Vol 62, No 2 (2018)

The purpose of study. To establish modern trend in morbidity of acute lymphoblastic leukemia in children and persons of young age (0-29 years) in Azerbaijan and to assess regional features of morbidity. Materials and methods. The study was organized on the basis of the B.A. Eivazov Azerbaijan research institute of hematology and transfusiology where the Republican register of leukemia is functioning. The continuous technique was applied to collect information concerning all cases of morbidity of individuals aged from 0 to 29 years during 1998-2014 with registration of residence of patients on the moment of diagnosis of acute lymphoblastic leukemia. The level of morbidity was calculated per 100 000 of population aged up to 30 years. The results. The level of morbidity varied in the range from 0.91±110/0000 (95% confidence interval 0,69-1,130/0000) to 2,07±0,150/0000 (95% confidence interval 1,77-2,370/0000). The minimal and maximal values of indicator differed significantly (p<0.01). The statistically significant increasing of morbidity was observed after 2008 and continued up to 2012 inclusively. In 2013 and 2014 the level of morbidity (1,16±0,11 and 1,21±0,110/0000 was closer to its level in 2006 and 2007 (1,15±0,12 и 1,16±0,120/0000). The comparatively higher average chronological level of morbidity of acute lymphoblastic leukemia according data of 2009-2014 is specific for Baku, Sumgait, Gäncä and Shirvan and also such districts as Absheron, Tovuz, Shamkir, Gekgel, Astara, Khachmaz, Guba, Shabran, Neftchala. Conclusions. The level of morbidity of acute lymphoblastic leukemia in individuals younger than 30 years during 1998-2014 varies in the range from 0,91±0,11 to 2,07±0,150/0000. The growth is the main trend of morbidity. In Baku and Sumgait, the average annual level of morbidity of acute lymphoblastic leukemia in population younger than 30 years is statistically significant higher than the republican level (95% - confidence interval is 1,56-3,64 and 0,26-5,940/0000 correspondingly). During 2008-2014 in cities and districts of republican subordination the average annual level of morbidity of acute lymphoblastic leukemia in population younger than 30 years varies in the range of 0,64-3,560/0000 and demonstrates significance of regional differences.

The consideration of obstetric-gynecological care as a medical service generates discussion about its improper provision and is accompanied by attempts of certain patients and their representatives to enrich themselves at the expense of medical organizations and particular physicians. The latter, due to altruism widespread among physicians and professional overloads, cannot effectively protect their own interests. At that, in Russia professional responsibility insurance is still to become available to most health professionals because of unavailability of policies. The number of civil claims related to provision of obstetric and gynecological care is one of the highest one in medicine. Annually, within the framework of one subject of the Russian Federation, in average 4 cases are considered apropos obstetric and gynecological care. Mainly, state health care institutions, providing basic volume of hospital care of women answer these claims. The overwhelming majority of requirements to medical organizations and medical workers is directed to compensation of moral harm and its average amount consists 150-200 thousand rubles. At that, a regressive demand from the prosecutor's office about bringing to material accountability for sum of employer's costs can be sent directly to physician-executor. With an incorrect expert conclusion, responsibility of medical organization and physician can occur even in case of accident when no fault of the medical worker is discovered. The medical organizations themselves, defending their own interests and interests of their employees, allow inconsistency since they do not admit any guilt in the committed defect and simultaneously agree to compensation of moral harm, but in a smaller amount than the patient requires.