Biomedical subjects
Publications and source records attributed to B P Bogomolov.
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AIM: To investigate the efficacy of combined therapy of patients with chronic hepatitis C (CHC) including intron A, pegintron (preparations of alpha-2b interferon) and ribavirin, and evaluation of the above treatment side effects. MATERIAL AND METHODS: 47 CHC patients (38 males and 9 females) were divided into two groups. 22 patients of group 1 received intron A and ribavirin, 25 patients of group 2 were given pegintron and ribavirin for 6-12 months. The examination made before the treatment, during the treatment and after it included clinical, biochemical, virusological blood tests, tests for autoantibodies, thyroid hormones, ultrasound investigation. RESULTS: The response in group 1 was 55%, in group 2--72.7%. In group 2, CNS and skin side effects occurred more frequently. After the treatment side effects regressed in 95.8% patients. CONCLUSION: The pilot experience in Russia confirmed the findings of the foreign investigators on higher efficacy of combined treatment with pegylized interferons (pegintron) and ribavirin vs combination of intron A with ribavirin. It is shown that side effects of the above treatment can be corrected in outpatient medication.
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Matched patients with chronic hepatitis C (CHC) were treated with monotherapy with intron A, or its combination with ribavirin or pegintron combination with ribavirin. The comparison group consisted of patients with a natural CHC course who received no specific antiviral therapy. The highest treatment efficacy was achieved in use of pegintron with ribavirin. However, this combination was associated with more frequent CNS and skin side effects. Side effects in all the above groups regressed completely for 1-3 months after the treatment.
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AIM: To study microcirculation (MC), hemostasis and blood viscosity (BV) in influenza and acute respiratory viral infections (ARVI) complicated by pneumonia. MATERIAL AND METHODS: Conjunctival biomicroscopy, hemostasis and BV were studied in 232 patients with influenza and ARVI. In 91 of them the disease complicated with acute pneumonia (AP), in 87--with obstructive bronchitis. RESULTS: Irrespectively of the disease course, patients with influenza and ARVI showed intravascular changes in MC system, hypercoagulation, deterioration of fibrinolysis. In convalescence platelet aggregation increased, fibrinolytic blood activity enhanced. In influenza and ARVI complicated with AP intravascular changes and hypercoagulation were most pronounced. In uncomplicated influenza and ARVI accompanied by bronchitis such changes are less severe. BV was the highest in development of AP. CONCLUSION: MC and hemostatic disorders arising in influenza and ARVI seem to be essential pathogenetic links provoking development of AP. In intravascular aggregation of platelets and red cells, activation of plasmic hemostasis differentiated treatment with desaggregants and anticoagulants are indicated.
The study enrolled 53 patients (29 males, 24 females) with respiratory mycoplasmosis aged 15-88 years. Most of them were 59 years of age and younger. In 1/3 of the patients the diseases started with symptoms of acute respiratory viral infection, in 2/3 of them--with pulmonary affection. Pneumonia was diagnosed in 50 patients (94.3%), acute bronchitis--in 3 patients. ECG changes were registered in about half of the examinees who had no cardiac complaints. 25 of them had alterations in the end part of the ventricular ECG complex; rhythm and conduction disturbances occurred rarely. Mycoplasmosis patients suffering from ischemic heart disease (IHD) had stable ECG changes while in those free of IHD the changes were short. Myocardial necrosis foci were absent. Cardiac damage comparison in patients with respiratory mycoplasmosis and in other acute respiratory infections has found that cardiovascular system suffers less in acute mycoplasmosis. These data are useful in differential diagnosis of myocardial infections.
Cardiovascular status was evaluated in 36 adult patients with respiratory syncytial infection, part of these coronary patients and the other part not. Respiratory syncytial infection had a negative impact on the cardiovascular system, particularly so in coronary patients, exacerbating the course of coronary disease and causing focal changes in the myocardium.
Integral rheography and conjunctival biomicroscopy studied central hemodynamics (CH) and microcirculation (MC), respectively, in 37 hypertensive patients with influenza and acute respiratory viral infection (ARVI) and 38 normotensive patients with influenza and ARVI aged 41 to 94 years (group 1 and 2, respectively). In group 1 vs group 2 specific peripheral resistance was significantly higher, intravascular changes were more manifest (disseminated aggregation of red cells, slow blood flow with its incomplete block. It is shown that patients with influenza and ARVI had main functional circulatory disorders in microcirculation zone. The study of microcirculation by conjunctival biomicroscopy is important for these patients for assignment of pathogenetically sound vascular therapy, first of all disaggregants.
Data on 40 patients (21 men, 19 women) who died in hospital of influenza in 1975-1990 are analysed. The age of the patients ranged from 47 to 92 years, 37 patients were over 60. 31 deceased had ischemic heart disease (IHD), of them 13 survived myocardial infarction; 11 patients had essential hypertension, 1--lymphoid leukemia, 1--pollenosis. Influenza caused by virus of A type (H3N2) was diagnosed in 27 patients. Influenza virus type B was detected in 13 patients. The disease ran a hypertoxic, severe and moderate course in 3, 20 and 17 patients, respectively. Influenza complicated with pneumonia in 23 cases, with hemorrhagic edema in 4 patients. The lethal outcome was caused by acute cardiovascular failure (n = 20) including acute myocardial infarction (n = 9), pulmonary edema (n = 9), pulmonary artery thromboembolism (n = 8). Influenza remains a serious disease especially for the elderly with IHD.
AIM: To study microcirculation (MC), hemostasis (HS) and blood viscosity (BV) in influenza and acute respiratory viral infection (ARVI) in hypertensive patients. MATERIAL AND METHODS: The study group consisted of 67 hypertensive patients with influenza or ARVI. 45 influenza and ARVI normotensive subjects served control. HS and BV tests were made, conjunctival biomicroscopy was performed. RESULTS: Patients with influenza and ARVI in the acute period had distinct perivascular and vascular abnormalities, sludge phenomenon in the majority of postcapillary venules and capillaries. In convalescence microcirculation improved. HS in the acute stage of infections was characterized by fast coagulation, depression of fibrinolysis; in convalescence, a significantly enhanced platelet aggregation was seen. The highest BV occurred at low shift speeds. Hypertensive patients had higher vascular permeability and more severe intravascular changes which presented with disseminated intravascular red cell aggregation, slowing down of blood flow, its partial block. In hypertension there was also significantly higher platelet aggregation, lower disaggregation, higher BV increase in convalescence. CONCLUSION: Hypertensive patients with influenza or ARVI had serious disorders of microcirculation, HS and BV threatening cardiovascular complications in such patients.
Microcirculatory disorders (MD) and hemostasis (HS) were studied in patients with influenza and acute respiratory viral infection (ARVI). The patients also suffered from ischemic heart disease (IHD), essential hypertension (EH) and diabetes mellitus (DM). Among 241 patients 63.9% were middle-aged and old. 45 patients under 60 years of age without coexisting diseases served control. In acute influenza and ARVI the majority of the postcapillary veins and capillaries were affected with sludge syndrome, there were marked perivascular and vascular changes. Convalescence was accompanied with reduced permeability and intravascular aggregation of erythrocytes, microvessels improved tonicity. HS responded to the acute infections with depression of fibrinolysis, in convalescence platelet aggregation activated. IHD patients had disseminated intravascular red cell aggregation, slowing of the microflow, hypercoagulation. Patients with postmyocardial infarction cardiosclerosis (PIC) had more severe affection of microcirculation and hemostasis in convalescence. In hypertensive patients microcirculation and hemostasis were similar to those with IHD. In diabetics platelet aggregation improved but sludge phenomenon and slow blood flow persisted. Thus, ARVI for IHD, EH DM patients are a risk factor for the disease aggravation. In influenza and ARVI, IHD patients, especially with PIC and EH are contraindicated active physical exercise, intake of dysaggregant drugs is desirable. Diabetics should take drugs improving blood rheology early in acute period of ARVI.
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