[A problem of self-consciousness and its reflection in psychopathology of alcoholism].
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Biomedical subjects
Publications and source records attributed to N A Aliev.
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To study self-consciousness changes in initial, manifesting and final stages of acute alcoholic hallucinosis, 60 patients have been examined. In 51 of them, the disease developed on the background of pseudo-dipsomania or constant hard drinking and in 9--of abstinent state. Initial stage of acute alcoholic hallucinosis was characterized by negative type of self-consciousness reaction. In manifesting stage the following variants of self-consciousness were detected: disturbation (vital, somatophysical, autopsychic), suppression (harmonic, dissociated), depersonalization and hyperactivity. In final stage, there were disactualization, nosognosia (adequate-, hypo- and hypernosognosia, anosognosia), partial and total reintegration of self-consciousness. These disorders of self-consciousness appear to be of prognostic and diagnostic value.
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As many as 20 alcoholics were examined for the therapeutic efficacy of interferon. The control group was made up of 20 alcoholics who were treated by teturam. The clinical, neuroendocrine and immune data demonstrate the high efficacy of the use of interferon in alcoholics. The mechanisms of the drug action are under discussion.
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Monoclonal antibodies were used to study the T and B immunity systems in 60 alcoholic patients suffering from pulmonary tuberculosis. The patients with that combined pathology demonstrated marked immunodeficiency as regards the T system and an increase of humoral immunity. It is assumed that one of the main causes of immunodeficiency lies in the blockade of the differentiation of T cells at the stage of T prothymocytes. The rise of the level of humoral immunity is connected to a decline of T suppressors. Administration of thymalin to patients with associated alcoholism and pulmonary tuberculosis was found to be highly effective.
Parameters of cellular and humoral immunity, and the levels of neurotransmitters and hormones both before and after the administration of various stimulators and blocking agents that affect the immune and neuroendocrine systems were investigated in 100 patients suffering from chronic alcoholism. The results direct attention to the significance of the impairment of interactions between these biological systems during chronic alcoholism.
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Comparative analysis of the immunoregulatory T-cells was carried out in 60 alcoholics suffering from tuberculosis and in 20 normal subjects by the monoclonal antibodies technique and the test of E-rosette formation sensitivity to theophylline. No correlation between the findings of the two tests was observed.
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The role of social and psychological factors in casual relationship between alcoholism and tuberculosis was studied in regard to alcoholic patients with tuberculosis. The results confirmed the suggestion that the role of these factors in relation between alcoholism and tuberculosis was of exceptional importance.
Clinical and immunological characteristics of the tuberculosis process in patients with mental diseases and congenital deficiency of glucose-6-phosphate dehydrogenase were investigated. Enzymopathy was detected in 34 (8.9 per cent) out of 382 patients subjected to the investigation. It was shown that among the carriers of the anomalous gene, the proportion of patients with chronic destructive tuberculosis was high. The patients (91.2%) showed more frequent bacterial isolation. Despite immunotherapy, no positive changes in the immunological indices were observed in the carriers, which was attributable to decreased activity of the enzyme in the immunocompetent cells.
The effect of neuromediators (DA, GABA) of the neostriatum on the immunogenesis has been studied in 50 noninbred white rats of both sexes weighing 150-200 g, using a new non-cannula method of microinjection of substances into the predetermined brain structures. The results obtained have demonstrated that stimulation of the dopaminergic or blocking of the GABA-ergic system mediated through the impact on the function of neurohormones and cyclic nucleotides increase the body's immunological resistance. In contrast, blocking of the dopaminergic or stimulation of the GABA-ergic systems via the same mechanisms adversely affect immunogenesis. On the basis of the elucidated neurohumoral and immunological impairments the author recommends a pathogenetic treatment of alcoholism taking into account the patients' clinical status. The author points to inadvisability of the use of neuroleptics and GABA-positive drugs for suppressing the pathological craving for alcohol.
The stimulation of the rat neostriatum dopaminergic system (with apomorphine) or blocking of the GABA-ergic (with picrotoxin) and serotoninergic (with parachlorphenylalanin) systems increased the level of immunological indices, whereas the lesion of dopaminergic system (with 6-hydroxydopamine) or the activation of two latter neurotransmitter systems (with GABA and serotonin, resp.) suppressed the immunogenesis.
Different kinds of postoperative analgesia were used in 106 patients after urgent proctological operations. A comparative analysis of the objective and subjective data obtained have shown that epidural anesthesia is the most effective method of postoperative analgesia in urgent proctology.
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