Objective. To define the most important manifestations of early RA. Methods. 92 pts aged 17 to 45 years (mean 34,9 ±8,52 years) with RA of 2-3 activity degree diagnosed during the first months of the disease (mean 3,5 months), were investigated and followed up for one year. Inclusion criteria was the absence of serious concomitant disease of internal organs. Results. During the follow up diagnosis of RA was confirmed in 90 patients (97,8%). SLE was diagnosed in 2 ptss. During the first months of the disease the most considerable manifestations were: morning stiffness, elevation of CRP (3+ and more) - 59 pts (65,5%) and ESR (more than 40 mm/h) - 21 ptss (23,3%), RF more than 1/160 - 46 pts (51,1%). Generalization of joint syndrome (more than 3 joints involved) had all pts at the sixth month of the disease. The onset of the disease with monoarthritis was revealed in 9 of pts (10%), oligoarthritis in 15 (16,7%), polyarthritis in 66 (73,3%). Conclusion. The most important manifestations of early RA are morning stiffness, RF (+), increase of CRP, symmetrical polyarthritis of hands and feet.

Objective. To study gout prevalence and clinical features in South-Sakhalinsk residents. Methods. Clinical picture of gout was analyzed in 120 pts (117 male and 3 female) followed up in South-Sakhalinsk city rheumatological center from 1990 till 1999. There are 7% of Koreans among the South-Sakhalinsk residents. The rest are Slavs. Results. Prevalence and some clinical features of gout depend on pts nationality. Gout prevalence among Koreans (280:100000) is 5,2 times higher than among Slavs (54:100000). All Koreans pts were male. Male/female ratio among Slavs was 26/1. Typical gouty attacks were recorded in 54% of Slavs and in 93% of Koreans. Attack duration in Slavs usually was 7-10 days and mean attack number per year 2 while in Koreans 3-5 days and 4-5 per year respectively. Tophuses were present in 3% of Koreans and in 17% of Slavs. There were also considerable differences between groups on frequency of gouty internal organs damage and concomitant diseases. Conclusion. Ethnic features of population can modify clinical course and prevalence of the disease.

Objective. To estimate arthroscopy diagnostic significance in knee chronic monosynovitis (CMS) of unknown origin. Methods. 83 pts (41 female and 42 male) aged 20 to 72 years with CMS were examined. Duration of the diseases varied from 2 months to 12 years. Origin of synovitis was unknown. Diseased knee joint arthroscopy was performed with synovial biopsy and microscopic examination of synovial tissue samples. Results. Early or atypical forms of at least 12 diseases were identified as reasons for CMS. Most often CMS reasons were rheumatoid arthritis, osteoarthritis, microcrystalline arthropathy. Presumable and final diagnosis coincidence was noted in 18,3%. Some CMS causes were not considered before the examination. Arthroscopy allowed to identify Knee joint CMS origin in 96,5%. Conclusion. Arthroscopy is a valuable diagnostic method and should be included in plan of obligatory examination of pts with knee joint CMS of unknown origin.

Objective. To estimate influence of educational programm on the level of knowledge of patients with RA about the disease, readiness for compliance, quality of life, efficiency of therapy and attitude to the disease. Methods. 103 women with RA were included in the study. They were divided into four groups: a control group, "passive" school and "active" school groups and a group with individual training (33, 21, 29 and 20 pts respectively). At the discharge from hospital and 12 months later medical estimation of patient knowledge and 10 test tasks were performed including "Index of biotic satisfaction" (N.Panin), quality of life estimation on visual analogous scale, a self-rating "of health and happiness" (Dembo- Rubinstein), "Level of social frustration" and "type of attitude to illness" (SPb Bechterev’s institute), readiness for complianse (original questionnaire). Results. At the time of discharge and in after 12 months test tasks and medical estimation of pts knowledge indices in "active" school and individual training groups were significantly higher, than in of control group and group of "passive" school (p < 0,001). The collective medical assessment demonstrated a correlation between treatment efficacy and the method of information transfer (p=0.29: p < 0,05). The quality of life correlates with the method of training according to all assessment techniques. Estimation of training method influencing on compliance provided similar results (p: = 0.45; p < 0,05). In groups of "active" school and individual training the number of pts who strictly followed the regimens of physical rehabilitation increased. Conclusion. Our data confirm the necessity of purposeful and systematic educational training in RA. The active methods and individual training promote the achievement of best results

Objective. To study the efficacy of Lansap (Lansoprasole) in treatment of esophagitis in pts with systemic sclerosis (SS). Methods. 30 SS pts with clinical manifestations and endoscopic signs of esophagitis received lansap 30 or 60 mg/day during two weeks. All pts had a standard endoscopic examination before and after the treatment. Results. Clinical symptoms of esophagitis were reduced significantly in most pts during the first day of treatment and resolved completely to the eleventh day. Endoscopic examination after two weeks revealed decrease of esophagitis severity in all pts. Esophagial erosions were healed in 16 from 18 pts. Conclusion. Lansap is an effective drug for treatment of reflux esophagitis in pts with SS.

Objective. To investigate the comparative efficacy of Magalphil 800 in NSAID-associated dyspepsia. Patients and methods. 30 pts with rheumatic diseases (RD) receiving NSAIDs and having dyspeptic symptoms were included. Pts were divided into 2 groups: group 1 (n=20, 2 males, 18 females, mean age 51,7+12,3 yTs, 7 pts had single erosion of stomach, 1 - multiple erosions, 1 - ulcer of stomach); group 2 (n=10, 1 male. 9 females, mean age 46,2±14,6 yrs, 2 pts had single erosion of stomach). Concomitant therapies (corticosteroids, cytotoxics) were approximately the same in both groups. Pts in Group 1 received one tablet of Magalphil 800 four times a day; pts in Group 2 were treated by ranitidine 150 mg bid. Therapy of RD was not changed during the study. Subjective complains were controlled after 2 weeks. Results. Complains related to dyspepsia disappeared in all pts of Group 1 and in 8 pts of Group 2 after 5,2±2,4 and 7,3±3,8 days of treatment respectively (p>0,05). Healing of ulcer in 1 and healing of erosions in 5 pnts was observed in Group 1. Conclusions. Magalphil 800 is effective in NSAID-associated dyspepsia and can be used for treatment of NSAID-induced gastropathy.