[Drug prevention of rheumatism: a glance into past and present time]. / Medikamentooznaia profilaktika revmatizma: vzgliad v proshloe i sovremennost'.

The paper provides scientifically grounded evidence for the principles of current (bicillin) prevention of rheumatism, gives the existing international and Russian primary and secondary prevention schemes for this disease, analyzes the causes of recurrent rheumatism in the 1990s, the main ones being the refusal of bicillin prevention or patient noncompliance. It is concluded that at present the bicillin prevention of rheumatism remains to be highly effective.

[Evolution of rheumatism in children during the past 30 years (1960-1989)]. / Evoliutsiia revmatizma u detei za 30 let (1960-1989).

The results of the anamnesis of more than 3000 case reports of patients with rheumatic fever treated at the pediatric hospital of the Institute of Rheumatology, USSR AMS during the recent 30 years have been presented. The authors established favourable tendencies of clinical evolution of rheumatism which found their reflection in a decreased markedness of carditis and extracardiac manifestations of the disease, considerable decrease in the number of relapses, development of cardiac defects and hospital lethality.

Rheumatic fever and streptococcal infections in an isolated population group in eastern Siberia.

During a two-week expedition, the prevalence of rheumatic heart disease (RHD) and the prevalence of group A streptococcal infections was investigated in a group of Yakut families of about 600 persons. In the 478 examined persons no clear-cut RHD was identified, but possible participation of rheumatic etiology in heart changes was not excluded in one adult. Group A streptococci were grown from pharyngeal swabs from 13.3% of the 202 persons examined, in the absence of any overt streptococcal disease in the settlement at the time of screening. Streptococci of at least six M-types were present among the population. Titres of antistreptolysin 0 greater than or equal to 250 u. and of antideoxyribonuclease-B greater than or equal to 1200 u. were found in 21% and 18%, respectively, of the 205 examined individuals. The bacteriological and serological data combined suggested a rather high streptococcal transmission rate in the settlement in the recent past, the pattern of which was reminiscent of the pattern of streptococcus spread in heavily interconnected population groups of the moderate climate. Possible reasons for the absence of definite RHD are discussed.

Characteristics of responders and nonresponders to slow-acting antirheumatic drugs in juvenile rheumatoid arthritis.

A 12-month double-blind, parallel, randomized, placebo-controlled multicenter trial of D-penicillamine and hydroxychloroquine was conducted in 162 children with juvenile rheumatoid arthritis in the United States and in the Union of Soviet Socialist Republics. No statistically significant intergroup differences were detected in primary outcome variables. We investigated the possible existence of select subgroups of patients who have a higher likelihood of response to active drugs than to placebo. Using previously published criteria, each patient was classified as a responder or nonresponder, and their demographic and disease characteristics at baseline were compared. We were unable to identify a subgroup of individuals who were more likely to respond to D-penicillamine or hydroxychloroquine than to placebo.

[Physical work capacity in rheumatic heart defects in children]. / Fizicheskaia rabotosposobnost' pri revmaticheskikh porokakh serdtsa u detei

Physical performance of children with rheumatic heart diseases depends upon the activity of rheumatism (rheumatism carditis) and specificity distinguishing the given disease. Spiroergometric examinations under a load of 1 w/kg is a highly informative method of evaluating the physical performance capacity of children with rheumatic heart diseases. By using this method it is possible to obtain quantitative and qualitative functional characteristics of their cardiopulmonary system, to disclose latent cardiac insufficiency. The data obtained help improve the rehabilitation of rheumatic patients.

[Meso-telesystolic sounds in children]. / O mezo-telesistolicheskikh shchelchkakh u detei

Many years of observations over 80 children with meso-telesystolic clicks have brought evidence that these clicks usually come in combination with late systolic murmur and specific alterations in the posterio-phrenic portion of the left ventricle myocardium. The prevalent view today is that at the root of this interrelated triad lies a single intracardiac pathogenetic mechanism triggered by various causative factors. The pathology in question is met with in children of different age and may appear as a consequence of congenital maldevelopment, of an overt or cubclinical inflammation and also of a fibrotic process in the subvalvular region of the posterio-phrenic portion of the left ventricle. Clinical observations point also to the etiological part played by the rheumatic heart disease in the development of the said changes. It is on rare occasions only that the systolic click is of an extracardiac origin, being caused by pleuropericardiac adhesions. The meso-telesystolic click and late systolic murmur, being an expression of a mild and moderate mitral insufficiency, have a favourable prognosis.