[New approaches to diet therapy for rheumatic diseases].
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Biomedical subjects
Publications and source records attributed to L N Denisov.
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AIM: To perform of clinical trial of alisate--a garlic preparation produced in Russia. MATERIALS AND METHODS: An open controlled trial of alisate enrolled 30 patients with rheumatoid arthritis (RA). 15 patients with RA of varying clinical form, stage and activity were given alisate in a dose 300 mg (1 tablet) twice a day for 4-6 weeks. 15 control RA patients received conventional antirheumatic therapy. RESULTS: The alisate group achieved a good and partial response in 86.5% of cases. The drug was well tolerated and had no side effects. In control group, some parameters changed for the worse. CONCLUSION: Alisate can be recommended for treatment of RA patients in combined and monotherapy.
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The review of the modern literature about a role of essential dietary antioxidants and first of all of vitamins E, C, P, A and carotenoids in protection of cell components against of damage by excessive strengthening of free radical oxidation is submitted. Expediency of inclusion of antioxidant vitamins in complex therapy of rheumatic diseases is discussed taking into account the failure in an antioxidant system and excessive strengthening of free radical oxidation as important symptoms in development of rheumatic diseases.
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93 patients with rheumatoid arthritis (RA) were given diet therapy and unloading diets (ULD). Adjuvant diets appeared beneficial for RA patients, allowed reduction in antirheumatic drug dosages. ULD are recommended as an alternative treatment of RA dependent on the process activity and pattern.
The course of the main chronic inflammatory diseases of the joints was analyzed with special reference to the rural region of Georgia. 30 patients with rheumatoid arthritis (RA), 13 with ankylosing spondylarthritis, and 6 with reactive arthritis are registered and followed up by the rheumatologist. It is shown that the population of the region in question is characterized by a later onset of RA, a high percentage of the seronegative variety of the disease with involvement of the hand joints, and ankylosing of the carpal joints. The males demonstrate a low activity of the process. Since RA ran a benign course, the patients were only treated with nonsteroidal anti-inflammatory agents. The RA patients preserved work fitness for a long time. Ankylosing spondylarthritis was marked by the primary injury to the spine associated with the development of ankylosis and calcification of the ligamentous apparatus without a well-defined spinal deformity. Large-scale examination of the population of the region has shown the necessity of such measures for they permit identification of new cases of the disease to carry out early adequate treatment and specialized employment of the patients.
As many as 200 patients with acute rheumatic fever were examined. Impairment of the joints in the form of classic migrating polyarthritic was detected in 96% of the cases. The knee (in 80%), talocrural (in 72%), slightly rare radiocarpal (in 21%), and elbow joints were mostly damaged. In addition to the above-indicated damage to the joints, one could see slightly atypical injuries in the form of monoarthritis (in 4%), arthritis of small articulations of the feet and hands (in 6%), and of the sternoclavicular articulations (in 3.5%). According to the cytological, biochemical and immunological findings, synovial fluid obtained from 11 patients suffering from acute rheumatic fever did not differ, significantly from synovial fluid of patients with reactive arthritis.
Presented are findings of comparative studies of the clinico-immunological parameters and the microcirculatory bed status in 17 DM I probands and 37 of their family members and in 17 SLE probands with 54 of their relatives. The DM I families were found to have DM and prediabetic cases, while among the SLE probands' families rheumatic and, less frequently, cardiovascular diseases prevailed. In the DM I probands' families, a significantly greater number of relatives were found to have rheumatoid factor, high IgG level, anti-DNA antibodies, and CIC (as compared to the SLE series). Both DM I and SLE groups demonstrated reduced efficacy of the cutaneous circulation as compared to norm; in the DM I relatives this disorder was more pronounced than in SLE relatives. The degree to which circulatory changes were pronounced was related to immunological disorders.
ELISA quantitation of antibodies to Klebsiella pneumonia, Proteus mirabilis, and Yersinia enterocolitica was conducted in 75 ankylosing spondylitis (AS), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE) probands and in 262 of their first-degree relatives. The control group comprised 28 healthy donors. Sixteen (64 per cent) AS probands (12 with B27+) and 26 (30.2 per cent) their relatives (14 with B27+) were found to have high titres of antibodies to Klebsiella pneumonia. In 18 (60 per cent) active RA probands and 27 (23.7 per cent) relatives, antibodies to Proteus mirabilis were found. The obtained results suggest the presence of genetic determinants of the increased immune response to various infectious agents, at least in the AS cases. The possibility of Enterobacteriaceae acting as polyclonal stimulators is not excluded.
Investigation findings are generalized based on quantitation of antibodies against the antigens of intestinal microorganisms of Enterobacteriaceae family conducted in 66 children with various joint disease using the enzyme-linked immunoassay (ELISA) methodology. High antibody titres were revealed in 77.1% juvenile rheumatoid arthritis cases and in 80% cases with chronic juvenile arthritis which was not defined nosologically. All the patients with reactive arthritis associated with intestinal infection showed high tension of immunity to all tested enterobacteriaceae antigens with cross reactions to them. Patients with reactive arthritis associated with oral infection, with Reiter's disease and other disorders exhibited high antibody titres at the same rate as in the control.
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