Early Morphological and Functional Reorganization of the Articular Cartilage in Rats with Experimental Osteoarthrosis of Different Genesis.

Peculiarities of the morphology of some phenotypes of experimental osteoarthrosis was studied in experiments on rats. Reorganization of the knee articular cartilage of Wistar rats during aging (age-associated phenotype), obesity (metabolic phenotype), circulatory disturbances (e.g., chronic heart failure), and their combinations (polymorbidity) was studied by hematoxylin and eosin staining, immunohistochemical staining for collagen II and caspase 3, and morphometry. High sensitivity of the cartilage to non-traumatic influence of different anthropomorphic factors was demonstrated; morphological changes in osteoarthrosis of different genesis. The most pronounced pathological changes were observed in polymorbid animals, which allowed developing a new pathogenetically substantiated model of nontraumatic osteoarthrosis.

[Comparative analysis of effectiveness and safety of diclofenac and nimesulide in patients with early rheumatoid arthritis].

The aim of the work was to evaluate effectiveness and safety of diclofenac and nimesulide in patients with early RA. The open clinical study included 80 outpatients (mean age 49.0 +/- 11.1 years) within the first year after development RA (mean duration of the disease 4.9 +/- 3.1 months prior to the onset of basic therapy). The patients were divided into 2 groups of 40 persons each depending on the type of non-steroidal anti-inflammatory agents they received. Patients in group 1 were treated with 100 mg of diclofenac daily and in group 2 with 100 mg BID of generic nimesulide preparation (nais, Dr. Reddy Co.). Duration of therapy was 30 days in both cases. The two drugs were roughly identical in terms of therapeutic effect although nimesulide produced fewer side effects. Subjective complaints of gastrointestinal problems were recorded in 11 (27.5%) patients f group 1 and in 8 (20%) of group 2. It is concluded that timely prescription of proton pump inhibitors permits to avoid premature withdrawal of non-steroidal anti-inflammatory agents at patient discretion.

[Pharmaco-economic efficiency of the treatment of patients with acute vertebrogenic lumbar pain syndrome].

The aim of the study was to evaluate pharmaco-economic efficiency of two therapeutic schemes for the treatment of acute vertebrogenic lumbar pain syndrome. One hundred patients (including 77 women) with this syndrome caused by vertebral osteochondrosis (VO) were examined. Mean age of the patients was 41.00 +/- 8.33, mean duration of exacerbation 6.92 +/- 4.55 days. The majority of the patients had roentgenologic stage II VO. Patients of one group (n=50) were given intramuscular injections of ketorol (1 ml twice daily for 5 days) and diclofenac-retard (100 mg per os twice daily for 10 days). The second group (n=50) received ketorol and nise (100 mg twice daily for 10 days). This treatment was followed by 10 seances of phonophoresis using 1% hydrocortisone ointment. The clinical efficiency of therapy was evaluated based on the visual analog scale and in terms of Lasagne symptom, muscular syndrome index, Schober test, Thomayer's symptom, vertebrogenic syndrome coefficient. Pharmaco-economic analysis included calculation of direct medical care expenses and cost index/efficiency. The efficiency of therapy in group 2 (restoration of lumbar vertebral column mobility and alleviation of pain) was higher than in group 1 while the number of adverse effects was lower and the periods of remission longer. Combined therapy with ketorol and nise per unit efficiency was more expensive but the total cost of the management of one case including all yearly relapses suggested its advantages over the alternative treatment with ketorol and diclofenacin terms of clinical and pharmaco-economic efficiency.

[Comparison of quality of life and treatment efficacy in patients with chronic low back pain syndrome].

AIM: To test use of quality of life (QL) parameters for assessing treatment efficacy in patients with chronic low back pain syndrome (CLBPS). MATERIAL AND METHODS: Clinical, device examinations, questionnaire survey were made in 100 patients, most of them females (77%) with CLBPS due to spinal osteochondrosis. Mean age of the patients was 45.69 +/- 7.61 years, mean duration of the disease 10.20 +/- 6.01 years, duration of the exacerbation 4.04 +/- 1.75 months. Most of the examinees had CLBPS x-ray stage II. QL was evaluated by questionning (general SF-36, HAQ and special Oswestry low back pain disability (OLBPD) questionnaires). RESULTS: The patients were divided into two groups by clinical and device findings and responses to the questionnaires. Group I patients had significant improvement of all the parameters studied, patients of group 2 had no improvement. A strong correlation was found between OLBPD responses and the patients' appraisal of the treatment efficacy. The effect value, standardized significance rates and factors intensity reflected high informative value of the questionnaire by assessment of efficacy of CLBPS treatment. CONCLUSION: SF-36 and OLBPD are recommended as adequate general and special questionnaires respectively, to estimate QL in patients with CLBPS. The treatment is effective if total parameters of physical and mental health by SF-36 rise significantly while vital activity disorders by OLBPD reduce more than 2-fold.

[Midocalm in complex therapy of chronic low back pain syndrome].

The aim of the study was to determine whether application of midocalm is appropriate in patients with chronic low back pain (LBP) from the point of view of quality of life (QL), efficacy and tolerance. The subjects were 50 patients with chronic LBP associated with spinal osteochondrosis, who underwent clinical examination and were questioned using four QL questionnaires: Health Assessment Questionnaire (HAQ), Womac osteoarthritis index Womac osteoarthritis index, Oswestry Low Back Pain Disability Questionnaire, and The 36-Item Short-Form Health Survey (SF-36). The subjects were divided into two groups. The 25 patients of Group I were administered nise in a dose of 100 mg twice a day during 10 days, the 25 patients of Group II--nise in a dose of 100 mg twice a day plus midocalm in a dose of 150 mg per day during the first two days and 450 mg per day from the third day through the tenth day. The study showed high efficacy of midocalm in complex therapy of patients with chronic LBP, as well as low rate of adverse reactions and high treatment tolerance. QL of the patients improved. Combining midocalm therapy with nise allows quicker positive effect in patients with chronic LBP and lowers need for long application of non-steroid antiinflammatory drugs.