The article reflects the main historical milestones in the establishment of the State institution «Republican research Center for radiation medicine and human ecology» (hereinafter referred to as the SI «RRCRM&HE»). We have shown its role in minimizing the medical consequences of the Accident at the Chernobyl NPP and the process of implementation of SI «RRCRM&HE» into the healthcare system as an institution of the republican level for the implementation of high-tech medical care.

In foreign periodicals, there are often reports of a high risk of severe complications in cancer patients with the development of COVID-19. This article provides a review of foreign literature data, including a number of aspects that reflect recommendations for vaccination against SARS-COV-2 in patients with oncohematological diseases, solid tumors, recipients of hematopoietic stem cells and cell therapy. Undoubtedly, cancer patients are at increased risk of severe COVID-19, and the current cancer does not allow for delay in therapy. In this regard, providing cancer care during the COVID-19 pandemic has become quite a challenge, given the competing risks of death from developing cancer and serious complications from the course of COVID-19 infection in immunocompromised people. To date, there are no official recommendations for vaccination against SARS-COV-2 in such patients. The leaders in this matter are the recommendations of foreign oncological communities, a review of which is presented in this article.

The active formation of the rules for conducting clinical investigations (CI) by the international community began only in the middle of the 20th century. By that time, many facts of the grossest violation of ethical norms and the rights of CI subjects have been recorded. With the development of state and international structures for monitoring the conduct of clinical investigations, the situation improved and today there is a single set of rules for Good Clinical Practice (GCP). The literature review presents data on the historical development and modern approaches to conducting of clinical investigations.

An article contains the results of radiochemical investigation of (134Cs+137Сs) and 90Sr content in 151 foodstuffs samples from the Far East territories of Russian Federation potentially contaminated after the accident on NPP «Fukushima-1», carried out in 2011-2012, and the analysis of obtained results. It is demonstrated that artificial radionuclides content in the investigated foodstuffs are much lower than permissible levels for these radionuclides in the correspondent products in Russian Federation. Peculiarities of the food ration affected the forming of internal exposure doses due to artificial radionuclides are presented for the population of the Far East territories of Russian Federation. These peculiarities were fixed in the process of surveys of local population in the frames of expeditions carried on by the Institute. Estimation of the most possible internal exposure doses is carried out for the population of Russian Federation Far East region due to caesium isotopes and 90Sr in the foodstuffs traditionally consumed by the local population. Foodstuffs are identified which give the main contribution to the internal exposure dose of the population of investigated region. It has been established that 90Sr could give up to 33% to the internal exposure dose of the population of Far East territories due to artificial radionuclides in the foodstuffs.

During the analyzed period from 2009 to 2019, in the Gomel region, there is a downward trend in the overall mortality rate of the population of working age, with a slight rise by 2019. High mortality rates of people of working age were noted in the Vetka, Dobrush, Yelsk, Loev, Oktyabr and Petrikov districts. The leading causes of mortality in the working-age population are diseases of the circulatory system, neoplasms and external causes, among which the largest share is taken by suicide and alcohol poisoning, which indicates significant reserves of interagency cooperation aimed at further reducing mortality from these causes.

The aim was to study the dynamics and structure of indicators of non-communicable morbidity in order to assess the health status of the affected population residing in the areas recovering from the disaster at the Chernobyl nuclear power plant.The aging of the population has led to the accumulation of chronic non-communicable diseases in older age groups, mainly due to diseases of the circulatory system, digestive organs, the musculoskeletal system and connective tissue. Among pensioners, the highest rates of overall incidence with chronic non-communicable diseases were registered, the clinical manifestation of which occurred at working age. The created system of medical support for recording in the database of the State Registry made it possible to assess and obtain information on the health status of various categories of citizens out of the affected population.

This article presents the results of a prospective study of the cardioprotective potential of two groups of hypoglycemic drugs: sodium-glucose cotransporter 2 inhibitors (empagliflozin) and dipeptidyl peptidase 4 (vildaglpitin). 90 patients with type 2 diabetes were randomized using a random number generator into 3 groups, depending on the antihyperglycemic therapy prescribed for the next 6 months: the group that continued to receive gliclazide and metformin, the group in addition to gliclazide and metformin received vildagliptin at a dose of 100 mg/day, the group in addition to gliclazide and metformin received empaglilflozin at a dose of 25 mg/day. The addition of vildagliptin to gliclazide and metformin therapy improved glycemic control and was associated with an increase in renal filtration function calculated using cystatin C, with a simultaneous decrease in podocin excretion. The addition of empagliflozin led to an increase in the filtration function of the kidneys, calculated according to cystatin C, a decrease in the excretion of markers of tubular damage of IMT-1.

This article presents a comparative analysis of clinical and laboratory criteria of 37 patients with confirmed subclinical Cushing’s syndrome (SCS). Patients with SCS more frequently had underlying diagnoses: arterial hypertension (AH), chronic heart failure (CHF), type 2 diabetes mellitus (DM), osteopenia compared with the control group (CG). There were no significant differences in the clinical assessment of lipid metabolism. The sizes of hormonally inactive formations of the adrenal glands are significantly smaller (about 2 cm) than the ones in patients with adenomas. Cortisol level at 8:00 after the overnight dexamethasone supression test (overnight DST) in patients with SCS was significantly higher and always exceeded 138 nmol/l. Cortisol concentration in blood at 23.00 in SCS patients significantly exceeded normal values, which confirms the circadian dysregulation of cortisol secretion. A comparative analysis of daily cortisol level in the urine showed a significant increase in the concentration of the latter in patients with SCS. A comprehensive assessment of the above-mentioned clinical and laboratory criteria allows us to identify SCS and choose a sustainable treatment course further on.

The article deals with the issues of diagnosing the obstructive sleep apnea syndrome, including through the use of specialized questionnaires/scales (Epworth sleepiness scale, Berlin questionnaire, STOP-BANG questionnaire). The main criteria for the obstructive sleep apnea syndrome according to the International Classification of Sleep Disorders are provided and covered. We have presented the results of the study which enable to evaluate the possibilities of using screening questionnaires at the primary outpatient stage of diagnosis. Clinical cases of the combined use of specialized questionnaires/scales and polysomnography for the diagnosis of obstructive sleep apnea syndrome are provided as well.

The article provides data from epidemiological studies on the correlation between hypertensive disorders in pregnant women and the risk of cardiovascular diseases in later life, describes possible pathophysiological determinants for the occurrence of arterial hypertension after complicated pregnancy. We carried out the analysis of the state of left ventricular diastolic function and the thickness of the intima-media complex of the common carotid arteries, endothelium-dependent vasodilation in women with abdominal obesity and hypertensive disorders in the history.

Osteodestructive syndrome is one of the prominent signs of multiple myeloma. Damage to the bones of the skeleton, often accompanied by severe pain due to pathological fractures and/or compression of the nerve roots or spinal cord, is one of the causes of impaired quality of life and reduced overall survival in this group of patients. The appearance of foci occurs as a result of increased activity of osteoclasts and reduced function of osteoblasts. However, the effect of various markers and cytokines on the processes of osteolysis in multiple myeloma, and especially in the early stages of development, has not yet been sufficiently studied. Therefore, it is currently relevant to study markers of bone tissue damage and risk factors that can predict future severe bone damage.To determine potential markers of prognosis the development of osteodestructive lesions the importance of laboratory indicators and immunohistochemical (IHH) markers in groups of patients with bone lesions and without bone lesions at the time of the diagnosis of plasma cell diseases were compared.According to the results of the study, it was found that the ratio of β-CrossLaps/osteocalcin combined with other indicators (IHC CD 138+ >10%, the ratio of light chains k/λ <0.1 and >10) makes it possible to identify a group of patients with an increased risk of developing osteodestructive syndrome for more frequent monitoring and can be used to diagnose osteodestructive syndrome at the stage of MGUS.

As a result of the study, statistically significant differences in the content of fibrosis biomarkers, indicators of immune inflammation and activity of the reninangiotensinaldosterone system in patients with coronary heart disease, cardiosclerosis and those who had myocardial infarction one year after inclusion in the study were revealed.

For cervical cancer, which in 99.7% of cases is caused by human papillomavirus (HPV), the primary prevention is vaccination against the infection. The HPV vaccines available today are safe and effective. Countries that have added HPV vaccine to their National Calendar have reported decreases in cervical cancer and other cancers caused by the human papillomavirus. However, there are a number of obstacles to the introduction of the vaccine. This article analyzes the main barriers to mass HPV vaccination.

Among all the symptoms that persist in patients after undergoing a new coronavirus infection (COVID-19), a special place is occupied by lesions of the nervous system. Based on a comprehensive examination of 99 patients of a multidisciplinary hospital, conclusions were made about the prevalence of disorders of the central and peripheral nervous system, as well as cognitive and anxiety-depressive disorders caused by COVID-19 infections.

The use of monoclonal antibodies in combination therapy is one of the most promising areas in the treatment of osteoporosis. We analyzed the results of combined treatment of postmenopausal osteoporosis with denosumab in combination with calcium preparations and active forms of vitamin D against the background of low levels of vitamin D in blood serum. After 24 months from the start of treatment, the level of vitamin D reached the target values. Significantly decreased pain scores. The mineralization indicators of all the studied localizations have significantly improved compared to the initial data. After 2 years from the start of therapy, bone mineralization indicators reached the range of normal values. The conducted study indicates the high efficiency of the combined treatment of postmenopausal osteoporosis using monoclonal antibodies.

To study clinical and laboratory indicators for algorithm design of early detection of insulin resistance and diabetes mellitus type 2 (DM 2). The study was conducted within 140 people of working age with body mass excess or obesity. The risk of the development of insulin resistance increases with the preperitoneal fat thickness (b=1,46) (ехр (b)=4,29 (1,54÷1,90), р=0,005): when the amount of preperitoneal fat more than 1,50 cm a relative risk (RR) of insulin resistance (IR) formation was 5,60 (2,48÷37,11). The risk of the development of IR with the triglycerides level more than 1,75 mmol/L was 2,86 (1,03÷7,91). The risk of the development of diabetes mellitus type 2 was significantly increased with age (b=0,11; ехр (b)=1,12 (1,01÷1,23), р<0,03). RR of diabetes mellitus type 2 within patients over the age of 37,74 years was1,52 (1,09÷15,39).The most significant observed risk factors of insulin resistance are the following: class I obesity within men, the thickness of preperitoneal adipose tissue more than 1,50 cm and triglyceride level more than 1,75 mmol/l. When there are no signs of insulin resistance, the age over 37,74 years within men and women.

Analysis of clinical characteristics of patients with multiple sclerosis according to the data of the Gomel Region register for the period 2017-2020. The register included 633 patients with MS, of which 143 patients were examined (100 women and 43 men, follow-up time: 4 years, average age: 38.9 years, average age of MS debut: 26.5, average EDSS score: 3.75 points, time from the onset of the disease to inclusion in the study: 7.4 years). The primary debut symptoms and clinical picture in the advanced stage of the disease are described, the characteristics of changes on MRI are also compiled, the leading type of course is identified. In patients with MS, at the onset of the disease, most patients have the Uthoff phenomenon and clinical symptoms of motor, sensory, cerebellar disorders. Less often, the debut symptoms were damage to cranial nerves and impaired pelvic organ function. The main ivalidizing symptom in the expanded clinical picture of the disease was the defeat of the pyramidal system and cerebellum.

Based on the analysis of data from the literature sources PubMed and Google Scholar and our own data from a study in 635 patients with various stages of chronic kidney disease, clinical recommendations for the diagnosis, differential diagnosis, prevention and treatment of secondary hyperparathyroidism in patients with CKD are proposed and substantiated, in accordance with the principles of evidence-based medicine. These recommendations are intended for use in the practice of endocrinologists, nephrologists, general practitioners, radiologists and other specialists involved in the provision of medical care to patients with SHPT against the background of CKD.