scholarly journals The rationale for dislocation of interregional specialized surgical care centers for children in the Russian Federation

2020 ◽  
Vol 10 (3) ◽  
pp. 263-274
Author(s):  
Vladimir M. Rozinov ◽  
Dmitriy A. Morozov ◽  
Sergey A. Rumyantsev ◽  
Nikolay N. Vaganov ◽  
Vladimir I. Petlakh ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Medical Care ◽  
Russian Federation ◽  
Current System ◽  
Surgical Care ◽  
Federal District ◽  
Urgent Care ◽  
High Tech ◽  
Universal Method ◽  
The Russian Federation

Introduction. In Russia, there is a need to reorganize the system of providing specialized surgical care to children, primarily in emergency and urgent care and in remote, sparsely populated, and hard-to-reach areas. This need is evidenced by the significant persisting disparities in the mortality rate in the countrys various regions. Purpose of the study. This study aims to provide multifactorial substantiation of the expediency, profile, and location of specialized (surgical) interregional centers (MRC), including high-tech, medical care for children, by the priority profiles of activity, about medical organizations of the federal districts (FD) of Russia. Materials and methods. The study design included a two-level (regional and federal) system of professional expertise and justification in terms of the profile, location, and area of responsibility of the MRC in the federal district of the country. At the regional level, Delphi technology was implemented with a mathematical and statistical analysis of 103 expert opinions from 85 constituent entities of Russia, the result of which activities priority profiles were substantiated (newborn surgery, neurosurgery, thoracic surgery, oncology, combustiology) and patient routing preferences. At the second stage of the work, with the involvement of federal experts, the SWOT analysis technology was implemented as a universal method of strategic planning, with the justification of the location and number of MRCs in individual FD of the country, about specific medical organizations where they are based. For an objective (quantitative) assessment of the provision of the Federal District of Russia with the MRC of specialized medical care for children according to the established profiles of activity, we have proposed a calculated indicator the regional contingency coefficient (CRC), representing the ratio of two uniformly calculated values the number of MRCs and regions in a particular Federal District, or the country as a whole. Results. The consolidated position of federal experts regarding the location of the MRC was formulated according to the established profiles of activity about FD and specific medical organizations in the Russian Federation constituent entities. The cattle in the profile of the activity of neonatal surgery was 0.14, and about neurosurgery, thoracic surgery, and oncology, respectively, 0.12, 0.11, and 0.11 for Russia as a whole. The lowest (0.09) cattle in the country characterized the situation with the combustiology profile. In the overwhelming majority (76.0%), the location of the MRC is tied to the administrative centers of the Federal District or cities of federal significance. Among the 50 MRCs of all priority profiles, 43 (86%) were potentially designated by experts based on multidisciplinary pediatric medical organizations. Discussion. The effectiveness of the MRC functioning is due to the organization of medical and evacuation support for children with diseases and injuries. The development of consultative and resuscitation centers in the primary hospital structure is promising. Its functionality, along with remote counseling, treatment, and evacuation activities, includes monitoring the condition of sick and affected children at the place of primary hospitalization. An alternative is a presence on the clinical base of the MRC of a structural unit or a branch of the regional center for emergency medical care and disaster medicine. Conclusion. Overcoming the inequality in the availability and quality of medical care for children in certain FD and regions of Russia is necessary to reorganize the current system of staged medical care. Optimal logistics of medical and evacuation support for specialized patients and injured people include the MRC as a collector for children in need of specialized care, including high-tech medical care, with the implementation of the predominant principle of evacuation of oneself.

scholarly journals Analysis of the availability and direction of improvement of medical care for patients with malignant neoplasms in the Moscow region

2018 ◽  
Vol 5 (4) ◽  
pp. 106-117
Author(s):  
E. Yu. Ogneva ◽  
A. N. Gurov ◽  
M. V. Pirogov ◽  
E. V. Gameeva ◽  
O. Yu. Aleksandrova
Keyword(s):  
Medical Care ◽  
Cancer Patients ◽  
Russian Federation ◽  
Federal District ◽  
Moscow Region ◽  
High Tech ◽  
Malignant Neoplasms ◽  
Patients With Cancer ◽  
The Subject ◽  
The Russian Federation

Purpose. Carrying out medical and statistical analysis of morbidity and mortality of the population with malignant neoplasms, development of proposals for greater accessibility and areas of improvement of specialized including high-tech medical care (HTMC) for patients with cancer in the Moscow region.Materials and methods. The analysis of morbidity and mortality of the population of the Moscow region from malignant neoplasms and the organization of specialized, including high-tech, medical care to cancer patients on the basis of forms of Federal state statistical observations in relation to the three-level system of the organization of medical care to the population of the region with identification of organizational and financial problems.Results. The incidence of malignant neoplasms in the Moscow region in 2017 amounted to 364.9 per 100 thousand population, which is 1.0% below the level of 2016-365.9 per 100 thousand population and below the average for the Central Federal district and the Russian Federation. The mortality rate from neoplasms in the Moscow region decreased in 2017 to 174.7 cases per 100 thousand population, which is less than the average for the Central Federal district — 207.1 and the Russian Federation — 196.9 per 100 thousand population. At the same time, the volume of specialized medical care (including high — tech medical care) for malignant tumors, in a 24-hour hospital is more than twice the average Russian standard — 13% for SMC and 50% for HTMC. Exceeding the standard of medical care is mainly due to the HTMC 2, which is not planned in the subject of the Russian Federation and is usually in Federal clinics. The share of oncological medical care received outside the medical organizations of the MR is 16%, which exceeds the share of medical care in all other profiles received outside the Moscow region (12%). This situation contributes to the availability of cancer care to the population of the Moscow region.Conclusion. The performed work allowed to draw conclusions that in normative legal acts of Federal level it is necessary to define separately the standard of volumes of specialized, including hi-tech medical care, on the profile of Oncology. Large volumes of HTMC cannot be an unambiguous characteristic of the availability of medical care in General, since HTMC is medical care with the use of complex methods of diagnosis and treatment in clinically complex cases. Large volumes of HTMC can be a consequence of the complexity of clinical cases, but also a consequence of neglect of the disease due to the lack of diagnosis and treatment in the provision of primary health care (PHC) at the 1st level. In the Moscow region, there is a need to redistribute the volume of this medical care not only to cancer dispensaries, but also to other medical organizations. After that, there is a need for the distribution of patients, taking into account the morbidity in the territories, the place of residence of citizens, and taking into account the capabilities of medical organizations for the treatment of cancer patients (surgical treatment, chemotherapy, radiotherapy). Medical organizations of the subject of the Federation shall be ranked taking into account the applied technologies and opportunities of drug therapy. As a result, a clear routing of patients with cancer should be developed in the subject of the Russian Federation.

Some indices characterizing medical care to children with cancer in the Russian Federation

2016 ◽  
Vol 21 (3) ◽  
pp. 146-150
Author(s):  
Maksim Yu. Rykov ◽  
N. A Susuleva ◽  
V. G Polyakov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Pediatric Oncology ◽  
Federal District ◽  
Controlled Study ◽  
High Tech ◽  
North Caucasus ◽  
Children With Cancer ◽  
The North ◽  
The Russian Federation

Introduction. The large size of the Russian Federation, different size and density of the child population in the regions of the country require for careful planning organization of care for children with cancer and the rational use of available resources, since in spite of the significant progress made in pediatric oncology, malignant neoplasms (External testing) are the second most common cause of the death in children. Purpose of the study. Perfection of the organizational-methodological approaches to care for children with cancer in Russia in order to improve the quality and effectiveness of treatment. Material and methods. In a non-randomized non-controlled study there were included reports of regional ministries and departments of health from 83 subjects of the Russian Federation for 2013. Results. The highest incidence rate of malignant tumors (per 100,000 ofpopulation agedfrom 0 to 17 years) was registered in the Lipetsk region - 21.7, the lowest - in the Republic of Tyva - 5.5. The number of patients newly diagnosed in 2013 was the highest in the Central and Volga Federal Districts - 775 and 653, respectively. The smallest - in the Far Eastern Federal District - 138. The number of primary patients referred to the federal clinic, was the largest in the North Caucasus Federal District (North Caucasus Federal District) - 80%, the lowest - in the South - 32.5%, the largest number of doctors who do not have primary specialization in “Children’s oncology”, was registered in the North Caucasus Federal District and the Volga Federal District - 50%, the lowest - Urals - 14.2%. Total in Russia 51 children’s oncological department operate, while the number of beds in which we treat these patients, including beds in non-core branches is 2021. 390 doctors treat children with cancer, out of which 252 (64, 6%) did not have a certificate in pediatric oncology. In 2013, 33 78 children were registered with the External testing, 1705 (50.5%) of them were directed for the management in federal clinics. Conclusion. It is necessary to improve further the existing vertical provision of high-tech medical care for children with cancer, the creation of regional cancer registers, certification of specialists and the quality control of medical care through the implementation of internal and external audit.

scholarly journals Monitoring in obstetric critical care (“maternal near miss”) in the Northwestern Federal District of the Russian Federation in 2018-2019

2021 ◽  
Vol 70 (1) ◽  
pp. 5-18
Author(s):  
Vitaly F. Bezhenar ◽  
Oleg S. Filippov ◽  
Leila V. Adamyan ◽  
Igor M. Nesterov
Keyword(s):  
Maternal Mortality ◽  
Medical Care ◽  
Russian Federation ◽  
Federal District ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Integral Model ◽  
Internal Quality ◽  
Quality Of Medical Care ◽  
The Russian Federation

This article presents data of monitoring critical obstetric conditions (maternal near miss) for the purpose of auditing the quality of medical care and prevention of maternal mortality, obtained on the basis of an analysis of statistical data from eleven federal subjects of the Northwestern Federal District of the Russian Federation for 2018-2019. We characterized the critical obstetric conditions that allow avoiding maternal mortality cases, which, in modern legal practice, most often require forensic examinations on the fact of providing obstetric and gynecological medical care of inadequate quality. We determined that the main causes of maternal mortality cases (83.1% in 2018 and 84.0% in 2019) were massive obstetric bleeding and complications of severe preeclampsia, which more often occurred during childbirth and the first days of the postpartum period. All patients who survived a near death condition belonged to the group of high obstetric and perinatal risk, but most of them were delivered in obstetric hospitals of the second level, with more than half of the women by caesarean section. We discussed the main ways of preventing and reducing the incidence of critical obstetric conditions and maternal mortality based on the improved modern integral model of internal quality control of medical care in obstetric institutions. We also discussed the findings based on the introduction into practice of medical, organizational and methodological (including telecommunication and other) technologies aimed at increasing professional competencies in the regions of the country. Special attention is drawn in this article to the need to systematize and develop uniform and clear criteria for assessing critical obstetric conditions.

scholarly journals Treatment of patients with malignant lymphoproliferative diseases in the Russian Federation: analysis of the data from 75 regions

2019 ◽  
Vol 11 (4) ◽  
pp. 3-15
Author(s):  
G. R. Hachatryan ◽  
T. S. Teptsova ◽  
V. A. Lemeshko ◽  
N. Z. Musina
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
High Tech ◽  
Lymphoproliferative Diseases ◽  
Number Of Patients ◽  
Icd 10 ◽  
The Russian Federation ◽  
Specialized Institutions

The aimis to analyze the medical records of patients with malignant lymphoproliferative diseases (LPD) in the Russian Federation in 2016- 2017.Materials and methods. Treating physicians in 75 regions of the Russian Federation were asked to fill the survey questionnaire containing 9 types of malignant LPDs (according to the ICD-10 classification). The questions covered the epidemiology of LPD (prevalence, resistant forms, relapses and mortality), the existence of specialized institutions and beds, the costs of medical care in patients with malignant LPD, and the financial support of pharmacotherapy in these patients during their hospital stay.Results. We found that the most common malignant LPD in 2016-2017 was Hodgkin’s lymphoma (73.5 and 73.4%, respectively). The prevalence of resistant forms and recurrences of malignant LPD over this period accounted for 6.8% of the total patient population. In 2017, the number of patients who died was 7.5% less than that in 2016. There are 815 and 1,763 specialized institutions of the oncology and hematology profiles that provide medical care to children and adult patients, respectively. Among the malignant LPDs, the highest costs of drug therapy in 2016 pertained to lymphosarcoma, and in 2017 – to Hodgkin’s lymphoma. In the system of compulsory health insurance (OMC), the largest spending for both adult and pediatric patients in 2016 and 2017 was accounted for Hodgkin’s lymphoma; a similar result was obtained for the cost of therapy based on high-tech medical care.Conclusion. In 2017, the total number of patients with malignant LPD in the Russian Federation increased by 2.65% as compared to 2016, while the proportion of primary LPD decreased by 1.2%. In 2017, the total costs of drug supply in patients with malignant LPD in the RF increased by 55.35% as compared with 2016.

REVISITING THE QUESTION OF COMPLIANCE WITH DEPARTMENTAL REGULATORY LEGAL ACTS OF THE PENAL SYSTEM OF RUSSIA, REGULATING THE PROCEDURE OF RENDERING AND QUALITY OF MEDICAL ASSISTANCE TO PENAL STAFF AND THE REQUIREMENTS OF FEDERAL LEGISLATION

2020 ◽  
pp. 77-84
Author(s):  
Олег Алексеевич Свидерский
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Medical Service ◽  
Legal Regulation ◽  
High Tech ◽  
Medical Assistance ◽  
Quality Of Medical Care ◽  
The Russian Federation ◽  
Correction System

В статье поднимаются отдельные вопросы правового характера оказания медицинской помощи сотрудникам УИС в лечебно-профилактических учреждениях ФСИН России, МВД России, Минобороны России, а также в учреждениях государственной или муниципальной систем здравоохранения. Проведен анализ нормативных баз Минздрава России и Минюста России, в которых осуществляется регламентирование вопросов оказания медицинской помощи. Показано, что в федеральных и ведомственных нормативно-правовых актах Минюста России законодательно не закреплен порядок оказания высокотехнологичной медицинской помощи по перечню видов, которые не включены в базовую программу ОМС. В целях устранения пробела в законодательстве предлагается медицинской службе ФСИН России разработать соответствующий регламент, в котором прописать перечень необходимых документов и порядок направления на лечение нуждающихся сотрудников. Проведенный опрос сотрудников УИС показал, что более 2/3 респондентов недовольны не только условиями, в которых оказываются медицинские услуги, но и качеством оказанной им медицинской помощи. Рассмотрены права и возможности сотрудников УИС по предъявлению претензий к лечебному учреждению в случае неудовлетворенности качеством оказанной медицинской услуги (помощи). Анализируются проблемы правового регулирования и практического решения вопроса, оценки качества оказанной медицинской услуги (помощи). Предлагается сформировать в системе ФСИН России институт экспертов по оценке качества медицинской помощи. The article raises certain issues of the legal nature of the provision of medical assistance to the penal correction system in medical institutions of the Federal Penitentiary Service of Russia, the Ministry of Internal Affairs of the Russian Federation, the Ministry of Defense of the Russian Federation, as well as institutions of the state or municipal health systems. The analysis of the regulatory framework of the Ministry of Health and the Ministry of Justice, which regulates the provision of medical care. It is shown that the federal and departmental regulatory legal acts of the Ministry of Justice do not legislatively regulate the procedure for providing high-tech medical care according to the list of species that are not included in the basic program of compulsory medical insurance. In order to fill the gap in the legislation, it is proposed that the medical service of the Federal Penitentiary Service of Russia develop an appropriate regulation in which a list of necessary documents and the procedure for referring treatment to needy employees are prescribed. A survey of employees of the penal correction system showed that more than 2/3 of respondents are dissatisfied not only with the conditions in which medical services are provided, but also with the quality of medical care provided to them. The rights and possibilities of the penitentiary system staff to make claims to a medical institution in case of dissatisfaction with the quality of the medical service (assistance) provided are examined. The problems of legal regulation and practical solution of the issue, assessing the quality of the medical service (assistance) provided are analyzed. It is proposed to form an institute of experts in the FSIN system for assessing the quality of medical care.

Medical Care for Children with Cancer in the North-West Federal District of the Russian Federation: An Ecological Study

2018 ◽  
Vol 5 (3) ◽  
pp. 155-163 ◽  
Author(s):  
M. Yu. Rykov ◽  
I. A. Turabov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Care Delivery ◽  
Pediatric Population ◽  
Federal District ◽  
Children With Cancer ◽  
North West ◽  
The North ◽  
Bed Capacity ◽  
The Russian Federation

Background.Analysis of statistical data in the federal districts of the Russian Federation provides opportunities to assess the quality of medical care delivery in children with cancer and plan further development with consideration for the point elimination of existing defects. Objective. Our aim was to analyze the main indicators characterizing medical care for children with cancer in the North-West Federal District.Methods.The study analyzed operative reports for 2017 provided by the executive public health authorities of 11 subjects of the Russian Federation affiliated to the North-West Federal District.Results.The pediatric population was 2 537 133 children (0–17 years), the pediatric oncological bed capacity — 174 (0.7 per 10 000 aged 0–17 years), the annual berth average occupancy — 290.7 days. 6 (54.5%) subjects did not provide pediatric population with departments of pediatric oncology, 4 (36.4%) subjects did not have bed capacity. The number of practitioners providing medical care to children with cancer was 38, 27 among them (71%; 0.1 per 10 thousand 0–17 years) had a certificate of pediatric oncologist. 2 (18.2%) subjects did not have pediatric oncologists in the medical stuff. The incidence of malignant tumors in children aged 0–17 was 15.6 (per 100,000), the prevalence was 92.6 (per 100,000), the mortality rate was 2.6 (per 100,000), one-year mortality rate — 4.5% (18/397). The number of patients identified actively was 11 (2.8%). 160 (40.3%) primary patients were sent to Federal medical facilities, 6 (1.5%) — left the territory of the Russian Federation for the further treatment.Conclusion.The incidence and mortality rates are rather low which indicates the defects in patient detection and lack of reliable follow-up data. The percentage of patients referred for treatment to Federal medical facilities is not very high; however, to interpret this indicator according to patient routing, we have to analyze the medical history of all the patients. We can assert that health care delivery service for children with oncological diseases is at an acceptable standard level but needs to be improved. 

scholarly journals INTERREGIONAL CENTERS FOR SPECIALIZED PEDIATRIC SURGICAL AID IN RUSSIA – PROFILE AND DISLOCATION

2019 ◽  
Vol 9 (1) ◽  
pp. 8-16 ◽  
Author(s):  
V. M. Rozinov ◽  
D. A. Morozov ◽  
S. A. Rumyantsev ◽  
N. N. Vaganov ◽  
A. K. Fedorov ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Russian Federation ◽  
Healthcare Providers ◽  
Federal District ◽  
Medical Aid ◽  
Pediatric Hematology ◽  
Expert Opinions ◽  
National Medical ◽  
Coefficient Of Concordance ◽  
The Russian Federation

Introduction. Russia needs to reform the stepwise model for delivering medical aid to children with surgical diseases and traumas mobilizing patients and those injured at specialized Interregional Centers (IRC). Purpose. To substantiate profiles and dislocation of IRC providing surgical aid to children in Russia. Material and methods. 103 specialists from 85 territorial entities of the Russian Federation presented their expert reviews concerning profiles and dislocation of IRC that provide surgical aid to children in accordance with the nomenclature of professions and administrative structure of the country. The expert reviews were analyzed using the methods of descriptive statistics to rate IRC profiles, their territorial dislocation, and focus on interaction of those surveyed with certain medical organizations. Consistency of expert opinions was estimated using Kendall’s coefficient of concordance. Results. Experts indicated 14 activity profiles of IRC providing surgical aid to children. According to rating results, more than a half of positive estimates belonged to five priority profiles including surgery of neonates, neurosurgery, oncology, thoracic surgery and combustiolgy. As far as IRC dislocation is concerned, experts mainly considered medical organizations within a federal district of territorial entities of the Russian Federation. Total number (287) of references (by priority profiles) to hospitals within territorial entities of Russia was 4 times more than the respective estimate (66) for federally governed healthcare providers. Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology that served as a base for potential IRC (oncology) was the most in-demand (19 requests) federal structure. Conclusion. Community of professionals has come to a consolidated opinion according to which buildup of IRC providing care in neonatal surgery, neurosurgery, oncology, thoracic surgery, and combustiology at children’s hospitals in territorial entities of the Russian Federation and 13 federally governed clinical research centers is a significant factor of providing affordable and qualitative medical aid.

scholarly journals Medical care for children with cancer in the Siberian Federal District

2019 ◽  
Vol 18 (1) ◽  
pp. 5-12
Author(s):  
M. Yu. Rykov
Keyword(s):  
Mortality Rate ◽  
Medical Care ◽  
Russian Federation ◽  
Federal District ◽  
Siberian Federal District ◽  
Children With Cancer ◽  
Aim Analysis ◽  
Incidence And Mortality ◽  
Hospital Beds ◽  
The Russian Federation

background. The analysis of the quality of medical care for children with cancer is based on statistical data. Evaluation of the results obtained is also the basis of the strategy for the development of medical care for this category of patients. aim: analysis of the main parameters characterizing medical care for children with cancer in the Siberian Federal District. material and methods. The reports for 2017 on the health protection of 11/12 (91.6 %) constituent entities of the Russian Federation belonging to the Siberian Federal District were analyzed (Irkutsk Region did not provide data). results. In 2017 the number of children aged 0–17 years was 3 722 470, the number of pediatric hospital beds for children with cancer (ages 0–17 years) was 260 (0,7 per 10,000), and the average number of bed-days per year was 342.2. In 3 (25 %) constituent entities of the Russian Federation, there were no departments of pediatric oncology and in 1 (8,3 %) there were no hospital beds for children with cancer. The number of physicians, who specialized in children’s cancer was 49, of them 32 (65,3 %, 0,08 per 10,000, ages 0–17 years) had a certificate of a pediatric oncologist. In 1 (8,3 %) constituent entity of the Russian Federation, there were no pediatric oncologists. For children aged 0–17 years, the cancer incidence rate was 11.7 per 100,000 children, the cancer mortality rate was 2,2 per 100,000, and one-year mortality rate was 7,4 %. 188 (43,2 %) primary cancer patients were referred to medical institutions of the Federal District, and 17 (3,9 %) primary patients left the territory of the Russian Federation. conclusion. The low incidence and mortality rates can be explained by the lost of reliable follow-up data. It is advisable to introduce electronic health record systems. For reliable estimation of hospital bed supply for children with cancer and percent of patients referred to medical centers for treatment, it is necessary to carry out a clinical audit. Deficiency of pediatric oncologists should be eliminated by reforming the training of medical personnel.

scholarly journals Medical care for children with cancer in the Central Federal District

2018 ◽  
Vol 63 (6) ◽  
pp. 75-82 ◽  
Author(s):  
M. Yu. Rykov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Pediatric Oncology ◽  
Conflict Of Interest ◽  
Federal District ◽  
Malignant Neoplasms ◽  
Age Group ◽  
Children With Cancer ◽  
Central Federal District ◽  
The Russian Federation

Relevance. Statistical indicators are the basis for planning of the organization of medical care for children with cancer, as well as analysis of the effectiveness of medical care. Materials and methods. The authors have analyzed operational reports for 2017 of the executive authorities in the field of health care of 18 objects of the Russian Federation being part of the Central Federal District. Results. There 9 pediatric oncology departments, there are 464 children’s oncological beds, the bed occupancy per yearis 319.3. There are 91 doctors providing medical care to children with cancer, 64 (70.3%) of the doctors have a certificate of pediatric oncologist. In 11 subjects there are no Departments for Pediatric Oncology. There are 821 primary patients with malignant neoplasms. There are 156 deceased patients, 66 of them were diagnosed in 2017. 52 (6.3%) patients are revealed actively. There were 12 (per 100 thousand for the age group of 0–17 years) cases of incidence of malignant neoplasms, mortality is 2.3 (per 100 thousand for the age group of 0–17 years), one-year mortality is 8%. The average time taken to diagnose and to verify the diagnosis before the beginning of treatment remains unknown. Conclusion. Operational reports contain non-matching indicators, thus, the information is not completely reliable. Incidence rates are significantly lower than those in countries with high reliability of statistical data. The percentage of patients identified actively remains extremely low. In order to eliminate the noted defects, it is necessary to introduce a single database of children with cancer in the Russian Federation.Conflict of interest: The author of this article confirmed the lack of conflict of interest and financial support, which should be reported.

Sign in / Sign up

Export Citation Format

Share Document