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Clinical Department History

Medical examinations of the population of various districts adjacent to the Semipalatinsk test site have been started by dispensary No. 4 since 1960 under the supervision of chief physician Smirnov A.A. Since 1962, the clinical department was included in the structure of the Dispensary.

The clinic of the Scientific Research Institute for Radiation Medicine and Ecology was established on the basis of the order of the Ministry of Healthcare and Social Development No. 108 dated 06.02.2001. The heads in different years were Zakharova O.I., Galich B.V., Masalimova G.A., Idrisova B.B.

Medical assistance to the population of Kazakhstan, affected to prolonged chronic exposure, is determined by the Law of the Republic of Kazakhstan dated 18.12.1992 «On social protection of citizens who suffered from nuclear tests at the Semipalatinsk nuclear test site», Decree of the Government of the Republic of Kazakhstan No. 336 dated 11.03.1997. «On program of medical rehabilitation of the population affected by nuclear tests at the former Semipalatinsk nuclear test site in 1949-1990».

The main tasks of the institute’s clinic are an in-depth examination of the population using modern highly informative diagnostic methods, indication of radiation exposure and the role of the radiation factor in the development of somatic diseases.

The clinic consists of an advisory and diagnostic department (head Azhmuratova Gulnara Kadyrovna) and a rehabilitation department with 40 beds (head Nurgalieva Venera Koshkengalievna). The clinical unit employs more than 60 people, of which 16 are doctors, 11 of whom have the highest and 5 first category.

The structure of ADD includes the following units:
I. Advisory unit:

  1. therapist
  2. neuropathologist
  3. endocrinologist
  4. cardiologist
  5. gynecologist
  6. urologist

II. Clinical and diagnostic unit:

- diagnostic laboratory
- functional diagnostics rooms
- ultrasound diagnostic room

Over the entire period of work, about 46,700 people were examined.

The main direction in studying the long-term effects of ionizing radiation on the health of the exposed population is the conduct of clinical examinations in order to assess the patterns and characteristics of the course of some socially significant somatic diseases.

The results of clinical and epidemiological studies conducted at the SRI RME are the basis for the development of medium and long-term programs for the early diagnosis of radiation-induced diseases, their treatment and rehabilitation of the suffered population.
As part of the « National Rehabilitation Program for Irradiated Population», the Institute for Radiation Medicine and Ecology is conducting a medical examination of the population suffered from nuclear tests at the Semipalatinsk test site from 1949 to 1990.

The tasks of the advisory and diagnostic department are early verification of:

  • oncological diseases,
  • cardiovascular disease,
  • diseases of the thyroid, mammary glands,
  • gastrointestinal diseases ...

In accordance with these ADD SRI RME carries out the following activities:
- initial screening of radiation-induced disease groups and subsequent in-depth examination;
- examination on modern medical equipment using new medical advances;
- consultations by qualified specialists in the prevention of diseases included in the program of medical rehabilitation of the population.

Based on the materials of screening and in-depth examination, individual programs for further rehabilitation are created, which also include the stationary stage. Treatment is carried out in the department of therapeutic profile. Combination therapy is aimed at improving the adaptive properties of the body, including the correction of the immune system, metabolic disorders.

Modern diagnostic methods in the advisory and diagnostic department of the SRI RME. In the advisory and diagnostic department of the institute, in addition to the generally accepted methods of diagnostic examination and treatment regimens for individual nosological forms of general somatic diseases, methods are used to refine the values of effective equivalent doses and the nature of radiation.
When asessing the non-oncological effects of ionizing radiation among the exposed population, an in-depth examination of the patient is carried out in the clinical diagnostic department of the SRI RME, which includes ultrasound examination, ECG, Holter monitoring of ECG, echocardiography, veloergometry. To study the neurophysiological changes in various somatic conditions, the following studies are carried out: REG, EEG, HRV study, ultrasound of vessels.

1. Holter (daily) monitoring of ECG allows to identify various cardiac arrhythmias, episodes of myocardial ischemia during exercise and at rest, to assess the effectiveness of treatment. The method is absolutely harmless, has no contraindications, does not require special preparation.

2. Veloergometry (VEM) is a diagnostic method of electrocardiographic studies to detect latent (latent) coronary insufficiency and determine individual tolerance to physical activity with the use of increasing step-by-step physical activity performed by a researcher on a veloergometry.

3. The analysis of heart rate variability (HRV) is now the only available, non-invasive and fairly simple method for assessing autonomic regulation.
4. Electroencephalography (EEG) is a non-invasive (without violating the integrity of the body) method of studying the functional state of the brain by recording its bioelectric activity. EEG is widely used as the main and most important - safe - method for diagnosing and monitoring the effectiveness of treatment of various paroxysmal conditions characterized and determining the functional state of the brain.

5. Echocardiography (ECHOCG) is a modern, painless, safe and, most importantly, highly informative method for the most accurate diagnosis of cardiovascular diseases.

6. Ultrasonic diagnostics of vessels (USDG) is used to determine blood flow disorders in the vessels and can be performed on the vessels of the head (cerebral vessels), neck, upper and lower extremities.

7. Laboratory diagnostic methods: markers of cancer (CA15-3, CA-125, CA-19-9, CEA, CIFRA, PSA), determination of thyroid hormones by ELISA.

The rehabilitation department of the institute is a hospital, which was opened in 2002 with 45 beds. At present, 40 beds are functioning in the hospital: 30 beds in a round-the-clock hospital and 10 beds in a day-time hospital.