[Features of microcirculatory disorders in acute and recurrent hemorrhagic vasculitis (Schönlein-Henoch disease)]. / Osobennosti mikrotsirkuliatornykh narushenii pri ostrom i retsidiviruiushchem gemorragicheskom vaskulite (bolezni Shenleina-Genokha).

AIM: To study microcirculatory disturbances in acute and chronic hemorrhagic vasculitis (HV). MATERIAL AND METHODS: The examination of 44 HV patients included clinical and immunological examinations, conjunctival biomicroscopy, tests for blood viscosity, aggregation of erythrocytes, coagulation parameters. In 8 patients morphological examination of skin microvessels was made (light microscopy and electron microscopy). RESULTS: Changes in microcirculation of patients with acute HV were characterized by increased IgA and red cell aggregation, tendency to hypercoagulation. Morphologically, there was high permeability of the microvessels wall. In patients with chronic HV laboratory parameters normalized except elevated level of circulating immune complexes and red cell aggregation. Morphological picture of microcirculatory disturbances in patients with chronic HV was characterized by productive vasculitis. CONCLUSION: In HV patients microcirculatory disorders caused by immunologic mechanisms are realized through increased permeability of microvessel wall, high aggregation of erythrocytes in microvessels and hypercoagulation in acute HV. In patients with chronic HV productive vasculitis and high aggregation of erythrocytes are registered.

[Acid-base balance parameters of the synovial fluid in patients with early-stage rheumatoid arthritis]. / Pokazateli kislotno-osnovnogo sostoianiia sinovial'noi zhidkosti u bol'nykh revmatoidnym artritom v rannei stadii.

AIM: To study changes in acid-base balance (ABB) of synovial fluid (SF) in rheumatoid arthritis (RA) patients in respect of the disease duration, clinical symptoms and treatment. MATERIAL AND METHODS: The examination of verified RA patients included clinical, x-ray, immunological and special tests. The patients received nonsteroid antiinflammatory drugs, 2 weeks later--physiotherapy followed by 10-day basic treatment (tauredon, methotrexate or cyclophosphamide). RESULTS: Before the treatment, SF acidotic shift was found in all the patients. The shift correlated with activity of the inflammation, serologic affiliation to the rheumatoid factor, presence of systemic manifestations, x-ray signs of the articular changes in response to the treatment. Attenuation of the inflammatory process accompanies an increase in SF acidotic shift. In administration of methotrexate SF pH was higher than in the use of other drugs. CONCLUSION: Adjuvant ABB correctors are recommended for RA patients.

[Changes in the acid-base status of the synovial fluid in rheumatoid arthritis patients]. / Izmenenie kislotno-osnovnogo sostoianiia sinovial'noi zhidkosti u bol'nykh revmatoidnym artritom.

AIM: The study of changes in joint fluid (JF) acid-base balance in RA patients to evaluate severity of joint lesions, efficacy of on-going therapy and to predict appearance and persistence of RA remission. MATERIALS AND METHODS: A routine examination and measurements of JF pH of the affected joints and venous blood before and during the treatment were performed in 65 RA patients with articular or articular-visceral forms (46 and 19 patients, respectively). 19 patients were seropositive and 20 seronegative by rheumatoid factor. A group of 17 patients suffering from osteoarthritis deformans with synovitis served control. RESULTS: Inflammation in RA is running with lowering of JF pH in the affected joints and with acidic shift in the acid-base balance manifesting as compensated metabolic acidosis in blood. JF pH of the affected joints inversely correlated with activity of the inflammation. Its changes were more pronounced in RA systemic lesions and in the seropositive variant. CONCLUSION: JF pH may be used for assessment of inflammation activity in RA.

[The role of an imbalance of sex and calcium-regulating hormones in osteoarthrosis deformans in women]. / O roli disbalansa polovykh i kal'tsiireguliruiushchikh gormonov pri deformiruiushchem osteoartroze u zhenshchin.

AIM: Determination of essential changes in hormonal background in evaluation of sex and calcium-regulating hormones levels in women of different age with osteoarthrosis deformans (OAD). MATERIALS AND METHODS: 30-34-year-old and 45-60-year-old females (60 premenopausal and 51 menopausal) with x-ray confirmed OAD and 34 control healthy women (23 premenopausal and 11 in menopause) were examined with radioimmunoassay for the baseline serum levels of calcitonin, parathyrine, osteocalcin, estradiol, testosterone, progesterone, dehydroepiandrosterone-sulfate (DHAS). RESULTS: Both age-groups patients had abnormal levels of testosterone and its metabolite DHAS. Significant deviations were found in menopausal women. With age, both patients and healthy women exhibited increasing levels of parathyrine and calcitonine. Compared to controls, OAD women had lower parathyrine, osteocalcine and higher calcitonine levels. With OAD progression, serum osteocalcin tended to lowering while testosterone was on the increase. CONCLUSION: Changes in blood levels of calcium-regulating hormones observed in osteoarthrosis may result in stimulation of cartilage degeneration. Calcitonine was low in premenopausal and menopausal OAD patients indicating impairment of bone metabolism in osteoarthrosis.

[Antibodies to cardiolipin and hemostasis in rheumatic patients during development of rheumatic valvular disease]. / Antitela k kardiolipinu i pokazateli gemostaza u bol'nykh revmatizmom pri formirovanii revmaticheskikh porokov serdtsa.

The observational study included 79 rheumatic patients aged 14-49 years. The diagnosis of acute rheumatic fever (ARF) was made in 29 patients (13-first attack, 16-recurrence), 50 patients had rheumatic heart disease (RHD) without signs of activity, 40 healthy donors served control. Antibodies to cardiolipin (a-CL) in the blood were determined by enzyme immunoassay, hemostasis was assessed by the level of antithrombin III, platelet aggregation, readings of electrocoagulograms. ARF patients were examined throughout the year, RHD patients--only once. Compared to the controls, both ARF and RHD patients demonstrated higher occurrence of a-CL, enhanced platelet aggregation, low antithrombin III level, hypercoagulation on electrocoagulogram, a-CL in ARF patients were detectable from the first month of the attack. By month 7-12 their count decreased, hemostasis normalized. In the onset and progression of RHD in the presence of ARF a-CL occurred more frequently. A direct relationship was found between the time of a-CL detection in the blood and severity, duration of rheumatic carditis. The data obtained validate feasibility of using a-CL for diagnosis of rheumatic carditis severity and prognosis of RHD development.

[The diagnostic and prognostic significance of the indices of the immune response to streptococcal group A antigens in rheumatism]. / Diagnosticheskoe i prognosticheskoe znachenie pokazatelei immunnogo otveta na antigeny streptokokka gruppy A pri revmatizme.

Serum samples obtained from 33 patients with acute rheumatic fever (ARF), 60 patients with rheumatic heart disease (RHD) and 30 adult healthy persons have been studied. Antibodies to streptococcal A polysaccharide (SAP) and lypoteichoic acid (LTA) were examined by ELISA, to streptolysin O by standard technique. SAP antibodies in high titers persisted from 5 to 12 months in ARF and rheumatic carditis patients especially when RHD was developing. High titers of antibodies to LTA and SLO persisted for 3 months since ARF onset, then fell (p < 0.05). ELISA proved sensitive in determination of antibodies to SAP and LTA. Its combination with determination of the titers to SLO antigens confirmed Streptococcus A infection involvement in emergence of ARF in all the cases including insidious or late-onset carditis and chorea. High levels of antibodies to SAP and LTA were more frequently detected in patients with RHD than in healthy persons (p < 0.001). Correlation between frequency of high levels of antibodies to SAP and bicillin 5 or erythromycin administration, duration of RHD was not established.

[Manifestation of the sensitization to penicillin preparations in rheumatism patients with a history of adverse reactions to them]. / Vyrazhennost' sensibilizatsii k preparatam penitsillina u bol'nykh revmatizmom s pobochnymi reaktsiiami na nikh v anamneze.

Observation over 56 out-patients with rheumatism who had previously developed side responses to penicillin preparations indicated a longer preservation of the condition of sensitization to prolonged preparations of penicillin (bicillin-3) and a direct dependence of its preservation degree on the extent of aggravation of allergologic history.