[MODERN CLINICAL EPIDEMIOLOGICAL CHARACTERISTIC OF LUPUS ERYTHEMATOSUS BASED ON THE DATA OF REGIONAL REGISTRY].

Systemic lupus erythematosus (SLE) is a severe rheumatic disease characterized by polysymptomatic clinical picture. At the present stage, there are no updated epidemiological data due to the low prevalence of the disease. The aim of the study was to examine the current clinical and epidemiological characteristics of patients with systemic lupus erythematosus based on the information contained in the territorial register, analysis of occurrence and symptoms at the early stage of the disease. This study demonstrated the epidemiological and clinical characteristics of SLE from the analysis of 107 cases during the period from 2011 to 2013 and retrospective analysis of the cases for 1980-2013. The epidemiological situation was evaluated based on extensive and intensive indicators using statistical software license. The current SLE prevalence was estimated at 5,59 per 100 000 population in 2013, the incidence between 1994 and 2003 at 0,29 per 100 000 population and between 2004 and 2013 at 0,49, with the peak in 2010 up to 1,35 per 100 000 population. The average absolute growth and growth rate of SLE in the first decade was 0,05% and 0,24%, in the second decade 0,001% and 0,006% respectively, with the female to male ratio being 9:1, mean age of the patients 37,62±11,65 years), and ethnic composition of 87 Slavs and 15 Crimean Tatars. The most common symptoms at the early (polyarthritis, fever, dermatitis) and advanced (polyarthritis, Raynaud's syndrome, carditis, myalgia) stages differed from those specified by American College of Rheumatology (1997). The difference between early and late symptoms of SLE was documented . Based on the data obtained, the division of the disease into clinical subtypes (phenotypes) is proposed.

Changes of humoral anti-endotoxin immunity and low-intensity inflammation in diabetes mellitus type 1 and 2.

The purpose: The purpose. Investigate the levels of different classes serum anti-endotoxin antibodies in patients with diabetes mellitus type 1 and 2 and to hold the cluster analysis of the relationship between the individual levels of such antibodies and the concentration of C-reactive protein in the blood. Methods: We examined 51 patients with diabetes mellitus type 1 and 60 patients with diabetes mellitus type 2. The diagnosis of diabetes mellitus type 1 or type 2 has been delivered in accordance with the criteria of the World Health Organization. The control group included 49 healthy people who have not a history of any chronic disease, and the clinical manifestations of acute diseases were absent at the time of the survey. By sex and age, the control group of healthy people matched to a group of patients with diabetes type 1 and type 2. The concentration of C-reactive protein in the blood and the levels of serum anti-endotoxin antibodies of different classes (A, M and G) was determined by ELISA. Results: Using cluster analysis revealed that 40.8% of patients with type 1 diabetes increased concentration of C-reactive protein in the blood is associated with a significant reduction of levels of serum anti-endotoxin antibodies classes A, M and G. In 56.7% of patients with type 2 diabetes the high concentration of C-reactive protein in the blood levels of serum anti-endotoxin antibody classes A and M were not significantly different from the normal values, but the levels of serum anti-endotoxin antibodies of class G were significantly increased. The activation of inflammation with a further increase of C-reactive protein in the blood of patients with type 2 diabetes mellitus accompanied by a significant increase in levels of serum anti-endotoxin antibodies classes A and G, and also a tendency to reduce of levels anti-endotoxin antibodies class M. Conclusion: The results suggest about the relationship between low-intensity inflammation and immune response to enterobacterial endotoxins in patients with diabetes mellitus type 1 and 2.

[Prevention of ostial obstruction after microendoscopic endonasal dacryocystorhinostomy].

Ostial dilatator was created to prevent recurrence and improve efficacy of microendoscopic endonasal dacryocystorhinostomy. Proposed technique was for the first time used in 52 patients. Postoperative results were analyzed: recovery was achieved in 78% of cases, improvement - in 22%. In a control group (51 patients) we used conventional technique, recovery was achieved in 67% of patients and improvement in 28%, in 5% recurrence occurred. The use of ostial dilatator resulted in microendoscopic endonasal dacryocystorhinostomy efficacy improvement.

[Lacrimal drainage system examination using functional multidetector computed tomography].

Computed tomography images are analyzed in patients with and without lacrimal drainage system abnormalities. Potential of functional multidetector computed tomography in dacryostenosis is showed.

[Digital X-ray examination in diagnosis of lacrimal pathways disorders].

Digital radiological images of normal and patients with lacrimal pathways disorders were analyzed. Potentials of digital X-ray in diagnosis of lacrimal pathways disorders are demonstrated.

[Current potentials of endoscopic rhinosinusosurgery].

Information on current potentials of endoscopic rhinosinusosurgery are presented in this review. Potentials of miniinvasive endoscopic procedures as an alternative or adjuvant treatment option in surgery of ophthalmologic patients are discussed.

[Hydrodynamic method for diagnosing impaired patency of the lacrimal tract].

A hydrodynamic method has been developed, which is based on measurement of the pressure of a certain amount of the fluid passing through the patient's lacrimal tract for a given period. Pressures were determined in 194 healthy volunteers (338 eyes). Three hundred and seventy-six patients (752 eyes) with impaired lacrimation were examined. The examinations have shown that the method provides a way of objectively defining the degree of dacryostenosis, which makes it possible to further use adequate therapy and to monitor its efficiency.

[The value of cytologic investigation for postoperative assessment in patients with nasolacrimal obstruction].

Cytologic investigation was performed in patients with dacryocystitis after microscopic endonasal dacryocystorhinostomy and in patients with lacrimal canaliculi orifice obstruction after microscopic endonasal canaliculocystorhinostomy. It allowed to monitor healing process, extubation time and to develop measures for prevention of dacryostoma cicatrisation.

[Diagnostic and prognostic value of determination of the endogenic intoxication and functional activity of neutrophils indices in odontogenic phlegmon].

There were studied up the peripheral blood indices in 109 patients, suffering odontogenic phlegmon (OPH), coexistant with severe and of medium severity systemic inflammatory response syndrome (SIRS). In the patients with OPH and severe SIRS (with the complicated course), the blood neutrophils indices, concerning endogenic intoxication and functional activity, differ essentially from those parameters, present in patients, suffering noncomplicated course of the disease.

[Morphological characteristics of actinomycotic dacryocanaliculitis].

The paper presents the results of pathohistological studies of the contents of the lacrimal canaliculi and the fragments of their walls, obtained at canaliculotomy in 25 patients. This permitted 14 cases of actinomycotic dacryocanaliculitis to be identified as drusens of the ray fungus Actinomyces israelii had been found. The reactive structural changes found in the wall of the lacrimal canaliculi due to the presence of fungal infection and foreign bodies in their lumen are described. A morphological study is shown to be effective in revealing the actinomycotic etiology of dacryocanaliculitis.

[Magnetic resonance imaging in the diagnosis of lacrimal tract pathology].

Magnetic resonance imaging (MRI) was used to examine 45 patients (23 females and 22 males) aged 16-67 years with lacrimal tract pathology on a Sigma Gorizont magnetic resonance (MR) tomograph ("General Electric"). This yielded head MR scans in the frontal, axial, and sagittal projections. The thickness of MR sections was 2-3 mm. MRI provides direct images in 3 projections, permitting a full estimation of the lacrimal tract and its adjacent soft tissues. MRI is recommended for use in the examination of patients with complicates pathological processes after ineffective operations on the lacrimal tract, congenital lacrimatory disturbances, posttraumatic lesions, suspected tumors of the lacrimal duct and its adjacent soft tissues and paranasal sinuses.

[Morphological features of the mucosa of the nasal cavity and lacrimal sac in lacrimal passage obstruction].

A comprehensive morphological study of the mucosa of the nasal cavity and lacrimal sac was conducted, by using 160 biopsy specimens taken from 44 patients at endoscopic endonasal dacryocystorhinostomy. In all cases, different areas of the nasal cavity exhibited abnormal changes that were generalized and appeared as inflammatory, dystrophic, and sclerotic processes.

[Alternatives to recovery of lacrimal duct patency].

Based on his many years' experience in treating patients with lacrimal duct abnormalities and on his familiarity with the latest progress of endoscopic microsurgery of dacryocystitis, the author presents a historic analysis of the development of currently available surgical treatments of dacryocystitis in Russia and foreign countries. He reviews treatments divided into the following groups: 1) operations applying an external approach to the lacrimal sac, such as Toti's-type ones; 2) those applying an intranasal approach to the lacrimal sac, such as West's-type operations; 3) intranasal endoscopic microdacryocystorhinostomies; 4) intranasal laser microdacryocystorhinostomies; 5) transcanalicular endoscopic laser microdacryocystorhinostomies; 6) operations that recanalize the lacrimal duct; 7) medical treatments of dacryocystitis. The author emphases the merits and discloses the prospects of endoscopic microsurgical treatments for impaired lacrimal duct patency and dacryocystitis.

[Low-intensity helium-neon laser in the treatment of patients after endonasal dacryocystorhinostomy]. / Primenenie nizkointensivnogo gelii-neonovogo lazera v lechenii bol'nykh posle éndonazal'noi dakriotsistorinostomii.

Described in the paper is an efficiency study of using, postoperatively, the low-intensity helium-neon laser (LIHNL) in patients with obstruction of the lacrimal tracts. Eighty patients were examined after endonasal dacryocystorhinostomy. They were shared between 2 groups with respect to a postoperative course: group 1--experimental, 40 patients, and group 2--control, 40 patients. The experimental patients received, apart from the traditional postoperative therapy, a course of LIHNL therapy. The controls received only the traditional postoperative treatment. The efficiency of postoperative treatment was evaluated by clinical, instrumental and laboratory examination methods. The study denoted that the use of LIHNL in the early postoperative period after endonasal dacryocystorhinostomy had a pronounced anti-inflammatory effect, speeded up the wound healing, prevented the growth of granulation tissues and the merging of the shaped lacrimal-sac fistula with the nasal cavity. LIHNL contributed to a complete recovery of the functional activity of the nasal mucous tunic. Thus, the LIHNL therapy essentially facilitates the postoperative management of patients, cuts the rehabilitation period and enhances the treatment results.

[Possibilities of using the method of crystallography of tears in pathologies of the lacrimal apparatus]. / Vozmozhnosti primeneniia metoda kristallografii slezy pri patologii slezootvoliashchei sistemy.

A total of 178 patients with pathologies in the lacrimal apparatus (including 81 patients with dacryocystitis, 51 patients with imperforation of the lacrimal canals' opening and 46 patients with dacryostenosis) were investigated. Crystallographic examination (CGE) of the lacrimal fluid was made for both eyes before and after surgery. 32 virtually healthy persons made up the control group. Normal types were defined and an operational scheme, which ensured the detection of 4 main types of crystals typical of the discussed pathologies, was elaborated. CGE was found to enable a reliable detection of relapses' threat, which can be a criterion in choosing the time for removing the intubation tube after canaliculardacryocystorhinostomy (CDCT) and an extra source of information in specifying a stage of dacryostenosis. CGE provides for determining indirectly the presence of an allergic or inflammatory component in the disease course. Finally, CGE is a simple and sufficiently informative method, which can turn into an additional tool in the diagnosis, differential diagnostics and evaluation of the efficiency of conducted therapy and in forecasting a clinical disease course in the lacrimal apparatus.

Prevalence of skin test reactions to natural rubber latex in hospital personnel in Russia and eastern Europe.

BACKGROUND: Allergic reactions to natural rubber latex have increased during the past 10 years, especially in many health care workers (HCWs) who have high exposure to latex allergens. The prevalence of skin test reactions to natural rubber latex in Russia, the Commonwealth of Independent States (CIS), and eastern Europe is unknown. OBJECTIVE: The purpose of this study was to determine the prevalence of skin test reactivity to natural rubber latex in a population of HCWs exposed to latex. METHODS: Nine hundred one HCWs regularly exposed to latex were evaluated using an allergy history questionnaire. Subjects were tested for latex allergy by titrated skin prick test with a biologically standardized latex extract. The diagnosis of latex allergy was defined by the presence of clinical symptoms when exposed to latex along with a positive skin prick test to latex. RESULTS: Forty-nine (5.4%) HCWs were skin test-positive to latex. Seventeen (1.9%) HCWs were classified as latex-allergic based upon positive skin tests to latex associated with allergy symptoms with exposure. Seven of 901 HCWs had experienced anaphylactic reactions to latex. The most frequently reported symptom related to latex exposure was contact urticaria. CONCLUSIONS: The prevalence of latex allergy among HCWs in Russia, the CIS, and adjacent eastern European countries is considerably less than reported in HCWs exposed to latex in western Europe and the United States. The low prevalence of latex allergy in Russia and the CIS suggests that lessened exposure to natural latex powdered gloves may diminish the prevalence of latex sensitization in HCWs in Russia and the CIS.

[Study of the binding between bacterial lipopolysaccharides and polymyxin by a bioluminescent method]. / Izuchenie sviazyvaniia bakterial'nykh lipopolisakharidov s polimiksinom bioliuminestsentnym metodom.

For rating the interaction of lipopolysaccharides (LPS) with polymixin B (PmB) a bacterial bioluminescence is offered to be used. Bioluminescence level of bacteria decreases under free antibiotic amounts action. It is shown, that as a result of interaction with LPS antibiotic properties of PmB are reduced, and the intensity of bacterial bioluminescence is restored. The bioluminescence level in such system characterizes the LPS quantity. Kinetic properties of bacterial light emission at the presence of LPS and PmB are investigated as well as equilibrium state of the system. Kinetic and equilibrium constants describing this reaction are determined. The conditions of quantitative bioluminescent definition of LPS in an interval of concentration 0.166-10 micrograms/ml have been chosen and calibration curves are presented.

[The prevention and treatment of recurrences after dacryorhinostomies]. / Profilaktika i lechenie retsidivov posle dakriorinostomii.

A total of 1206 dacryorhinostomies carried out from January, 1991 to December, 1997 at Institute of Ocular Diseases of the Russian Academy of Medical Sciences are analyzed. The main causes of relapses were underevaluation of the data of examinations and improper choice of operative access and method of surgery, errors in the technique of operation, and wrong postoperative treatment. For improving the efficacy of surgery, the authors developed a comprehensive method for preventing and treating relapses. X-ray and rhinological data are decisive for the choice of the access and method of operation. Unfavorable rhinogenic factors are removed and measured aimed at suppression of the cicatricial process at the site of anastomosis are carried out in primary dacryorhinostomy. For this purpose the authors for the first time in Russia applied a cytostatic antibiotic mitomycin C to the site of dacryostoma (44 cases) and a polymeric film Diplen with hemostatic and wound-healing effects (87 cases) with good results. Thorough follow-up after surgery detected a threatened relapse sufficiently early to carry out adequate treatment promoting cure.