History of Republican Scientific and Practical Centre of Pulmonology and Tuberculosis | Print |

Republican Scientific and Practical Centre of Pulmonology and Tuberculosis



A. The full name of so far: State Institution Republican Scientific and Practical Centre of Pulmonology and Tuberculosis

Foundation Date: August 21, 1928

The first full name: Belarusian Research Institute of Tuberculosis.
Move Dates (with full name of institution):

1988 - "Research Institute of Pulmonology and Tuberculosis" (Order of the Ministry of Health of the Byelorussian SSR № 86 of 20.05.1988, "On the reorganization of the network of research institutes of the BSSR Ministry of Health").

2001 - State Enterprise "Scientific-Research Institute of Pulmonology and Phthisiology" (MOH Order № 180 of 20.06.2001, the).

2009 - State Institution «Republican Scientific and Practical Center of Pulmonology and Tuberculosis"

Two. List of heads of agencies (with tenure):

The first director was appointed Professor EL Marshak, who directed the institute from 1928 to 1941.

The second director was appointed professor of IL Tamarine, who led the institute in 1941 to 1959.

The third director was Doctor of Medical Sciences, Professor Mikhail Lomako - Honored Worker of Science of Belarus, Head of tuberculosis of the Minsk State Medical University, which was organized on the basis of the Institute in 1971, headed the Institute of 1959-1991 years.

From 1991-2005. Institute has successfully led the Honoured Doctor of the Republic, PhD Valentin Vikentievich Borschevsky.

From 2005 to the present director of the institute is a Doctor of Medical Sciences, Professor Gennady L. Gurevich.

Three. The scientific achievements of the State Institution "Research Institute of Pulmonology and Tuberculosis from 1928 to 2008.


From the first years of its existence, the activities of the institute focused on the development of various aspects of TB control: measures to reduce morbidity and mortality from tuberculosis, eliminating the causes of the spread of the disease. Began to open TB dispensaries, health centers. Has the scientific development of various aspects of TB vaccines: comparative evaluation of the specific reactivity of vaccinated and unvaccinated children, the study of their general physical development and the state of the lungs by serial images, a technique of studying the overall morbidity and mortality from tuberculosis of children, the social aspects of BCG vaccination. Employees of the department of social pathology (Head Kugel MB) installed predominant clinical forms of TB in smear of Minsk, TB infection identified students and industrial workers. The characteristic of the social conditions in the tubochagah, studied the incidence of tuberculosis "contact" person.
The scientific topics included issues of studying tuberculosis clinic, sanatorium treatment, treatment of pneumothorax, the gas and the main exchange. Some results of these studies were presented at the 2nd National Conference phthisiologists in 1932.
Since 1931 the institute developed surgical techniques are beginning to treat patients with tuberculosis (thoracoplasty, thoracotomy, frenikoekzerez, burnout intrapleural adhesions).
EL Marshak clinical and radiologically examined the types of pulmonary tuberculosis, and showed them prakticheschkoe value in the clinic.
Importance to the practice of scientific papers were: "Kimografichesky method in lung diseases", "On the treatment of tuberculous pleurisy", "Employability in artificial pneumothorax", "infiltrative TB in children," Some of these studies subsequently summarized and presented in a doctoral dissertation (EL Marshak, 1940) and Ph.D. (AL Polyak, 1938, F. J. Goldin, 1940) dissertations.
In 1933 expanded research on bacteriological diagnosis of tuberculosis (SM Danovich).
Much attention was paid to the development of organizational issues for TB control and research needs of the people in TB care. The research results were presented at the Belarusian conferences TB (1928, 1932), the Minsk City Conference (1934) and the Belarusian methodological meeting (1938).
Begins to develop rationalization work at the institute. In 1933, of the Institute of MB Kurgel modified apparatus for sucking air in spontaneous pneumothorax, and in 1936 proposed a simplified apparatus for the extraction fluid.
During this period, was prepared by 38 scientific papers, 24 of them published. Protected by a doctor and three master's theses.
By the beginning of World War II strengthened the material base of the institute. He served seven buildings: two buildings actually institute TB dispensary 3 building, the building of a children's tuberculosis department and the building of a sanatorium for young children with 100 beds. It consisted of three laboratories (two clinical and one biochemical) and 4 of the Cabinet (2 x-ray, metabolism, social pathology).
The scientific themes of the Institute, were based mainly on clinical and outpatient departments allowed to make a definite contribution to the study of the pathogenesis of tuberculosis, provided new information about the clinic and treatment of disease. Thus, the developed method applying an artificial pneumothorax for the treatment of tuberculosis, emphysema secondary complications, indications for surgery frenikoekzereza, methods of early diagnosis of pulmonary tuberculosis, the indications for referral to the local nursing home. We describe the pathogenesis, therapy and prevention of complications of artificial pneumothorax septic exudates, the pathogenesis of pulmonary hemoptysis, clinical bronhoadenitov in children, congenital and acquired bronchiectasis, etc. The place of exudative pleurisy in the genesis of pulmonary tuberculosis and epidemiology of tuberculosis in children in the age aspect.
A very relevant and necessary for the practical activities of the Institute of Health has been aborted because of the treacherous attack on our country, Hitler's Germany. Belarusian gostubinstitut temporarily ceased operations.
After the liberation of Belarus from Nazi invaders July 3, 1944 by order of the SNK BSSR № 299 resumed its activities and the Belarusian Research Institute of Tuberculosis, which is temporarily located in the Gomel-based TB dispensary. However, due to the absence of base to meet their immediate functions only in the Institute began IY quarter of 1945. For 3 months the work was carried out a socio-historical nature of the "devastation inflicted by the Nazis TB organizations of the BSSR and the first steps in her recovery."
The material resources of the Institute during this period was weak. The Institute was housed in a dilapidated building with a walled brick windows, where it was mastered by a plywood partition partitioned room (45 m2) with a socio-hygienic department, consultation, X-ray study and office. Our own clinical base was absent. We used the 20 beds in the 2nd Soviet hospital deployed May 6, 1946.
The lack of the necessary equipment is not allowed to organize research on a high scientific level. The institute were registered a steady rentgenapparat 1 flyuroustanovka, a thoracoscopy, 5 and 1 elektrotsentrifuga microscopes. There was no biochemical and bacteriological laboratories. As of 01.01.1947, in the institute have worked a professor, an associate professor, nine research assistants and two doctors. All staff, including technical staff numbered 38 people.
The main directions of scientific activity in the early postwar years were: epidemiology and organization of tuberculosis control, receiving and studying the properties of dried BCG vaccines, diagnostics, clinic and treatment of tuberculosis. Developed the epidemiology and organization of tuberculosis among residents of the village (FA Movshovich, L. Livshits, R. Levinskaya) in 8 cities of the BSSR (LI Irger (Fig. 7), F. A . Minsker, D. C. Lukantsever, Z. L. Cherches, A. Perlov. Based on these data have been developed related activities.
In the section "Treatment of Tuberculosis" works on the justification of the methods of blood transfusion in the clinic ftiziatrichskoy (IL Tamarin, S. A. Agranovich, AA Yurkovtseva), pneumoperitoneum (IL Tamarin, BI Kivelevich) penicillin therapy in the clinic of pulmonary and cutaneous tuberculosis (IL Tamarin, S. A. Agranovich, N. J. Entin), sanatorium treatment of patients (BI Kivelevich). The features of the inactivation of acetylcholine in blood serum of patients with pulmonary tuberculosis (EL Rasinovich). Planned research on detection of tuberculosis in disabled World War II (MB Kurgel, Baubkin), home visits bone-TB patients (IV Geronok) and justification of methods of surgical collapsotherapy.
Decision of the Board of Ministry of Health of the Byelorussian SSR August 24, 1947 provided for the opening of pulmonary surgery department at the institute through 4 rooms dermatovenerologic Institute. Since then, research on how to start blowing adhesions in artificial pneumothorax, the refinement of indications for gidropreparovke tissues Bogush (N. White), and drainage of endokavernoznomu Monaldi (IL Tamarin).
Since 1949, the research expanded in the direction of the study of tuberculosis among workers and young people engaged in heavy industry (IL Marshak, Zapolskaya, VI Shpilevsky) tuberculosis infection of children schools and kindergartens in Minsk (AA Putao , Knureva, FA Movshovich). Widespread use of collapsotherapy resulted in an increase in cases pnevmoplevritov, and therefore required the development of more precise indications for this method (Marshak, IL).
Associate Professor S. Agranovich and physician M. E. Brandin given bacteriological characteristics of a mixed infection with pulmonary tuberculosis, E. L. Rabinovich shows the effect of some antibiotics on the cardiovascular system of patients with tuberculosis.
For the first time in the Republic Institute in 1948 by the method of fluorographic examination of certain contingents of urban population, and from February 1951 the Institute introduced tomoflyuorograficheskoe study of patients with tuberculosis, which allowed an additional 25% of cases diagnosed in the lung cavity.
In a five-year work plan for the Institute for 1946-1950. included studies on BCG vaccination and revaccination of different age groups, urban and rural populations; for use in the clinic of radiant energy, hydro and diet, surgical treatment and a number of organizational and epidemiological work aimed at strengthening the fight against tuberculosis. The final section of this plan, the director of the Institute Professor. Tamarin IL wrote: "New prospects for recovery and rebuilding of the economy offer ample opportunities for TB control in the Byelorussian SSR, and the reduction of tuberculosis as a mass disease. Research Institutes and agencies will carry out anti-gratifying role in the struggle for promotion of health of our countrymen. " The tasks of the first postwar years, the five-year research plan had been successfully resolved. At the same time established the basis for new scientific research and development of various aspects of Phthisiology.
This period of activity of the institute is characterized by further developing research on the epidemiology, clinical picture and treatment of tuberculosis. Particular attention is given to the establishment of the true incidence of tuberculosis in rural areas and the development of organizational forms and methods of early detection of disease among this segment of the population.
In 1950 the Institute started to develop methods of surgical treatment of tuberculous empyema (H. S. Levin). During the 1950-1954 years. operated on 24 patients.
In 1951 the recommendations of the Scientific Institute was first tested and implemented a method of mass fluorographic examination of the villagers (10,450 people).: Orekhovo district, Vitebsk region (MH Levin, T. B. Komar). In 1952, these field studies carried out in Vileika (9424 people). And Postavy (5424 people). Areas Molodechno oblasti.Povtornoe population survey conducted in these areas 1954-1956. and achieved a reduction in the incidence of tuberculosis.
The staff of the Institute Yarkho M., Z. J. Mantulenko, EL and M. Rabinovitz J. Levine provides recommendations on how to tubkabinetov dispensary work in the industry. With the help of fluoroscopy shows a high detection rate of tuberculosis among the contingents of the Minsk polyclinics (LS Livshits). Head. orgmetodotdelom FA Minsker (Fig. 6). and fellow TV Komar in 1952 - 1954. conducted a scientific analysis of the incidence of tuberculosis in the country for the years 1944 -1954. status and characteristics of TB care to the population in these years, which allowed to implement a number of organizational forms of TB in the practice of TB facilities.
In clinical research fellow EL Rabinovich started the study of conditioned and unconditioned vascular reactions in patients with tuberculosis, presented by the author later in the thesis (1955), and fellow NM Kliptsanom - justification of intratracheal administration of streptomycin in pulmonary tuberculosis .
Head. rentgenkabinetom VI Shpilevsky studied X-ray method for investigation of unilateral lesions of the lung, and fellow MH Levin - tomography in the diagnosis of cavernous processes.
In studying the pathogenesis and clinical pnevmoplevritov found a beneficial effect of antibiotics on prevention.
In 1956-1957. researchers T. Komar and M. Levine A 460 pupils studied in the feasibility of enteral administration of high doses of BCG vaccine.
Developed by the application of antibacterial drugs in the clinic and the clinic (M. Yarkho, Z. J. Mantulenko, LM Pilkov), methods for treating patients with tuberculosis of the spine in home (D. Shuhmareva), biochemical changes in patients children with tuberculosis (EP Kosovo, M. E. Brandin).
Research IL Marshak have new evidence for the differential diagnosis of early symptoms of tuberculosis and lung cancer. The place of artificial pneumothorax in treatment of patients with pulmonary tuberculosis (LP Fireeva, AA Putao).
In the works of P. Kuzyukovicha, ES Korobkova and KE Kozintseva reflects the important issues of lung resection in tuberculosis and intubation anesthesia.
Experimental studies of AK Dushkevich shows the relationship of streptomycin and ftivazidoustoychivyh strains of Mycobacterium tuberculosis and their catalase activity.
During this period, the institute began the study of reactivity and the electrocapillary properties of the skin in patients with tuberculosis (VG Kolb), chemopreventive treatment of children from bacillary environment (T. Komar) imaging of intrathoracic lymph nodes and detection in children (M. Levin, H. ), which are summarized later in the master's thesis.
For scientific work became increasingly involved practitioners. Only in 1959 with 24 physicians with practical scientific work. Thus, the physician NY Guletskii on the material the surgical department of sanatorium "Novoelnya" (25 beds) has studied the results of the separated thoracocautery and features of surgery on the lungs in large cavities. With the interesting reports in the press, based on their own observations, performed Ilyin (Brest), VS Buchan (Vitebsk), LA Hanin (Bobruisk), VM Gorinenko, TG Bolozya (Grodno) GS Atamanov, G. Blazer (sanatorium "Sosnovka"), IL Druyan (Gomel), etc. Many of them subsequently defended their Ph.D. theses.
During the period from the date of the institute until 1960 scientists published 57 papers. Published abstracts of scientific section of the Institute (1959) and a monograph (GS Levine, 1959). Defended a doctoral thesis (IL Marshak, 1940) and four master's theses (AL Polyak, 1938, EZ Shpreyregen, 1940, F. J. Goldin, 1940, E. L. Rabinowitz, 1955).
This period of activity of the institute is characterized by further developing research on the epidemiology, clinical picture and treatment of tuberculosis. Particular attention is given to the establishment of the true incidence of tuberculosis in rural areas and the development of organizational forms and methods of early detection of disease among this segment of the population. It was during this period was the institution to operate as a unified scientific-practical and educational center.
The main research work was aimed at resolving these pressing problems Phthisiology: prophylactic vaccination and immunity Clinic and treatment of pulmonary tuberculosis, the state of metabolism in patients with pulmonary tuberculosis, epidemiology, and organizational forms of TB control activities.
Continued research into the dynamics of the epidemiology of tuberculosis in areas where previously there were mass fluorographic examinations of the population (AM Lomako et al.). In the analysis of group III contingent dispensary in Minsk concluded unreasonably prolonged observation of anti-bodies (FA Minsker).
Since 1960, the first in the country began a profound socio-hygienic study on the epidemiology, clinical manifestations and treatment of pulmonary tuberculosis in disabled World War II (Lomako MN). As a result, The Company now a clear accounting of these patients in tuberculosis facilities shows the clinical course of pulmonary tuberculosis in this population, established a high relapse rate, made specific suggestions for clinical examination, early detection of disease and restorative treatment. Materials research summarized Lomako MN (1968) in his doctoral thesis, which represents the first major scientific work of the Institute in the postwar period.
Compared the incidence of tuberculosis of the population structure of the BSSR in 1950-1960. (Minsker FA), defined group of patients with chronic fibro-cavernous pulmonary tuberculosis for surgical recovery (GS Levine), set the frequency of specific sotsetannogo lesions in various organs and systems (L. Barash, M. Kalechits) and helminthes prevalence of patients with pulmonary tuberculosis (EA Lugovets), the reasons for mortality from tuberculous meningitis (P. Sosnowski, GA Voitovich), the incidence of tuberculosis infection, and industrial workers (J. A. Rust, E. A . Pavhovich, EA Lugovets) studied the organizational forms of mass rentgenoflyuorografii population (M. Levin, X).
The epidemiology of tuberculosis and the organization to combat it is widely covered in the papers of J. Sosnowski, M. Kalechits, EA Lugovets, NM Pozdnyakova and other employees of the institute. The results of these studies investigated the dynamics and represented in many short-term reviews, which made specific proposals to improve the epidemiological situation of tuberculosis in the country (P. Sosnowski et al.).
Subjected to scientific analysis of various aspects of occupational therapy in TB facilities (BT Shvinyako). Particular attention was paid to issues spetsificheskoyprofilaktiki tuberculosis. The usefulness of repeated administration of BCG vaccine in 10-12 months after vaccination in terms dekretivnye children and adolescents, responding negatively to tuberculin, which resulted in a broad segment of the population immune.
In 1966 a group of employees of the Institute together with the Ministry of Health of the Byelorussian SSR, led by Professor MN Lomako begin comprehensive controlled studies to develop evidence-based epidemiological model of tuberculosis, and new organizational forms of control. As shown, the experimental program to drastically reduce the incidence of tuberculosis have been found highly effective and widespread adoption in the country.
A special place in the research is to develop new methods of surgical treatment of patients with chronic disseminated forms of pulmonary tuberculosis (P. Kuzyukovich). Proposed original methods of surgical treatment of patients with lesions of the upper lobe and the 6th segment with UCB units and UKL-60 (P. Kuzyukovich), modified by the operation of partial plevroektomii chronic extrapleural empyema (BK Kutsko). The technique of simultaneous bronchoscopy and bronchography under general anesthesia with the use of contrast agent aqueous suspension of barium (P. Kuzyukovich, M. H. Levin, KE Kozintsev).
Extensive development in the country ftiziohirurgii heavily favored the effectiveness of treatment, reduction of troops chronically ill and disabled in their midst. Developed in the surgical department of the Institute (BK Kutsko) technique vnetrivennogo administration of antibacterial agents and corticosteroids in patients with common pulmonary processes in pre-and postoperative periods, provided the reduction in mortality after surgery.
Proposed and put into practice the method of complex bronhologicheskogo examination of patients with separate bronchospirometer, angiopulmografii, sensing the pulmonary vessels with subsequent blood gas analysis (M. Shchukin). The characteristic changes in the bronchial tree in the common processes that have practical value in the topical diagnosis of the process of clarifying the scope of surgical interventions. For the first time in clinical practice is applied bypass the pulmonary circulation during Pneumonectomy with pulmonary hypertension (P. Kuzyukovich). Successfully used cardiac catheterization in patients with pulmonary tuberculosis (P. Kuzyukovich, M. Shchukin).
A. Kazakov held remote health monitoring in patients undergoing surgery for lung for tuberculosis, and it is shown that they have a high (82.5%), residual disability, which allowed to evaluate the degree to recommend MLCE disability in this cohort of patients in Depending on the functional state of the cardiopulmonary system.
Some contribution to the development of ftizioortopedii made made in the research institute for early diagnosis of specific synovitis (VF White), and surgical treatment of focal forms of osteoarticular tuberculosis (L. Barash).
In the late 50's began the widespread introduction into clinical practice of antibacterial agents. There is a problem of drug intolerance, and in 1963 the institute began to develop a comprehensive theme for the treatment of patients with pulmonary tuberculosis, poorly tolerate antibiotics (LP Firsov et al.) (Fig. 10). As a result, a classification of adverse reactions to tuberculostatic drugs, diagnostic methods of therapeutic tactics in complicated chemotherapy. It is established that the drug allergy desinsebiliziruyuschy good effect has the use of heparin, with toxic nature of intolerance to medication therapeutic efforts should be aimed at normalizing the disturbed parts of the metabolism and use of anabolic hormones. The ability of serum proteins to enter into kompleksnoobrazovanie with anti-tuberculosis drugs in patients with clinical signs of side effects of tuberculostatic drugs.
It is shown that the value of skarifikatsionnyh and intradermal tests, reaction Uane, Coombs, Perkedi, allergic alterations of leukocytes, Shelley test in the diagnosis of drug allergy to the drug protivoltuberkuleznym (LP Firsov, and AK Abramovskaya, AV Baturo, ND Tagunova). We study some biochemical factors of the reactivity of TB patients with symptoms of intolerance to antibacterial agents (GA Przhelyaskovsky, SV Bestuzhev).
Great value to clinicians and research workers had MLCE fuknktsionalnogo sotoyaniya cardiopulmonary system to assess the disability of patients with pulmonary tuberculosis made Alekseichik RI, AK Abramovsky, LM Pilkov.
A method for treatment of pneumothorax, used in conjunction with antibacterial drugs (LP Firsov, MB Kurgel, AA Putao). Done a very important study on the use of imaging in X-ray diagnostics of root processes in children with tuberculosis (M. Levin, J.). The work of the Ministry of Health awarded the BSSR.
With the opening of the institute in 1959 of the biochemical department (headed by G. Kolb) begins with a thorough study on the cellular and molecular levels of biochemical and biophysical bases of reactivity with pulmonary tuberculosis (VG Kolb). Significant disturbances in the metabolism of proteins, fats and carbohydrates, as well as in the neurotransmitters and hormones, depending on the shape and phase of tuberculosis. Simultaneously, proposed methods of normalization of the individual units of metabolic processes in patients with tuberculosis, which were introduced to the work of major anti-institutions of the republic.
Investigations concerning the changes of serum protein fractions in chronic intra-and extrapleural empyema in patients with tuberculosis, cholinesterase activity in the brain during experimental tuberculosis, amino acid composition of serum hyaluronidase content, antigialuronidazy, nucleic acids, fosfolipoproteidov, histamine, biogenic amines, seromucoid 17-ketosteroids, catecholamines in patients with pulmonary tuberculosis. GA Przhelyazkovskim and LD Golchanskoy studied neurotransmitters and hormones in adults and children with tuberculosis.
Together with clinicians (LN Firsova) studied some means of pathogenetic therapy of normalizing amino acid composition of the blood of patients with pulmonary tuberculosis (1961-1962.).
New data on the content of trace elements (manganese, copper, zinc) in the blood of patients with various forms of pulmonary tuberculosis (AK Abramovskaya, LP Shiman), the impact of some of pharmaceutics (phenylbutazone, amphetamine, etc.) on the rate of kidney isoniazid and its transformation products in the experiment (BT Shvinyatko), the effect of antibiotics on blood coagulation and fibrinolysis in patients with specific pulmonary lesions (JA Rust).
Studies carried out by employees of the Department of Bacteriological (AK Dushkevich, Antipov, SI), allowed to improve the determination of bacteriological activity metodikuts blood by vertical diffusion and the modified method of accelerated determination of catalase activity of BC.
Defined a typical affiliation of Mycobacterium tuberculosis in patients with extrapulmonary disease (AK Dushkevich), high efficiency of the method of fluorescent microscopy in the diagnosis of tuberculosis laboratonoy (OE Osipuk). Studied the types of tubercle bacilli from patients allocated to people living in the lesions of tuberculosis in cattle (AM Barb).
Successful implementation of such an extensive scientific program of the Institute would have been unthinkable without the participation in the work of practicing physicians. Actively working on research topics of doctors FE Orsha, N. Zusman, LD Zayko, LB Gorhina, RI Resurrection, VV Eryuzheva, M. Shchukin, LA S. Ivashkova, LG Grechishnikova, VS Avlasenko, PG Bavli, M. G. Zorina, PA Zdanowicz, WH Brovkovich, N. Vorobiev, D. C. Gutman, VM Degtyar, AI Nesis, GA Tsvirko, VG Cheshik and many others.
Develop extensive ties of the Belarusian Research Institute of Tuberculosis with other scientific institutions: the Central Tuberculosis Research Institute of the USSR Ministry of Health, the Belarusian Research Institute of Hematology and Blood Transfusion, the Belarusian Research Institute of Traumatology and Orthopedics, Department of Chemistry, pharmacology and Phthisiology Minsk State Medical Institute, Department of Tuberculosis of the Belarusian Institute of Advanced Medical.
During the 1960-1969 years. Institute staff are protected 4 doctor (MN Lomako, W. G. Kolb, P. Kuzyukovich, LP Firsov) and 11 master's theses (AK Dushkevich, P. Kuzyukovich, M. X . Levin, AM Barb, T. B. Komar, B. K. Kutsko, AK Abramovskaya, J. A. Rust, L. Barash and VF White, AF Kazakov in Fig. 11). In addition, under the guidance of the scientific staff of the Institute PhD theses completed two practice physician (NK Vorob'ev, M. Shchukin). Published two monographs (GS Levine, P. Kuzyukovich), 10 collections of scientific works of the institute staff and practitioners, 19 policy recommendations.
In 1963 and 1968 I and II held congresses TB specialists of the republic, which summed up the scientific, organizational and methodological work of the Institute over the past few years. Proceedings of Congresses published in print in the form of collections of scientific works.
Thus, during the institute since 1960 the main directions of his work was the introduction to the broad practice of antibiotic therapy, improvement and the search for new organizational forms to improve early diagnosis and treatment of pulmonary and extrapulmonary tuberculosis, surgical treatment of patients fibroznlo-cavernous pulmonary tuberculosis and its complications, the development of methods for determining the reactivity of the organism of tuberculosis, as well as methods of treatment of patients with symptoms of intolerance to anti-TB drugs, prevention of tuberculosis among children and adolescents, the study of tuberculosis infection in the population.
This period is characterized by the institute to improve facilities, increase in personnel, the new rise of the creative forces of scientists and significant achievements in various areas of science phthisiatric. In September 1972, the Institute received a new clinical database of 540 beds for a good set of laboratory and other diagnostic offices, vivarium. It is possible to increase the level and quality of scientific research, to reduce the time of their performance and ensure the speedy implementation of the results of implementation in practice.
During these years the institute has worked on a problem "Tuberculosis", which included three main themes (direction):
A. Features of clinical tuberculosis in the modern socio-epidemiological settings;
Two. Developing new and improving existing methods of immunobiological characteristics of the state of the organism at different stages of tuberculosis and its treatment;
Three. The study of patterns of epidemiology of tuberculosis in the light of socio-hygienic factors.
Scientists of the Institute (T. Comar, LD Gelchanskaya) in conjunction with clinicians (NA Fedorov, IB Ivanov, GM Neifach, KE Volfovskaya, BJ Rusakov ) during 1970 - 1972 years. theme of the work done to develop criteria for the diagnosis and clinical manifestations of tuberculosis in children, which allowed to consider the most appropriate Mantoux test with 2 TE to identify the infectious "bend".
Together with the Central Tuberculosis Research Institute of the USSR Ministry of Health carried out in the dynamics determination of sensitivity to tuberculin in adults and adolescents of the Byelorussian SSR (P. Sosnowski, A. Baturo, S. I. Antipov, OM Kalechits), and also provides information the effectiveness of various methods of chemotherapy regimens, WHO (YI Rust, SI Monakhova).
M. Levin and X. G. Borisevich proved a serious epidemiological importance in the reactivity of inactive tuberculosis changes detected by mass x-ray screenings. The analysis of the dispensary contacts of patients with active tuberculosis (M. Kalechits), established the true incidence of urogenital tuberculosis in the country (EV Sukhorukov), and detection in the outpatient clinics of persons with non-specific changes in the lungs (BT Shvinyako). Further scientific development of the organization of TB were disability (MN Lomako, GA Voitovich, SI Sudnik, VK Kutsko). The parameters tested in the surgical treatment of patients with active pulmonary tuberculosis (AF Kazakov, G. Nizhnikov). Developed the most appropriate recommendations for diagnosis, patient care and treatment of patients with combined forms of TB lesions (OM Kalechits). The frequency of residual tuberculous changes in the respiratory tract (4%) and shows the reasons for their activation (SI Sudnik).
As applied to modern epidemiological conditions are given (OM Kalechits, A. M. Ossowski, S. Sobol, A. Shustrov) evidence-based recommendations for the planning of the precinct phthisiatrician doctor, diagnosis, treatment and dispensary observation of patients with urogenital Tuberculosis (EV Sukhorukov, VV Barshcheuski), functional studies cardiopulmonary system in patients with pulmonary tuberculosis (RI Alekseichik, AK Abramovskaya, LM Pilkov) by the method of analysis of the anti- institutions (OM Kalechits, VF White, B. K. Kutsko, VA Alkhimovich, SI Antipov), for use in the clinic phthisiatric different pathogenetic therapy (AK Abramovskaya, A. S. Solovieva, Igor S. Gelberg, (Fig. 13), YA Bobrov, VS Avlasenko).
During 1970 - 1975 years. conducted the study pulmonary tuberculosis with the modern position of immunological characteristics of the organism. (LP Firsov, M. H. Levin, B. T. Shvinyako, LK Surkov, RI Alekseichik, OP Lukashok, ZV Lavaur (Fig. 12), G. N. Voronkov). According to the materials of this study is protected and prepared for a protection of two Ph.D. theses, published three guidelines and wrote a monograph.
A. M., and L. Ossowski K. Surkova (1971-1973 gg.) Was created in the experiment the original model of genital tuberculosis were studied morphogenesis, the path of infection in the genital organs in antibiotic therapy, the role of popredelena hormonal, allergic and neurogenic damage pathogenesis of genital tuberculosis.
RI Alekseichik and AK Abramov studied the medical, occupational and social rehabilitation once again taken on account of pulmonary tuberculosis and the necessity of their employment and labor re-orientation, based on the functional state of the cardiopulmonary system.
During this period, the Institute carried out a number of important scientific developments, successfully used in health care, and thus made some contribution to the further progress of medical science. The main of them should be called.
A new method for diagnosis of focal forms of osteoarticular tuberculosis by biopsy and necrectomy lesions in the head and neck of the femur (L. Barash). A method for sensing peripheral bronchi controlled bronchial brushing, which increased to 95% rate of preoperative diagnosis (AF Kazakov). Worked out indications and contraindications for diagnostic mediastinotomii method that allows to establish the nature of respiratory disease in 83.3% of cases (GI Nizhnikov).
Based on previously elaborated complex allergological examination of patients offered a rational method of determining the activity of tuberculous process (GN Voronkov, GA Przhelyaskovsky).
EV Suhorukova proposed set of laboratory tests used in the clinic to determine the activity of a specific process in the urinary organs. The original research on machine eksperss-specific and nonspecific diagnosis of pulmonary lesions performed A. Kazakov.
The technique spirograficheskogo survey of newly diagnosed patients with pulmonary tuberculosis in order to timely diagnosis of bronchial obstruction and correction of various mixtures of bronchodilator drugs (RI Alekseichik).
The efficacy of different culture media for bacteriological diagnosis of tuberculosis and proved most effective medium Finn.
The criteria determining the activity of the process in pulmonary and genitourinary tuberculosis, which allows us to differentiate timing of chemotherapy (EV Sukhorukov, VV Borschevsky).
A method for differential diagnosis of postinfection immunity to tuberculosis in long-term post-vaccination after BCG intradermal vrocks method based on the use of blast transformation reactions and consumption of complement (AK Abramovskaya).
A significant place in the scientific activities of the Institute took the development of effective treatments for patients with various forms of tuberculosis.
Given the scientific rationale for the method of intermittent treatment of newly diagnosed patients with pulmonary tuberculosis in ambkulatornyh conditions.
T. Komar suggested a rational scheme of chemotherapy of destructive pulmonary tuberculosis in adolescents, which resulted in cure of the disease in 98% of cases.
Scientific method was developed aiming ionaerozolterapii the treatment of patients with pulmonary tuberculosis and bronchial tubes, thereby increasing the effectiveness of chemotherapy and reduced the duration of treatment (ZV Lavaur). Clinical and experimental method is justified infusion of drugs in the branches of the pulmonary artery and proved highly effective in the treatment of patients with progressive tuberculosis and severe lung disease nagnoiteldnymi (P. Kuzyukovich, M. Shchukin, SI Monakhova, L. Pilkov M., M. J. Danko).
GI Nizhnikovym studied acid-base balance and blood gases in patients with tuberculosis during surgery on the lungs.
Przhelyazkovskim GA (1971) studied the exchange of biogenic amines and corticosteroids in patients with tuberculosis and nonspecific lung diseases during surgery.
Developed a very effective method of administration of antibacterial drugs in the gastro-intestinal tract in oxygen cocktails, which allows the treatment of patients with symptoms of intolerance to anti-TB drugs (OP Lukashok).
Developed and applied the method of intravenous administration of antibiotics for tuberculosis of the genitourinary system, which greatly increased the effectiveness of treatment of patients with advanced pochevyh of specific processes (VV Borschevsky).
The high medical, social and economic effects provides science-based BK Kutsko method of controlled ambulatory chemotherapy on the job at the newly vyyavleknnyh patients with minor forms of tuberculosis, without decay and batsillovydeleniya. Implementation in practice of this technique allowed the economic effect of $ 2 million.
Further developed in the research ftiziohirurgii. In particular, P. Kuzyukovichem and co-workers developed a new method for plastic cavities and lung tissue used in patients with fibro-cavernous pulmonary tuberculosis with good long-term results of observation.
Studied in primary drug resistance of Mycobacterium tuberculosis in newly diagnosed patients and is defined by the BSSR medical tactics in such cases, which allows to achieve better success in the therapy (AK Dushkevich, S. I. Antipov, B. T. Shvinyako). SI Antipova the characteristic of the causative agent of tuberculosis in the Byelorussian Soviet Socialist Republic. Of great importance in determining the effectiveness of different culture media for bacteriological diagnosis of tuberculosis research had AK and TA Dushkevich Bartashevich that showed the most efficient environment Finn.
Developed and implemented in public health practice common method of prophylactic fluorographic examinations for tuberculosis of the population, which increased the profitability of the use of technology and streamlined fluorographic X-ray examination of the population (MH Levin, M. Kalechits, MA Popkovsky, EA Lugovets .)
Since 1973 the Institute began the development of an information retrieval system of accounting tuberculosis as one of the subsystems, "ACS-TB" (PI Kurmel, M. Kalechits, AM Osovska). In 1976 the first machine in the country received a statistical report on the activities of district tuberculosis institutions of Grodno region.
Successfully executed, begun in 1974, SI Antipova, research carried out by economic activity of TB control, which allowed the economy from the standpoint of public health to assess the profitability of TB control activities and to determine their priority.
For the first time in the country carried out a mathematical approach using computers to build models of the spread of long-term plan for TB care to the population of the republic.
The methods of intensive therapy in patients with disseminated forms of TB (GV Egorov, BF Makovsky, M. J. Danko, Kotsyrev VI), the pathogenetic therapy (AK Abramovskaya, L. P. Schiemann, and . A. Rozhkov, N. Sarychev, TM Shmarakova).
Belarusian Research Institute of Tuberculosis has been successfully cooperating with the Central Research Institute of Tuberculosis in the implementation of 16 research programs on various topics Phthisiology. In addition, complementary to the scientific work of 12 scientific institutions in the country.
Constantly improving the planning system in the institute of research. Since 1976, introduced the principle of target-oriented research planning. It is possible to formulate a clear objective of the study, to develop a specific program to achieve it and to determine the final result, including its cost-effectiveness.
An agreement on creative collaboration with many public health authorities of the republic, which allowed even more to bring the scientific program of the Institute to the needs of practical public health and to ensure the speedy implementation of research findings into practice.
According to the materials research staff of the Institute from 1970 to 1977. including 13 master's theses are protected. Two physician practice (AP Tepteev and EM Muravitsky) completed dissertations under the guidance of the scientific staff of the institute. Published 4 monographs, six collections, generalizing scientific, organizational and methodological achievements of the institute staff and TB specialists of the republic, issued 20 guidelines (Guidelines), published 323 articles in scientific journals and anthologies, including 135 - in national publications, made over 300 scientific reports. Obtained 66 certificates for rationalization proposals.
The staff of the Institute have participated in the Exhibition of Economic Achievements of the USSR and BSSR, and VV Barshcheuski - by electrode catheter for recording reonefrogramm - awarded the bronze medal in 1976 the USSR Exhibition of Economic Achievements.
Scientific research institute has been praised Ministry of Health. In 1976, for their achievements in socialist competition and the early implementation of the plan of scientific work institute was awarded second prize money USSR Ministry of Health, and in 1977 the staff of the institute handed challenge Red Banner of the Ministry of Health and the Central Committee of trade union health care workers.
Thanks to the efforts of the Institute of Tuberculosis in Belarus was controlled infection and in 1978 for achievements in the development of public health, medical science and training institute was awarded the "Badge of Honor."
Based on scientific research institute in this period laid the foundations of the modern system of identification, medical examination and TB Prevention. In 1980 - 1985 years. were grounded and shaped by a group of social and medical risk of tuberculosis, the principles of preventive examinations. These studies are a priority and have not lost their relevance in the present.
Conducted research and development is also allowed to significantly improve the quality of surgical treatment of pulmonary and extrapulmonary tuberculosis. Proposed and put into practice new methods of surgical interventions on the lungs of chronic widespread processes of tuberculosis of bones and joints, genitourinary system. These unique designs are protected by copyright certificates. Expanded indications for surgical treatment of patients with caseous pneumonia.
In addition to the multifaceted research in clinical and experimental Phthisiology in 80-90 years. 20th century, the institute is actively developing newer direction of science - Pulmonology. This may reflect the fact that in 1984 for the comprehensive development and implementation of original methods for diagnosis of respiratory diseases institute staff GL Gurevich, I. Kazakov, I. Kovalenko, VP Skiba in 1984 awarded the Lenin Komsomol of Belarus.
Accumulated over the years, the scientific potential in the area of ​​pulmonology allowed in 1988 to convert the Belarusian Research Institute of Tuberculosis Research Institute of Pulmonology and Phthisiology (Order of the Ministry of Health of the Byelorussian SSR № 86 of 20.05.1988, "On the reorganization of the network of research institutes of the BSSR Ministry of Health").
The institute was created Department of Diagnosis and Therapy of nonspecific respiratory diseases, which in 1988 led PhD, Associate Professor, Chief Department of Health Visiting pulmonologist IM Laptev. Under her leadership, founded the national school of Chest Physicians, including MD Dubrovsky, AS, SV Davydchenko, Turin, O., Laptev, EA, Egorova NV began intensive research into the diagnosis and treatment of sarcoidosis, chronic bronchitis, bronchial asthma. Obtained new data on the etiology, pathogenesis, diagnosis, treatment and immunorehabilitation inflammation in the lungs. Developed and tested techniques and modes of speleotherapy in speleohospital Soligorsk. An important contribution to the development of Pulmonology have also candidates of medical sciences, GL Borodin, GA Borisevich, E. Skryagin.
Ordeal for the Belarusian people, scientists of the republic has become a disaster at the Chernobyl Nuclear Power Plant (1986). The scientific themes of the Institute extended the study occurred in the direction of the radioecological situation and its impact on the prevalence and course of tuberculosis and nonspecific diseases of the respiratory system. According to the research concept was first formed on the negative pathomorphism tuberculosis in modern radio-ecological conditions (G. Gurevich, LK Surkov). A new model of organization of TB care in the changed socio-economic and radioecological conditions (VV Barshcheuski, M. Kalechits, AV Bogomazova).
Found that in areas of Gomel region most affected by the Chernobyl disaster, the incidence of all forms of tuberculosis and pulmonary tuberculosis in 1997 not only exceeded the pre-accident rates, but more than 2 times the incidence in non-contaminated with radionuclides territories, and the average national performance.
Designed and implemented a method of indirect endolymphatic administration of anti-TB drugs with simultaneous local levamisole electrophoresis in destructive forms of osteoarticular tuberculosis, as well as the combined methods of physiotherapy treatment of ocular tuberculosis, female genital mutilation. The estimation of the role of anti-antibody determination by ELISA in detecting tuberculosis.
The factors of the pathogenesis of acutely progressive pulmonary tuberculosis. The connection between long-term persistence of circulating immune complexes in the bloodstream to their deposition in the lungs (in 54.4% cases) and the inclusion of immunocomplex pathological mechanism in the pathogenesis of the progression of pulmonary tuberculosis. Found that all patients with acutely progressive pulmonary tuberculosis revealed nonspecific bacterial microflora (in 72% of cases - mixed), which has pathogenetic significance in terms of worsening of the disease. It was established that 84-90% of patients with acutely progressive tuberculosis revealed persistence of herpes simplex virus or cytomegalovirus, which may indicate its role in the progression of a specific process in the lungs.
Found that multirezistetnye strains of Mycobacterium tuberculosis at an earlier date picture of the cause expressed tuberculous inflammation until the caseous pneumonia and are more virulent than ordinary bacteria. It was revealed that MDR-TB observed more pronounced deficiency of T-lymphocytes, T-helper cells, a profound inhibition of the secondary immune response (production of class Ig G) and reduced functional activity of phagocytic blood cells, especially in groups with chronic and acute-progressive course of disease.
It was established that to determine the degree of reversibility and the development of optimal treatment and rehabilitation regimens in patients with chronic obstructive bronchitis is advisable to use a comprehensive diagnostic study of respiratory function with the use of bronchodilators differntsirovannyh tests. It is established that the use of anticholinergics in chronic obstructive bronchitis can achieve durable improvement of airflow obstruction, including background on the resistance to sympathomimetics. It was found that in patients with chronic obstructive bronchitis observed a pronounced change in reaction to corticosteroid therapy with a tendency to eliminate the imbalance of T-helper response, and the extinction of the inflammatory process, "neutrophil" type. For the first time demonstrated that asthma is a significant increase in the intensity of spontaneous and induced apoptosis in dexamethasone.
Found that the main risk factors for tuberculosis in modern conditions are social epidemics. Developed and implemented in pilot districts of computer automated system "Fluorography", which allows continuous monitoring of the conduct of surveys of different populations of the area.
Long-term studies conducted on the basis of Theatres on the development of a modern model of the organization of TB care to the population, allowed to justify the reduction of one booster dose of BCG (at age 14) and selective tuberculin hold for children under 3 years.
Developed their own criteria of stability and sensitivity to all anti-TB drugs in a liquid medium, based on the features of the dynamics of growth of sensitive and resistant strains of MBT in the presence of specific anti-TB drugs.
The concept of the national computer register "Tuberculosis".
Developed the basic provisions of medical and social examination for tuberculosis of the respiratory system, the criteria for determining disability in this disease.