Problems of Radiation Medicine and Radiobiology

D. I. Zabolotnyi, N. S. Mishchanchuk

State Institution «O. S. Kolomiychenko Institute of Otolaryngology, National Academy of Medical Sciences of Ukraine», 3 Zoolohichna St., Kyiv, 03057, Ukraine

HIRUDOTHERAPY IN PRESBYACUZIS PRAECOX IN CLEAN-UP WORKERS AFTER THE CHORNOBYL ACCIDENT DURING THE POST-CATASTROPHE YEARS

Objective. to study the hirudotherapy efficacy in presbyacuzis praecox in clean-up workers (CUWs) of the Chornobyl disaster (ChD) during the post-accident years.
Materials and methods. From archive data of previously examined 8,136 males’ CUWs we selected among them 129 persons with the determined presbyacuzis praecox during the post-accident years. According to the physical dosimetry data the individual radiation of received by CUWs during the work on a rotational scheme in the Chornobyl exclusion zone from the end of 1986 to 1992–1994 amounted to 0.21–0.50 Gy. The examinations were carried out using a modern standard set of audiometric, vestibulometric and electrophysiological methods. Two forms of sensory and neural hearing loss in the elderly were distinguished, namely the presbyacuzis and presbyacuzis praecox. Prior to work in the exclusion zone, patients’ auditory and vestibular functions were within normal range. Among 129 patients, 68 ones with presbyacuzis praecox were included in two main age groups (aged 40–49 and 50–59 yrs) and were treated using hirudotherapy, taking into consideration their coagulation hemostasis. Other 61 patients of analogical age groups were treated by allopathotherapy. For the analysis of results obtained, techniques of variational statistics were used.
Results. Direct correlation (r = 0.71) between inhibitory processes in central areas of the auditory analyzer in presbyacuzis praecox in CUWs was established by electrophysiology and by speech audiometry data obtained before the treatment. Hyperacusis signs were detected in CUWs of two main and two control groups. Following the use of two treatment schemas, a significant improving of auditory functions was found (p < 0.05) according to tone and speech audiometries. The positive hirudotherapy effect concerning hearing functions was registered in 88% cases (in 59 CUWs among 68 ones); if allopathotherapy had been used, such effect was found in 65% cases (in 45 control patients among 61 ones of control group). The duration of allopathotherapy effect reached 6–9 months comparing to 12–18 months of hiruditherapy one, being twice longer. Improving the patients’ coagulation hemostasis, hirudotherapy activated cardiovascular activity favoring the increase of social adequacy in CUWs with presbyacuzis praecox.
Conclusions. It has been shown that hirudotherapy as a kind of naturopathy has significant advantages over alopatotherapy by the absence of side effects, 23.0% higher and twice as long as improvement of auditory functions. Hirudotherapy, as an effective therapeutic and recreational measures, should be more widely implemented in clinical practice in order to minimize the development and progression of diseases in the special population of people who have been exposed to ionizing radiation due to the Chornobyl catastrophe to continue their vitality.
Key words: radioactive irradiation, sensoro-neural hearing loss by presbyacuzis praecox, audiometry, vestibulometry, hirudotherapy.

Problems of Radiation Medicine and Radiobiology.
2019;24:522-536. doi: 10.33145/2304-8336-2019-24-522-536

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1. Bazyka DA, Sushko VO, Chumak AA, Tal’ko VV, Yanovych LA. State Institution “National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine” – research activities and scientific advance in 2014. Probl Radiac Med Radiobiol. 2015;19:2-24.

2. Chumak AA, Pleskach G. Analysis of some risk factors for myocardial infarction in a cohort of the Chornobyl clean-up workers (according to the data of Clinical and Epidemiological Registry). Probl Radiac Med Radiobiol. 2013;18:289-98.

3. Bazyka DA, Bilyi DO. Cardiovascular diseases and systolic function of left ventricle in clean-up workers of Chornobyl accident (based on 30 years follow-up). Probl Radiac Med Radiobiol. 2017;22:291-305.

4. Bazarov VG, Kardash SI, Ovsianyk YeV. [Indices of vestibulometry and hearing induced potentials in Chernobyl AES clean-up workers]. Zhurnal Ushnykh, Nosovykh і Horlovykh Bolieznej. 1994;6:11-8. Russian.

5. Loganovskij KN. [Psychic disorders due to ionizing radiation as a result of the Chornobyl catastrophe: neurophysiological mechanisms, their unified clinical diagnostics and treatment] [thesis of the dissertation]. Kyiv; 2002. 49 p. Ukrainian.

6. Loganovskij KN, Vasylenko ZL. Depression and ionizing radiation. Probl Radiac Med Radiobiol. 2013;18:200-19.

7. Loganovskij KN, Kutz K. Evoked bioelectrical brain activity following exposure to ionizing radiation. Probl Radiac Med Radiobiol. 2017;22:38-68.

8. Fedirko PA, Babenko TF, Dorichevsska RY, Garkava NA. Retinal vascular pathology risk development in the irradiated at different ages as a result of Chornobyl NPP accident. Probl Radiac Med Radiobiol. 2015;20: 467-75.

9. Zabolotnyi DI, Mishchanchuk NS. Vestibular and acustic dysfunctions in clean1up workers of Chornobyl accident (30 years of follow-up). Probl Radiac Med Radiobiol. 2016;21:218-37.

10. Garkava NA, Fedirko PA, Dorichevska RY. Radiation induced violations of blood circulation in the ciliary body and changes of the anterior chamber angle in the pathogenesis of glaucoma in clean-up workers of the Chornobyl NPP accident and residents of contaminated areas. Probl Radiac Med Radiobiol. 2017;22:332-8.

11. Nosach OV. Comorbidity and radiation: methodological aspects of health assessment of persons exposed to the Chornobyl accident factors. Probl Radiac Med Radiobiol. 2013;18:240-52.

12. Levine YS, Branchb DW, Rauch Y. The antiphospholipid syndrome. Engl J Med. 2000; 346:752-63.

13. Nasonov UL. [Antiphospholipid syndrome]. Moscow. Litera. 2004; 440 p. (in Russian).

14. Simonova LI, German VZ, Abramova LP. Danger of praecox aging as a factor of distant Chernobyl catastrophe consequences. In: Distant Medical Consequences of the Chernobyl Catastrophe: Materials of the Conf, 1st -6th of June 1998, Kyiv. Kyiv; 1998. p. 370-371. Russian.

15. Fedirko PA, Mischanchuk NS, Kholodenko TYu. [Atherosclerotic changes in aorta and retinal vessels, hearing and vestibular disorders as a praecox aging symptomocomplex in clean-up workers of the Chornobyl catastrophe (clinical and epidemiological investigation]. Zhurnal Vushnykh, Nosovykh і Horlovykh Khvorob. 2004;4:44-9. Ukrainian.

16. Zabolotnyi DI, Mischanchuk NS. [Hearing decrease belonging to the type presbyacuzis praecox in clean-up workers following the Chernobyl catastrophe during the post-catastrophe period]. In: Materials of the XIII Scientific & Practical Conference with International Participation (Ecology, Radiation, Health), Qazagstan Respyblikasy, Semej; 2017. p. 71. Russian.

17. Kharshak YeM. [Modified drawing curve for applying of tone threshold audibility levels on a audiogram in cases of praecox age-due hearing changes (presbyascuzis praecox)]. Zhurnal Ushnykh, Nosovykh і Horlovykh Bolieznej. 1970;(6):104-6. Russian.

18. Lopotko AI, Pluzhnikov MS, 8Aramouradov MA. [Old age deafness (Presbyascuzis)]. Ashkhabad: Ilym; 1986. 360 p. Russian.

19. Tavartkiladze GA. [Manual on clinical audiology]. Moscow: Meditsina; 2013. 676 pp. Russian.

20. Nikonov GI, Baskova IP. [Physiological and biochemical aspects of medicinal leeche (Hirudo medicinalis) treating influence]. Uspiekhi sovremennoj biologii. 1986;101(1):141-54. Russian.

21. Krashcheniuk AI, Krashcheniuk SV, Korotkov K. [Energo-informational effect of the hirudotherapy]. In: Hirudologia-97. Materials of the V Scientific & Practical Conference of the Association of Hirudologists of Russia (27th-29th of May 1997). Sankt-Petersburg, Zelenogorsk; 1997. p. 83-9. Russian.

22. Sukhov KV. [Treatment using leeches as an approach of integrative medicine]. Collection of Scientific Papers. Moscow; 2000. p. 59-70. Russian.

23. Baskova IP, Zavalova LL. [Inhibitors of the medicinal leech (Hirudo medicinalis) proteolytic enzymes]. Biokhimia. 2001;66(7):869-83. Russian.

24. Savinov VA, editor. [Hirudotherapy] (Manual). Moscow. OAO “Meditsina”. 2004; 432 pp. Russian.

25. Mischanchuk NS. [Hirudotherapy in cases of acute sensoro-neural presbyacuzis praecox in Chernobyl clean-up workers with fibrinolytic changes in their blood]. Zhurnal Vushnykh, Nosovykh і Horlovykh Khvorob. 2005;2:18-9. Ukrainian.

26. Krashcheniuk AI, Krashcheniuk SV, Krylov AA. [Role of a systemic approach in the treatment of elderly patients]. Nielekarstviennaya terapiya. 2007;1(6):52-73. Russian.

27. Shogenova ZKh, Zatsepina YeYe, Ivashchev MN. [Possibilities of hirudotherapy]. Mezhdunarodnyy zhurnal eksperimental'nogo obrazovaniya. 2013;11:264. Russian.

28. Kamenev OYu, Baranovski AYu. [Treatment using leeches. Hirudotherapy: Teoriya i praktika]. IG:“Vies”; 2014, 304 p. Russian.

29. Tiupin OL. [Hirudotherapy: medical and social aspects]. Miezhdunarodny Zhurnal Prikladnykh і Fundamentalnykh Issledovanij. 2016;9:244-7. Russian.

30. Lapach SN, Chubenko AV, Babich PN. [Statistical methods in medical and biological studies using Excel]. 2nd ed. Kyiv: MORION; 2001. 408 p. Russian.

31. Fukuda T. Vertical writing with eyes covered: a new test of vestibule-spinal reaction. Acta Otolaryng (Stockholm). 1959;50(1):26-36.

32. Fukuda T. The stepping test: two phases of labyrinthine reflex. Acta Otolaryng (Stockholm). 1959;50(2):95-108.

33. Melnik AA. [Clinical laboratory tests for practical medicine, their interpretation]. Kyiv: Knyha-Plus; 2017. 308 p. Russian.