[Epidemiologic situation of tuberculosis in the Republic of Kazakhstan]. / Epidemiologicheskaia situatsiia po tuberkulezu v Respublike Kazakhstan.

The tuberculosis epidemiological situation has greatly deteriorated in the Republic of Kazakhstan in recent years. Tuberculosis morbidity has annually increased by 11.1% and, but in 1995 it amounted to as much as 100 per 100,000 in some areas and mortality was 29.5%. Forty five thousand patients with active tuberculosis types are registered at tuberculosis dispensaries, among them 12 thousand patients isolate Mycobacterium tuberculosis. The main reason is sharply deteriorated socioeconomical conditions and lower volumes of antituberculous measures.

[The validation of the annual universal fluorographic examinations of the population of Kazakhstan]. / Obosnovanie ezhegodnykh sploshnykh fliuorograficheskikh obsledovanii naseleniia Kazakhstana.

Many years' observations carried out in different territories of Kazakhstan have demonstrated that repeated total fluorographic examinations of the population result in decrease of tuberculosis morbidity, in the proportion of destructive forms and fibrocavernous tuberculosis. In the urban areas where the epidemiologic situation for tuberculosis is rather favourable an increase in the intervals between fluorographic examinations resulted in increase of tuberculosis morbidity, lung cancer and roentgen-positive nonspecific pulmonary diseases and in the proportion of patients to whom diagnosis was established not in due time or too late.

[Effectiveness of hyperbaric oxygenation in the treatment of postresection bronchial fistulas]. / Znachenie giperbaricheskoi oksigenatsii v lechenii postrezek- tzionnykh bronkhial'nykh svishchei.

The article discusses the results of treatment of 84 patients with postresection tuberculous pyothorax and bronchial fistulas with hyperbaric oxygenation session (HBO) included in the complex of therapeutic measures. As a result, the bronchial fistulas closed in 30 (35.7%) patients, the diameter of the fistulas reduced markedly in 20 (24.3%) patients, the bronchial fistulas failed to close in 40% of cases. As the result of HBO therapy the count of red cells and lymphocytes increased, leukocytosis and eosinophilia reduced, the ESR diminished. The content of ALT transaminase, sugar, total protein and bilirubin decreased. The migration index for all immune antigens in the reaction of leukocyte migration inhibition and in the nitro blue tetrazolium test increased. HBO promoted the efficacy of radical operations by 29.4% as compared to that in the control group of the similar patients.

[Concept of the development of phthisiological services in the Kazakh SSR]. / Kontseptsiia razvitiia ftiziatricheskoi sluzhby v Kazakhskoi SSR.

Basic prospective directions of tuberculosis control in the Kazakh SSR are presented, which provide for specific measures aimed at the optimization of BCG vaccination, further development of chemoprophylaxis in the groups of subjects at higher risk of the disease, full repeated population screening, treatment intensification, improvement of dispensary follow-up and strengthening of sanitary epidemiologic prophylaxis. The results of the study carried out by the Kazakh Research Institute of Tuberculosis are given, which substantiate the performance of the above measures. The organizational and methodologic approaches for their provision are suggested.

[The concept of a material incentive system based on the end results of carrying out antituberculous measures]. / Kontseptsiia sistemy material'nogo stimulirovaniia za konechnye rezul'taty provedeniia protivotuberkuleznykh meropriiatii.

It is proposed to introduce a system of differential supplementary payments in view of the results achieved by the medical officers in detecting and treating the patients with varying severity of a tuberculous process and at the same time the deductions from those payments for late detection, ineffective treatment and the deterioration of tuberculosis epidemiological situation. The system entails a mutual control of work carried out by the medical officers responsible for the detection and treatment of the patients, including regular officers and heads of the antituberculosis institutions.

[The use of rheography for assessing the adequacy of prolonged artificial ventilation of the lungs in patients undergoing surgery of pulmonary tuberculosis]. / Primenenie reografii dlia otsenki adekvatnosti prolongirovannoi iskusstvennoi ventiliatsii legkikh u bol'nykh, operirovannykh po povodu tuberkuleza legkikh.

When prolonged end-expired-air positive pressure ventilation (EEPPV) is performed to prevent possible respiratory complications after operation for pulmonary tuberculosis, thorough monitoring of the circulation system seems to be necessary since EEPPV affects the cardiovascular system. In this case rheography makes it possible to objectively assess the hemodynamics and phasic pattern of heart performance. An optimum regimen of EEPPV is that which ensures a maximum increase of the pulmonary ventilation in each zone, including the best blood oxygenation without negative action of EEPPV on circulation. EEPPV below 10 sm H2O is recommended for patients with disseminated and complicated tuberculosis.

[Results of ambulatory observation of patients registered as group O in an anti-tuberculosis dispensary]. / Rezul'taty dispansernogo nabliudeniia za kontingentami O gruppy ucheta protivotuberkuleznogo dispansera.

414 patients registered under O-group, 149-under VIIB and 129-under IA were observed by the antituberculosis dispensary of Alma-Ata. The minor differences detected in the clinical symptomatology of these patients did not allow one to decide how the process was proceeding in a specific case. The results showed that it was advisable to enroll++ subjects not with focal, but with cirrhotic and disseminated processes, tuberculomas and intrathoracic lymphatic tuberculosis into the O-group. The presence of X-ray archiv does not rule the necessity of following-up in this group in some cases. The process activity in the O-group can be defined by such methods, as bacillary excretion test and study of X-ray dynamics in the presence of challenge therapy, while in cirrhoses and intrathoracic lymphatic tuberculosis, only bacillary excretion test can be done. The outcomes of observation, in addition traditional ones (transfer to IA and VIIB groups), may lead to the transfer to VIIA group and striking off the register of the antituberculosis dispensary. Direct and indirect economic impact of the observation in the O-group of the dispensary registration was estimated.