[Traumatic myocardial infarction].

The paper reports development of acute myocardial infarction as a result of blunt chest injury in a woman having no signs of atherosclerosis. Coronary bleeding was caused by dissection of intima of the interior interventricular artery. Transdermal coronary intervention included balloon angioplasty and stenting of the anterior interventricular artery.

[Thrombus precursor protein (soluble monomeric protein) in patients with acute coronary syndrome].

The purpose of the study was to determine the level of thrombus precursor protein (TrP) in patients with acute coronary syndrome (ACS). Twenty-six patients with ACS and anginal pain experienced during 2 to 12 hours (7.2 +/- 1.3 hours), admitted to cardiological intensive care unit, were enrolled in the study. Five ml of blood were sampled from a cubital vein of all the patients during the phase of the most intensive pain. TrP blood levels were measured with ELISA, Enzyme-Linked Immunoadsorbent Assay. The control group consisted of 29 healthy volunteers and 22 patients with stable exertional stenocardia. A significant increase in TpR (7.2 +/- 1.45 mcg/ml) was noted in the ACS patients as early as during the first 6 hours, vs. the healthy controls (1.01 +/- 0.12 mcg/ml) and the patients with stable stenocardia (1.21 +/- 0.06 mcg/ml), p < 0.01. A high level of TrP in the ACS patients could be noted earlier than a diagnostically significant increase in creatine phosphokinase level. No direct correlation was observed between the TrP level and the dynamics of such indices of the procoagulatory hemocoagulation chain as fibrinogen, prothrombin index, and active partial thromboplastin time. The results of the study demonstrate that the measurement of TrP level is highly informative when the intensity of intravascular blood coagulation in ACS patients is to be evaluated, which can be used to clarify indications to anticoagulation therapy. The enzyme immune method of TrP detection in the plasma of ACS patients can be recommended for clinical application.

[The functional condition of the left ventricle in patients suffering from rheumatoid arthritis with subcutaneous rheumatoid nodules].

The purpose of the study was to evaluate the systolic and diastolic left ventricular (LV) function in patients with the system form of rheumatoid arthritis (RA) with subcutaneous rheumatoid nodules (SRN). The subjects, 105 patients with proved RA, were divided into two groups. The main group consisted of 40 patients suffering from system RA with SRN. The comparison groups included 40 patients suffering from the articular-and-visceral form of RA without SRN, and 25 patients with the articular form of RA. The systolic LV function was evaluated in all the 105 RA patients using M-mode Echo CG. In 20 patients with SRN systolic and diastolic LV function was evaluated with radionuclide ventriculography (RVG). The hemodynamic parameters obtained with Echo CG and RVG were processed according to variation statistics rules, presenting the data in groups as a mean and the standard error (M +/- m); the results were compared between the patients and between the patients and healthy controls. The significance was estimated using Student criterion (p < 0.05). In the group of RA patients with SRN, Echo CG and RVG found a significant decrease in LV systolic function parameters vs. patients without SRN and healthy controls. RVG revealed LV diastolic dysfunction in RA patients with SRN. Systolodiastolic LV dysfunction in these patients suggests myocardial involvement. Present-day instrumental methods of the evaluation of functional heart condition may be used to evaluate systolic and diastolic LV function in RA patients, especially during the dynamic observation of the effectiveness of RA treatment with modern anti-rheumatic preparations.

[The soluble fibrin monomer in patients with instable angina].

The purpose of the study was to measure the blood level of thrombus precursor protein (TpP), a soluble fibrin monomer, in patients with stable exertional angina (SEA) and healthy people. The study included the examination of 33 patients with SEA (functional class II and III) and 29 practically healthy volunteers (control group). The detection of TpP in blood plasma was performed by solid-phase immune-enzyme analysis ("sandwich" type) using commercial diagnosticum "Kit" ("ABS", USA) and a microplate reader "IEMS Analyzer\Dispenser, with automatic result calculation in "Logistic fif" mode. TpP level in patients with SEA on the average was slightly higher than in control group, but the difference was not significant. TpP blood level was independent of the patients' gender, age, angina functional class and an old myocardial infarction. TpP blood level in patients with SEA depended on the duration of the illness, and proved to be significantly higher (compared with that in control group) in patients with SEA during the first 5 years of the illness, i.e. at early stages of CHD. Solid-phase immune-enzyme analysis ("sandwich" type) is a highly informative and affordable clinical method. TpP level in patients with SEA on the average was slightly higher than in healthy people (1.21 +/- 0.06 mkg/ml and 1.01 +/- 0.12 mkg/ml, respectively), but the difference was significant only in patients during the first 5 years of having SEA (1.41 +/- 0.11 mkg/ml).

[Diagnostic and therapeutic problems in adult onset Still's disease (data of a long-term follow-up)]. / Problemy diagnostiki i lecheniia bolezni Stilla vzroslykh (po dannym mnogoletnego dinamicheskogo nabliudeniia).

15 patients with Still's disease of adults (SDA) were followed up for 17 years maximum. The disease showed a principal clinical-laboratory syndrome observed both in SDA debut and exacerbations (recurrences). Clinical manifestations of SDA do not arise stereotypically causing difficulties in its nosological interpretation. SDA course is represented by three variants: monophasic (monocyclic), recurrent and chronic persisting with development of destructive arthritis. Use of nonsteroid antiinflammatory drugs is analysed, indications to administration of glucocorticoids and basic treatment are listed. Reversibility of systemic SDA manifestations except the articular one is shown. About half of the patients develop chronic destructive arthritis. In active SDA, renal amyloidosis and chronic renal failure may develop with lethal outcome.

[Clinical picture of some diseases in HIV-infected Ethiopians]. / Klinika nekotorykh zabolevanii v Efiopii u bol'nykh, infitsirovannykh virusom immunodifitsita cheloveka.

238 Ethiopians with different diseases have been examined for HIV antibodies. HIV infection was found in 167 of them. HIV infection seems to have changed symptoms and severity of other diseases. Special clinical signs were established enabling the physicians to suspect HIV infection prior to laboratory verification.

[Comparison of myocardial effects of various antirheumatic modalities in patients with rheumatoid arthritis (prospective clinico-echocardiographic study)]. / Sravnitel'naia otsenka vliianiia razlichnykh antirevmaticheskikh sredstv na miokard u bol'nykh revmatoidnym artritom ( prospektivnoe kliniko-ékhograficheskoe issledovanie).

A prospective study was conducted of basic antirheumatic drugs (chrisanolum, myocrisin, ridaura, chlorbutin, D-penicillamine) versus nonspecific antiinflammatory treatment in 127 patients with rheumatoid arthritis (RA). The drugs were compared by their effect on myocarditis. Basic antirheumatic drugs were found much superior to nonsteroid antiinflammatory drugs. The highest response was registered for chrisanolum myocrisin and chlorbutin after 6-12 month continuous treatment. Warning: chrisanolum, myocrisin and ridaura may produce unwanted short-term effects on left ventricular contractility in developing extracardiac complications of aurotherapy.

[Heart defects in rheumatoid arthritis patients (the results of a multiyear prospective clinico-echocardiographic study)]. / Poroki serdtsa u bol'nykh revmatoidnym artritom (rezul'taty mnogoletnego prospektivnogo kliniko-ékhokardiograficheskogo issledovaniia).

The analysis of life-time diagnosis of valvular heart disease in rheumatoid arthritis (RA) patients has been made basing on a long-term clinico-echocardiographic investigation. Within 18-year follow-up valvular disease was revealed in 17 out of 214 RA patients (7.9%). Only 3 patients developed the disease in childhood prior to RA diagnosis. In 8 patients the diagnosis of valvular disease was established in the presence of RA, in 6 RA patients the disease was determined during the follow-up period. Mitral stenosis, aortal stenosis, combined mitral valve incompetence, combined aortal defect, mitral defect and tricuspid incompetence, combined mitral defect and pulmonary artery valvular incompetence were detected in 2, 2, 3, 1, 1, and 1 patients, respectively. Valvular disease occurs more frequently in progredient seropositive RA uncontrollable by on-going therapy. The authors emphasize the value of a prospective clinical echocardiographic examination of RA patients in early diagnosis of valvular disease in them. Frequent valvular lesions in RA patients dictate the need of persistent antirheumatic therapy to inhibit the activity and prevent progression of the disease.

[The effect of Ridaura on cardiac function in patients with rheumatoid arthritis (based on echocardiographic data)]. / Vliianie ridaury na funktsiiu serdtsa u bol'nykh revmatoidnym artritom (po dannym ékhokardiografii).

The method of echocardiography was used to study the effect of ridaura on the functional state of the heart in patients with rheumatoid arthritis (RA) depending on the duration of therapy and its efficacy. A total of 28 patients with RA were examined in the dynamics of therapy. The favourable effect of ridaura on the size of the left ventricle of the heart and its contractile function with the general positive effect of therapy was revealed. A decrease in the size of the left ventricle began 6 months after treatment with ridaura and continued up to the end of the first year, the contractile function considerably rose after two years of treatment. In 1/3 of the patients side effects developed; they manifested themselves in deterioration of the indices of hemodynamics. The unfavourable effect of ridaurotherapy on the myocardium had a latent course and was reversible.

[The effect of parenteral gold preparations on heart function in rheumatoid arthritis patients (based on echocardiographic data)]. / Vliianie parenteral'nykh preparatov zolota na funktsional'noe sostoianie serdtsa u bol'nykh revmatoidnym artritom (po dannym ékhokardiografii).

A total of 30 patients were treated by chrisanolum and myocrisin. The course of treatment lasted more than 2 years. The authors observed clear positive effect of parenteral preparations of gold on the contractile and pumping function of the heart in RA patients; clinical and laboratory manifestations of the disease were decreased.