Introduction The TROPHY registry has been established to conduct an international multicenter prospective data collection on the surgical management of neonatal intraventricular hemorrhage (IVH)-related hydrocephalus to possibly contribute to future guidelines. The registry allows comparing the techniques established to treat hydrocephalus, such as external ventricular drainage (EVD), ventricular access device (VAD), ventricular subgaleal shunt (VSGS), and neuroendoscopic lavage (NEL). This first status report of the registry presents the results of the standard of care survey of participating centers assessed upon online registration. Methods On the standard of treatment forms, each center indicated the institutional protocol of interventions performed for neonatal post-hemorrhagic hydrocephalus (nPHH) for a time period of 2 years (Y1 and Y2) before starting the active participation in the registry. In addition, the amount of patients enrolled so far and allocated to a treatment approach are reported. Results According to the standard of treatment forms completed by 56 registered centers, fewer EVDs (Y1 55% Y2 46%) were used while more centers have implemented NEL (Y1 39%; Y2 52%) to treat nPHH. VAD (Y1 66%; Y2 66%) and VSGS (Y1 42%; Y2 41%) were used at a consistent rate during the 2 years. The majority of the centers used at least two different techniques to treat nPHH (43%), while 27% used only one technique, 21% used three, and 7% used even four different techniques. Patient data of 110 infants treated surgically between 9/2018 and 2/2021 (13% EVD, 15% VAD, 30% VSGS, and 43% NEL) were contributed by 29 centers. Conclusions Our results emphasize the varying strategies used for the treatment of nPHH. The international TROPHY registry has entered into a phase of growing patient recruitment. Further evaluation will be performed and published according to the registry protocol.

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The subject of the study is the inter-regional differences in the state of public health and the demographic situation in the Russian Federation regions. The theoretical aspect of the subject is determined by the development of priorities of the Russian healthcare development strategy aimed at alignment of regional differences in the levels of healthcare development in the Russian Federation regions. The empirical aspect of the subject is to identify interregional differences in the state of public health and the demographic situation in the Russian Federation regions by using the EM cluster analysis method (Expectation Maximization). The method was implemented in the integrated development environment RStudio. The official statistics from Rosstat for the period 2014–2018 were used as the initial dataset. The purpose of the study is justifying the regulation of inter-regional differences of the Russian Federation regions. As a result of clustering, nine homogeneous clusters of the Russian Federation regions were identified. The main characteristics of the formed clusters are determined. Among the priorities of the RF healthcare development strategy are as follows: implementation of a unified tariff policy in the system of compulsory medical insurance; ensuring the balance of territorial compulsory medical insurance programs within the framework of the basic programme of compulsory medical insurance through financial security based on a single per capita standard; development of telemedicine, providing prompt remote consultation of leading experts in the provision of medical care, regardless of the territorial location of the patient and the doctor; ensuring the implementation of distance education courses and continuing education programs for medical workers; rationalization of the distribution of resources and capacities of medical organizations based on a three-tier system of medical care; development of regional public health centres. The results of this study can be used to develop federal and territorial programs for socioeconomic development, formulate a strategy for the development of healthcare at macro- and meso- levels, and optimize decisions of regional authorities regarding population policy.

Педиатрия 612 Н астороженность исследователей вызывают сложившиеся в последнее время неблагоприятные тенденции состояния здоровья детского населения [1]. Дефекты регистрации заболеваний в условиях первичного звена медицинской помощи не позволяют анализировать реальные цифры детской заболеваемости. Кроме того, применяемая в официальной статистике возрастная группа 0-14 лет исключает возможность более глубокого анализа заболеваемости детей в значимые для их развития временные периоды [2]. целью настоящего исследования явился анализ исчерпанной заболеваемости у детей и подростков, проживавших в мегаполисе. Материал и методы. Под исчерпанной заболеваемостью детского населения понимают общезаре-гистрированную заболеваемость по обращаемости, дополненную случаями заболеваний, выявленных при медицинских осмотрах, и данными по причинам смерти. Использование для анализа этого показателя позволяет получать более объективные данные, чем при оценке заболеваемости по данным обращаемости, используемой в официальной статистике [3]. Объектом исследования явились дети, находившиеся на медицинском учете в детской городской поликлинике № 9 Казани в 2012-2014 гг. Исследование исчерпанной заболеваемости выполнялось по специальной методике с использованием программы «SOCPEDIATRIA» [3]. Углубленные осмотры несовершеннолетних проводились на основании приказа Минздрава России от 21.12.2012 № 1346н. Расчет интенсивных показателей заболеваемости осущест