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PubMed2000

[The state of psychiatry in Ukraine. Psychiatric hospitals in Kiev and Shitomir].

The situation of psychiatric patients in the Ukraine is determined by the financial and economic difficulties of this country. In the larger cities, so-called polyclinics take care of ambulant psychiatric patients. However, no other social psychiatric institutions exist. Here, the modalities of hospital psychiatric treatment are discussed using the psychiatric hospitals in Kiev and Shitomir as examples. Undertreatment is also a problem, because only a few psychopharmacological drugs are produced in the Ukraine. Import of new psychopharmacological agents is hampered by economical problems. Improving the availability of psychopharmacological drugs and the establishment of a social psychiatric network are major aims for psychiatrists working in Ukraine.

Commitment of Persons with Psychiatric Disorders↗
PubMed1997

Thyroid cancer incidence in the Ukraine after the Chernobyl accident: comparison with spontaneous incidences.

The thyroid cancer incidence in the Ukraine among those born in the period 1968-1986 was analyzed with the aim to identify the enhancement due to the Chernobyl accident. Since any Ukrainian data referring to the time period before the accident are scarce and the variation of spontaneous incidences in other countries is immense, the Ukrainian incidences in the period 1986-1989 were used to estimate the baseline risk. Following 1990, the incidence in the southern part of the Ukraine increased by about 30%, independent of age. In the other parts the increase of the incidence depended on age at exposure. In the age group of 9-year-old children, the incidences in three regions defined as the 'high-dose area', the northern, and the middle oblasts, increased by factors of 50, 20, and 6, respectively. These rates (1991-1995) are well above spontaneous rates in other countries. In the age group of 17-year-old juveniles, the incidence increased by a factor of 6 for the 'high dose area' and in the three northern oblasts, whereas in the nine 'middle' oblasts it was similar to the incidence of the 'southern' Ukraine. These rates are within the range found in other countries.

Adolescent↗
PubMed2001

Radiation sclerosing proliferative atypical nephropathy of peritumoral tissue of renal-cell carcinomas after the Chernobyl accident in Ukraine.

After the Chernobyl accident, the morbidity of renal-cell carcinomas in Ukraine increased gradually from 4.7 to 7.5 per 100,000 of the total population. Cesium 137 (137Cs) is responsible for 80-90% of the internal radioactivity in people living in radiocontaminated areas of Ukraine, and 90% of 137Cs is eliminated through the kidneys. Histological and immunohistochemical study of proliferating cell nuclear antigen (PCNA) and K-ras protein was performed in peritumoral kidney tissues of 167 Ukrainian patients (groups I-III, according to varying degrees of internal exposure to radiation), and of 85 analog Spanish patients, as a control group. Our data showed in the majority of Ukrainian patients a radiation sclerosing proliferative atypical nephropathy (RSPAN) in association with an increase in the incidences of tubular epithelial nuclear atypia and carcinoma in situ (CIS). Areas of epithelial nuclear atypia and CIS of the cortex and medulla showed significant PCNA expression with means of extent as 12, 14, and 15% of stained nuclei in groups I, II, and III respectively. K-ras expression of the same areas occurred in 67, 87, and 85% of cases in groups I, II, and III respectively. The present study points to a strong relationship between the long term of low-dose radiation exposure of the Ukrainian population and the development of RSPAN as a possible precursor of malignancy. In addition, it confirms the possible initiator, promoter, or progressor role of chronic low-level radiation of renal human carcinogenesis in Ukraine.

Adult↗
PubMed1994

Health problems of the population in different regions of the Ukraine.

The ecological situation in some regions of the Ukraine is critical due to the concentration of major ferrous and nonferrous metallurgy, oil refining and chemical industries, and due to the consequences of the Chernobyl accident. The health status of the whole population over the last few years has deteriorated and resulted in 1992 in a decrease in the birth-rate coefficient to 11.5 per million and an increase in the mortality rate up to 13.4 per million. The average level of life expectancy for men and women in 1991 decreased to 63.3 and 74.5 years, respectively. In 1991 the number of occupational diseases registered increased to 7958 or 3 per 10,000 of the working population, which does not reflect the real situation in the country. Major medical and biological problems of the consequences of the Chernobyl accident are restricted to the field of studying the effect of low-dose exposure and assessment of delayed stochastic effects. Until now no significant increase was registered in age-adjusted cancer, leukemia and lymphoma incidence rates among the male and female population of the most contaminated, strictly controlled territories and regions of the Ukraine in comparison with the average rate in the whole country. But the incidence of thyroid cancer in 1990 was 0.23, in 1991 0.19 and in 1992 0.35 per 100,000 children under 14 years of age. In the Ukraine the incidence of thyroid cancer in 1981-1985 did not exceed 0.04-0.06 cases per 100,000 children.

Adolescent↗
PubMed2005

Iodine-129 in soils from Northern Ukraine and the retrospective dosimetry of the iodine-131 exposure after the Chernobyl accident.

Forty-eight soil profiles down to a depth of 40 cm were taken in Russia and Ukraine in 1995 and 1997, respectively, in order to investigate the feasibility of retrospective dosimetry of the 131I exposure after the Chernobyl accident via the long-lived 129I. The sampling sites covered areas almost not affected by fallout from the Chernobyl accident such as Moscow/Russia and the Zhitomir district in Ukraine as well as the highly contaminated Korosten and Narodici districts in Ukraine. 129I was analyzed by radiochemical neutron activation analysis (RNAA) and accelerator mass spectrometry (AMS). 127I was measured for some profiles by RNAA or ion chromatography (IC). The results for 127I demonstrated large differences in the capabilities of the soils to store iodine over long time spans. The depth profiles of 129I and of 137Cs showed large differences in the migration behavior between the two nuclides but also for each nuclide among the different sampling sites. Though it cannot be quantified how much 129I and 137Cs was lost out of the soil columns into deeper depths, the inventories in the columns were taken as proxies for the total inventories. For 129I, these inventories were at least three orders of magnitude higher than a pre-nuclear value of 0.084+/-0.017 mBq m(-2) derived from a soil profile taken in 1939 in Lutovinovo/Russia. From the samples from Moscow and Zhitomir, a pre-Chernobyl 129I inventory of (44+/-24) mBq m(-2) was determined, limiting the feasibility of 129I retrospective dosimetry to areas where the 129I inventories exceed 100 mBq m(-2). Higher average 129I inventories in the Korosten and Narodici districts of 130 and 848 mBq m(-2), respectively, allowed determination of the 129I fallout due to the Chernobyl accident. Based on the total 129I inventories and on literature data for the atomic ratio of 129I/131I=13.6+/-2.8 for the Chernobyl emissions and on aggregated dose coefficients for 131I, the thyroid exposure due to 131I after the Chernobyl accident was estimated for the inhabitants of four villages in the Korosten and of three villages in the Narodici districts. The limitations and uncertainties of the 129I retrospective dosimetry are discussed.

Chernobyl Nuclear Accident↗
PubMed2000

Preterm birth in two urban areas of Ukraine.

OBJECTIVE: To determine whether the preterm birth rate was elevated in two urban areas of Ukraine, a former eastern bloc country that experienced serious economic, social, and health problems during its transition from a socialist republic. METHODS: We identified every pregnancy in a defined period in two urban sites where a separate study of pregnancy and childhood was being conducted. We obtained gestational age and vital status at delivery for each. Information about onset of labor and conduct of delivery was available for the subgroup enrolled in the collaborating study. RESULTS: Among 17,137 pregnancies, all but 6774 were terminated voluntarily. Among the continuing pregnancies, the preterm birth rate was 6.6% for live-born singletons of 20 or more weeks' gestation. Only 12% of preterm births involved medical intervention, the rest were idiopathic. The preterm birth rate was higher than in Europe (4.0% to 5.4%) and Canada (5.9%) but lower than for whites in the United States (8.4%). CONCLUSION: Live-born preterm birth rates are influenced by whether infants survive to be included in calculations. The high fetal mortality rate in Ukraine causes many preterm births to be excluded, thus lowering the rate. Frequent pregnancy termination and lack of ultrasound dating in Ukraine also might cause the preterm birth rate to be lower. Preterm birth rates, especially among live-born infants, are difficult to interpret and treacherous to compare across nations. Survival of the fetus and its health and development at birth are better indicators of reproductive outcome.

Female↗
PubMed2000

The HIV/AIDS epidemic in Ukraine: its potential social and economic impact.

Present and immediately foreseeable medical knowledge suggest that HIV infection cannot be avoided by vaccination and that an affordable cure for the resulting syndrome, AIDS, is a long way off. There is a strong possibility that Ukraine is confronted by an HIV epidemic which will spread into the general population and that the most common mode of transmission will be through heterosexual intercourse. The epidemic in the Ukraine is currently concentrated among intravenous drug users. It is estimated that between 60,000 and 180,000 people may currently be infected. In present economic and social circumstances there are many features of Ukrainian society that may add to the probability of the epidemic becoming widespread in the general population. It is likely that this process may have already commenced. The result of this will be numerous additional deaths and illness over the short (5 year) (19,000-23,000 deaths), medium (10-15 year) (61,000-111,000), and longer terms (>20 year) (in excess of 40,000-160,000 deaths). The research reported here was undertaken in 1997-8 and describes the potential medium to long term social and economic impact of an HIV/AIDS epidemic in Ukraine. Using the concepts of risk environment, susceptibility and vulnerability, it reports the problems which might be expected to develop in relation to care of excess orphans, the elderly, vulnerable households and regions as well as among those working in the "third sector", a social sector upon which exponents of the importance of developing sound "civil society" in "transitional economies" place heavy emphasis.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Colorectal cancer in the Ukraine: analysis and statistical data.

Colorectal cancer is the third most common cause of death due to malignancy in the Ukraine (21.7 per 100,000 in 1992). Only lung cancer (43.6) and stomach cancer (30.6) occur more frequently. Mortality is high; 47.9% and 38% of patients dying from colon and rectal cancer, respectively, within 1 year. The majority of patients present with advanced disease; 71.5% of patients with colon cancer and 60.1% of patients with rectal cancer have stage 3 or 4. Only 20.4% of patients with colon cancer and 29.4% with rectal cancer are suitable for radical surgery. The range of operative procedures performed reflects the stage of disease. Improvement in operability and survival figures in the Ukraine will result from improved facilities, increased public awareness of colorectal disease, introduction of screening programmes and closer links forged between the Ukraine and other European centres.

Colorectal Neoplasms↗
PubMed1996

Suicide in the Ukraine: epidemiology, knowledge, and attitudes of the population.

For several decades suicidology could not be discussed in the Ukraine, and so this is one of the first papers on suicide in this country. After a brief discussion of the epidemiology of suicide in the Ukraine, the authors present the results of research investigations on caregivers' knowledge about suicide, as well as an investigation of attitudes towards suicide. The principal conclusions are: 1. The frequency of suicide in the Ukraine is relatively high (24 per 100,000). The rate of suicide is much higher in rural areas than in the cities. The frequency of completed suicide is not the same in different regions of the country. 2. Sociopsychological processes in the post-totalitarian society have resulted in the development of the "Soviet syndrome" in the population. 3. Suicidal behavior in the post-totalitarian society exists in a special social, psychological, and cultural context that creates obstacles for its effective prevention. 4. Research on the level of suicide knowledge revealed a high prevalence of mythical ideas, even in those groups of the population or professional groups that should be directly involved in education and participate in suicide prevention. 5. An assessment of the attitude of the respondents toward suicide revealed an ambivalence of their feelings and attitudes that could have a negative influence on their practical involvement in helping to deal with suicidal clients.

Adult↗
PubMed1999

Polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans, and coplanar polychlorinated biphenyls in breast milk from two cities in Ukraine.

Substantial environmental pollution has been alleged in Ukraine, but little information is available to allow an assessment of the possible impact on humans. To help remedy this lack of information, it was of interest to investigate whether certain polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), or coplanar polychlorinated biphenyls (PCBs) were elevated in people from Ukraine. Samples of breast milk were obtained from 200 women from the cities of Kyiv and Dniprodzerzhinsk; Kyiv is the capital and Dniprodzerzhinsk is a highly industrialized city. The samples were combined into four pools by city and age, and analyzed for 7 PCDDs, 10 PCDFs, and 2 coplanar PCBs (126 and 169). The total of the measured PCDDs, expressed as toxic equivalent, ranged from 5.1 to 7.6 pg/g lipid; for PCDFs from 3.6 to 5.2, and for PCBs from 11 to 18 pg/g lipid. Results from the two cities were similar; older women had slightly higher concentrations than did younger women. Levels of these compounds seen in Ukraine were similar to or lower than those seen in other recent studies from European and Asian countries.

Adult↗
PubMedDate not supplied

Drug injectors and dealers in Odessa, Ukraine.

This article reports on the results observed in a series of focus groups and in-depth interviews with injection drug users (IDUs) and drug dealers in Odessa, Ukraine. Ukraine has the highest rate of HIV infection in Eastern as well as Western Europe, and Odessa ranks among the cities in that country with the highest seroprevalence. The epidemic is largely concentrated among IDUs, although heterosexual transmission is increasing. The purpose of this study was to further understand the context in which HIV-related risk behaviors occur in order to recommend intervention strategies that might reduce the rate of new infections. The drug users who participated in the research were impoverished and severely addicted. Findings revealed that there were two sources for drugs in Odessa: either from gypsies in preloaded syringes, or from drug dealers also in a liquid form. The most common drug injected was liquid poppy straw, a weak opiate known as "hemia." Results showed widespread victimization of drug users by police officials, leading to increased risk-taking to avoid arrest or harassment. Needle/syringe sharing was common and users rarely had time to disinfect their works. The most common product used to clean was urine, believed to be an antiseptic. When asked to recommend prevention strategies to reduce the rising rate of HIV, the most common response by the users and dealers was to legalize drugs. The drug and HIV epidemics in Odessa, as well as all of Ukraine, call for urgent public health measures to impact and improve the health of its citizens.

Adult↗
PubMed2000

Epidemic diphtheria in Ukraine, 1991-1997.

In 1991, Ukraine experienced a return of epidemic diphtheria after decades of control that had resulted in <40 sporadic cases reported every year. Increased incidence was first recorded in Kiev, Lviv, and Odessa. By 1993, the epidemic had spread to >50% of the oblasts (provinces) in the country, and by 1995, all regions were affected. In 1995, at the peak of the epidemic, >5,000 cases and >200 deaths were reported. As in Russia, >80% of these cases were diagnosed in persons 16-59 years old. In 1993, the government of Ukraine initiated a program of increased immunization among children and at-risk adults, and by 1995, a mass immunization strategy was adopted in an effort to arrest the epidemic, which was increasing exponentially. In 1996, the number of cases started to decrease, and data from 1998 indicate that the downward trend has continued. It is likely that the diphtheria epidemic in Ukraine started among children, who had been left vulnerable due to inadequate childhood immunizations, and then quickly spread to inadequately protected adults.

Adolescent↗
PubMed2002

First report of CRF03_AB recombinant HIV type 1 in injecting drug users in Ukraine.

It has been reported that subtypes A throughout H of HIV-1 are circulating in the former Soviet Union. In this sequence note, we analyzed the genetic prevalence of HIV-1 among injecting drug users (IDUs) in Ukraine. The subjects studied included two individuals from Kiev and six individuals from Simferopol', the latter located in the Crimean Peninsula. We found that one of eight IDUs was infected with a CRF03 gagA/envB recombinant HIV-1 and was from Simferopol', whereas the others were infected with HIV-1 subtype A. There combinant was closely related to other A/B recombinants reported previously, and had silent mutations Inthe V3 region, the same as other envB strains of HIV-1 circulating among mDUs in the former Soviet Union. The data supported reports that the Russian AIB recombinant HIV-1 was probably from Ukraine. This is the first report of a CRF03 gagA/envB recombinant HIV-1 found in Ukraine.

Amino Acid Sequence↗
PubMed2006

Molecular epidemiology of HIV Type 1 in Ukraine: birthplace of an epidemic.

During the 1990s, HIV-1 spread rapidly through drug networks in Ukraine and from there throughout the former Soviet Union. To examine the origins of this epidemic, the genetics of HIV-1 in Ukraine were studied. Proviral DNA from PBMC was extracted and PCR amplified. Part of pol and nearly full genomes of HIV-1 were sequenced and characterized. The predominant genetic form in 163 strains was subtype A (66%), followed by subtypes B (30%), C (2%), D (1%), and a new AB recombinant form (1%). HIV strains from Kiev were diverse having subtypes A, B, C, and D. In Crimea, Donetsk, Poltava, and Odessa, however, the strains were overwhelmingly subtype A, while in Nikolaev subtype B predominated. After the near simultaneous introduction of subtypes A and B in Ukraine, subtype B remained where it was introduced while subtype A spread widely, creating the fastest growing epidemic in the world.

Adolescent↗
PubMed2005

Epidemiology of heavy alcohol use in Ukraine: findings from the world mental health survey.

AIMS: To describe the epidemiology of heavy alcohol use in Ukraine, using data from the world mental health (WMH) survey in Ukraine. METHODS: The WMH composite international diagnostic interview was administered in 2002 to a national probability sample of Ukrainian adults (n=4725). An algorithm for classifying heavy use in the past year was developed from self-reports about the quantity and frequency of drinking, and its convergent validity was demonstrated. Prevalence rates and socio-demographic risk factors were examined separately for men and women. RESULTS: The 12-month rates of heavy alcohol use were 38.7% in men and 8.5% in women (22.0% overall). Among heavy alcohol users, 92% of men and 52% of women consumed at least 80 g of ethanol in a typical drinking day on a monthly basis in the year before the interview. The most significant risk factors in men and women were age (26-54 years for men; 18-25 years for women), living in the Southeast region, being in the labour force whether employed or unemployed, and for men, low education and being the father of a young child. A highly significant linear relationship of number of risk factors with heavy alcohol use was found for both sexes. CONCLUSIONS: The rates for men were similar to those reported in a Russian national survey with the exception of Southeast Ukraine where the rate was >10% higher. The highest rates were among men who were middle-aged, fathers and unemployed. Future prospective studies are needed to assess the impact of heavy alcohol use on Ukrainian health, mental health and occupational and social functioning.

Adolescent↗
PubMed2006

Tobacco use, cessation advice to patients and attitudes to tobacco control among physicians in Ukraine.

To examine the relationship between physicians' smoking behaviors and their attitudes toward tobacco use by their patients and tobacco control in the Ukraine, a 70-item questionnaire was administered to 799 general practitioners (287 men and 512 women) working in both rural (278 physicians) and urban (521 physicians) areas of three regions of Ukraine. In all, 13.9% of physicians were current smokers and 21.6% reported being past smokers, with significantly (P<0.001) more men than women being current or past smokers. Odds ratios from logistic regression analysis reveal that physicians who are heavy smokers are 26% less likely to record tobacco use by patients than medium smokers. Heavy smokers devote significantly less effort to providing cessation information to patients and are 36% less likely to support the complete prohibition of smoking in the physician's workplace. Older physicians, female physicians and physicians working in urban areas are significantly more likely than younger, male and rural physicians to advise their patients on smoking. The provision of smoking cessation to patients by general practitioners in Ukraine is influenced by several factors, a major one being the smoking status of the physician. If smoking among physicians declines, this will encourage the patient to consider a serious quit attempt in several ways, most notably: (1) physicians act as societal role models and can promote non-smoking as a norm and (2) the likelihood that a patient will be provided smoking cessation counseling increases.

Adult↗
PubMed2004

Predictors of self-reported HIV infection among drug injectors in Ukraine.

OBJECTIVE: To identify characteristics, including current high-risk drug and sex behaviors, associated with self-reported HIV infection among injection drug users (IDUs) in Ukraine. DESIGN: Targeted sampling of IDUs from Kiev, Odessa, and Makeevka/Donetsk, Ukraine. METHODS: From June through August 2002, 100 IDUs from each site were recruited through street outreach, including 212 who had previously been tested for HIV and knew their serostatus. Subjects were administered a standardized computer-assisted interview assessing HIV-related drug and sex risk behaviors and history of HIV testing. RESULTS: Twenty six percent of the 212 participants reported they were HIV-positive. Univariate followed by multiple logistic regression analyses were used to identify factors associated with HIV infection. In the 30-day period before their interview, HIV-infected IDUs were significantly more likely to have injected with a needle previously used by another injector without disinfecting, frontloaded and/or backloaded, and shared the drug solution from a common container. In addition, they had higher prevalence rates for hepatitis B virus and hepatitis C virus than those not infected with HIV. On the other hand, they were more likely to have reported no sex partners and, if sexually active, more likely to have used a condom. CONCLUSION: The high HIV seroprevalence among IDUs in Ukraine, combined with their continued engagement in needle-related risk behaviors, assures the continuance of the epidemic in this region, a region that is the epicenter of HIV in Europe.

Adult↗
PubMed2005

The elderly people of post-Soviet Ukraine: medical, social, and economic challenges.

Over the past 14 years, since Ukraine became an independent nation, the country has made major strides toward achieving political and economic reforms, exemplified by the recent populist uprising for fair and free elections. Despite these successes, many challenges still lie ahead, particularly in the area of health care for older people. The average life expectancy in Ukraine is only 67 years, and those who achieve old age often live in poverty. Women are expected to retire from their professions at age 55 and men at 60. Pensions are so low that retirees are often forced to take laborious jobs on the streets. Because of deficiencies in medical education, deteriorating hospital facilities, a lack of modern medications and supplies, and inadequate physician payment mechanisms that breed corruption, many elderly people mistrust the medical system and often turn to folk medicines and Eastern medical practices to treat their illnesses. By understanding the expectations and former medical practices of elderly patients who have emigrated from Ukraine, Western physicians will be better able to meet their emotional and medical needs.

Aged↗