[Combantrin effectiveness and tolerance in intestinal nematodiases].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to A M Shcherbakov.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The correlations between blood eosinophils, serum immunoglobulins (Ig), circulating immune complexes (CIC) content, alpha- and gamma-interferon (IFN) production and HLA class I antigens were analyzed in 33 patients with hydatid disease aged 37.5 +/- 1.5 years. Direct correlation between the activity of gamma-IFN production, blood eosinophils, IgG and specific IgE content was found in patients with multiple pulmonary damage. In this group the high level of CIC correlated with the high content of IgG and specific IgE. In patients with solitary and multiple cysts in the liver in spite of high alpha- and gamma-IFN production the levels of total and specific IgE were low, IgG and CIC contents were moderate and eosinophils percent was low. In patients with combined damage of the liver and multiple cysts in the abdominal cavity high CIC production correlated directly with high total IgE content. In the total group of patients percent of HLA B5 carriers was significantly higher than in controls: 36.6 and 14.7 respectively (R = 0.01 after Fischer) that correlated with comparatively active gamma-IFN production in patients with the pulmonary and the liver cysts. The possible explanation of the different immune response in patients with the different localisation of the parasite cysts are discussed.
Chemotherapy was administered to 53 patients with hydatid disease; to 27 of them it was administered to prevent recurrences. Mebendazole was prescribed by courses lasting for 14 to 30 days with intervals between the courses of 1 to 3 months, in a daily dose of 50 mg/kg to be taken 4 times. The treatment efficacy was assessed in accordance with the criteria suggested by the WHO experts. On the whole our results did not evidence any essential differences in mebendazole therapy efficacy in our patients and in those represented in a WHO report. No recurrences occurred over the period of observation, that lasted for 6 months to 6 years, in the 27 patients who were administered the drug to prevent the disease recurrences. The treatment was fairly effective in 27% of the patients, good effect was attained in 42%, no desirable results were attained in 19%, and lethal outcomes were recorded in 12% of patients.
Chemotherapy was administered to 17 alveolar echinococcosis patients. Two of these patients developed an uncomplicated disease (a subtotal involvement of both liver lobes), fifteen a complicated condition. In 13 patients with the complicated condition metastases to the lungs, peritoneum, as well as diaphragmatic and abdominal organs' growth were detected, in 4 ones jaundice developed. Mebendazole was administered in a daily dose of 50 mg/kg together with the drugs improving its absorption. 30-day courses with 1-3 month intervals were administered. The efficacy of this therapy and its tolerance were assessed from clinical, laboratory and instrumental findings, including serologic tests. Intolerance presenting as alopecia was observed in 4 women, in one of them twice. Mebendazole efficacy in these patients was compared to that in patients administered the drug in a daily dose of 100 mg in 1978-1980. A positive time course was observed in 53% of patients.
The role of histocompatibility antigens in the realization of invasions and the nature of its course were studied in 71 patients with Echinococcus granulosus infection and in 18 with E. multilocularis infection. It has been shown that the effects of HLA antigens on the realization of invasion is heterodirectional; the factors predisposing to the occurrence of echinococcosis are HLA-B5, B18, and A28 antigens, whereas those preventing their realization are HLA-B14 antigen. The carriage of HLA-B5 and B18 antigens determines a high risk of E. granulosus infection of the lungs and liver. The realization of the latter is prevented by the carriage of HLA-B27 antigen. The development of E. multilocularis infection of the liver is promoted by that of HLA-A11, whereas the carriage of HLA-A9 antigen prevents the occurrence of this lesion. Solitary hepatic lesion in E. granulosus infection correlates with HLA-A10 and B18 antigens, while multiple lesion with HLA-B5 antigen, but the development of E. multilocularis infection metastases is associated with HLA-B8 antigen. The occurrence of spontaneous cystic ruptures of E. granulosus correlates with HLA-A32, A26, and B5 antigens, which is likely to associated with cystic formation defect due to the influence of these factors.
Mebendasole is better absorbed in the gastrointestinal tract if administered together with essential to patients with hydatid disease. Thirty-four patients with alveolar and hydatid echinococcosis were administered mebendasol in a daily dose of 50 mg/kg in 4 doses and essentiale in a daily dose of 600-1000 mg in 4 doses. A total of 86 therapeutic courses, 30 days each, were carried out. The treatment was sufficiently well tolerated. Mebendasole levels in the course of therapy surpassed the minimal effective ones in 2/3 of the patients, that is, they were significantly higher than in administration of mebendasole alone.
The reversing action of verapamil on the effect of chloroquine was found in in vivo experiments by using a model P. berghei resistant to chloroquine, an LNK65 isolate having a naturally lower resistance to the agent, and its polyresistant strain with the acquired resistance to chloroquine and fansidar, as well as by employing the chlorine-resistant P. falciparum isolates from the south of the Socialist Republic of Vietnam. The magnitude of this effect was related to the dose of verapamil, the frequency of administration of a combination of the agents in vivo, while that was associated to the concentration of verapamil and the level of isolate resistance to chloroquine in vitro which was the most pronounced. Taking into account the dose-dependent effect of verapamil, it can be suggested that increasing its concentration in combination with chloroquine can provide a more marked reversing action with lower chloroquine concentrations. The parameters accepted by the authors in evaluating the combined effect enable the effect of the verapamil/chloroquine concentration to be regarded as potentiation.