Respiratory diseases - acute and chronic respiratory diseases - is the largest group of diseases that affect almost all people. All over the world, there is a tendency to increase the number of sick people, including chronic forms of bronchopulmonary diseases. This is largely due to widespread environmental degradation, human immune system disorders, in some cases untimely diagnosis and treatment. There is also a tendency to increase the frequency of severe forms of respiratory diseases, especially respiratory tract infections that are resistant to antibiotic treatment. The diagnostic and therapeutic capabilities of medical institutions in the regions of Kazakhstan are of significant importance.
Unique in this aspect is pulmonology unit of Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan, represented, first of all, by highly qualified specialists in respiratory medicine, trained in large scientific-clinical centers of near and far abroad, having rich experience of clinical, research and educational activities, having the highest clinical qualification category, scientific degrees and titles.
The diagnostic capabilities of the hospital are unique due to the introduction of modern, high-tech methods of diagnosing the most complex, including rare respiratory diseases. The Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan is the only clinic in Kazakhstan where such ultramodern examinations of the bronchopulmonary system as diffusion lung capacity determination (DLco) and Body plethysmography are performed.
The hospital has introduced endoscopic biopsy of the bronchi and lungs, intrathoracic lymph nodes under the control of endobronchial ultrasound (EBUS), allowing for a short time (1-2 days), with minimal impact on the patient's quality of life, to diagnose the most complex diagnosis and timely start the necessary therapy. This technology has been implemented and successfully applied only in the Medical Centre Hospital of the President’s Affairs Administration of the Republic of Kazakhstan.
Today the Medical Centre Hospital of the President’s Affairs Administration of the Republic of Kazakhstan is diagnosing and treating such common respiratory diseases as severe bronchial asthma, chronic obstructive pulmonary disease, pneumonias, including viral, bacterial, non-tuberculous mycobacterioses, secondary pneumonias in neurological patients with impaired respiratory function, interstitial lung diseases idiopathic and within connective tissue systemic diseases, including progressive pulmonary fibrosis, sarcoidosis, lymphangioleiomyomatosis and other hard-to-diagnose lung lesions, revealed oncological diseases of the bronchopulmonary system.
High accuracy of interstitial lung diseases diagnosis can be achieved using high-resolution computed tomography with the use of ultramodern computer programs for reconstruction of the obtained lung image by specialists of the computer diagnostics department, bringing the sensitivity of the method closer to morphological examination of lung tissue, in particular in the diagnosis of idiopathic pulmonary fibrosis, which allows in a number of cases to avoid lung biopsy. Lung perfusion scintigraphy, planned inhalation lung scintigraphy, as well as positron emission tomography combined with computed tomography (PET/CT) are used in the diagnosis of diseases of bronchopulmonary system of inflammatory, tumor genesis, interstitial pathology of lungs, including sarcoidosis and other granulomatous processes in lungs.
Already at early stages of interstitial lung lesions, before their detection by CT scanning, the decrease of oxygen diffusion at the level of alveolar-capillary membrane allows to detect the lung diffusion capacity (DLco) by single breath method on modern Shiller equipment. In the RK today this research is carried out only in the Medical Center Hospital of the President's Affairs Administration of the Republic of Kazakhstan.
Rapid diagnosis of the most complex morphological variants of ILD, including idiopathic pulmonary fibrosis, idiopathic interstitial pneumonia, interstitial pneumonia of viral genesis, granulomatous processes in lung interstitium, progressive pulmonary fibrosis of known and unknown genesis, including systemic connective tissue diseases, pulmonary vasculitis, diagnosis of sleep breathing disorders in a sleep laboratory with the selection of hardware treatment programs (CPAP, BiPAP), attract patients from all regions of Kazakhstan to Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan.
Functional stress tests to assess the functional status of the respiratory system are widely used in the work of pulmonology clinicians.
Serious support in the treatment of patients with respiratory problems is provided by rehabilitation programs developed at the Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan, including individual programs of therapeutic exercise, physical therapy procedures, massage, use of oxygen barochamber, aerosol therapy in halochamber (salt mine) conditions, which is especially relevant during the pandemic of coronavirus infection. Comprehensive rehabilitation in the conditions of pulmonology department is taken by patients who had COVID-19-associated interstitial pneumonia in severe form with the formation of post-covid syndrome (long-covid), as well as by patients with chronic diseases of bronchopulmonary system.
An important component of the successful work of the pulmonology unit at the Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan is a multidisciplinary, team approach, based on the principles of evidence-based medicine, with the participation of specialists in the diagnostic process - pulmonologists, functionalists, radiologists, endobronchologists, rheumatologists, thoracic surgeons, pathomorphologists. The team work of specialists of different profiles in the therapeutic and diagnostic process allowed to achieve high results in diagnosis and treatment, improvement of quality of life and life expectancy of patients with the most complex diseases of the respiratory system.
The Pulmonology Unit of the Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan is the only one in Kazakhstan, where the diagnosis and treatment of bronchopulmonary diseases involves a full range of the latest technologies and methods currently available in medicine, which allow to diagnose any complexity in the shortest possible time and determine the patient's treatment program.
The experience of diagnostics and management of patients with ILD is highly evaluated by the leading specialists in respiratory medicine, the Ministry of Health of the Republic of Kazakhstan, RCHD, which is confirmed by the involvement of Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan specialists in the management and the Republican Commission on ILD for expert evaluation and solution of issues of indications for expensive antifibrotic therapy of progressive pulmonary fibrosis. The results of clinical and research activities of specialists in the field of respiratory medicine at the Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan are analyzed, summarized and published in national and foreign publications, reported at international and national forums, used in the educational process within the framework of residency, master's program, webinars for Kazakhstan doctors. Specialists in the field of respiratory medicine of Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan participate in development of CP diagnostics and treatment of respiratory diseases of MH RK, in particular CP “Idiopathic pulmonary fibrosis”, in work of CP “Progressive pulmonary fibrosis”.
An important aspect of the pulmonology unit of the Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan is the availability of all types of diagnostics and treatment to any citizen of RK who needs pulmonological care, as well as to foreign citizens.
As part of educational programs, specialists in the field of respiratory medicine share their experience with doctors from the regions of Kazakhstan, residents studying at the Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan, doctoral students, consult complex patients from the regions of Kazakhstan in the form of remote consultations using telemedicine technology, consultations on-site.
The specialists at the Medical Centre Hospital of the President’s Affairs Administration of the Republic of Kazakhstanin the field of respiratory diseases do not stop at the high results achieved. The search for new technologies, improvement of existing methods and technologies aimed at improving the care of patients with diseases of the bronchopulmonary system is continuing.