The article highlights the main results of the activities of the state institution «Republican Research Center for Radiation Medicine and Human Ecology» in research and diagnostic and treatment work. The role of the institution in the development of the healthcare system of the Gomel region has been shown, achievements in improving the health of the population affected by the Chernobyl accident, research and educational activities has been reflected. Promising areas of activity has been identified

The CNS integrates efferent signals from the somatic and autonomic parts. Also the CNS also receives information from the periphery about inflammation and infection. Cytokines, chemokines and damage-associated soluble mediators of systemic inflammation can also enter the CNS via the blood and/or lymphatic systems. At the same time these substances can penetrate directly through periventricular structures, as well as by increasing the permeability of the blood-brain barrier and disrupt the healthy functioning of neurons and glia, leading to a violation of brain homeostasis. This can lead to the onset of a neurodegenerative disease or worsen its clinical symptoms. In this publication, we present current international scientific data indicating a link between the neurodegenerative process and immune disorders. In addition to identifying immune-mediated pathways of neurodegeneration, new, potentially significant, immunomodulatory targets are presented for the development of possible effective therapy for this group of diseases.

Multiple myeloma is a malignant neoplasm caused by the uncontrolled proliferation of tumor plasma cells. With the introduction of new drugs and treatments in the last decade, the response rate and overall survival rate of MM patients have increased. However, MM remains an incurable disease with relapses or refractoriness to treatment. Therefore, the search for prognostic factors is a constant topic of study in many researches. Due to the application of modern technologies in diagnostics, it has become possible to identify a group of patients at high risk at an early stage. This allows the development of new treatment strategies. This review presents new achievements in the diagnosis and treatment of MM.

This article provides a review of current literature data on the use of shear wave ultrasound elastography in assessing the condition of the renal allograft. Currently, kidney transplantation is the most complete method of replacing the lost function of one's own kidneys, providing the highest quality of life, but it is associated with the risk of rejection. Rejection of a transplanted kidney leads to severe organ dysfunction. Today, the gold standard for diagnosing renal transplant dysfunction is histological examination of a biopsy specimen, but biopsy, being an invasive diagnostic method, has its limitations, contraindications and complications. Therefore, the emergence of an accessible and non-invasive method for assessing the function of a renal graft is relevant.

Pulmonary arterial hypertension (PAH) is a severe, rapidly progressing disease. Apoptosis of endothelial cells (EC) and their resistance to programmed death play a decisive role in the pathogenesis of PAH. It is assumed that the ratio of Bcl-2 and Bax proteins may be the main determinant of cellular ability to apoptosis. The article presents the results of a study of pulmonary artery EC apoptosis in the dynamics of monocrotaline-induced PAH development.
Apoptosis is an important factor in arterial remodeling in PAH. With the development of PAH, activation of apoptotic death of EC reaches its maximum values 1 month after the beginning of the experiment; 2 months after the introduction of monocrotaline (MCT) to rats, apoptosis transitions to necrosis and a decrease in the apoptotic index is observed.
Inhibition of anti-apoptotic mechanisms in the early stages of PAH leads to impaired permeability of the EC barrier and the risk of thrombosis. Apoptosis of EC is characterized by a decrease in the expression of the anti-apoptotic factor Bcl-2 with a fairly high expression value of the pro-apoptotic protein Baх.
Thus, the ratio of pro- and anti-apoptotic proteins of the Bcl-2 family plays a significant role in the development of pathological changes in the pulmonary arteries in rats with PAH.

The analysis of 602 175 results of the assessment of individual effective doses of internal radiation of residents of the Gomel region, calculated based on the results of whole-body γ-spectrum analyzer (WBSA) measurements of the content of 137Cs in the body in 2015-2023, was carried out. To estimate the annual individualized dose of internal radiation, distributions of individual doses of internal radiation in those settlements of the Gomel region where there is a sufficient volume of WBSA measurement results are constructed. On their basis, the annual individualized doses of internal radiation are calculated. A database of annual individualized doses of internal radiation in 1 085 settlements for the period from 2015 to 2023 has been formed. It was found that even in the most studied areas, the proportion of residents surveyed for WBSA did not exceed 50%. By comparative analysis of individualized and individual doses, it was shown that the error in estimating the individualized dose of internal radiation varies up to 76%, which is explained by many factors affecting the dose formation process and the small values of these doses in the region. The error in estimating the individualized dose of internal radiation under conditions of uncertainty and incomplete WBSA measurement data averaged 44%.

A comparative analysis of the applied methods for reconstructing individualized external exposure doses for population living in an area contaminated with radionuclides as a result of the Chernobyl accident showed that conservative approaches to dose reconstruction have a negative impact on the prognosis of the latter in general. The proposed new method for reconstructing individualized external exposure doses is methodologically consistent with its analogues, but at the same time it allows taking into account not only the direct dose-forming factor (contaminated density), but also indirect factors in the aggregate (occupation, gender and age), which, in turn, makes it possible to reconstruct individualized external exposure doses for each year under research with minimal error. Correlation analysis showed that there is a high correlation between the model estimates of the new method and the data of individual dosimetric control (Spearman's correlation coefficient varies from 0,77 to 0,85; p<0,05), while the average dose estimation error using the new method ~ 4 times lower than that of its analogues.

Research shows that the current level of knowledge and awareness about the nature of radio frequency electromagnetic fields and their impact on the environment and human health is low, and therefore there is a critical and urgent need to educate the public on this issue.
In order to further develop methodological support for socio-psychological rehabilitation and adaptation of the population to the conditions of ionizing and non-ionizing radiation, a sociological study was conducted in the Gomel (radionuclide-contaminated territory) and Vitebsk (conditionally clean territory) regions, during which the opinion of residents was studied as to which devices (types of communication) they and their family members use in everyday life, and also revealed self-assessments of the population of their knowledge in the safe use of various technical devices and types of communication.
The sociological survey was conducted in February-March 2022 among various population groups of the Gomel and Vitebsk regions (N=1180, Δ=±4,0% with a confidence probability of 95,0%), identified by type of settlement (city/village), gender (male/female), age (16-29 years, 30-49 years, 50 years and older), the level of education (basic/general secondary; vocational-technical/secondary-specialized; higher) and the type of employment (student, student; working; non-working pensioner; working pensioner; running a household; entrepreneur, farmer, self-employed; unemployed). The research methodology is the systematization and generalization of the data obtained during the sociological survey.
It was revealed that the vast majority of respondents, regardless of gender, age, level of education and place of residence (city / village), use a fairly extensive list of devices (types of communication). With general similar trends in the use of various devices (types of communication), respondents in the Vitebsk region more often than in the Gomel region use remote monitoring, surveillance, and control devices, but in the Gomel region – more often use mobile phone without Internet access, as well as mobile communication of standard 4G.
At the same time, a significant part of the respondents of the studied regions are not fully aware that with improper use (distance from a person during operation, operating time, etc.), various devices (types of communication) can have a negative impact on human health.

A new methodology for express assessment of the radiation situation using a mobile laboratory has been developed. It characterized by a set of new methods for assessing the main parameters of the radiation situation, united by a common goal, new unified approach and principles. The purpose of developing the new methodology was to ensure in-situ assessment of the density of contamination of the territory, the volumetric activity of the surface layer of the atmosphere, the activity of gamma radiation sources and the contribution of various radionuclides to the ambient equivalent of dose rate under conditions of a radiological accident. The methodology is aimed at extracting maximum information about the contamination levels of specified objects from the instrument line of the gamma spectrum. The methodology is based on new principles – on obtaining all the necessary initial information and in situ assessment results, promptly and without personnel entering to the contaminated area from the protected interior of the vehicle. Methodological recommendations have been developed and implemented to perform an independent express assessment of the radiation situation in the area of exposure to nuclear facilities and ionizing radiation sources using a mobile radiation monitoring laboratory.

Predictive calculations of the dynamics of the ¹³⁷Cs soil pollution density and the ambient dose equivalent capacity were performed on the example of 100 forest blocks with a ¹³⁷Cs soil pollution density from 50 to 550 kBq/m2 and the dose of external irradiation of workers during forestry work. It is shown that during the time period from 2024 to 2064, the main number of forest blocks will belong to the I zone of radioactive contamination, during this time a decrease in the number of blocks in the Ib subzone and an increase in Ia is predicted. By 2084, half of the forest districts will be classified as conditionally uncontaminated territories. In the period from 2024 to 2084, a 4-fold decrease in the interquartile power interval of the equivalent ambient dose at a height of 1 m and the dose of external irradiation of workers in forest plantations caused by gamma radiation of ¹³⁷Cs is predicted.

The early morphological features of osseointegration of the stem of cementless total hip replacement were studied in laboratory rats against the background of intramedullary biocomposite bone grafting. The biocomposite consisted of bone matrix extracted from the bone mar-row canal and previously prepared rat plasma enriched with soluble platelet factors in a ratio of 9:1. In the control group, the implantation of the stem of cementless total hip replacement was performed in the traditional way without the use of bone-plastic biocomposite. Statistically significant morphological parameters indicating optimization of osseointegration when using the bone-plastic biocomposite were established: a smaller area of the bone marrow canal damage zone on the 14th day (p˂0,001), a smaller area of granulation tissue on the 7th (p˂0,001) and 14th days (p˂0,001) and higher areas of forming bone tissue along the periphery of the implant on the 7th (p˂0,001) and 14th days (p˂0,001) of the experiment. The obtained data can serve as an experimental justification for introducing a new method of cementless hip arthroplasty into clinical practice.

Currently, the World Health Organization (WHO) recognizes that radio frequency electromagnetic fields (RF EMF) are one of the most common sources of electromagnetic radiation and are significant factors for human health, having a pronounced biological effect. In addition, oxidative stress caused by hyperproduction of free radicals due to exposure to RF EMF is a factor that provokes the development of many diseases and, in particular, liver pathologies, including in the elderly.
For the first time, studies were conducted on the state of the antioxidant system of the liver of male rats at various stages of postnatal development (young, adult, aging and pre-senile periods) under conditions of chronic exposure to EMF from a Wi-Fi device (2,45 GHz, PD=0,79±0,52 μW/cm2, 24 h/day, daily) from the age of 50 days until they reach 24 months. In the cytosolic-microsomal fraction, the activity of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and glutathione-S-transferase was determined by spectrophotometry, and in the tissue homogenate, the concentration of protein-bound glutathione, sulfhydryl groups of proteins, total SH groups, reduced glutathione and protein oxidation products was determined.
The revealed changes in the state of the liver antioxidant system during chronic exposure to EMF from Wi-Fi equipment on the body during aging indicate activation of the glutathionedependent system in experimental animals. The revealed changes are manifested in maintaining a stably elevated level of the reduced form of thiols in the liver tissue and are an adaptive response of cells to prolonged exposure of the body to EMF from Wi-Fi equipment.

The article is devoted to the analysis of cases of uterine smooth muscle tumors with undetermined malignant potential (STUPM), identified in the State Institution «Republican Scientific and Practical Center of Russian Medical Research and Emergencies» in the period from 2017 to 2024. The proportion of tumor among all patients operated on for leiomyoma during the indicated period was 0,38%. The average age was 43 (32-45) years. Clinical manifestations of the disease and ultrasound characteristics of the tumor were identical to uterine leiomyoma. Pathological criteria for STUMP are difficult to identify and were rarely established intraoperatively (20% of cases). During the observation period, no cases of tumor recurrence or metastasis were detected. Considering the rarity of the tumor and the complexity of preoperative diagnosis, there was no uniform protocol for patient management.

We studied 35 medical histories of renal transplant recipients who underwent kidney transplantation in the surgical department (transplantation, reconstructive and endocrine surgery) of RRCRM&HE in Gomel. Tacrolimus concentrations were assessed on days 3, 10, and 30 after kidney transplantation. The tacrolimus C0 (zero concentration) level was determined fasting, before the morning administration of medications. Among kidney transplant recipients, there were 19 (54,3%) men and 16 (45,7%) women. The mean age was 42,7±2,0 years [95% CI 38,58; 46,73]. Before transplantation, 91,4% of patients were on programmed hemodialysis and 8.6% on peritoneal dialysis. All patients received triple immunosuppressive therapy: a calcineurin inhibitor (tacrolimus), antiproliferative drugs (azathioprine or mycophenolate mofetil), and prednisolone. Tacrolimus was administered at a dose of 0,1 mg/kg per day. According to our data, the concentration of tacrolimus on day 3 was 5,2 [4,1; 5,5] ng/ml, on day 10 it was 5,1 [2,5; 7,4] ng/ml (p3,10 = 0,809), on day 30 after surgery the tacrolimus level reached 8,2 [4,6; 10,2] ng/ml (p10,30 = 0,0007 and p3,30 = 0,027). Thus, when tacrolimus was administered at recommended doses, 8,6% of renal transplant recipients failed to achieve concentrations exceeding 4 ng/ml one month after surgery. Moreover, on day 30 of the postoperative period, the concentration of tacrolimus exceeded 7 ng/ml in 71% of renal transplant recipients.

This article presents study of immediate and long-term outcomes following 73 nasal reconstruction using cartilage allografts. Postoperative complications developed in 9 cases (12,3%). Two cases (2,7%) were associated with cartilage allograft. Cosmetic outcome was evaluated minimally in 6 months after reconstruction. Patients and experts evaluated 6 particular parameters and total nasal appearance using 5-point scale. Patient scores were higher than expert scores for nasal alar (р=0,001), nostril size (р=0,005), nasal skin color (р=0,028), nasal position (р=0,028). Declined scores were more common registered for parameters nasal alar, nasal dorsum, nostril size, nasal skin color. Experts defined total nasal appearance as acceptable (4 or 5 points) in 62 cases (84,9%). Twelve patients underwent ultrasonography and magnetic resonance tomography of facial tissues in minimally 2 years after reconstruction. Cartilage allografts within reestablished nasal subunits were identified using both methods. No significant deformities and dystrophic changes were discovered. This study showed that allogeneic cadaver cartilage can be used effectively for nasal reconstruction.

The study was conducted in Vietnam among 1,228 workers (836 steel workers and 392 ceramic tile workers) to investigate the risk of chronic obstructive pulmonary disease (COPD) among workers. The study used a screening questionnaire for chronic obstructive pulmonary disease in the community based on the «Guidelines for the Diagnosis and Treatment of Chronic
Obstructive Pulmonary Disease» provided by the Ministry of Health. The results showed that the proportion of workers at risk of COPD was 8,6% (9,7% among steel workers and 6,4% among ceramic tile workers). The risk of COPD tends to increase with age and length of service. Among those at risk of COPD, the levels of exposure to dust, toxic fumes, and smoking were 10,2%, 11,6%, and 51,8% among steel workers and 7,2%, 9,9%, and 36,0% among ceramic tile workers. The environmental factors to which the workers

This study investigates the functional activity of peripheral blood neutrophils in children with hereditary spherocytosis − one of the most common forms of congenital hemolytic anemias. For the first time, a comprehensive examination of various aspects of neutrophil reactivity in this pathology was conducted, including their ability to form reactive oxygen species and neutrophil extracellular traps (NETosis). The results revealed significant changes in neutrophil functional activity in patients with hereditary spherocytosis outside of hemolytic crisis, particularly an increased capacity for reactive oxygen species formation and enhanced NETosis. Notably pronounced NETosis activation was observed in patients of the younger age group (up to 5 years). Correlations were identified between NETosis indicators and the number of erythrocytes and leukocytes in patients' peripheral blood. This study contributes significantly to understanding the relationship between erythrocyte pathology and neutrophil functional status, an aspect that had not been previously studied in detail in the context of hereditary spherocytosis.

The main clinical androgenital manifestations of pelvic vein disease in men were represented by venogenic erectile dysfunction (ED), primary and secondary varicose veins of the superficial and deep veins of the penis, varicocele, hematospermia, hematuria, and chronic pelvic pain syndrome (CPPS). The criteria for choosing the method of surgical correction of venogenic ED were the following: terminal blood flow velocity, the presence or absence of retrograde blood flow in the deep vein of the penis, the diameter of the vein, the presence of pelvic varicose veins, the presence or absence of venous obstruction due to arteriovenous conflict, the presence of varicose veins of the superficial venous system of the penis and the veins of the spermatic cords according to the CEAP classification and multispiral computer phlebography.
A total of 45 roentgen-endovascular occlusions of the veins of the periprostatic plexus (REVOPP) were performed through the deep vein of the penis and/or the femoral vein with ligation of the proximal segment of the deep vein of the penis; open phlebectomies of the superficial veins of the penis with vein extraction according to Babcock, saphenofemoral crossectomy combined with circumcision and ligation of the veins in the coronal sulcus were performed in 10 cases; two-stage - REVOPPs and open phlebectomies of the superficial veins (in combination with circumcision) in 7 cases. In 25 cases of patients with venogenic ED combined with varicocele after REVOPP, microsurgical phlebectomy of the veins of the spermatic cord on the left was performed from the subinguinal approach; isolated microsurgical resection of the deep vein of the penis with circumcision was performed in 1 case. 7 left common iliac vein stentings and one bilateral common iliac vein stenting were performed in patients with May- Thurner syndrome.

A total of 120 microsurgical operations were performed with positive results (including 105 operations using a top con OMS 90 microscope (Japan) and 15 operations using a Zeiss microscope and a 3D NGENUITY visualization system) in patients with varicocele. The mean age of men was 33±2,3 years (M±m). The diameter of the veins of the spermatic cord was 3,5±1,2 mm. All patients with varicocele had retrograde blood flow and reflux through the veins of the pampiniform plexus. Varicocele was found on the left in 105 (87%) patients, on the right – in 15 (13%). 25 out of 120 (20,7%) patients had a recurrence of varicocele on the left after high ligation (Ivanissevich operation). Bilateral varicocele was observed in 5 (4,1%) patients out of 120. Primary varicocele was detected in 95 (78,8%) patients, secondary due to veno-obstructive syndromes (May-Thurner syndrome, compression of the left renal vein by the superior mesenteric artery (nutcracker syndrome) was detected in 25 (20,7%) patients. Postoperative complications: scrotal hematoma in 3 cases (2,5%), scrotal edema in 7 cases (5,8%), ischemic orchiepididymitis in 3 cases (2,5%), persistent pain in the scrotum for 6 months in 4 cases (3,3%). One year after microsurgical phlebectomy of the veins of the spermatic cord from the subinguinal approach, no recurrence of varicocele was detected according to ultrasound data. Microsurgical phlebectomy using the NGENUITY 3D visualization system for varicocele allows eliminating chronic venous insufficiency of the testicle with varicose veins of the spermatic cord with minimal early postoperative complications.

During the coronavirus pandemic (COVID-19), views have evolved in various fields of medicine due to a significant number of studies in the field of epidemiology of the new infection and its numerous complications, observation of patients in the post-COVID period, the formation of registries and the analysis of big data. As a result of the study, the main structural and functional changes of the heart were determined in patients with a history of pneumonia associated with COVID-19 infection according to standard echocardiography with the additional use of tissue myocardial Doppler imaging and 2D Speckle Tracking technology. The data obtained show that standard echocardiography, combined with an assessment of longitudinal deformation based on speckle-tracking echocardiography, is important and provides additional opportunities in the diagnosis of cardiovascular pathology in patients with COVID-19 infection.

The article presents the results of a study on the function of the hypothalamic-pituitaryadrenal axis in patients who underwent unilateral adrenalectomy. The prevalence and severity of postoperative adrenal insufficiency were studied according to the results of a low-dose overnight dexamethasone test at the preoperative stage. A proposal has been developed on the tactics of prescribing hormone replacement therapy to patients after unilateral adrenalectomy depending on the clinical picture and blood cortisol level at 0800. Directions for further study of postoperative adrenal insufficiency and possible methods of its prevention are outlined.

The article reviews problematic issues of headaches and management the patients with chronic migraine, as one of the types of primary headaches. Risk factors and triggers, mechanisms of chronicization of migraine headaches are presented. Possible approaches and methods for increasing the effectiveness of chronic migraine treatment are reviewed. The article presents a clinical case of successful use of a multidisciplinary approach in the treatment of a patient with chronic migraine combined with drug-induced headache at the RRCRM&HE with the participation of medical specialists of various profiles, with the administration of drug preventive therapy, cognitive-behavioral therapy, acupuncture and psychotherapy sessions, and treatment of drug-induced headache.

Anomalies of the female genital organs (malformations) are a complex medical problem because of the variety of anatomical forms and clinical manifestations, which can be asymptomatic or have pronounced symptoms. Of particular importance are cavity formations in the uterus, which may be due to a violation of the outflow of menstrual blood and other uterine cavities. As a rule, the debut of clinical manifestations coincides with the onset of menarche. The combination of the patient's complaints of severe dysmenorrhea with the characteristic localization of a cavitated myometrial mass under the round ligament, visualized by ultrasound and MRI examination, may indicate a rare uterine pathology associated with anomalies of the Müllerian ducts. The article presents a clinical case of a rare congenital anomaly of ACUM development, issues of diagnosis, treatment, and prevention.

Thyrotoxicosis is a clinical syndrome that can be a manifestation of various diseases. One of the reasons for its development is amiodarone-induced thyroid dysfunction. Amiodarone is a drug widely used to treat various arrhythmias; its effect on the functional activity of the thyroid gland must be taken into account when prescribing to a patient. The article discusses the causes of thyrotoxicosis during treatment with amiodarone, the types of amiodarone-induced thyrotoxicosis and the features of their treatment. A case of clinical observation of a patient with amiodarone-induced thyrotoxicosis is presented.