Among rheumatic diseases reactive arthritis occupies one of the leading places in terms of prevalence and it is one of the most common chronic inflammatory joint diseases. When the process is chronic, destructive processes in the joints develop up to ankylosing. This article presents the results of studies on the features of the clinical course of reactive arthritis of post-enterocolitic and urogenital forms. The study was carried out in 120 patients with an established diagnosis of reactive arthritis.
Subject of the inquiry: 116 patients with rheumatoid arthritis of the hand joints and 25 healthy subjects.
Aim of the inquiry: improvement of the diagnosis of rheumatoid arthritis of the hand joints using sonography and magnetic resonance imaging.
Methods of inquiry: X-ray, sonography, magnetic resonance imaging and magnetic resonance imaging with contrast enhancement.
The results achieved and their novelty: For the first time data were presented on the role of sonography, magnetic resonance imaging and magnetic resonance imaging with contrast enhancement in the diagnosis of rheumatoid arthritis of the hand joints. The findings have shown that sonography in hand joint rheumatoid arthritis allowed detection of changes in soft tissues, synovial capsule, joint surfaces and ligaments. Diagnostic value was given of sonography in revealing characteristic sonographic signs of rheumatoid arthritis. Magnetic resonance imaging was highly informative radiological method to detect synovitis, changes of synovial capsule and subchondral cysts. Magnetic resonance imaging with contrast enhancement reliably detected the degree of activity and severity of the rheumatoid process.
Practical value: consisted in revealing and describing characteristic sonographic and MRI signs of hand joint rheumatoid arthritis and in the developed radiological algorithm of the disease.
Degree of embed: the results of the investigation were introduced in the practice of rheumatology and radiology departments of the First Tashkent Medical Institute, in teaching process of the Radiology Chair of the First Tashkent Medical Institute.
Sphere of usage: radiology, rheumatology, traumatology and orthopedics.
The review article provides up-to-date information about the etiology, pathogenesis, classification, clinical picture and diagnosis of the disease. The issues of drug treatment of reactive arthritis are covered.
Objects of inquiry: 107 women with rheumatoid arthritis in climacteric period.
Aim of inquiry: studying clinical-immunologic and roentgenologic indices in females with rheumatoid arthritis in connection with climacteric periods and perfecting therapeutic approaches.
Methods of inquiry: clinical studies, assessment of pain syndrom under visual analogous scale (VAS), determination of pro-inflammatory cytokins in blood scrum, roentgendensitometry, determination of body mass index, gravity of climacteric syndrom under modified menopausal index, determination of osteosyndrom by Ritchie and Lee test.
Results achieved and their novelty: for the first time in RA women in climacteric an interrelation between clinical laboratory RA manifestations and an expression of reproductivity disorders has been revealed. An interplay between acute phase indices, rheumatoid arthritis and Lee test and grade of severity of climatcric period has been established. An intcraggravating effect of RA and climacteric syndrom was approved. Predictive valuable factors in RA women in climacteric were determined. Osteoporosis in females with RA was began earlier before climacteric, it lasted more pronounced with lowering mineral density of bones. An advancing lowering of mineral density of bones in RA began in climacteric was shown. Dependance between a level of pro-inflammatory cytokins and duration of disease has been revealed, and less expressed regression of IL-ip indices in women with preserved menstrual function. Recommendations for strategy of RA treatment in women in climacteric taking into consideration features of a course of disease were worked out.
Practical value: rocngcnometry in females with RA, determination of TNF-a, IL-ip cytokins, modified menopausal index by Kuppermann contributed to diagnosis and prediction, management of an adequate therapy. Using of plasmapheresis and climadinon in complex therapy of rheumatoid arthritis reduced manifestations of disease and climacteric syndrom.
An implementation degree and economic efficacy: results of studies were implemented into activities of the Republican Arthrology Center, Specialized Qualified Ambulance Treatment, departments of Rheumatology, Cardiorhcumatology, 1st clinic of the Tashkent Medical Academy, in teaching process on a department of Faculty & Hospital Therapy, Oriental Medicine and Internal Diseases of the medico-preventive faculty.
A field of application: Internal Diseases, Rheumatology
The article presents the results of a study of 189 children with juvenile idiopathic arthritis. The results of the study show that the prevalence of oligoarthritic (33.8%), polyarthritic (32.8%) and systemic (27.5%) forms of diseases is observed in the frequency of occurrence of various forms of juvenile idiopathic arthritis. In children, juvenile idiopathic arthritis can debut at any age and is characterized by varying degrees of arthritis activity, and the systemic form of the disease is characterized by the predominance of systemic manifestations, severe course of the disease and frequent relapses.
Reactive arthritis is an inflammatory lesion of the joints that occurs as a reaction to the invasion of the body by any infectious agents. The high social significance of nosologies dictates the need to search for reliable cartilage biomarkers that have diagnostic value not only in recognizing degenerative changes at an early stage of joint deseases, but also in monitoring the effectiveness of treatment.
The article demonstrates the effect of genetically engineered biological therapy on the clinical course of systemic onset juvenile arthritis in children. The analysis of the results showed that the administration of human monoclonal antibodies against the IL-6 receptor - a geneticallyengineered biological drug (tocilizumab) was confirmed by normalization of clinical symptoms and laboratory parameters, reduced disease activity, prevented oral administration of glucocorticoids and systemic initiating juvenile arthritis. provided the transition to the stage. The results obtained showed that the addition of tocilizumab to the complex treatment of systemic onset juvenile arthritis was correct, and confirmed its high efficacy in the treatment of this orphan disease in children.
Subjects of the inquiry: 103 patients with rheumatoid arthritis, 20 healthy individuals.
Aim of the inquiry: To study therapeutic effect of low frequency physical factors on the cytokines and the processes of lipid peroxidation and to confirm scientifically the efficacy of their use based on the their effect on the clinical laboratory findings.
Methods of investigation: Clinical and laboratory investigations, immunological analyses of the blood scrum cytokine levels and synovial fluid, biochemical examinations of the lipid peroxidation and antioxidant system indicators, phospholipase-A2 activity, nonspecific phosphatases and free oxyprolinc in the blood serum of patients.
The results achieved and their novelty: There was studied clinical efficacy of ultraphonophoresis with benzketozon during treatment and rehabilitation of the patients with rheumatoid arthritis. It was proved that disbalance between inflammatory and anti-inflammatory cytokines as well as lipid peroxidation activation activity in the erythrocyte membranes and blood scrum destabilized cellular membrane structures, increase in phospholipase-A2 activity and, consequently, stimulating prostaglandines, inflammation mediators, synthesis. There was shown that complex therapy with inclusion of low frequency physical factors, particularly ultraphonophoresis with benzketozon, gave marked positive effect normalizing interrelation ship between inflammatory and anti-inflammatory cytokines reducing activity of phospholipase-A2, lipid peroxidation products and rising the levels of antioxidant system indicators.
Practical value: There has been shown rationality of inclusion of the physical-pharmacological method ultraphonophoresis with benzketozon into clinical practice. The differential indicators developed for application of low-frequency physical methods of therapy for rehabilitation of the patients with rheumatoid arthritis allow prolongation of the remission, improvement of the patients life quality.
Degree of embed and economic effectivity: The practical recommendation and guidelines have been applied in the clinical practice of the out-patient special course of arthrological treatment in the Republican Rhcumatological Center, Clinical Hospital N 1, Central Hospital of Zangiota district of Tashkent province. Sphere of usage: Rheumatology, physiotherapy.
The article presents the results of the investigation on the evaluation of the effectiveness of rehabilitation methods in children with systemic onset juvenile arthritis. The analysis of the obtained results showed that regular exercise in children with systemic onset juvenile arthritis activates movements in the joints, increases blood circulation in the joints and muscles, decreases muscle atrophy, improves the quality of life of patients, prevents complications and disability.
The article presents the study results of the value of Anti-MCV in children with juvenile arthritis, depending on the variant of the disease. An analysis of obtained results reveal that in children with juvenile arthritis, Anti-MCV indicates the likelihood of the joint syndrome formation, that frequently leads to the development of significant functional insufficiency of the joints, which is the justification for the early appointment of active, often aggressive therapy in order to prevent disability of the patient. The level of Anti-MCV can be as a basis for the using of this indicator in monitoring activity and assessing the effectiveness of treatment.
The article presents the results of evaluating the effectiveness of a genetically engineered biological drug (tocilizumab) in children with juvenile arthritis with a systemic onset. Analysis of the results of the study showed that the use of a genetically engineered biological drug (tocilizumab) in the treatment of patients with juvenile arthritis with systemic onset contributes to a decrease in disease activity, regression of systemic signs and normalization of laboratory parameters in a significantly short time and improves the prognosis of the disease in these children.
The paper presents data on heart damage in patients with rheumatoid arthritis (RA), peculiarities of ischemic and non-ischemic heart disease development with a significant increase in the risk of adverse cardiovascular events. Patients with RA are characterised by an increased risk of myocardial infarction, heart failure, rhythm disturbances, sudden cardiac death and total cardiovascular death. The possibility of fairly rapid development of myocardial dysfunction in RA patients since the manifestation of the disease, the development and progression of coronary atherosclerosis is emphasized, and when RA patients develop coronary artery lesions, the worse survival rate after suffered myocardial infarction is established.
The evidence suggests that rheumatoid arthritis is a significant contributor to cardiovascular morbidity and mortality.
This article describes functional renal failure and related factors in patients with rheumatoid arthritis, the complications of rheumatoid arthritis outside the joints, and methods for assessing renal function.
In many countries and in our country reactive arthritis (RA) is a topical rheumatologic problem requiring early and individual therapy. Recently in the diagnostics of RA there is an active search of early biomarkers (BM) of articulate structures damage, which provide revealing of the symptoms of lesion of articulate soft tissues elements at the early stages of the disease. It can also help to assess the stage of lesion and prognosis of the disease. Later it will assist to prescribe adequate therapy according to the stage of the pathological process and perform monitoring of the therapy [1].
The article presents a clinical case of observation of the reactive course of the
postoperative period in a child with a combined injury of the eyeball, who was on inpatient treatment
in the department of ophthalmology of the clinic of the Tashkent Pediatric Medical Institute. The
results of the study showed: adequate specialized surgical treatment of combined eye trauma in
combination with intensive therapy allowed to stop the exudative process in the eye chambers, in the
vitreous body, which allowed to stabilize the reactive course of the postoperative period, preserve the
eye as a functional organ and prevent the development of post-traumatic uveitis.
Проблема изучения гендерных особенностей и качества жизни при ревматоидном артрите является одной из актуальных в ревматологии. Ревматоидный артрит (РА) – широко распространенное аутоиммунное заболевание неизвестной этиологии, характеризующееся хроническим эрозивным артритом (синовитом) и системным поражением внутренних органов, приводящее к снижению качества жизни и функциональных возможностей. Женский пол является фактором риска ревматоидного артрита. Женщин с РА в 2,5 раза больше, чем мужчин. Известно, что половой диморфизм РА у мужчин и женщин проявляется различиями в частоте метаболического синдрома, венозных тромбозов, развитии вовлечения в патологический процесс легких, однако не установлено влияние гендерных особенностей на клиническое течение и качество жизни пациентов с РА.