiditis, which indicated a relationship between thy-roid function, impaired carbohydrate and fat metabolism and the state of parathyroids.No difference in the incidence of carbohydrate metabolic disorders was found in the ChNPP ACCUW,evacuees from the 30-km exclusion zone, and residents of radiologically contaminated territories in whom parathy-roid hyperplasia was detected vs. the control group. Patients with parathyroid hyperplasia were found to be defi-cient in vitamin D in 94% of cases, and level of latter was significantly lower than under the normal parathyroid size.There was a significant increase in the incidence of diagnosed arterial hypertension among ACCUW who had parathy-roid hyperplasia vs. the control group: (76.9 ± 3.5)% vs. (51.2 ± 3.7)%. According to multivariate analysis a strongassociation between the vitamin 25(OH)D insufficiency/deficiency and development of thyroid disease, carbohydratemetabolic disorders, cardiovascular disease, and osteopenia/osteoporosis was established. The average level of pa-rathyroid hormone in the blood serum of the ChNPP ACCUW of the «iodine» period with diagnosed parathyroid hyper-plasia was significantly higher (57.2 ± 2.87) pg / ml against (32.74 ± 3.58) pg / ml; p0,05) in the control group.Meta: doslidyty klinichni, gormonal'no-metabolichni ta strukturni osoblyvosti urazhennia pryshchytopodibnykh zalozpostrazhdalykh osib, oprominenykh vnaslidok avariï na ChAES u doroslomu i dytiachomu vitsi, ïkh sporidnenist' z inshy-my nezloiakisnymy endokrynnymy porushenniamy, vstanovyty mizhgormonal'ni ta dysmetabolichni vzaiemozv’iazky.Materialy ta metody. Ob’iekt doslidzhennia: klinichni naslidky diï ionizuiuchogo vyprominiuvannia na endokrynnusystemu u 224 osib, postrazhdalykh vnaslidok avariï na ChAES ta 146 ïkhnikh nashchadkiv, u porivnianni z zagal'noiu po-puliatsiieiu naselennia (70 osib). Vsim patsiientam bulo provedeno ul'trazvukove doslidzhennia shchytopodibnoï ta pry-shchytopodibnykh zaloz (PShchPZ). Vykorystani zagal'novyznani klinichni, antropometrychni (masa tila, zrist, obsiagstegna, indeks masy tila), instrumental'ni (ul'trazvukove doslidzhennia shchytopodibnoï ta PShchPZ), laboratorni(biokhimichni, gormonal'ni), statystychni. Vykorystovuvaly parametrychni i neparametrychni metody doslidzhennia.Pry rozrakhunku statystychnoï znachushchosti ïï riven' r0,05 vvazhaly statystychno dostovirnym. Rezul'taty. Ne znaĭdeno virogidnoï riznytsi v chastoti porushen' vuglevodnogo obminu v uchasnykiv likvidatsiïnaslidkiv avariï (ULNA) na ChAES, evakuĭovanykh iz 30-km zony vidchuzhennia, meshkantsiv radiatsiĭno zabrudnenykh te-rytoriĭ ta v grupi kontroliu, v iakykh bula vyiavlena giperplaziia PShchPZ. Vstanovleno znachne pidvyshchennia chastotyarterial'noï gipertenziï sered ULNA, iaki maly giperplaziiu PShchPZ (76,9 %), porivniano z grupoiu kontroliu (51,2 %).U patsiientiv z giperplaziieiu PShchPZ pokaznyky zabezpechenosti organizmu vitaminom D buly virogidno nyzhchi, nizh bezneï. Nestachu/defitsyt vitaminu D vyiavleno u 94 % obstezhenykh. Vyznacheno, shcho v ULNA na ChAES ĭodnogo periodu,v iakykh vyiavlena giperplaziia PShchPZ, seredniĭ riven' paratgormonu u syrovattsi krovi virogidno buv vyshchym, nizh ugrupi kontroliu: (57,2 ± 2,87) pg/ml proty (32,74 ± 3,58) pg/ml, p0,05. Bagatofaktornyĭ analiz pokazavvirogidnyĭ zv’iazok nestachi/defitsytu vitaminu 25(ON)D z rozvytkom tyreoïdnoï patologiï, porushenniam vuglevod-nogo obminu, sertsevo-sudynnymy zakhvoriuvanniamy, osteopeniieiu/osteoporozom, a UZD PShchPZ ie diievym diagnos-tychnym metodom pervynnogo skryningu giperplaziï PShchPZ i postupovogo monitoryngu klinichnoï efektyvnostilikuvannia. Pry obstezhenni diteĭ, iaki narodylysia vid bat'kiv, oprominenykh vnaslidok avariï na ChAES, giperplaziiaPShchPZ (58 %) i nyz'kyĭ riven' vitaminu D v syrovattsi krovi – (11,6 ± 3,5) nmol'/l naĭchastishe vyiavlialy u diteĭ,meshkantsiv radiatsiĭno-zabrudnenykh terytoriĭ (RZT). Vstanovleno virogidnyĭ koreliatsiĭnyĭ zv’iazok mizh indeksominsulinorezystentnosti NOMA i vitaminom D (r = 0,65), paratgormonom (r = 0,60), vil'nym tyroksynom (r = 0,68)u grupi diteĭ, narodzhenykh vid bat'kiv, oprominenykh vnaslidok avariï na ChAES, z khronichnym autoimunnym tyreoïdy-tom, shcho svidchyt' pro naiavnist' vzaiemozv’iazku mizh funktsiieiu shchytopodibnoï zalozy, porushenniam vuglevodnogo izhyrovogo obminu ta stanom PShchPZ. Vysnovky. Takym chynom, v ULNA na ChAES, evakuĭovanykh iz 30-km zony vidchuzhennia, meshkantsiv radiatsiĭno zabrud-nenykh terytoriĭ ta v grupi kontroliu ne vyiavleno virogidnoï riznytsi v chastoti porushen' vuglevodnogo obminu vobstezhenykh osib, v iakykh bula vyiavlena giperplaziia PShchPZ. U patsiientiv z giperplaziieiu PShchPZ vyiavlena nesta-cha/defitsyt vitaminu D u 94 %, a ĭogo riven' buv virogidno nyzhchym, nizh pry normal'nykh rozmirakh tsykh zaloz. Vsta-novleno znachne pidvyshchennia chastoty diagnostovanoï arterial'noï gipertenziï sered ULNA, iaki maly giperplaziiuPShchPZ, porivniano z grupoiu kontroliu: (76,9 ± 3,5) % proty (51,2 ± 3,7) %. Bagatofaktornyĭ analiz pokazavvirogidnyĭ zv’iazok nestachi/defitsytu vitaminu 25(ON)D z rozvytkom tyreoïdnoï patologiï, porushenniamy vuglevod-nogo obminu, sertsevo-sudynnymy zakhvoriuvannia, osteopeniieiu/osteoporozom. Vyznacheno, shcho v ULNA na ChAES ĭodnogo periodu, v iakykh vyiavlena giperplaziia PShchPZ, seredniĭ riven' paratgormonu u syrovattsi krovi virogidnobuv vyshchym (57,2 ± 2,87) pg/ml proty ((32,74 ± 3,58) pg/ml; p0,05) nizh u grupi kontroliu.

Biosample preservation for future research is a fundamental component of translational medicine. At the same time, the value of stored biosamples is largely determined by the presence of related clinical data and other information. Electronic medical records are a unique source of a large amount of information received over a long period of time. In this regard, genetic and other types of data obtained from the biosample analysis can be associated with phenotypic and other types of information stored in electronic medical records, which pushes the boundaries in large-scale genetic research and improves healthcare. The aim of this review was to analyze the literature on the potential of combining electronic medical records and biobank databases in research and clinical practice.

Study of the status of parathyroid glands in individuals exposed to ionizing radiation as a result of the ChNPP accident and comparison with the general population of Ukraine.Subjects exposed as a result of the ChNPP accident (n = 1,348) and people from the general population of Ukraine (n=655) were examined. Diagnostic ultrasound scan of thyroid and parathyroid glands (PTG) was conducted in all study subjects. The technique of parathyroid ultrasound screening was developed, which led to an increase in the efficiency of their imaging. Additionally, the 25-hydroxyvitamin D (25(OH)D), parathyroid hor- mone, ionized calcium and some other parameters were selectively assayed in serum.High incidence of parathyroid hyperplasia was detected 27-32 years after the irradiation in persons ex- posed as a result of the ChNPP accident, especially in evacuees from the 30-km exclusion zone (71.4%; χ2Yates' = 24.1; р = 0) and residents of radilogically contaminated territories (41.7%; χ2Yates' = 6.45; p0.01) having no primary hyperparathyroidism. High prevalence of vitamin D insufficiency and deficiency was revealed in all study subgroups, namely in 83.1 % of the general population of Ukraine along with a bit better vitamin D status in the ChNPP acci- dent survivors i.e. the vitamin insufficiency and deficiency was found in 78.7 % of them. Incidence of hyperparathy- roidism, predominantly of the secondary (normocalcemic) one, was 33.8 % among persons exposed as a result of the ChNPP accident (p0.3) being somewhat higher than in the general population of Ukraine (26.1%), despite above- mentioned better supply of vitamin D.There is a widespread insufficiency or deficiency of vitamin D (over 78.7%) in the population of Ukraine in general providing an unfavorable background for the higher prevalence of health disorders associated with calcium and phosphorus metabolism. The latter features parathyroid hyperplasia and musculosceletal, immune, cardiovascular, and endocrine system comorbidities. Such disorders should exacerbate with a secondary increase in parathyroid hormone secretion (26.1 %). Higher incidence of normocalcemic hyperparathyroidism (33.8% versus 26.1%) against a background of better vitamin D status among irradiated individuals indicates the existence of other factors, where the past combined effects of Chornobyl radioactive fallout and external parathyroid exposure are most likely to be involved. This could explain the greater number of cases of parathyroid hyperplasia and hyper- parathyroidism among the exposed subjects. However the additional precise studies are required here with clarifi- cation of the personal data in population groups of the ChNPP accident survivors. Participants of the ChNPP acci- dent clean-up work in the «iodine period» of 1986 are of especial concern here. Besides that, the study population should be expanded with inclusion of subjects exposed in prenatal period.Meta: doslidyty stan pryshchytopodibnykh zaloz u osib, iaki zaznaly oprominennia vnaslidok avariï na ChAES, porivniaty iz zagal'noiu populiatsiieiu meshkantsiv Ukraïny.Materialy ta metody. Namy bulo obstezheno 1348 osib, oprominenykh vnaslidok avariï na ChAES, ta 655 osib iz za- gal'noï populiatsiï meshkantsiv Ukraïny. Vsim patsiientam bulo provedeno ul'trazvukove doslidzhennia shchytopodibnoï ta pryshchytopodibnykh zaloz (PShchZ). Bula vidprats'ovana metodyka skryningovogo ul'trazvukovogo doslidzhennia PShchZ, shcho pryzvelo do pidvyshchennia efektyvnosti ïkh vizualizatsiï. Dodatkovo provodylos' vybirkove doslidzhennia rivnia 25-gidroksyvitaminu D (25(ON)D), paratgormonu ta ionizovanogo kal'tsiiu u syrovattsi krovi, deiakykh inshykh pokaznykiv.Rezul'taty. Cherez 27–32 roky pislia oprominennia vyiavleno vysoku chastotu giperplaziy̆ PShchZ u osib, opromine- nykh vnaslidok avariï na ChAES, peredusim v evakuy̆ovanykh z 30-kilometrovoï zony vidchuzhennia (71,4 %; χ2Iatsa = 24,1; r = 0) i meshkantsiv radioaktyvno zabrudnenykh terytoriy̆ (41,7 %; χ2Iatsa= 6,45; r0,01) bez pervynnogo giperpa- ratyreozu. Vstanovleno vysoku poshyrenist' nestachi/defitsytu vitaminu D v usikh grupakh doslidzhennia: sered osib iz zagal'noï populiatsiï meshkantsiv Ukraïny – 83,1 %, ta deshcho krashchyy̆ status za vitaminom D v osib, postrazhdalykh vnaslidok avariï na ChAES (78,7 %). Chastota giperparatyreozu, perevazhno vtorynnogo (normokal'tsiiemichnogo), stanovyla 33,8 % sered osib, oprominenykh vnaslidok avariï na ChAES (r0,3), i bula deshcho vyshchoiu, nizh v zagal'niy̆ populiatsiï ukraïntsiv (26,1 %), nezvazhaiuchy na krashchu zabezpechenist' vitaminom D.Vysnovky. Zagalom naselennia Ukraïny maie poshyrenu nestachu/defitsyt vitaminu D (ponad 78,7 %), shcho stvoriuie negatyvnu bazu dlia bil'shogo poshyrennia porushen' zdorov’ia, pov’iazanykh z dysfunktsiiamy kal'tsiievo-fosfornogo obminu u vygliadi giperplaziï PShchZ i komorbidnykh staniv z boku oporno-rukhovogo aparatu, imunnoï, sertsevo-sudyn- noï, endokrynnoï system. Taki zminy povynni posyliuvatysia pry vtorynnomu zbil'shenni sekretsiï paratgormonu (26,1 %). Bil'sha chastota normokal'tsiiemichnykh giperparatyreoziv (33,8 % proty 26,1 %) na tli krashchoï zabezpeche- nosti vitaminom D sered oprominenykh osib, svidchyt' pro isnuvannia inshykh chynnykiv, do iakykh z nay̆bil'shoiu virogidnistiu mozhna vidnesty mynulyy̆ kombinovanyy̆ vplyv radionuklidiv avariy̆nogo chornobyl's'kogo vykydu i zovnishnie oprominennia PShchZ. Tse moglo b poiasnyty bil'shu kil'kist' giperplaziy̆ PShchZ ta giperparatyreozu sered oprominenykh, ale potrebuie provedennia dodatkovykh utochniuiuchykh doslidzhen', z detalizatsiieiu danykh za grupamy postrazhdalykh vnaslidok avariï na ChAES i obov’iazkovym vydilenniam uchasnykiv likvidatsiï naslidkiv avariï na ChAES y̆odnogo periodu 1986 r. ta rozshyrenniam kil'kosti obstezhenykh osib, oprominenykh vnutrishn'outrobno.

In modern conditions of development of the national economy, one of the main priorities, for an increasingly conscious Kazakhstan society, is the need to follow the course of innovation policy, since the level of competitiveness of domestic enterprises depends on innovative activity in the scale of the global economy, the share in different types of markets and the effectiveness of innovation. In this article, a literature review of domestic and foreign reseach is conducted, which carried out the regularities and the features of the development of innovation and innovation action, including the Republic of Kazakhstan. As a result of the conducted study, the theoretical and the methodological aspects of researching the development of innovation policy are systematized, on the basis of which the corresponding conclusions are drawn., peer-reviewed

Current prophylactic actions prevent or significantly delay the majority of cardiovascular diseases (CVD). Various factors are interconnected and affect a person throughout his life, determining the risk of CVD. This indicates the need for preventive measures at all stages of life and even before birth. The beneficial effects of CVD prevention are realized through various genetic, epigenetic and metabolic mechanisms. Due to the fact that many risk factors for CVD have a cumulative effect, the introduction of preventive measures from the earliest life stages will be most effective. The purpose of the article is to consider various aspects of CVD prevention in the preconceptional, prenatal and infant periods.

In recent years, researchers have increasingly noted that the development and health of cardiovascular system is influenced by both traditional risk factors (RF) and other determinants of human exposome — a combination of factors of the external and internal environment that affect genetics and epigenetics, as a result of which, one or another (more or less healthy) phenotype is formed. Exposome components have a continuous effect throughout all periods of life. Many RFs have a cumulative effect, and therefore it is important to start prevention of cardiovascular diseases (CVDs) as early as possible. The aim of this review was to consider various aspects of CVD prevention in childhood and adolescence. These periods are critical for the development of most behavioral habits, which maintain throughout life. Leading by personal example by parents and the immediate environment plays a paramount role in healthy lifestyle inclusion of children and adolescents. Targeted programs in kindergartens and schools aim at improving health literacy, early detection and timely changing traditional and non-traditional CVD RFs, diagnosis of genetic diseases involving the heart and blood vessels, prevention of sudden cardiac death are also important methods of CVD prevention in childhood and adolescence. Measures of population-based prevention are of great importance, including monitoring of advertising and media content, statutory ban of alcohol and tobacco sale, and the formation of healthy lifestyle.

Estimation of the parathyroid hyperplasia prevalence after the ChNPP accident in adults exposed to ion izing radiation and their descendants using the diagnostic ultrasound and its methodology elaboration.The pilot prospective study of the prevalence of parathyroid hyperplasia among the Chornobyl Nuclear Power Plant (ChNPP) accident adult survivors (n=686) and their descendants (54 children) was performed using diagnostic ultrasound examination of thyroid and parathyroids. Among the study subjects there were 339 ChNPP accident clean up workers (ACUW), 32 persons were evacuated from the 30 km exclusion zone and 224 ones were included to the control group. Diagnostic ultrasound of thyroid and parathyroids was performed according to the standard method. Additionally, in children with parathyroid hyperplasia an additional assay of 25 hydroxyvitamin D levels in serum was performed. In calculating the statistical significance, its level p0.05 was considered statistically significant.Parathyroids are a few small but critically important endocrine glands that synthesize parathyroid hormone, regulating mainly phosphoric calcium metabolism. Insufficient (hypoparathyroidism) or excessive (hyperparathy roidism) function of parathyroids is harmful to the patients affecting the state of nervous and cardiovascular sys tem. Parathyroidss can accumulate isotopes of cesium, strontium and radioactive iodine. The available data testify to an increased incidence of clinically significant hyperplasia of parthyroids (more than 9 mm in adults and more than 5 mm in children) among persons exposed toionizng radiation as a result of the accident at the ChNPP (28.64%) and their descendants (23.8-70.6%). First of all are concerned those adults who live in contaminated areas in comparison with the control group (24.15% in not irradiated). Evacuees from the 30 km exclusion zone being the category of people who were exposed to the absorbed iodine isotopes in the first days of the Chernobyl accident are the another risk group. These data demonstrate sensitivity of parathyroidss to the impact of incorpo rated isotopes (iodine, cesium and strontium), which in the long term exposure create conditions for structural and functional changes in regulation of phosphorous calcium metabolism being the basis for a significant prevalence of osteopenia and osteoporosis in irradiated individuals and their descendants. A number of further studies are required to clarify the findings and to disclose the hormonal mechanisms of radiation effects on parathyroids.Parathyroid glands are radiosensitive and susceptible to effects of strontium, cesium and iodine iso topes, which cause parathyroid irradiation and subsequent structural and functional changes, being a prerequisite for development of osteopenia and osteoporosis in the ChNPP accident survivors and their descendants. High inci dence of parathyroid hypertrophy is found in the inhabitants of the radiation contaminated territories (long term irradiation by cesium isotopes), as well as in evacuated from the 30 km exclusion zone (irradiation by iodine iso topes in the early days of the accident).Meta. Vyznachennia poshyrenosti giperplaziy̆ pryshchytopodibnykh zaloz u oprominenykh vnaslidok avariï na ChAES do roslykh ta ïkh nashchadkiv pry skryningovomu ul'trazvukovomu doslidzheni ta vidpratsiuvaty y̆ogo metodologiiu. Materialy ta metody. Pilotne prospektyvne doslidzhennia poshyrenosti giperplaziï PShchPZ sered osib, postrazh dalykh vnaslidok avariï na Chornobyl's'kiy̆ atomniy̆ elektrostantsiï (ChAES) doroslogo viku (686 osib) ta ïkh na shchadkiv (54 ditey̆) provedeno UZD ShchPZ ta PShchPZ, z iakykh 339 vidnosylysia do uchasnykiv likvidatsiï naslidkiv avariï na ChAES, 32 osoby – evakuy̆ovani z 30 km zony vidchuzhennia ta 224 osib z grupy kontroliu. Provedeno ul'trazvu kove doslidzhennia shchytopodibnoï ta pryshchytopodibnykh zaloz za standartnoiu metodykoiu. Dodatkovo u ditey̆ z giperplaziieiu pryshchytopodibnykh zaloz provodylos' vybirkove doslidzhennia rivnia 25 gidroksyvitaminu D u syro vattsi krovi. Pry rozrakhunku statystychnoï znachushchosti, ïï riven' r0,05 vvazhaly statystychno dostovirnym. Rezul'taty. Pryshchytopodibni zalozy – tse dekil'ka nevelykykh ale vplyvovykh endokrynnykh zaloz, shcho syntezu iut' paratgormon, reguliuiut', golovnym chynom, fosforno kal'tsiievyy̆ obmin. Nedostatnia (gipoparatyreoz) abo nadlyshkova (giperparatyreoz) funktsiia pryshchytopodibnykh zaloz ie shkidlyvymy dlia patsiientiv, vplyvaie na stan nervovoï ta sertsevo sudynnoï systemy. Pryshchytopodibni zalozy mozhut' nakopychuvaty izotopy tseziiu, strontsiiu i radioaktyvnogo y̆odu. Otrymani dani svidchat' pro pidvyshchennia chastoty klinichno znachushchykh giperplaziy̆ pryshchyto podibnykh zaloz (ponad 9 mm u doroslykh, bil'she 5 mm u ditey̆) sered oprominenykh osib vnaslidok avariï na ChAES (28,64 %) ta ïkh nashchadkiv (23,8–70,6 %), persh za vse tykh, iaki meshkaiut' na zabrudnenykh terytoriiakh doroslogo viku v porivnianni z kontrol'noiu grupoiu (neopromineni – 24,15 %). Inshoiu grupoiu ryzyka buly evakuy̆ovani z 30 km zony vidchuzhennia – kategoriia osib, iaka zaznala diï poglynutykh izotopiv y̆odu v pershi dni avariï na ChAES.Tsi dani demonstruiut' chutlyvist' pryshchytopodibnykh zaloz do diï inkorporovanykh izotopiv (y̆odu, tseziiu i strontsiiu), shcho u viddaleni terminy oprominennia stvoriuiut' umovy dlia strukturno funktsional'nykh zmin u systemi reguliatsiïfosforno kal'tsiievogoobminu,iepidґruntiamdlia znachnoïposhyrenostiosteopeniïtaosteoporozuuop rominenykh osib ta ïkh nashchadkiv. Neobkhidno provesty nyzku doslidzhen' dlia podal'shogo utochnennia otrymanykh da nykh ta rozkryttia gormonal'nykh mekhanizmiv vplyvu ionizuiuchogo vyprominennia na pryshchytopodibnykh zaloz. Vysnovky. Pryshchytopodibni zalozy ie radiatsiy̆no chutlyvymy do diï izotopiv strontsiiu, tseziiu ta y̆odu, iaki obumov liuiut' ïkh oprominennia ta nastupni strukturno funktsional'ni zminy, shcho ie peredumovoiu rozvytku osteopeniï ta osteoporozu v osib, iaki postrazhdaly vnaslidok avariï na ChAES ta ïkh nashchadkiv. Vysoka chastota giperplaziï pry shchytopodibnykh zaloz vyiavlena v meshkantsiv radiatsiy̆no zabrudnenykh terytoriy̆ (dovgotryvale oprominennia izo topamy tseziiu), a takozh u evakuy̆ovanykh z 30 km zony vidchuzhennia (oprominennia izotopamy y̆odu v pershi dni avariï).

The objective of this paper is to analyze the data from scientific literature and available recommendations for health professionals on healthcare providing to pediatric population in the events associated with risk of radiation exposure. Over the past sixty years there were several large scale radiological events with a large number of chil dren affected, namely the atomic bombing of Hiroshima and Nagasaki, accident at the Chornobyl nuclear power plant, contact to 137Cs radiation source unutilized at the hospital shutdown in Brazil etc. Further research has crys tallized injuries and health disorders in the survived children in all cases being much more significant vs. other pop ulations. Analysis of circumstances and features of a number of emergency situations or incidents in the nuclear industry for several decades has shown a high probability of radioactive materials release into the environment. The danger of terrorism with the use of ionizing radiation sources resulting in a considered inevitable hazard to the chil dren is estimated as serious in recent years and deserves an especial mention here.Metoiu statti ie analiz danykh naukovoï literatury ta naiavnykh rekomendatsiy̆ shchodo nadannia pratsivnykamy okhoro ny zdorov'ia dopomogy dytiachomu naselenniu pry podiiakh, iaki pov'iazani z ryzykom radiatsiy̆nogo vplyvu. Za ostanni shistdesiat rokiv vidbulosia kil'ka masshtabnykh radiatsiy̆nykh podiy̆, u khodi iakykh postrazhdala velyka kil'kist' dy tiachogo naselennia – atomni bombarduvannia iapons'kykh mist Khirosima i Nagasaki, avariia na Chornobyl's'koï atom noï elektrostantsiï, oprominennia dzherelom 137Cs, neutylizovanym pry zakrytti gospitaliu u Brazyliï toshcho. Prove deni vidpovidni doslidzhennia zrobyly ochevydnymy nezrivnianno bil'sh znachni urazhennia i porushennia stanu zdo rov'ia ditey̆, porivniano z inshymy grupamy naselennia, v usikh tykh vypadkakh. U svoiu chergu, analiz obstavyn i osob lyvostey̆ kil'kokh pozashtatnykh sytuatsiy̆ abo intsydentiv na pidpryiemstvakh atomnoï promyslovosti za kil'ka desia tylit' pokazav vysoku imovirnist' nadkhodzhennia pry ts'omu radioaktyvnykh materialiv u navkolyshnie seredovyshche. Okremoï uvagy zaslugovuie sery̆ozno otsiniuvana v ostanni roky nebezpeka teroryzmu z vykorystanniam dzherel ionizuiuchykh vyprominiuvan', vnaslidok chogo urazhennia ditey̆ takozh vvazhaiet'sia nemynuchym.

To advance the efficiency of tooth caries prevention in children with enamel hypoplasia through a com plex intervention focused at amelioration of oral hygiene, secretory immunoglobulin A (sIgA) level, and mineral con tent of oral fluid.Hypoplasia of permanent teeth enamel was the target of research. State of oral cavity hygiene, sIgA, total calcium and orthophosphate content in oral fluid were the research subject. Enamel vital stain ing, transillumination, immunoenzymometric and photometric techniques were applied. Indices of oral cavity hygiene: simplified oral hygiene index (OHI S) by Green and Vermillion (1964) and Silness Loe (1964, 1967) plaque index were the assayed. Assessment of oral cavity hygiene and assay of sIgA, calcium and orthophosphate content in oral fluid were held in 43 children 6-14 years old (n=21, Group 1; n=22, Group 2) with a systemic enamel hypoplasia and underlying diffuse non toxic (euthyroid) goiter. All children were born from the ChNPP accident clean up work ers and evacuees from territories of mandatory resettlement. Children in the Group 1 were prescribed a set of preven tive interventions including recommendations on choice of the oral care tools and teaching the standard dental cleaning skills. Children in the Group 2 additionally used the remineralizing gel with calcium, phosphorus, magnesium and xylitol (Sanction of the State Sanitary and Epidemiological Service of Ukraine # 05.03.02 03/9351 from 07.02.2014).State of oral cavity hygiene in children of the both study groups was assayed by a "dissatisfactory" criteri on according to the OHI S by Green and Vermillion and by a "poor" criterion according to the Silness Loe plaque index. Upon application of preventive intervrntions the state of oral cavity hygiene improved in children of Group 1 and Group 2: there was a significant decrease of OHI S by Green and Vermillion (p=0.0001) and Silness Loe plaque index (p=0.0003). Administration of remineralizing gel resulted in a significant increase of calcium (р = 0.0008) and orthophosphate (р = 0.001) content in oral fluid. No substantial change in sIgA concentration was found in both groups.Implementation of the preventive intervention tools including preparation with remineralizing effect promoted the amelioration of oral hygiene, increased content of mineral constituents in oral fluid, however with no effect on sIgA level.Meta doslidzhennia. Pidvyshchyty efektyvnist' profilaktyky kariiesu u ditey z gipoplaziieiu emali shliakhom vprovad zhennia kompleksu zakhodiv, spriamovanykh na optymizatsiiu gigiieny porozhnyny rota, rivnia sIgA ta vmistu mineral' nykh skladovykh rotovoI ridyny.Materialy i metody. Ob’iekt doslidzhennia – gipoplaziia emali postiynykh zubiv. Predmet doslidzhennia – gigiienichnyy stan porozhnyny rota, sekretornyy imunoglobulin klasu A (sIgA), riven' zagal'nogo kal'tsiiu ta ortofosfativ v rotoviy ridyni. Metody doslidzhennia: vital'ne zabarvlennia emali, transiliuminatsiynyy, imunofermentnyy ta fo tometrychnyy metody, pokaznyky gigiienichnogo stanu porozhnyny rota (indeks Green Vermillion (1964), indeks Silness Loe (1964, 1967)). Provedena otsinka gigiienichnogo stanu porozhnyny rota ta vyznachennia rivnia sIgA, kal'tsiiu ta ortofosfativ v rotoviy ridyni 43 ditey vikom 6–14 rokiv (grupa No 1 – 21 osoba, grupa No 2 – 22 oso by) z systemnoiu gipoplaziieiu emali na tli dyfuznogo netoksychnogo vola, eutyreozu, narodzhenykh vid bat'kiv – uchasnykiv likvidatsiI naslidkiv avariI na ChAES ta evakuyovanykh z terytoriy obov’iazkovogo vidselennia. Grupa No 1 – dity, iakym pryznachavsia kompleks profilaktychnykh zakhodiv, shcho vkliuchav rekomendatsiI shchodo vyboru zasobiv i predmetiv dlia dogliadu za porozhnynoiu rota ta navchannia standartnomu metodu chyshchennia zubiv. Grupa No 2 – dity, u iakykh dodatkovo zastosovuvaly remineralizuiuchyy gel', shcho mistyt' kal'tsiy, fosfor, magniy ta ksylit („Vysno vok DerzhavnoI sanitarno epidemiologichnoI sluzhby UkraIny No05.03.02 03/9351 vid 07.02.2014r. ”). Rezul'taty. Gigiienichnyy stan porozhnyny rota ditey obokh grup buv otsinenyy zgidno z kryteriiem „nezadovil'nyy ” indeksu Green Vermillion ta kryteriiem „poganyy ” indeksu Silness Loe. Pislia provedennia profilaktychnykh zakhodiv u ditey grup No 1 ta No 2 pokrashchyvsia gigiienichnyy stan porozhnyny rota: suttieve znyzhennia indeksu Green Vermillion (p = 0,0001) ta indeksu Silness Loe (p = 0,0003). Pryznachennia remineralizuiuchogo geliu dostovirno pidvyshchuvalo vmist kal'tsiiu (r = 0,0008) ta ortofosfativ (r = 0,001) v rotoviy ridyni. U ditey obokh grupy ne bulo vyiavleno suttievykh zmin rivnia sIgA.Vysnovky. Vprovadzhennia kompleksu profilaktychnykh zakhodiv iz zastosuvanniam preparatu remineralizuiuchoI diI spryialo pokrashchenniu gigiieny porozhnyny rota, pidvyshchenniu vmistu mineral'nykh skladovykh rotovoI ridyny, odnak suttievo ne vplynulo na riven' sIgA.

To summarize the verified clinical and epidemiological data on the natural history of non cancer endocrine disease in remote period after the ChNPP accident in survivors of adult and children age.Retrospective estimation was carried out of data on 24,588 adult persons and 20,087 chil dren survived after the ChNNP accident and being healthy or having any diseases. Data were retrieved from database of the Clinical Epidemiological Registry (CER), NRCRM for the 23 years (1992-2014) of survey. Average total external radiation dose in adults was 0.187 Gy, range of thyroid dose in children was 0.1-1.55 Gy. These data were verifies in a separate clinical study. Anthropometric, laboratory biochemical and hormonal assay values, thyroid ultrasound imaging patterns and radiation dose values were retrieved for the study.Retrospective data review for the 1992-2014 period indicated that incidence of thyroid disease in all per sons survived after the ChNPP accident run at 40.29% with 35.37% among the clean up workers, 27.24% among evac uees, and 28.6% among population of contaminated territories that all is significantly (p0.0001) higher vs. the entire population of Ukraine (3.9%). Following non cancer endocrine diseases were most prevalent in the ChNPP acci dent survivors: nodular goiter (14.35%), chronic autoimmune thyroiditis (~8%), pre obesity and obesity (41.9% and 36.8% respectively), prediabetes and diabetes mellitus (15.5% and 21.4% respectively). Nodular goiter (21.8%), chronic autoimmune thyroiditis (12.95%), pre obesity and obesity (41.71% and 33.61% respectively), and predia betes and diabetes mellitus (8.6% and 12.15% respectively) were most often diagnosed in the ChNPP accident clean up workers. Children evacuated from the 30 kilometer exclusion zone were a critical population group. They were diagnosed diffuse non toxic goiter in 43.68%, chronic autoimmune thyroiditis in 1.74%, primary hypothyroidism in 0.96%, and nodular goiter in 2.57%. Peak prevalence of chronic autoimmune thyroiditis occurred in 2001-2003 i.e. in a period of their intensive pubertal maturation. In children (first generation) of exposed parents the thyroid dis ease was revealed in 42.64%, that exceeded the incidence in control group, chronic autoimmune thyroiditis was found rarer i.e. in 0.45%, diffuse non toxic goiter in 9.5-13.8%, nodular goiter in 1.7%.Non cancer endocrine disease in children and adults exposed to ionizing radiation is frequent and reg istered in 3 53% of persons. It occurs in most of survivors 10-15 years upon the impact of radiation factor as a result of man made accident and continues to grow slowly in 30 years.Meta doslidzhennia. Uzagal'nyty veryfikovani klinichni ta epidemiologichni dani shchodo rozvytku nezloiakisnoI en dokrynnoI patologiI u viddalenyy period avariI na ChAES u postrazhdalykh osib doroslogo i dytiachogo viku. Materialy i metody doslidzhennia. Provedena retrospektyvna otsinka danykh 24 588 osib doroslogo viku ta 20 087 ditey, postrazhdalykh v rezul'tati avariI na ChAES, iz bazy kliniko epidemiologichnogo reiestru (KER) NNTsRM za 23 roky (period 1992–2014 rr.), iaki buly zdorovymy chy maly shyrokyy spektr endokrynnoI patologiI. U doros lykh osib serednia doza zovnishn'ogo oprominennia sklala 0,187 Gr, u ditey oprominennia shchytopodibnoI zalozy – v mezhakh 0,1–1,55 Gr. Tsi dani veryfikuvalysia v okremomu klinichnomu doslidzhenni. Zalucheni antropometrychni, la boratorni biokhimichni ta gormonal'ni pokaznyky, ul'trazvukove doslidzhennia shchytopodibnoI zalozy, dozy op rominennia.Rezul'taty. Retrospektyvnyy analiz danykh 1992 2014 rr. pokazuie, shcho chastota tyreoIdnoI patologiI sered vsikh osib, postrazhdalykh vnaslidok avariI na ChAES skladaie 40,29 %, v uchasnykiv likvidatsiI naslidkiv avariI – 35,37 %, evakuyovanykh iz zony vidchuzhennia – 27,24 %, zhyteliv radiatsiyno zabrudnenykh terytoriy – 28,6 %, shcho znachno bil' she (r0,0001), nizh u zagal'niy populiatsiI (3,9 %) naselennia UkraIny. Naybil'sh poshyrenymy nezloiakisnymy en dokrynnymy zakhvoriuvanniamy v osib, postrazhdalykh vnaslidok avariI na ChAES buly: vuzlovyy zob – 14,35 %, khro nichnyy autoimunnyy tyreoIdyt ~ 8 %, peredozhyrinnia/ozhyrinnia 41,9 %/36,8 %, pereddiabet/diabet 15,5 %/21,4 %. Naychastishymy nezloiakisnymy endokrynnymy zakhvoriuvanniamy v osib, uchasnykiv likvidatsiI naslidkiv avariI na ChAES buly vuzlovyy zob – 21,8 %, khronichnyy autoimunnyy tyreoIdyt – 12,95 %, peredozhyrinnia/ozhyrinnia – 41,71 %/33,61 %, pereddiabet/diabet– 8,6 %/12,15 %. Krytychnoiu grupoiu ditey buly evakuyovani z 30 km zony vidchuzhennia, opromineni u vitsi 3 6 rokiv. U nykh dyfuznyy netoksychnyy zob vstanovleno u 43,68 %, khronichnyy au toimunnyy tyreoIdyt– 1,74 %, pervynnyy gipotyreoz – 0,96 %, vuzlovyy zob – 2,57 %, a pik poshyrenosti khronichnogo autoimunnogo tyreoIdytu prypav na 2001–2003 rr. – period Ikh aktyvnogo statevogo dozrivannia. Se red ditey, iaki buly narodzheni vid oprominenykh bat'kiv (pershe pokolinnia), zakhvoriuvannia shchytopodibnoI zalozy vyiavyly u 42,64 %, shcho perevyshchuvalo chastotu v grupi kontroliu, khronichnyy autoimunnyy tyreoIdyt vyiavlialy pomitno ridshe – u 0,45 %, dyfuznyy netoksychnyy zob u 9,5–13,8 %, vuzlovyy zob u 1,7 %.Vysnovky. Nezloiakisna endokrynna patologiia u oprominenykh doroslykh i ditey ie chastoiu, zustrichaiet'sia u 3–53 % osib, vynykaie u bil'shosti postrazhdalykh cherez 10–15 rokiv pislia vplyvu radiatsiynogo faktora v rezul'tati tekh nogennoI avariI chy intsydentu, prodovzhuie povil'no narostaty cherez 30 rokiv.

Objective. To justify and evaluate the effectiveness of treatment and preventive measures taken to correct the bio-chemical and biophysical changes in the structure of bone in children exposed to ionizing radiation due to Chornobyl accident in the dynamics of leukemic process. Materials and methods. The study involved 144 patients with acute lymphoid and myeloid leukemia. Serum calcium, total protein, alkaline phosphatase, cortisol and thyroid-stimulating hormone were investigated, as well as calcium and phosphate excretion, amino acids composition in the urine, acid-base balance and buffer systems of blood, bone density. Results. A reduction of bone densitometry, calcium and cortisol levels and increase of serum alkaline phosphatase and urine oxyproline were found in children with acute leukemia in acute I phase and during the chemotherapy. In the period of remission the majority of patients did not differ from the comparison group. The signs of osteopenic syndrome that require monitoring of the bone structure status were revealed in 10.0 % of children of the comparison group. Radiation doses of leukemia patients were 3.66 ± 0.11 mSv. No relationship between radiation dose and indicators that reflect the state of the bone tissue structures has been established. The use of complex health care measures in children with acute leukemia in remission, contributed to the positive effect of 62.0 %. Worser effect was observed in patients with an unfavorable course of the disease. Conclusions. Results of the study of bone tissue metabolism prove fore a change in the organic and mineral matrix in patients with acute leukemia exposed to ionizing radiation as a result of the Chonobyl NPP accident, and persons without hematologic diseases, and the need for treatment and prevention.Meta. Obg'runtuvaty ta ocinyty efektyvnist' likuval'no-profilaktychnyh zahodiv, zastosovanyh dlja korekcii' biohimichnyh i biofizychnyh zmin v strukturi kistkovoi' tkanyny u ditej, jaki zaznaly vplyvu ionizujuchogo oprominennja vnaslidok avarii' na ChAES, v dynamici lejkemichnogo procesu. Materialy i metody. Obstezheno 144 ditej, hvoryh na gostri limfota mijeloblastni lejkemii'. Doslidzhuvaly dozy oprominennja hvoryh, vmist kal'ciju, zagal'nogo bilku, luzhnoi' fosfatazy, kortyzolu i tyreotropnogo gormonu gipofizu v syrovatci krovi, kyslotno-luzhnu rivnovagu, ekskreciju fosfativ kal'ciju, sklad aminokyslot v sechi, shhil'nist' kistkovoi' tkanyny. Rezul'taty. U ditej z gostrymy lejkemijamy v I gostryj period ta pry provedenni himioterapii' vyjavleno znyzhennja pokaznyka densytometrii' kistok, rivnja kal'ciju, kortyzolu ta pidvyshhennja luzhnoi' fosfatazy v syrovatci krovi i oksyprolinu v sechi. V period remisii' zahvorjuvannja u bil'shosti hvoryh pokaznyky ne rozriznjalys' z grupoju porivnjannja. U 10,0 % ditej grupy porivnjannja vidmichajut'sja projavy osteopenichnogo syndromu. Dozy oprominennja hvoryh na gostri lejkemii' stanovyly 3,66 ± 0,11 mZv. Ne vstanovleno zv'jazku mizh dozamy oprominennja ta pokaznykamy, jaki harakteryzujut' stan struktury kistkovoi' tkanyny, i medianoju vyzhyvanosti hvoryh. Zastosuvannja kompleksu likuval'no-profilaktychnyh zahodiv u ditej, hvoryh na gostri lejkemii' v period remisii', spryjalo pozytyvnomu efektu u 62,0 %. Girshyj efekt sposterigavsja u pacijentiv z nespryjatlyvym perebigom zahvorjuvannja. Vysnovky. Rezul'taty doslidzhennja pokaznykiv metabolizmu kistkovoi' tkanyny svidchat' pro najavnist' zmin v organichnomu ta mineral'nomu matryksi jak u hvoryh na gostri lejkemii', jaki zaznajut' vplyvu ionizujuchogo oprominennja vnaslidok avarii' na ChAES, tak i osib bez onkogematologichnoi' patologii', ta neobhidnist' zastosuvannja likuval'no-profilaktychnyh zahodiv.

Overall 806 children evacuated from the city of Pripyat were examined for the thyroid condition. The children who received a dose of more than 30 rad for the thyroid manifested primary response in the form of euthyroid hyperthyroxinemia, a high risk of the development in future of autoimmune diseases in the lack of hypothyrosis.

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

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