RENAL HEMODYNAMICS EVALUATION IN PATIENTS SUFFERING FROM RHEUMATOID ARTHRITIS WITH AND WITHOUT COMORBID HYPERTENSION

Aim. To study the features of renal arterial blood flow in patients suffering from rheumatoid arthritis, its interaction with visual markers of atherosclerosis in the presence of comorbid hypertension.Materials and methods. 113 patients with rheumatoid arthritis (RA) were enrolled into this study. Depending on the comorbidity of hypertension the patients were divided into two groups: without (n=53) and with hypertension (n=60). The comparison group consisted of 41 patients with arterial hypertension without RA. Clinical characteristics and blood biochemistry of all the patients were measured. Renal arterial resistance index (RI), presence of atherosclerotic plaques (ASP) in the carotid arteries were assessed by ultrasound scan.Results. In this investigation we report the correlation of the of renal resistive index (RI) and ultrasound signs of carotid atherosclerosis with hypertension in patients with RA. It was found out that there is the increase of RI in RA associated with the age of patients, the onset of the disease at a later age, the presence of atherosclerotic plaques in the carotid arteries and hypertension. In addition, patients with RA had a high frequency of bilateral RI increase by more than 0.7 (64%). Patients with bilateral high RI had a two-fold increase in the registration rate of atherosclerotic plaques in both group of patients with RA.Conclusion. Increased renal arteries RI in patients with RA is a factor associated with the comorbid hypertension and accompanied by more significant atherosclerotic changes in the carotid arteries in the form of an increased incidence of atherosclerotic plaques

THE RUSSIAN DATA OF INTERNATIONAL ENDORSE REGISTER (EPIDEMIOLOGIC INTERNATIONAL DAY FOR THE EVALUATION OF PATIENTS AT RISK OF VENOUS THROMBOSIS IN ACUTE HOSPITAL CARE SETTING)

Aim. To estimate a risk factor frequency of venous thromboembolism (VTE) in patients urgently hospitalized in hospitals, and also to estimate of patients part having effective prevention of VTE.Material and methods. ENDORSE (Epidemiologic International Day for the Evaluation of Patients at Risk of Venous Thrombosis in Acute Hospital Care Setting) is the international register. Patients of 40 years and older hospitalised in therapeutic departments as well as patients of 18 years and older hospitalised in surgical departments (358 hospitals in 32 countries) were included in the register. The case history analysis of all patients was performed for estimation of risk VTE and evaluation of preventive therapy quality according to American College of Chest Physicians (ACCP) Recommendation 2004.Results. Totally 68 183 patients (including 30 827 (45%) surgical patients and 37 356 (55%) therapeutic patients) were enrolled in Global ENDORSE Register. Russian centers enrolled 4 788 patients (including 2 829 (59%) surgical patients and 1 959 (41%) therapeutic patients). Totally 35 329 (51,8%) patients enrolled in Global ENDORSE Register (64,4% of surgical patients (19 842) and 41,5% of therapeutic patients (15 487)) had VTE risks. In Russia 2 188 enrolled patients (45,7%) had VTE risks (52% of surgical patients (1 470) and 36,7% of therapeutic patients (718). Totally 17 732 (50,2%) patients enrolled in Global Register ENDORSE and having VTE risks received VTE preventive therapy according to АССР Recommendations 2004. In Russia 521 (23,8%) patients enrolled in Global ENDORSE Register and having VTE risks received VTE preventive therapy according to АССР Recommendations 2004. It is more than 2 times less in comparison with world level (р<0.001).Conclusion. There are a lot of patients with VTE risks in hospitals. It is necessary to improve preventive therapy of VTE due to better hospital management and more active use of АССР Recommendations 2004

The influence of the dentifrice water with lysozyme on soft tissues of the oral cavity of patients with oral lichen planus together with dental pathology

Изучено состояние процессов перекисного окисления липидов в слюне больных типичным красным плоским лишаем кожи (КПЛ) в сочетании с хроническим генерализованным пародонтитом (ХГП). Полученные данные свидетельствуют о сниженной у этих больных резистентности к перекисному окислению, что может быть одним из механизмов повреждения тканей полости рта. Разработан комплекс лечебно-профилактических мероприятий, в который входят: системная терапия КПЛ, профессиональная гигиена полости рта с использованием зубного эликсира «Лизомукоид», лечебно-профилактической зубной пасты «Лакалут актив». Предложенный метод терапии оказался достаточно эффективным для лечения ХГП на фоне ЧПЛ; Досліджено стан процесів перекисного окиснення ліпідів у слині хворих на типовий червоний плоский лишай шкіри (ЧПЛ) в поєднанні з хронічним генералізованим пародонтитом (ХГП). Одержані дані свідчать про зниження в цих хворих резистентності до перекисного окиснення, що може бути одним із механізмів ушкодження тканин порожнини рота. Розроблено комплекс лікувально-профілактичних заходів, до якого входять: системна терапія ЧПЛ, професійна гігієна порожнини рота із застосуванням зубного еліксиру «Лізомукоїд», лікувально-профілактичної зубної пасти «Лакалут актив». Запропонований метод терапії виявився досить ефективним для лікування ХГП на тлі ЧПЛ типової форми; Prevalence and severity of generalized parodontitis depend especially on the course of diseases affecting the oral mucosa and those ones which are characterized by involvement of the oral mucosa. These diseases include mainly lichen planus. The common pathogenic agent of generalized parodontitis and lichen planus as well as of combination of them is inflammation, as generalized parodontitis is inflammation of parardontium tissue characterized by destruction of periodontium and dental ligamentous apparatus of the alveolar bone and lichen planus is a chronic inflammatory disease of skin and oral mucosa. The purpose is to study processes of lipid peroxidation in the saliva of patients with lichen planus of the skin along with chronic generalized parodontitis. The study involved three groups of patients: Group 1was represented by patients with generalized parodontitis associated with typical form of lichen planus of skin (12 individuals). Group 2 involved patients with chronic generalized parodontitis without comorbidities, lichen planus in particular (19 individuals). Group 3 was represented by apparently healthy donors (control group) (19 individuals). Complete examination of parodontium tissue was carried out for all patients. The parodontium condition was estimated on the basis of patients’ complaints, dental examination over time with assessment of basic hygienic and parodontal indices. Unstimulated mixed saliva of patients and control group were used as the material for study of lipid peroxidation processes at organ level. In order to estimate level and character of free-radical oxidation 4 indices were applied: TBA-active products level, activity of catalase, superoxide scavenger and functional index of free-radical oxidation. It has been established that in patients with chronic generalized parodontitis as well as in patients with chronic generalized parodontitis combined with lichen planus increased level of end products of lipid peroxidation processes is observed. However, in patients with lichen planus significantly (1.8 times as much) increased content of TBA-active products indicating more pronounced activation of processes of lipid peroxidation at organ level in these patients is observed. Activity of antioxidant defense enzymes in the saliva of patients is decreased. Dramatic changes are apparent in activity of SOD in patients of both groups under study. The obtained data showed the decreased resistance to peroxidation at organ level and can be considered as one of mechanisms of affecting of oral cavity tissues. The study that has been carried out proved influence of oxidative stress in pathogenesis of lichen planus and ground the necessity to use antioxidants and antihypoxants in complex therapy. Taking the obtained data into consideration, complex therapy including systemic treatment of lichen planus and topical treatment of chronic generalized parodontitis was indicated to patients with combined course of lichen planus of typical form and chronic parodontitis of primary and mild degree. The clinical study has made it possible to establish that complex of medical and preventive measures such as systemic treatment of lichen planus, advanced hygienic care of the oral cavity with the use of Lizomucoid mouthwash, Lacalut aktiv therapeutic toothpaste is rather effective for treatment of chronic generalized parodontitis associated with lichen planus of typical form

PHYSICAL REHABILITATION OF PATIENTS WITH SIGNS OF CONNECTIVE DYSPLASIA AND JOINT PAIN SYNDROME

In the article presents the results of physical rehabilitation of patients with signs of connective tissue dysplasia and articular pain. As a result of exercises to strengthen the muscles of the back, marked bending strength increase and extension of the lumbar spine, rotation angles to the right and to the left, and their strength (the side muscles of the back), the power of flexion and extension of the cervical spine and muscle strength of the right and the left half of the neck and the decrease in the intensity of joint pain

Functionally-morphological kidneys condition in patients with rheumatoid arthritis

The aim of the investigation was to study the functional-morphological state of kidney in patients with rheumatoid arthritis (RА). Examination was performed on 75 patients with RA and 25 healthy subjects. In addition to complete clinical and instrumental examination accepted in specialised clinic, biopsy of kidney was conducted. At 62 patients changes in an urinary deposit are taped. According to 25 nephrobiopsies in 12 cases took place mesangioproliferative variant of a chronic glomerulonephritis, the amyloidosis was detected at 5 patients, in 8 cases - vascular changes, the weak and moderate phenomena of a productive vasculitis of arterioles, the capillaries, accompanied by a focal perivascular sclerosis. Nephroprotective effect of basic therapy of RА was found