[Differential diagnosis of chronic urogenic arthritis]. / O differentsial'noi diagnostike khronicheskogo urogennogo artrita.

AIM: To investigate features of chronic urogenic arthritis (CUA) and its differences with psoriatic arthritis (PA) and ankylosing spondylarthritis (AS) with joint lesion. MATERIALS AND METHODS: CUA, AS, PA were diagnosed according to S. M. Sidelnikova et al., S. van der Linden and Agababova, respectively, in 94 patients. The disease ran for more than 3 years. Articular syndrome was examined in CUA, AS and PA. RESULTS: Articular syndrome in CUA remains for the most part monoarticular with affection of the joints of the low extremities. AS has clinical and x-ray signs of sacroileitis, affection of the spinal column and hip joints. PA runs with multiple arthritic lesions of the hand and foot joints. CONCLUSIONS: Chronic infection persists in all the CUA and PA patients. Its exacerbation coincides with arthritis aggravations. Only in CUA there is a chronological connection between acute or aggravated chronic urogenital infection and initial symptoms of joint disease.

[Pathogenetic aspects of chlamydia-associated urogenic arthritis: feasibility of microorganism reproduction in cells of articular cartilage]. / O patogeneticheskikh aspektakh urogennykh artritov, assotsiirovannykh s khlamidiiami: vozmozhnost' mikroorganizma razmnozhat'sia v kletkakh systavnogo khriashcha.

AIM: The study of feasibility of Chlamydia trachomatis infection and reproduction. This microorganism is an essential etiologic factor in urogenic arthritis, in chondrocytes and fibroblasts of human skin. MATERIALS AND METHODS: Infection of human skin chondrocytes and fibroblasts was made with chlamydia CP-1 strain isolated from joint fluid of the patient and serially passaged in the hen's embryo yolksacs. The inoculation results were assessed by direct staining with the use of monoclonal and fluorescent antibodies and hematoxiline. RESULTS: Chlamydial infection of human skin connective tissue, chondrocytes of the auricular cartilage and fibroblasts in particular, is possible. CONCLUSION: The findings confirm the ability of Chlamydia trachomatis to reproduce in the cartilage tissue.

[The local therapy of enthesitis and bursitis of the calcaneal area in seronegative spondylarthritis]. / Lokal'naia terapiia éntezitov i bursitov piatochnoi oblasti pri seronegativnykh spondiloartritakh.

Four methods of local treatment of calcaneal enthesopathy and bursitis (hydrocortisone phonophoresis, laser radiation, glucocorticosteroids injections into the calcaneal region, physiotherapy with sinusoidal modulated currents) were tried in 69 patients with seronegative spondylarthritis. Local injections of glucocorticosteroids produced the best effect. Laser therapy or hydrocortisone phonophoresis is recommended in dominating pain syndrome in the calcaneal region. SMC therapy was not good in inflammation of tendinous-ligamentous system and calcaneal bursas in patients with spondylarthritis.

[Use of fluoroquinolones in rheumatology]. / Primenenie ftorkhinolonov v revmatologii.

The efficacy and tolerance of 3 fluoroquinolones (ciprofloxacin, pefloxacin, lomefloxacin) were studied in 157 patients with rheumatic diseases concurrent with infection-induced abnormalities. Infection cure was achieved in 123 (78.6%) patients, as evidenced by clinical, microbiological, and serological studies. The tolerance of fluoroquinolones was regarded as good, satisfactory, and poor in 114 (72.6%), 37 (23.6%), and 6 (3.8%) patients, respectively. All representative drugs of the fluoroquinolones series produced typical adverse reactions. The authors consider it expedient to make further clinical studies to test the optimal treatment regimens and to expand indications for the use of fluoroquinolones in this group of patients.

Spondyloarthropathies in circumpolar populations of Chukotka (Eskimos and Chukchi): epidemiology and clinical characteristics.

OBJECTIVE: We sought to determine the prevalence of HLA-B27 and the prevalence and nature of spondyloarthropathies in the native residents of Eastern Chukotka, Siberia, Russia. METHODS: We conducted a cross sectional study with medical examination and interview of 464 of 640 (72.5%) native residents of 2 Eastern Chukotka settlements, Sireniki and Novo-Chaplino. RESULTS: Among them were 212 Eskimos, 98 Chukchi and 154 subjects of mixed race. There were 2 subjects (0.4%) with ankylosing spondylitis, 2 with Reiter's syndrome, 2 with undifferentiated spondyloarthropathy and 1 with late onset pauciarticular juvenile arthritis consistent with spondyloarthropathy. Four of the subjects were Eskimos, 2 were of mixed race, and 1 was Chukchi. We found a high percentage of HLA-B27 antigen in the population, 32% in the native population overall, and 40% among the Eskimos. CONCLUSION: Our data complement other studies of circumpolar populations and reinforce the reported high prevalence of spondyloarthropathy and HLA-B27 among those people.

[The epidemiology of spondylarthropathies among the native inhabitants of Chukotka (Eskimos and Chukchi). 1. The prevalence of spondylarthropathies among the Eskimos and the coast Chukchi]. / Epidemiologiia spondiloartropatii sredi korennykh zhitelei Chukotki (éskimosov i chukhei). Soobshchenie 1. Rasprostranennost' spondiloartropatii sredi éskimosov i beregovykh chukchei.

To establish the prevalence of spondyloarthropathies among the indigenous population of Chukot Peninsula, a one-stage cross-sectional study was made with a direct medical examination of the natives of the two settlements of Eastern Chukot Peninsula: Sireniki and Novo-Chaplino where the main part of Eskimos live. During expedition, 640 natives aged over 6 years lived in both settlements (382 and 258 respectively). 464 persons (72.5%) were examined. Of these, 7 persons (1.5%) were diagnosed to suffer from diseases belonging to the group of spondyloarthropathies: 2 persons (0.4%) had ankylosing spondyloarthritis, 2 (0.4%) Reiter's syndrome, 2 undifferentiated spondyloarthropathies, and 1 juvenile chronic arthritis. Of the 7 patients, 4 were Eskimos, 2 half-breeds and 1 was a Chukchi man. The incidence of ankylosing spondyloarthritis among Eskimos amounted to 0.9%, Reiter's syndrome to 0.5%, and undifferentiated spondyloarthropathies to 0.5%. Thus the one-stage expedition examination of the indigenous population of Chukotka Peninsula (Eskimos and Chukchi) has shown that diseases belonging to the group of spondyloarthropathies are widely prevalent among Eskimos.

[Leukocyte function in reactive arthritis]. / Funktsiia leikotsitov pri reaktivnykh artritakh.

The authors studied ++chemotaxis, phagocytosis and the activity of intracellular enzymes of leukocytes in the peripheral blood of 90 patients with reactive arthritis as compared to 23 patients with rheumatoid arthritis and 28 healthy individuals. Disorders of all these parameters were noted. They correlated with the specific features of the clinical course of the disease and its activity. In case of reactive arthritis the persistence of the infection and immunopathological disorders underlying chronic synovitis are attributable to the condition of nonspecific resistance.

[The effect of tetracycline therapy on the laboratory indices of chlamydia infection in Reiter's disease (preliminary report)]. / Vliianie tetratsiklinoterapii na laboratornye pokazateli khlamidiinoi infektsii pri bolezni Reitera (predvaritel'noe soobshchenie).

The authors studied the effect of tetracycline therapy (short and long courses) on the indices of chlamydia infection (antigens and antibodies) in Reiter's urogenous disease. The concentration of tetracycline in the blood serum and synovial fluid when administered in a daily dose of 2.0 g (single dose 0.5 g) was determined. It has been established that tetracycline exerts an inhibitory effect on the chlamydia infection not in all the patients suffering from Reiter's disease despite sufficient concentration of the antibiotic in biological fluids (blood serum, synovial fluid). Prolonged courses of tetracycline therapy proved most effective.

[Effect of various physical factors on clinical and laboratory indicators and on nonspecific resistance of the body in reactive arthritis]. / Vliianie nekotorykh fizicheskikh faktorov na kliniko-laboratornye pokazateli i nespetsificheskuiu rezistentnost' organizma pri reaktivnykh artritakh.

Application of UV-therapy and acupuncture in the complex therapy and rehabilitation of reactive arthritis patients had a positive effect on the disease course. The clinical efficacy of the compared physiotherapy methodologies is determined, to a certain degree, by the increase in the nonspecific resistance of the organism in this category of patients.

[Various aspects of the chronic course of Reiter's disease]. / Nekotorye aspekty khronicheskogo techeniia bolezni Reitera.

A comparative clinicolaboratory study of followed-up patients with a chronic (38 patients), acute and lingering (137 patients) course of Reiter's disease was conducted. The role of a persisting focus of infection in the genitourinary organs and genetic predisposition (HLA-B27 was detected in 100% of the cases) in the formation of a chronic variant of disease was shown. Sacroileitis, amyotrophy, bursitis and enthesitis developed more frequently in a chronic than in an acute variant; erosion in the joints was detected in over 40% of the patients. Morphological investigation of the synovial bioptates revealed a picture of chronic synovitis with superficial localization of an inflammatory process.