[RHEUTMATIC MYALGIA COMPLICATED BY AA-AMYLOIDOSIS].

Rheumatic myalgia is associated with intense inflammation and, unlike other diseases, is very rarely complicated by AA- amyloidosis. Only 12 such cases have been described worldwide, most of them in combination with giant cell arteritis. The present article reports the first case of rheumatic myalgia complicated by AA-amyloidosis encountered in Russia and the relevant literature review.

[Chronic hepatitis B, hemosiderosis, and hepatic fibrosis in a renal graft recipient].

Chronic hepatitis B is a frequent concomitant disease in recipients of a renal graft that worsens results of kidney transplantation due to renal and extrarenal complications. Much rarer hemochromatosis either has genetic roots (hereditary hemochromatosis) or results from multiple blood transfusions and hemolysis during treatment by hemodialysis (secondary hemochromatosis). Combination of chronic hepatitis B and hemochromatosis increases the risk of chronic liver disease leading to cirrhosis and hepatocellular carcinoma. Success of antiviral therapy combined with massive phlebotomy is illustrated by a case of kidney transplantation to a patient with chronic hepatitis B of large duration and iron overload syndrome.

[Chronic hepatitis B and C in renal graft recipients].

Clinical and morphological features of chronic hepatitis B (CHB), C (CHC), and B+C (CHB+C) were studied in 283 renal graft recipients. High total bilirubin serum levels were detected significantly more often in CHB and CHB+C patients vs. CHC patients. High ALT activity was noted in 65% of CHB patients and only in 45% of CHC patients (p = 0.003). Stable low activity of hepatitis prevailed in renal recipients; it was noted in 56.7% of CHB patients, 66.2% of CHC patients, and 62% of CHB+C patients. The character of pathomorphological liver changes in chronic viral hepatitis was studied in 53 renal graft recipients using puncture biopsy. Histopathological activity index (HAI, Knodell R.G. et al., 1981) witnessed a more severe liver lesion in CHB vs. CHC and CHB+C. Thus, inflammatory activity in CHB was found to be minimal or low in 13 patients, and moderate or high in 11 patients, whilst a minimal or low activity in CHC or CHB+C was found in 16 and 10 patients, respectively, and a moderate activity was detected only in two and one, respectively (p = 0.016 and 0.024 compared with CHB). Advanced hepatic fibrosis or cirrhosis was significantly more frequent (p = 0.006) in CHB patients (eight out of 24) than in CHC ones (none out of 18). The rate of advanced sclerotic changes in CHB+C was lower (one out of 10 patients) than that in CHB, and similar to CHC. Thus, clinico-morphological manifestations were more prominent in renal graft recipients with CHB vs. CHC.

[Significance of antibacterial therapy of Chlamydophila pneumoniae infection in patients with bronchial asthma]. / Znachenie antibakterial'noi terapii pri Chlamydophila pneumomiae infektsii u bol'nykh bronkhial'noi astmoi.

AIM: To study effects of eradication of Chlamydophila pneumoniae CP) infection in bronchial asthma (BA) on BA course and changes in quality of life (QOL) in BA patients. MATERIAL AND METHODS: 194 BA patients in clinical remission participated in the trial. Microbiological diagnosis of asymptomatic CP infection was made serologically (ELISA, indirect enzyme immunoassay) using polymerase chain reaction. Clinical and biochemical tests, assessment of pulmonary ventilation function, QOL by AQLQ during 6-week antimicrobial therapy were made in 56 patients. RESULTS: Patients with stable BA had high frequency of serological signs of clinically asymptomatic CP infection (52%) deteriorating BA symptoms and QOL. Antibacterial therapy of latent CP infection with azitromycin significantly improved BA course and QOL of BA patients. CONCLUSION: When laboratory tests detect CP infection in patients with long-term course of BA, especially in smoking males with moderate and severe BA it is clinically valid to prescribe addition of azitromycin to basic antiinflammatory treatment of BA.

[The trace element status in patients with chronic hepatic diseases]. / Osobennosti élementnogo statusa pri khronicheskikh zabolevaniiakh pecheni.

Despite of the achievements of pharmacology it is very actually to improve the diagnosis and therapy of different chronic hepatic diseases. The purpose of the investigation is to study trace element (TE) status in patients with chronic hepatic diseases for estimating the possibility of therapy efficiency improvement. 102 patients with chronic hepatic diseases, aged from 19 to 60 were clinically and laboratory investigated. Group 1 (36 patients) suffered from alcoholic liver cirrhosis, group 2 (35 patients) had chronic alcoholic steatohepatitis and group 3 (31 patients) had non-alcoholic steatohepatitis (NASH). Multielement blood plasma analysis by ICP-MS and ICP-OES was perfomed in the Center of Biotic Medicine (Moscow). The results showed the significant changes in TE status in patients with chronic hepatic diseases that proves the expediency of studying both the essential and toxic element in such patients to improve the diagnosis and to optimize the treatment. Patients with chronic hepatic diseases are characterized by changing of such elements as Al, Ca, Cu, K, Se, Zn, that leads to necessity of using them for diagnosis.

[Correction of selenium deficiency in patients with pneumonia]. / Korrektsiia nedostatochnosti selena u bol'nykh pnevmoniei.

The estimation of selenium (Se) safety in patients with pneumonia is important for evaluation of antioxidant defense system capacity and the immune status of the patients. The research has been carried out on the serum Se levels in patients with pneumonia at standard treatment and at treatment with the usage of selenium enriched food supplement (Se-spirulina). The results of research have shown that application of additional selenium in amount providing physiological requirement leads to full varnishing its deficiency cases and to restoration in the majority of patients the suboptimum Se level.

[Change in activity of angiotensin-converting enzyme in pneumonia and chronic obstructive lung diseases]. / Izmenenie aktivnosti angiotenzinprevrashchaiushchego fermenta pri pnevmonii i khronicheskikh obstruktivnykh bolezniakh legkikh.

AIM: To study the activity of angiotensin-converting enzyme (ACE) in patients with pneumonia and chronic obstructive lung diseases (COLD). MATERIAL AND METHODS: Sixty nine patients with pneumonia and 77 with COLD were examined. The activity of ACE in the serum and bronchoalveolar lavage (BAL) and the effects of leukocytic elastase and concentrations of zinc, endogenous inhibitors, and activators were studied. RESULTS: The patients with pneumonia in the acute phase of the disease have been found to have low ACE activity in both blood and BAL. As the inflammatory process comes to an end, ACE activity normalizes. In the patients with COLD, the activity of ACE is primarily decreased at remission. When COLD aggravates, the activity of ACE in blood and BAL increases. In pneumonia and COLD, the changes in ACE activity are more profound in BAL than in blood. CONCLUSION: The only cause of the altered activity of ACE in patients with COLD and pneumonia is a change in the concentration of the enzyme.

[Nutrition mixes in the complex rehabilitation of young men with constitutional deficit of body weight]. / Pishchevye smesi v kompleksnoé reabilitatsii molodykh muzhchin s konstitutsional'no obuslovlennym defitsitom massy tela.

It was investigated peculiarities of the constitutional malnutrition in 94 young men. The influence of oral supplementation by enteral nutrition on recovering 54 young men with constitutional malnutrition was examined. The results of investigation indicated a high efficacy of using oral supplementation in the complex treatment of malnourished young men. It results in improvement of patient's rehabilitation and reduce the time of hospitalization.

[Changes in angiotensin-converting enzyme activity in pneumonia and chronic obstructive lung diseases]. / Izmenenie aktivnosti angiotenzinprevrashchaiushchego fermenta pri pnevmonii i khronicheskikh obstruktivnykh bolezniakh legkikh.

The activity of angiotensin converting enzyme (ACE) was analysed in blood serum and bronchial fluid of 69 patients with acute pneumonia and 77 patients with chronic obstructive pulmonary diseases (COPD). In patients with pneumonia in acute phase ACE activity was lower in both serum and bronchial fluid. During recovery of patients with acute pneumonia ACE activity was normalizated. In patients with COPD ACE activity was lower in remission stage and higher (both serum and bronchial fluid) during COPD exacerbation. The changes of ACE activity were more pronounced in bronchial fluid than serum in both COPD and pneumonia.

[Experience of nutritional support in late period of traumatic disease of wounded patients]. / Opyt korrektsii troficheskoi nedostatochnosti u ranenykh v pozdnem periode travmaticheskoi bolezni.

There are no standards of nutritional support of wounded patients in different periods of disease. Influence of supplementation with Nutrition on dynamic of anthropometric indexes, some biochemical and laboratory parameters in wounded malnourished patients in the last period of disease was examined. The results of investigation indicated that supplementation with Nutrizon increased all tianthropometric indexes, normalized albumin blood level, nitrogen balance, decreased nitrogen of urine.