[The formation of bio-films by opportunistic microorganisms isolated from patients with rheumatic diseases].

The study was carried out concerning capability of 194 strains of opportunistic microorganisms to form bio-films. It is established that bacteria ecizing organism of patients with rheumatic diseases have capacity to form microbial bio-films. The formation of bio-films is manifested with the same rate as in agents of inflammatory processes. At that, Escherichia coli, Staphylococcus haemolyticus and bacteria of genus Proteus isolated under rheumatic diseases have significantly higher capability to form biofilms that matters for development of comorbide infections.

[Strategy for the use of chondroprotectors in osteoarthrosis].

Symptomatic slow-acting drugs (chondroprotectors) as different dosage forms have widespread application in the treatment of osteoarthrosis (OA) at different locations. The literature review considers their possible effect on carbohydrate metabolism, which is particularly important due to the high prevalence of diabetes mellitus in patients with OA. Current clinical recommendations for the use of chondroprotectors in the therapy of OA are given.

[Relationship of subclinical atherosclerosis indicators to exercise tolerance in patients with coronary heart disease].

AIM: To study the spread of a number of indicators of subclinical atherosclerosis in patients with coronary heart disease (CHD) and the pattern of their relationship to their functional state and muscle mass. SUBJECTS AND METHODS: Twenty patients with chronic forms of CHD were examined. Vascular wall stiffness was judged from pulse wave velocity (PWV) along elastic-type vessels, by calculating the carotid-femoral index (CFI). Endothelial function was estimated by endothelium-dependent vasodilation (EDV) in a reactive hyperemia test. Ultrasound scanning of the common carotid artery was used to estimate intima-media thickness. All the patients underwent bicycle ergometry; their exercise tolerance (ET) was determined by the amount of consumed oxygen when the metabolic equivalent (MET) was calculated; the percentages of active cell mass (ACM%) and lean mass (LM%) of total body weight were determined; the levels of total cholesterol, high- and low-density lipoprotein cholesterol, and triglycerides were estimated. A control group comprised 20 matched persons without CHD. RESULTS: A prognostically unfavorable increase of >12 m/sec in CFI was revealed in 20% of the patients with CHD and in 10% of the controls; endothelial vasomotor dysfunction (EDV < 10%) in 65 and 50%; a more than 0.9-mm increase in 55 and 15%, respectively. A low ET was stated in the majority of patients with abnormal vascular stiffness and endothelial vasomotor dysfunction. The CHD patients with a low ET were found to have significant correlations of CFI with ACM% and LM%, EDV and ACM% and LM%, CFI and EDV. The control patients with a low ET also showed correlations of EDV and ACM% and LM%. There was a correlation of ACM% and LM% with MET in both groups. CONCLUSION: EDV and PWV reflect a more decrease in physical activity and dysadapted functional status than in the degree of subclinical atherosclerosis.

[Efficiency of use of autologous activated serum in coxarthrosis].

AIM: To evaluate the clinical efficiency of using autologous conditioned (activated) serum (ACS) versus hyaluronic acid (HA) in coxarthrosis (CA). SUBJECTS AND METHODS: Two groups of patients (n = 54) who were matched for age, sex, and disease duration and had a valid diagnosis of CA were examined. During 3 weeks, Groups 1 and 2 patients received intra-articular therapy with ACS or synocrome forte (Croma Pharma, Sotex), respectively, for 3 weeks. A 12-month follow-up evaluated the magnitude of pain, by using the visual analog scale (VAS, mm), the functional index WOMAC and general health, by applying the EQ-VAS scale. RESULTS: The only benefit of HA was found to be more functional improvement as detected by the WOMAC index (-21.8%; t = 2.56) at an early (1-month) follow-up. After 3 months, the patients in the ACS group were recorded to have the maximum VAS pain intensity reduction that was 76.5% greater than that (t = 4.31) in the HA group. The clearest advantages of ACS therapy were traced 6 months after treatment. CONCLUSION: The use of ACS may be a real alternative to that of HA derivatives in achieving good clinical outcomes in patients with CA. After ACS administration, there was a long-term preservation of achieved positive results.

[Effect of local therapy of autolgous platelet-enriched plasma on pain syndrome in patients with knee osteoarthritis].

The influence ofplatelet-enriched plasma (PEP) ofpain intensity was estimated using a visual-analogous scale and the Wormac questionnaire in patients with knee osteoarthrosis (KOA). Beneficial effect on all variables studied was documented within I month after the onset of therapy. It was totally absent after 3 months in severe KOA but was apparent in typical KOA. Positive dynamics throughout months 1 and 3 was observed only in patients with early manifestations of KOA. It persisted during all 12 months of the study.

[Colonic microbial biocenosis in rheumatoid arthritis].

The aim of the work was to study colonic microbial biocenosis and colonizing ability of opportunistic bacteria in 32 patients with rheumatoid arthritis (RA) and 30 healthy subjects. RA was diagnosed based on the American Rheumatism Association criteria (1987). Qualitative and quantitative composition of the microflora was detected by a bacteriological method. StatSoft Statistics 6.0 was used to treat the data obtained. RA was associated with significant modification of the intestinal flora, viz. decrease in lactobacteria and significant increase of enterococci, clostridia, colibacteria showing reduced enzymatic activity, and opportunistic species. Also, symbiotic relationships between microorganisms altered. The fraction of bifidobacteria, bacteroids, and lactopositive colibacteria reduced while the abundance of opportunistic enterobacteria and staphylococci was elevated. Opportunistic Enterobacteriaceae were present in urine and nasal mucosa which suggested their translocation from the intestines. It is concluded that changes in intestinal microflora and colonization by opportunistic bacteria enhance the risk of development of co-morbid conditions in patients with RA.

[The influence of ration with different content of fat the pain syndrome in osteoarthrosis with the knee joint].

Study the influence of ration different content of fat the pain syndrome in osteoarthrosis with the knee joint. We examined 112 women at the age 59 (54-63) with osteoarthrosis the knee joint. Elicit what plenty in ration of fat (more than 45% caloric intake) promote the aggravation pain syndrome in the knee joint in osteoarthrosis patients.

[Alflutop in local therapy of shoulder periarthritis].

AIM: To study efficacy of a compound biological preparation alflutop in local therapy of shoulder periarthritis (SP), to compare its efficacy with that of periarticular diprospan. MATERIAL AND METHODS: The trial included 54 patients with SP. Clinical SP forms consisted of subacromial and subdeltoid bursitis (SSB) (42.6%), tendinitis (57.4%). Acute disease was diagnosed in 35.2% patients, chronic one--in 64.8%. Alflutop and diprospan were injected periarticularly. The patients were divided into three groups. Patients of group 1 (n = 15) received alflutop monotherapy (2 ml, 5 injections). Group 2 (n = 24) received a single injection of diprospan (7 mg). Group 3 (n = 15) patients were given combined treatment: a single injection (7 mg) of diprospan followed by alflutop infiltrations (2 mg, 5 injections). The efficacy of the treatment was judged by some score clinical parameters, dynamometrical findings, SDQ score set, thermographic and ultrasonic signs of periarticular inflammation. RESULTS: A course of periarticular alflutop infiltrations in SP demonstrated the same efficacy as a single dose diprospan. However, in acute SP with bursitis diprospan produced a significantly better results while alflutop was better in chronic SP with tendinitis. Diprospan combination with alflutop produced the highest therapeutic effect irrespective of the disease course and clinical SP course. CONCLUSION: Local administration of alflutop in SP as monotherapy alternative to glucocorticosteroids or in combination with diprospan is effective. A differentiated approach allowing for a clinical form and course of SP raises therapeutic efficacy noticeably.

The use of homeopathic preparation Vozraston in the therapy of patients with rheumatoid arthritis.

We studied clinical and psychosomatic characteristics in 34 patients with rheumatoid arthritis. Sixteen patients received Vozraston (without considering the individual sensitivity) in addition to standard therapy. No changes in clinical and psychoemotional parameters were revealed. Vozraston reduced pain syndrome and increased the tone of the sympathetic nervous system.

[Negative consequences of enterosorption in rheumatoid arthritis]. / Negativnye posledstviia énterosorbtsii pri revmatoidnom artrite.

Aggravation of the patients with rheumatoid arthritis after enterosorption was apparently related to an increase in the rate of lipid peroxidation and to decrease in the antioxidation activity, which was expressed as a decrease in cholesterol and tocopherol content and an increase in ferrum and cuprum concentration in blood plasma. After-effect of alterations in phospholipid composition in blood plasma, erythrocytes, neutrophils and thrombocytes are also considered.

[Megaloblastic pancytopenia in a female patient with rheumatoid arthritis given methotrexate and amidopyrine simultaneously]. / Megaloblasticheskaia pantsitopeniia u bol'noi revmatoidnym artritom pri odnovremennom primeneniem metotreksata i amidopirina.

The paper is concerned with the development of megaloblastic pancytopenia in a female patient with grave rheumatoid arthritis. The patient had been given methotrexate (15 mg per week) for a long time, supplemented by amidopyrine (1.0 to 1.5 g/day). The author holds that the development of the above-indicated complication is provoked by both drugs interference into folate metabolism. It is concluded that caution should be taken as to the combined use of methotrexate with non-narcotic analgesic drugs, nonsteroidal anti-inflammatory agents and sulfanilamides.

[Lipid peroxidation and anti-oxidative systems of an organism in experimental streptococcal myocarditis and rheumocarditis]. / Perekisnoe okislenie lipidov i antioksidantnye sistemy organizma pri éksperimental'nom streptokokkovom miokardite i revmokardite.

Lipid peroxidation rate and activity of glutathione and tocopherol antioxidant systems were studied in rats with experimental streptococcal myocarditis and in patients with rheumatic carditis. During the acute period of inflammation content of diene conjugates and activity of glutathione reductase were increased in myocardium and erythrocytes of rats simultaneously with a decrease in tocopherol concentration in blood plasma. In the patients with rheumatic carditis activation of lipid peroxidation and the glutathione reductase was found in erythrocytes as well as a decrease of the tocopherol content--in blood plasma. Interrelationship between alterations in these patterns and their functions in rheumatic carditis pathogenesis are discussed.

[Antioxidant systems of erythrocytes in rheumatism]. / Antioksidantnye sistemy éritrotsitov pri revmatizme.

Patients with inactive and active rheumatic fever were examined for the intensity of lipid peroxidation of red blood cell membranes, lipid antioxidant system of tocopherol, non-lipid system of glutathione and related total activity of the pentosophosphate pathway of carbohydrate metabolism in red blood cells. It was established that activation of rheumatic process is accompanied by a increase in the content of diene conjugates in lipids of red blood cell membranes, a reduction of the tocopherol content in blood plasma, activation of glutathione reductase and glucose-6-phosphate dehydrogenase with the lowering of the total activity of the pentose cycle in red blood cells. The characteristics under study depended to a lesser degree on circulation insufficiency. The interrelationship between the shifts revealed is discussed, the mechanism by which they develop is suggested.