Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR最新文献

{"title":"The prevalence of respiratory diseases associated with herpes infection under conditions of aerotechnogenic exposure to chemicals in children","authors":"O. Ustinova, N. Zaitseva, O. A. Maklakova, S. Valina","doi":"10.47470/0044-197x-2022-66-6-505-512","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-6-505-512","url":null,"abstract":"Introduction. Respiratory diseases consistently occupy a leading position in the structure of pediatric pathology. Materials and methods. We performed clinical examination of 5-17 years four hundred ninety six children living at a large industrial center, on a territory with a relatively favourable sanitary-hygienic situation. The examination involved establishing markers of Herpes simplex, and chemical and analytical blood tests aimed at determining contents of technogenic chemicals in it. Results. In 29.7-66.1% children living in the industrial center elevated blood levels of benzene, p-, m-xylene, manganese and zinc are recorded relative to background levels. Up to 77.6% of children in the observation group had markers of the virus Epstein-Barr, cytomegalovirus, 48.2% - Herpes simplex virus type 1.2. In ¾ of children, respiratory diseases are represented by inflammatory diseases of the nasal mucosa (53.4%) and chronic lymphoproliferative pathology of the nasopharynx (58.2%), associated with increased blood levels of chemicals and the level of markers of Herpes simplex type 1.2, virus Epstein-Barr. The risk of developing chronic lymphoproliferative pathology in children of the observation group is 1.3 times higher. In 39.8% of cases, an intrasystemic comorbidity of respiratory diseases is formed. In 29.1-48.5% of children with respiratory pathology, thyroid diseases, vegetative dystonia, functional heart pathology are registered due to the combined effect of elevated blood levels of aromatic hydrocarbons, formaldehyde, metals and the level of markers of Herpes simplex type 1.2, virus Epstein-Barr. Under conditions of aerogenic pollution with technogenic chemical factors, the risk of developing intra-system and inter-system comorbidity increases up to 1.6 times. Limitations. The study was conducted in 5-17 years children on a representative sample. Conclusion. In conditions of aerotechnogenic exposure to chemicals, the prevalence of respiratory diseases associated with herpes infection in children is higher, which must be taken into account when carrying out preventive measures.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48619839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New institutes for assessing the qualifications of medical specialists: functions and significance","authors":"O. Kolennikova, M. Toksanbaeva","doi":"10.47470/0044-197x-2022-66-6-535-541","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-6-535-541","url":null,"abstract":"Introduction. Accreditation and certification for the qualification category are the main institutions that provide assessment of the qualifications of medical specialists. Nevertheless they are not effective enough. Therefore, hopes are pinned on new institutions, namely an independent assessment of qualifications and certification for obtaining the status of “Moscow Doctor”. The purpose of the study is to identify to what extent the institutes of independent assessment of the qualifications (IAQ) of medical specialists and their certification for the status of a Moscow doctor correspond to the purpose based on the analysis from the point of view of the functions performed and the approaches implemented to the assessment of qualifications. Material and methods. The study was based on regulatory documents of the Ministry of Health of the Russian Federation, the Ministry of Labour and Social Protection of the Russian Federation and the Government of Moscow. The statistical base was made up of data from Rosstat and departmental statistics of the Moscow Department of Health, and materials of sociological surveys conducted by the method of expert interviews. Results. The institute of IAQ is at an experimental stage. The analysis of the pilot projects was carried out in two directions: what functions the institute should perform and what circumstances caused the delay in its implementation. It is established that this institute does not provide specialists with a significant social status. The prolonged terms of its development are caused by managing difficulties, including the long approval of professional standards. The certification for the status of “Moscow doctor” introduced into practice is similar in function to the certification for the qualification category and can be considered as its element of a higher level. Limitations. The study of new institutions for assessing the qualifications of medical specialists is limited to an analysis of their functions. The expert interview method is not designed to obtain quantitative estimates. Conclusion. New institutes of qualification assessment have actualized a number of controversial issues. This is a question of a preferred assessment based on a specialty (accreditation) or position (IAQ). The Institute of certification for the status of “Moscow Doctor” made a contribution to the discussion on the preservation or cancellation of certification for the qualification category.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43931388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural and functional features of the myocardium in residents of the industrial region of the Far North under the exposure to nickel and arsenic","authors":"A. E. Nosov, O. Ustinova","doi":"10.47470/0044-197x-2022-66-6-513-520","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-6-513-520","url":null,"abstract":"The study of the role of chemicals of industrial origin in the development of cardiovascular pathology determines the relevance of this study. The purpose of the work is to study the features of cardiac structural and functional disorders in residents of the industrial region of the Far North under the exposure of nickel and arsenic. Materials and methods. The study included one hundred fifty eight women living in the industrial center of the Far North with the location of large metallurgical enterprises (observation group) and 65 women living in similar climatic and geographical conditions, but without the location of industrial enterprises (comparison group). An echocardiographic study was carried out with the measurement of structural and doppler parameters of the heart on an expert-class ultrasonic scanner “Vivid q”. Results. In the observation group the values of myocardial performance indices (MPI) values for mitral annulus (0.55 ± 0.09 vs. 0.48 ± 0.07, p=0.005) and tricuspid annulus (0.57 ± 0.10 vs. 0.48 ± 0.06, p=0.001) were higher than in the comparison group. A gain in the concentration of nickel in the blood is associated with an increase in isovolumic relaxation time (IVRT) of the mitral atrioventricular ring (p=0.0001) and systolic pressure in the pulmonary artery (p=0.00002). An increase in the concentration of arsenic in the blood is associated with an increase in the filling pressure of the left ventricle (E/Em) and end diastolic diameter of the left ventricle (EDD LV) (p=0.0001), the diameters of the right ventricle (RV) and right atrium (RA) (p=0.0001), and rate of late diastolic filling of the RV and MPI of the tricuspid atrio-ventricular ring (p=0.0001). Limitations. This study did not include middle aged and elderly women, and also did not include male patients and did not include the population of other territories except the Far North. Conclusion. The revealed changes in echocardiographic parameters indicate subclinical dysfunctions of the myocardium of the left and right ventricles, affecting both systolic and diastolic function in residents of the industrial city of the Far North, living under the influence of nickel and arsenic.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47064355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value-based health care: alignment the tools and methods (literature review)","authors":"N. Kamynina, N. Polishchuk","doi":"10.47470/0044-197x-2022-66-6-444-450","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-6-444-450","url":null,"abstract":"The desire to solve the problem of efficient spending of funds in the public sector has been transformed into an understanding of values. The desire to reduce costs, maintain the proper quality and maximize the availability of medical care led to the emergence and formation of a new concept of effective functioning based on values - VBHC (Value-based Health Care). Purpose. To systematize the criteria, metrics and methods for evaluating effectiveness in the context of the VHBC concept. To obtain the necessary information, a selective literature review was carried out. Electronic bibliographic databases in Russian (“RSCI/eLibrary”) and English (“Pubmed”) were used. Search queries were formed taking into account the MeSH nomenclature. To determine the effectiveness of the provision of medical services and the implementation of government programs (projects) in general, there are a number of methods. First of all, it is an analysis of costs, benefits, effectiveness and benefits. The most applicable performance measure is Quality Adjusted Life Years. QALY is a universal indicator of any health program. This expression of “utility” is by default the ultimate goal (final target unofficial indicator) of any government management decision in health care. Assessing the effectiveness of health care and developing a value-based model of health care through cost-benefit analysis is a time-consuming and important task. The study showed that it is necessary to use multidimensional tools for assessing the effectiveness of medical care. Conclusions. As a result of the review, it was found that there is no unified information system that offers ready-made assessment tools, and metrics have not been developed to evaluate the effectiveness of value-based healthcare VBHC models. It seems possible to create a checklist with universal parameters, implement it into a ready-made information system available on the market today to any medical institution, and analyze the effectiveness of the VBHC model based on the developed checklist.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43553905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Principles of laboratory service management in modern conditions","authors":"A. N. Tsibin, M. F. Latypova, Andrew G. Komarov, E. A. Slutsky, O. I. Ivanushkina","doi":"10.47470/0044-197x-2022-66-6-466-472","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-6-466-472","url":null,"abstract":"Introduction. Today, the medical laboratory is focused on operational efficiency and cost control. Our work presents the experience of transforming laboratory practice, its informatization and reorganization of the management model. Purpose of the study. Creation of a management model for fast, economical and high-quality testing in laboratories of various levels to provide Muscovites with laboratory services in full. Materials and methods. An assessment of the resource support of clinical diagnostic laboratories (CDL) of the Moscow City Health Department (MCHD) number of attached population and the need for tests, made it possible to develop and implement concepts for their centralization in the outpatient clinic link, unify the nomenclature of laboratory studies and tests, create a unified reference book of laboratory studies (IF) for the centralized laboratory service (CLS) of the unified medical information and analytical system (UMIAS), develop a plan for the development of a quality management system based on international standards and begin the activity on the standardization of laboratory services through accreditation of medical laboratories in the national accreditation system, manage centralized large-scale screening for SARS-CoV-2; implement sequencing technology (NGS) for genomic surveillance. Results. The MCHD laboratory service is built according to a 3-level system. There is a complex IF EMIAS. Laboratory studies are computerized, test results are transferred to the personal account and the patient’s electronic medical record. A single information space has been created for all CDL MCHD. The tariffs for laboratory services of the registry of the Moscow City Compulsory Medical Insurance Fund (MCCMIF) have been changed, the list has been optimized. Under the control of spending, the productivity of laboratories has increased. Moscow’s needs for laboratory services have been met. Research limitations. The scenario of managerial approaches was carried out in a strategic partnership with MCHD, proved to be viable only in the conditions of the city of Moscow. Conclusion. The problems of precision medicine have been solved and the sustainable provision of laboratory services to the population by the clinical diagnostic laboratories of the MCHD has been ensured.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46133096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, laboratory and ultrasound characteristics of autoimmune thyroiditis in the children’s population of territories with the location of metallurgical enterprises","authors":"I. Shtina, K. P. Luzhetsky, S. Valina, M. T. Zenina, O. Ustinova","doi":"10.47470/0044-197x-2022-66-6-499-504","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-6-499-504","url":null,"abstract":"Introduction. The combination of iodine deficiency and the negative impact of environmental factors determines the pathomorphism of thyroid diseases, including autoimmune thyroiditis (AIT). The purpose of the study was to establish clinical, laboratory, and ultrasound features of autoimmune thyroiditis in children living under the influence of metallurgical production. Materials and methods. AIT children residing in the zone of influence of the enterprises of the metallurgical industry (one hundred two cases) and outside the exposure zone (46 people) underwent a comparative analysis of the results of clinical and laboratory research, ultrasound imaging of thyroid gland tissues. Results. During the period 2010-2020, the increase in the incidence of thyroiditis in the territory with metallurgical production enterprises exceeded the average indicator in the Perm region by 1.5 times. Children from the test group had concentrations of lead, manganese, nickel, chromium and zinc in their blood higher than the regional background level. These elevated concentrations were detected in them by 1.7-5.5 times more frequent than in their counterparts from the reference group. The number of AIT cases elevated by 2 times in the exposed boys; diffuse lesions of the thyroid gland and combination of AIT with other diseases, by 1.3 times (p = 0.03-0.04). Levels of IgA and IgG in blood serum were by 2.7 times higher in the test group (p = 0.015-0.043); TSH contents, by 2.3 times higher (p = 0.096); free T4 contents, by 5.4 times lower (p = 0.057). Limitations of the study. Children living at the only one subject of the Russian Federation; a comparatively small sampling; selected study of compounds with direct thyreo-cytotoxic effects Conclusions. Incidence of thyroid gland diseases and thyroiditis in territories with developed metallurgic industry is higher than on territories with a relative favorable sanitary-hygienic situation. Children with elevated contents of metals in their blood had disorders of thyroid and immune status, thyroid gland disease and concomitant damage to other systems in the body. The mathematical relationships indicate the possible influence of metals on the formation of AIT.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45243487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International aspects of anti-vaccination attitude: implications for public health (literature review)","authors":"O. A. Pivovarova, V. M. Kuraeva","doi":"10.47470/0044-197x-2022-66-6-542-548","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-6-542-548","url":null,"abstract":"Successful immunization programmes are the result of high vaccine effectiveness and timely use. Numerous studies have shown that immunization will be effective with government support, taking into account the local culture of the population, and approaches to vaccination to optimize results. Purpose. Summarize the world’s data on existing immunization programs and their accompanying problems. Literature search methods included search queries, in the form of a set of keywords «vaccination/vaccine», «immunization», «anti-vaxxers», «pandemic», «public health» followed by full-text sources, Web of Science, Scopus, MedLine, The Cochrane Library. In the information retrieval systems, the analysis of the results was carried out, taking into account full compliance with the specified criteria of search among documents and sites. Unlike most medicines, which have limited benefits, vaccines prevent serious diseases and their public health consequences. Immunization outcome is determined by assessing the impact directly on the vaccinated person, indirectly on the unvaccinated community. The success of immunization depends on a level of universal coverage sufficient to interrupt pathogen transmission. Declines in immunization coverage will lead to a resurgence of diseases and new outbreaks with significant gain in the morbidity and mortality rate. In many cases, refusal to vaccinate is the result of people listening to beliefs and copying the behavior of others. An important consequence of this misperception is the potential involvement in the spread of an infectious pathogen due to the false belief that “vaccination is harmful”. Thus, ensuring the success of the continuity of immunization programs is the responsibility of citizens, health professionals and government, among others.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47016163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the role of unhealthy diet and low physical activity in the development of diabetes mellitus and cardiovascular complications (literature review)","authors":"O. Oynotkinova, V. M. Kuraeva, Evgeny V. Esin, S. Gusarenko","doi":"10.47470/0044-197x-2022-66-6-478-483","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-6-478-483","url":null,"abstract":"The presented review is based on a generalization of epidemiological, demographic and country studies and expert materials of the World Health Organization (WHO), the European Observatory on Public Health Systems and Policies in the Field of Public Health and an analysis of existing and progressive medical and social problems associated with the growth of overweight, obesity and metabolic-associated diseases among the population, including diabetes mellitus. The search and selection of articles was carried out using the information databases Scopus, Web of Science, Medline, The Cochrane Library, EMBASE, Global Health, CyberLeninka, RSCI, materials published in WHO bulletins. Non-compliance with the principles of a healthy diet, low physical activity are considered risk factors for the development diabetes of type 2. The above analysis shows that such modifiable risk factors as improper, unbalanced diet, low physical activity are trigger risk factors for the development of obesity and metabolically associated diseases, in particular, diabetes mellitus type 2 with subsequent cardiovascular complications. At the same time, the five-year risk of developing new cases of diabetes type 2 is high, which entails early disability and, according to experts, the economic costs of providing medical care. Strategies aimed at reducing risk factors for diabetes mellitus type 2 and cardiac vascular diseases should be focused on lifestyle correction, improving diet, and increasing physical activity.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47247161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining priority socio-hygienic determinants of life expectancy at birth for the Russian Federation population","authors":"N. Zaitseva, S. Kleyn, M. Glukhikh","doi":"10.47470/0044-197x-2022-66-6-435-443","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-6-435-443","url":null,"abstract":"Introduction. The study focuses on examining socio-hygienic determinants of life expectancy at birth as an integral health indicator at the federal level. Purpose of study. To determine propriety socio-hygienic determinants of life expectancy at birth (LEB) for the population of the Russian Federation. Materials and methods. Our initial data were taken from the statistical reports issued by Rosstat and Rospotrebnadzor in 2010-2018 in all 85 RF regions - 148 indicators of habitat and lifestyle factors were analyzed. The indicators were structured as a data matrix. Effects produced by them on LEB were calculated by using factor analysis and an artificial neural network based on a four-layer perceptron. Results. We determined fory priority socio-hygienic determinants with the greatest influence on the existing level of life expectancy at birth. Seventy-seven point five percent of them were lifestyle indicators and socio-demographic ones; 12.5% described sanitary-epidemiological welfare of the population. The most significant effects on a LEB growth were produced by 1% increase in the following indicators: “Working hours per one employed person per week”, 7.32 days; “A share of population who have physical activity or do sports”, 4.52 days; “Equipment of housing with centralized water supply”, 3.71 days. Limitations. This study has certain limitations including a limited set of the analyzed factors that modify LEB - 148 indicators over 2010-2018 as per region of the Russian Federation; an area within which initial statistical indicators were determined and limited scenarios of changes in them, properties of the employed artificial neural network. Conclusion. Planning activities aimed at improving the existing medical and demographic situation requires developing adequate approaches to determining priority socio-hygienic determinants given the effects produced on LEB by multiple environmental and lifestyle factors that are variable and heterogeneous as per their types and intensity of their influence.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42207937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Russian Register of Potentially Hazardous Chemical and Biological Substances: 30 years in the forefront of the control of the chemical safety in the Russian Federation","authors":"K. Khamidulina, A. R. Yeghiazaryan, A. V. Shvykina","doi":"10.47470/0044-197x-2022-66-5-428-430","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-5-428-430","url":null,"abstract":"","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43138506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}