Biomedical subjects
Publications and source records attributed to V M Kolomiets.
Two epidemic outbreaks of tuberculosis were observed among young socially dysadapted individuals at a juvie. They were liquidated, by chiefly implementing social preventive measures and by introducing new chemotherapy regimens.
Evidence is provided for that there is a need for making additions and amendments in Federal Law No. 77 "On Prevention of the Prevalence of Tuberculosis in the Russian Federation". Amendments are aimed at improving the legal base to increase the financing of governmental programs, at organizing the prevention and treatment of tuberculosis, at optimizing labor in specialized health care services. The authors propose to support the initiative of the Kursk Branch of the Russian Society of Phthisiologists for appealing to the State Duma of the Russian Federation to submit a legislative initiative in amending the law.
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Six biological specimens, including BCG obtained from Mycobacterium tuberculosis or animal tissues in accordance with an original procedure were studied. Their protective efficiency in tuberculosis infection was evaluated by the magnitude of allergic reactions and by pathological tissue changes 5 months after animal immunization and infection. The drug PKP-3 was found to be most effective and its further study is promising.
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Studies were made of the structure of individuals with residual pulmonary changes who were at corrective labour institutions. Among them, the incidence of active tuberculosis is 16-21 times greater than that of reactivation among the other populations. It is these persons who should be regarded as a risk group and regular prophylactic measures should be used in them.
Characteristic features of medical care of tuberculosis patients staying at places of their confinement are considered on the basis of the examination data collected during a year. Inpatient treatment was primarily indicated for subjects with pulmonary tuberculosis (66%), including 31.9 per cent of the newly diagnosed. It is recorded that the percentage of patients with fibrocavernous process was rather high (13.7%), while those suffering from concurrent conditions and excreting drug-resistant tubercle bacilli made up 41.2 and 45.9 per cent; respectively. Some measures are recommended to optimize sufficiently provided medical care and treatment efficacy.
The results of the examination of the tuberculosis cases detected during 7 years among the annually screened population are given. Still, with 43.6% incidence of the destructive forms 55.3% of the cases were detected between the prophylactic examinations. Further employment was recommended in 33.7% of those cured from tuberculosis. It is concluded that the existing early tuberculosis detection approach is not effective any more and has to be improved. First of all, the responsibility for implementing of medical instructions needs to be stimulated.
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Efficiency of the activities of medical curators in tuberculosis dispensaries is discussed in connection with reconstruction of public health care. An improvement of the quality of prophylactic arrangements, introduction of centralized control of treatment and observation of patients and other organizational innovations made the activity of the curators unnecessary at the present stage. It is proposed to discuss the possibility of performing organizational and methodological measures by indications in regional dispensaries according to contracts with preserving the system of centralized control.
Reconstruction in public health requires further improvement of medical personnel training by using more perfect curricula and methods of teaching. Different curricula on phthisiology are discussed in regard to disease pathomorphism and organization of personnel activity. It is advisable that the main attention should be paid to mastering differential diagnosis by medical students during their individual work.
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The author finds it appropriate to take advantage of antituberculous sanatoria for secondary prevention of various diseases during annual mass screening of population with account of pathomorphosis of tuberculosis.
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Explore the source record for details and available documents.