2022 Issue №3

Chronic obstructive pulmonary disease (COPD) is a significant public health problem due to its widespread prevalence. It becomes a medical and social burden for both society and the patient. To what extent comorbid alcoholism is able to influence the features of the clinical course of COPD remains an open issue. The study aimed to reveal the impact of alcoholism on the level of COPD subjective symptoms in patients with different compliance. Materials and methods. 147 men with COPD in the age of 40―88 years were examined. The study relied on spirometry criteria, mMRC, CAT, domestic questionnaire of adherence to therapy, 6-minutes walking tests. It also established the stage of alcohol disease. The inhalation therapy was clarified during the interview, the episodic and systemic omissions fixed. Results and discussion. We observed the trend to subjective COPD symptoms underestimation in patients with the II, III stages of alcohol disease. Alcohol disease did not affect subjective symptoms in patients with stages III, IV of COPD. The compliance level and subjective symptoms severity showed no interrelation in patients suffering from alcoholism. This emphasized the absent association between the high level of compliance and critical self-state perception in patients with concomitant diseases. Regardless of the concomitant dependence, systemic omissions were rarely observed in patients receiving inhalers with a lower dosage frequency. Conclusion. The poor informativity of mMRC dyspnea scale and CAT-test was demonstrated in patients with mild and moderate COPD and severe alcoholism. The high level of compliance showed no impact on this tendency. Using single dose per day regimen was associated with a better compliance to recommendations, regardless of alcohol adherence.

To maintain the normal state of the immune system, the processes of cell proliferation must be strictly regulated and balanced by the processes of apoptotic death to prevent the development of autoimmune and neoplastic reactions. T-lymphocytes of immune memory are under strict control from the immune system.

The role of γc-cytokines (IL-2, IL-7, and IL-15) in the regulation of maturation, differentiation, and apoptotic death of memory T-lymphocytes under in vitro cultivation conditions was evaluated.

The study revealed the ability of γc-cytokines to increase the content of CD3+HLA-DR+CD95+ T cells in the effector populations of immune memory cytotoxic lymphocytes, which may indicate the processes of cell differentiation and maturation under the influence of γc-cytokines.

The authors also showed that in CD3+CD4+CD45RO+ T-lymphocytes have a relative resistance to the action of γc-cytokines, in comparison with cytotoxic CD45RO+ T-cells.

Thus, maintaining homeostatic concentrations of γc-cytokines plays an important role in maintaining the normal functioning of the immune system by maintaining the balance of homeostatic proliferation and apoptotic death. We also noted that cytokine imbalance contributes to an increase in the surface expression of late activation molecules (HLA-DR) and apoptosis (CD95), which is necessary to control excessive proliferation of lymphocytes, and, ultimately, prevents the breakdown of immune tolerance mechanisms and the development of hyperproliferative pathologies of the immune system.

There is a large number of ways to measure the size of the spleen by ultrasonography. Methodically correct examination is the key to the accurate determination of splenomegaly. The article describes well-known methods for determining its size and volume, which are used in sonography, computed tomography and magnetic resonance imaging. The aim of the study is to identify the most accurate way to measure the volume of the spleen during ultrasound examination. Therefore, the authors performed the ultrasound examination of the spleen of 40 patients, the measurement was carried out in three positions of the patient’s body, in each of the positions three methods of measuring and calculating the volume of the organ were used. During the processing of the results, it was revealed that optimal visualization was provided in the patient’s supine position, the orientation of the ultrasound transducer along the long axis of the spleen. One patient obtained different volume values — the average difference was 40—70 ml, and in some cases reached 150 ml. This indicates the influence of additional factors on visualization — these include the somatic type of the patient, the variability of the shape of the spleen when changing the position of the body, the shape of the spleen.