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Biomedical subjects

E L Nasonov

Publications and source records attributed to E L Nasonov.

At least 37 records · Page 2Linked to original sources

[The condition of peripheral arteries in patients with systemic lupus erythematosus].

To evaluate the condition of peripheral arteries and its correlations with blood lipid spectrum and intake of glucocorticoids (GC), 53 female patients with SLE entered the study. Of them, 20 patients were GC untreated (group 1) while 33 ones took GC for a long time (group 2). Nine of 20 (45%) patients and 9 of 33 (27%) patients of group 1 and 2, respectively, had antiphospholipid syndrome (APS). Ultrasonography examined common carotid arteries (CCA), brachial arteries (BA), femoral arteries (FA) with measurement of the thickness of the intima-media complex (IMC). Lipid spectrum was examined with standard enzyme assay using kits by Boehringer Mannheim GmbH (Germany). Atherosclerotic plaques of carotid arteries were detected only in group 2. CCA IMC thickness reached 0.78 +/- 0.17 and 0.75 +/- 0.16 mm in groups 1 and 2, respectively. This thickness was significantly greater in SLE patients with APS than free of APS (0.89 +/- 0.18 and 0.87 +/- 0.18 mm in groups 1 and 2, respectively; 0.72 mm on the average in both groups, p = 0.02). Patients of group 1 with dyslipidemia showed a significant increase in CCA IMC (0.84 +/- 0.18 mm) vs patients with normolipidemia (0.70 +/- 0.13 mm, p = 0.042). Significantly increased levels of cholesterol, LDLP cholesterol and triglycerides were recorded in SLE patients of group 1 with CCA IMC > 0.8 mm. In group 1 there were significant positive correlations between CCA IMC and levels of total cholesterol, LDLP cholesterol, triglycerides (r = 0.78, 0.76 and 0.66 respectively, p < 0.05). Thus, atherosclerotic affection of the peripheral arteries in SLE is associated with long-term course of the disease, APS, dyslipidemia and intake of GC.

Adult↗

[Level of soluble tumor necrosis factor receptor type I in patients with systemic scleroderma].

AIM: To study content and clinical correlations of sTNF-RI in patients with systemic sclerosis (SS). MATERIAL AND METHODS: Thirty nine SS patients were examined with enzyme immunoassay for serum levels of sTNF-RI and soluble adhesion molecules (sSAM) sVSAM-1, sISAM-1 and sR-selectine using R&D System kits (USA). The control group consisted of 14 healthy subjects (donors). Content of sTNF-RI and sSAM was considered as elevated if it exceeded relevant mean values by 1SD. RESULTS: sTNF-RI content was significantly higher in the patients than in the controls (p = 0.0001) and was similar in patients with diffuse and limited forms of the disease. A rise in sTNF-RI correlated with a rise in pulmonary artery pressure. In patients with pulmonary hypertension or restrictive pulmonary affection sTNF-RI was higher than in patients free of pulmonary hypertension or impaired external respiration function. A marked correlation was found between sTNF-RI and sVSAM-1. Patients with high CRP had significantly higher sTNF-RI level than patients with normal CRP. CONCLUSION: SS is characterized by elevated content of sTNF-RI. This content may serve a diagnostic marker of the disease progression.

Adult↗

[Serum nitrates in patients with systemic lupus erythematosus and antiphospholipid syndrome].

AIM: To elucidate clinical implications of nitrates (NO3) concentration as an indicator of nitric oxide (NO) level in blood serum of patients with systemic lupus erythematosus (SLE) and primary antiphospholipid syndrome (PAPS). MATERIAL AND METHODS: Blood serum concentration of NO3 was measured by high-performance liquid chromatography in a total of 41 patients with SLE (n = 17), PAPS (n = 14) and secondary APS (n = 9). Sera from 10 healthy subjects (donors) served as control. NO3 concentration > 40 mcmol/l was stated high. SLE activity was assessed by V. A. Nasonova's scale and SLEDAI index (SLEDAI > 9 indicated SLE exacerbation). Patients with PAPS were divided into two groups depending on clinical symptoms: 7 patients with significant thrombosis or history of more than two thrombotic complications (group 1); 7 patients with the history of two or less thromboses (group 2). RESULTS: The mean serum nitrate concentration in the SLE group was 43.59 mcmol/l (range 17.06-113.22). The nitrate level of the sAPS + SLE group was 49.81 +/- 27.54 and did not significantly differ from APS (33.67 +/- 14.70). By univariate standard analyses, serum nitrate concentration was significantly higher in patients with high disease activity (57.31 +/- 25.12 vs. 25.62 +/- 6.96, Mann-Whitney test, p < 0.01). The Spearman correlation coefficient of nitrate level with SLEDAI was 0.8 (p < 0.001). CONCLUSION: A nitrate level is increased in patients with active SLE and in APS patients with severe thrombotic complication.

Antiphospholipid Syndrome↗

[Insulin resistance syndrome in patients with gout and its influence on formation of clinical characteristics of the disease].

AIM: To evaluate the occurrence of immunoresistance (IR) syndrome in gout and its correlation with a gout course. MATERIAL AND METHODS: Anthropometric parameters, blood lipid spectrum, levels of glucose, uric acid (UA), immunoreactive insulin, HOMA index were studied in 55 male patients with gout (mean age 50.1 +/- 7.9 years, mean duration of the disease 7.5 +/- 7.2 years). Statistic processing was made with computer program Statistica 6.0. RESULTS: IR was revealed in 49% patients. Immunoresistant patients had visceral obesity, arterial hypertension, abnormal lipid profile, high UA concentrations, longer disease, chronic articular syndrome, high occurrence of diabetes mellitus and vascular events significantly more frequently. CONCLUSION: IR in gout patients is the risk factor of cardiovascular diseases; combination of IR and hyperinsulinemia is characterized by marked hyperuricemia and a trend to chronic course of the articular syndrome. Longer duration of gout, especially treated inadequately, raises the risk of IR. IR deteriorates prognosis in relation to cardiovascular diseases, diabetes mellitus type 2, course of gout itself.

Adult↗

[Oxidative stress in the pathogenesis of anti-phospholipid syndrome].

Summarized in the paper are the data describing the significance of the oxidative stress within the pathogenesis of anti-phospholipid syndrome (APS). The mechanisms related with formation of active oxygen metabolites in human body, triggers of the oxidative stress as well as its involvement in the APS pathogenesis (i.e. in the aPL synthesis), in the endothelial malfunction development and in the development of pro-coagulation impairments within the hemostasis system leading to thrombosis are in the focus of attention. Approaches to treatment schemes of vascular disorders in APS comprising the oxidative stress correction are suggested.

Anticholesteremic Agents↗

[Detection of sodium monourate crystals in biopsies of gastric mucosa in patients with gout].

AIM: To examine gastric biopsies with polarization microscopy for detection of sodium monourate crystals (SMC). MATERIAL AND METHODS: The trial included 20 patients with gout diagnosis (mean age 55.7 years, mean duration of the disease 12.3 years) in whom esophagogastroduodenoscopy was made with biopsy of gastric mucosa from the antral part of the stomach and middle third of the gastric body. RESULTS: Crystals in the biopsy specimens were detected in 11 of 20 examinees. The crystals were characterized by strong double refraction, length 3-20 mcm, acicular or planiform shape, blue or yellow color depending on position in compensated polarized light. Quantitative distribution of the crystals within one biopsy specimen was uneven and varied from solitary crystals to clusters of 70-80 crystals in sight, up to formation of tophus-like structures. Clinical picture in detection of SMC was characterized by more frequent occurrence of cases with subcutaneous tophuses of various location combined with higher hyperuricemia. CONCLUSION: One of the essential lines in the research of gout concerns mechanisms of SMC formation in organs and tissues and microcrystalline gastroduodenal inflammation. Methods of correction of this inflammation are to be designed.

Adult↗

[Autoantibodies Against beta(1)-Adrenoreceptors in Patients With Cardiac Rhythm Disorders. Prevalence and Possible Role in Development of Arrhythmia].

AIM: To assess prevalence of autoantibodies against beta(1)-adrenoreceptors (beta(1)-AR) in patients with arrhythmias of various etiology. MATERIAL: Patients with arrhythmias (n=110, including 59 patients with primary [idiopathic] electrical abnormalities, 33 - with chronic myocarditis and dilated cardiomyopathy [DCM]; 18 - with ischemic heart disease [IHD]) and healthy control subjects (n=20). METHODS: Antibodies against beta(1)-AR were measured in blood serum by direct immunoassay. Synthetic fragment containing 26 amino acids of beta(1)-AR second loop was used as antigen. RESULTS: Patients with primary electrical abnormalities and chronic myocarditis/DCM had similar prevalence of beta(1)-AR (49.1% and 54.5%, respectively), what was significantly higher than in controls (10%) and in patients with IHD (16.6%). These results provided evidence for the possible presence of an autoimmune process in the genesis of idiopathic arrhythmias. Among patients with idiopathic arrhythmias beta(1)-AR were found in 40% (10 of 25) of patients with ventricular tachycardia (VT), 63.6% (14 of 22) of patients with ventricular extrasystoles (VE), 41.6% (5 of 12) of patients with atrial fibrillation (AF). Among patients with chronic myocarditis and DCM beta(1)-AR were found in 72.2% (13 of 18) of patients with VT, 28.5% (2 of 7) of patients with VE, 37.5% (3 of 8) of patients with AF. Among patients with idiopathic arrhythmias female sex and frequent respiratory viral diseases were more common in beta(1)-AR-positive compared with beta(1)-AR-negative patients. VT and left ventricular ejection fraction <40% were more common in beta(1)-AR-positive than beta(1)-AR-negative patients among those with chronic myocarditis and DCM.

Autoantibodies↗

[Osteonecroses in systemic lupus erythematosus and antiphospholipid syndrome].

The purpose of the study was to analyze the incidence of osteonecroses (ON) in systemic lupus erythematosus (SLE) patients with and without antiphospholipid syndrome (APS), primary APS (PAPS) and to define a relationship of the development of ON to some risk factors for vascular diseases. The study included 369 patients, including 293 with SLE, 160 with secondary APS, 76 with PAPS. The patients aged 14 to 63 years (mean 31.9+/-10.9 years). The history of disease was 0.6 to 30 years (mean 9.1+/-7.5 years). Among them 32 (8.7%) patients with aseptic necroses of different bones were selected in accordance with the data of X-ray studies. ON was detected in 8.7 patients with SLE and APS. The X-ray signs corresponded to third-to-sixth-degree ON. The most common site of ON was the head of the femur, although another site of ON was observed and multiple ON was typical. Leukopenia, creatininemia, fibrinogen levels were associated with ON (p < 0.05 by the Mann-Whitney test). The activity of SLE was significantly associated with SLEDAI scale scores (p < 0.05 by the Wald-Wolfovitz test). Six patients with SLE and ON had high scores by this scale--more than 40 scores of the maximum 150 possible scores. APS was diagnosed in 87.5 of the patients with ON (28 of the 32 patients) and only in 61.7% of the patients without ON (in 208 of the 337 patients) (chi2 = 8.4; p = 0.004). The development of ON in the examinees was significantly associated with the presence of APS. The activity of SLE, particularly nephritis, arthritis, positive tests for phospholipid antibodies, the presence of arterial thromboses, thrombocytopenia at the height of disease, therapy with large doses of glucocorticoids.

Adolescent↗

[Effect of small-dose glucocorticoids on the course of early rheumatic arthritis].

The study was undertaken to evaluate the effect of small-dose glucocorticoids (GCs) in combination with essential drugs used in early rheumatic arthritis (RA) on the clinical and laboratory activity and progression of joint destruction. Sixty-two patients aged 18-63 years who had active RA (its history being 1.5 to 24 months) and had not received basic therapy before were given methotrexate (MT) in a dose of 7.5-10.0 mg/week. Prednisolone (P) was randomly used in a dose equal or more than 10 mg/day). The efficiency of treatment was evaluated every 3 months by the ACR criteria 20/50/70. X-ray study of the hand and foot joints (the Larsen procedure by erosion calculations) was performed and the serum levels of C-reactive protein (C-RP) and interleukin-6 (IL-6) were measured before and 12 months after therapy. In the MT group, the patients' mean age was 52.0 +/- 10.5 years, the history of RA was 8.4 +/- 6.8 months; 82% of the patients were seropositive in terms of rheumatoid factor; the DAS 28 index was 5.2 +/- 0.8; in the P+MT group, the above parameters were 51.9 +/- 11. 7 years, 9.1 +/- 6.0 months, 83%, and 5.4 +/- 0.8, respectively (p > 0.05). Throughout one-year follow-up, the patients whose parameters corresponded to ACR 70 were more in the P+MT group than in the MT group (p < 0.05). The level of IL-6 and C-RP significantly decreased only in the P+MT group. There was a significant in the Larsen scores in both groups. A much fewer number of new erosions was revealed in the P+MT group than that in the MT group. According to the ACR 70 criteria, the efficiency of treatment with small-dose GCs was much higher than that in MT monotherapy. The small doses of GCs significantly lowered the laboratory activity of RA (C-RP, IL-6) and the occurrence of erosions.

Adolescent↗

[Clinical value of soluble tumor necrosis factor-alpha receptors in patients with systemic lupus erythematosus].

The study was undertaken to examine the clinical value of serum levels of soluble receptors of tumor necrosis factor-alpha with a molecular mass of 55 kDa (rTNF-alpha-55R) in patients with systemic lupus erythematosus (SLE). The serum level of rTNF-alpha-55R was measured by enzyme immunoassay (a "Quantikine" set, R&D System, USA) in 73 patients with SLE and 22 donors. In the patients, the mean level of rTNF-alpha-55R was significantly higher than that in donors. Higher serum levels of rTNF-alpha-55R were noted in 43.8% of the patients with SLE. There was a correlation between the level of rTNF-alpha-55R and the progression of SLE (p < 0.05), the exacerbation (p < 0.05), and the clinical manifestations of the disease (cardiac valvular apparatus damage, active lupus nephritis). rTNF-alpha-55R are a marker of the progression and exacerbation of SLE and reflects that there is a prognostically poor factor, i.e. the involvement of the kidneys in a pathological process.

Adolescent↗

[Antibodies to cyclic citrullinized peptide in rheumatoid arthritis].

AIM: To estimate a diagnostic value of antibodies to cyclic citrullinized peptide (CCP) in rheumatoid arthritis (RA). MATERIAL AND METHODS: The study was made of 85 RA patients. Of them, 48 patients had early RA, i.e. of 8 month and less duration. The control group consisted of 35 patients with non-differentiated arthritis (NDA) and 8 healthy donors. Concentrations of CCP antibodies, rheumatoid factor (RF) IgM and RF IgA were measured with enzyme immunoassay (EIA). RESULTS: The level of CCP antibodies in RA patients (76.3 +/- 43.8; median 100.0 U/ml) was significantly higher than in NDA patients (25.1 +/- 43.9; median 0.8 U/ml; p < 0.05) or in donors (0.38 +/- 0.36; median 0.2 U/ml; p < 0.05). A correlation was found between the CCP antibodies level and that of RF IgM (chi2 = 15.4; p = 0.001) and RF IgA (chi2 = 10.3; p = 0.001). Sensitivity (82%) and specificity (90%) of CCP antibodies in RA diagnosis was higher than these parameters for RF IgM and IgA (78%, 86% and 72%, 83%, respectively). Simultaneous tests for CCP antibodies, RF IgM and RF IgA led to a 93% specificity. CCP antibodies were detected in 50% patients seronegative by RF IgM and in 62% patients seronegative by IgA. Detection of CCP antibodies was closely associated with early RA (chi2 = 30.8; p = 0.0001). CONCLUSION: The EIA for CCP antibodies is a sensitive and specific serological test for early RA diagnosis.

Adult↗

[The effectiveness and safety of nimesulide (nimesile) in patients with gouty arthritis].

Patients with gout are at a high risk for drug-induced complications associated with the use of nonsteroidal anti-inflammatory drugs due to the baseline renal and hepatic abnormalities, metabolic disturbances, and concomitant diseases, such as arterial hypertension or type 2 diabetes mellitus. In this connection, it is expedient to use safer selective cycloxygenase-2 (COG-2) inhibitors. However, there are only single reports dealing with studies of the effectiveness and safety of selective COG-2 inhibitors in gout. The study was undertaken to evaluate the effectiveness and safety of the selective COG-2 inhibitor nimesulide (nimesile) in acute gouty arthritis (GA). Twenty male patients (whose mean age was 51.1 +/- 8.4 years) with PA were examined. Seven patients were found to have monoarthritis of 1 metatarsophalangeal joint, oligoarthritis was present in 9 patients and 4 patients had polyarthritis. The history of arthritis was as long as 6 days in 16 patients and 21-30 days in 4. Nimesulide was given in a dose of 200 mg/day for at least 14 days. The time course of changes in the objective and subjective symptoms of arthritis was studied. The tolerability of the drug was evaluated by its effect on renal (the levels of creatinine and urea, creatinine clearance) and hepatic (alanine transferase (ALT), aspartate transferase (AST), gamma-glutamyltranspeptidase (gamma-GTP)) functions, and blood pressure (BP) [24-hour BP monitoring (24-h BPM) before and after treatment. There were clear positive changes in the major parameters of arthritis: the swelling index was 4.5 +/- 2.7 and 0.5 +/- 0.5 scores before and after treatment, respectively; hyperemia, 3.5 +/- 2.5 and 0.1 +/- 0. 1 scores; articular index, 3.6 +/- 2.0 and 0.7 +/- 0.6 scores; pain (visual analogue scale) when resting, 53.8 +/- 17.6 and 4.7 +/- 4.6 scores, and that when moving, 68.3 +/- 16.0 and 9.0 +/- 8.8 mm, respectively. Negative changes in the levels of creatinine and uric acid and a reduction in creatinine clearance were not observed. There were no increases in the levels of ACT, ALT, gamma-GTP. 24-h BPM did not reveal any significant changes in the mean 24-hour, mean diurnal and nocturnal variables of BP. The 24-hour BP profile became better in some patients. Thus, nimesulide is an effective and safe drug for the treatment of PA.

Adult↗

[Bone mineral density in idiopathic inflammatory myopathies].

The study was undertaken to examine the impact of glucocorticoid therapy (GCT) on mineral bone density (MBD) in patients with idiopathic inflammatory myopathies. Double-energy X-ray absorptiometry was used to determine MBD of the vertebral column and proximal femur in 42 females (30 with the preserved menstrual cycle (PMC), 12 in postmenopause (PMP) with polymyositis/dermatomyositis (PM/DM). All the patients received GCT. A random population sample including 106 females aged 20 to 69 years formed a control group. MBD of the neck of the femur was significantly lower in patients from all age groups, in the lumbar vertebral column in young (20-29 years) and old (over 50 years) females than in the controls. The development of osteoporosis (OP) was more frequently observed in PMP females: OP in the lumbar spine was in 16.7 and 66.7% of the PMC and PMP females, respectively; that in the neck of the femur was in 11 and 33%. There was no relationship between MBD and the specific features of GCT, namely the duration, cumulative dose, and the maximum dose. There was a reduction in MBD in patients with PM/DM on GCT in all age groups, more frequently in PMP patients.

Absorptiometry, Photon↗