Biomedical subjects

E S Mach

Publications and source records attributed to E S Mach.

At least 19 recordsLinked to original sources

PubMed2006

[Atheroscleotic vascular lesion in systemic lupus erythematosus and antiphospholipid syndrome in men].

The aim of the study was to determine the prevalence of various clinical and subclinical manifestations of atherosclerosis (AS) in men with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APLS), as well as to evaluate correlations between vascular atherosclerotic lesions, risk factors, and the levels of C-reactive protein (CRP) and cardiolipin antibodies (CLA). The subjects of the study were 62 patients (mean age 35.7 +/- 11.6 years, disease duration 129 +/- 102 months). Conventional and disease-related risk factors were analyzed. Carotic ultrasonography (CU) was performed in order to reveal vascular atherosclerotic lesions. Serum CRP levels were measured by the high-sensitive immunonephelometric technique. IgG and IgM CLA were studied by solid-phase immunoenzyme assay. CU found carotic arterial involvement in 58% of the patients; clinical manifestations of AS were revealed in 42% of the patients. The patients were divided into two groups: group I included 19 patients with APLS signs, group II consisted of 43 patients without APLS symptoms. The disease duration and lesion index were higher in group I. The study revealed a significant correlation between CRP level and intima-media complex (IMC) thickness in patients suffering from SLE with or without APLS (p < 0.05). Patients with AS displayed higher levels of IgG CLA, although the difference was insignificant. The study demonstrates that men suffering from SLE with or without APLS have a high risk of AS. An increase in CRP level is associated with an increase in IMC thickness.

Adolescent↗

PubMed2006

[Soluble receptors of TNF-alpha: association with atherosclerotic vascular affection in systemic lupus erythematosus in males].

AIM: To study association between concentration of soluble receptors of TNF-alpha (sTNFa-R1) and atherosclerotic vascular affection in systemic lupus erythematosus (SLE) in men. MATERIAL AND METHODS: The examination covered 75 patients (mean age 34.76 +/- 11.8 years), duration of the disease 126 +/- 110 months. Standard cardiovascular risk factors were analysed. SLE activity was estimated by SLEDAI and ECLAM scales, SLICC/ACR index was calculated. Atherosclerotic vascular affection was studied with ultrasonic scanning of the carotid arteries. sTNFa-RI concentration in blood serum was determined with enzyme immunoassay technique in 73 SLE patients and 20 healthy donors. RESULTS: By sTNFa-R1 concentration, the patients were divided into two groups. Group 1 consisted of patients with sTNFa-R1 < or = 2.87 ng/ml, group 2 > 2.87 ng/ml. Higher concentrations of the receptors were associated with higher mean values of the damage index and proteinuria occurrence, with older age and higher body mass, with signs of vascular atherosclerotic affection (atherosclerotic plaques and intima-media thickness > 0.9 mm. CONCLUSION: Concentration of sTNFa-R1 can be considered as a laboratory marker of atherosclerotic vascular lesions.

Adolescent↗

PubMed2006

[Soluble CD40 ligand in systemic lupus erythematosus and antiphospholipid syndrome].

AIM: To investigate a clinical role of soluble (s) CD40 ligand in systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). MATERIAL AND METHODS: A serum concentration of sCD40 ligand was measured with enzyme immunoassay (Bender Medsystems, Austria) in 21 patients with primary antiphospholipid syndrome (PAPS), in 25 patients with secondary APS (SAPS) associated with SLE, in 92 SLE patients and in 16 healthy donors. RESULTS: A sCD40 ligand concentration in sera of SAPS and SLE patients was significantly higher than in donors. Significant differences by the ligand level between the above patients were not seen. In PAPS sCD40 ligand concentration was normal. Elevated serum concentration of the ligand was observed in 9.5% patients with PAPS, 54.0%--with SAPS, 73.9%--with SLE. This rise in SLE and SAPS was not related with the disease activity or renal damage. Hyperexpression of the ligand in APS was associated neither with thromboses nor with a high concentration of IgG/IgM antibodies to cardiolipin. A direct correlation occurred between sCD40 ligand level and platelet count. In SLE and SAPS elevation of the ligand level correlated with increased thickness of carotid artery intima-media complex, hypercholesterinemia and diastolic dysfunction of left ventricular myocardium. CONCLUSION: Hyperexpression of sCD40L in SLE and SAPS is associated with developing cardiovascular diseases and atherosclerosis.

Adult↗

PubMed2006

[The significance of cardiovascular risk factors and C-reactive protein to the development of atherosclerosis in women with systemic lupus erythematosus].

Compared with general population, women suffering from systemic lupus erythematosus (SLE) have signs of coronary artery disease (CAD) five to eight times more often, especially in young age. Early development of atherosclerosis in patients with SLE is caused by conventional cardiovascular risk factors and specific ones, associated with the disease and its therapy. A slight increase in such an inflammatory marker as C-reactive protein (CRP) is thought to reflect the presence of subclinical inflammation in the vascular wall, connected with atherosclerotic process. The authors analyzed the frequency of clinical and subclinical (an increase in the thickness of intima-media complex (IMC)) atherosclerotic manifestations, the summary coronary risk, the prevalence of conventional risk factors, and CRP level in 133 female patients with SLE and in 50 healthy donors. Compared to the control group, SLE patients were younger, developed cardiovascular diseases (CAD, stenocardia, myocardial infarction, and cerebral stroke (p = 0.05) as well as arterial hypertension more often, had higher levels of hs-CRP and triglycerides, and lower levels of high density lipoprotein cholesterol (HDLC). There was a positive correlation between hs-CRP level and the activity of the disease according to ECLAM score, ES value, IgG and IgM levels, hematological disturbances (anemia, leucopenia, and/or thrombocytopenia) , and a negative correlation with total cholesterol level, HDLC there was a moderate correlation between hs-CRP and a maximal IMC value.

Adult↗

PubMed2005

[Vascular symptoms of Behcet's disease].

AIM: To characterize vascular symptoms of Behcet's disease (BD) in patients treated for the last 10 years in the Institute of Rheumatology. MATERIAL AND METHODS: Vascular symptoms of BD were studied in 151 patients with BD (mean age 33.5 +/- 9.5 years, duration of the disease 14.0 +/- 10.1 years, 104 males and 47 females, 67.4% carried HLA B51(5) antigen). Duplex vascular scanning was made to detect venous thrombosis. RESULTS: Thrombotic complications were found in 37 of 151 (24.5%) patients with BD (30 males and 7 females, mean age 37.1 +/- 9.1 years, mean duration of the disease 7.3 +/- 9.7 years). Venous thromboses prevailed (36 patients). Four males (2.6%) had arterial lesions: aneurysms of the iliac arteries (n = 1), thrombosis of the iliac artery (n = 1), pulmonary infarction and thrombosis of the pulmonary arteries (n = 2). Combination of venous and arterial manifestations occurred in 3 patients. One patient had thrombosis of the venous sinus, occlusion of the retinal vessels was diagnosed in 7 patients. CONCLUSION: Incidence of vascular disorders was observed in 1/4 of the patients. This corresponds to those observed worldwide and concerns venous thrombosis and other thromboses. Among the examinees, vascular disorders were associated with a young age, earlier development of thrombotic complications in males than in females.

Adult↗

PubMed2005

[Atherosclerotic lesion of the vessels in systemic lupus erythematosus in males: relations with concentration of C-reactive protein].

AIM: To elicit prevalence of clinical and subclinical manifestations of atherosclerosis in men with systemic lupus erythematosus (SLE), to assess correlation between vascular atherosclerosis, risk factors and concentration of C-reactive protein (CRP). MATERIAL AND METHODS: Analysis of conventional and disease-related factors of risk, ultrasonic scanning of the carotid arteries, high-performance enzyme immunoassay for CRP were made in 37 patients (mean age 36.9 +/- 10.7 years, duration of the disease 130.2 +/- 108.2 months). RESULTS: Clinical symptoms of atherosclerosis were seen in 35% patients. By thickness of the intimamedia complex (IMC), the patients were divided into 2 groups. Group 1 consisted of 21 patients with vascular atherosclerosis (IMC > 0.9 mm), group 2--of 16 patients with IMC < 0.9 mm. Mean age, age of the disease onset, body mass index were greater in group 1. A mean CRP concentration in patients with athrosclerosis was significantly higher than in the group without vascular atherosclerosis (p = 0.004). CONCLUSION: SLE men comprise a group of high atherosclerosis risk. An elevated CRP level is associated with thicker IMC.

Adult↗

PubMed2004

[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↗

PubMed2004

[Antiphospholipid syndrome and exogenic risk factors in thromboses].

AIM: To examine relationships between incidence rate of thromboses in antiphospholipid syndrome and exogenic risk factors (RF) of thrombosis. MATERIAL AND METHODS: The trial enrolled 131 patients (105 females and 26 males). They were divided into three groups: 23 patients with systemic lupus erythematosus (SLE, group 1), 63 patients with SLE and antiphospholipid syndrome (APS, group 2), 45 patients with primary APS (PAPS, group 3). Thrombosis RF questionnaire survey was made. Effects of corticosteroids and cyclophosphamide on occurrence of thrombosis were assessed. RESULTS: Such exogenic RF as intake of coffee, fat food, alcohol were not related to thromboses. Hypodynamia was more typical for APS patients (21.3%) than for SLE patients free of APS (8.7%). Overweight for was characteristic for APS patients (49 and 34.7%, respectively). The proportion of smokers was higher in APS patients, though smoking did not provoke thrombotic complications. A direct correlation was found between occlusion and corticosteroids administration, while occlusion and cyclophosphamide treatment correlated inversely. CONCLUSION: Venous thrombosis RF in patients with APS and PAPS are obesity and treatment with glucocorticosteroids.

Antiphospholipid Syndrome↗

PubMed2003

[Dynamic changes in synovitis activity after intra-articular administration of xefocam in patients with rheumatoid arthritis (according to clinical and device examinations)].

AIM: To assess efficacy of intraarticular administration of lornoxicam (xefocam) in patients with rheumatoid arthritis (RA). MATERIAL AND METHODS: Xefocam was injected into the knee joints of 58 patients with RA once a week for 3 weeks in a dose 8 mg. The treatment efficacy was evaluated by changes in the severity of arthralgias, pain in the joints at palpation, circumference of the knee joints at the level of the upper edge of the patella, ultrasound and thermography of the knee joints. RESULTS: Xefocam relieved arthralgia (in 44 patients at least by 30%), pain in the joints at palpation and joint circumference. Ultrasound investigation registered a significant thinning of the synovial membrane and amount of exudates. CONCLUSION: If local steroid therapy is not definitely indicated, intraarticular administration of xefocam can be effectively used for suppression of moderate inflammation in the joints in RA patients.

Adult↗

PubMed2003

[Survival and prognostic factors of death risk in antiphospholipid syndrome: results of 8-year follow-up].

AIM: To evaluate survival and mortality in antiphospholipid syndrome (APS) as well as prognostic factors of APS deterioration. MATERIAL AND METHODS: We retrospectively studied 248 case histories of patients admitted to the Institute of Rheumatology for 8 years. Primary APS was diagnosed in 35 patients, SLE + APS (according to criteria of ACR, 1982)--in 122 patients and SLE without APS--in 91 patients. Mean age was 31.2 +/- 15.0 years (range from 14 to 63), median length of follow-up from the time of diagnosis was 11.9 +/- 5.4 years. During 8 year period all the patients annually and the latest 5 years at least twice a year were examined for the presence of IgG and IgM-anticardiolipin antibodies (aCL) and lupus anticoagulant (LA). Thrombotic events were verified with special techniques. RESULTS: Thirty-eight patients (15%) died during the follow-up period. Mean age of the decreased was 35.4 +/- 12.2 years (range 21-52 years) and the disease duration 8.6 +/- 8.2 years (range 0.6-20), the median length of the survival from the time of the diagnosis was 6.2 +/- 4.3 years. The 8-year survival for SLE patients without APS was 98%, for those with SLE + APS-75% and for patients with primary APS-83%. The presence of APS in SLE patients was significantly associated with high mortality (chi 2 = 12.3, freedom = 4, p = 0.006). Cox regression analysis revealed that the activity of the disease at onset, arterial thrombosis, especially recurrent, thrombocytopenia, valvular disease of the heart, capillaritis, digital necrosis and nephritis were independent risk factors for mortality (p < 0.05). CONCLUSION: Thus, long-term follow-up is necessary for patients with antiphospholipid antibodies especially with APS which lowers survival of SLE patients. Such patients need early corrective therapy to prevent thrombotic events.

Adolescent↗

PubMed2003

[Articular lesions in Ixodes tick-borne borreliosis (Lyme disease)].

Articular lesions in 157 patients infected with ixodes tick-borne borreliosis (ITB) in a central Russia's region set on, on the average, in 4 months after tick attack; they were associated with systemic signs of an early disseminated infection and set on less seldom in a late period. The most often encountered systemic signs were as follows: secondary erythema (32% of patients), neurological syndrome (13%), cardio-vascular lesions (22%), ocular lesions (13%) and hepatic lesions (8%). The articular syndrome manifested itself through arthralgia (53 patients) and arthritis (104 patients), which set on quite often in the tick-attack area. There was a peculiarity typical of articular lesions, which made it possible to distinguish them from other rheumatic disease. A dynamic follow-up revealed different clinical variations of Lyme's arthritis and peculiarities of the genetic profile, i.e. a higher prevalence of HLA A2, HLA-B15 and HLA-DR4 as well as of haplo-types HLA A2-B15 and HLAB15-DR4. The articular lesions were associated with an intensive specific humoral immune response. The instrumental examination methods, i.e. ultrasonography of joints as well as scintigraphy of bones and joints, did not reveal any qualitative differences between arthralgia and arthritis, which is indicative of a common nature different-intensity manifestations of arthropathy in thick-borne borreliosis.

Adult↗

PubMed2002

[Mutation of a 5,10-methylenetetrahydrofolate reductase gene in systemic lupus erythematosis and antiphospholipid syndrome].

AIM: To study prevalence of mutation C677T in gene 5.10-MTHFR in systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) as well as in persons free of symptoms of systemic diseases of the connective tissue. MATERIAL AND METHODS: 85 patients participating in the study were divided into three groups: those with SLE (n = 17), with SLE + APS (n = 42), with primary APS (n = 26). The control group consisted of 30 persons without SLE or APS. 55% of the examinees had thrombotic complications of different location. The diagnosis of the mutation was made using DNA isolated from the peripheral blood with standard methods and polymerase chain reaction. Allele (homozygous or heterozygous) condition of the mutation was confirmed by means of allele-specific primers. RESULTS: Mutation C677T in MTHFR gene was found in 40 of 85 patients (47%); 11(27.5%) had a homozygous variant, 29(72.5%)--heterozygous. C677T mutation occurred in 5 of 17 SLE patients (29%), it was in all the cases heterozygous. In primary and secondary APS mutation was detected in 51.5% (35 of 68 patients). Recurrent thrombosis occurred more frequently in patients with mutation MTHFR. Three and more episodes of thrombosis were registered in 17 of 40 patients with mutation C677T against 9 of 44 patients without the mutations (p = 0.04). CONCLUSION: Relationship between elevated blood levels of APL and MTHFR mutation points to the fact that this genetic marker is an additional thrombogenic factor in APS. Mutation C677T in MTHFR gene in APS patients correlates with recurrent thrombosis.

5,10-Methylenetetrahydrofolate Reductase (FADH2)↗

PubMed2002

[The role of suprasegmental and segmental autonomic disorders in the development of muscular syndrome of rheumatoid arthritis].

UNLABELLED: AID: To investigate the role of suprasegmental (anxious disorders) and segmental vegetative disorders (dysfunction of neuromuscular transmission and cutaneous microcirculation) in pathogenesis of muscular syndrome of rheumatoid arthritis (RA). MATERIAL AND METHODS: MMPI, Beck's questionnaire, Spilberger's test were used in experimental-psychological assessment of RA patients' personality profile. A total of 60 healthy subjects and 340 RA patients were examined. Segmental vegetative disorders were studied by excitability of hand muscles (Prognoz-6 device) and cutaneous microcirculation (doppler flowmetry). RESULTS: RA patients showed suprasegmental disorders manifesting as frequent anxious disturbances (95%). Dysfunction of the segmental part of the autonomic nervous system was represented by various changes in excitability of hand muscles in response to weak currents, by abnormal regulation of cutaneous microcirculation. CONCLUSION: Neuromuscular and microcirculation disturbances participate in development of RA muscular syndrome. This is confirmed by a positive correlation coefficient. There was also a negative correlation between suprasegmental and segmental disorders.

Anxiety Disorders↗

PubMed2002

[Corticosteroids in the treatment of secondary antiphospholipid syndrome].

The study of changes in the levels of antiphospholipid antibodies (aPL) and clinical manifestations of antiphospholipid syndrome (APS) in response to corticosteroids in secondary APS in patients with systemic lupus erythematosus (SLE) included 219 patients (28 males and 191 females) with APS observed at least for 3 years. aPL in the blood were measured each half of year. Mean age of the patients was 31.2 +/- 11.1 years, mean duration 8.6 +/- 5.2 years. The patients were divided into 3 groups: 54 patients (persistently positive) of group 1 had IgG-anticardiolipin antibodies (aCL) in the blood for the whole period of the observation, were positive by lupus anticoagulant (LA). 73 patients of group 2 were initially aPL-positive, but aPL levels fluctuated in the observation period from positive to negative and vice versa. 92 patients of group 3 had no aPL. For 3-year follow-up 25% of SLE patients were aPL positive, 42%--negative, aCL levels fluctuated in 33%. No APS symptoms were observed in 9%, 33% of groups 1 and 2, respectively, but APS symptoms appeared in the observation period. 10% of group 3 had some aPL-associated signs. aCL levels did not depend on mean daily dose of corticosteroids in groups 1 and 2 initially and within the follow-up. Frequency of LA, irrespective of corticosteroids dose, was significantly higher initially vs that in the follow-up. In spite of correlation between aPL positivity and SLE activity, depressed activity of the disease during the treatment did not entail a significant lowering of a PL levels in the follow-up. Thus, corticosteroids in APS in SLE patients influence LA more than aCL. SLE activity, corticosteroids therapy in APS are independent factors affecting aPL. Detection of aCL and LA in SLE is not the cause of prescription of high-dose corticosteroids.

Adult↗

PubMed2002

[Primary antiphospholipid syndrome in combination with heterozygous mutation in prothrombin (G20210A) gene: a case report].

A 47-year-old man had residual effects of acute disorders of cerebral circulation in the territory of the median cerebral artery. Computer tomography confirmed the presence of the postischemic focus in the area of the head of the caudate nucleus. Also, thrombosis of small branches of the coronary arteries with development of postinfarction cardiosclerosis and arrhythmia, thrombosis of deep veins in the left leg gave grounds for verification of primary antiphospholipid syndrome (PAS). The diagnosis was serologically confirmed by the presence of anticardiolipin antibodies and the presence of lupus anticoagulant. A genetic examination detected heterozygous mutation G20210A in prothrombin gene but failed to identify G1691A (Leiden) mutation in gene of factor V and C677T in gene 5,10-methylentetrahydrofolatreductase. A family history was collected. Thrombotic complications were found in grandmother and aunt (by mother), in sister and brother. The latter had also a heterozygous mutation of prothrombin gene. Genetic mutations in PAS patients are an additional risk factor of recurrent thrombosis.

Antiphospholipid Syndrome↗

PubMed2001

[Comparative evaluation of tissue microcirculation in patients with aseptic necrosis of the femur head in rheumatoid arthritis and systemic lupus erythematosus].

AIM: Comparative investigation of tissue microcirculation above hip joints affected with verified aceptic necrosis of the heads of the femur (ANHF) in patients with rheumatoid arthritis (RA) and SLE. MATERIAL AND METHODS: The microcirculation was compared in 44 RA and 22 SLE patients. Capillary blood flow above the necrotic heads of the femur was studied by 133-Xe clearance from the intratissue depot. Laser doppleroflowmetry examined basal blood flow and factors of its regulation. RESULTS: Effective skin blood flow decreased both in RA and SLE patients at ANHF stage I, remained low at stage II, went up a little at stage III. At stage IV the flow continued to rise in RA patients but fell sharply in SLE. Laser dopplerflowmetry with functional tests reflects ANHF evolution both in RA and SLE. CONCLUSION: Changes in capillary blood flow in SLE above the necrotic heads of the femur are more severe and account for more extensive destruction in the heads of the femur than in patients with RA.

Adult↗

PubMed2000

[Effect of vazaprostan on microcirculation in patients with scleroderma systematic].

AIM: To investigate the effect of vazaprostan (alprostadil) on skin blood flow in patients with sclerodermia systematica (SS). MATERIAL AND METHODS: A total of 51 patients with SS aged 33-70 years were included in the study. 33 of them received a 3-hour infusion of vazaprostan at the standard dose for 20 consecutive days. The rest 18 patients received low molecular dextran solution. Before and at the end of the treatment digital skin microcirculation was measured with a laser Doppler flowmeter. The laser probe was attached to the distal pad of the ring finger on the left hand. Baseline blood flow and vascular reactivity in the tests with sympathetic stimulation, local heating and during orthostasis were evaluated. RESULTS: Baseline blood flow and vascular response to functional tests were significantly reduced in all the patients. At the end of the treatment the flow increased only in patients treated with vazaprostan. Vascular reactivity was not changed after the treatment in both groups of patients. CONCLUSION: Vazaprostan increases baseline blood flow and contributes to the improvement of microcirculation in patients with SS.

Adult↗

PubMed1999

[Assessment of tissue microcirculation in patients with aseptic necrosis of femur heads in systemic lupus erythematosus (SLE)].

AIM: To study microcirculation in the tissues above the hip joints with and without aceptic necrosis of the femur head for diagnosis of necrosis stages. MATERIALS AND METHODS: 22 SLE patients were examined for blood flow above the region of affected and intact (control) hip joints using clearance of Xe-133 from the intratissue deposit. Basal circulation and factors of its regulation were investigated with laser dopplerflowmetry. RESULTS: Effective skin blood flow above the hip joints with necrosis stage I significantly differed from that of the control. Basal skin blood flow above the hip joints in suspected stage I of aceptic necrosis differed significantly from the control and that in stage II osteonecrosis. CONCLUSION: The study of tissue microcirculation above the hip joints in SLE patients with aceptic necrosis of the femur heads allows making diagnosis both at early and late stage of osteonecrosis.

Blood Flow Velocity↗