Biomedical subjects
Publications and source records attributed to M P Boĭchak.
The article is dedicated to the history of the foundation, development of the principle military medical institution of Ukraine, which celebrates its 250 anniversary in June 2005. The authors proposed the periodization of the origin, main achievements and tendency of the development of the management of this military medical institution.
Data are submitted of the analysis of indices for humoral and cell-mediated immunity in those patients presenting with recurrent pneumonias versus the above indices in patients with sporadic forms of the illness. Shown in patients with recurrent pneumonias is formation and progression of T-lymphocyte derangement associated with decline in their functional activity, which event is characteristic of different clinical types of acquired immune deficient states.
As many as 159 patients with pneumonia (all men aged 18-39) were examined. Functional activity of monocytes was studied in an integral test with nitroblue tetrazolium as was nonspecific cellular antiviral resistance by the level of viral damage to the monocytes and lymphocytes. The progression of pneumonia was found to be accompanied by a decrease in the number of phagocytizing mononuclears and the activity of phagocytosis. Nonspecific cellular antiviral resistance is significantly impaired. The proportion of monocytes and lymphocytes containing viral inclusions increases several-fold. The treatment of patients is accompanied by positive dynamics of indicators of functional status of monocytes and nonspecific cellular antiviral resistance. By the time of discharge from hospital the impaired functions of immunocompetent cells fail to completely restore.
Functional activity of mononuclear phagocytes and antiviral cellular resistance have been examined in 75 patients with acute bronchitis, 159 pneumonia patients and 46 healthy males as shown by intracellular viremia in monocytes and lymphocytes. Progression of acute bronchitis and pneumonia conformed to inhibition of phagocytosis in mononuclear phagocytes, growing percentage of virus-affected monocytes and lymphocytes.
Overall 132 patients at greater risk for pneumonia were examined for functional activity of monocytes and antiviral cellular resistance according to the status of intracellular viremia in monocytes and lymphocytes. The control group included 46 healthy men. Proneness to pneumonia was discovered to be related to abnormal function of mononuclear phagocytes and a decrease of antiviral cellular resistance. The conclusion is made about the necessity of the control over functional activity of monocytes, viremia in immunocompetent cells and advisability of carrying out immunomodulatory and antiviral therapy.
452 case histories were analysed of patients with acute glomerulonephritis who were treated at the specialized unit of military hospital. 96.1% of these patients were enlisted men at the age of 18-20. Acute respiratory diseases had a great significance for etiological structure of acute glomerulonephritis. About 1/4 of all cases took place after the purulent affections of skin or subcutaneous fatty tissue. In the conditions of the Trans-Baikal region the clinical course of acute glomerulonephritis was basically represented by manifestative form of illness with pronounced swelling syndrome, arterial hypertension and typical changes in urine.
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A study of 30 patients suffering of acute pneumonia indicates that the development of acute pneumonia occurs against the background of disorders of the functional activity of monocytes with prevalent reduction of the functional activity of phagocytosis and inhibition of the unspecific cellular antiviral resistance. Leucocytic interferon sharply activates phagocytosis. The number of phagocytic cells and activity of phagocytosis reduced and the number of virus-involved immunocompetent cells increased under the effect of antibiotics.
The external respiratory function was examined in 141 patients with acute pneumonia on "METATEST" spirographs. All calculations were computerized. It is concluded that use of native spirographs for examination of the external respiratory function by means of the stream-volume loop analysis method widens the diagnostic possibilities and is of value in pathogenetic therapy.
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As many as 188 records of IE patients were studied as were 67 autopsies of deceased persons. Significant changes in the clinical course of IE were disclosed over the past 10-15 years versus previous 15: more prominent role of staphylococcal and gram-negative flora in the etiology of the illness, with microbial associations-caused IE cases having become more common. Diagnostic value of hemoculture did not appear to show much promise. The following items were found to be important risk factors for IE: prior viral and bacterial infection, invasive interventions, and chronic somatic diseases. There prevailed those IE forms having appeared on the intact heart valves in elderly persons and those at a mature age. In the course of the illness there tended to be more toxic and allergic manifestations, thromboembolic complications, and extensive vascular pathology.
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The results of employing intratissue (intraorganic) electrophoresis in a complex of therapeutic measures applied in patients with acute pneumonia with a grave course in young individuals (n = 195) versus homogeneous control group of patients (n = 50) in whom intratissue electrophoresis was not done, were as follows: the percentage of those discharged from hospital in the former group exceeded those among control by 15.9%, the average bed occupancy was reduced by 5 days, the number of persons whom sick leaves had been granted dropped by 9.9% and there were no dismissals from the Army whereas in the control group these amounted to 6%. The present method of treatment used in combination with other therapeutic modalities promotes undelayed resolution of an acute pneumonia and prevention of certain complications in this category of patients.
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