Objective. To study prevalence of knee joints osteoarthritis (OA) in menopausal women and its influence on menopausal syndrome severity and quality of life of pts. Material and methods. A random sample (673 pts) from the general population of pts (6734 women) consulted by specialists due to menopausal problems was examined. History evaluation, physical examination by a rheumatologist, calculation of body mass index (BMI) and waist/hips circumference ratio (WHR) were performed. Pain (VAS), Lequesne index, modified menopausal index (MMI), depression presence and severity and quality of life (QL) with SF-36 questionnaire were assessed. OA was diagnosed according to common clinical and radiological criteria. Results. 73% of examined persons complained of joint pain. 45,1% of cases fulfilled OA criteria. 932 women with knee OA were analyzed (mean age 51,6±5,5 years). Control group included 372 women without OA (mean age 50,1+5,7 years). Frequency of manifest knee OA in women visited a specialized center due to menopausal problems was higher than in general population. Obesity doubled risk of knee OA development in menopause. Pts with knee OA had decreased QL according to physical functioning and pain scales. QL restriction on social and emotional functioning scales, general and mental health in OA pts was associated with presence of comorbid depression.

Objective. To define frequency and character of low back pain (LBP) in Moscow outpatients. Material and methods. 1300 pts aged 18 to 50 years actively seeking medical care in ambulance №17 of Moscow South Administrative Region were examined during one month with a questionnaire developed in the Institute of Rheumatology of RAMS. Results. LBP is a frequent reason of visits to a doctor in outpatient practice. Majority of such pts had acute and subacute pain. Cases with moderate or severe pain were predominant. LBP is a frequent cause of disability.

Objective. To assess by noninvasive methods degree, character and relationship of structural and functional endothelium state disturbances in different regions of vascular bed in systemic vasculitides. Material and methods. 65 pts with systemic vasculitides were examined: 20 with hemorrhagic vasculitis (HV), 20 — with thromboangitis obliterans (TO), 10 — with polyarteritis nodosa (PN), 15 — with Takayasu arteritis (ТА). 30 conditionally healthy persons were included in the control group. Carotid angioscanning with intima-media complex thickness (IMT) measurement and functional tests on brachial artery under sonographic control using SONOS-1500 apparatus with assessment of endothelium-dependent and endothelium- independent vasodilatation were performed. Intracutaneous blood flow was examined by laser Doppler flowmetry with functional tests using LAKK-01 apparatus. Results. Examination of common carotid arteries showed significant increase of IMP in pts with PN and ТА. Pts with HV and TO did not differ from control. Endothelium-dependent vasodilatation was decreased in all groups of pts. The most prominent changes were revealed in ТА and TO. Response to nitroglycerine was normal only in pts with TO. In other groups it was decreased. Endothelium sensitivity to reactive hyperemia was decreased. Hyperemic type of microcirculation prevailed in groups with systemic vasculitides but in HV group microcirculation was mainly normal. Capillary blood flow reserve was significantly lower in PN and TO. Correlation relationship was revealed between main IMP, brachial artery reactivity measures and skin microcirculation. Conclusion. Structural and functional endothelium state disturbances of different regions of vascular bed revealed in systemic vasculitides are interconnected what proves their participation in endothelium damage in these diseases.

Objective. To assess influence of different treatment intensification regimens on clinico- laboratory parameters of activity and quality of life of pts with rheumatoid arthritis (RA). Material and methods. 40 RA pts of group 1 received pulse-therapy with methotrexate (MT) and dexamethasone (DM), 20ptsofgroup 2 received pulse-therapy with methylprednisolone (MP) and cyclophosphane (CP). After that all pts continued treatment with disease modifying antirheumatic drugs. Pts were examined at baseline, 1 and 6 months after completion of therapy intensification cycle. Results. At 1 month tender and swollen joint counts decrease in group 1 was more prominent than in group 2. After 6 months significant decrease of all disease activity measures was maintained in group 1 but not in pts received CP and MP. Conclusion. Pulse therapy with MT and DM provided more prolonged decrease of RA clinico-laboratory activity than treatment with MP and CP. Group 1 pts also showed significant increase of quality of life. None method of intensive treatment caused severe adverse events.

Objective. To assess efficacy and tolerability of diclofenac-emulgel local application in comparison with oral ibuprofen administration for the treatment of active interphalangeal hand joints osteoarthritis (Heberden and/or Bushar nodules). Material and methods. 321 pts were randomized into two groups. Diclofenac-emulgel (active drug) and placebo ibuprofen tablets were administered in one of them, placebo diclofenac-emulgel and ibuprofen tablets (active drug) — in the other. Diclofenac was administered as 10 cm strip locally 4 times a day and 400 mg of ibuprofen were given 3 times a day. Frequency of improvement was used as the main outcome measure. Improvement was registered if pain on 100 mm visual analog scale decreased at least by 40%. Disease activity, pain at rest, pain at movement, morning stiffness, grip strength and quality of life were used as additional outcome measures. Results. To the end of treatment according to 5% lower equivalency limit local therapy was at least as effective as oral administration of ibuprofen (p=0,007). Administration of both treatment methods provided also comparable improvement of all additional outcome measures. Both treatment methods showed good tolerability but more pts with receiving ibuprofen experienced serious adverse events than those using diclofenac (9 and 4 pts respectively). There was also similar proportion of pts prematurely withdrawn due to side effects (n=21): 5 (3%) from them received diclofenac and 16 (10%) - ibuprofen. Similar ratio of adverse events attributed to study treatment was revealed. Such events were present in 2 pts using diclofenac and in 13 (8,3%) receiving ibuprofen. Most of these events applied to gastrointestinal tract (in 1 pt using diclofenac and in 8 pts receiving ibuprofen). Conclusion. Local treatment of active interphalangeal hand joints osteoarthritis (Heberden and/or Bushar nodules) with diclofenac is at least as effective as systemic administration of ibuprofen. Tolerability of local therapy with diclofenac probably exceeds tolerability of systemic treatment with ibuprofen. This applies to gastrointestinal safety and frequency of adverse events leading to treatment withdrawal.