RESUMEN
OBJECTIVE: To carry out a clinical and morphological analysis of thyroid cancer cases in the children of the Chelyabinsk Region. SUBJECT AND METHODS: Thyroid tumor pathology was verified in 50 of the 196 patients aged 7-17 years, who had been operated on in 2000-2016. Clinical and morphological features, including immunohistochemical and ultrastructural characteristics of thyroid cancer, were studied. RESULTS: Over the past 17 years, there has been a decline in the number of children with surgical thyroid diseases, including thyroid carcinomas. There is a predominance of papillary carcinoma (70%) that is characterized by more aggressive clinical and morphological signs than follicular and medullary thyroid carcinoma. The immunophenotype of follicular cell tumors in children is characterized by the expression of growth factors (TTF-1, EGFR-384) and malignancy markers (mesothelial cell, AMACR (P504S), S 100). CONCLUSION: The vector change (decrease) in the long-term unfavorable trend toward an increasing incidence of thyroid cancer in children of the Chelyabinsk Region is currently accompanied by the pathomorphism of thyroid carcinoma.
Asunto(s)
Carcinoma Papilar , Neoplasias de la Tiroides , Adolescente , Carcinoma Papilar/diagnóstico por imagen , Niño , Humanos , Racemasas y Epimerasas , Federación de Rusia , Neoplasias de la Tiroides/diagnóstico por imagenRESUMEN
Perinatal mortality rate is an indicator that characterizes the quality of medical care, as well as the social and economic situation in the region. OBJECTIVE: to audit perinatal losses in large regional centers of the Russian Federation with a population of over 1 million inhabitants, such as Chelyabinsk and Novosibirsk. MATERIAL AND METHODS: A comprehensive postmortem examination of 309 cases of perinatal losses in 2016 was made, which was supplemented with an assessment of preventability according to the Scandinavian-Baltic classification. RESULTS: The rate of preventable deaths in Chelyabinsk and Novosibirsk amounted to 91 and 81.5% of cases, respectively; the deaths were due to stillbirths at more than 28 weeks' gestation and to dead newborns in almost half of cases. The proportion of intranatal deaths was shown to increase in Chelyabinsk; the number of neonatal deaths at more than 33 weeks' gestation rose in Novosibirsk. CONCLUSION: Supplementing the traditional clinical and postmortem analysis with an assessment of the preventability of perinatal loss makes it possible to ensure a unified approach to evaluating these conditions and the comparability of autopsy results in different subjects of the Russian Federation and to determine regional reserves for reducing perinatal mortality rates.
Asunto(s)
Mortalidad Infantil , Mortalidad Perinatal , Mortinato , Ciudades , Femenino , Humanos , Lactante , Mortalidad Infantil/tendencias , Recién Nacido , Mortalidad Perinatal/tendencias , Embarazo , Federación de Rusia/epidemiologíaRESUMEN
The paper describes a case of giant (123 x 109 x 70-mm) placental chorioangioma that is a capillary hemangioma in structure, which led to significantly impaired placental-fetal blood flow to give rise to non-immune hydrops and right heart failure in the fetus at 33 weeks' gestation; obvious polyhydramnios developed. This served as an indication for preterm one-stage cesarean delivery. A premature live girl was born with a weight of 2430 g, a height of 44 cm, Apgar score 6-7. Dynamic echographic monitoring makes it possible to record increased placental tumor sizes and fetal abnormalities and to make a timely decision on delivery, which promotes perinatal death prevention. At 11-month follow-up, the child's physical and mental developments were for age.
Asunto(s)
Hemangioma Capilar/patología , Hemangioma/patología , Placenta/patología , Femenino , Feto/patología , Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/patología , Hemangioma/complicaciones , Hemangioma/diagnóstico , Hemangioma Capilar/complicaciones , Hemangioma Capilar/diagnóstico , Humanos , Recién Nacido , Trabajo de Parto Prematuro , Embarazo , Complicaciones del EmbarazoRESUMEN
Comprehensive study of the "normal" thyroid gland in fetuses and children of different age groups in the Chelyabinsk region revealed a number of changes characteristic of the so-called dysregulation pathology. The role of ecological factors and outcome of resuscitation and intensive therapy in these changes is discussed. It is shown that the development and manifestation of tumoral and non-tumoral diseases of thyroid gland prone to a combination of various diseases are delayed till the school age.