[Changes in indices of inflammatory activity in patients with rheumatoid arthritis during early stages of basic therapy with leflunomide]. / Dinamika pokazatelei vospalitel'noi aktivnosti u bol'nykh revmatoidnym artritom na rannikh étapakh bazisnoi terapii leflunomidom.

AIM: To assess leflunomide efficacy and tolerance in patients with rheumatoid arthritis (RA) during the first four months of the treatment. MATERIAL AND METHODS: The study included 200 RA patients treated in four Moscow clinical centers. Leflunomide was given in a dose of 100 mg/day for 3 days, then 20 mg/day for 16 weeks. The activity of the disease according to the criterion DAS 28 was assessed before the treatment and 4, 8, 12 and 16 weeks after the treatment start. RESULTS: RA activity diminished considerably after one month of leflunomide treatment. Later, the articular syndrome continued to improve. A significant improvement by DAS 28 was observed after 16 weeks of the treatment in 65% (129 of 200) patients, high RA activity persisted only in 17 of 90 patients. CONCLUSION: Leflunomide reduces articular inflammation and raises RA patients' quality of life at early stages of the treatment. This reduction continued for 4 months of the study. Therefore, adequate assessment of leflunomide efficacy should be made only after 4-6 months of therapy.

[Gastrointestinal hemorrhages as complications of gastropathies associated with intake of nonsteroidal anti-inflammatory drugs]. / Zheludochno-kishechnye krovotecheniia kak oslozhneniia gastropatii, sviazannykh s priemom nesteroidnykh protivovospalitel'nykh preparatov.

AIM: To examine gastroduodenal mucosa in patients treated with nonsteroidal anti-inflammatory drugs (NSAID), to evaluate the rate and severity of gastrointestinal hemorrhage (GIH) as NSAID-gastropathy manifestation by the results of clinical and device tests. MATERIAL AND METHODS: A retrospective analysis of 2042 case histories of patients admitted to the surgical department of the Moscow city hospital N 1 in 1997-2001 with diagnosis GIH confirmed at esophagogastroduodenoscopy (EGDS). 989 patients (566 males and 423 females) had acute GIH from the upper gastrointestinal tract. RESULTS: Relationship between intake of NSAID and GIH was documented in 342 patients (16.7% of overall number of the examinees and 34.6% of patients with acute GIH). According to EGDS, GIH was provoked by gastric lesions (68%), duodenal lesions (20%), gastroduodenal lesions (9%), esophageal erosions (3%). GIH was caused primarily by low-dose aspirin, indometacin, diclofenak and ibuprofen. Severe GIH occurred in 28.9% cases, moderate and mild ones in 20.8 and 50.3%, respectively. CONCLUSION: To reduce the incidence of GIH, it is necessary to take preventive measures against NSAId-gastropathies.

[Clinical and instrumental characteristics of gastrointestinal bleeding caused by non-steroidal anti-inflammatory drugs]. / Kliniko-instrumental'naia kharakteristika zheludochno-kishechnykh krovotechenii, obuslovlennykh nesteroidnymi protivovospalitel'nymi preparatami.

UNLABELLED: There was a study of the condition of mucous membranes of upper parts of the gastrointestinal tract in patients with gastrointestinal bleedings (GIB), who were taking non-steroidal anti-inflammatory drugs (NSAID); the blood loss severity was assessed. 2,042 health records of patients, who came to surgical departments with the gastrointestinal bleeding diagnosis, were studied pro- and retrospectively. A group of 342 patients with GIB induced by NSAID was selected. The age of the group of patients under examination was from 17 to 86. RESULTS: Chronological relation between the application of NSAID and GIB was discovered in 16.7% of all cases. When assessing the bleeding source area, stomach affections were discovered in 68% of cases; duodenal affections were discovered in 20% of cases; associated stomach and duodenal affections were recorded in 9% of cases; esophagus erosion was found in 3% of cases. Bleedings were most often induced by the application of Aspirin, Indometacin, Diclofenac and Ibuprofen. Severe bleedings were revealed in 28.9% of cases, medium bleedings were recorded in 20.8% of cases, and 50.3% of cases were attributed to light bleedings.

[Effectiveness of ketonal and diclofenac in spondylarthrosis complicated with spinal pain]. / Effektivnost' ketonala i diklofenaka pri spondiloartroze, oslozhnennom boliami v spine.

The article compares efficacy and safety of ketonal used in a dose 300 mg/day and diclofenac in a dose 150 mg/day in patients with primary spinal pain. The treatment of 60 patients aged 35 to 70 years (mean age 42.7 +/- 12.4 years) showed high efficacy of ketonal in spinal pain and low rate of side effects induced by this drug. Diclofenac was also effective.

[Staphylococcal toxic shock syndrome in young women]. / Stafilokokkovyi toksicheskii sindrom u zhenshchin molodogo vozrasta.

A literature review is presented on staphylococcal toxic shock syndrome. A case of this syndrome in a 39-year-old woman is reported. Clinical, pathology, treatment data on this condition are analysed.