Objective. To assess significance of Simplified Disease Activity Index (SDAI) in early arthritis. Material and methods . 76 pts with suspicion of rheumatoid arthritis (RA), duration of the disease less than 6 months (3,6±1,7 months), meanage48,5±14years(17-76years)and male/female ratio 1/5 were examined. DAS 28 and SDAI were calculated for complex assessment of arthritis activity. Results. Mean SDAI value was 28,9±14,9 (1,37-67,64). In 40 (52,1%) of pts it corresponded to moderate, in 20 (26,6%) - to low and in 16 (21,3%) - to high activity of RA. Mean DAS 28 value was 4,86+1,23 (2,31-6,92). 12,5% of pts had low, 40,3% - moderate and 47,2% - high activity. SDAI significantly correlated with DAS 28 (p<0,0001). Functional status examination showed mean HAQ value 0,82±0,62(0-2,5). HAQ correlated with SDAI and DAS 28 (p<0,005). In 37 from 76 pts (48,7%) RA was diagnosed according to ACR 1987 criteria. In 39 (51,3%) of pts the diagnosis was not verified and they were considered as having undifferentiated arthritis (UDA). SDAI values in RA were significantly higher than in UDA (33,1±I5,9 and 24,5+12,3 respectively, p<0,05). Similar differences were shown for DAS 28 (4,72±1,1 in RAand 2,9±0,7 in UDA, p<0,05. 30,8% of RA pts had low, 48,7% - moderate and 20,5% - high inflammatory activity according to SDAI. In UDA low and moderate activity were more frequent (59,5% and 32,4% respectively) than in RA. DAS 28 and SDAI activity stages completely coincided neither in RA nor in UDA pts. Conclusion. SDAI is a sensitive method of activity assessment and correlates with DAS and HAQ not only in definite long standing RA that was shown at validation of this index but also in early arthritis.

Objective. To assess quality of life (QL) of pts with osteoarthritis (OA) in the city of Yakutsk. Material and methods . 100 outpts with OA (50 with knee and 50 - with hand OA) were included. QL was assessed with SF-36 in comparison with a population group (500 residents of comparable age and sex). Results. Role physical functioning state in pts was 2 times decreased in comparison with control group. Significant direct correlation between physical activity indices and age of pts was revealed. Significant sex differences of QL assessment results were shown. Conclusion. OA exerts negative influence on human physical, psychological and social functioning.

Objective. To study features of endothelium-dependent regulation of vascular tone in pts with systemic lupus erythematosus (SLE). Material and methods . 52 SLE pts aged 17 to 52 years (mean age 34±1,3 years) and 33 healthy volunteers of control group aged 22 to 50 years (mean age 32±2 years) were examined. Mean disease duration was 7,4+0,4 years. 4% of pts had acute, 27% - subacute, 69% - chronic course of the disease. 29% of pts had minimal, 50% - moderate and 21% - high activity. D. Celemajer ultrasonic method was used to assess endothelial function. Results. In healthy persons reactive hyperemia test showed increase of vascular lumen in systole and diastole so as decrease of relative systolic increase. SLE pts had increase of vascular wall rigidity, ultrasonic signs of brachial artery changes. Reactive hyperemia test at 15th second showed normal reaction of brachial artery in 38%, pathological - in 48% and indefinite - in 14% of pts. All pts with pathological reaction and only 40% of pts with normal reaction had renal disease.

Objective. To assess coagulation parameters and activity indices in pts with systemic lupus erythematosus (SLE). Material and methods . 86 pts with SLE (83 female and 3 male) were examined. 12 of them had antiphospholipid syndrome. Mean age was 35,9±1,5 years (from 18 to 58 years), mean disease duration was 9,8+1,4 years. Control group consisted of 60 healthy volunteers with mean age 37,1+4,1 years. SLE activity assessment was performed with SLAM, SLEDAI and ECLAM indices. Results. SLE pts showed 5-fold (p<0,01) increase of spontaneous platelets aggregation and more than 3-fold increase of factor von Willebrand antigen (FWA) concentration. Platelet activation in pts was accompanied by decrease of platelet aggregation with collagen (on 27%), p<0,01. Characteristic sign of coagulation hemostasis activation was significant increase of soluble fibrin-monomer complexes (SFMC) concentration on 81 % (p<0,01) so as increase D-dimers level in 53,3% of pts. Fibrinogen concentration was increased on 29%, spontaneous fibrinolysis parameters were decreased on 20%, antithrombin (AT) 111 - on 21% in comparison with control. Direct correlation between activity indiccs and SFMC(ECLAM, r=0,5), fibrinogen concentration (SLAM, r=0,34), D- dimers level (ECLAM, r=0,5), spontaneous platelet aggregation (ECLAM, r=0,5) so as inverse correlation with AT III activity (SLEDAI, r-0,73) was revealed. Conclusion. Changes of hemostasis parameters in SLE may serve as predictors of thrombotic disorders development and indication to drug correction of blood coagulation disorders. Direct correlation between blood coagulation system activity and indices of SLE activity.

Objective. To study proinflammatory cytokines and brain natriuretic peptide (BNP) in patients with rheumatic heart diseases (RHD) and coronary heart disease (CHD) complicated by chronic heart insufficiency (CHI). Material and methods. 54 pts with CHI (among them 16 with RHD and 38 with CHD with signs of CHI ofll-IV functional class according to NYHA that correspond to 11A-III stage according to N.D. Strazesko-V.H. \frsilenko classification) and 30 healthy persons of control group were examined. Besides clinical evaluation common laboratory and instrumental methods were used. Thorough echocardiography analysis, quantitative evaluation of serum TNF a, IL6 and BNP by immuno-enzyme assay was performed. Results. Direct correlation between cytokines and BNP levels and pts with CHI clinical state severity was revealed. These indiccs significantly differed in coronary and non-coronary (RHD) CHI. TNF a concentration was minimal in mitral stenosis. Maximal concentrations of IL6 and TNF a were revealed in tricuspid regurgitation. TNF a concentration elevated with increase of heart linear dimensions. BNP showed similar but less prominent tendencies. Conclusion. Significant difference of studied indices in coronary and non-coronary (RHD) CHI was shown. Despite of similarity of CHI clinical features levels of inflammation biological indices in RHD was significantly lower than in CHD that requires further discussion.

Objective. To assess efficacy and safety of "stepped" therapy with movalis (consecutive parenteral administration during 3 days and oral during 20 days 15 mg/day) for exacerbation of chronic pain in rheumatic diseases. Methods 262 pts with raheumatoid arthritis (RA) and 384 pts with osteoarthritis (OA) in 22 cities of Russia were included. Quantitative assessment (using 10-point scale) of clinical parameters (pain at rest and at movement, severity of functional disturbances and local inflammation) at different phases of therapy was performed. Frequency and character of adverse events in pts having risk factors of adverse events were analyzed. Results. Intramuscular movalis administration provided fast analgesic and anti-inflammatory effects which increased during the second phase (oral) of treatment. Despite of presence risk factors adverse events were rare and mild. Conclusion. These data show high efficacy and safety of movalis in RA and OA.

Objective. To study clinical efficacy of aiflutop (A) in lumbar osteochondrosis (LO) with chronic back pain syndrome. Material and Methods. 32 pts with LO were included. 14 from them (group 1) during a year received 2 courses of A intramuscular injections (I ml/day, 30 ml total) and nonsteroidal anti-inflammatory drugs (NSAIDs) if necessary. 18 pts (group 2) received NSAIDs only. Clinical examination of pts was performed at the stert of the study, before and after each A course and in 3 months after the last course. Results. Pain in the spine at rest and forward bending significantly decreased in group 1 pts (p<0,05) after each A course. Full pain disappearance after the first A course was achieved in 7,1% and after the second course - in 35,7% of group I pts and was not shown in control group. Significant stepped decrease of Thomayer's test value (p<0,00l) was also shown in group 1: 3,6 times decrease in comparison with baseline was achieved in 3 months after completion of treatment with A. During treatment period these pts showed 2-2,5 times increase of static and dynamic spine load (according to Vxdel chronic inability index). 42,9% of group I pts stopped NSAIDs after A treatment completion. Only 5,6% of control group pts stopped NSAIDs during follow up. A tolerability was good. It can be combined with any other medications the pts received due to comorbid diseases.

Objective. To define clinical efficacy of diclofenac and nise in pts with low back pain (LBP) considering quality of life (QL) and pharmacoeconomic aspects (PA) Material and methods . 100 pts with chronic LBP due to vertebral osteochondrosis were included. Clinical examination was performed. QL was assessed with 4 questionnaires: Health Assessment Questionnaire (HAQ), WOMAC osteoarthritis index (Vfersion vas. 1), Osvestry Low Back Pain Disability Questionnaire and SF-36. 50 pts of the 1 group received diclofenac retard 100 mg twice a day during 10 days. Nise was administered to the 50 pts of the 2 group 100 mg twice a day. All pts received midocalm 450 mg/day. Results. The study showed high efficacy of nise in complex treatment of pts with chronic LBP considering its analgesic and anti-inflammatory properties, low adverse events frequency so as PA and QL improvement.

Course and previous drug treatment of 25 pts with juvenile idiopathic arthritis admitted in pediatric department of Institute of rheumatology of RAMS with severe functional insufficiency which excluded possibility of independent movement were analyzed. Causes of incapacitating deformity development in that group of pts were revealed. Results of complex drug and functional treatment are presented

Objective. To study prevalence ofjoint complaints among children (0-17 years of age) in Bashkiria. Material and methods. Study sample was formed in 4 cities and 2 country regions where 51633 children aged 017 years live. Questionnaire constructed by the Institute of Rheumatology of RAMS and adapted to children age was used. 43907 (85%) of children and/or their parents were evaluated. Results. Joint pain were revealed in 5478 (12,5%), joint swelling - in 761 (1,7%) children. Total 5520 (12,6%) children had arthralgia and/or joint swelling. Conclusion. Joint complaints are quite frequent in children (12,6%). According to the results of the I stage of the study a group of children for thorough clinical and instrumental examination was formed to reveal prevalence and structure of juvenile chronic arthritides.

Statistical analysis of annual republic accounts of North Osetia-Alania Ministry of public health showed increase of musculoskeletal diseases (MSD) prevalence on 68,3% and incidence - on 42,7% among adult population. MSD are on the 6th place in the general structure of morbidity. Regions with high and relative low levels of these indices were revealed. The data of the present study show that MSD prevalence has similar tendency to increase as in Russian Federation as in North Osetia but rate of increase and absolute increase of MSD prevalence in North Osetia-Alania are respectively 2,85 and 1,79 times higher than in Russian Federation. High increase of MSD incidence and prevalence among children and teenagers (152,0% and 345,8% respectively) causes especial concern. During 5 years temporary working losses connected with MSD increased on 12,8% in cases and on 3,8% in days of disability per 100 working people. Primary invalidity increased to 2002 on 69,5% in comparison with 1998.