[Evaluation of topical therapy of patients with osteoarthritis of small joints of the hands with Voltaren® Emulgel® 2% (diclofenac diethylamine 2%)].

AIM: To evaluate the efficacy and safety of using the drug Voltaren Emulgel 2% (diclofenac diethylaminе 2%) for 14 days in patients with osteoarthritis (OA) of small joints of the hands. MATERIALS AND METHODS: 62 patients of both sexes with hands OA were included in the study, 31 of whom (main group) used Voltaren Emulgel 2% (diclofenac diethylaminе 2%) topically, and the remaining 31 (comparison group) Voltaren Emulgel 2% (diclofenac diethylamine 2%) + oral nonsteroidal anti-inflammatory drugs. The effectiveness of therapy was assessed by using a visual analogue scale (VAS) in dynamics: joint pain and stiffness at rest, pain on movement and during palpation, by functional indices AUSCAN, FIHOA, by assessment of the effect of therapy by the doctor and the patient on a weekly basis. RESULTS AND DISCUSSION: Joint pain decreased after 2 weeks of therapy in all patients during treatment with Voltaren Emulgel 2% (diclofenac diethylamine 2%) in both groups. Significant reduction in stiffness and improvement in hand joint function was achieved after 7 days and lasted until the end of treatment. By the end of treatment, 100% of patients assessed their condition as improvement. CONCLUSION: Voltaren Emulgel 2% (diclofenac diethylamine 2%) demonstrates comparable clinical efficacy in patients with OA of the hand joints (reduced pain, stiffness and improved joint function) in monotherapy as complex therapy in combination with oral NSAIDS, while being well tolerated.

[Evaluation of a 12-week allopurinol-lowering therapy in combination with the non-steroidal anti-inflammatory drug meloxicam in patients with gout].

AIM: To evaluate a 12-week course of combined alloturinol-lowering therapy with a prophylactic anti-inflammatory dose of movalis for the frequency of exacerbations and the quality of life of patients with gout. MATERIALS AND METHODS: Allopurinol was administered orally, 1 time per day. Every 3 weeks, the dosage of the drug was increased by 50 mg to 300 mg per day under the control of the level of serum uric acid (sUA). The total daily dose of the drug movalis, used in the form of different dosage forms, was 7.515 mg. The clinical effectiveness of the treatment was evaluated after 3, 6, 9 and 12 weeks according to physical examination, the dynamics of joint pain at rest, during movement and palpation, according to the visual analogue scale (VAS) in millimeters, Likert scale, EuroQol-5D-5L questionnaire, care for oneself, habitual daily activities, the presence of anxiety and depression, assessment of satisfaction with treatment (on a scale of 1 to 5, where 1 is the complete absence of improvement or worsening, and 5 is a very good result); took into account the period of remission, as well as the time before the onset of relapse of gouty arthritis. An adverse event (AE) was recorded. RESULTS AND DISCUSSION: On the background of treatment with movalis 7.5 mg per day more than two-thirds of patients showed no worsening of the articular syndrome with an increase in the dose of allopurinol to 300 mg per day. By the 12th week of observation, a significant difference was found between the severity of gouty arthritis characteristics in the direction of improving mobility, self-care, normal daily activities, reducing soreness, reducing anxiety and depression (p0.05). In addition, the ESR and sUA levels were significantly different initially and at the final observation point (p0.05), which indicates a positive effect on the inflammatory process. A 3-month course of combination therapy was not accompanied by significant increases in blood pressure, changes in creatinine clearance in blood serum. There were no adverse events from the gastrointestinal tract. 90.9% of patients rated the treatment result as very good. AE in the form of a skin allergic rash was observed in one patient; it did not require interruption of treatment and completely stopped without consequences after completion of the course. CONCLUSION: 12 a week-long combined therapy of the allopurinol-reducing drug with the anti-inflammatory dose movalis prevents the exacerbation of the articular syndrome and improves the quality of life of patients with gout.

[A rationally grounded approach to treating gout with regard to its onset and course and the presence of comorbidity according to the European League against Rheumatism (EULAR 2016) recommendations]. / Ratsional'no-obosnovannyi podkhod k lecheniiu podagry s uchetom debiuta, techeniia i sochetannoi patologii po materialam rekomendatsii Evropeiskoi antirevmaticheskoi ligi (EULAR 2016 g.).

The review analyzes in detail the management of gout, which takes into account its onset and course and the presence of comorbidity. Emphasis is placed on drug and non-drug treatments and urate-lowering therapy in patients with kidney dysfunction. Along with allopurinol, the urate-lowering drug febuxostat is first recommended in Russia. The purpose of this review is to notify physicians of the possibility of achieving the target uric acid levels when treating gout with hyperuricemia.

[Trends in the spread of pandemic influenza A(H1N1) swl in the Far East in 2009].

The paper describes the trend in the spread of pandemic influenza A(H1N1) swl virus in the Far East, which started in this region 2-3 months later than that in the European part of Russia. By mid-October seasonal epidemic influenza was practically displaced by pandemic one.

[Visual evoked potentials in management of amblyopia in children]. / Zrakové evokované potenciály v manazmente amblyopie u detí.

GOAL: The authors want to point out the possibility of using the visual evoked potentials (VEP) in the diagnostic process of amblyopia, especially in preverbal children. We also researched the possibility of screening for amblyopia with VEP in young patients with anisometropia without strabismus being present, especially those who come from affected families. The authors followed changes in the course of an occlusion therapy and suggest that VEP could be used to predict a success of the amblyopia therapy. MATERIAL AND METHODS: We analyzed group of 45 pediatric patients ages 2-10 years who were investigated in years 2006-2009 at Pediatric Ophthalmology Department of Children University Hospital in Bratislava with amblyopia. This group was compared with a control group of 25 healthy children. The cause of amblyopia in a majority of children (29 patients) was hyperopic anisometropia, 13 children had hyperopic isometropia, 3 patients had myopia over -3D. These causes in 22 children were combined with strabismus. The monocular pattern of VEP was evaluated in all patients. In cooperative children (25) we also evaluated binocular pattern of VEP. 18 patients with amblyopia had a second VEP evaluation done during the occlusion therapy, among those were 23 amblyopic eyes. The time frame from the first VEP evaluation to the second VEP evaluation was 1-11 months, average 5,1 months. The material was statistically evaluated. RESULTS: Our study showed statistically significant prolongation of the latency of both P and N2 waves (p = 0.01) in children with amblyopia.This can be used in diagnostic process of amblyopia in preverbal children as well as in the screening for amblyopia. We also followed changes during the occlusion therapy and we discovered persistent prolongation of the latency of the P wave and also changes in the amplitudes (p = 0.05) During repeated measurements and with applied therapy one can follow the dynamics of amblyopia, course of therapy by VEP changes. CONCLUSIONS: Results of our research suggest a great contribution of VEP especially in the diagnosis of anisometropic amblyopia, especially in preverbal children. The advantage of VEP is in the screening, prediction and dynamics of therapy too. The amblyopia management is a long lasting process requiring a thorough communication and cooperation among the patient, parent and a doctor.

Ocular manifestations of neurofibromatosis 1--m. Recklinghausen.

Neurofibromatosis type 1 (NF 1)--morbus von Recklinghausen is an autosomal dominant phacomatosis with variable expression. The gene for NF 1 is located on chromosome 17q11.2. Incidence is 1 in 3500 live births. The diagnosis is made on the basis of clinical manifestations. Diagnosis requires the presence of 2 or more major criteria: 6 or more café au lait spots, 2 or more cutaneous neurofibromas or 1 plexiform neurofibroma, an optic nerve glioma, 2 or more iris Lisch nodules, axillary or inguinal freckling, bony lesions--pseudoarthrosis, sphenoid wing hypoplasia, or a first-degree relative with NF 1.

Ocular manifestations of neurofibromatosis 1 - m. Recklinghausen.

Neurofibromatosis type 1 (NF 1) - morbus von Recklinghausen is an autosomal dominant phacomatosis with variable expression. The gene for NF 1 is located on chromosome 17q11.2. Incidence is 1 in 3500 live births. The diagnosis is made on the basis of clinical manifestations. Diagnosis requires the presence of 2 or more major criteria: 6 or more café au lait spots, 2 or more cutaneous neurofibromas or 1 plexiform neurofibroma, an optic nerve glioma, 2 or more iris Lisch nodules, axillary or inguinal freckling, bony lesions--pseudoarthrosis, sphenoid wing hypoplasia, or a first-degree relative with NF 1.

[Spiral computed tomography in the diagnosis of gunshot wounds of the abdomen and pelvis].

Spiral computed tomography (SCT) in combination with SCT angiography with the rapidity and low-invasiveness of the study yields necessary information and minimizes the number of diagnostic measures in severely wounded patients, by substantially reducing the preoperative period of their examination. The assessment of findings, the processing of data, and the construction of additional repairs do not require the presence of the patient and may be made in later periods. If required, repeated studies make it possible to evaluate the time course of postoperative changes, to identify complications of wound disease at the right time, and to optimize surgical treatment policy. Thus, SCT for fighting gunshot abdominal injury may significantly amplify and, in many cases, substantiate for the existing radiation diagnostic techniques.

[Spiral computed tomography in the diagnosis of the abdomen gunshot wounds and their complications]. / Rol' spiral'noi komp'iuternoi tomografii v diagnostike ognestrel'nykh ranenii zhivota i ikh oslozhnenii.

The results of studies by spiral computed tomography (SCT) in 62 patients with abdominal wounds were analyzed at the Main Military Clinical Hospital of Internal Forces, Ministry of Internal Affairs of Russia. The main contingent of the wounded included active servicemen who had been wounded in the areas of local conflicts, military men. The studies were conducted on days 2 to 15 of their receiving a wound. The potentialities of the technique in evaluating damages to abdominal organs, retroabdominal space, bony structures, in assessing the topography of foreign bodies are described. SCT was compared with classical X-ray and ultrasound studies, laparocentesis which are traditionally used in the diagnosis of gunshot injury. In the authors' opinion, SCT has become the method of choice in the diagnosis of gunshot injury to the abdomen and its complications today.

[Effects of acute pharmacological blockade of the renin-angiotensin system on intrarenal hemodynamics in patients with systemic lupus erythematosus and systemic scleroderma]. / Vliianie ostroi farmakologicheskoi blokady renin-angiotenzinovoi sistemy na vnutripochechnuiu gemodinamiku u bol'nykh sistemnoi krasnoi volchankoi i sistemnoi sklerodermiei.

AIM: To evaluate effects of an ACE inhibitor captopril on intrarenal hemodynamics during acute test in patients with lupus nephritis (LN) and chronic sclerodermic nephropathy (CSN). MATERIAL AND METHODS: Renal hemodynamics was studied using ultrasound duplex scanning of renal vessels (UDS) on Vingmed SD-100 unit in 5 patients with SLE with renal affection, 5 patients with scleroderma systematica (SS) with renal affection. The hemodynamic parameters were measured before and 1 hour after administration of 50 mg captopril. RESULTS: LN were found to have low arterial perfusion. CSN patients exhibited low intrarenal blood flow in high resistance of small vessels. Captopril improved intrarenal hemodynamics (enhancement of linear and volume blood flow) in LN patients; in CSN renal artery dilated and resistance of small vessels reduced while renal arterial perfusion increased. CONCLUSION: Improvement of intrarenal hemodynamics in LN and CSN patients in response to captopril allows to recommend administration of ACE inhibitors in SLE and SS with renal damage. Ultrasonic duplex scanning of renal vessels provides detailed information about the condition of intrarenal vessels without invasion.

The direct effect of heavy ions and electrons on thymidine in the solid state.

PURPOSE: To study the direct effect of heavy ions and electrons on thymidine. MATERIALS AND METHODS: The thymidine samples in the solid state were exposed to a beam of O7+ heavy ions with an energy of 10.6 MeV/u (LET approximately 500keV/microm) and to electrons of 2MeV (LET approximately 0.18keV/microm). The major decomposition products of thymidine were purified by high performance liquid chromatography (HPLC) and identified by extensive spectrometric measurements (UV, mass spectroscopy, 1H and 13C NMR). RESULTS: The main degradation products of thymidine were isolated and characterized. Reaction mechanisms, involving transient radical species, are proposed to explain the heavy ion-mediated formation of the modified products. Furthermore, a semi-quantitative comparison of the modifications induced within thymidine by the two types of radiations was performed. CONCLUSION: Several new radiation-induced thymidine decomposition products have been isolated and characterized. The comparison of the effects induced by heavy ions and electrons on thymidine in the solid state clearly indicates several significant differences in the mechanisms of action. A relative increase in the extent of the modifications of the sugar moiety with respect to those of the base is observed with the heavy ions by comparison with electrons.

Effects of heavy ions on nucleic acids: measurement of the damage.

In this short survey the main, available information on the molecular mechanisms of action of heavy ions on DNA is critically reviewed. Formation of single- and double-stranded DNA breaks in cells exposed to heavy particles is well established. On the other hand, base damage and, in a more general way, clustered lesions, whose formation should be increased upon exposure to heavy ions, have not yet been isolated and characterized. Efforts should be made to identify this important class of DNA damage in both isolated and cellular DNA. Sensitive and specific assays involving chemical and biochemical approaches have to be developed for such a purpose.

[Use of selective media with lincomycin for the directed screening of antibiotic producers]. / Ispol'zovanie selektivnykh sred s linkomitsinom dlia napravlennogo poiska produtsentov antibiotikov.

Relation between lincomycin resistance of Micromonospora cultures freshly isolated from soil samples and their capacity for production of antibiotics related to lincomycin by the structure or mode of action was shown. 32 cultures of Micromonospora were isolated from soil platings containing 50--100 microgram/ml of lincomycin. Crude antibiotic substances were recovered with the method of organic solvent extraction from 10 cultures possessing pronounced antibiotic activity. Selective inactivity (MIC more 1000 microgram/ml) of the crude substances with respect to the lincomycin resistant variant of Staph. aureus 209 p was observed, 2 of them having no inhibitory effect on the erythromycin resistant variant of the staphylococcus. The crude antibiotics inhibited the growth of the initial strain of the staphylococcus and its other antibiotic resistant variants in concentrations of 0.5--10 microgram/ml. It was demonstrated with the use of gas chromatography and mass spectrometry that one substance was lincomycin and 4 substances were known macrolides. Efficiency of the simple method of directed screening of antibiotics belonging to definite groups is indicated. Resistance of actinomycetes freshly isolated from natural substrates to various antibiotics is used as the criterion for antibiotic screening. The method provides detection of various antibiotics which are analogs in the structure or mode of action of the selecting antibiotic used for the screening.