Különböző adalékok hatása az ellentétes töltésű polielektrolitok és tenzidek asszociációjára

Munkánk elsődleges célja az elektrolit ellentmondásos hatásának vizsgálata, értelmezése volt. Kutatásaink során polikation/anionos tenzid (PEI-NaDS) és polianion/kationos tenzid (PSS-DTAB, PSS-CTAB) elegyekkel foglalkoztunk. Az elektrolit egyik hatása akkor észlelhető, ha a polielektrolit-tenzid asszociátumok elkészítése során elektrosztatikusan stabilizált kolloid diszperzió képződik. Kis elektrolit koncentráció értékek esetén az elektrolit a diszperzió kinetikai stabilitását csökkenti. PEINaDS és PSS-CTAB elegyei esetén polielektrolit feleslegben egy szűk, és tenzidfeleslegben széles koncentráció tartományban keletkezik kinetikailag stabil kolloid diszperzió. Ugyanakkor PSS és DTAB elegyeinél nem sikerült tenzidfeleslegben kolloid diszperziót létrehozni. Az elektrolit másik hatása akkor figyelhető meg, ha a P/T elegyhez hozzáadott elektrolit jelentősen csökkenti a kötött tenzid mennyiségét, ugyanakkor a tenzid oldhatósága elegendően nagy marad az elektrolitoldatban. Nagy NaCl koncentráció esetén az elektrolit az egyensúlyi fázistulajdonságokra hat: nem történik asszociatív fázisszeparáció. Ezt a hatást észleltük PSS és alkil-trimetilammónium bromidok (DTAB, CTAB) elegyeiben – bizonyos sókoncentráció felett a teljes tenzidkoncentráció tartományban transzparens oldatokat kaptunk. Megállapítható, hogy az elektrolit kettős hatással bír az ellentétes töltésű polielektrolit-tenzid rendszerekre, annak minőségétől függ, hogy az elektrolit egyik, másik, vagy akár mindkét hatását látjuk. Ezek az eredmények érdekes felhasználást nyerhetnek a jövőben. Például polielektrolittenzid aggregátumok elektrosztatikusan stabilizált kolloid diszperziója lehetőséget teremt arra, hogy a részecskék hidrofób belsejükben apoláris anyagot raktározzanak, ami az elektrolit koncentráció hirtelen megemelésével felszabadítható. Más lehetőség lehet, hogy P/T nanorészecskékből álló felületi réteg létrehozásával a felület hidrofóbicitása hangolható a közeg ionerősségének változtatásával. A PEI-NaDS-PEO rendszerrel ellentétben a PSS-CTAB-Pluronic rendszerekben nem tapasztalható a semleges polimer oly mértékű adszorpciója a P/T nanorészecskék felszínére, ami sztérikus stabilizálást biztosítana a PSS-CTAB nanorészecskék kolloid diszperziójának. Az eddigi eredmények azonban nem nyújtanak elegendő információt a polimeradalék hatásáról a polielektrolit-tenzid asszociációra, ezért további vizsgálatok szükségesek

EXPERIENCE OF ALPROSTADIL APPLICATION AGAINST RAYNAUD'S SYNDROME AMONG CHILDREN

The article provides the data on the causes and mechanisms of Raynaud's syndrome development. initial or idiopathic Raynaud's syndrome is characterized by the spasm of the digital arteries and thermoregulatory vessels of skin under the impact of the cold without any signs of vessel lesions. In the event of secondary Raynaud's syndrome, there is combination of Raynaud's syndrome with the symptoms of other diseases. Secondary raynaud's syndrome is most often associated with scleroderma systematica, systemic erythema centrifugum, other rheumatic diseases, hematologic disc orders and intake of some medications. There is also data on the opportunity to apply the synthetic medication prostaglandin е 1 — alprostadil to treat Raynaud's syndrome associated with rheumatic diseases. The given clinical example demonstrates high efficacy of alprostadil in case of the patient, suffering from scleroderma systematica and generalized Raynaud's syndrome.Key words: children, scleroderma systematica, alprostadil, Raynaud's syndrome

APPLICATION EXPERIENCE OF PROCALCYTONINE TEST FOR THE DIFFERENTIAL DIAGNOSTICS OF THE ACUTE SYSTEMIC INFLAMMATORY RESPONSE

The article provides the clinical observation, allowing for the conclusion that the use of pct test in the daily practice of a rheumatologist makes it possible to early carry out differential diagnostics of a patient with the manifestations of the systemic inflammatory response and to duly start necessary pathogenetic and/or etiotropic therapy. Key words: procalcytonine test, sepsis like syndrome, treatment, children

RITUXIMAB EFFICACY IN TREATING SYSTEMIC JUVENILE ARTHRITIS REFRACTORY TO TRADITIONAL IMMUNOSUPPRESSANT AND TNF BLOCKER THERAPY

The article describes the clinical case of a difficult systemic juvenile arthritis refractory to traditional immunosuppressant and TNF blocker therapy. The disease was characterized by such extra-articulate manifestations as fever, lymphadenopathy, hepatolienomegaly, polyorrhymenitis, generalized joint affection and high laboratory activity indicators (ESR, CRP). The inclusion of rituximab stimulated the remission of systemic manifestations and the joint syndrome, as well as normalized the laboratory disease activity indicators. The therapeutic effect duration was 22 weeks upon the initial infusion of rituximab. The results demonstrate that rituximab is a promising medication for treating systemic juvenile arthritis children.Key words: children, treatment, rituximab, juvenile arthritis.</strong

OF THE APPLICATION OF THE CYCLOSPORINE GENERICS IN THE PEDIATRIC RHEUMATOLOGY

The article presents the findings of the research dedicated to the efficacy, bioavailability and safety of the generic medications and authentic cyclosporine a. it shows that the application of the generic medications leads both to the reduction in the treatment efficacy and development of the severe side effects. It also presents the information on the qualitative and quantitative contents of cyclosporine a generic medications. Neither of the tested medications complied with authentic Sandimmune Neoral in terms of qualitative and quantitative contents. Likewise, neither of the generic medications has the microemulsive form, which provides for the uniform absorption of a medication and its bioavailability. There are also clinical examples of the application experience, regarding cyclosporine a generic medications among the patients with severe systemic rheumatoid arthritis. The application of the generic medications proved to be ineffective and was accompanied by the growth of renal toxicity.Key words: cyclosporine generics, children, juvenile rheumatoid arthritis.</strong

A CLINICAL EXPERIENCE OF METHOTREXATE USE IN TREATMENT OF PATIENT WITH JUVENILE OLIGOARTHRITIS

This article presents clinical case of early manifestation of juvenile oligoarthritis with rapid contracture and destructive joint changes formation. Methotrexate was administered IM 15 mg/m2 once a week. After 3 months of treatment — acute inflammatory changes in the joint were relieved as well as arthralgias, morning stiffness and there was a decrease in laboratory markers of the disease. After 6 months full motion range of the joint was achieved and contracture relieved. Remission is maintained for the last 12 months.Key words: children, juvenile arthritis, methotrexate. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (6): 191–197)</p

APPLICATION EXPERIENCE OF PROCALCYTONINE TEST FOR THE DIFFERENTIAL DIAGNOSTICS OF THE ACUTE SYSTEMIC INFLAMMATORY RESPONSE

The article provides the clinical observation, allowing for the conclusion that the use of pct test in the daily practice of a rheumatologist makes it possible to early carry out differential diagnostics of a patient with the manifestations of the systemic inflammatory response and to duly start necessary pathogenetic and/or etiotropic therapy. Key words: procalcytonine test, sepsis like syndrome, treatment, children.</strong

CEFTRIAXONE EFFICIENCY AMONG PATIENTS, SUFFERING FROM JUVENILE ARTHRITIS AND RECEIVING IMMUNOSUPPRESSIVE THERAPY

The article is dedicated to diagnostics and treatment of infectious complications among children with juvenile rheumatoid arthritis, receiving immunosuppressive therapy. The research involves 92 children with different variants of the illness run, who received immunosuppressive therapy. All the patients showed development of the systemic inflammatory response manifestations. The researchers used the definition of the procalcytonine levels as a marker for the bacterial infectiondevelopment. All the patients showed it higher than 0,5 ng/ml, while 7 patients — higher than 10 ng/ml. keeping in mind several courses of the antibacterial therapy in the anamnesis and presence of the combined bacterial infection, ceftriaxone was prescribed to all the children. As a result of the ceftriaxone based therapy, reduction of the clinical and laboratory manifestations of the bacterial infection was noted among more than 90% of patients. The development of the allergic reaction was noted in 1 case, and leukopenia was also found in 1 patient.Key words: children, juvenile rheumatoid arthritis, ceftriaxone.</strong

CEFTRIAXONE EFFICIENCY AMONG PATIENTS, SUFFERING FROM JUVENILE ARTHRITIS AND RECEIVING IMMUNOSUPPRESSIVE THERAPY

The article is dedicated to diagnostics and treatment of infectious complications among children with juvenile rheumatoid arthritis, receiving immunosuppressive therapy. The research involves 92 children with different variants of the illness run, who received immunosuppressive therapy. All the patients showed development of the systemic inflammatory response manifestations. The researchers used the definition of the procalcytonine levels as a marker for the bacterial infectiondevelopment. All the patients showed it higher than 0,5 ng/ml, while 7 patients — higher than 10 ng/ml. keeping in mind several courses of the antibacterial therapy in the anamnesis and presence of the combined bacterial infection, ceftriaxone was prescribed to all the children. As a result of the ceftriaxone based therapy, reduction of the clinical and laboratory manifestations of the bacterial infection was noted among more than 90% of patients. The development of the allergic reaction was noted in 1 case, and leukopenia was also found in 1 patient.Key words: children, juvenile rheumatoid arthritis, ceftriaxone