Objective. To stude the indices of lipid-protein blood spectrum in SLE pts with A PS as one of the risk factors of atherosclerosis development. Material and methods. 60 pts (45 females and 15 males) with definite SLE (ARA criteria, 1982) were examined; age 15-44 (median age 28.9+8.1; M+G), disease duration from 2 months to 28 years (median 8.6+6.6 years) APS was diagnosed in 39 out of them( G.R.V.Huges and E.N.Harris criteria, 1986) with subsequent isolation of Wr' -wKable, possible and unreliable A PS; thrombotic complications were observed in 23 out of 39 SLE pts with APS. Control group was composed of 35 practically healthy persons without risk factors of atherosclerosis and related diseases development. Results. There were no difference in the levels of cholesterol, triglycerides low density lipoproteid cholesterol and apolipoprotein В in SLE pts with APS as compared with SLE pts without APS. Concentration of high density lipoproteid cholesterol (HD LP C) and apolipoprotein AI (apo A!) was higher in SLE pts with APS as compared with SLE pis without APS and reached for HD LPC- 46. I±11.0mg/dl against 40.5±8.1 mg/dl, for apoAl - 133.7±28.1 tng/cll against 118.5±28.2 mg/dl correspondingly (p=0.04 and p-0.05). There was no difference in the content oJHD LP phospholipids in the group of SLE pts with and without APS. The level ofHD LP phospholipids in the group of SLE pts with APS was lower (91, 8±21.2 mg/dl) as compared to the control group (131.8+3 5.1 mg/dl)(p=0.001), The relation ofHD LP С/apoAl in SLE pts with APS: 0.35+0.06 against 0.38±0.08 in persons from the control group (p-0.04). With the decreased level ofHD LP in basic groups of pts as,compared with control statistically reliable difference of all HD LP phospholipids was found (p<0.001). Иге level of apoAl was lower in pts with unreliable APS as compared with such in pts with definite APS (137.4+26,6 mg/dl and 103.8±23.5 mg/dl (p-0.002). Conclusion. In SLE pts with APS there are interrelated pathogenic mechanisms, which could lead to thrombotic complications as well as to atherosclerotic vascular damage.

There are currently no accepted criteria for positive Western blots in Russian patients with Lyme borreliosis. The purpose of the current study was to develop criteria for a positive IgG westem-blot to aid particularly in the diagnosis of patients with joint manifestation of the disorder. Patients: 97 with Lyme disease, 145 - control subjects. IgG antibody responses were determined to 3 species ofB.burgdorferi sensu lato by Western blotting, using blots prepared by manufacturer. The best discriminatory ability of test criteria was chained by requiring any 3 of 11 IgG bands, a definition that could be used with B. burgdorferi sensu stricto, B.garinii and B.afzelii strains. With these 3 antigen preparation, positive IgG blots were found in 0 to 18% of patients with localized erythema migrans of < 4 weeks duration, 23 to 39% of those with disseminated infection < 20 weeks duration, and in 39 to 46% of those with late arthritis/arthralgia of >6 months duration the specificity was 93 to 99%. Thus, IgG Western blotting may bring greater specificity to serologic testing in Lyme borreliosis, but the sensitivity is limited.

Objective. Assessment of the efficacy and tolerability of Pentoxifilline (PF) as compared with Methotrexate [ MT> and combination of MT+PF in patients with rheumatoid arthritis (RA). Material and methods. Controlled study of the efficacy and tolerability of MT, PF and their combination was done in 30 patients with active RA. 12 patients had PF in dose of 800-1200 mg/day, 11 - MT by 7.5-10 mg/week, 7 - MT 7.5 mg/week + PF 800-1200 mg/day. Assessment of the results was done in I, 3 and 6 months. Results. Patients taking MT demonstrated reliable improvement of the studied indices (10 out of 14). In the groups having PF and PF+MT there were no reliable improvement in any of the parameters under study. Conclusion. The obtained results testify to inefficacy of PF during the treatment of RA patients. Combined indication of MT and PF has no advantages as compared with monotherapy by MT.

Objective. To asses the dependence of the efficacy of Kenalog intraarticular injections on the disease activity according the index of the number of joints needing treatment. Material ami methods. 50 RA pts with insufficient effect of systemic drug treatment of inflamma- tory changes in joints (45 females and 5 males) aged 18-77 (median age 53.0±13.0). Disease duration varied from 6 months to 30 years (median 11.5±7.9 years). Results. 50 pts had 495 Kenalog intraarticular injections. 31 pts had no more than 3 joints (median 1. 9±0.8), 19 pts had injections into 4 and more joints (median 5.9±1.5). Duration of improvement after single Kenalog injection in both did not differ significantly (3.4±3.2 months in the 1st group and 4.3±6.2 months in the 2nd). Conclusion, active inflammation persisted in a few of joints inspite of the effective in the whole systemic therapy, periodic intraarticular Kenalog injections can time be used for a long as an active assisting treatment completing the basic therapy. In cases of persisting polyarthritis not responding to systemic therapy Kenalog administration into inflamed joints can not only complement but also substitute the systemic steroid therapy for some time

Clinical and laboratory study was carried out including 30 pts with definite diagnosis of osteoarthritis (OA ) of knee joint. The effect of chondroitin sulfate (Structum) on basic bio-energetic indices of synovial fluid was studied. The obtained results testify to the fact that the expressed local hypoxia of cartilage tissue favoring the development, conserving and chronization of inflammatory process in synovial environment of knee joint in О A is successfully arrested by the above drug. Simultaneously bio-energetic parameters of synovial fluid were normalized: the level of oxygen absorption by synovial cells, the activity of a number of enzymes of hydrogen-phosphor (energetic) metabolism as well as of glucuronidaze and gialuronidaze,

The aim of the research was to create education programme and investigate its effict in patients with osteoarthritis. The programme included 9 subjects, concerning of main questions of osteoarthritis self-control. The course was conducted 2 times a week during 1 months in closed osteoarthritis out-patient groups. 36 osteoarthritis out-patients were taght in 2 groups. The number of the patients in each group was 18 patients. Each study lasted 1-1,5 hours in the osteoarthritis groups. The patients were examined and questionnaired before and 6 months after intervention. The main results of the programme were sighnificant in provement of know ledge about their disease, decreasing of exacerbation in 1,5 times, visits to doctors, jointache, for 5,7 mm, on the visual analogical scale and statilization of functions of joints. The spectrum of medicine was changed to mordener and safer. There was decreasing of other effects of medicine. Thus achieved results showed the effectiveness of suggested training programme and nesessity of its using for complex treatment of osteoarthritis patients.

33-year-old patient with Behcet's disease developed severe lesion of gastro-intestmal tract involving esophagus. Behcet’s disease diagnosis was verified by recurrent aphtous stomatitis, genital ulcers and erythema nodosum. Peculiarity of this case was wide involving of gastro-iniestinal tract with multiple ulcers in ileocecum and esophagitis leading to the development of diverticulum and gullet narrowing. This case demonstrates the results of late diagnosis of the disease as the diagnosis was determined in IS years after the onset of first symptoms.

Objective. То study the efficacy and tolerability of potassic salt of Diclofenac (Rapten rapid) in pts with low back pain. Material and methods. The study included 20 pts with low back pain. Rapten rapid was indicated by 50 mg thrice a day for 10 days. Clinical efficacy of treatment was assessed according the next indices: pain index (in points), morning stiffness (in min), character of pain by MacGill (in points) and index of chronic invalidity by Waddel (in points). Emerging side effects were thoroughly analyzed. Results. After the course of therapy the next positive changes were revealed: pain index, morning stiffness and invalidity index reduced, pain character changed - from stabbing, piercing, cramping and gnawing it went to weak or absent. Good tolerability was noticed. Conclusion. Rapten rapid possess expressive pain reducing effect, good tolerability and could be recommended as monotherapy for pts with acute and chronic low back pain.

Ummary Objective. To reveal J'reguency of accompaning virus infection and possibility to use antivirus therapy together in therapy RA. Material. 40 patients with RA at the age of 17-45 were studied. The duration of disease was not more than 6 months; patients had 2-3 degrees of activity. Every one had a positive rheumatoid factor. Results. 78,2% of the examined patients connected the beginning of the illness with virus infection they have had. The most difficalt variant of RA course and uneffectiveness of basic therapy were registerd among the patients with combination HSV and CMV infection. Inclusion of Cymevene in complex therapy RA has exerted positive influence on clinical-laboratory, signs stregthened effect of basic therapy. Conclusion. The most difficult variant of RA course was registered among the patients with virus infection. Inclusion of antivirus drugs had a positive influence on effectiveness of basic therapy.