Biomedical subjects
Publications and source records attributed to A Susta.
In a review of organic changes of rheumatic diseases the more important changes of skeletal musculature, gastro-intestinal apparatus, kidneys, blood vessels and eyes are discussed. The paper is based upon investigations, publications and post-graduate activities of the Rheumatism Research Institute of Prague.
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The analysis of the working population in a chemical plant demonstrates that back pain accounted for 6% of all working disabilities and for 7.3% of the total number of days of absence from work. Increased morbidity was generally found with increasing age. The exception was the high morbidity of the youngest group of male office staff.
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The paper presents the results of study of 28 synovial exudations in which the uricase method was used for uric acid determination with simultaneous pyrophosphatase and cathepsin C and D activity determination. The presence of crystals in these exudations was investigated as well. From the study follows that a higher uric acid level and higher pyrophosphatase activity coincide with the finding of urate and pyrophosphate crystals. The reported method of examination applies also to other identifications of microcrystals or crystalline split of urates or calcium pyrophosphate dihydrate in the exudation. The activity of cathepsin D permits to conclude on potential participation of peptides and/or polypeptides in the formation of crystals in the exudation.
Three therapeutic regimens using nonsteroidal antirheumatic drugs in the treatment of rheumatoid arthritis were compared in an open long-term cross-over trials. Voltaren 100 mg suppositories or Naprosyn 500 mg suppositories were introduced every evening at bed-time, and Naprosyn tablets were administered twice in a day, in the morning and at night. Each drug was administered for one month and every patient was treated with all three drugs in succession. The individual sequence was determined by randomization. The assessment included nine objective and subjective criteria and after the termination of the trial each patient named his preferred sequence of drugs. All three drugs proved effective. The results of our investigations showed that nonsteroidal antirheumatic drugs in the form of suppositories were more effective in the treatment of rheumatoid arthritis. They exerted a more beneficial effect on morning stiffness and on pain than tablets of the same drug. The treatment was most effective as late as in the third month of the therapy, regardless of the substance which was administered as the third drug. This confirmed our experience of the advantage of alternate administration of various nonsteroidal antirheumatic drugs. A series of subjective and objective criteria, as well as the preference expressed by the patients spoke in favour of Voltaren suppositories, which was obviously due to the fact that Naprosyn was ineffective in about 20 per cent of the patients.
Coinciding investigations of the 85Sr test and of bone derived serum alkaline phosphatases activity were undertaken in 38 patinets with locomotor system diseases. In 15 patients there was congruence between the positive result of the 85Sr test and an increased activity of B-ALP. In 5 patients there was congruence between negative outcome of B-ALP and negative 85Sr test. The activities of T-ALP, B-ALP, L-ALP and I-ALP were compared with a group of 124 healthy controls. The causes of 18 incongruent results were analysed. In rhizomelic form of ASp, active Paget's disease, osteomalacia and in some forms of osteoporosis there was congruence between increased activity of B-ALP and the positive 85Sr test over the clinically involved area of the locomotor system. In ankylosing spondylitis (without rhizomelic involvement) there may be a moderate fall of B-ALP activity but the 85Sr test is usually positive; this may correspond with metabolic activity in the paravertebral region of the ligaments. Low B-ALP activity and positive 85Sr test in MP may refer to a latent process in the bone apparatus without marked activity of osteoblasts. The fall of B-ALP may be a result of therapy or due to the reduced capacity of B-ALP to be released from the bone. In osteomalacia the rapid fall of 85Sr activity during the test is the cause by the presence of pathological osteoid which may be, even in patients with hypertension, of renal origin. A method was described permitting the evaluation of the process of active incorporation of bone minerals (after 8 days). The activity of the 85Sr test over clinically silent areas (e.g. spine) may indicate a decompensated process in the spine due to an involvement to the large joints. The two methods used in this study are metabolically different (85Sr binds to proteoglycans and inorganic structures of bone tissue, alkaline phosphatase to the activity of osteoblasts) and prove to be clinically valuable. Detailed analysis of the results makes it possible to define the stages of clinical activity of disease and to check more exactly the efficiency of the therapeutic method.