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Biomedical subjects

V A Nasonova

Publications and source records attributed to V A Nasonova.

At least 19 recordsLinked to original sources

[Vasculopathy in patients with systemic lupus erythematosus and the antiphospholipid syndrome].

Clinicomorphological examination covered 100 patients with confirmed SLE: 79 with concomitant APS (group 1), 21 free of APS (group 2). In group 1 thrombolytic complications occurred in 75%, in group 2- in 13%. The recurrences were more frequent in group 1. Overall percentage of arterial and venous thromboses was approximately the same. According to biopsy and autopsy 2 kinds of morphological changes were found: typical for SLE and APS. Morphological specificity of APS manifested with proliferative and thrombotic changes in both arteries and veins.

Adolescent

[A multicenter evaluation of efficacy and tolerance in the local treatment with dolgit cream of patients with osteoarthrosis].

A 2-week clinical trial of cream dolgit efficacy and tolerance in 76 patients with primary osteoarthritis in 8 rheumatological centers showed this preparation to reduce local pain syndrome in 70.1%, palpation pain sensitivity in 79.2%, joint swelling in 75.5% of patients. Unwanted reactions in the form of skin itch at the site of application were reported in 7.8% of cases.

Administration, Topical

[A trial of the use of the preparation Arthrotec for treating rheumatic diseases].

A clinical trial of arthrotek (Searle) in 60 RA patients aged 16-77 years demonstrated its high anti-inflammatory activity in 47 of them. These patients have received a complete treatment course, 10 patients were not included in the overall estimations because of side affects (gastric pains and nausea) causing them to withdraw early in the treatment course, 3 patients were nonresponders. The responders experienced attenuation of joint pain, morning stiffness. Inflammation in some joints declined, the articular index decreased.

Adolescent

[Present problems of neuroimmunology].

The paper provides the data available in the literature and their own findings of immunopathological impairments in the central nervous system, and spinal cord and polyneuropathies. The most detailed comparison of immunological and clinicotomographic changes is made in system lupus erythematosus. With this, a correlation is shown between peripheral vascular diseases (butterfly, capillarites, reticular livedo, Raynaud's syndrome), the levels of circulating immune complexes and local neurological abnormality. Particular attention is paid to the antiphospholipid syndrome. A relationship is found in patients with neurolupus and Sneddon's syndrome between cardiolipin antibodies and various (mainly vascular and ischemic) neurological syndromes as recurrent cerebral circulatory disturbances, episyndromes, etc.

Antiphospholipid Syndrome

[Splenic perfusion in the combined treatment of patients with systemic lupus erythematosus].

Twenty patients suffering from severe systemic lupus erythematosus (SLE) underwent 52 sessions of splenoperfusion (SP) by means of extracorporeal perfusion of the patient's blood through isolated porcine spleen. It got prepared directly before the perfusion. The organ was obtained from a healthy animal in sterile conditions, washed from the blood after cannulation of the artery and vein. The patient's blood was pumped from the peripheral vein to the spleen artery. After passing through the splenic vascular bed the blood outflew from the spleen vein into the opposite peripheral vein of the patient. SP was followed by positive clinical changes: normalization of body temperature, regression of skin symptoms and articular syndrome, reduction of lymphadenopathy, hepato- and splenomegaly. The tests indicated inhibition of SLE activity. Sp-related immunocorrective effect was also present as shown by depression of B-cell hyperreactivity and T-cell immunity stimulation. 1-4-year follow-up of 19 patients showed them to be in remission. The data obtained favour SP inclusion into intensive therapy of severe SLE.

Acute Disease

[Acute rheumocarditis in young men].

A study was made of the characteristic features of rheumocarditis in 200 young recruits. Rheumocarditis developed within the first 2-3 days since the onset of migrating polyarthritis and high fever. In many cases, it was accompanied by rhythm and conduction disorders as well as by a moderate increase of the left heart in combination with intracardiac hemodynamic disturbances. In 42 patients (21%), myocardial injury was coupled with mitral valve lesion. Injury to the pericardium was recorded in 20 patients (10%); fibrinous pericarditis was diagnosed in 15 patients, exudative pericarditis in 5 patients. Injury to all 3 heart membranes was ascertained in 5 patients (2.5%) (according to echocardiography). Thus, the clinical and instrumental manifestations of rheumocarditis made it possible to diagnose marked carditis symptoms almost in all the patients (in 96%). Unmarked carditis was only discovered in 7 patients. The above-mentioned characteristics of rheumocarditis in young men may be due to the intensity of the action of streptococcal infection on the heart structures within the first days of the disease as well as due to the action of immunopathological processes. Besides, a definite role may be played by the foregoing physical load.

Acute Disease

[The clinico-immunological subtypes of systemic lupus erythematosus].

Based on clinico-immunologic studies subtypes of systemic lupus erythematosus (SLE) were distinguished. The ANF-R++H-DNA-CH50 variant determines acute onset of SLE with renal injury in the form of diffuse glomerulonephritis. The ANF-Sp-RNP-RF mirrors the development of Raynaud's syndrome, Sjögren's syndrome, polymyositis, pneumosclerosis and myocarditis. The ANF-Sp-Ro-RF variant is associated with skin derangement in the form of discoid foci, anular, papulosquamous eruption, vitiligo, hyperpigmentation, and cerebrovasculitis. The Ro-anti-Po, La-anti-La system is related to the idea of SLE, seronegative in accordance with ANF, when rat liver sections are used as a substrate in immunofluorescence.

Antibodies

[The serum neopterin level in acute rheumatic fever].

Acute rheumatic fever (ARF) is a systemic inflammatory disease etiologically related to infection with group A streptococcus characterized by a broad spectrum of disorders of cellular and humoral immunity. To estimate the activity of the immunopathological process and to forecast myocardial derangement in ARF patients, measurements were made of neopterin in the serum of ARF patients. Nine men with ARF serving in the armed forces were examined. The control group comprised 24 donors. The reference group included 13 patients with dilated cardiomyopathy and 14 with chronic myocarditis. The mean level of neopterin in ARF patients was equal to 14.5 +/- 12.2 nM/l and was significantly higher than in the donors (5.0 +/- 2.0 nM/l). In patients with dilated cardiomyopathy and chronic myocarditis, it was 9 +/- 6 and 16 +/- 11 nM/l, respectively. On more careful clinical analysis the highest level of neopterin was recorded in 3 patients with impairment of the valvular apparatus of the heart. That level was observable during the whole period of the follow-up of the patients. In other patients, no impairment of the valves was detected, whereas the concentration of neopterin fell to normal. Therefore, the rise of the level of neopterin was described for the first time in patients with ARF. Besides, a relationship was found between the high level of neopterin and impairment of the valvular apparatus of the heart.

Adolescent

[The results of a retrospective examination of patients with acute rheumatic fever].

The authors describe the results obtained during retrospective examinations of 45 subjects who suffered from acute rheumatic fever 10-14 years before. Of these, 19 subjects were treated with prednisolone in the acute disease period, 16 with indomethacin, and 8 subjects with voltaren. The examinations were mostly randomized (30 subjects); no differences in the anti-inflammatory effect were discovered. Heart disease was found in 9 persons (20%). Of these, 6 were treated with prednisolone, 2 with indomethacin, and 1 with voltaren. The disease relapses were recorded in 4 of them, the signs of valvulitis in the past were shown only by 2 persons (echocardiographically). 12 persons (27%) had mitral valve prolapse which had not been diagnosed on the first admission to the hospital, with any clinical signs of hypermotility lacking. In 18 persons (40%) having no valve lesions (disease, prolapse), an x-ray examination revealed a slight increase of the heart size, estimated as a manifestation of postmyocardial cardiosclerosis. Thus, it has been shown that modern anti-inflammatory therapy does not prevent the development of heart disease. Apparently, its onset is related to specific proneness in some of the patients.

Follow-Up Studies

[Cardiolipin antibodies in acute rheumatic fever].

The paper presented the results obtained in studying the patients with acute rheumatic fever for antibodies to cardiolipin (ACL). The study resulted in the establishment that the development of immunopathies in the presence of acute rheumatic fever combined with the acute streptococcal infection was accompanied by hyperproduction of ACL (more common IgG versus IgM isotypes). The phenomenon mentioned widened the spectrum of acute infectious diseases associated with an increase in ACL synthesis. It was also stated that increased ACL contents were closely related with the involvement of the cardiac valves. Authentic clinical and echocardiological signs of the heart disease were mainly revealed in the patients with high contents of IgG and IgM isotypes of ACL. A certain relationship between the laboratory activity of the disease and ACL hyperproduction was noted as well. The latter permitted the discussion on the impact of streptococcal infection initiating the development of acute inflammation on the hyperproduction of ACL.

Acute Disease