[Reactive arthritis: terminology, etiology and pathogenesis]. / Reaktivnye artrity: terminologiia, etiologiia, patogenez.

Different serovars of Y. enterocolitica, Y. pseudotuberculosis, Acinetobacter calcoaceticus, and Pseudomonas pauimobilis were isolated from the synovial fluid of 23 out of 34 patients with Yersinia-triggered arthritis by a new bacteriological method based on the selection of the optimal conditions for microorganism culturing; in some cases the strains were isolated repeatedly. The authors discuss the necessity of correcting the previous notions on the aseptic nature of reactive arthritis.

[Approach to evaluation of the indicators of Yersinia infections in reactive and rheumatoid arthritis]. / Podkhody k otsenke pokazatelei iersinioznoi infektsii pri reaktivnom i revmatoidnom artrite.

A total of 140 patients with reactive arthritis due to Yersinia infection were under observation for 2-10 years. A group of 104 patients with erosive rheumatoid arthritis served as control for analysis of the results of bacteriological and serological studies. The bacteriological analysis of the feces, urine, smears of the feces and blood were made repeatedly. As established the articular syndrome in reactive arthrosis has its specific features depending on the nature of the pathological process: primary, recurrent and chronic. Patients with primary reactive arthritis exhibited recovery without residual phenomena and relapses in 35.8% of the cases; in 86% the disease relapsed; in 36% it was chronic, persisting for a number of years as a non-erosive seronegative arthritis; in 25.3% arthralgia persisted; in 6.2% the clinical picture of secondary osteoarthrosis developed; in 17.3% the disease changed into spondyloarthritis and in 1.2% of the cases it changed into RA. Since in reactive arthritis Yersinia infection was confirmed in 48.5% of the cases and in RA in 14-21%, laboratory diagnosis cannot serve as an absolute criterion for reactive arthritis. It is necessary to take into consideration the anamnesis and the peculiarities of the clinical picture and the course of the articular syndrome.

[Microbiocenosis and the status of the intestinal mucosa in alkylosing spondyloarthritis]. / Mikrobiotsenoz i sostoianie slizistoi obolochki kishechnika pri ankiloziruiushchem spondiloartrite.

Intestinal microbiocenosis was examined in 53 patients with ankylosing spondyloarthritis (AS). Of these, 23 had the central and 30 presented with the peripheral form. 34 patients underwent endoscopic examinations (rectoromanoscopy, ileocolonoscopy). As a result, in 74% of cases with the central form of AS and in 80% of cases with the peripheral form of AS, alterations in the intestinal microflora were revealed, which can be regarded as intestinal dysbacteriosis (ID), with dysbacteriosis being more pronounced in patients with the peripheral form. In such patients it manifested by a considerable decrease of the amount of bifido- and lactoflora, which promoted the increment of the amount of opportunistic microorganisms, particularly Klebsiella. Macroscopic signs of nonspecific inflammation of the small and large intestines were identified in 63% of patients with the central and in 67% of those with the peripheral form of AS. Mean-while histomorphological study of biopsy specimens of the intestinal mucosa showed that all the examinees had chronic inflammation of varying degree.

[The development and testing of diagnostic criteria in psoriatic arthritis]. / Razrabotka i aprobatsiia diagnosticheskikh kriteriev psoriaticheskogo artrita.

The paper is concerned with diagnostic criteria of psoriatic arthritis developed by the expert method. The criteria include 14 signs with the aid of which one can diagnose classical, definite and probable psoriatic arthritis. The sensitivity of the developed diagnostic criteria tried in 108 patients afflicted with psoriatic arthritis constitutes 99.2%, whereas the specificity tested in patients suffering from related diseases (reactive arthritides, ankylosing spondyloarthritis, seronegative rheumatoid arthritis) amounts up to 77.8%.

[The state of the gastrointestinal tract in reactive arthritis]. / Sostoianie zheludochno-kishechnogo trakta pri reaktivnom artrite.

The gastrointestinal tract status (GIT) was evaluated in 23 reactive arthritis (RA) patients: in 17 after intestinal infection, in 2 after urogenital infection, and in 4 after mixed infection. All the examined were found to have signs of diffuse variously pronounced chronic inflammation of the small and large intestine, impaired barrier function of the stomach, liver disorders, and moderate-severe intestinal dysbacteriosis with developing transitory bacteraemia in most severe cases. The GIT changes were correlated with the severity of the RA course. In 20 control-group patients not afflicted with joint disease and operated on for cicatricial stricture of the oesophagus, no signs of chronic inflammation of the mucosa were revealed in the biopsy samples of the large and small intestine. The obtained results may be indicative of the role played by the GIT in the development of pathogenic processes in RA.