The physical development of newborns and infants is the most important parameter in assessing their health. However, the standards of anthropometric parameters, and most importantly their growth in premature babies, especially those born with low and extremely low body weight, are still controversial.Objective: to apply the methodology for measuring and assessing the main anthropometric indicators of newborns using the international standards of postnatal growth of premature babies INTERGROWTH-21st to resolve the issue of the feasibility of its adaptation and widespread introduction into neonatological and pediatric practice in the Russian Federation. 4876 children were born at Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology (participant of the international project for the implementation of INTERGROWTH-21st standards in neonatological and pediatric practice) from 15.05.2018 to 26.11.2018. 439 (9%) of them were born premature, of which 376 children (89,3%) with gestational age confirmed by ultrasound were included in the study. There was a detailed file for each child to assess the environment and health of the mother, the course of pregnancy, childbirth, the state of health of the child from birth to discharge from the hospital. 2.1% of children classified by INTERGROWTH-21st as children with intrauterine growth retardation, according to Fenton charts, had normal intrauterine growth. When comparing the postnatal growth at discharge from hospital on the Fenton scale, more children were classified as children with impaired postnatal growth; the discrepancy between INTERGROWTH-21st and Fenton diagrams was 8%. At discharge, 52% of premature babies were exclusively breastfed, 28.8% of premature babies were at mixed feeding.Conclusion. On the one hand, the use of INTERGROWTH-21st scales helps to correct nutrition in case of delay in physical development, and, on the other hand, it reduces the risk of metabolic disorders associated with an aggressive desire to achieve rapid growth of a premature baby.

В данном обзоре литературы представлена актуальная информация о восстановлении репродуктивного здоровья женщин после перенесенной новой коронавирусной инфекции (COVID-19). Рассмотрены такие вопросы, как ведение беременности и аспекты профилактики осложнений у родильниц после перенесенного COVID-19, рекомендации по прегравидарной подготовке, подбору методов контрацепции и проведению вспомогательных репродуктивных технологий после перенесенного COVID-19. В обзоре отражены клинические рекомендации международных профессиональных сообществ, включая RCOG (Королевский колледж акушеров и гинекологов Великобритании) и ESHRE (Европейское общество репродукции человека и эмбриологии). Рассмотрены вопросы взаимосвязи психологического состояния женщин после перенесенного COVID-19 и репродуктивного здоровья.

Background . The article presents the results of external audit of medical care management provided for children with cancers conducted in the regions № 1 and № 2, the South Federal District. Methods . We performed the analysis of medical records for cases of solid tumors in patients who received specialized and symptomatic treatment at the Department of Pediatric Oncology of the Republican Children’s Clinical Hospital (Region № 1) and at the Oncology Centre (Region № 2) in the period 2011–2015. We assessed the treatment compliance with the federal clinical practice recommendations (FCPR) and evaluated the equipping of medical equipment and staffing of medical personnel. Results . We analyzed 20 items of medical equipment, only 11 (55%) positions comply with the recommendations of Annex № 6, 9 (45%) positions are missing. 58 patients with solid malignant tumors were registered in the region in 2011–2015: 31 (53.4%) girls and 27 (46.6%) boys, mean age 6.1 years (1 month – 17 years). 2 (3.4%) patients had stage I disease, 18 (31%) — stage II, 16 (27.6%) — stage III, 22 (37.9%) — stage IV. FCPR had been fully implemented in the treatment of 48 (82.7%) patients. Violations of treatment protocols were revealed in 10 (17.3%) cases. Conclusion . The majority of chemotherapeutic treatment procedures, simple surgery can be performed on the basis of the analyzed department in the Region № 1. There is no need in Oncology Department in the Region № 2 because of a few cases of cancer in children registered each year. These patients are directed to the specialized institutions of the Region № 1. Complex surgery and other phases of the treatment should be provided on the basis of federal research institutes in Moscow or Rostov-on-Don.

The article analyzes the statistical data (morbidity rate for malignant neoplasms, provision of the population with the pediatric oncologists, bed capacity provision) and the results of external audit of medical care delivery for children with oncological diseases. On the basis of that analysis, a new procedure on rendering medical care to children (specialization «pediatric oncology») was developed. It includes patients’ routing protocols as applicable in terms of the 3-level system of medical care. The proposed package of measures is focused on the medical care quality improvement: reduction the percentage of common stages of disease, treatment outcomes improvement, patient routing and spending budget funds optimization, and implementation of federal clinical guidelines.

Background. To improve the quality of medical care for children with cancer should take into account peculiarities of the Russian Federation regions: geographical location, population density and the incidence of child population, medical equipment and staff. Methods. We performed the analysis of medical records for cases of solid tumors (except brain tumors) in children who received specialized and symptomatic treatment at the Department of Oncology and Hematology of the Republican Children’s Clinical Hospital, part of the Volga Federal District № 2 in the period 2011–2015. We assessed the treatment compliance with the federal clinical practice recommendations and evaluated the equipping of medical equipment and staffing of medical personnel. Results. We analyzed 20 items of medical equipment, only 11 (55%) positions comply with the recommendations of Annex № 6, 9 (45%) positions are missing. 81 patients with solid malignant tumors were registered in the region in 2011–2015: 43 (53.1%) girls and 38 (46.9%) boys, mean age 6.2 years (1 month — 17 years). 2 (2.5%) patients had stage I disease, 29 (35.8%) — stage II, 16 (19.8%) — stage III, 34 (42%) — stage IV. Federal clinical recommendations had been fully implemented in the treatment of 69 (85.2%) patients. Violations of treatment protocols were revealed in 12 (14.8%) cases. Conclusion. The majority of chemotherapeutic treatment procedures, simple surgery, including open biopsy can be performed at the analyzed department. Other phases of the treatment should be provided on the basis of specialized research institutes with the more qualified stuff.

The analysis was implemented concerning informational statistic data characterizing health of children population of different age groups in the Russian Federation on the basis of results of dispensarization in its federal okrugs and subjects in 2014. The purpose of the study was to discover ways and modes of developing and increasing efficiency of preventive examinations of underage population. The following indices were analyzed: coverage of children population by preventive medical examinations, distribution according health groups and medical groups for physical culture involvement, level and stricture of established total and primary morbidity, rate of dispensary registration, requirements in additional consultations, examinations and treatment in out-patient condition, day hospital, day-and-night hospital and also coverage with all these medical services. In the most of the subjects of the Russian Federation a high level of coverage of underage population with preventive medical examinations is registered. The percentage of healthy children population in the Russian Federation comprises more than one third of all covered by dispensarization. The significant variations in indices of rate of healthy children and children with functional disorders and chronic diseases in subjects of the Russian Federation is determined by quality and accessibility of medical care at the regional level. The established total and primary morbidity of children population in significant percentage (more than one third) of the subjects has a level higher than a national one. The leading causes of morbidity in children are diseases of respiratory system, musculoskeletal system, nervous system. In adolescents, these causes are diseases of musculoskeletal system, eye diseases and diseases of respiratory system. Despite high prevalence of chronic pathology in children population of the Russian Federation, the guidelines concerning treatment and rehabilitation on the basis of results of preventive medical examinations were developed in inadequate scope. The regional characteristics of the results of dispensarization are established. These results made it possible to sort out the most unfavorable territories and to determine defects in its organization and absence of continuity between medeical institutions providing the given type of medical services.

Introduction . The article presents the results of the external audit conducted in a region of the North Caucasian Federal District where we evaluated the quality of health care services for children with cancer. Patients and methods . We investigated the regional cancer registry data and medical histories of children with solid tumors (except brain tumors) who received specific therapy or symptomatic treatment at the oncology department of the regional hospital or federal research institutes in the period of 2011–2015. Results. The analysis revealed 64 patients who were registered in the region in 2011–2015. The detected group included 28 (43.8%) girls and 36 (56.2%) boys with cancer (age 0–17 years). The group enrolled 5 (7.8%) patients with stage I disease, 14 (21.9%) — with stage II, 19 (29.7%) — with stage III, and 26 (40.6%) — with stage IV. Pediatric oncology facilities are not available at the local level. Partially, specific therapy and symptomatic treatment was performed in 18 (28.1%) patients at the oncology department of the Republican regional hospital and in 46 (71.9%) patients at the federal research institutes. At the moment, 28 (43.8%) patients from the analysed group are alive, the progression of disease resulted in death of 26 (40.6%) patients, and 10 (15.6%) patients dropped out of follow-up. Conclusion . The establishment of the oncology department is reasonable according to the situation in the region. It will provide timely diagnosis, early intervention including chemotherapeutic treatment, and patients’ routing with effective application of budgetary funds.

Introduction : The article presents the analysis of the external audit results of the delivery of medical care in children with cancer conducted in one of the regions of the Volga Federal District (VFD). Materials and Methods : The authors analyzed the clinical histories of children with solid tumors who received specialized treatment in the oncology department of the Regional Children’s Hospital in the period of 2011–2015, and evaluate the available equipment and existing competence of the staff. Results : oncology unit provides 10 beds for inpatient care. 20 main positions of the equipment are required for the department functioning: according to the conducted analysis 10 (50%) items are available and 10 (50%) items do not exist. The department staff includes Head doctor — a pediatric oncologist — a senior nurse, and six ward nurses. Analyzing the case clinical histories, it was found that specialized and symptomatic treatment was provided to 99 patients (44 (44.5%) girls and 55 (55.5%) boys, mean age 6.7 years) with solid tumors in the period of 2011–2015. 6 (6%) patient presented with stage I disease, 23 (23.3%) — with stage II, 32 (32.3%) — with stage III, and 38 (38.4%) — with stage IV. 58 (58.6%) patients underwent chemotherapy, 36 (36.4%) received symptomatic treatment, 4 (4%) patients were provided with palliative care. The surgery was provided at the federal research institutes. At the moment of evaluation, 45 (45.5%) patients from the analyzed group were alive; 15 (15.2%) patients died after the progression of the underlying disease, 39 (39.4%) patients discontinued the follow-up. Conclusion : We recommend administration of a certain chemotherapeutic treatment if there will be the optimal routing of patients provided.

Introduction . The article presents the results of the external audit conducted in a region of the North Caucasian Federal District where we evaluated the quality of health care services for children with cancer. Patients and methods . We investigated the regional cancer registry data and medical histories of children with solid tumors (except brain tumors) who received specific therapy or symptomatic treatment at the oncology department of the regional hospital or federal research institutes in the period of 2011–2015. Results. The analysis revealed 64 patients who were registered in the region in 2011–2015. The detected group included 28 (43.8%) girls and 36 (56.2%) boys with cancer (age 0–17 years). The group enrolled 5 (7.8%) patients with stage I disease, 14 (21.9%) — with stage II, 19 (29.7%) — with stage III, and 26 (40.6%) — with stage IV. Pediatric oncology facilities are not available at the local level. Partially, specific therapy and symptomatic treatment was performed in 18 (28.1%) patients at the oncology department of the Republican regional hospital and in 46 (71.9%) patients at the federal research institutes. At the moment, 28 (43.8%) patients from the analysed group are alive, the progression of disease resulted in death of 26 (40.6%) patients, and 10 (15.6%) patients dropped out of follow-up. Conclusion . The establishment of the oncology department is reasonable according to the situation in the region. It will provide timely diagnosis, early intervention including chemotherapeutic treatment, and patients’ routing with effective application of budgetary funds.

Introduction: Malignant tumors (MT) in children are not common but contribute significantly to infant mortality . Materials and methods: We evaluate the available equipment and the competence of the staff of the Oncology Department of cancer chemotherapy at the SBPHF AR Regional Children's Hospital (ARCH) in accordance with the requirements of the Annexes 5-6 to the Order of Ministry of Health of the Russian Federation № 560n dated October 31, 2012 (as amended September 02, 2013 № 608n) “On approval of procedures for the provision of healthcare services in the profile ‘Pediatric oncology’”. The analysis of the case histories of patients with solid tumors (except brain tumors) treated in the period from 2011 to 2015 was also performed. Results: During the period from 2011 to 2015 specialized and symptomatic treatment was provided to 49 patients (23 (46.9%) girls and 26 (53.1%) boys, mean age, 5.9 years; range 1 month – 17 years) with solid malignant tumors (excluding brain tumors). Out of 49 patients, eleven (22.4%) had neuroblastomas, ten (20.4%) – nephroblastomas, six (12.2%) – liver tumors, five (10.2 %) – thyroid cancer, three (6.1%) – osteosarcomas, three (6.1%) – rhabdomyosarcoma (RMS), two (4%) – Ewing's sarcoma, two (4%) – organ RMC, two (4%) – retinoblastomas, one (2%) – synovial sarcoma, one (2%) – fibrosarcoma, one (2%) – juvenile granulosa cell tumor, one (2%) – primitive neuroectodermal tumor, one (2%) – testicular cancer. Seven (14.3%) patients presented with stage I disease, twenty-two (44.9%) – with stage II, five (10.2%) – with stage III, fourteen (28.6%) – with stage IV, and one (2%) patient with unidentified tumor stage. Currently, forty (81.6%) patients from the analyzed group are alive: four (10%) continued treatment and thirty-six (90%) achieved remission. Nine (18.4%) patients died from the progression of the underlying disease. Conclusion: Medical facilities of the Arkhangelsk Region have the opportunities to provide specialized medical care for children with the majority of malignant tumors. The specialized department can provide chemotherapy and surgery, excluding complex organ preservation surgery (in patients with bone sarcomas) as it requires professionals with extensive experience.

Background: Cancer is the second most common cause of death in children. The organization of cancer care for children requires further reforming and rational use of available resources. Objective : Our aim was to assess the provision of federal districts (FD) with cancer specialists and relevant bedspace needed for providing medical care for children with newly diagnosed malignant disease. Methods : The ecological study investigated reports of regional ministries and departments of health of 82 subjects of the Russian Federation for 2013. It was analyzed the morbiden (newly diagnosed cases of cancer) of children aged 0–17 years, the provision of bedspace, doctors, diagnostic and therapeutic technologies. Results : In 2013 it was registered 3378 children with cancer. The average incidence rate in Russia amounted to 12.4 per 100 thousand of the child population, in the RF subjects index values ranged from 5.5 to 21.8. 1705 (50.5%) patients were sent to federal clinics. In total, in 2013 in Russia there were 51 children's oncology departments with 2021 beds (including beds in non-core departments), therewith, the provision of bedspace varied by FD from 0.40 to 1.13 per 10 thousand of the child population. Treatment of children with cancer was carried out by 390 doctors, 138 (35.4%) among them did not have a certificate of Pediatric Oncology. The provision of doctors varied by FD from 0.06 to 0.20 per 10 thousand of the child population. The availability of modern diagnostic tools in the RF remains at a relatively low level. As a result, 76.6% of all newly diagnosed cancers were stage III–IV. Conclusion: It is required the improving of the vertical and the amount of specialized medical care for children with newly diagnosed cancer.