Assessment of quality oflife in patients with early knee osteoarthritis using SF-36

Objective. To study quality of life (QL) measures in pts with early knee osteoarthritis (OA) with SF-36. Material and methods. 102 outpatient pts with early knee OA were included. Mean age was 48,3± 12,7 years, mean OA duration - 10,5±7,9 months. 33,3% of pts had 0, 42,6% - I, 20,5% - II stage of knee OA. According to sonographic examination of knee joints the patients were divided into two groups: group I without synovitis and group II — with synovitis of the knee joints. 50 healthy volunteers were included in control group. QL was assessed with SF-36. Results. All QL measures in early knee OA pts were lower than in control. There was significant difference of physical functioning, role physical functioning (RPF), social functioning (SF) and role emotional functioning (REF) (p<0,05). Pts of group II had significantly lower RPF and REF than group I pts (p<0,05). Conclusion. QL of pts with knee OA decrease at early stage of the disease what requires administration of proper therapy as soon as possible after verification of the diagnosis

Features of diagnosis and treatment of anemic syndrome in patients with rheumatoid arthritis

Features of diagnostics and course of anemic syndrome in rheumatoid arthritis patients Objective. To study features of anemic syndrome in rheumatoid arthritis (RA) pts, to estimate influence of disease modifying anti – rheumatic drug therapy efficacy on the course of anemic syndrome. Material and methods. 62 pts with definite RA and level of hemoglobin less than 130g\l for men and less than 120g\l for women were examined. Research of hemoglobin, red cells count, mean corpuscular volume (MCV), mean concentration of hemoglobin (MCH), serum iron and ferritin was carried out. In a part of pts serum transferrin receptor and erythropoietin concentrations was defined. 30 pts were examined after 6 month of disease modifying therapy. Results. In 49(79 %) of the pts the anemia was an easy degree of weight, MCH decreased in 33(53 %) of the pts and 15(24 %) pts had decreased values for MCV. Deficiency of iron in 16(26%) of pts has been established at research of concentration a ferritin, sTfR and an index sTfR \log ferritin. At the dynamic research after 6 month of disease modifying therapy the authentic gain levels of hemoglobin, red cells count and serum iron significantly increased in the pts with good and satisfactory effect of therapy. Сonclusion. Definition of MCH, MCV and ferrokinetic data for assessment of iron defi- ciency in the RА pts is necessary. sTfR and sTfR\log ferritin may be study for pts with normal and increased ferritin levels. The major factor influencing on the course of anemia of chronic disease in the rheumatoid arthritis pts is the course rheumatoid arthritis, that efficacy disease modifying treatment to control

HIGH RISK STRATEGY EFFICACY IN PROGNOSIS OF PRIMARY ONSET OF ISCHEMIC HEART

High morbidity and mortality from ischemic heart disease (CHD) in RF presupposes the significance of individual prognosis of cardiovascular risk and of primary prevention.Aim. To analyze the level of risk that could be calculated in patients with CHD debut just before the manifest of the disease and therefore to evaluate the opportunities for the CHD debut by standard scores; to evaluate the relation of a real volume of primary prevention events to current Guidelines.Material and methods. In 122 patients hospitalized with CHD debut as an acute coronary syndrome, a retrospective cardiovascular risk evaluation, which could be found just before the onset of the disease.Results. The prevalence of traditional risk factors among persons with CHD onset was high: 88% patients had ≥3 risk factors. However, before the onset of acute coronary syndrome 68% patients at Framingham scale and 47% by SCORE could have been under the low and moderate calculated risk that shows low sensitivity for the real CHD risk. Calculated risk by the scores has not correlated with the severity of coronary vessels lesion. In analysis of primary prevention events in was found that in the studied group drug therapy of dyslipidemia was not being performed as primary prevention, though it is indicated by the standards for at least 82% patients.Conclusion. The data shows that the use of the main risk scores underestimates real chance of CHD development in the exact patient. Also even for the patients, who require statin prescription for the aim of primary prevention, this therapy is not prescribed

Rheumatoid arthritis and bacterial infections

To study features of bacterial infections course in pts with rheumatoid arthritis (RA) and changes of laboratory measures after focus of infection sanation. Material and methods. 46 pts with definite rheumatoid arthritis were examined at the time of comorbid infection (Cl) detection and after infection focus sanation. Bacteriological test with evaluation of flora sensitivity to antibiotics by disco-diffusion method was performed at baseline and after the course of antibacterial therapy to assess its efficacy. Hemogram, serum fibrinogen, rheumatoid factor, circulating immune complexes (CIC), C-reactive protein levels were assessed. Serum interleukin (IL) 1(3, IL6 and neopterin concentrations were examined by immune-enzyme assay in a part of pts. Typical clinical features of Cl were present in only 28 (60,9%) pts. 13 (28,3%) pts had fever, 12 (26,0%) — leukocytosis, 15 (32,6%) — changes of leucocyte populations. Some laboratory measures (thrombocytes, fibrinogen, CIC, neopterin levels) significantly decreased (p<0,05) after infection focus sanation without correction of disease modifying therapy. Cl quite often develop as asymptomatic processes most often in pts with high activity and can induce disturbances promoting appearance of endothelial dysfunction, atherothrombosis and reduction of life duration. So timely detection and proper sanation of infection focuses should be performed in pts with R

Structum (chondroitin sulfate) in treatment of osteoarthritis

Objective. To assess Structum (chondroitin sulfate) efficacy in treatment of osteoarthritis in Republic of Karelia. Methods. 34 pts with osteoarthritis (mean disease duration 6,44±0,67 years) were included. Functional Leken score (FLS), pain at rest and at walk on visual analog scale (VAS), pts nonsteroidal anti-inflammatory drugs (NSAID) requirement (diclofenac daily requirement in mg), percent of pts refused NSAID treatment, achievement of clinically significant improvement (40% decrease of FLS and/or 50% decrease of NSAID requirement) were regarded as variables for the evaluation of therapy efficacy. Results. Structum administration in pts with osteoarthritis provided reduction of FLS, pain at rest and at walk, NSAID requirement and in some cases allowed to withdraw of NSAID completely. Structum has good safety and is effective in doctor and pts opinion. Conclusion. Structum is an effective drug for treatment of osteoarthritis

Prevalence of rheumatic diseases TOC \o "1-5" \h \z in Karelia Repablic

Цель. Анализ распространенности ревматоидного артрита (РА) и остеоартроза (ОА) в Республике Карелия (РК). Результаты. В 2000 г по сравнению с 1998 и 1999 гг. в РК выявлен рост обшей заболеваемости болезнями костно-мышечной системы. Однако показатели общей заболеваемости были более низкими по сравнению с Россией в целом. Самой частой формой суставной патологии являлся ОА, на долю которого приходится от 60 до 80 % всех ревматических болезней. Первичная заболеваемость ОА в РК превышала среднюю первичную заболеваемость по России. Самые высокие показатели выявлены в крупных промышленных центрах. Распространенность РА в Карелии сопоставима с показателями по России и не увеличивается в течение 1998-2000 гг. Заключение. Высокая распространенность болезней костно-мышечной системы обусловливает возрастание медико-социальных и экономических потерь общества. Поэтому важна разработка программ по ранней диагностике, своевременному и эффективному лечению, первичной и вторичной профилактике этих заболеваний с учетом климато-географических и производственных услови

Experience with Karmolis liquid administration for rheumatic diseases local therapy (data of multicenter clinical examination)

Objective. To assess clinical efficacy and tolerability of "Karmolis" liquid (KL) in pts with osteoarthritis (OA) and rheumatoid arthritis (RA). Material and methods. 230 RA pts and 123 OA pts were included. KL was applied on the most damaged joint surface 10 ml 4-5 times a day with subsequent massage. The course of the treatment continued for three weeks. Joint pain at rest, at movement and at palpation so as joint swelling were used as efficacy measures. Treatment efficacy was assessed at day 1, 7, 14 and 21. Possibility of NSAID dose decrease was also recorded. Results. KL administration provided significant decrease of joint pain at rest, at movement and at palpation already to day 7 as in RA as in OA pts. The improvement then persisted during the rest period of treatment. Joint swelling disappeared to the end of the treatment in 141 from 209 RA pts having such changes at baseline. 74% of RA pts considered KL efficacy very good and good. Synovitis signs disappeared after the treatment with KL in 52 from 65 OA pts. Vfcry good and good results were achieved in 102 (83%) of OA pts. 76 RA pts (33%) and 73 OA pts (53%) could decrease NSAID dose. Adverse events were very seldom and did not require treatment termination. Conclusion. KL in effective in complex treatment of RA and OA. It decrease pain and inflammation and may be recommended for wide administration in the treatment of inflammatory and degenerative joint diseases