Human Well-being and Educational Investment Efficiency

Society's attitude to investments in human beings changed due to the ideas contained in the theory of human capital. Nowadays it is proved – these investments provide a production effect, the benefits for the individual and the benefits to the government. We can say that investments in the education today become tomorrow a competitive advantage. Therefore the well-being and sustainable economic development of nations depend on the human capital. That is why the paper considers human well-being and its key factors, the relationship between the human well-being and human capital, and criteria for estimation of investment efficiency in education. The quantitative analysis was carried out using dependencies between education and wages, graduates’ wages and their profession, education and unemployment. Non-monetary income from educational investments is shown in this paper. A conclusion is made about the benefits from educational investments and their impact on human well-being. It is proposed to pursue a special policy in the field of development of human resources and investments in the human capital

Comparative characteristics of vascularization hepatocellular carcinoma and focal nodular hyperplasia of the liver

We made a comparative analysis of the degree of vascularization of tissues of hepatocellular carcinoma (HCC) and focal nodular hyperplasia of the liver. On immunohistochemical specimens (with antibodies CD34 and CD105) were determined the number and the total area of the section of the sinusoids and was calculated index of tissue vascularization by morphometric methods. It was established greater number of vessels and the area of their section is in the larger FNH. Increasing the degree of malignancy of HCC accompanied by changes in its vascularization. Morphological indices of vascularization is recommended to use as additional criteria for differential diagnosis and prognosis of the disease.Проведен сравнительный анализ степени васкуляризации ткани гепатоцел-люлярного рака (ГЦР) и очаговой узловой гиперплазии печени. На иммуногистохимических препаратах (с антителами CD34 и CD105) морфометрическими методами определяли количество и общую площадь сечения синусоидов, а также рассчитывали показатель васкуляризации ткани. Установлено большее количество сосудов и площади их сечения в более крупных ОУГ. Повышение степени злокачественности ГЦР сопровождается изменениями ее васкуляризации. Морфологические показатели васкуляризации рекомендуется использовать в качестве дополнительных критериев для дифференциальной диагностики и определения прогноза заболевания

Восьмое издание Международной TNM-классификации злокачественных опухолей печени

New criteria for T, N and M categories and characteristics of the stages of hepatocellular carcinoma and intrahepatic cholangiocarcinoma are presented in the eighth edition of the international TNM classification of malignant tumors in 2017. The differences of this classification from the previous seventh edition of 2009 are noted, due to the receipt of new data on the survival of patients. The main characteristics of the primary tumor remained its size, the number of nodes and the presence of vascular invasion.Приведены новые критерии T, N и M категории и характеристики стадий гепатоцеллюлярной карциномы и внутрипеченочной холангиокарциномы, представленные в восьмом издании Международной TNM-классификации злокачественных опухолей 2017 г. Указаны отличия данной классификации от предыдущего седьмого издания 2009 г., обусловленные получением новых данных о выживаемости больных. Основными характеристиками первичной опухоли остались ее размеры, количество узлов и наличие сосудистой инвазии

Advanced liver disease in Russian children and adolescents with chronic hepatitis C.

Russia has one of the highest prevalences of paediatric chronic hepatitis C infection (CHC). Our aim was to provide a detailed characterization of children and adolescents with CHC including treatment outcomes. Thus, an observational study of children with CHC aged <18 years was conducted in three hepatology centres from November 2014 to May 2017. Of 301 children (52% male), 196 (65%) acquired HCV vertically, 70 (23%) had a history of blood transfusion or invasive procedures, 1 injecting drug use and 34 (11%) had no known risk factors. Median age at HCV diagnosis was 3.1 [interquartile range, IQR 1.1, 8.2] and 10.8 [7.4, 14.7] at last follow-up. The most common genotype was 1b (51%), followed by 3 (37%). Over a quarter of patients (84, 28%) had raised liver transaminases. Of 92 with liver biopsy, 38 (41%) had bridging fibrosis (median age 10.4 [7.1, 14.1]). Of 223 evaluated by transient elastography, 67 (30%) had liver stiffness ≥5.0 kPa. For each year, increase in age mean stiffness increased by 0.09 kPa (95% CI 0.05, 0.13, P < 0.001). There was significant correlation between liver stiffness and biopsy results (Tau-b = 0.29, P = 0.042). Of 205 treated with IFN-based regimens, 100 (49%) had SVR24. Most children (191, 93%) experienced adverse reactions, leading to treatment discontinuation in 6 (3%). In conclusion, a third of children acquired HCV via nonvertical routes and a substantial proportion of those with liver biopsy had advanced liver disease. Only half of children achieved SVR24 with IFN-based regimens highlighting the need for more effective and better-tolerated treatments with direct-acting antivirals. Further studies are warranted in Russia on causes and prevention of nonvertical transmission of HCV in children

Посмертная характеристика гипоплазии легких при диафрагмальной грыже: МРТ – патоморфологические сопоставления

Purpose: the study of postmortem MRI possibilities for the diagnosis of lung hypoplasia in congenital diaphragmatic hernia.Materials and methods. A comparison of the results of postmortem MRI study and data of pathoanatomical autopsy of 23 newborns was performed. In group I, the bodies of 10 deceased newborns with congenital diaphragmatic hernia without operative intervention were examined. In group II – the bodies of 7 newborns who died after surgery for congenital diaphragmatic hernia. Group III (control) included 6 bodies of newborns without diaphragmatic hernia and signs of lung hypoplasia. Before the autopsy, an MRI study was performed on a 3T Magnetom Verio device (Siemens, Germany) in standard T1 and T2 modes. The volumes of the lungs and chest cavity were calculated in the analysis of the tomograms data and their 3D reconstruction. The stage of the lung development and number of radial alveoli were identified at the microscopic study of histological preparations.Results. As a result of the postmortem MRI study, it was established that the observations of group I are characterized by minimal lung volumes. The mean lung volume on the side of the diaphragmatic hernia was 4.1 times less than the contralateral lung (p &lt; 0.01), and the mean values of the volume of both lungs were 4.6 times less than the corresponding values of the control group (p &lt; 0.01) . The average value of the specific volume of the lungs in newborns who died as a result of congenital diaphragmatic hernia (group I) was 8.8%, which is 4.2 times less than the control group (p &lt; 0.01) and was accompanied by histological signs of hypoplasia. The operation in Group II observations led to an increase in lung size. However, the specific volume of the lungs in this group remained by 18.6% less than the control group, and on histological specimens there were signs of lung hypoplasia.Conclusion. The postmortem MRI of dead newborns allows for an objective quantification of lung volumes and verifies the presence of hypoplasia. This helps to clarify the pathogenesis and determine the immediate cause of death. Indices of specific lung volume relative to the chest cavity of less than 20% indicate lung hypoplasia as the immediate cause of death of the newborn.Цель исследования: изучение возможностей посмертной МРТ для диагностики гипоплазии  легких при врожденной диафрагмальной грыже.Материал и методы. Проведено сопоставление результатов посмертного МРТ- исследования и данных патологоанатомического вскрытия 23 тел новорожденных. Группу I  составили тела 10 умерших новорожденных, страдавших врожденной диафрагмальной  грыжей без оперативного вмешательства; группу II – тела 7 новорожденных, умерших после операции по поводу врожденной диафрагмальной грыжи; группа III (контрольная) представлена 6 наблюдениями новорожденных без диафрагмальной грыжи и признаков  гипоплазии легких. До аутопсии проводили МРТ-исследование на аппарате 3 T Magnetom  Verio (Siemens, Германия) в стандартных Т1- и Т2-режимах. При анализе данных полученных томограмм и их 3D-реконструкции были рассчитаны объемы легких и  грудной полости. При микроскопическом исследовании гистологических препаратов  определяли стадию развития легких, а также количество радиальных альвеол.Результаты. В результате проведенного посмертного МРТ-исследования установлено, что  наблюдения группы I характеризуются критически малыми объемами легких. Среднее  значение объема легкого на стороне диафрагмальной грыжи было в 4,1 раза меньше показателей контралатерального легкого (р &lt; 0,01), а средние значения объема  обоих легких были меньше соответствующих показателей контрольной группы в 4,6 раза (р  &lt; 0,01). Среднее значение удельного объема легких у новорожденных, погибших в  результате врожденной диафрагмальной грыжи (группа I), составило 8,8%, что в 4,2 раза  меньше показателей контрольной группы (р &lt; 0,01), и сопровождалось гистологическими признаками гипоплазии. Проведение операции в наблюдениях группы II приводило к  увеличению размеров легких. Однако удельный объем легких в группе оперированных  новорожденных оставался на 18,6% меньше показателей контрольной группы, а на гистологических препаратах отмечались признаки гипоплазии легких.Заключение. Выполнение посмертной МРТ тел умерших новорожденных позволяет  провести объективную количественную оценку объемов легких и тем самым  верифицировать наличие гипоплазии, что способствует выяснению звеньев патогенеза и  определению непосредственной причины смерти. Показатели удельного объема легких  относительно грудной полости менее 20% свидетельствуют о гипоплазии легких как непосредственной причине смерти новорожденного

ПОРАЖЕНИЕ ЛЕГКИХ ПРИ ГРИППЕ У ДЕТЕЙ

The article presents the results of clinical and laboratory studies of patients with influenza complicated by pneumonia. Peculiarities of clinical manifestations of pneumonia caused by influenza virus have been disclosed.В статье представлены результаты клинико-лабораторных исследований больных гриппом, осложненным пневмонией. Выявлены особенности клинических проявлений пневмонии при А(H1N1)pdm09 и А(H3N2)

Postmortem radiology studies in global and national healthcare: literature analysis and perspectives of Russian specialists

Despite the significant importance of autopsies for determining the cause of death and the evaluating the effectiveness of treatments, there is a progressive decrease in their number across all countries. At the same time, there is an active introduction of postmortem radiological studies to analyze the bodies of deceased patients. The article presents literature analysis summarizing the results of surveys from foreign specialists, as well as the opinions of Russian specialists, regarding the possibilities and features of postmortem radiological studies, mainly focusing on deceased newborns and infants. It is noted that postmortem radiological studies are carried out as part of both pathoanatomical autopsy and forensic medical examination. Postmortem computed tomography in cases of violent death and postmortem magnetic resonance imaging in cases of death from diseases were performed more often. General clinical equipment located in clinical radiology departments was more frequently used than those located in the mortuary, pathology department, or forensic facility. The analysis of the results of postmortem radiological examinations was predominantly carried out by radiologists, with a joint analysis involving a radiologist and a pathologist being less common. It is emphasized that in the Russian Federation, postmortem radiological studies are mostly of a single nature. According to Russian researchers, in the current era of advancing personalized medicine, radiation techniques, and information technologies, there arises a need to use postmortem radiological studies to objectify and improve the accuracy of traditional autopsies. Postmortem radiological studies, which are objective operator-independent methods of examining the bodies of dead people, should be considered as a highly effective stage of pathology and, especially, forensic autopsy

Analysis of statistical indicators of congenital anomalies as causes of early neonatal death in the Russian Federation

The article contains the analysis of Rosstat data for 2012–2016 on early neonatal death due to congenital developmental anomalies. From 2012 to 2016 there was an annual progressive decrease in the number of early neonatal deaths (from 6969 to 4113) in the Russian Federation. The total number of newborns died in the first 168 hours of life due congenital anomalies decreased from 1126 (2012) to 759 (2016), while the values of early neonatal mortality decreased from 366.4 to 217.8. However, the proportion of such infants increased from 16.2% (2012) to 18.5% (2016) from the total number of deaths in the early neonatal period. The type of defects and the frequency of their registration as the initial cause of early neonatal death differ in the federal districts of the Russian Federation and there are certain gender differences.Conflict of interest: The authors of this article confirmed the lack of conflict of interest and financial support, which should be reported