Objective. To analyze and compare clinical, radiological and ultrasonic signs of coxitis in pts with ankylosing spondylitis (AS). Material and methods. 35 pts with AS and clinical signs of coxitis were included. Median age was 26 years, AS duration 9 years, coxitis duration 5 years. 17 pts with AS without clinical signs of coxitis constituted control group. Pain on visual analog scale, hip joint mobility, radiological changes and ultrasonic signs of exudation were assessed. Results. Among the pts with AS prevailed those with the beginning of the disease before 20 years of age (77%). 71% of pts had bilateral coxitis. In 40% of pts coxitis signs during the first years were inconstant. Most frequent radiological signs of coxitis were narrowing of joint space (91,9%), femoral head or/and acetabulum cysts (77,4%), femoral head osteophytes (67,7%). Femoral head deformity (8,1%), partial bone anchylosis (6,5%), marginal bone erosions (3%) acetabulum protrusion (1,6%) were rare signs. Exudation was present in 84% of damaged hip joints. Bone destruction was significantly more frequent in pts with longer duration of AS and coxitis and was associated with more prominent functional disability and higher frequency of exudation. Hip joint exudation frequency and its volume did not influence pain intensity. Radiological changes were revealed in 12 hip joints of 7 pts of control group.

Radiologically revealed spine osteoporosis in male with hypertension and coronary heart disease Objective. To study prevalence and intensity of spine osteoporosis (OP) in men suffering from hypertension (H) and coronary heart disease (CHD). Material and methods. 101 men with H and CHD aged 50 to 78 years (mean age 60,6±0,85 years) and 37 men of control group without cardiovascular diseases aged 50-66 years (mean age 58,6±0,74 years) were examined. Clinical examination, radiological, radiomorphometric spine examination and echocardioscopy were performed. Results. OP was revealed in 34,65% of main group pts what is 3,2 times more frequent than in control group (10,8%, p<0,05). OP intensity in men with H and CHD was significantly higher than in healthy people. Vfertebral fractures were revealed in 12,87+3,3% of main group pts and only in 2,7±2,7% in control group (p<0,05). OP development dependence from cardiac history duration and cardiac pathology severity was demonstrated. Conclusion. The results of the study show significantly higher prevalence of spine OP among men suffering from H and CHD. Long history and severity of cardiovascular pathology clinical signs promote OP frequency and severity increase.

Objective. To study contamination with parvovirus B19 of a group of patients with rheumatic diseases (RD). Methods. 77 pts with RD (mean age 42,5 years, 79% female) admitted to Institute of Rheumatology of RAMS were examined. 34 of them had rheumatoid arthritis (RA), 11 - systemic lupus erythematosus (SLE) and Sjogren's disease (SD), 15 with osteoarthritis (OA) and seronegative spondyloarthritides (SS) and 17 with early (before a year) undifferentiated arthritis (EUA). Quantitative determination of IgM and IgG serum antibodies to parvovirus BI9 was performed by I FA with IBL kits (Hamburg, Germany). Results. Anti-B19 IgG antibodies were found in 52% of pts, IgM antibodies - only in one case. Mean antibodies values in pts with RD of disease duration less then 6 months were significantly higher then in pts with longer disease duration (21,5+36 U/ml and 8,4+14.7 U/ml respectively, p<0,05). Anti-B 19 antibodies were present in 62% of pts with RA, 53% of pts with EUA, 45% of pts with SD, 33% of pts with OA and SS. High levels of antibodies (4-10 times higher positivity threshold) were revealed in 13 pts with different RD with short duration of joint syndrome (6,3±7,6 months) and fever at presentation. A case of B19 parvovirus infection in a boy of 3 years age accompanied by symptoms of Still's disease is described.

Objective. To assess psychometric characteristics of Russian versions Health Assessment Questionnaire (HAQ), WOMAC and the brief form of a questionnaire of pain Me Gill at patients with a low back pain (LBP). Material and methods. It is surveyed 100 patients with the chronic syndrome LBP caused by an osteochondrosis of a backbone. Mean age of patients has made 45,69 ± 7,61 years, from them women (77 %) prevailed. Average duration of disease was 10,20 ± 6,01 years, and duration of an aggravation - 4,04 ± 1,75 months. Among surveyed patients with II radiological stage (R) prevailed. The assessment constructive validity questionnaires HAQ, WOMAC and the brief form of a questionnaire of pain Me Gill was carried out by the multifactorial analysis with allocation of the main components, a method of "known groups" on the basis of construction of hypotheses, the correlation analysis with external criteria and separate clinical-tool parameters. Reliability of questionnaires was estimated with the help of coefficient internal constancy a Kronbach, sensitivity - definition of the answer to therapy on the clinical data and self-estimations of patients, to calculation of index Gyatt. Results. Simultaneously with improvement of a condition of patients the positive authentic by criterion Mann- Whitney (Z) dynamics of parameters under questionnaires HAQ, WOMAC and the brief form of a questionnaire of pain Me Gill was marked. In group of patients with LBP where the answer from therapy was absent, changes of parameters of investigated questionnaires did not occur, that testified to sensitivity of questionnaires. Other methods have shown sufficient validity and reliability of questionnaires WOMAC, the brief form of a questionnaire of pain Me Gill, questionnaire HAQ, except for his scales "force of a brush ” and "reception peep" which were less actual for patients with LBP. High correlation communications of size FDI (Functional Disability Index) on HAQ, scales WOMAC, sections of a brief questionnaire of pain Me Gill with scales of general questionnaire SF-36 are revealed. Conclusion. Russian versions of questionnaires HAQ, WOMAC and the brief form of a questionnaire of pain Me Gill has high psychometric characteristics it is validity, the reliable and sensitive tool for assessment of quality of life (QL) of patients with LBP and can be recommended to application in clinical practice for assessment QL of patients and monitoring of effect of spent therapy at LBP.

Objective. To assess frequency of gastro-intestinal (Gl) bleeding and ulcer perforation as direct cause of death in pts with rheumatic diseases. Material and methods. Statistical analysis of Tula region patient care institutions documentation was performed to assess frequency and character of severe GI complications leading to death of pts. 300 cases of death which took place during 5 years (1996-2000) in 3 rheumatologic (105 cases) and 10 therapeutic (195 cases) departments of Tula region patient care institutions were studied. Results. Gl bleeding and ulcer perforation were the direct causes of death in 15 pts with rheumatic diseases i.e. in 5% from the whole number of died. GI complications caused death in 4 pts with chronic rheumatic heart disease (HRHD) (1,7%), in 7 (15,2%)with rheumatoid arthritis -, in 2 with ankylosing spondylitis and systemic lupus erythematosus (8,0 and 22,2% respectively). Pts with systemic sclerosis did not die because of GI damage. GI changes most frequently localized in duodenum (8 pts). 4 pts had complications connected with gastric ulcer and in 2 diffuse erosive damage of Gl mucosa was the source of bleeding. Conclusion. Severe Gl complications quite often lead to death of pts with rheumatic diseases in Tula region.

Objective. To characterize Jaccoud’s syndrome - hand deforming arthropathy (HDA) in systemic lupus erythematosus (SLE). Material and vethods. Analysis of 235 case histories of pts with SLE followed up in the Institute of Rheumatology of RAMS from 1982 to 2002 was performed. 26 from them had HDA according to D. Alarcon-Segovia criteria (1988). SLE activity was determined according to V.A Nassonova and SLEDAI-I scale. Results. 26 from 235 SLE pts (11 %) had H DA. More than in 25% from them this damage formed during the first year of the disease and included nonerosive joint damage with the development of finger deformities such as "swan neck", "boutonniere", Z-deformity of thumb, muscle atrophia and ulnar deviation. Longer treatment with glucocorticoids put off HDA development (r=0,64, p=0,0003)

Sulfasalazine is one of the main disease modifying drugs for the treatment of chronic inflammatory joint and spine diseases. The article describes mechanism of action of sulfasalazine and its main metabolites. Detailed information about anti-inflammatory and immunosuppressive action of the drug is presented. Results of many studies of sulfasalazine efficacy in rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and reactive arthritis are discussed from the evidence based medicine point of view. Data on sulfasalazine tolerability and safety are presented with separate discussion of hypersensitivity and dose-dependent adverse reactions so as their treatment and prophylaxis.

Objective. To assess efficacy and safety of a year and three-year therapy with varfarin in pts experienced one or several episodes of venous thrombosis. Material and methods. 220 pts with one or more episodes of venous thrombosis (VT) were included. 141 pts received varfarin during a year, 79-3 years.Mean age of pts with the first thrombosis was 41,6+6,3 years, with rethrombosis - 47,4+9,5 years. Exclusion criteria were contraindications to varfarin administration, severe trauma and vast operations within 1 month before the development of VT, tumors renal ang hepatic function disturbances. Results. During the follow up thrombosis did not recur. Frequency of hemorrhagic complications during the first year was about 20%. 2/3 of bleeding episodes occurred within the first 6 months of treatment during titration of effective therapeutic dose of varfarin. Later frequency of hemorrhagic complications decreased to 6,4% within the 2nd year and 3,8% within the 3rd year. Conclusion. In most cases it is impossible to determine the cause of bleeding at normal level of INO and the cause ol'INO elevation immediatelly before the appearance of hemorrhagic complications

Objective. To assess efficacy and safety of nimulid and CONDROnova according to data of District rheumatologists of Moscow Material and methods. 216 adult outpatients (115 with osteoarthritis, 39 with rheumatoid arthritis, 22 with ankylosing spondylitis, 12 with gout, 8 with reactive arthritis, 2 with psoriatic arthritis and 18 with mixed pathology) were included. Nimulid (nimesulid) 200-300 mg/day and CONDROnova (250 mg of glucosamin sulfate and 200 mg of chondroitin sulfate) 2-6 capsules/day were administered as monotherapy or in combination. Quantitative assessment of clinical and laboratory parameters at different stages of therapy was performed. Frequency and spectrum of adverse events in pts with concomitant diseases were analyzed. Results. Nimulid provided fast analgetic and anti-inflammatory effect, Condronova - analgetic effect (with aftereffect). Effect of combination therapy was more rapid. Adverse events frequency in pts with concomitant diseases receiving nimulid and CONDROnova in abovementioned doses was low. Conclusion. Isolated and combined administration of nimulid and CONDROnova in pts with rheumatic diseases is highly effective and safe.

Objective. 7 cases of AHA syndrome (arthralgia, arthritis, hives, angioneuroticedema) in children described. Literature and own data are presented. Possible pathogenetic mechanisms, clinical symptoms and treatment are discussed.

Objective. To develop software and data base "Register of pts with juvenile arthritides" (JA). Material and methods. Development of "Register of pts with JA" was performed with data manager Visual Fox Pro 7.0 Results. "Register of pts with JA" allowes to perform collection and storage information about every pt, analyze primary and general JA morbidity and their structure including examination of different regions so as clinical and laboratory data during the whole period of the disease, calculate annual requirement of drugs, record frequency of drugs adverse events. - Conclusion. "Register of pts with JA" software may be used in pediatric rheumatological centres

Questions of rehabilitating conservative orthopedic and operative treatment of musculoskeletal disorders in pts with juvenile arthritis (JA) of different age groups are discussed. Specified indications to knee joint synovectomy and features of large joints replacement in these pts are presented. Several cases of successful medical and social rehabilitation in JA pts with knee and hip joint damage.