[Efficiency of unsaponifiable compounds of soya beans and avocado in health care personnel with osteoarthrosis in Volgograd].

The authors used immunoenzyme method to assess level of oxydated low density lipoproteins (o-LDL) in 130 patients with osteoarthrosis. High serum level of o-LDL was seen in 60% of the patients with osteoarthrosis. 40 patients with osteoarthrosis were treated by unsaponifiable compounds of soya beans and avocado (Piaskledin, Expanscience, France)--dose of 300 mg daily, over 3 months. The treatment resulted in good effect in the patients with high level of o-LDL (over 168 ng/ml).

[Rheumatoid arthritis: psychosomatic aspects].

The review considers the results of studies of the psychosomatic aspects of rheumatoid arthritis (RA), which have been published in the past 5 years. In particular, there is evidence for the impact of chronic pain on the psychological status of patients with RA, for that of the disease on quality of life in the patients, their sociopsychological and interpersonal relationships; trials of the efficiency of additional treatment options for RA are given.

[Clinico-pathogenetic significance of enzymes regulating nucleic metabolism in erythrocyte lysates and sera of patients with osteoarthrosis].

Lysates of erythrocytes and sera of 52 patients with osteoarthrosis (OA) and 30 healthy subjects were used used to determine adenosine deaminidase (ADA, AMP deaminase (AMPDA) and adenine deaminidase (AD). Their activities were unrelated to the age and sex of the patients. At admission, patients with OA showed enhanced activity of ADA in sera and reduced activity of AMPDA and AD in lysates compared with normal values. These changes depended on clinical features of OA and were especially pronounced in patients with poly-OA and synovitis. These data suggest participation of enzymes of the adenyl branch of purine metabolism in pathogenesis of OA. Treatment of hospitalized patients allowed to achieve positive dynamics of the above activities coupled to their improved clinical conditions even though enzymatic activity of erythrocyte lysates remained different from that in healthy subjects. It is concluded that enzymatic assays used in the study may be used as additional diagnostic methods for the assessment of synovitis and optimizatic of control over efficiency of OA therapy.

[The clinical diagnostic value of a study of the activity of enzymes of the guanyl branch of purine metabolism in patients with ankylosing spondyloarthritis].

AIM: To assess the diagnosis of the activity of a pathological process in patients with ankylosing spondyloarthritis (AS) and to reveal purine metabolic (PM) changes in relation to the clinical features of AS. MATERIALS AND METHODS: The serum activities of the PM enzymes: xanthine oxidase (XO), guanine deaminase (GDA), guanosine deaminase (GSDA), purine nucleoside phosphorylase (PNP), guanosine phosphorylase (GP), and adenosine deaminase (ADA) were determined in 55 patients (51 males and 4 females) aged 36.0 +/- 1.4 years). A control group comprised 30 apparently age- and gender-matched healthy individuals, as in the study group. RESULTS: On admission, the patients were found to have increased XO, GDA, PNP, and GD activities and decreased GSDA activity. The higher activity of the process was observed, the greater activities of GDA, XO, PNP, GP and the lower activity of GSDA and ADA were. There were the enzymatic activity differences that depended on the degree of pathological process activity, clinical form, the magnitude of X-ray changes, and the degree of joint functional insufficiency. CONCLUSION: The findings suggest that there may be PM disturbances in the immunocompetent cells.

[Normalizing effect of rehabilitative techniques on the psychoemotional status of patients with inflammatory and degenerative joint diseases].

120 subjects with a verified diagnosis of rheumatoid arthritis (RA) and 94 ones with osteoarthrosis (OA) were examined to evaluate the influence of structural electromagnetic resonance therapy (SEMRT) on psychological status of patients suffering from both inflammatory and dystrophic joint diseases. Spielberger test for situational and personal anxiety and Beck test for depression were used to detect and assess changes in the patients' psychological condition. Comparative studies demonstrated advantages of incorporation of SEMRT in combined RA and OA treatment. Wide spectrum of SEMRT therapeutic actions accounts for its beneficial action in patients presenting with anxiety and depressive disorders associated with inflammatory and dystrophic joint diseases highly refractory to routine treatment.

[Psychosomatic relationships in patients with primary fibromyalgia syndrome].

This clinical and psychological study involved 100 patients aged 24-51 years with primary fibromyalgia syndrome (PFS). The patents exhibited clinical manifestations of neurotic disorders, low level of subjective control, dysadaptive attitude toward the disease, and an intense spectrum of protective psychological mechanisms. The main clinical manifestations of PFS correlated with psychological status of the patients. It is concluded that objective evaluation of clinical conditions of PFS patients requires integrated psychosomatic assessment of their health status.

[Poor prognosis factors in SLE: results of 5-year follow-up].

AIM: To determine factors of poor prognosis of systemic lupus erythematosus (SLE). MATERIAL AND METHODS: Clinical and device examinations were made in 64 patients hospitalized with verified SLE. Its activity was assessed by SLAM and SLEDAI indices, severity--with SLICC/ACR. Five years after the primary examination the patients were re-examined. Prognostic factors were investigated using multiple linear regression and binary logistic regression. RESULTS: A 5-year survival of SLE patients was 87.5%. For 5 years SLICC/ACR has risen from 1.24 +/- 1.29 to 2.58 +/- 1.89 points (p < 0.001). Reproductive, nervous, cardiovascular and osseomuscular disorders made the greatest contribution to this rise. The age of SLE onset, SLICC/ACR at the start of the study, the absence of a rapid response to treatment were significant predictors of SLICC/ ACR rise in the model of linear regression. This model explains 62.7% of the dependent index variance. The model of binary logistic regression, in which a dependent variable was survival, identified the same three indices as statistically significant. The model explained 74.4% of 5-year survival variance and predicted an outcome correctly in 86.2% cases. CONCLUSION: Key factors of a poor SLE prognosis are a late SLE onset, a severe initial lesion and no rapid response to therapy.

[Prospects for using antigenic nanosystems in the diagnosis and treatment of inflammatory rheumatic diseases].

AIM: To study whether immobilized antigenic nanosystems (ANS) may be designed on the basis of antigens of varying chemical nature to identify and to remove specific antibodies (Ab) from the blood of patients with systemic lupus erythematosus (SLE). SUBJECTS AND METHODS: Sixty patients with the diagnosis of SLE verified by the 1997 American College of Rheumatology criteria and 30 apparently healthy individuals were followed up. The levels of Ab to catalase (Cat), xanthine oxidase (XO), and cardiolipin (CL) were measured by enzyme immunoassay, by applying the respective ANS as an antigenic matrix. RESULTS: There was a significant relationship of the levels of Ab to Cat and XO to the activity of SLE. It was shown that Ab to Cat and XO could affect the functional activity of serum enzymes. The level of Ab to CL in patients with SLE was found to depend on two parameters - the intensity of the disease and the presence of antiphospholipid syndrome; acute cerebral circulatory disorder and thrombocytopenia were observed to have a significant unidirectional impact on the level of Ab to CL. Immobilized CL-based ANSs were effective in eliminating Ab to CL from the whole blood of patients with SLE, without resulting in a significant hemolysis of blood corpuscles and in a reduction of total protein concentrations. CONCLUSION: The development and introduction of preventive methods for the early diagnosis of SLE may be extended, by using ANS based on Cat, XO, and CL antigen. The designing and putting into practice novel ANS-based hemosorbents may allow immunosorption to occupy a prominent place in the pathogenetic therapy of inflammatory autoimmune diseases.

[Use of life quality indices in the rehabilitation therapy of inflammatory and degenerative rheumatic diseases].

AIM: To study whether life quality (LQ) indices may be used to evaluate the efficiency of structural resonance electromagnetic therapy (SREMT) and its correction in patients with rheumatoid arthritis (RA) and in those with osteoarthrosis (OA). SUBJECTS AND METHODS: One hundred and twenty patients with significant RA and 94 patients diagnosed as having OA were followed up. The SF-36 questionnaire was used to detect and assess objective data on health problems and changes. The patients with RA and those with OA were randomized to the groups matched for gender, age, and disease duration: a study group (n = 80) and a control one (n = 40) for RA; a study group (n = 56) and a control one (n = 38) for OA. Both group patients received the same medical and physiotherapeutic treatment (within each nosological entity, respectively). Furthermore, in the study groups, the patients with RA and those with OA had additionally 10-12 daily (43-min) sessions of SREMT on a Rematerp apparatus. RESULTS: The inclusion of SREMT into the multimodality treatment of patients with RA and those with OA has shown significant benefits. A wide spectrum of therapeutic action of SREMT exerts a positive impact on the basic LQ indices (the indicators of physical and role physical performance, somatic pain, general condition, and social and role emotional performance). CONCLUSION: SREMT may be recommended for use in rheumatological care as a technique that enhances the efficiency of performed therapy and medical rehabilitative measures in inflammatory and degenerative rheumatic diseases.

[The evaluation of the quality of life as a criterion of the efficiency of rehabilitating treatment in rheumatoid arthritis].

Under observation there were 120 patients with rheumatoid arthritis (RA), which were divided into basic (n = 80) and control group matched by gender, age and duration of the disease. The all patients received the similar drug and physiotherapeutic treatment. Furthermore additional sessions of structural resonance electromagnetic therapy (SREMT were performed) in patients from basic group. The comparative studies showed significant benefit of inclusion of SREMT in complex management of RA patients. The wide spectrum of therapeutic action of SREMT has positive influence on basic parameters of the quality of life of RA patients: the general indices of physical and role physical functioning, somatic pain, overall health, social and role emotional functioning. SREMT may be recommended for using in rheumatologic clinic as a method of increasing the efficacy of conducted treatment and therapeutic and rehabilitation measures in RA.

[Bishofit in the treatment of rheumatoid arthritis]. / Bishofit v lechenii bol'nykh revmatoidnym artritom.

AIM: To evaluate effectiveness of a natural mineral bishofit in combined treatment of rheumatoid arthritis (RA). MATERIAL AND METHODS: The study included 71 RA patients with minimal activity of the pathological process and articular disorders of stage II. Bishofit was used in baths and compresses. 33 AR patients of group 1 took bishofit baths (14 procedures) and non-steroid anti-inflammatory drugs (NSAID), 27 RA patients of group 2 were treated with bishofit compresses (14 procesures) and NSAID, 11 patients of group 3 (controls) received NSAID alone. The effect of the treatment was assessed on the basis of clinical data, the length of the affected joint circumference, antitryptic blood activity, activity of malate dehydrogenase, lactate dehydrogenase isoenzymes, plasmin, plasminogen, ESR, sialic acids. RESULTS: Bishofit-treated patients showed earlier (by 5-6 days) and greater (by 25-35%) decrease of the pain, joint and inflammatory indices as well as duration of morning stiffness, length of the affected joint circumference and joint mobility, improvement of the tests' results. A response and an appreciable response to combined therapy with bishofit were achieved in 62.9-63.6% of cases vs 45.5% in the control group. Bishofit baths and compresses did not differ considerably by therapeutic efficacy.

[Use of affinity interaction of biologically active substances in practice of public health system]. / Vozmozhnosti primeneniia affinnogo vzaimodeistviia biologicheski activnykh veshchestv v praktike zdravookhraneniia.

AIM: To determine the potentialities of use of affinity interaction of immobilized biologically active substances (bacterial cells or their fragments, toxins, antigens of various chemical nature, immunoglobulins, enzymes, gangliosides, etc.) for medical practice. MATERIALS AND METHODS: Emulsion polymerization of acrylamide monomers in the gaseous nitrogen current was used as a basic method for preparation of solid-phase magnetic immunosorbents (MIC). A procedure for preparation of siliceous MIC was also applied. The prepared MICs were used a solid phase in enzyme immunoassay and immunofluorescence assay and the recorded data were compared with those of studied conventionally used in practical medicine. RESULTS: The use of MIC made it possible to detect pathogens of particularly dangerous infections in large volumes of the samples contaminated with another microflora. With the proposed MIC, one can stand a good chance of surveying large contingents of the population, of obtaining the quantitative results in shorter periods to establish a diagnosis. With this, the sensitivity and specificity of immunoassays substantially increase. Whether MIC may be used as selective hemosorbents to remove specific antibodies from the blood of patients with rheumatic diseases for therapeutic purposes was studied. CONCLUSION: The findings are indicative of wide potentialities of use of affinity interaction of biologically active substances immobilized on inert carriers with the inserted magnetic material in the laboratory diagnosis of diseases of both infectious and autoimmune nature, which may be widely used in the in- and outpatient settings.

[Affinity sorbents having magnetic properties in the clinical picture and diagnosis of communicable and non-communicable diseases]. / Affinnye sorbenty s magnitnymi svoistvami v klinike i diagnostike infektsionnykh i neinfektsionnykh zabolevanii.

Affine magnetic sorbents which have no analogs in the practice of our country have been for the first time developed for the rapid diagnosis of various life-threatening diseases (plague, cholera, anthrax, glanders, meliodosis, tularemia, leptospirosis, dysentery, viral hepatitis A) and for the identification of their causative agents. The efficacy of new magnet-controlling test systems has been repeatedly confirmed by their applications in epidemiological events and emergencies: in the epidemiological surveillance of viral hepatitis A in Stavropol and in the Caucasian Mineralnye Vody towns, Stavropol Territory (1994), in the identification of cholera patients, in the detection of transmission factors, when monitoring during large epidemic out-bursts of cholera in Stavropol (1990), Daghestan (1994), as well as in the microbiological monitoring during military conflicts in the Chechen Republic (1995). The application of the sorbents has shown that their sensitivity is 4-5 times as much as that of conventional serological assays. In addition, biotechnologies for the production of polyacrylamide and composite aluminosilicate affine immunosorbents with magnetic properties have been developed. They have been used as the basis for designing immobilized granulated antigen reagents for the immunodiagnosis, differential diagnosis, evaluation of the time course and severity of a disease, the efficiency of therapy in patients with systemic scleroderma, proliferative arthritis, systemic lupus erythematosus, juvenile rheumatoid arthritis, osteochondrosis.

[Use of magnetosorbents in the immunodiagnosis and therapy of systemic lupus erythematosus and rheumatoid arthritis]. / Perspektivy primeneniia magnitosorbentov v immunodiagnostike i lechenii sistemnoi krasnoi volchanki i revmatoidnogo artrita.

The authors present new technology of producing immobilized granulated antigenic magnetosorbents (MS) using collagen type II, IgG, denaturated DNA and cardiolipin which were employed in enzyme immunoassay for detection of specific antibodies in the blood of patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Due to high capacity, MS demonstrated effectiveness in early diagnosis, prognosis of RA and SLE as well as in control over the treatment effects. As shown in in vitro experiments, MS have high selective capacity and atraumaticity for blood corpuscles. MS can be sterilized, regenerated and reused which is a great advantage.

[Purine metabolism enzymes in diagnosis and differential diagnosis of osteoarthritis and gout arthritis]. / Fermenty purinovogo metabolizma v diagnostike i differentsial'noi diagnostike osteoartroza i podagricheskogo artrita.

AIM: To characterize purine metabolism in osteoarthritis (OA) and gout arthritis (GA) diagnosis and differential diagnosis of these diseases. MATERIALS AND METHODS: We estimated xanthine oxidase (XA), xanthine dehydrogenase (XDG), 5'-nucleotidase (5'-NT) activity, esoenzymes of XDG and content of uric acid (UA) in the sera of 44 patients with osteoarthritis and 34 patients with gout arthritis. RESULTS: Hyperuricemia was revealed in 25 percent of patients with osteoarthritis, in 64.7 percent of patients with gout arthritis. XO, XDG, 5'NT activity, XO/XDG activities ratio, XDG-2 esoenzymes and content of UA were increased in OA patients compared to healthy controls. XO, XDG activity, XDG-2 esoenzymes and UA content in GA patients were higher than those in OA patients. CONCLUSION: The enzyme difference found may promote differential diagnosis of OA and GA. The enzyme indices essentially depend on clinical specificity of the disease and can be helpful in the assessment of the treatment efficiency.

[Immobilized antigenic preparations with magnetic properties in the diagnosis and treatment of rheumatic diseases]. / Immobilizirovannye antigennye preparaty s magnitnymi svoistvami v diagnostike i lechenii revmaticheskikh zabolevanii.

A procedure was first developed to prepare the immobilized granulated antigen agents (IGAA) based on collagens of types I, II, III, IgG, native DNA, RNA, cardiolipin, superoxide dismutase, and glutathione reductase. The agents were applied to both immunofluorescence and enzyme immunoassay to identify specific antibodies. IGAA were effective in early diagnosis, prognosis, and control of therapy for systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis due to their high capacity. These antigen agents were used in vitro and in vivo in hyperimmune laboratory animals as magnetic sorbents and exhibited high capacities and low traumatic properties for blood cells. IGAA may be regenerated, sterilized, and reused.

[The relation between the level of antibodies to the glycosaminoglycans of the cartilage in patients with osteoarthritis and the efficacy of treatment with chondroprotectors]. / Sviaz' urovnia antitel k glikozaminoglikanam khriashcha u bol'nykh osteoartrozom s éffektivnost'iu lecheniia khondroprotektorami.

AIM: To improve the efficacy of osteoarthrosis (AO) treatment by chondroprotectors by defining individual indications for their use, based on the initial level of antibodies to cartilaginous glycosaminoglycans (GAG) in the blood serum. MATERIALS AND METHODS: Anti-GAG were detected by indirect solid-phase enzyme immunoassay. The antigen was a sulfated GAG preparation GAG-polysulfate (arteparon) manufactured by Luitpold-Werk (Germany). Sera of 110 OA patients were tested. Fifty of them were treated by rumalon, 20 with arteparon, and protocols of 40 patients included no chondroprotectors. RESULTS: The highest levels of anti-GAG were found in OA patients with multiple involvement of the joints, rapidly progressing disease, and secondary synovitis. The titer of antibodies increases with disease duration and in patients with the roentgenological stage of OA, reaching the maximum by 10-15 years of disease or by stage III. Efficacy of chondroprotectors was lower at lower levels of antibodies to cartilaginous GAG. CONCLUSION: Chondroprotector therapy of patients with initially high levels of antibodies to GAG is unadvisable, for it can lead to exacerbations, specifically, to secondary synovitis.

[Efficacy of D-penicillamine and methotrexate in the treatment of rheumatoid arthritis in relation to levels of circulating rheumatoid factors of different classes]. / Effektivnost' D-penitsilamina i metotreksata pri lechenii revmatoidnogo artrita v zavisimosti ot urovnia revmatoidnykh faktorov raznykh klassov.

AIM: To optimize treatment for rheumatoid arthritis (RA) and to define indications for D-penicillamine and methotrexate therapies on an individual basis by taking into account the levels of rheumatoid factor (RF) isotopes circulating in blood. MATERIALS AND METHODS: A total of 105 patients (mean age 46.39 +/- 1.35 years) with varying RA were observed. Indirect solid-phase enzyme immunoassay was used to analyze RF isotopes; the pattern of the disease and the efficiency of therapy for RA were compared with the patients' immunity. RESULTS: With elevated RF IgG levels, the cardiovascular system, thyroid, mucous membranes were found to be more frequently impaired and vasculitis was diagnosed. CONCLUSION: The use of cuprenil and methotrexate in RA substantially improves patients' immunity.